GROWTH, DEVELOPMENT AND BEHAVIOR

Newborn ( neonatal) period: begins at birth and include the 1st month of life.

Physical examination: term newborn

Average weights: 3.4 kg (7 lb) Average length: 50cm (20 in) head circumference: 35 cm (14 in)

 Hearing is well developed

Behavioral state:
Quite sleep Active sleep Drowsy Alert Fussy Crying

 Behavioral state determines an infants muscle tone, spontaneous movement, electroencephalogram pattern and response to stimuli.

Developmental milestones in the first 2 yr of life

Gross motor:
Hold head steady while sitting Pulls to sit, with no head lag Brings hands together in midline Sits without support Rolls back to stomach Walks alone Runs 2 mos 3mos 3mos 6mos 6.5mos 12mos 16m0s

Fine motor:
grasps rattle Reaches for object Palmar grasp done Transfers object from hand to hand Thumb-finger grasp 3.5mos 4mos 4mos 5.5mos 8mos

Communication and language:

Smiles in response to face, voice Monosyllabic babble Inhibits to NO Follows one-step command w/ gesture Follows one-step command w/o gesture Say mama or dada Points to object Speaks first real word Speaks 4-6 words Speaks 10-15 words Speaks 2 word sentences 1.5mos 6mos 7mos 7mos 10mos 10mos 10mos 12mos 15mos 18mos 19mos

cognitive:
Stares momentarily at spot where object disappeared Stares at own hand Uncovers toys Egocentric symbolic play Uses stick to reach toy Pretend plays with doll 2mos 4mos 8mos 12mos 17mos 17mos

The first year of life

Age 0-2 months:
Tremendous growth Effective feeding routines Predictable sleep-wake cycle

Physical development:
Weight decrease 10% below birthweight in the first week as a result of excretion of excess extravascular fluid and limited intake.

 Infant regain or exceed birth weight by 2 weeks of age and should grow at approx 30 gms/day during the first month. Period of fastest postnatal growth. Smiling occurs involuntarily. Recognition memory. Sleep and wakefulness are evenly distributed throughout the 24hr day Learning also occurs.

Cognitive development:
Infants habituate to the familiar, attending less and less to repeated stimuli and increasing their attention when the stimulus changes. Infant can differentiate among patterns, colors and consonants. Recognize facial expression

Emotional development:
Dependent on the environment to meet his or her need.

Age 2-6 month:

Voluntary social smile. Increasing eye contact

Physical development:
Between 3 and 4 months of age, the rate of growth slows to approx 20gm/day. By 4 month, birth weight is doubled. Grasp reflex Roll over Regular sleep wake cycle

Cognitive development:
Qualitative change 4 months of age infants are described as hatching socially Explore their own bodies Sense of self first stage of personality development

Emotional development and communication:

Distinct facial expressions Initiating games, increases social development.

Ages 6-12 months

Shows advances in cognitive understanding and communicative competence. Develop will and intentions

Physical development:
Growth slows more By the first bday, birth weight has tripled, length has increased by 50%, and head circumference has increased by 10cm.

Sit unsupported (6-7mos) Pivot while sitting (9-10mos) Thumb finger grasp (8-9mos) Neat finger grasp by 12 mos Pulling to stand by 8mos Walk by 1yr

 Motor achievements correlate with increasing myelinization and cerebellar growth. Tooth eruption occurs, usually starting with the mandibular central incisors Tooth development reflects skeletal maturation and bone age.

Cognitive development:
At first everything goes into the mouth. A major milestone is the achievement at about 9 mos. Of object permanence (constancy)

Emotional development:
Stranger anxiety Poor weight gain Tantrums

Communication:
7mos adept of non verbal communication 9mos aware of the emotions 8 and 10mos babbling takes Social interaction First true word

The second year

Age 12-18mos:
Physical development:
Growth rate slows further in the 2nd yr of life Appetite decline Increase in head circumference of 2cm over the yr.

Cognitive development:
Exploration of the environment increases and mobility Playthings Imitation of parents and older children Symbolic play

Emotional development:
Predominant mood changes Tantrum

Linguistic development:
Infants speak their first words Respond appropriately to several simple statement Points to major body parts and uses 4-6 words spontaneously and correctly

Age 18-24 months:

Physical development:
Height and weight increase at a steady rate, w/ gain of 5in and 5lb. By 24mos, children are about of their ultimate adult height. Head growth slows slightly 90% of adult head circumference is achieved by age 2 yrs.

Cognitive development:
Object permanence is firmly established Cause and effect are better understood

Emotional development:
Separation anxiety Self-conscious awareness

Linguistic development:
Most dramatic development Childs vocabulary balloons, the beginning of grammar Understand 2-step commands