2. Contents
• Review: Child Development
• Evaluation of the Development Milestone
• Fields of Development
• Cognitive Development
• Development Screening Tests
• Continence Development & Brain Control
• Child Abuse
3. Heredity & Environment
• A child’s development represents the interaction of
heredity and the environment on the developing
brain.
• Heredity determines the potential of the child, while
the environment influences the extent to which that
potential is achieved.
7. • Developmental milestone of walking unsupported:
• 25% by 11 months
• 50% by 12 months
• 75% by 13 months
• 90% by 15 months
• 97.5% by 18 months
Median= 12 months
Limit= 18 months
8. Variation in the Pattern of
Development
• e.g. Motor development from immobility to walking
9. Adjusting for Prematurity
• When assessing development age you calculate it
from expected date of delivery.
• Correction isn’t required after 2 years of age.
11. • Concentrate on each field of development; separately
• Consider the developmental pattern; sequence of skills achieved &
anticipated ones
• Determine level reached in each field
• Relate progress of each developmental field to the others; similar rate or
lagging behind?
• Relate child’s developmental achievements to age; chronological or
corrected
12. • Normal development implies steady progress in all four
developmental fields with acquisition of skills occurring before
limit ages are reached.
• If there is developmental delay, does it affect all four
developmental fields (global delay), or one or more
developmental field only (specific developmental delay)?
28. Short-cut Approach
• Gross motor: explosion of skills during 1st year of life
• Vision & fine motor: evident acquisition of skills from 1 year
onwards
• hearing,speech & language: expansion of skills from 18 months
• social, emotional & behavioural: evidently obvious from 2.5
years
30. • Pre-operational thought
Preschool children - Piaget’s Intellect development
• Operational thought
Middle-school children - practicality & order tied to immediate circumstances & specific experiences
• Formal operational
thought
Mid-teens - abstract reasoning; testing hypotheses; manipulating abstract concepts
30
31. • Which vitamin predicts cognitive deficiency in older
adults?
Fun Fact
37. WHO Definition
‘‘Child abuse or maltreatment constitutes all forms of :
Physical and/or emotional ill-treatment,
Sexual abuse,
Neglect or negligent treatment
Or commercial or other exploitation,
Resulting in actual or potential harm to the child’s health, survival,
development or dignity in the context of a relationship of responsibility,
trust or power.’’
For optimal development, the environment has to meet the child’s physical and psychological needs. These vary with age and stage of development:
• Infants are totally physically dependent on their parents and require a limited number of carers to meet their psychological needs.
• Primary schoolage children can meet some of their physical needs and cope with many social relationships.
• Adolescents are able to meet most of their physical needs while experiencing increasingly complex emotional needs.
A deficit of one skill may have an impact on other areas.
Would anyone like to share an example?
e.g hearing impairment affects?
- language , social & communication skills & behaviour
Additional skills become important later on as the child grows up, such as attention, concentration and integration of skill
Chronological age, physical growth and developmental skills usually evolve hand in hand. Just as there are normal ranges for changes in body size with age, so there are ranges over which new skills are acquired. Important developmental stages are called develop mental milestones.
• •
When considering developmental milestones:
The median age is the age when half of a standard population of children achieve that level; it serves as a guide to when stages of development are likely to be reached but does not tell us if the child’s skills are outside the normal range.
Limit ages are the age by which they should have been achieved. Limit ages are usually 2 standard deviations (SD) from the mean. They are more useful as a guide to whether a child’s development is normal than the median ages. Failure to meet them gives guidance for action regarding more detailed assessment, investigation or intervention.
What is the median and limit age for the example above?
There is a variance however - see next slide
83% go through crawling first; limit age by 18 months
children who become mobile by bottomshuffling, 50% will walk independently by 18 months and 97.5% by 27 months of age, with even later ages for those who initially commando crawl.
Detailed questioning and observation is required to assess children with developmental problems but is unnecessary when screening develop mental progress in normal clinical practice, when a short-cut approach can be adopted
For the Purposes of this presentation we will take a look at the short-cut approach
This concentrates on the most actively changing skills for the child’s age.
Vitamin D ( http://www.medscape.com/viewarticle/835226?nlid=70743_2843&src=wnl_edit_dail)