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S2 Lec 2: Growth and Development (Part 2) by Dr. Maria Cielo B.
September 6, 2010
Re
ai Malijan
M GROWTH • Available learning experiences
n • A process
Re • Increase in size or mass
F. • By multiplication or by enlargement of THEORIES AND MODELS OF DEVELOPMENT
co component cells • Physiologic development (Organogenesis)
Ri • Whole individual or a part • Cognitive Development (Piaget)
• Psychosexual Development (Freud)
DEVELOPMENT
fie
• A process • Psychosocial Development (Erickson)
ul
• Growing and acquiring skills in an orderly or • Neurodevelopment (Gesell)
predictable pattern •
Pa
Moral Development (Kohlberg)
vs • Due to maturation and experience
Vi • Increase in skills and complexity of function PHYSIOLOGIC DEVELOPMENT (ORGANOGENESIS)
ne
le SIGNIFICANCE OF DEVELOPMENT THE PERIODS OF DEVELOPMENT
Ar • Permits early detection of delays and deviance
a • Allows the health professional to help the PRENATAL PERIOD POSTNATAL PERIOD
ň parents understand their observations. Ovul 0-14th day Infancy Birth to 2
ar years
Embr 14th day to 8th Early 2 to 6 years
Ni
BASIC LAWS THAT GOVERN DEVELOPMENT
• Development goes through defined stages and yo week (end) Childhoo
g
an phases. d
ad • Development infers change. Fetal 9th week to birth Late 6 – 10 years
D • Development is seen as an increase in function Childhoo (female)
er and ability. d 6 – 12 years
h • Development involves maturation. (male)
ac • Development and maturity takes time. Adolesce 10 – 18 years
nce (female)
12 – 18 years
e
BASIC PRINCILES
T (male)
ar • Development is a continuous process
intimately related to the central nervous
be
system (from conception to maturity) . COGNITIVE DEVELOPMENT
(Piaget’s Theory)
• Development follows a definite sequence
co
Ri although the rates may differ. • Touches on the basic concepts of education
and deals with the processes of learning
ie • Development is intimately related to the
ck maturation of the nervous system • Development is considered to occur as a result
of the interaction of
• Development follows a cephalocaudal pattern.
o Maturation – differentiation and
Ni
• Development proceeds from gross and
elaboration of the CNS
ad
undifferentiated skills to precise and refined .
Gl o Experience – interaction with the
• Certain primitive reflexes have to be lost
Je physical world
before the corresponding voluntary movement
nz o Social Transmission – the effect of care
is acquired.
Ay and education upon the nature of the
experience
h FACTORS AFFECTING DEVELOPMENT
o Equilibration – self-regulation
at • Biological endowment
• 2 aspects of adaptation:
K o Intellectual
o ASSIMILATION
o o Physical size
o Health conditions  Ability to accept and integrate
experiences
Jh
o Nutritional status
h o ACCOMODATION
• Environmental influences
a  The modifications provoked by
o Relative strengths can be affected
n the experiences
by the environment
o Opportunities to practice the skill
e
PSYCHOSEXUAL DEVELOPMENT
o Culture/ practices
Gi
o (Freud’s Theory)
• Theories lead to the understanding of the
Ed • Human Relationships child’s emotional growth.
e o Adult attitudes
ll o Nurturing caregivers
ce
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ar
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• Freud et al revealed those strong influences, of o Development follows a cephalocaudal



“G which we are normally not aware, which pattern.
n control our emotional development and o Development proceeds from gross and
h stability, attitudes and reactions and undifferentiated skills to precise and
Jo interpersonal relationships. refined.
n • Continuity of influences
Ia • Early childhood experiences may have DOMAINS OF DEVELOPMENT
a profound consequences later on. • LOCOMOTOR (GROSS MOTOR) SKILLS
• The existence of sexuality in infants o Posturing of the head, trunk and
extremities
n
• Sexual behaviour involves an interplay
Ni
between excitation and satisfaction o Gross movement
g • FINE MOTOR SKILLS
A PSYCHOSOCIAL DEVLOPMENT o Well-coordinated movements of the
n (Erickson’s Theory) small muscles
e • Places emphasis on the social interactions and o Manipulation using the hands
Bi less on the sexual matters o Coordinated with vision
• The psychosocial development of individuals • LANGUAGE SKILLS
depend on the social relations established at o The art of communication
various points in life o The ability to understand another
• Based on Erickson, the following are important person (receptive language)
for children: o The ability to make oneself understood
o To have an awareness and stability (expressive language)
which is appropriate for their level of • PERSONAL-SOCIAL
development o Affected by the environment and
o That this awareness and stability is culture
achieved by balancing opposing o Demonstrates neuromuscular
influences, and that the behaviour at coordination
any age is a reflection of their success o Activities of daily living
in achieving this balance o The ability to get along well with other
o That the direction of the equilibrium people
varies at different ages • ADAPTIVE SKILLS
o That periods of transition from one o Closely related to intelligence
orientation to another are times of o The ability to utilize and manipulate
crisis and stress objects
o the use of motor and sensory
NEURODEVELOPMENTAL THEORY coordination in the solution of practical
(Gesell’s Theory) problems
• The various responses and behaviours of o the resourcefulness in adjusting to new
babies and children emerge gradually. situations
PERMANENT THE FIRST YEAR OF LIFE
RESPONSES
• Physical growth, maturation and psychological
TEMPORARY
reorganization occur rapidly.
• Changes occur in outbursts and not as a
• Responses may be classified as:
smooth transition.
• PERMANENT
o when the responses have appeared THE FIRST YEAR OF LIFE:
they persist as a constant feature of GROSS MOTOR SKILLS
the child’s behaviour repertoire. • During the first few months, gross motor
o If absent - delayed evaluation describes the motor activities of the
• TEMPORARY infant in the following positions:
o when the response appear for a period o Supine
and they are superseded by another  Neonates arms and legs are in
type of response a flexed position
o If absent – either delayed development,  Head begins to be raised in
accelerated development or weakness anticipation of being pulled to
of the response that is overlooked sit
• Based on Gesell’s theory, the pattern of  Pulling the baby into sitting
development is so uniform. position (with head lag , then
• Principles: without head lag
o Development follows a definite  Independent sitting
sequence although the rates may (protective reflexes at 8 - 9
differ. months)
o Prone

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 Head stabilization is observed
with extension of the neck THE FIRST YEAR OF LIFE:
 Ability to support the chest LANGUAGE SKILLS
with the forearms • COMMUNICATION SKILLS
 Ability to support the chest o movement of heads, eyes, arms
with the hands o Vocalization (at birth)
 Motor skills above the waist is o Crying
more proficient than below o Cooing
 Moves by hauling themselves o Babbling (repetitive vocalization)
or scooting o Syllables
 While on prone, they creep o 2-syllable repetitions (non-specific
(movement involving arms and “mama’ and “dada”)
the legs with the trunk on the o Vocalization and imitation of sounds
floor) o Echolalia
o Upright
 Anti-gravity position THE FIRST YEAR OF LIFE
AT 0-2 MONTHS
 Stepping reflex: (no pelvic PHYSICAL DEVELOPMENT Weight loss of 10%
stability)
during the first week of
 Positive supportive reflex life but exceeds birth
o ROLLING weight after 2 weeks.
 Suppression of the fencing Movements are largely
reflex (ATNR’s) uncontrolled.
o CRAWLING Smiling is involuntary.
o PULL TO STAND Crying occurs in
o CRUISING response to stimuli but
o STANDING: Readiness to stand often obscure. (peaks at
without support – appearance of the 6 weeks)
parachute reflex
o WALKING WITH , then WITHOUT COGNITIVE Stimuli – visual, tactile,
SUPPORT DEVELOPMENT olfactory and auditory
(from the caregivers)
Habituation and renewed
THE FIRST YEAR OF LIFE: attention, recognition of
FINE MOTOR SKILLS differences between
• Hands are closed most of the time similar patterns
• (+) Grasp reflex EMOTIONAL Basic trust – urgent
• Disappearance of the grasp reflex allows the DEVELOPMENT needs are regularly met
object to be touched and held.
• Appearance of the ASSYMMETRIC TONIC
REFLEX (Fencing reflex) AT 2 – 6 MONTHS
• The early arm movements become more Emergence of voluntary
purposeful. social smiles and
• Disappearance of the ATR allows the hands to increasing eye contact.
be in the midline. Range of motoric and
social control and
• Things are brought to the face
cognitive engagement
• Holding objects in the 2 hands
increases dramatically.
• Passing objects from one hand to another Mutual regulation takes
• Knocking the objects together the form of social
• Holding Objects interaction
o Palmar grasp
o Ulnar side PHYSICAL DEVELOPMENT Rate of growth slows
o Radial side Early reflexes that inhibit
o Finger-thumb apposition voluntary movement
• Releasing Objects recede (ATNR, grasp
o accidental release reflex)
o voluntary release (end of the 1st year) Head control improves to
o searching for dropped objects (object allow gazing.
permanence – 8 to 9 months) Visual maturation
improves.
• Once voluntary release is established, casting
Sleep requirements – 12 –
appears.
14 hours per day.
• Puts cube into a cup and takes them out of it.
• Finding a cup under a cup. COGNITIVE DEVELOPMENT “hatching socially”, being

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interested in a wider world – security,
Exploring their bodies experimentation,
(cause and effect) competence
Voluntary actions OBJECT CONSTANCY –
generate predictable major milestone at 9
tactile and visual months
sensations
Sense of self EMOTIONAL Object constancy
DEVELOPMENT corresponds with
EMOTIONAL Interaction with increasing qualitative changes in
DEVELOPMENT AND sophistication and range communicative and social
COMMUNICATION Emotions – distinct facial development
expressions Looking back and forth
Face-to-face interactions – between a stranger and a
sharing emotional states – parent
first step in the Separations are more
development of difficult
communication and also With a new demand for
developing expectations autonomy – manifested as
about social relationships tantrums
(conflict between drive for
autonomy and mastery
with parental control and
AT 6 – 12 MONTHS limitation)
Increased mobility and
exploration of the COMMUNICATION At 7 months – adept at
inanimate world nonverbal communication,
Advances in cognitive expressing a range of
understanding and emotions, vocal tone and
communicative facial expressions.
competence Babbling at 8 to 10
Issues of attachment and months, followed by
separation multiple syllables and
Development of will and inflections
intention – challenging Appearance of first true
caregivers word (sound used
consistently to refer to a
PHYSICAL DEVELOPMENT Ability to sit without specific object or person)
support (7 months) and to appears simultaneously
pivot while sitting (9 – 10 with the discovery of
months) - enables the object constancy.
child to manipulate Shared focus and
objects attention – between child
Emergence of the pincer and caregiver
grasp (9 months)
Crawling at nine months
and walking before the YEAR 1 TO YEAR 5
first birthday • Rapid development of the motor and language
Enables the child to skills
explore but provides new • To explore and to control their environment
physical dangers as well • Enables them to wean from their mother
as opportunities for • Rapid spurt of motor activity
learning • Motor skills and greater ease and precision to
explore his environment
COGNITIVE DEVELOPMENT At first everything goes
into the mouth. YEAR 1 TO YEAR 5:
Objects are picked up, GROSS MOTOR SKILLS
inspected, passed on form • Walking
one hand to another, o Upper acceptable limits is 18 months
banged, dropped and
• Running
mouthed.
o Well established by the second
Each action represents an
birthday
idea about what things
are for (schema – Piaget) • Negotiating steps
Intrinsic drive for mastery o Walking up without support, alternating
feet

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o Walking down without support and control play
alternating feet 4 Constantly
• One leg skills questioning
o Standing on one leg Recounting
• Jumping experiences
o Stepping down from the stairs is less Exaggerates,
complicated than standing long jump enjoys fantasy
• Catching and throwing stories
5 Carries out Speech is fluent
YEAR 1 TO YEAR 5: complex and
FINE MOTOR SKILLS commands grammatically
• MANIPULATION SKILLS correct
o Manipulation of cubes
o Manipulation of pencil and paper THE SECOND YEAR OF LIFE
AT 12 – 18 MONTHS
 Scribbling with Palmar grip
Emergence of symbolic
 Scribbling with Ulnar grip
thought causes a
 Tripod grip reorganization of
o Handedness behaviour
 Handedness begins to show PHYSICAL DEVELOPMENT Early walking is not
during the second year associated with advanced
o Imitating and copying of symbols development in other
 Imitating < Copying domains.
o Drawing Infants toddle with a wide
 Reflects their draftsmanship, based gait, knees bent
perceptual awareness , and the arms flexed at the
knowledge and understanding elbow. Feet falls flat on
of the world around them and the floor.
their feelings Eventually refinements
 The mental age is computed lead to better gait –
based on the details of the swinging of the arms on
drawing (points) the side while walking.
YEAR 1 TO YEAR 5: Ability to stop, pivot and
LANGUAGE SKILLS stoop without toppling
• Stimuli over.
o As the child grows older the ability to COGNITIVE DEVELOPMENT Object exploration
interpret and respond to stimuli gets accelerates because
more complex manipulation using the
• Awareness hands become mature.
• Interpretation The toddler combines
• Response objects to produce
interesting effects.
• RECEPTIVE LANGUAGE
Playthings are used for
o Infants pay attention to sounds
intended purposes.
o Recognize sounds
Imitation is an important
o Recognize and understand words
mode of learning.
• EXPRESSIVE LANGUAGE EMOTIONAL Once the child starts
o Vocal and non-vocal DEVELOPMENT walking, the child’s mood
o Verbalizations (vocalizations are LINGUISTIC changes markedly.
modified to reproduce word sounds) DEVELOPMENT Orbiting around parents,
using a parent as a secure
base.
YEAR 1 TO YEAR 5: Receptive language
LANGUAGE SKILLS precedes expressive
AGE IN YEARS RECEPTIVE RECEPTIVE language .
2 Listening to More than 50 First words at 12 months
songs words Pointing to body parts and
Combining objects at 15 months
words Jargoning
Jargoning Communication of wants
Echolalia and ideas continue to be
Joins in nursery non-verbal
rhymes and
songs
3 Used to direct THE SECOND YEAR OF LIFE

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AT 18 TO 24 MONTHS From telegraphic 2-word
PHYSICAL DEVELOPMENT Motor development is sentences to 3-word
incremental with phrases and sentences
improvements in balance incorporating the
and agility and the grammatical rules.
emergence of running and Language is a critical
stair climbing barometer of both
COGNITIVE DEVELOPMENT End of the sensorimotor cognitive and emotional
period development.
Object permanence is Delays in langue may
firmly established contribute to problems of
Cause and effect are socialization, behaviour
better understood. and learning
Toddler shows flexibility in Preschool language
problem solving development lays the
Symbolic transformation foundation for later
not only on body but also success in school
on doll COGNITIVE DEVELOPMENT Corresponds to the
EMOTIONAL From independence to preoperational stage
DEVELOPMENT rapprochement (growing Characterized by magical
awareness of the thinking, egocentrism
possibility of separation (inability to take the other
hence clinginess) person’s point of view)
Use of transitional objects and thinking that is
(stuffed toys, etc.) dominated by perception
Self-conscious awareness PLAY Marked by increasing
and internalized standards complexity and
of behaviour imagination
LINGUISTIC Labelling objects coincides Scripts, re-enactment
DEVELOPMENT with the advent of From solo or parallel play
symbolic thought. at 1-2 years old to
Pointing to objects to cooperative play (3-4
know their names. years old) to organized
Vocabulary balloons from group play
10 to 15 to 100 or more Play becomes governed
words by rules.
Able to combine words Fairness is taken to mean
Understanding 2-step equal treatment
commands regardless of
Emergence of language circumstantial differences.
marks the end of the EMOTIONAL Challenge – accepting
sensorimotor period DEVELOPMENT limits while maintaining a
As the toddler learns to sense of self-direction,
use symbols to express reigning in aggressive and
ideas and solve problems, sexual impulses and
the need for cognition interacting with a
based on direct sensation widening circle of adults
and motoric manipulation and peers.
wanes. Children learn what
behaviours are acceptable
and how much power they
wield.
THE PRESCHOOL YEARS Inability to control some
2 TO 5 YEARS OLD aspect of the external
PHYSICAL DEVELOPMENT Most walk with a mature world often results in a
gait and run steadily at loss of internal control
the end of the 3rd year. (tantrums).
Wide range of motoric They normally experience
activities – throwing, complicated feelings
catching, kicking balls, towards their parents:
riding bikes, climbing, etc. intense love, jealousy,
Handedness is usually resentment, fear, that
established by the 3rd year anger may lead to
LINGUISTIC Vocabulary increases to abandonment.
DEVELOPMENT 2000.

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techer adn peer
relationships allowing
THE EARLY SCHOOL YEARS social competence
6 to 12 YEARS Issues of conformity
PHYSICAL DEVELOPMENT The Middle Childhood Or “Dress rehearsals” – hero
Latency Stage worship and adoption of
The child can consider adult-like dress and
multiple factors that mannerisms
enable them to evaluate
themselves and perceive EMERGING PATTERNS OF BEHAVIOR
others’ evaluation of 15 MONTHS
themselves. MOTOR Walks alone,
Self-esteem becomes a crawls upstairs
central issue. ADAPTIVE Makes a tower of 3 cubes;
Erickson: Industry vs. makes a line with crayon;
Inferiority inserts pellet in bottle
Increasing separation LANGUAGE Jargon;
from the parents and follows simple commands;
finding acceptance in the may name a familiar
peer group and object (ball)
negotiating challenges in SOCIAL Indicates some desires or
the outside world. needs by pointing;
Muscular strength, hugs parents
coordination and stamina
increase
Ability to perform 18 MONTHS (1 ½ years)
complex-pattern MOTOR Runs stiffly
movements Sits on small chair
SOCIAL AND EMOTIONAL Children apply rules based Walks up the stairs with
DEVELOPMENT on observable phenomena one hand held
Piaget: Concrete Explores drawers and
operational stage waste basket
Schooling: attention and Makes a tower of 4 cubes;
receptive language affect Imitates scribbling;
each other imitates a vertical stroke
First 2 years of Dumps pellet from bottle
elementary schooling: 10 words (average)
reading, writing, basic Names pictures
math Identifies one or more
Third or fourth grade: use parts of the body
of the fundamentals to
SOCIAL Feeds self
learn increasingly
Seeks help when in
complex materials
trouble
Intellectual activity
May complain when wet
extends beyond the
or soiled
classroom.
Kisses parent with pucker
Becoming experts in the
field of their own choosing
24 MONTHS (2 years)
COGNITIVE AND LANAUGE Sexual energies are
MOTOR Runs well
DEVELOPMENT channeled away toward
Walks up and down the
the pursuit of socially
stairs, one step at a time
accepted
Climbs on furniture
accomplishments.
Jumps
Social and emotional
development proceeds in ADAPTIVE Makes a tower of 7 cubes;
3 contexts: home, school Circular scribbling;
and neighborhood. imitates a horizontal
Regular chores provide an stroke
opportunity to contribute Folds paper once
to the family in a imitatively
meaningful way. LANGUAGE Puts 3 words together
Siblings play critical roles (subject, verb, object)
as competitors, loyal SOCIAL Handles spoon well
supporters and role Often tells immediate
models. experience
School – development of Helps to undress

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Listens to stories with
pictures 60 MONTHS (5 years)
MOTOR Skips
30 MONTHS (2 ½ years)
MOTOR Goes up stairs in ADAPTIVE Draws a triangle from
alternating feet copy
ADAPTIVE Makes a tower of 9 cubes; Names heavier of 2
Circular scribbling; makes weights
vertical and horizontal LANGUAGE names 4 colors
strokes (but will not join Repeats sentences of 10
them together) syllables
Imitates circular stroke, Counts 10 pennies
forming a closed figure correctly
LANGUAGE Refers self to pronoun “I”; SOCIAL Asks questions about
Knows full name meaning of words
SOCIAL Helps put things away Domestic role-playing
Pretends in play
METHODS OF
DEVELOPMENTAL SURVEILLANCE
36 MONTHS (3 years) • Denver Development Screening Test
MOTOR Rides tricycle • Gesell Development Scales
Stands momentarily on • CAT – CLAMS
one foot • Bayley Scales of Infant Development
ADAPTIVE Makes a tower of 10 • Draw-a-Person Test
cubes;
Imitates construction of DENVER DEVELOPMENT SCREENING TEST
“bridge” of 3 cubes • Assesses the developmental status in children
Copies a circle 0 – 6 years of age
Imitates a cross • Gross Motor
LANGUAGE Knows age and sex; • Fine Motor-Adaptive
counts 3 objects correctly
• Language
Repeats 3 numbers
• Personal-Social
Repeats a sentence of 6
syllables • Pass or Fail
SOCIAL Plays simple games (in
“parallel” play with other GESELL DEVELEOPMENT TEST
children) • Compares the maturity of the child that of the
Helps in dressing chronological age
(unbuttons and puts on • DEVELOPMENTAL QUOTIENT:
shoes) o DQ = (
Washes hands
• Has clinical diagnostic orientation (diagnosis
and evaluation of abnormalities
48 MONTHS (4 years) • Motor, adaptive, language and personal-social
MOTOR Hops on one foot
Throws a ball overhand CAT-CLAMS
Uses scissors to cut out • CAT (Clinical Adaptive Test)
pictures o Problem solving skills
Climbs well • CLAMS (Clinical Linguistic and Auditory
ADAPTIVE Copies a bridge from Milestone Scale)
model o language skills (receptive and
Imitates construction of a expressive)
“gate” of 5 cubes;
Copies a cross and a
square
Draws a man with 2 – 4
parts besides head
Names longer of 2 lines
LANGUAGE Counts 4 pennies correctly
Tells a story
SOCIAL Plays with several children
with beginning of social
interaction and role-
playing
Gets to toilet alone

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