Development and Milestones Krzysztof Narębski

Problems to discuss What is normal child development - definitions Influences on development Milestones Percentile charts Basic life support - extra 2

Normal child development - definitions Auxology – science of development and environmental influences on it Development (pre & postnatal) : Growth Specialization / Differentiation Maturation 3

Postnatal development – stages : Newborn Infant Toddler Pre – school School Adolescent 4

Influences on development 1. Intrinsic factors : - genes - parents’ age - number of pregnancies 2. Environmental factors - nutritional - economic and social (deprivation !) - geographical 5

Developmental Milestones Important developmental skills (0 – 5 years of age) [later cognition and abstract thinking] Median and limit age of acquisition Sequence of progress Remember prematurely born ! Variation in the pattern of development 6

Locomotor pattern variation 7

Category of milestones (fields of development) Gross motor Vision and fine motor Hearing, speech and language Social, emotional and behavioural Progress should be similar in each field ! (global delay vs specific delay) 8

Gross motor – median age Raises head – 6 – 8 weeks Sits without support – 6 – 8 months Crawling – 8 – 9 months Cruises around furniture – 10 months Walks unsteadily – 12 months Walks steadily – 15 months 9

Milestones Gross motor 10

Vision and fine motor – median age Follows face by turning head - 6 weeks Reaches out for toys – 4 months Palmar grasp – 4 – 6 months Transfer toys from one hand to another 7 months Pincer grip – 10 months Draw line – 2 years 11

Milestones Vision and fine motor 12

Hearing, speech and language – median age Vocalises alone or when spoken to, coos and laughs – 3 – 4 months Turn to soft sounds out of the sight – 7 months Two to three words – 12 months Simple phrases – 20 - 24 months Talks constantly – 2,5 – 3 years 13

Milestones Hearing, speech, language 14

Social, emotional and behavioural – median age Smiles responsively – 6 weeks Waves bye – bye – 10 – 12 months Drink from a cup with two hands – 12 months Symbolic play – 2 years Interactive play – 2.5 – 3 years 15

Milestones Social, emotional, behavioural 16

Limit ages - proposal 17

Fields of development with limit ages 18

Fields of development with limit ages 19

Centile charts - characteristics - method of assessment - growth, weight, head circumference - lines (centiles) 3, 10, 25, 50, 75, 90, 97 - centiles 3 and 97 are limits - centile 50 (median) 20

Centile chart for weight Boys 21

Centile chart for height Boys 22

Height velocity chart

Centile chart Boys Height Final height (Tanner) in cm: Father 185 cm Boy 181,1 cm Mother 165 cm Centile chart Height Final height (Tanner) in cm: Boys = (father + mother + 13) : 2 Girls = (father + mother – 13) : 2 Boys Age Months

Pediatric basic life support Pediatric problems mean respiratory problems (rarely primary cardiac problems) !!! 25

Primary respiratory problem Secondary cardiac problem 26

Pediatric Basic Life Support

Basic Life Support – Airways & Breathing Trained resuscitator

Basic Life Support - Circulation Trained resuscitator

Thank you 30