1. Normal development Sanjay Suri Child Health Rotherham 2011

2. Learning objectives To understand the principles of normal development To learn the sequence of development in the 4 modalities To be aware of the various ages of acquistion of developmental milestones

3. Principles of development Continuum from conception to maturity Quality of the skill is more important than mere acquisition of the skill Depends on myelination and maturation of the nervous system Sequence is the same for all children even though the rate may be different

4. Principles of development Primitive reflexes must be lost before the corresponding voluntary movement develops Direction of development is cephalocaudal Generalised mass activity gives way to specific individual responses Stops and starts – not a smooth curve All modalities are not always affected One modality affects another

5. 4 modalities Gross motor Fine motor/vision Speech/language/hearing Behavioural/Social/adaptive

6. Gross motor Supine Prone Ventral suspension Pull to sit Sitting Crawling Standing Walking Stairs Jump Ball Tricycle

7. Fine motor/Vision Fine Motor Cubes Raisins Pages Pencil/Paper Draw a person Vision Light Dangling object Object permanence Picture book Colour matching

8. Speech & Language/Hearing Comprehension No & Bye Bye Own name Body parts 2 step command Verbs Prepositions Adjectives Negatives Expression Coos Monosyllabic babble Bi-syllabic babble Jargon Words Phrases Sentences Complex sequences

9. Behaviour/Social/Adaptive Smile Rattle Caring routines Claps Peek-a-boo Explores Imitates Plays alongside Toys Concern for siblings Best friend Rules of play Feeding Toileting Dressing Washing

10. How to test in a clinic Ask the parent Observe Takes 15 minutes Tools take longer Denver SOGS Bayley

11. What do you need? Rattle Dangling ball Raisins Cubes Pencil/Paper Picture book Miniature toys Colour cards

12. Questions