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Overview of Child Development

Introduction

This article contains a bit of background info about normal child development. For info on milestones, please see:

Background Info

Most developmental abnormalities present within the first 5 years of life. During this period there is rapid development of motor ability, speech and language, communication and cognitive skills. After this age, development is mainly just cognitive.

Why detect problems early?

Nature vs Nurture

It is now generally believed that:
The only area we can really have much influence over is the environment (although gene therapy may change this in the future!)
Environmental needs are different in children of different age groups
There are four main areas of child development:

Pattern of development

Each child’s pattern of development should be identical – however, the rate at which goals are achieved varies from child to child. The pattern in which skills are acquired is very much longitudinal – with one goal acquired after another. Later goals are often dependent on the achievement of earlier goals within the same field.For example, the failure of development of hearing will impact the development of language skills.
The four areas of development should be assessed individually.

Birth Reflexes

These should be present in neonates, and typically disappear between 4-6 months of age:
Reflex
Test
Response
Moro
Sudden neck extension
Extension then flexion of the limbs
Grasp
Place an object in the palm of the hand
Baby will firmly grip the object by flexing the fingers
Rooting
Stimulus placed near the edge of the mouth
Baby will turn the head towards the stimulus
Placing / Stepping
Baby help in an upright position, and feet gently touched against a stimuli (edge of the bed)
Baby should lift the feet as if stepping. One foot followed y the other
Supporting reflex
Again, hold the baby upright, and this time, rest the baby on their feet
Baby should extend the legs in an attempt to support their own weight
Atonic neck reflex (ATNR)
Baby is laid on their back. Turn the baby’s head to one side
Baby should outstretch their arms to the side of the head turn.

Terms and concepts

Cognitive Development

Typical ideas and beliefs in the pre-school child are sometimes called pre-operational thought, and include:

In primary school age children, thought processes are called operational thought. Thought processes are practical and followed ordered patterns. They are still tied to the child’s own immediate beliefs and experiences.

In adolescence, the adult pattern of thought emerges. This is called formal operational thought. This allows reasoning behaviours and abstract concepts.

IQ testing

Is widely used and often quoted to describe the degree to which a disease affects cognitive functioning. It can be a very useful test, but does have some notable drawbacks:
In children, particularly young children, testing is typically performed with:

Screening and observation

Specific Testing

There are loads of specific tests for loads of different areas. You are unlikely to have to know many of them, unless you become a specialist in child development!
For purposes on the ward / in a general clinic, details are given below:

Vision

Official visual testing is carried out in pre-school children (age 4-5) by optometrists. If there are any parental concerns, it can be tested before this. Normal visual development includes:

Sound

Neonatal sound checks

References

Read more about our sources

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