Child Development
Original Editor - The Open Physio project.
Top Contributors - Naomi O'Reilly, Siobhán Cullen, Admin, Chelsea Mclene, Oyemi Sillo, Kim Jackson, Lucinda hampton, Tony Lowe, WikiSysop, Simisola Ajeyalemi, 127.0.0.1, Lauren Kwant, Saeed Dokhnan, Claire Knott, Rucha Gadgil, Amrita Patro, Rachael Lowe, Jess Bell, Paule Morbois, Olajumoke Ogunleye, Matt Huey and Scott Buxton
Introduction[edit | edit source]
As a child grows they learn and acquire more refined gross and fine motor skills, as well as developing social skills. Reflexes that initially developed to aid survival, become integrated into more refined movements as the child matures. Children tend to acquire these skills in an orderly fashion and within certain age brackets. This patter of skill acquisition is often referred to as 'normal development', and is used to monitor a child's developmental progress. In some cases late acquisition of these 'milestones' can indicate developmental delay . However, it must be remembered that the time span within which acquistion of these skills is still considered 'normal' is wide (see WHO study discussed later), and that some children may skip a milestone altogether eg crawling.
The average age at which gross motor, fine motor and social skills are acquired are outlined below.
Gross motor activities[edit | edit source]
Activity |
Age |
Lifts head to 45° | 2/12 |
Props on forearms in prone | 3/12 |
Rolls over | 5/12 |
Prone on extended arms | 6/12 |
Balance reactions | 6/12 |
No Head lag | 5/12 |
Sitting without support | 6-8/12 |
Pulls to stand | 8-9/12 |
Cruises | 8-9/12 |
Crawls reciprocally | 9/12 |
Stands alone | 11/12 |
Walks alone | 12/12 |
Runs | 18-24/12 |
Walks up and down stairs with handrail | 2 yrs |
Pedals tricycle | 3 yrs |
Walks narrow line | 5 yrs |
Fine motor skills[edit | edit source]
Activity |
Age |
Follows objects with eyes | 1-2/12 |
Grasps objects | 4/12 |
Hand to hand transfers | 5/12 |
Finger feeds | 6/12 |
Objects into container | 12/12 |
Builds 2 block tower | 14/12 |
Helps with dressing | 15/12 |
Builds 6-7 cube tower | 2 yrs |
Uses fork and spoon skilfully | 2.5 yrs |
Holds pencil with adult grasp | 4 yrs |
Colours inside lines | 5 yrs |
Social skills[edit | edit source]
Activity/Interaction | Age |
Smiles when stimulated | 1/12 |
Vocalises to self | 6/12 |
Plays peek-a-boo | 8/12 |
Stranger anxiety | 8/12 |
Drinks from cup | 12/12 |
Uses spoon | 13/12 |
2-6 words | 15/12 |
Feeds self fully | 2 yrs |
Bladder and bowel control | 2 yrs |
Has 50+ words, understands 1000+ | 2 yrs |
Undresses | 2.5 yrs |
Gramatically correct speech | 4 yrs |
Fluent | 5 yrs |
Age Ranges of Skill Aquisition[edit | edit source]
Primitive Reflexes[edit | edit source]
The primitive reflexes are movement patterns that can be involuntarily elicited in a newborn. They exist to enhance chances of survival. These reflexes should be integrated as the child's motor development matures. The persistence of these reflexes beyond the usual ages of integration is suggestive of ischemic brain injury. Below several of the primitive reflexes, their appearance and integration dates are discussed.
Rooting reflex:
The rooting reflex can be elicited by gently stroking the child's cheek. The reflex is intact if the child's response is to attempt to bring the object to their mouth[4]. This is demonstrated in the video below.
Age of integration: 3-4 months
Palmar Grasp:
This reflex can be elicited by stimulating the palmar surface of the child's hand. The reflex is intact if the child reflexively grasps the object stimulating the palm[4]. Both this and the plantar grasp reflex are seen in the next video clip.
Age of integration: 4 months[6]
Plantar grasp:
This reflex is elicited by stimulating the plantar aspect of the child's foot, just below the toes. The reflex is intact if this cuases toe flexion. Age of integration: 9 months[6]
Moro:
<u</u>The Moro reflex is typically elicited by rapid extension of the child's neck. However it can also occur in response to loud noises. The reflex is intact if the child symettrically and simultaneously abducts and extends the upper limbs, and extends the trunk. The upper limbs then immediately adduct[4]. This reflex is demonstrated in the clip below.
Age of integration: 3-6 months[6]
Asymmetrical Tonic Neck Reflex (ATNR):
This reflex is elicited by turning the child's head to one side. A normal response is seen if the baby's extensor tone increases on the side the head is facing, and flexor tone increases on the opposite side[4]. This is demonstrated in the clip below.
Age of integration: 6 months[6]
Recent Related Research (from Pubmed)[edit | edit source]
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1XMgV6jliA8ARN2yDLIfMBSoFqzTslxA7PFp3nPxHIR-jpvU5k|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 1.0 1.1 Bly L. Motor skills acquisition in the first year: An illustrated guide to normal development. ed. 1. Great Britain: Elsevier Science &amp;amp;amp;amp;amp;amp;amp; Technology books, 1998.
- ↑ 2.0 2.1 2.2 Sheridan M. D. Sharma A. and Cockerill H. From birth to five years. ed. 3. London: Routledge, 2008.
- ↑ WHO Multicentre Growth Reference Study Group. ‘WHO Motor Development Study: Windows of achievement for six gross motor milestones’. Acta Paediatrica. 2006: Suppl 450; 86-95.
- ↑ 4.0 4.1 4.2 4.3 Zitelli BJ, McIntire SC and Nowalk AJ. 2012. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. Ed. 6. Philadelphia: Elsevier
- ↑ onlinemedicalvideo. Physical exam-Newborn Normal: Primitive reflexes-suck, root. Available from: http://www.youtube.com/watch?v=_Vs7_aHfOy8 [last accessed: 17/06/13]
- ↑ 6.0 6.1 6.2 6.3 Votroubek W. 2009. Pediatric Home Care for Nurses: A Family-Centred Approach. Ed. 3. Sudbury: Jones and Bartlett Pblishers Inc.
- ↑ onlinemedicalvideo. Physical exam-Newborn normal: Primitive reflexes-grasp. Available from: http://www.youtube.com/watch?v=BF1j1PXRq-I [last accessed: 17/06/13]
- ↑ Onlnemedicalvideo. Physical exam-Newborn normal:primitive reflexes-moro. Available from: http://www.youtube.com/watch?v=7oD6set72lo [last accessed: 17/06/13]
- ↑ Dr. Prodigious. Primitive Reflexes, Asymettric Tonic Neck-3 months-Infant clinical exam (MRCP. Available from: http://www.youtube.com/watch?v=uXsb7bxTc5g)[last accessed: 17/06/13]