Developmental Milestones PDF

Lecture RS 3320 Human development between 0 and 6 years of age Major milestones Dr. Cynthia Lai Associate Professor, Department of Rehabilitation Sciences, PolyU All Rights Reserved by...

Lecture RS 3320 Human development between 0 and 6 years of age Major milestones Dr. Cynthia Lai Associate Professor, Department of Rehabilitation Sciences, PolyU All Rights Reserved by The Hong Kong Polytechnic University @2023  Intended Learning Outcome 01 02 03 04 Give examples of Give examples of Describe the key Explain how biological pediatric OT’s Frame developmental stages of physical, systems, socio- of Reference theories cognitive and socio- cultural factors and emotional physical contexts development contribute to a child’s development of play All Rights Reserved by The Hong Kong Polytechnic University @2023  What is the basis to comment on the performance of a People with person with developmental disabilities? Which areas of human Developmental development do you need to learn? Are the developmental stages Disabilities universal or race-specific? How could you learn development stages efficiently? All Rights Reserved by The Hong Kong Polytechnic University @2023 Frame of Reference All Rights Reserved by The Hong Kong Polytechnic University @2023 All Rights Reserved by The Hong Kong Polytechnic University @2023 (Johnson & Ethridge, 2012)  (Johnson & Ethridge, 2012) All Rights Reserved by The Hong Kong Polytechnic University @2023 Theories contributing to child development All Rights Reserved by The Hong Kong Polytechnic University @2023 Cognitive development - Piaget Development occurs through the interaction between the environment and the child’s innate abilities Children are intrinsically motivated to learn from their surroundings and that they act on, rather than simply react to, their environment Child’s maturation through stages of sensorimotor exploration to the acquisition of symbolic through and formal cognitive operations Developmental stages follow a predictable sequence but vary due to genetic influence and experience Four levels of cognitive function (sensorimotor, preoperational, concrete operational, & formal operational) lead to cognitive maturity of adulthood Piaget's Theory of Cognitive Development https://www.youtube.com/watch?v=IhcgYgx7aAA (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 Cognitive development - Vygotsky Zone of proximal development: the distance between the actual developmental level & the level of potential development Scaffolding: the support provided by caregivers and teachers Interaction between a child’s learning, his/her environment, & type of instruction Implications: Offering just-right challenge (a task that is slightly difficult than the tasks the child has currently mastered) to promote the learning of the child Vygotsky in 60 seconds https://www.youtube.com/watch?v=e7k2Ix2eEKs Vygotsky's Theory of Cognitive Development in Social Relationships https://www.youtube.com/watch?v=8I2hrSRbmHE (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 Children learn through interaction with the environment (Lev Vygotsky, 1896-1934) (Jean Piaget, 1896-1980) All Rights Reserved by The Hong Kong Polytechnic University @2023  Attaining developmental milestones is linear and * consistent across children Skills emerge sequentially according to the maturation of the central nervous system structures Brainstem structures develop first while the Motor cortical structures develop later Principles: development - Movement progresses from primitive reflex Neuromaturation patterns to controlled movement Sequence of milestones is consistent across children, constant & predictable Lower level skills are prerequisites for high- level skills (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 Motor development – Dynamical Systems Theory It refers to the performance or action patterns that emerge from the interaction and cooperation of many systems As the child strives to achieve a functional goal, performance patterns emerge from the interaction of an individual’s systems and performance context Motivation to obtain the toy Ability to local the toy in space Humans are complex biologic systems Understand that the toy is reachable Planning of the reach trajectory Subsystems: musculoskeletal, sensory, Correction of movement upon psychological etc. approaching the toy Lift and stabilization of arm in space (Case-Smith & O’Brien, 2015) Grasping All Rights Reserved by The Hong Kong Polytechnic University @2023 Motor development – Perceptual Action Reciprocity Perception and action are interdependent (Case-Smith & O’Brien, 2015) Perception of the environment informs action, while actions provide feedback about movement, performance & consequences in the environment Affordance is the fit between the child and his/her environment Enriching -> Motivated Environment and object in it offer the child opportunities to explore and act All Rights Reserved by The Hong Kong Polytechnic University @2023  (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 Social-Emotional Development TEMPERAMENT ATTACHMENT EMOTIONAL REGULATIONS All Rights Reserved by The Hong Kong Polytechnic University @2023 *A (Case-Smith & O’Brien, 2015) Arousal may not be optimal to function -> drowsy / / Try to learn about themselves and the enviornment through reaching -> sensorimotor activities > - adjust behaviours XXX asked by others All Rights Reserved by The Hong Kong Polytechnic University @2023 may problems in neurophysical state /sensorimotor issue  Self-Identity and Self-Determination Development Self-identity and motivation (e.g., Erikson’s psychosocial stages, Maslow’s hierarchy) Self-efficacy and self-determination (e.g., Bandura) Children are inherently self-organizing and goal directed They typically have interest in new events and activities, initiate new tasks, and persevere in those tasks. When they succeed, Positive self-efficacy is reinforced, and they attempt other challenges When they do not succeed, They are at risk for developing poor self-efficacy and eventually do not attempt new or challenging activities Resilience A child’s internal characteristics that enable him or her to thrive and develop despite high-risk factors in the environment A child’s resiliency versus vulnerability also seems to relate to basic physiologic and regulatory characteristics (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 Self-identity and motivation (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023  Cultural, Social and Physical contexts Ecological Models E.g., Bronfenbrenner Ecological Systems (microsystem, I / mesosystem, / exosystem, & / macrosystem) and Contexts for Development All Rights Reserved by The Hong Kong Polytechnic University @2023 Stages of physical, cognitive and social-emotional development All Rights Reserved by The Hong Kong Polytechnic University @2023 Reflexes All Rights Reserved by The Hong Kong Polytechnic University @2023  “An automatic, involuntary reaction to a Reflexes stimuli..” (Brandes, 2009) Hardwired patterns of movement elicited by a stimuli, such as sound, touch, or movement, and serve a specific developmental purpose (Brandes, 2009) Details will be discussed in the lesson of Cerebral Palsy All Rights Reserved by The Hong Kong Polytechnic University @2023  Uterine: Postural: Types of Withdrawal/Fear Paralysis Righting reflexes : Reflexes Primitive Reflexes: Oculo-headrighting Labyrinthine Moro headrighting Hands grasping/Palmar Reflex Amphibian reflex Asymmetrical Tonic Neck Landau reflex* Reflex Segmental rolling Rooting Reflex reflexes Spinal Galant Spinal Perez Equilibrium reactions: Tonic Labyrinthine Reflex Startle (Strauss) reflex Symmetrical Tonic Neck Parachute reflex Reflex* All Rights Reserved by The Hong Kong Polytechnic University @2023 Functions of Reflexes Essential for survival Drive development in the womb Assist with the birthing process Help the newborn adjust to life outside the womb Organize the development of our postural control Support the development of higher brain centers, psychological development, and behavior All Rights Reserved by The Hong Kong Polytechnic University @2023 Uterine Reflex Reflex Emerges Inhibited Stimulus Response Purpose Fear Paralysis 5th week in utero 12th week in utero Stress of any kind Shuts down Prevents the fetus from making system; demands on the mother’s system Freeze if she is in “fight or flight.” response Protects the fetus during this early time. All Rights Reserved by The Hong Kong Polytechnic University @2023 Primitive Reflexes Reflex Emerges Inhibited Stimulus Response Purpose Moro between 8-9 2-4 months Sudden, Instantaneous arousal Breathing mechanism in https://www.you tube.com/watch? weeks in of life unexpected Rapid inhalation, uterus v=PTz-iVI2mf4 utero occurrence of momentary freeze/startle First “breath of life” at birth any kind followed by expiration, often Survival mechanism (vestibular, crying Develop flexion and auditory, Activation of the “fight or extension and front/back visual, tactile) flight” response Palmar 11 weeks in 2-3 months Light Closure of the fingers Sets foundation for manual Reflex utero of life touch/pressur dexterity https://www.you tube.com/watch? e to palm of Link with feeding v=6tPXGSxEkm0 hand Inhibits Moro Rooting 24-28 weeks 3-4 months Light touch to Head turns to the stimulus, Turns baby’s head to source Reflex in utero of life the cheek mouth opens, tongue of food and opens mouth https://www.you extends wide enough to feed tube.com/watch? v=b0CLcNtOOEQ All Rights Reserved by The Hong Kong Polytechnic University @2023 Primitive Reflexes Reflex Emerges Inhibited Stimulus Response Purpose Spinal 10-20th 3-9th month Side of the Flexion of the whole body to In utero, it helps the fetus Galant week in of life spine is the side of the touch to hear and feel sound https://www.you utero stroked from vibration in the womb tube.com/watch? v=bswn56Qg_XM top to bottom Helps the baby work its way through the birth canal Primes trunk movement All Rights Reserved by The Hong Kong Polytechnic University @2023 Primitive Reflexes Reflex Emerges Inhibited Stimulus Response Purpose Asymmetrica 18 weeks in 6 months of Head turning Limbs extend on the same Frees air passage in prone l Tonic Neck utero life to the side side of the body to which Increases extensor tone Reflex the head is turned, while the Helps develop motor skills https://www.you tube.com/watch? limbs on the opposite side and eye hand coordination v=ArhL_1Q9icg flex Development of asymmetrical coordination Symmetrical 6-9 months 9-11 months Vestibular Head bent backward – spine Get up on to his hands and Tonic Neck of life of life stimulation extends, arms extend, and knees for crawling Reflex caused by legs flex Strengthens muscle tone of https://www.you tube.com/watch? head flexing Head bent forward – spine the back and neck v=eH48tDd11bo or extending. flexes, arms flex, and legs Trains vision: extend accommodation, binocular vision and binaural hearing Tonic Forward: Forward: Forward: Forward: flexor tone Adapt to new gravitational Labyrinthine 12 weeks in 3-4 months neck flexion increases in the neck, back, conditions Reflex utero of life Backward: and legs links between https://www.you tube.com/watch? Backward: Backward: neck Backward: extensor tone proprioceptive and v=HZriJqf1w2I At birth 6 weeks to 3 extension increases in the neck, back, vestibular senses years All Rights Reserved by The Hong Kong andPolytechnic legs University @2023 Balances opposing muscles Righting Reflexes Reflex Response Labyrinthine head righting Allows the head to right itself in relation to gravity in all positions https://www.youtube.com/watch?v=0nT8jBEeBsE Reflex Emerges Inhibited Stimulus Response Purpose Landau 3-10 weeks 3 ½ years of Pressure on Spine, head, and limbs arch Develops motor control in Reflex of life life the belly and backwards extending the the back of the body. https://www.you tube.com/watch? sight of an whole body Inhibits TLR flexion v=-APdTGmjaGI exciting visual stimulus All Rights Reserved by The Hong Kong Polytechnic University @2023 Equilibrium Reflexes Reflex Emerges Inhibited Stimulus Response Purpose Parachute 6-9mths ---- Holding the Arms extend as a defensive Protection Reflex child in mechanism https://www.you ventral tube.com/watch? = protective extension forward v=tJ1_a1FGFs4 suspension & suddenly lowering him to the couch All Rights Reserved by The Hong Kong Polytechnic University @2023 Principles of Motor Development Principle 1: PROXIMAL DISTAL *Trunk *Hand coordination *Shoulder *Dexterity All Rights Reserved by The Hong Kong Polytechnic University @2023 Principles of Motor Development Principle 2: From GROSS motor development to FINE motor control Basic Manipulation Skills Reaching Fine Manipulation Skills Grasp and Release Bilateral Hand Use Pre-writing skills Eye-Hand Coordination Daily Object Manipulation Basic Manipulation All Rights Reserved by The Hong Kong Polytechnic University @2023  Recognizing Early Motor Delays as Early as Two Months of Age Identify https://www.youtube.com/watch?v= 56LwgvprfzU their Recognizing Early Motor Delays as Early as Four and Six Months of Age problem https://www.youtube.com/watch?v= LLi-6dU43uY All Rights Reserved by The Hong Kong Polytechnic University @2023  Gross Motor Development All Rights Reserved by The Hong Kong Polytechnic University @2023 Gross Motor Development All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Gross Motor Skills Milestones 0-3 Raised head and chest on stomach Stretches and kicks on back Opens and shuts hands Bring hands to mouth Key Gross 3-6 Rolls both ways Plays with feet and brings feet to mouth when on back Sits with support Motor Reaches with either hand Transfers object from hand to hand Supports whole weight on legs Milestones Begins to pivot to left and right while on belly 6-9 Sits and plays with toys (Infants) Assumes hands-and-knees position Gets from sitting to crawling position Crawls forward on belly 9-12 Gets to sitting position without help Pulls self-up to stand Take steps holding on to furniture May Stand without support May take some steps without support All Rights Reserved by The Hong Kong Polytechnic University @2023 Key Gross Months 12-18 Gross Motor Skills Milestones Gets to standing without support Motor Walks alone Carries a toy while walking Milestones 18-24 May walk up steps with support May begin to run (Toddler) Can stand on tiptoes while reaching for a toy All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Gross Motor Skills Milestones 24-36 Carries large toy or several toys while walking Key Gross Runs Begins to jump Kicks a ball Motor Climbs onto and down from furniture unassisted Walks up and down stairs holding on to support Milestones 36-48 Walks well and able to change directions easily Goes upstairs and downstairs without support Kicks ball forward (Pre-schooler) Throws ball overhand Hops and stands on one foot up to five seconds 48-60 Stands on one foot for ten seconds or longer Swings and climbs May be able to skip All Rights Reserved by The Hong Kong Polytechnic University @2023 Fine Motor Development All Rights Reserved by The Hong Kong Polytechnic University @2023 Reaching Months Developmental Milestone 0-3 Starring at hands 5 Palm open 6 Reach by one hand, another hand for stabilize 9-12 Reach different direction All Rights Reserved by The Hong Kong Polytechnic University @2023 Grasping Months Developmental Milestones 4 Ulnar Palmar Grasp 5 Palmar Grasp 6-7 Radial Palmar Grasp 8 Radial Digital Grasp 8 Scissor Grasp 9 Inferior Pincer Grasp 12 Fine Pincer Grasp All Rights Reserved by The Hong Kong Polytechnic University @2023 All Rights Reserved by The Hong Kong Polytechnic University @2023 Release Months Developmental Milestone 7 Release object on surface with asst. by slight ext rotation 8 Rough release above a large container with wrist flexed 9 Release above a large container with wrist extended 10 Smooth release above a large container 12 Attempts to release above a small container 14 Release above a small container by trial and error 15 Release above a small container accurately All Rights Reserved by The Hong Kong Polytechnic University @2023 Eye- hand Coordination 48-60 mths 36-48 mths 24-36 mths 19-24 mths 13-24 mths 0-6 mths All Rights Reserved by The Hong Kong Polytechnic University @2023 Bilateral Coordination 24-36 mths Highly differentiated asymmetrical coordination 12-24 mths One hand Stabilizes, One hand manipulates 7-12 mths Transfer object 3-5 mths Keep in midline All Rights Reserved by The Hong Kong Polytechnic University @2023  Symmetrical Pushing, pulling movements Asymmetrical Stabilization and manipulation movements Bilateral Coordination Alternating Bead threading movements Reciprocal Wring towel movements All Rights Reserved by The Hong Kong Polytechnic University @2023  Age 2-4 Translation (finger-to-palm, palm-to-finger) Translation with stabilization In-hand Shifting manipulation Up/down Lateral Rotation (simple, complex) All Rights Reserved by The Hong Kong Polytechnic University @2023  (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023  Sensory Development All Rights Reserved by The Hong Kong Polytechnic University @2023 Sensorimotor Visual Auditory Olfactory Taste Development Critical period varied between senses Neuroplasticity Proprio- Vestibular Tactile Sensory experience, motor output ception Body scheme and sense of control Interact with external environment All Rights Reserved by The Hong Kong Polytechnic University @2023 Sensory Development Importance of Sensory Integration https://www.youtube.com/watch?v=1_Iuj8dr9oY Sensory Issues in Children: Developing your Child's Senses https://www.youtube.com/watch?v=7OmrG4bl9uE All Rights Reserved by The Hong Kong Polytechnic University @2023  Cognitive Development All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Developmental Milestones 1 Watches person when spoken to 2 Smiles at familiar person talking. Begins to follow moving person with eyes. 4 Shows interest in bottle, breast, familiar toy, or new surroundings. 5 Smiles at own image in mirror. Looks for fallen objects. Cognitive 6 May stick out tongue in imitation. Laughs at peekaboo game. Developmental Vocalizes at mirror image. May act shy around strangers. Milestones 7 Responds to own name. Tries to establish contact with a person by cough or other noise. 8 Reaches for toys out of reach. Responds to "no." 9 Shows likes and dislikes. May try to prevent face-washing or other activity that is disliked. Shows excitement and interest in foods or toys that are well-liked. All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Developmental Milestones 10 Starts to understand some words. Waves bye-bye. Holds out arm or leg for dressing. 11 Repeats performance that is laughed at. Likes repetitive play. Shows interest in books. 12 May understand some "where is...?" questions. May kiss on request. 15 Asks for objects by pointing. Starting to feed self. Negativism begins. 18 Points to familiar objects when asked "where is...?" Mimics familiar adult activities. Know Cognitive 24 some body parts. Obeys two or three simple orders. Names a few familiar objects. Draws with crayons. Obeys found simple orders. Participates in parallel play. Developmental 30 Names several common objects. Begins to take interest in sex organs. Gives full names. Helps Milestones to put things away. Peak of negativism. 36 Constantly asks questions. May count to 10. Begins to draw specific objects. Dresses and undresses doll. Participates in cooperative play. Talks about things that have happened. 48 May make up silly words and stories. Beginning to draw pictures that represent familiar things. Pretends to read and write. May recognize a few common words, such as own name. 60 Can recognize and reproduce many shapes, letters, and numbers. Tells long stories. Begins to understand the difference between real events and make-believe ones. Asks meaning of words. All Rights Reserved by The Hong Kong Polytechnic University @2023 Social-emotional Development All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Development 0-3 Crying as the way for communication Distress, disgust Social smile 4-8 Pleasure, happiness, fear, and frustration are shown Emotional Noises such as gurgles, coos, wails, and cries, and physical movements such as kicking, arm-waving, rocking, and smiling. Development 18 Develop a sense of self. Recognize their image in a mirror as themselves Begin to become independent of their mothers or caregivers Have a broad range of emotional states All Rights Reserved by The Hong Kong Polytechnic University @2023  Months Developmental Milestones Newborn Bonding (Parentchild) Self-regulation/soothing 2 Attachment (Childparent) Social Smile 4 Turn-taking conversations Explores parent’s face Social 6 9 Expresses emotions: happy, sad, mad Separation Anxiety Developmental 12 Explore from secure base Points at wanted items Narrative memory begins Milestones 15 Shared attention: points at interesting items to show to parents Brings toys to parent 18 Increased independence Parallel play All Rights Reserved by The Hong Kong Polytechnic University @2023  Age in Developmental Milestones Year 2 Testing limits, tantrums Negativism Possessive 3 Separates easily Social Sharing, empathy Cooperative play Developmental Role play 4 Has preferred friend Milestones Elaborate fantasy play 5 Has group of friends Follow group rules Games with rules All Rights Reserved by The Hong Kong Polytechnic University @2023  (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023  (To be discussed in the tutorial) What is your comment on the performance of this boy? https://www.youtube.com/watch?v=MPLk0nuct2c All Rights Reserved by The Hong Kong Polytechnic University @2023  Tutorial RS 3320 Human development between 0 and 6 years of age Major milestones Dr. Cynthia Lai Associate Professor, Department of Rehabilitation Sciences, PolyU All Rights Reserved by The Hong Kong Polytechnic University @2023 What is your comment on the performance of this boy? https://www.youtube.com/watch?v=MPLk0nuct2c All Rights Reserved by The Hong Kong Polytechnic University @2023 Tips for you to visualize the client Sensory Motor Cognitive Psychosocial Process: Muscle function: Attention: Emotional function: Registration Power Sustained Regulate emotion Modulation … Tone … Divided … Appropriateness Domain & function: Movement function: Memory: Social interaction skills: Visual Motor reflexes Short-term Look: Eye-contact Auditory Involuntary m reactions Long-term Touches Working memory Tactile Gait patterns … Initiate interaction Vestibular Fine motor skills: Executive function: Replies Proprioceptive Reach Inhibition Express emotion Gustatory Grip Working memory Time response Olfactory Coordinate two hands Shifting … Takes turns … Others … Others … Others … Others … Depending on theory / model / frame of reference 8/31/2024 Add a footer 64 All Rights Reserved by The Hong Kong Polytechnic University @2023  Is it necessary to know and memorize all the milestones? All Rights Reserved by The Hong Kong Polytechnic University @2023  Gross motor and fine motor PDMS-2 developmental scale Bayley HK-PFMDA Handwriting assessment Developmental Visual Perceptual Test tool Motor Free Visual Perceptual Test Handwriting Speed Test All Rights Reserved by The Hong Kong Polytechnic University @2023  What is the difference between a talking computer and a therapist? Information is the King? All Rights Reserved by The Hong Kong Polytechnic University @2023 Based on the Could you draw some important observations? provided developmental How does the information help you to identify the strengths and weaknesses of milestones, your clients? How does the information help you to tackle the problems underlying the clinical symptoms of developmental disabilities? Class exercise All Rights Reserved by The Hong Kong Polytechnic University @2023 (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023  How is the progression development during 24 to 72 months? Hints: Please compare with the tables of development during 0 to 24 months (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023  (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 What is the role of the children at this age? Demand Skills (Case-Smith & O’Brien, 2015) All Rights Reserved by The Hong Kong Polytechnic University @2023 What is your comment on the performance of this boy? https://www.youtube.com/watch?v=MPLk0nuct2c All Rights Reserved by The Hong Kong Polytechnic University @2023 Bibliography Case-Smith, J., & O’Brien, J. C. (2015). Occupational therapy for children and adolescents (7th ed.). St. Louis, MO: Elsevier Mosby. Johnson, J. A., & Ethridge, D. A. (Eds.). (2012). Developmental disabilities : a handbook for occupational therapists. Routledge. https://julac- hkpu.primo.exlibrisgroup.com/permalink/852JULAC_HKPU/10ml02k/alma991022612518503411 Simion, F., & Butterworth, G. (1998). The development of sensory, motor and cognitive capacities in early infancy: From perception to cognition. East Sussex, UK: Psychology Press. https://www.cdc.gov/ncbddd/actearly/milestones/index.html https://www.fhs.gov.hk/tc_chi/health_info/class_topic/ct_child_health/ch_child_develop.html https://childdevelopment.com.au/resources/child-development-charts/ https://pathways.org/all-ages/milestones/ Thanks teachers of this subject contributing to part of the contents of this PPT. All Rights Reserved by The Hong Kong Polytechnic University @2023