Neurological development 2019.pdf

NEUROLOGICAL DEVELOPMENT OF CHILD AHLAM ALOSAIMI,MD ASSISTANT PROFESSOR OF PEDIATRICS COLLEGE OF MEDICINE IMAM MOHAMMED IBN SAUD ISLAMIC UNIVERSITY LECTURE OBJECTIVES Definition of growth and development General principals on development Factors affecting development Monitoring of development Develo...

NEUROLOGICAL DEVELOPMENT OF CHILD AHLAM ALOSAIMI,MD ASSISTANT PROFESSOR OF PEDIATRICS COLLEGE OF MEDICINE IMAM MOHAMMED IBN SAUD ISLAMIC UNIVERSITY LECTURE OBJECTIVES Definition of growth and development General principals on development Factors affecting development Monitoring of development Developmental milestones Developmental delay Growth VS Development Growth  Process of physical maturation resulting an increase in size of the body and various organs due to multiplication of cells and an increase in intracellular substance.  Quantitative changes. DEVELOPMENT  Process of functional and physiological maturation of the individual.  It is progressive increase in skills and capacity to function.  It is related to maturation of the nervous system.  It includes psychological, emotional and social changes.  Qualitative aspects. PRINCIPLES OF GROWTH AND DEVELOPMENT 1. Cephalocaudal direction: The process of cephalocaudal direction from head down to the inferior. This means that improvement in structure and function come first in the head region, then in the trunk, and last in the leg region. 2-Proximodistal direction: from center or midline to periphery direction. 3-General to Specific:  Children at first are able hold the big things by using both hands, In the next part able to hold things in a single hand, then only able to pick small objects like peas, cereals etc.  Children when able to hold pencil, first they scribble starts draw circles then squares then only letters after that the words Factors influencing Development: A-Genetic factors B-Prenatal factors C-Postnatal factors  Nutrition  Childhood illness  Physical & Psychological environment  Socio economic status  Hormonal influence DEVELOPMENTAL AGE PERIODS Neonatal: Birth to 1 month Infancy:1 month to 1 year Early Childhood(Toddler): 1-3 years Preschool: 3-6 years Middle Childhood: School age– 6 to 12 years Late Childhood(Adolescent):13 years to approximately 18 years Development Monitoring HEAD CIRCUMFERENCE:  It is related to brain growth and development of intracranial volume.  Average head circumference measured about 35 cm at birth.  At 3 months it is about 40 cm, at 6 month 43 cm, at one year 45cm, at 2 years 48 cm, at 7 year 50 cm and at 12 years of age it is about 52 cm, almost same as adult. ASSESSMENT OF DEVELOPMENT Developmental milestones: DEVELOPMENTAL MILESTONES 1. Gross motor development 2. Fine motor skill development 3. Personal & social development 4. Language, vision & hearing. KEY GROSS MOTOR DEVELOPMENT MILESTONES  3 months: Neck holding  12 months: stand without support  5 months: Rolls over  6 months: Sits with support  15 months: Walks alone  18 months: Runs  7 months: Sitting without support  9 months: Standing holding on (with support)  2 yrs : Walks up and down stairs  3 yrs :Rides tricycle, FINE MOTOR DEVELOPMENT MILESTONES :  4 months: reaching out for the objects with both hands.  6 months: Reaching out for the objects with one hand.  9 months: Immature pincer grasps  12 months: Pincer grasp mature  15 months: Imitates scribbling  18 months: Scribbles, tower of 3 blocks  2 yrs: Tower of 6 blocks.  3 yrs: Tower of 9 blocks, copies circle  4 yrs: Copies cross  5 yrs: Copies triangls SOCIAL DEVELOPMENT MILESTONES  2 months: Social smile  3 months: Recognizes mother  12 months: Waves “bye bye”  3 years: Asks for food, drink and toilet.  6 months: Recognizes strangers  4 years: knows full name and gender  9 months: stranger anxiety  5 years: Helps in household tasks, dressing and undressin. LANGUAGE DEVELOPMENT Most of children use single words at age of 1 year. two-word combinations at age 2 years Three-word phrases at age 3 years Four-word phrases at age of 4 years (75% of child's speech is understood. DEVELOPMENTAL DELAY Global Developmental Delay (GDD) defined as significant delay in two or more developmental domains Developmental regression is when a child lose previously acquired skills or millstone. RED FLAGS Gross Motor Age Limit Head control 6 months Sits unsupported 9 months walks 16-18 months Fine Motor Age Limit Reach for objects 6 months Transfer objects 9 months Pincer grasp 12 months RED FLAGS Language Age Limit babbles 9 months Join words 2 and half years 3 word sentence 3 and half years Personal/Social Age limit Smiles 4 months Interactive play 3 and half years Using toilet 4 and half years THANK YOU