Domains of Development

Normal development is a complex process . However, it is easy to under stand and assess development under the following five domain;

i. Gross motor development

ii. Fine motor skill development

iii. Personal and social development and general understanding

iv. Language

v. Vision and hearing

Gross Motor Development

Motor development progresses to ultimate attainment of locomotion and more complex motor tasks thereafter.

Supine and pull to sit:

The infant is observed in supine and then gently pulled to sitting position.

Control of head and curvature of the spine is observed.

• In the newborn period, the head completely lags behind and back is rounded as shown in first one baby.

• Starting at 6 weeks- the head control develops as shown in second one baby.

• By 12 weeks(3 months) there is only a slight head lag .The spine curvature also decreases accordingly

Ventral suspension:

The child is held in prone position and then lifted from the bed, with the examiner supporting the chest and abdomen of the child with the palm of his hand.

• Up to 4 weeks of age, the head flops down

• At 6 weeks, the child momentarily holds head in the horizontal plane and by 8 weeks, he can maintain this position well.

• By 12 weeks, he can lift his head above the horizontal plane

Prone position:

• within a few days after birth or at birth the newborn turns the head to one side and the baby lies on the bed with high pelvis and knees drawn up ;as shown in first baby.
• The infant lies with flat pelvis and extended hips at 6 weeks as in second baby.

By 8 weeks, face is lifted up at 45°

• by 4 months, the child can bear weight on forearms with chin and shoulder off the couch and face a 45° as in 3rd one baby.

• At 6 months, he can lift his head and greate part of the chest while supporting weight on the extended arms as in 4th one baby.

By the age of 8 months, he crawls (with abdomen on the ground)

• At 10 months, creeps abdomen off the ground, with weight on knees and hands. As shown below;

Sitting, Standing and walking:

• By the age of 4 to 6months, the child can sit steadily with support of pillows hands, At first the back is rounded but gradually straightens as in 2nd baby

• He independently sits with his arms forward in 4 to 9 months as in 3rd baby

• By 9 to 15 months the child can bear almost all his weight when made to stand as in 5th baby.

At 9 months, the child begins to stand holding onto furniture and pulls himself to standing position.

By 10 and 11 months, the child starts cruising around furniture

At about 12-13 months, the child can stand independently and can walk with one hand held

Between the ages of 13 and 15 months, the child start walking independently.

He runs by 18 months and at this age he can crawl up or down stairs .

Fine motor skills development

hand to eye coordination–

• Between 12-20 weeks ,child obseves his own hands very intently.
• At 3-4 months hands of child come together in midline as he plays.
• he can grasp the offered red cube.

Hand-to-mouth coordination:

At 6 months, as the ability to chew develops, the child can take a biscuit to his mouth and chew. At this age, he tends to mouth all objects offered to him till 1 year of age .

By 18 months, he can feed himself well using a spoon.

Advanced hand skills (as shown below)and dressing ability also get increases.

Personal and Social Development and General Understanding

Much of the cognitive development and understanding is reflected by the attainment of important milestones in this sphere.

social smile

Language

Throughout the development of language it is the ability and understanding, which precedes expressive ability

Vision and Hearing

Adequate sensory inputs are essential for development.

Both normal vision and hearing are importance for child development. The ability to see and hear is apparent even in the newborn.

Vision:

• The best stimulus to check visual behavior is the primary mother’s face. At birth, a baby can fixate and follow a moving person or dangling ring held 8-10 inches away up to a range of 45°.

• This increases to 90° by 4 weeks

• And 180° by 12 weeks.

• At around 1 month, the baby can fixate on his mother as she talks to her as shown below.

• At about 3-4 months, the child fixates eyes on an object shown to him (‘grasping with the eye’) as if the child wants to reach for the object .

• Binocular vision begins at around 6 weeks and is well established by 4 months.

• By 6 months, the child adjusts his position to follow objects of interest, can follow rapidly moving objects by 1 year.

Hearing:

• Newborns respond to sounds by startle, blink cry, quieting or change in ongoing activity.

• By 3 to 4 months, the child turns his head towards the source of sound.

• Hearing, may be checked by producing sound 115 feet away from the ear (out of field of vision), and a pattern of evolving maturity of hearing can be observed.