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Developmental Milestones-An overview. Illingworth 1987. Development is continuous from conception to maturity and its sequence is the same in all children,though its rate varies from one child to another. Developmental Milestones.

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illingworth 1987
Illingworth 1987
  • Development is continuous from conception to maturity and its sequence is the same in all children,though its rate varies from one child to another
developmental milestones
Developmental Milestones
  • Children develop from being totally dependent newborns to independent individuals by the acquisition of skills
  • Range of normality in the acquisition of skills
  • Development follows an orderly process in a cephalic to caudal direction
principles
Principles
  • Listen to parents-partnership
  • May need to see a child a second time
  • Opportunistic pick up
  • The state of the child-take into account
  • Distinguish between developmental items reported and those observed
routine child surveillance
Routine Child Surveillance
  • Newborn
  • Supine (6-8wks)
  • Sitting (6-9 mths)
  • Mobile toddler (18-24mths)
  • Communicating child (3-4yrs)
developmental milestones6
Developmental Milestones
  • 4 fields with a sequence of development
  • Gross Motor - the development of locomotion
  • Vision and fine manipulation - the development of eye-hand control
  • Hearing & speech - the devt. of language
  • Personal & social - integration of acquired abilities to reflect understanding of env.
developmental milestones7
Developmental Milestones
  • Birth prone: pelvis high, knees under abdo
  • 6-8 weeks smiles to maternal overtures fixes & follows prone: pelvis flat, hips extended ventral: briefly holds head up
  • 3 months holds head up, good eye contact holds rattle in hand turns to sound ear level
developmental milestones9
Developmental Milestones
  • 4-5 months able to reach out for object
  • 6 months transfers hand to hand Chews, babbles sits with hands forward lifts head spont from supine
  • 10 months index finger approach finger thumb apposition waves bye-bye,
developmental milestones11
Developmental Milestones
  • 13 months casting objects walks without support single words
  • 15 months feeds self from cup domestic mimicry
  • 18 months casting stops ,tower of 3 Walking well, scribbles
developmental milestones12
Developmental Milestones
  • 2 years joins 2/3 words, 50 words Runs well,climbs, stairs cubes tower 6 or 7
  • 3 years mainly dry by day+/- night dresses & undresses fully stairs - alternate feet rides tricycle
developmental warning signs at any age
Developmental Warning Signs - at any age
  • FHx of note eg deafness, cataracts
  • Maternal concern
  • Persistent primitive reflexes
  • Persistent squint
  • Discordance in developmental abilities in different areas
  • Regression of previously acquired skills
causes of delayed development
Causes of Delayed Development
  • (Correct for Prematurity)
  • Idiopathic: constitutional, familial (affecting one field & catching up later)
  • Deprivation
  • Intellectual disability
  • Specific abnormality eg Blind, deaf, cerebral palsy
causes of arrested deteriorating development
Causes of arrested/deteriorating development
  • Common
  • Emotional deprivation
  • Intercurrent illness eg malabsorption
  • Acute cerebral injury eg encephalitis, trauma
  • Seizures: uncontrolled, prolonged
  • Drugs eg phenytoin excess
causes of arrested deteriorating development19
Causes of arrested/deteriorating development
  • Uncommon/rare
  • Hydrocephalus
  • Metabolic eg hypothyroidism, lead poisoning
  • Degenerations - Infections: AIDS, SSPE - Genetic: Wilson’s Dx Huntington’s Chorea, Lysosomal storage dx
developmental milestones delayed motor development
Developmental Milestones - Delayed Motor Development
  • Familial feature
  • Environmental - deprivation, practice
  • Mental subnormality
  • Hypotonia (Down’s Syn)
  • Hypertonia (Cerebral Palsy)
  • Neuromuscular problems (DMD)
  • Bottom shuffling
  • Visual impairment
developmental milestones summary
Developmental Milestones - Summary
  • ordered process of development
  • range of normality in acquisition of skills - bands of normality - delayed
  • relevance of delay varies
  • early detection of delayed development desirable for maximum intervention and for parental acceptance
video
Video

Developmental examination of a child from birth to 18 months