HUMAN GROWTH AND

DEVELOPMENT
ELIZABETH 0B0NDI
BROAD OBJECTIVE
• The module is designed to enable the learner to acquire knowledge,
skills and develop attitude on growth and development of the child.
LEARNING OUTCOMES
• Describe human growth and development
• Factors influencing growth and development
• Types of deviations from normal growth and development and their
management.
CONTENT
• stages of normal growth and development
• Developmental milestones
• Factors influencing growth and development
• Types of deviations from normal growth and development and their
management.
CONTENT cont.
• Growth monitoring, factors influencing normal growth and
development, role of play in normal growth and development, share
appropriate health messages on growth and development, factors
affecting normal growth and development, development disorders.
INTRODUCTION
• Knowledge of human growth and development is basic to the
healthcare of individuals across the life span. For healthcare
professionals to properly and appropriately care for their patients, an
understanding of the different stages of development and tasks to be
accomplished in each stage are necessary. The following review and
testing of development and milestones throughout the life span is
intended to familiarize you with and provide a minimal competency
of growth and development.
INTRODUCTION cont.
• Assessment of growth, development and maturation focuses on four
major areas: physical, cognitive, social and emotional capabilities.
Physical capabilities include gross and fine motor skills as well as
strength, stamina, fatigue and pain. Cognitive capabilities include
thought, perception, understanding and reasoning. Social capabilities
are reflected by relationships established with family, friends, and
others. Emotional capabilities reflect one’s awareness and ability to
apply feelings to people and situations.
DEFINITION: GROWTH AND
DEVELOPMENT
• Growth refers to specific body changes and increases in the child’s
size (such as: height, weight, head circumference, and body mass
index). These size changes can easily be measured.
• Development typically refers to an increase in complexity (a change
from simple to more complex) Involves a progression along a
continuing pathway on which the child acquires more refined
knowledge, behavior, and skills. The sequence is basically the same
for all children, however the rate varies.
STAGES OF NORMAL GROWTH
AND DEVELOPMENT
• NEONATE: Birth to 1 month
• Physical Development
• Has Strong Reflexes:
• Automatic Grasp Reflex- Infant’s fingers curve around finger placed in infant’s
palm/
• Sucking Reflex- Neonate sucks on object placed in mouth.
• Rooting Reflex- when cheek is brushed, neonate turns head toward stimulus and
attempts to grasp with mouth.
• Moro (Startle) Reflex- Generalized Activity in response to stimulation.
• Babinski Reflex- when stroking outer sole of foot upward from heel to across ball
of foot causes toes to hyperextend.
CONT.
• At this stage, a newborn is able to see objects that are close to his
eyes such as his parents' faces, recognize certain smells, move his
head from side to side, smile and cries to indicate his needs.
• Normal Vital Signs: Pulse = 150 (+/- 20), Respirations = 35 (+/- 5).
• Neonate has poor temperature regulation. Gains about 170grms per
week. Grows approximately one inch during the first month.
Fontanels are soft and flat. Umbilical cord should dry and fall off
during the first or second week of life. Is unable to support the
weight of his/her head.
Psychosocial Development

• Responds to environment through visual, auditory, tactile and taste

senses. Is totally dependent upon caregiver. Perceives self and parent
as one. Responds to human voices and faces. Cries when
uncomfortable, sleepy or hungry. Soft music and bright coloured
mobiles provide pleasant stimulation for neonate.
Nursing considerations
• Physical assessment should include temperature, pulse (counted for
one full minute), respirations (also counted for one full minute),
weight, head and chest circumference, length and assessment of
fontanels. Perform the most uncomfortable or intrusive procedures
last. First Hepatitis B Vaccination should be initiated by the age of
two months.
Nursing considerations cont.
• Hold and cuddle during feeding. Maintain feeding schedule. Check
for soiling of diapers. Always transfer neonate via crib, stretcher, or
stroller. Keep warm. Place infant in supine position for sleeping
(“Back to Sleep”). When keeping track of Intake and Output, weigh
diapers for an accurate output. One cc of urine weighs about one
gram.
Infant development

• Between one and 12 months, infants displays new developmental

abilities. A three-to-six-month-old child is able to control her head
movements and play with her hands together. An infant is able to sit
without support, respond to her name and babble between six and
nine months old. Between nine and twelve months, a baby can crawl,
stand with support and pick up objects with her index finger and
thumb or a pincer grasp.
Specific development
• Two to Three Months
• Physical Development
• Posterior fontanel closes around the second month. Head
circumference increases by approximately 1.5 cm per month for the
first six months. Startle, sucking and rooting reflexes begin to be lost
around three months. Normally, infant should gain about one ounce
during the first six months of life.
Cont.
• Normal vital signs: Pulse = 130 (+/- 20), Respirations = 35 (+/- 10),
Blood Pressure = 80/45 (+/- 20/10)
• Can strike at a toy but cannot grasp it. Able to hold head up when
supported in the sitting position, but it will bob forward. Rolls over.
Around the third month, will purposefully put hand into mouth. Will
make crawling movements when in prone position. Can push chest
up with forearms. Will visually pursue sounds by turning head.
Cont.
• Psychosocial Development
• Laughs out loud, coos, blows bubbles and squeals. Crying becomes
differentiated. Smiles at primary caregiver’s face. Responds
pleasurably to gentle touch and motion. Enjoys simple toys, such as a
rattle, music box, or brightly coloured mobile.
Nursing Considerations

• Physical assessment should include vital signs, weight, head and chest
circumference, length, assessment of fontanels and reflexes and
immunization status. DPT, Polio and Hib (H. Influenzae type B)
immunizations are initiated at 2 months. Second Hepatitis B
vaccination is should be administered one month after first dose was
given, usually at two to three months of age. Perform most
uncomfortable and intrusive procedures last.
Cont.
• Take precautions to prevent falls and rolling off surfaces. Keep side
rails up on crib at all times. Transport using crib, stretcher, or stroller.
Provide play stimulation. Hold and cuddle for feeding. “Back to
Sleep.”
Four to Five months

• Physical Development
• Holds head steady in a sitting position. Supports part of weight with
legs when held in a standing position. Reaches out with hands.
Brings hands together, plays with them, and puts them into mouth.
Can grasp objects with both hands. Drooling begins at four months.
At five months, birth weight should be doubled. Can transfer objects
from one hand to the other. Rolls back to side. Can balance head
well.
Cont.
• Normal vital signs: Pulse = 130 (+/- 20), Respirations = 35(+/- 10),
Blood Pressure = 80/45 (+/- 20/10).
Psychosocial Development

• Begins to discriminate family members from strangers. Laughs out

loud. Initiates social play. Sleeps longer periods at night. May have
one or two naps during the day. At five months, will babble vowels
such as “goo”. Enjoys hearing self make vocal sounds and splashing in
water. Imitates others. Searches for objects at point of
disappearance.
Nursing Considerations

• Physical assessment should include vital signs, weight, head and chest
circumference, length, assessment of fontanels, and immunization
status. The second Polio, DPT and Hib are given at four months.
Perform the most uncomfortable or intrusive procedures last.
Cont.
• Protect from fall injury. Assess environment for safety hazards.
Provide variety of small, multi-textured and colored objects that can
be held, BUT not swallowed. Use floating toys for the bath. Mobiles
are entertainment for the crib. Talk, play, smile, and laugh with infant.
Hold and cuddle. May introduce solid foods. Introduce one new
food at a time, allowing a week before introducing the next new food
to assess for food allergies. Introduce in this order: cereals, fruits,
vegetables, then meats. “Back to Sleep.”
Six to Eight Months

• Physical Development
• Brings objects to mouth at will. Bangs objects on table. Drops toy
from hand to reach for another when it is offered. Lower incisors may
begin to erupt. Upper central incisors may begin to erupt at around
seven months. Drools constantly. Can sit alone. Begins to show food
likes and dislikes. Can drink from a cup. Sucking and rooting reflexes
disappear. At eight months, can eat finger foods, such crackers,
cookies and bread. Crawls forward and backward. Weight gain is
approximately half an ounce daily from six to twelve months.
Cont.
• Normal vital signs: Pulse = 120 (+/- 20), Respirations = 30 (+/- 10),
Blood Pressure = 90/60 (+/- 20/10)
Psychosocial Development

• Begins to recognize the meaning of certain words and vocal tones.

Begins to demonstrate fear of strangers. Enjoys looking at self in
mirror. Imitates simple acts of others. Recognizes own name.
Vocalizing “da”, “ma”, “ba”. Holds arms out when wants to be picked
up.
• Nursing Considerations
• Use drinking cup designed not to spill (“sippy cup”) Provide sound
making toys and larger toys with moving parts, such as set of
measuring spoons, bowls and pots. Provide large, safe area for
crawling, such as a playpen. Provide stimulation with simple games
such as clapping hands, placing toy under blanket. Read, talk and sing
to infant while holding. “Back to Sleep”. Third DPT and Hib
immunization is at six months. Third Hepatitis B vaccination is also
given four months after first dose, usually in this time frame.
Nine to Ten Months

• Physical Development
• Hand and eye coordination perfected. Picks up small objects with
pincer grasp. Pulls self to standing position. Able to step sideways
while holding on to furniture.
• Normal Vital Signs: Pulse = 120 (+/- 20), Respirations = 35 (+/- 10),
Blood Pressure 90/60 (+/- 20/10).
• Psychosocial Development
• Says first words, such as “dada” and “mama”. Waves bye-bye. Enjoys
playing games like “peek-a-boo” and “pat-a-cake”. Cries when
scolded. Repeats activities that attract attention.
Nursing Considerations

• Remove all objects small enough to be swallowed or aspirated from

play areas. Provide safe play area keeping objects above infant’s
reach. Provide walker for infant to push self around in. Expect some
discomfort, drooling, and low-grade fever with teething. Refrain from
giving bedtime bottle that contains sugar-containing fluid. Counsel
parents to minimize sweets in baby’s diet and avoid adding salt.
“Back to Sleep”.
•
Eleven to Twelve Months

• Physical Development
• Holds cup alone. Scribble with crayon. Has tripled birth weight by
twelfth month. Bowel movements are decreased to one or two per day.
At eleven months may begin to stand alone for variable amount of time
and begin to walk alone at twelve months. Cooperates with dressing.
Takes toys out of box and puts them back into box. Grows about one
half inch per month. Anterior fontanel closes between twelve and
eighteen months. Babinski reflex disappears at twelfth month. Head
and chest are equal in circumference.
• Normal Vital Signs: Pulse = 120 (+/- 20), Respirations = 25 (+/- 5), Blood
Pressure = 90/60 (+/- 20/20).
Psychosocial Development

• Understands simple, short commands. Expresses frustration when

restricted. Tantrums may begin. Enjoys simple games. Resists going
to bed. Able to form two or three word sentences. Recognizes
objects by name.
•
Nursing Considerations

• Set Limits. Maintain a regular bedtime schedule that parents have

established at home. Provide toys which allow placing objects into a
large container and taking them out again, such as large stacking
blocks. Push and pull toys encourage walking. Play simple games
such as rolling balls. Provide hazard-free play area. Begin weaning
from bottle.
•
TODDLER DEVELOPMENT
• Children between one and three years old are toddlers. At this age,
they display ritualistic behavior, such as a bedtime routine, which
gives them a sense of reliability and comfort. Although toddlers are
clumsy, they can walk without help, go up a staircase, jump in place,
hold a crayon, draw a circle, build a tower of two blocks, follow simple
directions and use short sentences.
Physical Development

• At one and a half years old, develops sphincter control. First upper and
lower molars appear around fifteen months. At age two, the toddler has
about sixteen teeth. Can crawl, run, jump, step backward and sideways. Can
climb stairs alone. At two and a half years old, the child’s weight is
approximately four times birth weight. Height increases by about four to five
inches per year. Learns to ride tricycle. Indicates when diaper needs to be
changed. Attempts to spoon-feed self. By age three feeds self completely.
•
• Normal Vital signs: Pulse = 110 (+/- 20), Respirations = 25 (+/- m5), Blood
Pressure = 99/60 (+/- 20/20).
Psychosocial Development

• Less fearful of strangers. Hugs and kisses parents. Begins to imitate

parents doing household chores. By age three, can use a noun, verb
and object in a three-word sentence. Has a vocabulary of over 300
words. Knows his/her own name. Shows pride in independence.
Uses “no” frequently. Tamper tantrums are less by age three. Likes to
do things without help. May begin to play with genitals as a process
of self-exploration. At age two, treats other children as objects and
cannot share possessions. By age three, is just beginning to
understand taking turns and sharing. Begins learning simple rules.
Nursing Considerations

• Provide toys like stuffed animals, dolls, musical toys, picture books,
stacking blocks, balls, low slide, toy telephone, hammer and
pegboard, pulling and pushing toys. Begin toilet training between
eighteen and twenty-four months old. Teach how to brush teeth.
Encourage parents to make first visit to the dentist. Use repetition to
enhance memory and understanding. Don’t expect child to
understand sharing.
Cont.
• Toddlers may be examined or have procedure done while sitting in
parent’s lap. Safety considerations include keeping crib rails up and
use of canopy cribs. Immunizations during this time period include
MMR (Measles, Mumps, Rubella) at fifteen months, fourth DPT and
third Polio vaccine at eighteen months. The fourth and final Hib
vaccine is given between twelve and fifteen months of age. A
Varicella immunization is also recommended at twelve to fifteen
months of age.
PRE SHOOLER DEVELOPMENT

• Preschool development occurs between the ages of three and five

years. This stage of child development is characterized by increased
refinement of fine motor skills, according to the book "Maternity and
Pediatric Nursing." The preschooler can throw a ball over his head,
skip, hop, stand on one foot for 10 seconds or longer, draw a person
with features, take care of his toileting needs and dress himself. He
can also have long conversations.
Physical Development

• Birth length doubles by age four. Nighttime bowel and bladder

control should be achieved by age three or four. Performs simple self-
care skills independently. Moves with speed and agility. Can lace
shoes and jump rope. By age five, can use pencil and scissors well.
•
• Normal Vital Signs: Pulse = 92 (+/- 5), Respirations = 25 (+/- 5), Blood
Pressure = 99/60 (+/- 10/10).
•
Psychosocial Development

• Can count to five. Knows primary colors. Understands concept of time

in terms of morning, nights, later and so on. Believes that whatever
moves is alive, such as car, hospital equipment. Thinking is concrete.
Enjoys helping with simple chores around the house. Unable to
comprehend the whole picture yet. Focuses on concrete details.
Becomes concerned about even the smallest injury. Egocentric in
thoughts and behavior. Engages in parallel play. Enjoys dolls, large
puzzles, taking toys apart, finger paints, hand puppets, large crayons,
play-doh, and moving toys, like pulling wagon.
•
Nursing Considerations

• Limited ability to judge distances and own strength predisposes

him/her to accidents. Preoperative teaching has little meaning, but
post-operative reteaching is meaningful and helpful. Band-Aid small
scratches and injection sites. Intrusive procedures, such as throat
swabs, rectal temperatures, blood drawing and IV starts are
distressing and should be done in a treatment room.
Cont.
• Preschool children are more cooperative during physical examinations
when they are allowed to actively participate, such as holding the
equipment, examining you as you examine them. Provide simple
explanations about the procedure.
SCHOOL-AGE DEVELOPMENT – middle childhood

• The school-age developmental stage is between six and 12 years old.

Children at this stage are more capable, independent and responsible,
according to the book "The Developing Person through Childhood and
Adolescence." The school-age child has greater motor skills and
begins to develop secondary sexual characteristics. Peer relationships
become important here and are typically with members of the same
sex.
Physical Development

• Greater muscle strength and coordination is gained. The child works

and plays hard but tires easily. Able to complete more complex self-
care skills. Starts to lose temporary teeth; acquires first permanent
teeth between six and eight years of age. Growth spurt occurs
between ten and eleven years with slow increase in height and rapid
increase in weight.
• Normal Vital Signs: Pulse = 80 (+/ 20), Respirations = 21 (+/- 5), Blood
Pressure = 103/60 (+/- 20/20).
Psychosocial Development

• Six to Eight Years of Age: Understands and uses classification systems.

Enjoys collecting favorite things. Learns to get along with peers.
Chooses best friends, usually of same sex. Will accept responsibility
for routine household tasks with occasional reminders. Likes to
participate in family decision-making. Likes rough and tumble play.
Insists on being first in everything. Craves attention.
Cont.
• Eight to Ten Years of Age: Curious about everything. Becoming peer-
oriented. Begins hero worship. Ashamed of failures. Interested in
schoolwork. Prefers companionship in play. May fight. Enjoys
making things. Can consider alternative solutions to simple problems.
Likes to belong to clubs. Fears the dark.
Cont.
• Ten to Eleven Years of Age: May leave clothes where they fall.
Prefers showers instead of baths. Needs constant reminder of
personal hygiene. Preoccupied with right and wrong. Respects
parents and their role. Has short outbursts of anger.
Nursing Considerations

• Six to Ten Years Old: Enjoys table games, board games, jump rope,
punching bags, roller skates, musical instruments, puppets, dolls,
painting, coloring, magic tricks, dancing, puzzles, records, tapes,
competition games, crafts, athletic sports, collecting things.
Cont.
• Ten to Eleven Years Old: Enjoys parties, talking on the phone, solitary
play, reading mystery and love stories, going to the movies.
Cont.
• School-age children often enjoy actively participating in their
examination and care. Allow them choices within acceptable limits.
Provide simple explanations. Remember that they are modest and
proud. Respect their modesty and keep them covered and screened
when possible. Do not embarrass them – especially in front of other
children.
• School-aged children are well coordinated and more safety-conscious.
Usually may ambulate freely. Keep bed in low position and side rails
down during day unless otherwise ordered.
ADOLESCENT DEVELOPMENT

• During the adolescent years, physical, mental, cognitive and sexual

changes occur. Girls are physically mature while boys might still be
maturing. Teenagers develop their identity and opinions. They have
concerns about their looks. Eating disorders may occur at this time.
Adolescents develop interest in members of the opposite sex and
spend more time with their friends and less time with their parents.
Physical Development

• A growth spurt takes place between ten and sixteen years old. Girls
retain more subcutaneous fat than boys do. Muscle development is
greater in boys than in girls.
•
• In females, breast development begins followed by the growth or
pubic hair and axillary hair. The average onset of menarche is
thirteen. Acne vulgaris may occur due to increased secretion of
androgens.
•
Cont.
• In males, pubic hair growth occurs around age thirteen. The penis,
scrotum, and testes become larger. The voice begins to deepen as the
larynx and vocal cords increase in size and strength.
•
• Normal Vital Signs: Pulse = 80 (+/- 20), Respirations = 20 (+/- 4),
Blood Pressure = 120/78 (+/- 20/10).
Psychosocial Development

• May have employment outside the home. Becomes independent and

self-directed in schedules and homework. Begins to explore career
options. Searches for new beliefs, resolves inconsistencies of old
beliefs and begins to form a personal philosophy of life. Frequent
mood swings. Sexual curiosity and fantasy are at a peak. Dating may
be a major activity. May be sexually active.
Cont.
• Engages in organized competitive sports. Uses slang within and
outside peer group. Peer-oriented. Begins to sever ties with parents.
Has fewer but closer friends. Enjoys shopping, driving cars, riding
motorcycles, reading books, and magazines, “hanging out” with
peers. Meal skipping is common. Snacking becomes a part of eating
pattern. Fast-food consumption is popular. May experiment with
smoking, alcohol, and drugs.
•
Nursing Considerations

• Adolescents consider themselves adults. Physical assessments are the

same as for an adult. Adolescents may become extremely self-conscious
and embarrassed. Provide privacy. Drape parts not being examined.
Adolescents need adequate explanations. Allow involvement in decisions
about care. Teach adolescent girls about self-breast examination.
STAGES OF GROWTH AND
DEVELOPMENT
• Stages are:
PRINCIPLES OF GROWTH AND
DEVELOPMENT
• 1) Development follows a pattern:
• Development occurs in orderly manner and follows a certain
sequence. For example, the human baby can stand before he walks
and can draw a circle before he can draw a square. He babbles before
he talks, he is dependent on others before he becomes self-
dependent.
cont.
• (2) Development proceeds from general to specific responses:
• It moves from a generalized to localized behavior. The newborn infant
moves its whole body at one time instead of moving only one part of
it. It makes random kicking with its legs before it can coordinate the
leg muscles well enough to crawl or to walk.
Cont.
• (3) Development is a continuous process:
• Development does not occur in spurts. Growth continues from the
moments of conception until the individual reaches maturity. It takes
place at slow regular pace rather than by ‘leaps and bounds’.
• Although development is a continuous process, yet the tempo of
growth is not even during infancy and early years, growth moves
swiftly. Later on, it slackens.
cont.
• (4) Different aspects of growth develop at different rates
• Neither all parts of the body grow at the same rate nor do all aspects
of mental growth proceed equally. They reach maturity at different
times.
Cont.
• (5) Most traits are correlated in development:
• Generally, it is seen that the child whose intellectual development is
above average is so in health size, sociability and special aptitudes.
Cont.
• (6) Growth is complex:
• All of its aspects are closely interrelated. The child’s mental
development is intimately related to his physical growth and its
needs.
Cont.
• (7) Growth is a product of the interaction of the organism and
environment:
• Among the environmental factors one can mention nutrition, climate
the conditions in the home, the type of social organization in which
individual moves and lives.
Cont.
• 8) There are individual differences in growth:
• Individual differences in growth are caused by differences in heredity
and environment.
Cont.
• (9) Growth is both quantitative and qualitative:
• These two aspects are inseparable. The child not only grows in ‘size’;
he grows up or matures in structure and function too.
Cont.
• (10) Development is predictable:

• It is possible for us to predict at an early age the range within which

the mature development of the child is likely to fall. But mental
development cannot be predicted with the same degree of accuracy.
FACTORS INFLUENCING GROWTH
AND DEVELOPMENT
• 1. Heredity - It is the process by which the features and characteristics
are passed from parents to the child before the child is born. Thus
features like the colour of the skin and eyes, the height, body build,
intellect and talents, etc., are all fixed and no one can change them
beyond a limit.
Cont.
• 2. Prenatal environment - This is the environment of the foetus in the
womb. If the mother gets poor nutrition, is emotionally upset or
smokes, drinks, or takes some medicine or suffers from certain
diseases, the growth of the child can be adversely affected.
Cont.
• 3. Nutrition - Proper nutrition is essential for the healthy
development of the child. A malnourished child’s growth may be
retarded or slow.
Cont.
• 4. Intelligence - Higher intelligence is associated with faster
development while lower intelligence is associated with retardation in
various aspects of development.
Cont.
• 5. Emotional climate of home - If there is a lot of discord/fights at
home or the child is not given enough love and attention or there is
physical/ mental abuse of the child, then the child’s development is
adversely affected.
cont.
• 6. Health of the child - If the child frequently falls sick, suffers from
some disorder, is disabled or has disturbed endocrine functioning, the
development is likely to suffer.
Cont.
• 7. Level of stimulation - The amount of stimulation the environment
provides to the child i.e., the opportunities for exploration of
environment, opportunities of interaction with other people, etc., all
influence the rate of development.
Cont.
• 8. Socio-economic status - It also influences the development by
deciding the kind of nutrition, stimulation, facilities, opportunities,
genetic endowment the child gets.
Cont.
• 9. Sex - All children follow the same sequence of development.
However, certain skills are faster in girls than in boys and some other
skills are faster in boys than girls. For example, language acquisition is
faster in girls and skills like jumping catching, throwing are faster in
boys. Sex is also a factor that decides the potential of a child in
physical development - boys grow up to be taller, heavier and more
muscular than girls.
•
Cont.
• Hormones.
• Hormones belong to the endocrine system and
influence the various functions of the body.
• Hormones secreted from different glands that are
situated in specific parts of body and control many
body functions
Cont.
• The proper functioning of these hormones play
a role in the normal physical growth and development
of children.
• If these hormone secreting glands do not function
properly, the children may suffer from growth
defects, obesity, behavioral problems and some
other diseases.
Cont.
• 11. Exercise.
• Children are encouraged to participate in different
physical activities as this will help them to gain their
muscle strength and put on bone mass.
• It has been observed that kids who engage in in
different physical activities attain developmental
milestones on time or sooner.
Developmental milestone

• A developmental milestone is an ability

that is achieved by most children by a certain age.
Developmental milestones can involve physical, social,
emotional, cognitive, and communication skills such
as walking, sharing with others, expressing emotions,
recognizing familiar sounds, and talking.
Types

• There are four basic categories for developmental milestones:

• 1. Physical milestones involve both large-motor skills and fine-motor
skills. The large-motor skills are usually the first to develop and include
sitting up, standing, crawling, and walking. Fine-motor skills involve
precise movements such as grasping a spoon, holding a crayon, drawing
shapes, and picking up small objects.
• 1. Cognitive milestones are centered on a child's ability to think, learn,
and solve problems. An infant learning how to respond to facial
expressions and a preschooler learning the alphabet are both examples of
cognitive milestones.
Types cont.
• 2. Social and emotional milestones are centered on children
gaining a better understanding of their own emotions and the
emotions of others. These milestones also involve learning how to
interact and play with other people.
• 3. Communication milestones involve both language and
nonverbal communication. A one-year-old learning how to say his first
words and a five-year-old learning some of the basic rules of grammar
are examples of important communication milestones.
Social and emotional milestones.

• While physical developmental milestones are often

some of the easiest to observe, the early years of a
child’s life are also marked by other
developmental milestones, including social
and emotional ones. In many cases, these
achievements can be difficult or even impossible
to identify directly since they often involve such things
as increased self-awareness.
Cont.
• Such skills can be tough to see, but they are just as
important as the physical milestones, especially
since social and emotional skills become so
important once a child enters school.
From Birth to 3 Months

• During the first three months, babies are actively

learning about themselves and the people around them.
Part of this skill-building involves:
• Looking at their own hands and sucking on fingers
• Looking at the part of their body that a
parent or caregiver is touching
Cont.
• Understanding how the legs and arms are attached
• Realizing that they are separate beings from those
around them
• Learning to be comforted and soothed by adults
• Enjoying social stimulation and smiling at people
• Responding to touch
From 3 to 6 Months

• Social interaction becomes increasingly important.

During this period of development, most babies begin to:
• Respond when their name is said
• Smile
• Laugh
• Play peek-a-boo
From 6 to 9 Months

• As babies get older, they may begin to show a

preference for familiar people. Between the ages
of six to nine months, most children can:
• Express a number of emotions including
happiness, sadness, fear, and anger
• Distinguish between familiar family and friends
and strangers
• Show frustration when a toy is taken away
• Respond to spoken words and gestures
From 9 to 12 Months

•As children become more social, they often begin to

mimic the actions of others. Self-regulation
also becomes increasingly important at the child
approaches one year of age.
•Most kids can:
• Hold a cup and drink with help
• Imitate simple actions
•Feed themselves small bites of food
Express anxiety when separated from parents or caregivers
From 1 to 2 Years

•From the age of one to two years, children often spend more time interacting with a
wider range of people. They also start to gain a greater sense of self-awareness. At this
stage, most can:
• Recognize their own image in the mirror
• Initiate play activities
• Play independently, often imitating adult actions
• Act pleased when the accomplish something
• Start trying to help, often by putting toys away
• Express negative emotions including anger and frustration
• Become more self-assertive and may try to direct the actions of others
From 2 to 3 Years

•During the toddler years, children become more and more creative and
confident. At two years old, most children begin to:
• Become aware that they are a boy or girl
• Begin to dress and undress themselves
•Demonstrate personal preferences about toys, food, and activities
• Start saying "No" to adults
• Enjoy watching and playing with other children
• Become defensive about their own possessions
• Use objects symbolically during play
• Often have rapid changes in mood
From 3-4 years
•Because three-year-old are becoming increasingly able to perform
physical actions, their sense of confidence and independence becomes
more pronounced at this age.
•During the third year, most children begin to:
• Follow directions
• Perform some tasks with little or no assistance
• Share toys with other kids
• Make up games and ask other children to join in
• Begin engaging in pretend play
From 4 – 5 years
• During the fourth year, children gain a greater awareness of their own
individuality. As their physical skills increase, they are more capable of
exploring their own abilities which can help lead to great confidence and
personal pride. At this age, most kids begin to:
• Understand basic differences between good and bad behavior
• Develop friendships with other kids
• Compare themselves to other children and adults
• Become more aware of other people’s feelings
• Enjoy dramatic, imaginative play with other children
• Enjoy competitive games
From 6-10 years
• Children ages 6 to 10 are more independent and physically active than
they were in the preschool years.
• They also are more involved with friends and are learning to think in
more complex ways.
• Progress in the major areas of development—physical, intellectual,
emotional, and social—is gradual. But the changes seen in the child
from one year to the next can be dramatic.

•
Physical change

• Strength and muscle coordination improve

rapidly in these years. Many children learn to throw,
hit a baseball, or kick a soccer ball.
Some children may even develop skills in more
complex activities, such as playing basketball or dancing.
Intellectual change

• From ages 6 to 10, your child develops a more mature

and logical way of thinking. He or she gradually
becomes able to consider several parts to a problem
or situation. This is a change from the simplistic
thinking of a preschooler.
Cont.
• Even though their thinking becomes more complex,
children in this age group still think in concrete terms.
This means they are most concerned with things that are "real"
rather than with ideas. In general, these things are those
that can be identified with the senses.
For example, actually touching the soft fur of a
rabbit is more meaningful to a child than
being told that an object is "soft like a rabbit."
Cont.
• Because they still can mostly consider only one
part of a situation or perspective at a time,
children of this age have difficulty fully
understanding how things are connected.
Emotional and social change

• When children enter school, they leave the security of

home and family. They become players on
the larger stage of school and friends.
Here, they learn some crucial skills—
including how to make friends—that
they can use for the rest of their lives.
Cont.
• Children's self-esteem, which is their sense of worth
and belonging, is fragile and can change rapidly
depending on what is happening around them.
At times, children of this age seem like
little adults as they march off to school
with backpacks full of responsibilities.
But at other times, they can be as unreasonable as toddlers.
Management of child

• Parents often overestimate their children's ability

to make good decisions. Children of this age
need firm and consistent rules that are explained
clearly and compassionately. Effective parents
are able to give their children enough independence
to learn from their successes and failures and at
the same time provide consistent direction and
unconditional support.
Cont.
• Try to check in with your child every day.
Ask him or her about the good and bad
things that happened.
And help child learn from those experiences.
From 15 – 17 Years

• Developmental Milestones
• This is a time of changes for how teenagers think,
feel, and interact with others, and how their bodies grow.
• Most girls will be physically mature by now,
and most will have completed puberty.
Cont.
• Boys might still be maturing physically during this time.
The teens might have concerns about their
body size, shape, or weight. Eating disorders
also can be common, especially among girls.
Cont.
• During this time, the teenager is developing
his/her unique personality and opinions.
Relationships with friends are still important,
yet the teenager will have other interests as
he/she develops a clearer sense of who he/she is.
This is also an important time to prepare for
more independence and responsibility;
many teenagers start working, and many
will be leaving home soon after high school.
Emotional/Social Changes

• Children in this age group might:

• Have more interest in romantic relationships and sexuality.
• Go through less conflict with parents.
• Show more independence from parents.
• Have a deeper capacity for caring and sharing and for developing
more intimate relationships.
• Spend less time with parents and more time with friends.
• Feel a lot of sadness or depression, which can lead to poor grades at
school, alcohol or drug use, unsafe sex, and other problems.
Thinking and Learning

• Children in this age group might:

• Learn more defined work habits.
• Show more concern about future school and work plans.
• Be better able to give reasons for their own choices, including about
what is right or wrong.
 Positive Parenting Tips
• Talk with teen about her concerns and pay attention to any changes in
her behavior. Ask her if she has had suicidal thoughts, particularly if
she seems sad or depressed. Asking about suicidal thoughts will not
cause her to have these thoughts, but it will let her know that you
care about how she feels. Seek professional help if necessary.
• Show interest in the teen’s school and extracurricular interests and
activities and encourage him to become involved in activities such as
sports, music, theater, and art.
• Encourage teen to volunteer and become involved in civic activities in
her community.
• Compliment your teen and celebrate his efforts and
accomplishments.
• Show affection for your teen. Spend time together doing things you
enjoy.
• Respect your teen’s opinion. Listen to her without playing down her
concerns.
Cont.
• Encourage teens to develop solutions to problems or conflicts. Help
teenager learn to make good decisions. Create opportunities for him to
use his own judgment, and be available for advice and support.
•• If a teenager engages in interactive internet media such as games,
chat rooms, and instant messaging, encourage her to make good
decisions about what she posts and the amount of time she spends on
these activities.
•• For teenagers who are working, use the opportunity to talk about
expectations, responsibilities, and other ways of behaving respectfully in
a public setting.
••
Cont.
• Talk with the teenager and help him plan ahead for difficult or
uncomfortable situations. Discuss what he can do if he is in a group
and someone is using drugs or under pressure to have sex, or is
offered a ride by someone who has been drinking.
• Respect the teen’s need for privacy.
• Encourage adolescents to get enough sleep and exercise, and to eat
healthy, balanced meals.
Questions?
End