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PRESENTED BY:

MOHAMMED HAMZA BAIG

Reg. NO: 12Y01T0013

PHARM.D INTERN.

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SEMINAR ON

DEVELOPMENT OF MILESTONES

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Development

Development is defined as “acquisition of qualitative and quantitative skills”. It depends on maturation and myelination of brain. It is a continuous process.

Development of the child is assessed in the following four areas:

1. Gross motor development: It pertains to control of the child over his body and is observed in ventral suspension, supine, prone, sitting and standing positions.

2. Fine motor and adaptive development: It pertains to fine coordination of eyes, hand-eye, and hand-mouth, and skills for manipulation with hands.

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3. Personal/social development: It pertains to interpersonal and social skills like social smile, mimicry, waving “bye-bye”, etc.

4. Language development: It pertains to hearing, sounds, understanding and true speech.

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Developmental milestones: the acquisition of important developmental skills

  • Median age – when half the population acquire a skill; serves as a guide to normal pattern of development
  • Limit age – when a skill should have been acquired; further assessment is indicated if not achieved.

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Gross motor

  • Head/neck holding- 3 months
  • Sitting (with support)- 5 months
  • Sitting (without support)- 7-8 months
  • Standing (with support)- 9 months
  • Walking with support- 10 months
  • Crawling/creeping- 11 months
  • Standing (without support)- 12 months
  • Walking (without support)- 13 months
  • Running- 18 months
  • Climbing upstairs- 24 months
  • Riding cycle 36 months

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Gross motor development median ages

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Fine motor

  • Grasping a rattle (when placed in hand)- 4 months
  • Reaching out for a bright object (intentional reaching)- 5 months and grasps it with both hands (bidextrous grasp)
  • Holding an object with crude grasp from palm (palmar grasp) -7 months
  • Holding a small object between index finger and thumb- 9 months (pincer grasp)

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Fine motor development

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Personal/social

  • Social smile- 4-8 weeks
  • Recognition of mother- 3 months
  • Smilig at mirror image- 6 months
  • Waving “bye-bye”- 9 months
  • Playing a simple ball game- 1 year
  • Knowing gender- 3 years

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Personal or social development

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Language

  • Turning head to sound (rattle, ball)- 1 month
  • Cooing- 3 months
  • Monosyllables (ma, pa, ba)- 6 months
  • Bisyllables (mama, papa, baba)- 9 months
  • Two words with meaning- 1 year
  • Simple sentence- 2 years
  • Telling a story- 3 years
  • Account of recent events- 4 years

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Language, speech and hearing development

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Fields of development with limit age

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Regression of milestones:

  • Child loses previously acquired skills
  • Loss of speech, hearing and locomotion
  • Seizures
  • Feeding impairment
  • Intellectual impairment.

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References

  • Tom Lissauer, Graham Clayden. Text book of pediatrics. 4th edition. London: Elsevier publisher, 2012.
  • Suraj Gupte. The short text book of pediatrics. 11th edition. India: Jaypee brothers medical publisher, 2009.

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