17 December, 2004ACADS Milestone 1. 17 December, 2004ACADS Milestone 1 Presentation Summary.
Milestone Final (1)
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Transcript of Milestone Final (1)
Infant Milestones
Babies grow at an amazingly fast rate during their first year of life. In
addition to babies’ physical growth in height and weight, babies also
go through major achievement stages, referred to as developmental
milestones. Developmental milestones are easily identifiable skills
that the baby can perform, such as rolling over, sitting up, and
walking. These milestones are usually classified into 3
categories: motor development, language development, and
social/emotional development.
Babies tend to follow the same progression through these milestones; however, no two babies
go through these milestones at exactly the same time. Babies also spend different amounts of
time at each stage before moving on to the next stage. A health care provider monitors babies
as they progress through these developmental milestones. Contact a health care provider if any
concern about baby’s development arises.
Physical Development
The rapid changes seen during infancy will never be encountered again throughout the
life span. As the body matures, skill development progresses in an orderly fashion to enable the
infant to respond to and cope with the world. Gross and fine motor skills develop in a
cephalocaudal (head to toe) and proximal-distal (central to peripheral) fashion; gross motor
abilities develop before fine motor abilities.
The infant’s physical growth is influenced by genetics, the environment, ethnic
background and biology. Physical growth patterns include weight, height and head
circumference changes. The infant’s growth measurements should be plotted on a growth chart
and, overtime, compared to the infant’s own growth curve.
Weight and Height
During the first 6 month of life, the infant’s birth weight typically doubles. The
approximate weight gain is 1.5lb per month or 5-7 oz per week. By the age of 12 months of age,
the infant’s birth weight will be tripled.
Height increases during the first 6 months by approximately 1 inch per month. The rate
of growth in height slows to approximately 0.5 inch (1.5cm) per month by 12 months of age,
resulting in almost a 50% increase in height from the birth length.
Head Growth
The size of the head changes rapidly during infancy, reflecting rapid brain growth. By the
age of 12 months, the infant’s brain will be two-thirds the size of an adult’s brain. During the first
6 months of life, head circumference will increases by approximately 0.5inch (1.3cm) per month.
During the second 6 months of life, head circumference will slow to approximately 0.25inch
CRITERIA:
Format 5%
Promptness 5%
Neatness 10%
Content 70%
References 10%
-----------------
TOTAL : 100%
(0.6cm) per month. As the head grows, the fontanels gradually close; the posterior fontanel
closing by 2 months of age and the anterior fontanel closing by 12-18 months of age.
Motor Development
Motor development is strongly related to physical, cognitive and social development.
Motor growth includes gross and fine motor development, which provides the infant with the
means and freedom to explore the environment.
Gross Motor
Gross motor development is the ability to use large muscles to maintain balance and
postural control or locomotion.
AGE GROSS MOTOR SKILL
2-3 months Some head lag when pulled to sitting position
Holds head up and supports weight on forearms when prone
Some head bobbing while supported in sitting position
Rolls from abdomen to back
Tonic neck and Moro reflexes disappearing
4-6 months Good head control with no head lag, holds chest and abdomen
up with weight supported by hands while in prone position
Sits with support
Rolls from back to abdomen
Bears weight in standing position with support
7-8 months Sits alone without support
Bears weight with some support
9-12 months Moves from prone to sitting to standing position without
assistance
Stands alone without support
Goes from crawling to creeping to cruising
Attempts to walk alone
Fine Motor
As development progresses, the infant begins to utilize the hands and eyes to explore
and manipulate the environment. Fine motor development is the ability to coordinate hand-eye
movement in an orderly and progressively manner.
AGE FINE MOTOR SKILLS
2-3 months Follows object past midline
Holds hands open
Regards own hands and fingers when held in front of face
Places hand in mouth
Briefly reaches at a dangling object
4-5 months Reaches for objects beyond grasp
Looks from object to hand and back again
Places object in mouth
Uses whole hand to grasp object
Plays actively with hands and feet
6-7 months Holds objects securely and bangs them together
Actively drops objects
Transfers object between hands
8-9 months Pincer grasp beginning
Releases object at will
Dominant hand preference emerging
10-12 months True pincer grasp present
Can self-feed finger foods
Can place small objects into a container
Can remove small objects from a container
Can hold and mark with a crayon
Can turn multiple pages in a book
Psychosexual Development
Psychosexual development is based on the individual’s need to seek pleasure. The
individual must be able to balance pleasure seeking with societal expectations. According to
Freud’s Theory, the infant is in the oral stage of development, during which the need for
pleasure dominates life. Oral stimulation or sucking is the central focus of this stage. According
to Freud, feeding or nutritive sucking becomes the most important source of pleasure and
satisfaction.
Psychosocial Development
The psychosocial development of an infant, as defined by Erikson, is centered on the
concept of trust versus mistrust. According to Erikson, trust is developed when the basic needs
of feeding, clothing and comforting are met by the caretakers. If these needs are not met, the
infant will develop a mistrust of others. The quality of the caregiver-infant interaction while
providing care also plays a major role. If the caregiver consistently demonstrates nurturing
behaviors such as talking, playing, smiling, dressing, and comforting, the infant will develop a
strong sense of trust. if the infant’s needs are met in a consistent manner by the caregiver or
alternative child care provider, trust in the self as well as trust in others and the surrounding
environment will develop. If not, the infant will eventually develop a sense of mistrust.
Cognitive Development
According to Piaget, an infant is in the sensorimotor stage of cognitive development
when knowledge is acquired about an object through interaction with that object and use of the
senses. The major task for the infant, according to Piaget, is object permanence, where the
infant learns an object is not an extension of the self and continues to exist even when it cannot
be seen.
Substage Description
1 The newborn learns about the world through repetitive use of
involuntary reflexes such as rooting, sucking or crying will provide the
infant with cause-and-effect experiences
2 Primary circular reactions occur between 1-4 months of age; the
infant’s random movements become voluntary actions. The infant
becomes an active observer of the world but continues to be
dominated by the need for pleasure
3 Between 4-8 months of age, secondary circular reaction progresses.
This is characterized by becoming more aware of the surrounding
environment and mastery of voluntary actions. The infant’s actions are
more intentional and not solely directed by pleasure, as the infant
learns through repetitive actions to create interesting sights and
sounds and begins to focus on the effects of the actions
4 The infant applies newly mastered skills to new experiences during 8-
12 months called coordination of secondary schema and is able to put
several events together to accomplish an end result
Language Development
Communication enables the infant to express needs, emotions and attitudes and
involves central nervous system maturation, cognitive abilities and social interaction. The
infant’s initial means of communication is through crying and smiling. The infant’s ability to
communicate through language follows a predictable course. As maturation progresses so do
the language abilities. During infancy, receptive language (the ability to understand words) is
greater than expressive language (the ability to speak words). By the end of the first year, the
infant can say several words such as “da-da” and “ma-ma” as well as understand simple
commands such as “bye-bye”, “poin your belly” and “no-no”.
AGE EXPRESSIVE SKILLS RECEPTIVE SKILLS
Birth-2months Crying
Comfort sound with feeding
Coos
Vocalizes to familiar voice
Sounds elicit startle reflex
Turns and looks for
sounds
Prefers human voice
3-6 months Vocalizes during play and pleasure
Squeals
Laughs aloud
Less crying
Uses vowels and consonant
sounds that resemble syllables
(ma, mu, ba, ga, ah, da)
Watches speaking mouth
Shifts gaze between
sounds
Understands own name
Uses sound to get
attention
7-9 months Increases vowel and consonant
sounds
Uses two-syllable sounds (baba,
dada)
Talks along with others
Associates words with
activity
Responds to simple
commands (“no-no”)
Understands familiar
words
10-12 months Says “mama” and “dada” to identify
caregivers
Repeats sounds made by others
Makes intentional gestures
Learns 3-5 words
Recognizes family
members’ names
Recognizes objects by
name
Understands simple
commands (say “bye-
bye”)
Health Promotion
The health status of an infant, a major concern for caregivers, is based on the ability to
adapt to rapid changes. Therefore, the caregiver needs to know the expected physical,
emotional and developmental growth patterns of an infant.
Temperament
Temperament is the way a child interacts with the surrounding environment. Children are
thought to be genetically endowed with specific temperamental characteristics, which, when combined
with caregiver’s personality, produce a characteristic pattern of social interaction between the child and
the environment.
TYPE CHARACTERISTICS
Easy Easy going and adapts rapidly to stimuli
Has an overall positive mood
Likes to be around people
Sleeps and eats well
Has regular and predictable behaviors
Difficult Adapts slowly to stimuli
Has an overall negative mood
Requires a structured environment
Likes people but can do well alone
Seems to be in constant motion
Has irregular patterns of behavior
Slow-to-
warm-up
Adapts slowly to stimuli but is watchful
Quietly withdraws and usually moody
Primarily a loner and socially shy
Oversensitive and slow to mature
Primarily inactive
Reacts passively to changes in routine
Sleeping Pattern
Infants have variable sleep patterns that are influenced by temperament, satisfaction with
feelings, caregivers’ responses to periodic awakenings and environmental conditions. As the child
matures, the sleep-wake cycle evolves into a pattern of being awake during the day and asleep at night.
AGE AWAKE DAY SLEEP NIGHT SLEEP
Newborn 7.5 hours 8 hours 8.5 hours
1 month 8.5 hours 6.75 hours 8.75 hours
4 months 9 hours 4.5 hours 10.5 hours
6 months 9.25-9.75 hours 3.25-4 hours 11 hours
1 year 10.25 hours 2.25 hours 11.5 hours
Physical Development
Despite the many factors, such as genetic background, environment, health, gender and
race that affect growth in the first year of life, the healthy infant progresses in a predictable
pattern. By the end of the year, the dependent infant who at 1 month of age had no teeth and
could not roll over, sit or stand blossoms into an emerging toddler with teeth who can sit alone,
stand and begin to walk alone. The growth seen in the prenatal development of the fetus
continues.
Head and Skull
At birth, an infant’s head circumference averages about 13.75 inches (35cm) and is
usually slightly larger than the chest circumference. The chest measures about the same as
the abdomen at birth. At about 1 year of age, the head circumference has grown to about 18
inches (47cm). the chest also grows rapidly, catching up to the head circumference at about
5-7 months of age. From then on, the chest can be expected to exceed the head in
circumference.
Fontanels and Cranial Sutures
The posterior fontanel is usually closed by the 2nd or 3rd month of life. The anterior
fontanel may increase slightly in size during the first few months of life. After the 6 th month it
begins to decrease in size, closing between the 12th and the 18th months. The sutures
between the cranial bones do not ossify until later childhood.
Eruption of Deciduous Teeth
Calcification of the primary or deciduous teeth starts early in fetal life. Shortly before
birth, calcification begins in the permanent teeth that are the first to erupt in later childhood.
The first deciduous teeth usually the lower central incisors, usually erupt between 6-8
months of age.
Neuromuscular Development
As the infant grows, nerve cells mature and fine muscles begin to coordinate in an
orderly pattern of development. Average rates of growth and development are useful for
purposes of making comparisons. Few landmarks call for special attention, and their absence
may indicate the need for additional environmental stimulation.
Psychosocial Development
The give-and-take of life is experienced by the infant who actively seeks food to fulfill
feelings of hunger. The infant begins to develop a sense of trust when fed on demand.
However, the infant eventually learns that not every need is met immediately on demand. Slowly
the infant becomes aware that something or someone separate from oneself fulfills one’s needs.
Gradually, as the result of the loving care of the family caregivers, the infant learns that the
environment responds to desires expressed through one’s own effort and signals. The infant is
now aware that the environment is separate from self.
Motor Development
Gross Motor
Birth to 4 weeks, able to catch and holds objects in sight that crosses his visual
fields. Can turn head from side to side when lying in a prone position and when in prone
position, can move extremities in a crawling position. At 6 weeks, tries to raise shoulders
and arms when stimulated and can hold head up when in prone position. When the infant
reach 10-12 weeks, he has no Moro reflex anymore and has symmetrical body positioning.
At 16 weeks, he plays with his hands and brings objects to his mouth. He can balance his
head and body for short periods in sitting position. At 20 weeks, he is able to sit up, can roll
over, bear weight on legs when held in a standing position and is able to control head
movements. When he reaches 24 weeks, his Tonic neck reflex disappears and he can now
sit alone in a high chair and can now roll over and then back to abdomen. At 28 weeks, he
can reach without visual guidance and can lift head up when in supine. At 32 weeks, he can
now crawl around and can pull toy towards himself and when the infant reaches 40 weeks,
he can now stand alone and can begin to walk alone.
Fine Motor
From birth to 4 weeks, grasp reflex is very strong and can flex the hands. At 6
weeks, can now open his hands and less flexions are noted. At 10-12 weeks, no grasp
reflex anymore, pulls on clothes, blanket but does not reach for them. At 16 weeks, he can
now grasp objects with 2 hands and eye-hand coordination begins. When the infant reach
20 weeks, he can now hold one object while looking for another one and can grasps
voluntarily and brings them to his mouth. At 24 weeks, can hold bottle well and he tries to
retrieve a dropped article. At 28 weeks, can hold cup, can transfer objects from one hand to
the other. At 32 weeks, pincer grasp is developed and can stand up while holding on. Lastly
when the infant reaches 40 weeks to 1 year, then the infant can holds a tool on one hand
and works on it on the other hand. Can now put toys in a box after demonstration and can
now hold a crayon to scribble on a paper.
AGE PHYSICAL PERSONAL- LANGUAGE COGNITION
SOCIAL
Birth-
4weeks
Weight gain of
5-7oz (150-
270g) per week
Height gain of
1” per month for
the first 6
months
Head ½ “ per
month
Moro, Babinski,
rooting, and
tonic neck
reflexes present
Some smiling
Begins
Erikson’s stage
of “trust vs.
mistrust”
Cries when
upset
Makes
enjoyment
sounds during
meal times
At 1 month, sucking activity
with associated
pleasurable sensation
6weeks Tears appear Smiling in
response to
familiar stimuli
Cooing
predominant
Smiles to
familiar voices
Babbling
Primary circular reactions
Begins to repeat actions
10-12
weeks
Posterior
fontanel closes
Aware of new
environment
Less crying
Smiles at
significant
others
Makes noises
when spoken
to
Beginning of coordinated
responses to different kinds
of stimuli
16
weeks
Moro, rooting
and tonic neck
reflexes
disappear;
drooling begins
Responds to
stimulus
Sees bottle,
squeals, laughs
Aware of new
environment
and shows
interest
Laughs aloud
Sounds “n”,
“k”, “g” and “b”
Likes social situations
Defiant, bored if unattended
20
weeks
May show
signs of teeth
Smiles at self in
mirror
Cries when
limits are set or
when objects
are taken away
Cooing noises
Squeals with
delight
Visually looks for an object
that has fallen
24
weeks
Birth weight
doubles; weight
Likes to be
picked up
Makes sounds
“guh”,”bah”,
Secondary circular reactions
Repeats actions that affect
gain slows to 3-
5 oz(90-150g)
per week
Height slows to
½ “ per month
Teething
begins with
lower central
incisors
Knows family
from strangers
Plays “Peek-a-
Boo”
Knows likes and
dislikes
Fear of
strangers
Sounds “p”,
“m”, “b” and “t”
are
pronounced
Babbling
sounds
an object
Beginning of object
permanence
28
weeks
Lower lateral
incisors are
followed in the
next month by
upper central
incisors
Imitates simple
acts
Responds to
“no”
Shows
preferences
and dislikes for
food
Babbling
decreases
Duplicates
“ma-ma” and
“pa-pa” sounds
32
weeks
Teething
continues
Dislikes diaper
and clothing
change
Afraid of
strangers
Fear of
separating from
mother
Combines
syllables but
has trouble
attributing
meaning to
them
40
weeks- 1
year
Birth weight
tripled; has 6
teeth; Babinski
reflex
disappears
Anterior
fontanel closes
between now
and 18 months
Does things to
attract attention
Tries to follow
when being read
to
Imitates parents
Looks for objects
not in sight
Words emerge
Says “da-da”
and “ma-ma”
with meaning
Coordination of secondary
schemes; masters barrier to
reach goal, symbolic
meanings
Nutrition
During the first year of life, the infant’s rapid growth creates a need for nutrients greater
than at any other time of life. The Academy of Pediatrics Committee on Nutrition has endorsed
breast-feeding as the best method of feeding infants
Age 1-3 Months
Between 1-3 months of age, babies begin the transformation from a totally dependent newborn
to active and responsive babies. Many of the newborn reflexes are lost by this age. Babies’
vision changes dramatically and they become more aware and interested in their surroundings.
They might follow moving objects, recognize familiar objects and people at a distance, and start
using their hands and eyes in coordination. At this age, babies usually turn toward familiar
voices and smile at their parent’s faces or other familiar faces. They also begin to coo (make
musical vowel sounds, such as ooo or aaa).
The neck muscles become stronger during these first few months. At first, babies can only hold
their heads up for a couple of seconds while on their stomachs. The muscles are strengthened
each time the head is held up. By age 3 months, babies lying on their stomachs can support
their heads and chests up to their forearms.
Arm and hand movement develops fast during this stage. What was once a tight, clenched fist is
now an open hand grabbing and batting at objects. Babies explore their hands by bringing them
in front of their face and putting them in their mouths.
By the end of this period, most babies have reached the following milestones:
PHYSICAL DEVELOPMENT
1 MONTH OLD:
The child gains 150-210 g weekly for the first 6 months. The height increases 2.5 cm
monthly for the first 6 months. And head circumference increases by 1.5 cm for first 6 months.
Primitive reflexes are present and strong. Obligatory nose breathing is noted.
2 MONTHS OLD:
Posterior fontanel is closed. And crawling reflex disappears.
3 MONTHS OLD
Primitive reflexes fading.
GROSS MOTOR
1 MONTH OLD:
Assumes flexed position neither with pelvis high but knees nor under abdomen when prone.
Can turn his head from side to side when in prone position. In sitting position, has uniformly
rounded back, absence of head control.
2 MONTHS OLD
Limbs relax and stretch partially; lifts head 45 degrees; head wobbly while held sitting;
muscle twitches lessen; hands partially unfold; swipes aimlessly; holds rattle briefly.
3 MONTHS OLD
Stretches limbs all the way out; holds head about 45 degrees; pushes down on legs
when feet are placed on a firm surface; supports upper body with arms when lying on stomach;
hands open, makes swiping reaches but still misses more than hits; holds and shakes rattle
longer; grabs clothing and hair of others; sucks fingers and fists; plays with hands.
FINE MOTOR
1 MONTH OLD
Baby’s Hands are predominantly closed. Their grasp reflex is strong. And they clench
their hand when they are contact with rattle.
2 MONTHS OLD
Hands are often open and grasp reflex is fading.
3 MONTHS OLD
Baby holds rattle but will not reach for it. Grasp reflex is absent. Holds kept loosely open.
Clutches own hand and pulls at blanket and clothes.
SENSORY DEVELOPMENT
1 MONTH OLD
They can able to fixate on moving object in range of 45 degrees when held at distance of
20-25 cm. Their visual acuity approaches 20/100. They can follow light to midline. And the keep
quit when they hear voice.
2 MONTHS OLD
Binocular fixation and convergence to near objects is beginning. When in supine position
the baby follows dangling toy from side point beyond midline. Visually searches to locate
sounds. And turns head to side when sound is made at level of ear.
3 MONTHS OLD
Follows object to periphery about 180 degrees. Locates sounds by turning head to side
and looking in same direction. And begins to have ability to coordinate stimuli from various
sense organ
Vocalization
1 MONTH OLD
They cry to express displeasure. They make small throaty sound. And makes comfort
sounds during feeding.
2 MONTHS OLD
They vocalize distinct from crying. Crying becomes differentiated. They make coos
sound. And they vocalize to familiar voices.
3 MONTHS OLD
They sequels loud to show pleasure. They make babbles and they chuckles. They
vocalize when someone smiles at them. And they have less crying during periods of
wakefulness.
SOCIALIZATION
1 MONTH OLD
They watches their parents face intently as they talk to them.
2 MONTHS OLD
They already demonstrate social smile in response to various stimuli.
3 MONTHS OLD
They display considerable interest in the surroundings. They cease crying when parents
enter the room. They can already recognize familiar faces and objects such as feeding bottle.
And shows awareness of strange situations.
Age 4-7 Months
From age 4-7 months, babies learn to coordinate their new perceptive abilities (including vision,
touch, and hearing) and motor skills such as grasping, rolling over, sitting up, and may be even
crawling. Babies now have more control over what they will or will not do, unlike earlier months
in which they mainly reacted by reflex. Babies will explore toys by touching them and putting
them in their mouth instead of just looking at them. They can also communicate better and will
do more than simply cry when they are hungry or tired or when they want a change in activity or
a different toy.
By this time, babies have developed a strong attachment for their parents and they may show a
preference for their primary caretakers. However, babies at this age usually smile and play with
everyone they meet.
Once babies can lift up their heads, they’ll push up using their arms and arch their back to lift up
the chest. These movements help strengthen the upper body and are preparation for sitting up.
They may also rock while on their stomachs, kick their legs, and swim with their arms. These
movements are necessary for rolling over and crawling. By the end of this period, babies should
be able to roll over from stomach to back and back to stomach and probably are able to sit
without any support.
By age 4 months, babies can easily bring toys to their mouth. They use their fingers and thumb
in a clawlike grip to pick up objects. By age 6-8 months, they can transfer objects from hand to
hand, turn them from side to side, and twist them upside down. Babies also discover their feet
and toes during this stage.
Babies’ range of vision is apparent as they concentrate and focus on objects and follow
movements. Babies like increasingly complex patterns and shapes. They also like looking at
themselves in a mirror. Babies continue to babble, but now they raise and lower their voice as if
asking a question or making a statement.
By the end of this period, most babies have reached the following milestones:
PHYSICAL DEVELOPMENT
4 MONTHS OLD
Moro, tonic neck, and rotting reflexes disappear.
5 MONTHS OLD
Beginning signs of tooth eruption. And their birth weight doubles.
6 MONTHS OLD
Their growth weight may begin to decline. They weight gain 90-150 weekly for 6 months.
Height gain 1.25cm monthly for 6 months. They may begin teething with eruption of 2 lower
central incisors. They may chew and bite.
7 MONTHS O.LD
The eruption of upper central incisors
GROSS MOTOR
4 MONTHS OLD
Stands with support; sits propped on arms and lifts head 90 degrees and scans 180
degrees; rests on elbows; rolls tummy-to-side; uses two-handed embracing reach; accurately
gathers dangled toy; explores clothing; uses mitten-like grasp.
5 MONTHS OLD
its propped with pillows on floor or chair; stands, holding on for balance; rolls
purposefully from tummy-to-back; rocks on tummy; assumes push-up position; wiggles forward;
cranes neck forward to see; reaches one hand with good aim; transfers toys from hand to hand
or mouth; begins block play.
6 MONTHS OLD
Sits briefly by self; sits in high chair; stands briefly while leaning on furniture; rolls over
both ways; digs in with toes and hands to move toward toy; reaches precisely; points at toys;
manipulates blocks; uses whole hand to pick up small objects with thumb and fingers.
7 MONTHS OLD
When in supine position they lift head off surface. When they are in a prone position
they bears weight on 1 hand. And they bears full weight on their feet.
FINE MOTOR
4 MONTHS OLD
They tries to reach object with hand but overshoot. They grasp object with both hand.
They play rattle placed on their hand, shakes it but can’t pick it up if dropped. Can carry object
to mouth.
5 MONTHS OLD
They are able to grasp object voluntarily. They use palmar grasp. Plays with toes. Takes
object directly to mouth. And they holds 1 cube and regarding the 2nd one.
6 MONTHS OLD
They resecure a dropped object. They drop 1 cube when another is given. Grasp and
manipulates small objects. Holds bottle. Grasp feet and pulls to mouth.
7 MONTHS OLD
They transfer object from one hand to another. Has unidextrous approach and grasp.
Holds 2 cubes momentarily. They bangs cubes on the table. They rakes at small objects.
SENSORY DEVELOPMENT
4 MONTHS OLD
Baby was able to accommodate to near objects. Binocular vision is fairly well
established. Can focus on a 1.25cm-block. Beginning eye-hand coordination.
5 MONTHS OLD
They visually pursue dropped objects. They are able to sustain visual inspection of an
object. And they can localize sound made below their ear.
6 MONTHS OLD
they adjust posture to see objects. Prefers more complex visual stimuli. They can
localize sounds made above ear. They will turn head to side, then look up and down.
7 MONTHS OLD
they can fixate on very small objects. They respond to their own name. Localize sound
by turning head in curving arch. They begin awareness of depth and space. They have rate
preferences.
VOCALIZATION
4 MONTHS OLD
They make consonant sounds like n,k,g,p,b. They laugh loud. And their vocalization
change according to their mood.
5 MONTHS OLD
They squeals. They makes cooing vowel sounds interspersed with consonant sound.
6 MONTHS OLD
They begin to imitate sounds. Vocalize to toys and mirror image. And they take pleasure
in hearing their own sound.
7 MONTHS OLD
They produce vowel sound and chained syllables like dada, mama, papa. They can
vocalize distinc vowel sounds. They take when other is talking.
SOCIALIZATION
4 MONTHS OLD
Forms mental images of what to expect when given a cue; becomes aware that people
and things have labels, such as cat or mommy or daddy.
5 MONTHS OLD
Learns which sounds and gestures get a response; shows decision-making expressions
during hand play; figures out objects and changes hand position to touch objects.
6 MONTHS OLD
Shows more intentionality during play, such as trying to figure out how to pick up a third
object with one already in each hand.
7 MONTHS OLD
Increase fear to stranger; show sign of fretfulness when parents disappears. Imitates
simple acts and noises. Tries to attracts attention by coughing. They plays pick-a-boo. Dislikes
dressing and diaper change.
Age 8-12 Months
By age 8 months, most babies can sit up without support. They also figure out how to roll down
to their stomachs and return to a sitting position again. Some babies are in constant motion;
they’ll arch their necks and look around while on their stomachs and grab at their feet or objects
while on their backs. All this activity is preparing them for crawling, which is usually mastered
between 7-10 months. Crawling is important for the development of integrated communication
between the 2 sides of thebrain. Some babies never crawl but rather scoot on their bottoms or
move on their stomachs, like an army crawl.
Babies become increasingly more mobile during this stage; now is the time to childproof so
baby can explore and discover without the possibility of injury. Baby gates are important to block
off stairs or rooms that could be dangerous (such as bathrooms).
After crawling is mastered, babies begin to pull themselves up to a standing position. They then
begin to take some steps while holding on to something for support. This will change into
cruising around the furniture. As their balance improves, babies may gradually take a few steps
without holding on. Many babies’ first steps are taken around 12 months, but earlier or later than
this is completely normal.
By the end of this stage, babies begin to use the pincer grasp, using the thumb and first or
second finger to pick up small objects. As babies learn how to open fingers, they are able to
drop and throw things. Babies also more thoroughly investigate objects by shaking them,
banging them, and moving them from hand to hand. Babies are interested in objects with
moving parts, such as wheels and things that open and close. They also like to poke their
fingers through holes.
Babies also show a lot of growth in their language development during this period. They begin
to make recognizable syllables like “ma” or “da,” which eventually turn into “mama” or
“dada.” They can also imitate speech sounds they hear others make. By age 12 months, many
babies say at least one word (other than mama and dada) clearly. They understand the
meaning of no and begin to follow simple commands. Babies communicate nonverbally by
pointing, crawling, or gesturing toward desired objects. The can also initiate and play gesture
games, such as peek-a-boo and pat-a-cake.
Babies learn object permanence, the concept that an object still exists when taken out of their
sight, during this stage. For example, if a toy is hidden under a blanket, babies will pick up the
blanket and search for it. Babies also learn that objects have functions besides being just
something to chew on or bang with (such as a hair brush or phone).
Separation anxiety and stranger anxiety usually begin during this period and are a normal part
of babies’ emotional development. Separation anxiety occurs when parents leave a babies’
sight, resulting in great distress with fussing and crying. Separation anxiety usually peaks
between age 9-18 months and fades before their 2-year birthday. Stranger anxiety is a reaction
of distress with an infant encounters a stranger.
By the end of this period, most babies have reached the following milestones:
PHYSICAL DEVELOPMENT
8 MONTHS OLD
Begins to show regular pattern in bladder and bowel elimination. And parachute reflex
appears.
9 MONTHS OLD
Eruption of upper lateral incisor may begin.
10 MONTHS OLD
Labyrinth-righting reflex is strongest when infant is in prone position or supine position.
And able to raise head.
11 MONTHS OLD
Eruption of lower lateral incisor may begin.
12 MONTHS OLD
The birth weight is tripled. The birth length is increased by 50%. Head and chest
circumference is equal with a 46 cm. anterior fontanel is almost closed. Landau reflex is fading.
Lumbar curves develops; lordosis evident during walking.
GROSS MOTOR
FINE MOTOR
8 MONTHS OLD
Reads objects at will. Rings bell purposely. Returns two cubes regarding the 3rd one.
And secures object by pulling on string.
9 MONTHS OLD
Use thumb and index finger in cube pincer grasp. Preference for use of dominant hand
now evident. And compares two cubes by bringing them together.
10 MONTHS OLD
Crude of an object release beginning. And grasp bell by handle.
11 MONTHS OLD
They explore object more toughly. Has an already neat pincer grasp. They drops object
deliberately for it to be picked up. Puts one object after another into container. And able to
manipulate object to remove it from tight-fitting enclosure.
12 MONTHS OLD
Releases cube in cup. Attempts to build 2-blocks tower but fails. Tries to insert pellets
into bottle but fails. Can turn pages in a book, many at a time.
REFERENCES:
Adele Pillitteri (2005) Fifth Edition, Volume 2, Maternal & Child Health Nursing: Care of
the Childbearing & Childrearing Family
Wong (2007) Nursing Care of Infants and Children
Hatfield, N (2008) 7th Edition, Broadribb’s Introductory Pediatric Nursing
Potts, N., & Barbara, M. (2007) Second edition Pediatric Nursing: Caring for Children
and their Families
Kozier (2007) 8th edition, Fundamentals of Nursing: Concepts, Process and Practice
Milestone of Infancy
In partial fulfillment
of the requirements of
NCM-101 RLE
School Nursing Rotation
Submitted to:
Mrs. Ma. Paz Ta-asan, RN,MNClinical Instructor
Submitted by:
Publico, Loney II
Samonte, Joyce Jemelle R.
BSN-2D
August 27, 2011