Milestone Final (1)

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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 CRITERIA: Format 5% Promptness 5% Neatness 10% Content 70%

Transcript of Milestone Final (1)

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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%

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(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.

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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.

Page 20: Milestone Final (1)

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

Page 21: Milestone Final (1)

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