Sunday, June 28, 2009

A Mother should know Child development issues

Subject: Article on developmental issues in children

Main Point: Knowledge for mother about a child's development and
early detection & management of any dev delay.

Category of Topic: Mentally-Challenged


Was my baby healthy at birth?"Dear Mom, you brought me into this new land, don't you want to know how
I'm feeling?" this is what the newborn baby seems to be saying

Sure, the new mother should be abreast of her baby's condition:

* What's his birth weight?
* Is he premature?
* Did he cry after birth?
* Is he feeding properly?
* Is he sick?
* Does he have any abnormality?
* Does he need any special treatment?

During the baby's stay in the hospital it is preferred that the mother
be constantly involved in the baby care. This early mother-child bonding
is the 1st step of early intervention to support normal development.

Is my child developing normally?
This is a question that comes to every mother's mind as she fondly
cradles her baby. But unfortunately, very few have a clear concept of
the developmental milestones and we professionals fail to provide the
required information to them.

In an attempt to make up for this shortfall, I put forth here a simple
list of achievements of your little master, for you mothers to go

At three months of age, most babies:

* turn their heads toward bright colors and lights
* move both eyes in the same direction together
* respond to their mother's voice
* make cooing sounds
* bring their hands together
* wiggle and kick with arms and legs
* lift head when on stomach
* become quiet in response to sound, especially to speech
* smile

At six months of age, most babies:

* follow moving objects with their eyes
* turn toward the source of normal sound
* reach for objects and pick them up
* switch toys from one hand to the other
* play with their toes
* recognize familiar faces
* imitate speech sounds
* respond to soft sounds, especially talking
* roll over

At 12 months of age, most babies:

* get to a sitting position
* pull to a standing position
* stand briefly without support
* crawl
* imitate adults using a cup or telephone
* play peek-a-boo and pat-a-cake
* retrieves a hidden toy
* wave bye-bye
* put objects in a container
* say at least one word
* make "ma-ma" or "da-da" sounds

At 18 months of age, most children:

* like to push and pull objects
* say at least six words
* follow simple directions ("Bring the ball")
* pull off shoes, socks and mittens
* can point to a picture that you name in a book
* feed themselves
* make marks on paper with crayons
* walk without help
* point, make sounds, or try to use words to ask for things
* say "no," shake their head, or push away things they don't want

At two years of age, most children:

* use two-to-three-word sentences
* say about 50 words
* recognize familiar pictures
* kick a ball forward
* feed themselves with a spoon
* demand a lot of your attention
* turn two or three pages together
* like to imitate their parent
* identify hair, eyes, ears, and nose by pointing
* build a tower of four blocks
* show affection

At three years of age, most children:

* throw a ball overhand
* ride a tricycle
* put on their shoes
* open the door
* turn one page at a time
* play with other children for a few minutes
* repeat common rhymes
* use three-to-five-word sentences
* name at least one color correctly

Of all these, 4 achievements must be noted:

* Social smile by 2 months
* Head holding by 4 months
* Sitting alone by 8 months
* Standing alone by 12 months

What is developmental delay?

A developmental delay is any significant lag in a child's physical,
cognitive, behavioral, emotional, or social development, in comparison
with the normal.

A baby's rate of development is determined partly before birth,
primarily as a result of genetic make-up and partly due to various
physical insults during and just after delivery. Normal development is
again quite flexible, occurring over a range of time. Definite deviation
beyond that range in any sector of development is developmental delay.
When a child consistently reaches developmental milestones much later
than other children, a professional consultation is usually warranted.
Few babies develop at a uniform rate; most develop quickly in some areas
and slower in others. Some babies reach most or all developmental
milestones slightly later than "average." As long as a child's
development falls within the broad range that is considered normal,
reaching one or more milestones late is generally not a cause for

Several developmental areas are of interest: gross motor skills (e.g.,
crawling, walking), fine motor skills (e.g., grasping and manipulating
objects), receptive (understanding) and expressive (speaking) language,
self-help (e.g., feeding, dressing), and social and play skills. While
it is important to consider each of these areas, some are more important
predictors of developmental difficulties than others.

Gross motor skills tend to be of particular importance to parents. They
are readily observable and easy to compare from one child to the next.
The timing of concrete achievements such as first steps is usually easy
for any parent to pinpoint. But a particular achievement such as early
walking bears little relationship to later intelligence. Communication
and social skills are generally more important in understanding a
child's developmental progress.

During the first half of the first year, baby's communication skills are
largely nonverbal. Smiling, making eye contact and turning in the
direction of a familiar voice, are all signs that baby is connecting
with and relating to his social environment. Later in the first year,
babbling begins and words may start to appear. In most cases, baby's
vocabulary will continue to grow by leaps and bounds as he moves through
the second year. Again, however, it is the ability to use language to
communicate and relate to the social world that is most important. A
child who has a limited speaking vocabulary late into the second year,
but is able to communicate needs through gestures, point to named
objects in books, and follow simple directions, is most likely not
exhibiting significant developmental delay.

The nature of a child's play also provides important information about
intellectual development. Very young children tend to play alongside,
rather than with, other children. Early play consists largely of using
body and senses to interact with the environment. During the toddler
years there is a move toward pretend play and increasingly interactive
play with other children. Flexibility and creativity become more evident
as a child begins to engage in symbolic play (e.g., using a block to
represent a car) and role-playing (e.g., "I'll be the mommy and you be
the baby"). Steady progression toward more social and complex play
suggests that development in this area is on track.

Some red flag warning signs that a child's development may not be on
track include:

Infants (0-2 years):

* Little interest in surroundings and caregivers
* Absence or minimal eye-contact or smiling
* Lack of responsiveness to sound
* Absence of babbling by end of first year
* Failure to walk by 15 months of age
* Failure to use hands to manipulate and explore objects.

Toddlers (2-3 years):

* Little interest in other children
* Limited use of words or gestures to communicate needs
* Repetitive non-communicative or parrot-like speech
* Very repetitive, non-purposeful play (e.g., focuses only on
parts of objects such a wheels, knobs; obsessively turns pages of book
without attending to or recognizing content).

Pre-schoolers (3-5 years):

* Speech that is very difficult to understand
* Little or no pretend or imaginary play
* Little interest in social interaction
* Difficulties with balance, running
* Difficulty using crayons or scissors, manipulating small

What are the different developmental disabilities (NDD)?

At least 8 percent of all children from birth to six years have
developmental problems and delays in one or more areas of development.
Some have global delays, which means they lag in all developmental

Common neuro developmental disabilities (NDD) include:

· Cerebral Palsy

· Mental Retardation

· Speech and language disorders

· Attention Deficit Hyperkinetic Disorder (ADHD)

· Autism

· Learning disabilities

· Visual and hearing defects

Where do I go to?

Consult your Pediatrician immediately.

Remember to get an Eye and Hearing test done.

You will be referred to a Child Developmental Clinic for Early
Intervention Therapy through a team approach.

What is done for Early Intervention?

Early intervention starts right from the baby's stay at the NICU. The
environment is rendered developmentally supportive through the

· Optimizing lights in the Nursery & mimicking diurnal variation

· Reduce noise to minimum

· Use of soft music

· Club painful procedures & interventions

· Non nutritive sucking

· Tactile stimulation through soft stroking and caressing.

· Kangaroo mother care

Later, early intervention is continued through the provision of :

· Stimulation in all sectors of development

· Stimulate the child through the normal developmental channel
and help him to achieve the next milestone every time.

· Passive exercises to prevent stiffness

· Parents are encouraged to constantly provide appropriate

· Counsel the parents. Assess the parenting skills and provide
necessary education.

What can I expect?

Early Intervention is neither a single dose therapy nor a magic
medicine. We do not expect miracles that the child will be absolutely
normal, coming 1st in class or winning an obstacle race. But we help him
to win his own obstacle race.

Through EIP the child gradually achieves the best of his potentiality.
He is taught to perform to the best of his ability to survive
independently in society. His strong points are brought into focus,
through which his life is made purposeful.

And again, in some, much is achieved beyond expectation, bordering on a

The take home message is "Be patient and sincere, you will be rewarded."

Name: Dr.Nandita Chatterjee

Organisation: Nanritam

Location: Kolkata


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