Physical Growth and Development (0-6 years)

1. Physical Growth and Development (0-6 years) Chapter 4

2. Chapter Outline • Patterns of growth • Motor development • Development of gross and fine motor skills 0-6 years • Promoting gross and fine motor skills 0-6 years • Sensory and perceptual development • Observing and recording children’s physical growth and development • Revision questions

3. Patterns of growth (infancy) • Average Irish baby now weighs in at 3.5kg (7lbs, 11ozs) • Average length at birth is 51cm (CSO, 2006) • After an initial weight loss after birth (usually about 150g or 6oz) babies gain up to 150g per week for the first month • Babies usually double birth weight by 4 months and tripled it by one year • Height increases rapidly - average baby 76cm by 1 year • During the 2nd year growth slows considerably. By their 2ndbirthday the average infant weighs 12.7kg (2 stone) and measures between 81 and 89cm (32-35 inches) in height - almost half their adult height • Cephalocaudal pattern – growth from head downwards: at birth, as a proportion of total body length a baby’s head makes up ¼ - in adults head makes up ⅛th

4. Growth patterns - Early childhood (2-6 years) • During the pre-school and early school years the rate of growth slows with each additional year • Head to body ratio evens out more as the child’s trunk and limbs begin to lengthen • Begins to loose fatty tissue and gain more lean muscle tissue (usually boys gain more muscle tissue than girls) • Up until about the age of 2 most children are in and around the same height • As children progress towards their 4th, 5th and 6th birthdays however some children will become noticeably taller or shorter than others • These differences are normally as a result of heredity but may also reflect nutritional status, chronic illness or in a small number of cases congenital problems e.g. pituitary dwarfism

5. Structure of the brain • The human brain consists of two halves or hemispheres • The cerebral cortex is the name given to the outer layer of the brain • Each hemisphere within the cortex consists of 4 lobes or areas • The inner core of the brain contains the pituitary gland, amygdale (responsible for emotions) and the hippocampus (responsible for memory and emotions).

6. Neurons • Neurons (nerve cells) are the basic working unit of the nervous system • Sensory neurons process information from the environment and motor neurons act on it • Within the brain there are specialised clusters of neurons called neural circuits that process specific types of information, e.g. • there are extensive neural circuits for language and creative thinking in the left side of the brain • whereas neural circuits for logic and mathematical thinking are more extensive in the right side • This is why someone who is brilliant at maths but a poor communicator may be described as right brain dominant

7. Brain Development • The brain develops most during the pre-natal stage and first 2 years of life (the human brain reaches 75% of its adult weight by 2 years) • Damage experienced at either of these stages can have very serious consequences • Studies have shown that children living in deprived environments show considerably less brain activity than children living in more enriching environments • These effects are not irreversible however and children’s brains are believed to be highly adaptable and resilient this property is known as plasticity

8. Brain development involves: • Myelination or development of the myelin sheath (an insulating layer) around neurons. This has the effect of speeding up transmission of messages by neurons • Increased connections between neurons also results in the brain becoming more developed and sophisticated. The actual size of the brain does not increase dramatically after age 2, but its internal structure or ‘wiring’ does • Increased specialisation of areas of the brain

9. Motor development • Nature V nurture debate exists here also • Theorists e.g. Arnold Gesell (1934) believed babies and children develop motor skills in a fixed genetically determined order and within quite specific timeframes. Developmental checkups often focus on how close a child is or is not to the developmental norm or average for his or her age group • In contrast to this those who believe in the dynamic systems theory e.g. Ester Thelen (2000) consider that motor development occurs as a result of babies acting on their environment and fine tuning their movements according to the outcomes of their actions. Babies and young children need to be given freedom to explore

10. Reflexes • Babies are born with number of inbuilt reflexes. • Reflexes are automatic responses to stimuli in the environment and involve only spinal cord - no brain • Most reflexes seem to have a survival function, which is why it is believed they are genetically programmed • Most disappear by 3 months • See textbook pages 61 & 62 for details

11. Gross and Fine motor Skills • Gross motor skills are skills that involve large muscle such as crawling, walking and running • Fine motor skills are skills that involve the small muscles of the fingers such as picking up a small object, eating with a spoon and doing up a button on a shirt • Developmental milestones or norms describe when certain skills are normally achieved. There is however considerable variation among different children

12. Key Terminology • Prone – lying face down • Supine – lying on the back (think of S for sky, baby is facing the sky) • Head lag – the head has little control, falls back when pulled to sit • Ventral suspension – held in the air, face down • Reflex – involuntary response to a stimulus • Neonate – newborn • Symmetrical movement –balanced movement on both sides of body • Asymmetrical movement – jerky, uncoordinated movements • See developmental tables textbook pages 64-70

13. Promoting Physical Development – (0-1) • Plenty of physical contact • Talk, sing and clap • Baby massage • Mobiles and baby gyms • Allow free movement during nappy changing and bath time • Give baby finger foods when appropriate • Provide safe toys such as bricks, stacking and nesting toys

14. Promoting Physical Development – (1-3) • Push pull and sit on toys • Small slides and climbing frames with close supervision • Balls to roll, throw and follow • Bath toys to fill, pour and squeeze • Action games • Treasure basket, shape sorters • Art activities • Bricks and other construction toys • Sand and water play when age appropriate

15. Promoting Physical Development – (3-6) • Ball games and others such as skipping and hopscotch • Wheeled toys – prams, tricycles and later bicycles • Art activities – painting, clay • Construction toys e.g. Lego and later more complex construction toys e.g. Mechano, Kinex and Bionicles • Jigsaw puzzles • Provide ‘writing’ materials • Provide props for dress up games • Gardening • Dance and rhythm movement to music

16. Sensory and Perceptual Development • The development of sensation and perception has long been the subject of research by developmental psychologists • Sensation is when information reacts with the sensory receptors in the eyes, ears, nose, tongue and skin - sensation is picking up information about the environment though the senses • Perception is interpreting that information e.g. lemon juice tastes sour, that ball is red - perception involves the brain

17. Vision • Because the muscles and lens of the eyes are still developing newborns have very poor eyesight • It is estimated to be 20/640 (normal vision is 20/20) meaning that an object viewed by a newborn at 20 feet is the same as an adult with normal vision viewing it at 260 feet • By 6 months vision is believed to be 20/40 (Image: A human face seen by an infant at 1, 2, and 3 months and 1 year)

18. Vision continued • Eleanor Gibson and Richard Walk (1960) - babies can perceive depth • Up until 4-5 years most children are long sighted explaining why they sit so close to TV • Also eye muscles are not fully developed so need to use finger to help follow words in a book

19. Eye defects • Short sightedness • Long sightedness • Squint • Colour blindness • Astigmatism • Blind and partially sighted (See textbook Page 76-77 for detail on each)

20. Hearing • During the last two months of pregnancy the foetus can hear sounds such as its mother’s voice and music from the womb - Important what they hear is non-aggressive • Young babies cannot hear soft sounds well so we naturally use infant directed speech or motherese (high pitched) • At approximately 6 months babies become what are called ‘native listeners’

21. Hearing Impairment • Approximately 1 in every 1000 children born in Ireland have a severe hearing impairment • There are three basic types of impairment: • Sensori-neural hearing impairment • Conductive hearing impairment • Mixed impairment (both of above)

22. Sensori-neural impairment • Damage to hearing apparatus (ear) and/or the nervous system can effect either one (unilateral) or both (bilateral) ears and is usually permanent • Causes may be congenital (before birth) or others are acquired after birth • Causes: genetic, maternal rubella, herpes, severe jaundice at birth , drug use by mother, pre-maturity, lack of oxygen at birth, brain injury during childhood e.g. falls, some chromosomal conditions e.g. many children with Down’s have also a hearing impairment, infections e.g. meningitis, measles, mumps

23. Conductive Hearing Impairment • Sound waves are prevented from getting to the eardrum or ear drum is prevented from vibrating (producing sound) • May be temporary • Causes: Blockages e.g. wax or foreign bodies such as beads, peanuts, swollen adenoids (at the back of the nose), middle ear infections, glue ear – occurs as a result of constant ear infections

24. Taste and Smell • Newborn babies can differentiate between very pleasant and unpleasant smells e.g. rotten eggs • Babies as young as 6 days old show preference for their mother’s used breast pad as opposed to a clean one –by doing this newborns are not demonstrating learning • Babies (by studying their facial expressions) are able to tell the difference between sweet and sour tastes • Subtle food likes and dislikes are thought to be as a result of environmental influences and that children are not born liking or disliking certain foods • Children should be exposed to a wide variety of food tastes and textures and adults should not let children observe their own fussy eating patterns

25. Touch and Pain • For many years it was widely believed that newborn’s nervous system was not yet developed enough to experience pain • Doctors routinely operated on newborns without anaesthesia • This is now known not to be the case, newborns do feel pain, they may forget about it and stop crying immediately the pain ceases but they still feel it • Some cultures still carry out male circumcision operations without anaesthesia at 3 days old

26. Observing and recording Physical Growth and Development • Developmental checklists such as the Denver II screening checklist are used with children from 0-6 years old, listing norms for the various developmental areas for each age group • Children are observed and compared to the checklist, which gives a general picture of the child’s development, highlighting potential areas of concern for screening (see example textbook page 161) • Developmental Centile chartswere devised after studying the developmental patterns of thousands of children and comparing the growth developmental progress of individual children against that of the ‘average child’ • Children’s height, weight etc. is expressed as a centile e.g. a child in the 95th centile for height would be taller than 95% of children his or her age

27. Revision Questions • What is meant by the cephalocaudal pattern of growth? • List three factors that can affect growth rates in children • What is meant by the brain’s plasticity? • Describe the basic structure of the brain • What are neurons? • When does most brain development occur? • There are two conflicting theories regarding how motor development occurs – describe both of these theories • What is a reflex? • Name 6 primitive reflexes present at birth • At what age most reflexes disappear at and why would it be a concern if they remained significantly beyond that time?

28. Revision Questions continued • Differentiate with examples between gross and fine motor skills • If a baby is lying in the prone position what does this mean? • Describe key milestones that a baby goes through while learning to walk • Describe how physical development can be promoted in (a) a six month old (b) an 18 month old (c) a 4 year old • Differentiate between the terms sensation and perception • Why do children often need to track words with their finger while reading? • What is short-sightedness? • In terms of hearing impairment what is (a) sensori-neural impairment (b) conductive hearing impairment? • What are (a) developmental checklists (b) centile charts