ADVANCE CARE GIVING
GROWTH AND DEVELOPMENT
PREPARED BY: MS. SANDRA MARINO
DEVELOPMENTAL MILESTONE
PERIOD OF INFANCY
a. Play
- Solitary play
- Non interactive
- Priority is safety
- Age who appreciate teddy bears
- Attitude: proper hygiene
b. Fear
- Stranger anxiety
- Begin at 6 7 months
- Peak at 8 months
- Diminish by 9 months
c. Milestones
E.I NEONATE
- Largely reflex
- Complete head lag
- Hands fisted
- Cry without tears (due to immature larcrimal duct)
- Visual fixation of human face
1 month
- Dance reflex disappears
- Looks at mobile objects
2 months
- Holds head up when in prone
- Social smile
- Baby coos
- Cry with tears
- Closure of posterior fontanel by 2 3 months
- Head lag when pulled to a sitting position
3 months
- Holds head and chest when in prone
- Follow object past midline
- Grasp and tonic neck reflex are fading
- Hand regards (3 months)
4 months
- Turns from front to back
- Head control complete
- Bubbling sounds
- Needs space to turn
- Laugh aloud
5 months
- Roll over
- Turn both ways
- Teething rings
- Handles rattle well
- Moro reflex disappear by 4 5 months
6 months
- Reaches outs in anticipation of being picked up
- Handle bottle well
- Sits with support
- Uses palmar grasp by 6 months
- Eruption of first temporary teeth (2 lower incisors)
- Says vowel sounds Ah, ah
7 months
- Transfer objects hand to hand
- Beginning fear of stranger
- Likes objects that are good sized
8 months
- Sits with support
- Peak of stranger anxiety
- Plantar reflex disappear
9 months
- Creeps/crawl
- Needs space for creeping
- Pincer grasp reflex
- Combine two syllables Papa, Mama
- Priority: safety
10 months
- Pull self to stand
- Understand word No
- Respond to own name
- Peak a boo
- Pat a cake since they can clap
11 months
- Cruises
- Stand with assistance
12 months
- Stand alone
- Take first step
- Walk with assistance
- Drink from a cup
- Cooperate in dressing
- Says the 2 words Mama, Papa
- Toys: pots and pans, pull toy and learn nursery rhymes
E.2. TODDLER
a. Play
- Parallel (2 toddlers playing separately)
- Provide two similar toys (squawky squeeze toy)
- Waddling duck to pull, pull truck, building block and pounding peg
b. Fear
- Separation anxiety
- Do not prolong goodbye, say goodbye firmly
- 3 Phases of separation anxiety
a. Protest
b. Despair
c. Denial
c. Milestones
15 months
- Plateau stage
- Walks alone (delay in walking maybe a sign of mental retardation)
- Puts small pellets into small bottle
- Scribbles voluntarily with pencil
- Holds a spoon well
- Seat self on chair
- Creep upstairs
- Speaks 4 6 words
18 months
- Hide of possessiveness
- Bowel control achieved
- No longer rotates a spoon
- Run and jump in place
- Walk up and down stairs holding on (typically places both feet on one step
before advancing)
- Able to name body part
- Speaks 7 20 words
24 months
- Can open doors by turning doorknobs
- Unscrew lids
- Walk upstairs alone by still using both feet on the same step at same time
- Daytime bladder control
- Speak 50 200 words
30 months
- 3 year old do tooth brushing with little supervision
- 2 3 year old is the right time to bring to the dentist
- Temporary teeth complete and last temporary teeth to appear is the posterior
molars
- 20 deciduous teeth by age 2 years
- Can make simple lines or stroke for crosses with a pencil
- Can jump down from the stairs
- Knows full name
- Copy a circle
- Holds up fingers
36 months
- Trusting three
- Able to unbutton
- Draw a cross
- Learns how to share
- Full name and sex
- speak fluently
- Right time for bladder control (night time control)
- Able to ride a tricycle
- Speak 300 400 words
- Clues for toilet training
a. Can stand, squat and walk alone
b. Can communicate toilet needs
c. Can maintain himself dry with interval of 2 hours
d. Character Traits
- Negativistic likes to say no (it is their way to search independence)
- Limit questions and offer options
- Temper tantrums (stomping feet and screaming)
- Ignore the behavior
- Rigid ritualistic: stereotype
- Cause: mastering
- Protruded abdomen
- Cause:
- Under development of abdomen
- Unsteady gait
- Physiologic anorexia (give foods that last for a short period of time)
APPROPRIATE TOYS FOR TODDLERS
Familiar household items such as plastic bowls and cups of various sizes,
large plastic serving utensils, pots and pans, wooden spoons, cardboard
boxes and tubes
Child-size household item toys (kitchen, broom, vacuum cleaner,
lawnmower, telephone, and so on)
Blocks, cars and trucks, plastic animals, trains, plastic figures (family,
community helpers), simple dolls, stuffed animals, balls, doll beds and
carriages
Manipulative toys with knobs, wind-ups, and buttons that make things
happen; putting large pegs or shapes into matching holes; stringing large
beads on shoelaces; blocks and containers that stack; jigsaw puzzles
Gross motor toys: play gym, push and pull toys, wagons, tricycle or other
ride-on toys, tunnels
Tape or CD players for music, various musical instruments
Chalk, large crayons, finger paint, Play-Doh, washable markers
Bucket, plastic shovel, and other containers for sand and water play
Squeaking, floating, and squirting toys for the bath
Gross Motor Skills use of large group of muscles
Fine Motor Skills use of small group of muscles
Reflexes
Primitive Reflexes
1. Selective Reflexes preset at birth, disappears later in life
2. Protective reflexes - (also termed postural responses or reflexes) are
gross motor responses related to maintenance of equilibrium.
- remain throughout life once they are established
Selective Reflexes
Rooting/ root
Description
When infants cheek is
stroked, the infant turns to
that side, searching with
mouth
When nipple or finger is
inserted to infants mouth.
Sudden extension of the
head, arms abduct and
move upward and hands
form a C
While lying supine,
extremities are extended on
the side to which the head
is turned and opposite
extremities are flexed.
Grasp when palm is
touched
Grasp with bottom of the
foot when pressure is
applied to the plantar
surface.
Stroking along the lateral
aspect of the sole and
across the plantar surface
results in fanning and
hyperextension of the toes
With one foot on flat
surface, infant puts the
other foot down as if to
step
Present
birth
Disappears
3 months
birth
2 5 months
birth
4 months
birth
4 months
birth
4-6 months
birth
9 months
birth
12 months
birth
4 8 weeks
Protective Reflexes
Description
Neck righting
Neck keeps head in upright
position when titled
Parachute
Extension with the arms
(sideways)
when tilted to the side in a
supported sitting position
Parachute (forward) Extension with the arms
when held up in the air and
and moved forward.
Reaches forward to catch
Present
4-6
months
6 months
Disappears
persists
6-7
months
persists
Suck
Moro
Asymmetric tonic
neck
Palmar grasp
Plantar grasp
Babinski
Step
persists
Parachute
(backward)
him/herself.
Extension with the arms
when tilted backward
9-10
months
persists
