# Baby Care and Development/Baby Development
## Table illustrating child development stages

Developmental Milestones :
| Age | Motor | Speech | Vision and hearing | Social development |
| 4-6 weeks | | | | Smiles at mother |
| 6-8 weeks | | Vocalises | | |
| 3 months | Prone:head held up for prolonged periods. No grasp reflex | Talks a great deal | Follows dangling toy from side to side. Turns head round to sound | Squeals with pleasure appropriately. Discriminates smile |
| 5 months | Holds head steady. Goes for objects and gets them. Objects taken to mouth | Enjoys vocal play | | Smiles at mirror image |
| 6 months | Transfers objects from one hand to the other. Pulls self up to sit and sits erect with supports. Rolls over prone to supine. Palmer grasp of cube | Double syllable sounds such as 'mumum' and 'dada' | Localises sound 45cm lateral to either ear | May show 'stranger shyness' |
| 9-10 months | Wiggles and crawls. Sits unsupported. Picks up objects with pincer grasp | Babbles tunefully | Looks for toys dropped | Apprehensive about strangers |
| 1 year | Stands holding furniture. Stands alone for a second or two, then collapses with a bump | Babbles 2 or 3 words repeatedly | Drops toys, and watches where they go | dressing, waves goodbye, understands simple commands |
| 18 months | stairs holding onto Handrail|rail. Begins to jump with both feet. Can build a tower of 3 or 4 cubes and throw a ball | 'Jargon'. Many intelligible words | | cup with both hands. Feeds self with a spoon |

## Cognitive and creative

Creative development could very well be seen as how the child learns in its environment through experimenting in different ways of doing everything. 6-9 months
* Looks for fallen objects by 7 months
* Plays ‘peek-a-boo’ games
* Cannot understand “no” or “Danger”
8-12 months
* Watches people, objects, and activities in the immediate environment.
* Shows awareness of distant objects (15 to 20 feet away) by pointing at them.
* Responds to hearing tests (voice localization); however, loses interest quickly and, therefore, may be difficult to test informally.
* Follows simple instructions.
* Reaches for toys that are out of reach but visible
* Recognizes objects in reverse
* Drops thing intentionally and repeats and watches object
* Imitates activities like playing drum loudly

## 1-4 months

Image:Babysmile.jpg|thumb|A baby's first smile usually occurs four to six weeks after birth.

### Physical

* Average length is 50.8-68.6 cm grows approximately 2.54 cm per month.
* Weighs an average of 3.6-7.3 kg
* Gains approximately 0.11-0.22 kg per week.
* Respiration rate is approximately thirty to forty breaths per minute.
* Normal body temperature ranges from 35.7-37.5°C.
* Head and chest circumference are nearly equal.
* Head circumference increases approximately 1.9 cm per month until two months, then increases 1.6 cm per month until four months. Increases are an important indication of continued brain growth.
* Continues to breathe using abdominal muscles.
* Posterior fontanel closes by the second month.
* Anterior fontanel closes to approximately 1/2 inch (1.3 cm).
* Skin remains sensitive and easily irritated.
* Legs may appear slightly bowed.
* Cries with tears.
* Eyes begin moving together in unison (binocular vision).

### Motor development

* Rooting and sucking reflexes are well developed.
* Swallowing reflex and tongue movements are still immature; continued drooling and inability to move food to the back of the mouth.
* Grasp reflex gradually disappears.
* Landau reflex appears near the middle of this period; when baby is held in a prone (face down) position, the head is held upright and legs are fully extended.
* Grasps with entire hand; strength insufficient to hold items. Holds hands in an open or semi-open position.
* Muscle strength and control improving; early movements are large and jerky; gradually become smoother and more purposeful.
* Raises head and upper body on arms when in a prone position.
* Turns head side to side when in a supine (face up) position; near the end of this period can hold head up and in line with the body.
* Upper body parts are more active: clasps hands above face, waves arms about, reaches for objects.

## 4-8 months
### Physical

* Puts on 0.5 kg per month in weight, doubling birth weight
* Grows about 1.3 cm in length per month; average length is 69.8-73.7 cm.
* Head and chest circumferences are basically equal.
* Head circumference increases approximately 3/8 inch (0.95 cm) per month untl six to seven months, then 3/16 inch (0.47 cm) per month; head circumference should continue to increase steadily, indicating healthy, ongoing brain growth.
* Breathing is abdominal; ranges from twenty-five to fifty breaths per minute, depending on activity; rate and patterns vary from infant to infant.
* Teeth begin to appear, with upper and lower incisors coming in first. Gums may become red and swollen, accompanied by increased drooling, chewing, biting, and mouthing of objects.
* Legs may appear bowed; bowing gradually disappears as infant grows older.
* True eye color is established.

### Motor development

* Reflexive behaviors are changing:
* Blinking reflex is well established
* Sucking reflex becomes voluntary
* Moro reflex disappears
* When lowered suddenly, infant throws out arms as a protective measure.
* Swallowing reflex appears allows infant to move solid foods from front of mouth to the back for swallowing.
* Picks up objects using finger and thumb (pincer grip).
* Reaches for objects with both arms simultaneously; later reaches with one hand or the other.
* Transfers objects from one hand to the other; grasps object using entire hand (palmar grasp).
* Handles, shakes, and pounds objects; puts everything in mouth.
* Able to hold bottle.
* Sits alone without support, holding head erect, back straightened, and arms propped forward for support
* Pulls self into a crawling position by raising up on arms and drawing knees up beneath the body; rocks back and forth, but generally does not move forward.
* Lifts head when placed on back.
* Can roll over from back or stomach position.
* May accidentally begin scooting backwards when placed on stomach; soon will begin to crawl forward.

## 8-12 Months
### Physical

* Infants reach approximately 1-1/2 times their birth length by first birthday
* Weight increases by approximately 0.5 kg per month; birth weight nearly triples by one year of age: infants weigh an average of 9.6 kg.
* Respiration rates vary with activity: typically, twenty to forty-five breaths per minute.
* Body temperature ranges from 96.4°F to 99.6°F (35.7-37.5°C); environmental conditions, weather, activity, and clothing still affect variations in temperature.
* Head and chest circumference remain equal.
* Continues to use abdominal muscles for breathing.
* Anterior fontanel begins to close.
* Approximately four upper and four lower incisors and two lower molars erupt.
* Arm and hands are more developed than feet and legs (cephalocaudal development); hands appear large in proportion to other body parts.
* Legs may continue to appear bowed.
* Feet appear flat as arch has not yet fully developed.
* Visual acuity is approximately 20/100.
* Both eyes work in unison (true binocular coordination).
* Can see distant objects (15 to 20 feet away) and points at them.

### Motor development

* Reaches with one hand leading to grasp an offered object or toy.
* Manipulates objects, transferring them from one hand to the other.
* Explores new objects by poking with one finger.
* Uses deliberate pincer grasp to pick up small objects, toys, and finger foods.
* Stacks objects; also places objects inside one another.
* Releases objects or toys by dropping or throwing; cannot intentionally put an object down.
* Beginning to pull self to a standing position.
* Beginning to stand alone, leaning on furniture for support; moves around obstacles by side-stepping.
* Has good balance when sitting; can shift positions without falling.
* Creeps on hands and knees; crawls up and down stairs.
* Walks with adult support, holding onto adult's hand; may begin to walk alone.

### Psychological development

Trust versus Mistrust (Erik Erikson)

## Toddlers (12-24 months)
### Physical

* Rate of growth slows
* Height increases approximately 5cm- 7.6cm with an average height of 81cm – 89cm
* Weighs 9.6-12.3 kg; gains 0.13-0.25 kg per month; weight is now approximately 3 times the child's birth weight.
* Respiration rate is typically twenty-two to thirty breaths per minute; varies with emotional state and activity.
* Heart rate (pulse) is approximately 80 to 110 per minute.
* Head size increases slowly; grows approximately 1/2 inch (1.3 cm) every six months; anterior fontanel is nearly closed at eighteen months as bones of the skull thicken.
* Chest circumference is larger than head circumference.
* Rapid eruption of teeth; six to ten new teeth will appear.
* Legs may still appear bowed.
* Body shape changes; takes on more adult-like appearance; still appears topheavy; abdomen protrudes, back is swayed.
* Visual acuity is approximately 20/60.

### Motor development

* Crawling|Crawls skillfully and quickly.
* Stands alone with feet spread apart, legs stiffened, and arms extended for support.
* Gets to feet unaided.
* Most children walk unassisted near the end of this period; falls often; not always able to maneuver around obstacles, such as furniture or toys.
* Uses furniture to lower self to floor; collapses backwards into a sitting position or falls forward on hands and then sits.
* Enjoys pushing or pulling toys while walking.
* Repeatedly picks up objects and throws them; direction becomes more deliberate.
* Attempts to run; has difficulty stopping and usually just drops to the floor.
* Crawls up stairs on all fours; goes down stairs in same position.
* Sits in a small chair.
* Carries toys from place to place.
* Enjoys crayons and markers for scribbling; uses whole-arm movement.
* Helps feed self; enjoys holding spoon (often upside down) and drinking from a glass or cup; not always accurate in getting utensils into mouth; frequent spills should be expected.
* Helps turn pages in book.
* Stacks two to four objects.

### Cognitive development

* Enjoys object-hiding activities
* Early in this period, the child always searches in the same location for a hidden object (if the child has watched the hiding of an object). Later, the child will search in several locations.
* Passes toy to other hand when offered a second object (referred to as "crossing the midline"-an important neurological development).
* Manages three to four objects by setting an object aside (on lap or floor) when presented with a new toy.
* Puts toys in mouth less often.
* Enjoys looking at picture books.
* Demonstrates understanding of functional relationships (objects that belong together): Puts spoon in bowl and then uses spoon as if eating; places teacup on saucer and sips from cup; tries to make doll stand up.
* Shows or offers toy to another person to look at.
* Names many everyday objects.
* Shows increasing understanding of spatial and form discrimination: puts all pegs in a pegboard; places three geometric shapes in large formboard or puzzle.
* Places several small items (blocks, clothespins, cereal pieces) in a container or bottle and then dumps them out.
* Tries to make mechanical objects work after watching someone else do so.
* Responds with some facial movement, but cannot truly imitate facial expression.

### Language

* Produces considerable "jargon": puts words and sounds together into speech-like (inflected) patterns.
* Holophrastic speech: uses one word to convey an entire thought; meaning depends on the inflection ("me" may be used to request more cookies or a desire to feed self). Later; produces two-word phrases to express a complete thought (telegraphic speech): "More cookie," "Daddy bye-bye."
* Follows simple directions, "Give Daddy the cup."
* When asked, will point to familiar persons, animals, and toys.
* Identifies three body parts if someone names them: "Show me your nose (toe, ear)."
* Indicates a few desired objects and activities by name: "Bye-bye," "cookie"; verbal request is often accompanied by an insistent gesture.
* Responds to simple questions with "yes" or "no" and appropriate head movement.
* Speech is 25 to 50 percent intelligible during this period.
* Locates familiar objects on request (if child knows location of objects).
* Acquires and uses five to fifty words; typically these are words that refer to animals, food, and toys.
* Uses gestures, such as pointing or pulling, to direct adult attention.
* Enjoys rhymes and songs; tries to join in.
* Seems aware of reciprocal (back and forth) aspects of conversational exchanges; some turn-taking in other kinds of vocal exchanges, such as making and imitating sounds.

### Social

* Usually friendly toward others; less wary of strangers.
* Helps pick up and put away toys.
* Plays by themselves for short periods
* Enjoys being held and read to.
* Often imitates adult actions in play.
* Enjoys adult attention; likes to know that an adult is near; gives hugs and kisses.
* Recognizes self in mirror.
* Enjoys the companionship of other children, but does not play cooperatively.
* Beginning to assert independence; often refuses to cooperate with daily routines that once were enjoyable; resists getting dressed, putting on shoes, eating, taking a bath; wants to try doing things without help.
* May have a tantrum when things go wrong or if overly tired or frustrated.
* Exceedingly curious about people and surroundings; toddlers need to be watched carefully to prevent them from getting into unsafe situations.

### Psychological

Autonomy vs. Shame and Doubt (will)
* ↑ Seminars in child and adolescent psychiatry (second edition) Ed. Simon G. Gowers. Royal College of Psychiatrists (2005) ISBN 1-904671-13-6