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Normal Development
•The basic science of Pediatric is Growth & Development
•It is a continuous process from conception to maturity.
•
It depend on maturation &myelenation of nervoussystem.
•The sequence of development is the same but the rate
varies.
•Direction of development Cephalocodal.
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Fields of development
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Median and limit ages
• Median age: When half the populationacquire a skill; serves as a guide to normal
pattern of development.
• Limit age: When a skill should have been
acquired; further assessment is indicated if
not achieved.
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MENTAL &PSYCHOSOCIAL DEVEOP.
•
SOCIAL SMILE ----------- 40 dayes• LAUGHING--------- 2 months
• MOTHER RECOGNITION------- 4 months
• FATHER RECOGNITION--------- 9 months
• SPEECH At 1 year -----------2words +mama & dada
• DRAWING
------ at 3 y.
-------at 4 y.
------- at 5 y.
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Primitive reflex & equilibrium
responseReflex appearance Disappearance
Moro Birth 4 months
ATNR 2 weeks 6 monthsToe grasp Birth 8-15 months
Hand grasp Birth 3 months
X adductor Birth 7 months
Head writing 4-6 months Persist voluntary
Protective eq. 4-6 months Persist voluntary
Parachute 8-9 months Persist voluntary
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ATNR
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MORO
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Head support
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LOCOMOTOR DEVELOPMENT
Headsupport
sitting
stand walkrun
Go
Up
stair
s
Go
do
w
n
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D.M.S
Age G.M F.M.V Cog.Lan. Social
6 week Raise head Follow witheyes
startle Fix onface
3 mo Hold headup
Hand open Smil 2m .Coos
Recognisepar.(2)
4-5mo Rolls Sit sup Grasp Orient tovoise
Observ
surrouding
6 mo Sits Transfer Babbels Recognise st
9-12 mo Crawel,C,pto s (9) Wa
Pincer graspThrow
release
Dada/mama1-8word
Play Pate acake come
when called
18 mo Run Feed self Point to B.P Play around
24 mo Walksup&down
Removeclothing 5.B
Tow stepcommand
Parallel play
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> 6 months of age
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3- 4 months
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6 months
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7 months
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10 months
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3-4 months
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11 months
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DELAYED LOCOMOTOR
DEVELOP.
Head
support
sitting
standingwalking
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CAUSES OF DELAYED MOTORDEV.
• Normal motor deve. Abn. Dev. In
CNS
Systemic
environ.
musculo
skeletal
MRCP
RICK.MALNUT.
CHRONICSYSTEMDISORD.
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Developmental Delay
• Global D D: Delay in aquistion of all skill fields.
• Specific D D: When one Field of D. or skill area
is more delayed than other or devlop in
disorderd way.
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Causes OF D D & Learning Dif.
Prenatal
Genatic
Teratogenic
Metabolic
Cong infection
Neurocutaneous S.
Chromosomal disorderCerbral dysgensis
Alcohol & drug abuse
Hypothyrodism,Phenylketonuria
Rubella C MV
T S,N.F
PerinatalPrem
B.Asphyxia
Metabolic
I.V.H/Periven. Leukomalasia
H.I.E
Hypoglycemia
Postnatal
Infection Anoxia,Trauma
Met
Meingitis,EncephlitisSeizurres,Head injury
I.E.M
Other 25%
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Developmental Delay
• Developmental warning signs:
• 1.Family history, deafness, cataract.
•
2.Maternal concern.• 3.Dribbling.
• 4.Persisting O.A.T.R.
• 5.Persistent squint.• 6.Discordance in dev.abilities.Regression.
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Causes of D.D
• 1.Prematurity.
• 2.Idiopathic,Constitutional,familial.
•
3.Deprivation.• 4.Mental retardation.
• 5.Specific abnormalities.
• 6.Autistic spectrum.
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DEGREES OF MR
• Mild (IQ 70 -51) Educable
• Mod.(IQ 50-36) trainable
• Severe (IQ 35-20) minimal self care
•
Profound (IQ
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Diagnosis of MR
• History
• C/P (odd features )
• Eye ex. (cataract)
• Heart ex.(cong. Cyan. D.)• Head ex.(micr. & macro-cephally)
• Hepato-splenomeg.
• Lab screening tests (t3&4)-urine(red.sub.) urine(cyanide-fecl)
• Radiology
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Spastic child
neurological disorder
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6 Week old
•Gross motor: Head control(0-3 mo).
• Moro response
• Ventral suspension.
• Prone position
• Fine motor and vision : Stares
• Follow horizontally
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6 Weeks (con)
• Hearing & speech: Rattleor bell
• Startle response
• Social behavior: Smile socially
• Turn to regard
• Warning signs at 6 week:
• No visual fixation, Failure to respond to
• sound, Asymmetrical N.R, Ex Head lag, Nosm
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6-8 Months
• Gross motor: Wton leg
• Parashut response.
• Sits; pullto sit.
• crawl
• Fine motor & vision: Grasp
•Transfer.
• Follows fallen toys
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6-8 Months (cont)
• Hearing & speech: Vocalize.
• Babbling; laughs; Respond to own name
• Social behavior: Mouthing
• Hand foot regard; Play speek-apo-
• Warning Signs:
• Hand preference, fisting,
• Squint, Persistence of N.R
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12 Months
• G.M: Stand.
• Walk.
• Fine motor & vision: Point with index finger.
• Through; Pincer grasp;Hold2 object.
• Hearing& speech: Turn to sound; Mum & dad.
•
Social behaviors & play: Drink; Wave good-by
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18 Months
• Gross Motor: Climb stair.• Fine motor & vision: Scribbles
• Turn pages.
•
Hearing & Speech:Utter3 or more wordssentence.
• Point to body parts.
• Social: Holdspoon; Explore environment.
• Takes off choose; toiletneed
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2 years
• G.M: Climb & descends stairs; Jump; Kicks a
• Ball.
•
Fine motor & vision: Pick sup hundreds;Vertical line.
• Hearing& Speech: Uses pleural; Give name.
•
Social: Play alone; Eats with spoon & fork.• Puts on clothes. Dry through day
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Done by :
Daniah gareebA2-2
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