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Infant Toddler Developmental Training Part 1
• Define child development and atypical development
• Describe each of the major domains of child development
• Describe the typical sequences of child development
• Differentiate between qualitative and quantitative development
• Explain how culture impacts development
• Identify factors that may lead to atypical development
• Identify developmental signals that indicate a possible developmental delay or problem from birth to three years of age
• Identify things that make it difficult to pinpoint a possible delay
• Explain the effect of developmental disorders on child development (e.g., sensory impairments, chronic illness, genetic syndromes, and cognitive delays) and the family
Child Development Assessment
• Child development is a normal progression by which children change as they grow older by acquiring and refining knowledge, behaviors, and skills.
• Assessment involves five specific areas:
• Motor/physical
• Cognitive
• Social/emotional
• Communication/language
• Self-help/adaptive (toileting, feeding, dressing, initiative)
Principles of Development
• Three generally accepted principles of child development are that
• The rate of development differs among children
• Development occurs in a relatively orderly process
• Development takes place gradually
• Atypical child development is used to describe children whose differences in development are to a marked degree or whose development appears to be significantly inconsistent with normal child development
• Many variations in child development may be explained by cultural life experiences (cultural differences), because parental beliefs, child-rearing practices vary across cultures
Differences in Development
• Quantitative differences in child development refer to the changes children encounter as they acquire more knowledge and grow physically. (What they know and can do physically)
• Qualitative differences focus on changes in the way children think, behave, and perceive the world differently as they mature.(concrete to formal operational thought)
• Nature refers to heredity and characteristics remaining stable through the years
• Nurture refers to the day to day interactions children encounter in their environment.
• If parents or caregivers believe that environment has a large influence throughout a child's life, then they would make sure children would have high quality experiences past their primary years
Prenatal Development
• When considering child development, one has to consider the prenatal period
• Exposure to teratogens
• Nutrition
• Having mom on psychotropics risk/benefit

Factors Leading to Atypical Development
• Teratogens (in the child and in utero)
• Illicit and OTC Drugs
• Pesticides
• Heavy metals: Mercury and Lead (exhaust, paint, contaminated fish)
• Poor nutrition
• Stress
• Maternal Behaviors
• Smoking
• Alcohol
• Maternal diseases
• Rubella
• Toxoplasmosis (cat feces OR undercooked meat)
• Cytomegalovirus

Factors Leading to Atypical Development
• Abuse or neglect: Physical, Psychological, Sexual
• Heredity: Down syndrome, spina bifida, vision impairment, hearing loss, cystic fibrosis, muscular dystrophy, Tay-Sachs disease, and Fragile X syndrome, scoliosis, heart defects, sickle cell anemia
• Birth Complications
• Oxygen Deprivation >3min: Cerebral Palsy, intellectual and motor delays
• Low Birth Weight (<5lb 11oz): Immature lungs and breathing, mild/severe cognition problems, cerebral palsy, delayed speech, and sensory impairments
• Post-Term Birth: After 40 weeks a decrease of amniotic fluid will cause the infant to squeeze the umbilical cord, extra size may cause difficulty moving through the birth canal leading to increased risk for oxygen deprivation and head injuries
Factors Leading to Atypical Development
• Birth Complications
• Prematurity (before 37 weeks): Respiratory issues, brain bleed, immature immune system, deficits in motor coordination, inattentiveness, overactiveness
• Preterm babies are sometimes irritable, unresponsive, and suck poorly.
• Because of these problems, some parents become less sensitive, interactive and responsive in caring for them, especially those who are very ill or in the NICU at birth. à attachment issues

Factors Leading to Atypical Development
• Caregiver Interaction
• Families of different cultures adopt unique methods for playing with, carrying, feeding, comforting, educating, and socializing their children
• (Table)

Cultural Differences In Parenting
Signs of Developmental Delays
• If by the end of 1 month of age the infant does not:
• Startle to loud noises
• Suck or swallow easily
• Make eye contact with caregiver
• Cease crying when held
• If by the end of 4 months of age the infant does not:
• Socially smile
• Track moving objects
• Turn head toward sounds
• Reach out
• Raise head while on stomach

• If by the end of 8 months of age the infant does not:
• Explore hands
• Look for hidden objects
• Pick up objects using pincer grip
• Sit unaided
• Appear interested in new or unusual sounds

Signs of Developmental Delays
• If by the end of 12 months of age the infant does not:
• Independently pull to a standing position
• Crawl
• Repeat simple sounds
• Have an interest in looking at pictures
• Respond “yes” or “no” to simple questions
• Show understanding of new words
• Attempt to feed self

• If by the end of 24 months the child does not:
• Identify familiar objects
• Enjoy listening to someone read to them
• Walk with little tumbles or falls
• If by the end of 36 months the child does not
• Begin the process of toilet training
• Show signs of empathy and caring
• Generally undress themselves
• Speak with 75% intelligibility

Difficulty in Identification
• Certain areas may appear to be delayed yet the child continues to develop typically in other areas
• Variations in children's achievements exist as well as uneven maturation and constantly changing conditions in the child's environment.
• Parenting patterns differ significantly across cultures as well as perception of developmental milestones.
• Delays may not be immediately noticed (e.g., vision/hearing loss).
• Health problems that can affect children's performance are sometimes intermittent (e.g., ear infections)

Early Intervention
• Assists the child and family in having the best outcome
• Reduces stressors in child, parents and siblings
• But I only work with adults
• Caregivers are adults
• It is important to help them:
• Cope with the stressors
• Grieve
• Manage partner relationship

Effect of Developmental Issues on Child
• Many children exhibit multiple impairments. Differences due to personal stamina, cognitive abilities, and self-esteem can create different outcomes for children with the same multiple disabilities
• Effect of Sensory Impairments on Child Development
• Deficits in identifying the source of a sound
• Difficulty in listening in a noisy environment
• Language delays
• Speech delays
• Lack of coordination
• Decreased muscle tone leading to delays in gross motor skills
• Delayed fine motor skills
• Delays in self-feeding
• Delayed social interaction and development of play

Effect of Developmental Issues on Child
• Effect of Chronic Illness on Child Development
• Delayed growth
• Lack of stamina
• Loss of strength
• Malnutrition
• Respiratory problems
• Socialization concerns
• Diminished immune system
• Effect of Genetic Syndromes on Child Development
• Language delays
• Maturation delays
• Cognitive deficiencies

Effect of Developmental Issues on Child
• Effect of Cognitive Delays on Child Development
• Decreased learning abilities
• Problems in working memory
• Distractibility
• Poor judgment
• Deficiencies in processing information
• Inflexibility
• Inability of brain to control muscle function

Effect of Developmental Issues on Child
• Effect of Motor Deficits on Child Development
• Difficulty in muscle control and coordination
• Lack of bladder and bowel control
• Loss of sense of balance
• Digression of motor skills
• Loss of equilibrium
• Disordered interpretation of tactile stimulation (tactile defensiveness)

Effect of Developmental Issues on the Family

• Recognize the family's strengths and empower the family to meet the needs of the child and family.
• Be respectful of cultural differences and religious beliefs (meaning of the disability)
• Needs of family members often go unnoticed or unfulfilled due to the heavy demand of meeting basic needs of the child with the disability in the household
• Isolation
• Parental depression, grief and guilt
• Grandparents may not understand the “diagnosis” or may even place blame on one of the parents.
• Friends of the family may feel awkward or uncomfortable in the presence of the child or lack words for consolation and stay away.
• Babysitters may also be hard to find due to the need for a more skilled professional sitter.
Effect of Developmental Issues on the Family

• Effects on Siblings
• children have mixed feelings about their siblings with disabilities
• Some children may feel guilty that they are able-bodied and their sibling isn’t
• Some may worry that they may contract the disability
• Others feel less loved or cared for (resentful) due to the time and care required for the child with the disability.
• Time/Physical Demands
• Increased time to do anything
• Need for special meals
• Need for physical assistance
• Scheduling of therapies
• Finding appropriate childcare (RSV)
Effect of Developmental Issues on the Family

• Financial Issues
• Hospital bills
• Assistive devices
• Home renovation
• Transportation (Wheelchair accessible)
• Job loss
• Effects on Parents
• Less time for each other
• Blaming/guilt
• Difficulty with service providers
• Normal postpartum stuff

• Child development has a general course that can be impacted by
• Prenatal factors
• Parenting/cultural factors
• Environmental Factors
• Genetic factors
• Other biological issues (TBI, virus, chronic ear infection)
• When working with parents, one must be sensitive to culture regarding
• The meaning of the disability
• Parenting practices
• Effective interventions
• Developmental delays in one area can impact the child in multiple areas
• Developmental delays in the child also impact the family resulting in a need for support of ancillary issues.
Summary cont…
• Atypical development describes children whose differences in development are to a marked degree or whose development appears to be significantly inconsistent with normal child development
• Developmental domains are: Physical, Cognitive, Social/Emotional, communication and self-help/adaptation
• Identify developmental signals that indicate a possible developmental delay or problem from birth to three years of age
• 3 things that make it difficult to pinpoint a possible delay include chronic health problems, parenting patterns and normal development in other areas.