By NIYOMURENGEZI ABENEZEL

UNIVERSITY OF RWANDA. COLLEGE OF MEDICINE AND COMMUNITY HEALTH

DEVELOPMENTAL MILLESTONE IN FIRST YEAR of life

Normal development Normal development is about developing skills like: Gross motor:  using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions. Fine motor:  using hands to be able to eat, draw, dress, play, write, and do many other things. Language:  speaking, using body language and gestures, communicating, and understanding what others say. Personal and Social:  Interacting with others, having relationships with family, friends, and teachers, cooperating, and

responding to the feelings of others. Vision and hearing

Gross motor milestones Movement using the large muscles 1st month: Chin up in prone position, Turns head in supine position. 2nd month: Chest up in prone position, Head bobs when held in sitting position. 3rd month: Props on forearms in prone position, Rolls to side 4th month: Sits with trunk support, No head lag when pulled to sit, Props on wrists Rolls front to

back. 5th month: Sits with pelvic support, Rolls back to front, Puts arms out front when falling, Sits

with arms, supporting trunk.

Gross motor milestones…….. 6th month: Sits momentarily propped on hands, Pivots in prone, In prone position, bears weight

on one hand. 7th month: Bounces when held, Sits without support steadily, Lateral protection, Puts arms out

to sides for balance. 8th month: Gets into sitting position, Commando crawls, Pulls to sitting/kneeling position. 9th month: ”Stands” on feet and hands, Begins creeping, Pulls to stand, Bear walks (all four

limbs straight). 10th month: Creeps well, Cruises around furniture using two hands, Stands with one hand held Walks with two hands held. 11th month: Pivots in sitting position, Cruises furniture using one hand, Stands for a few seconds, Walks with one hand held 12th month: Stands well with arms high, legs splayed, Posterior protection, Independent steps

Watch out! I’m mobile now!5-6 mo: commando

crawl

6-9 mo: creeping

9-10 mo: cruising

11.7 mo: median age of walking 3

steps alone; range: 9-17 mo

Fine motor milestones Fine motor: movements using the hands and smaller muscles in daily living skills. 1st month: Hands fisted near face. 2nd month: Hands unfisted 50% of the time, Retains rattle if placed in hand, Holds hands together 3rd month: Hands unfisted 50% of the time, Inspects fingers, Bats at objects 4th month: Hands held predominately open, Clutches at clothes, Reaches persistently, Plays with

rattle. 5th month: Palmar grasps cube, Transfers objects, hand-mouthhand, Reaches/grasps dangling ring

Hand eye coordination

Fine motor milestones……. 6th month: Transfers hand hand, Rakes pellet, Takes second cube and holds on to first,

Reaches with one hand 7th month: Radial-palmar grasp 8th month: Bangs spoon after demonstration, Scissor grasp of cube,Takes cube out of cup,

Pulls out large peg. 9th month: Radial-digital grasp of cube, Bangs two cubes together 10th month: Clumsy release of cube, Inferior pincer grasp of pellet, Isolates index finger and

pokes 11th month: Throws objects, Stirs with spoon. 12th month: Scribbles after demonstration, Fine pincer grasp of pellet, Holds crayon, Attempts tower of two cubes.

Fine Motor Development

Reflexive palmar grasp-

disappears at 1 month

2-3 mo: midline hand play &Sucking on

thumb/finger 4-5 mo: use hands as entire units to draw

objects toward them

Be concerned if a child does not have

open grasp & midline activity by 4 mo or reaching by 6 mo

PERSONAL AND SOCIAL DEVELOPMENT 1st month: Discriminates mother’s voice, Cries out of distress 2nd month: Reciprocal smiling, responds to adult voice and smile 3rd month: Expression of disgust (sour taste, loud sound), Visually follows person who is moving

across a room 4th month: Smiles spontaneously at pleasurable sight/sound, Stops crying at parent voice, To and

fro alternating Vocalizations 5th month: Recognizes caregiver visually, Forms attachment relationship to caregiver 6th month: Stranger anxiety (familiar versus unfamiliar people)

PERSONAL AND SOCIAL DEVELOPMENT … 7th month: Looks from object to parent and back when wanting help (eg, with a windup toy) 8th month: Lets parents know when happy versus upset, Engages in gaze monitoring: adult looks

away and child follows adult glance with own eyes 9th month: Uses sounds to get attention, Separation anxiety, Follows a point, “Oh look at.”,

Recognizes familiar people visually. 10th month: Experiences fear, Looks preferentially when name is called 11th month: Gives objects to adult for action after demonstration (lets adult know he or she needs

help) 12th month: Shows objects to parent to share interest, Points to get desired object (proto-

imperative pointing).

Red FlagsLack of looking at faces/lack of

fixation at 2 monthNo smiling, laughing, or expression

at 4 monthAbsence of back-and-forth smiles

and vocalizations in “conversation.” at 9 month

LANGUAGE

1st month – receptive Startles to voice/sound. -Expressive: Throaty noises. 2nd month –receptive Alerts to voice/sound. –Expressive: Coos, Social smile

(6weeks), Vowel-like noises. 3rd month: receptive Regards speaker -Expressive Chuckles Vocalizes when

talked to 4th month: receptive Orients head in direction of a voice, Stops crying to

soothing voice. –Expressive: Laughs out loud, Vocalizes when alone 5th month: receptive: Begins to respond to name. –Expressive Says “Ah-

goo” , Razzes, squeals, Expresses anger with sounds other than crying 6th month: receptive: Stops momentarily to “no”, Gestures for “up”.

Expressive: Reduplicative babble with consonants, Listens, then vocalizes when adult stops, Smiles/vocalizes to mirror

LANGUAGE……

7th month: receptive: Looks toward familiar object when named, Attends to music. Expressive: Increasing variety of syllables.

8th month: receptive: Responds to “Come here”, Looks for family members, “Where’s mama?”. Etc. Expressive: Says “Dada”(nonspecific), Echolalia (8 to 30 months), Shakes head for“no”.

9th month: receptive: Enjoys gesture games Orients to name well Orients to bell. Expressive: Says “Mama” (nonspecific), Nonreduplicative babble Imitates sounds

10th month: receptive Enjoys peek-aboo, Waves “bye-bye” back. Expressive: Says “Dada”(specific),Waves “bye-bye”

11th month: receptive: Stops activity when told “no”, Bounces to music. Expressive: Says first word, Vocalizes to songs.

12th month: receptive: Follows one-step command with gesture • Recognizes names of two objects and looks when named. Expressive: Points to get desired object (proto-imperative pointing), Uses several gestures with vocalizing (eg, waving, reaching).

Failure to orient to sound or absent babbling may indicate a hearing deficit

Language Red Flags

Vision

1st month: Focuses 8 to 12 inches away, Eyes wander and occasionally cross ,Prefers black-and-white or high-contrast patterns, Prefers the human face to all other patterns

End of 3rd month: Watches faces intently, Follows moving objects, Recognizes familiar objects and people at a distance, Starts using hands and eyes in coordination

End of 7th month: Develops full color vision, Distance vision matures, Ability to track moving objects matures

Question????

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