医学精品课件：03 development(YH-20160528BDNG-Administrator-2016-06-27-19,31,40).ppt

1、1 842014.3Child Behavioral Development Lecturer Ying DaiDept.Child Health CareCHCMU2 842014.3OBJECTIVESl Be able to list and discuss the principles and milestones of normal behavioral development l Understand Sensation&Perception Developmentl Understand influence factors on growth and development3 8

2、42014.3Vision developmentSensation&Perception Development4 842014.3Focal lengthNeonate:8-12 in5 842014.3Visual predilectionnewborn1 month2 months3 months6 monthsadultVisual acuity 7 842014.3VisionSensation&Perception DevelopmentAt birth3-4mo4-5mo6-9mo1-5yr6yrFocal length 8-12 inEye-head coordination

3、Eye-hand coordinationDepth perceptionShapes&colors discriminationVision well developed8 842014.3Auditory development Sensation&Perception Development9 842014.3fully developedNeonateSensation&Perception DevelopmentAt birth3-4mo7-9mo12mo12yr3-4yrAuditoryfully developedear-head&eye coordinationundersta

4、nd the tone of voiceresponse to namefollow simple guide mature 11 842014.3 Hearing screening Early detection and treatment of hearing impairment improves the outcome for speech and language and behaviour.12 842014.3Taste development Crucial period for taste development:46moSensation&Perception Devel

5、opment13 842014.3Sensation&Perception DevelopmentFully developed at birthSmell development14 842014.3Sense of skin developmentSensation&Perception Development15 842014.3 Does not fully developed at birth painWhy is there the delay between injection and newborns crying?16 842014.3mouth is sensitive t

6、han handstouch17 842014.3temperatureMore sensitive to cold than hot18 842014.3Gross motor Fine motor LanguagePersonal-SocialBehavior development19 842014.3 The Pattern of Acquisition of Skills lis sequentially constant lshould always be considered longitudinally,relating each stage to what has gone

7、before and what lies ahead lvaries in rate between children20 842014.3Three processes Balance of flexor and extensor tone Evolution of protective and equilibrium responses Decline of obligatory primitive reflexes Motor development Primitive reflexesPrimitive reflexesexistRooting reflexMoro reflexSuc

8、king reflexLower portions of NS well developed22 842014.3Primitive reflexesupper portions of NS well developedPrimitive reflexesdisappear or inhibited 23 842014.3Primitive Reflexes Clinical Implications to assess the neurological integrity of the newborn baby the persistence of primitive reflexes be

9、yond their typical timespan interferes with subsequent development and indicates neurological impairment The Decline of Primitive Reflexes Primitive reflex disappear(mo)Sucking 4 Rooting 4 Moro 4 Grasp 5-6 Tonic neck 3-425 842014.3Gross motor developmentinvolving large body movements such as lifting

10、 head,walking,and jumping-Lift Head raise head to 45 raise head to 902mo4moGross motor developmenthead lag on pulling up with no head lag on pulling up 27 842014.3-Roll over4-5mo SupineSide6-7mo Prone Supine SupineProneGross motor development28 842014.3-Sit6 6m mo o tripod position8 8m mo o sit well

11、 with free handsGross motor development29 842014.31515mo mo crawl onto stairs9 9-1 10mo0mo crawl on all fours7 7m mo o creep-Creep&CrawlGross motor development30 842014.39 9m mo o stand with support1010-11mo11mo stand alone3 30mo 0mo stand with one leg-StandGross motor development1.51.5y yr rrun3 3y

12、 yr r hop12mo12mowalk alone9 9-10mo10mo cruising2 2yr yr jump-Walk Run Jump HopGross motor development2molift head4moroll over6mosit 8 mo crawl10 mo stand alone12mo walk alone2yr jump3yr hopGross motor development(Average Age)33 842014.3Gross motor-limit ageMedical issues:cerebral palsy，primary musc

13、le disorder，global developmental delay Gross motorLimit agesHead control4 moSits unsupported9moStands independently12moWalks independently18mo34 842014.3Fine Motor Developmentsmall movements using the small muscles of thumb,fingers,hand,and wrist.35 842014.3play handshold object3-4moFine motor devel

14、opment36 842014.3-Reach out for toys5mo Fine motor development37 842014.3-Transfer object7mo7moFine motor development38 842014.3-Pincer grip9moFine motor development39 842014.3-Scribble1-1.5yr1-1.5yrFine motor development40 842014.3-Tower of cube 18mo 18mo Tower of three-fourTower of three-fourFine

15、motor development41 842014.3-Fold paper2yryrFine motor development42 842014.3-imitate bridge2.5-3yr2.5-3yrFine motor development3m3mo o play hands5mograsp object7motransfer object9mopincer grip14mo scribbles2yr fold paper 3yr imitate bridgeFine motor development(Average Age)44 842014.3Fine motorLimi

16、t agesReaches for objects6 moTransfer9moPincer grip12moFine motor-limit ageMedical issues:cerebral palsy，primary muscle disorder，global developmental delay 45 842014.32 lift head4 roll over 6 sit8 crawl crawl10 stand12 walk0 0 2 4 6 8 10 12 （momo）Trends of Motor development Cephalocaudal(46 842014.3

17、(from the proximal end to the distal end)ProximodistalTrends of Motor development 47 842014.3Trends of Motor development UncoordinatedcoordinatedDevelopmental Anatomy-Myelination and Development axon myelination time course and pattern axon Head-to toeProximodistalmyelination time course and pattern

18、 Proximal axon Upper extremities and the trunk axonLower extremities axon Developmental Anatomy-Myelination and Development axon myelination time course and pattern cortical modulationbalance and muscle cocordinationDevelopmental Anatomy-Myelination and Development51 842014.3Language DevelopmentOh O

19、h ohoh！Fell outFell out！Spoon fell outSpoon fell out！Oh oh！A system of signs,including text,speech,gestures,audio-visual signals and other forms A sign of the comprehensive development of children.52 842014.3Hearing CNS Speech mechanismreceptive&expressive languagereceiving informationvocalizationen

20、vironmentLanguage development Influence factors53 842014.3lUnderstanding is basis of Language development lCritical periods 724moReceptive Language Development54 842014.3 Startles to loud sounds Seems to recognize parents voice and quiets if crying birth-3mo Receptive Language Development55 842014.3

21、 Moves eyes in direction of sounds Responds to changes in tone of parents voice Notices toys that make sounds Pays attention to music Receptive Language Development4-6mo 56 842014.3 Recognizes words for common items like cup,shoe,book,or juice Enjoys games like peek-a-boo Begins to respond to reques

22、ts (e.g.Come here or Want more?)Receptive Language Development7-12mo 57 842014.3 Points to objects when named.Points to a few body parts when asked.Follows simple commands and understands simple questions(Roll the ball,Kiss the baby,Wheres your shoe?).Receptive Language Development1-2yr58 842014.3 F

23、ollows two requests(Get the book and put it on the table).Listens to and enjoys hearing stories for longer periods of time Receptive Language Development2-3yr59 842014.3 Cries differently for different needs Verbal play through cooing and gooing.Vowel sounds heard such as ooohh,eee,and ahhh.Expressi

24、ve Language Developmentbirth-3mo 60 842014.3 Babbling sounds more speech-like with many different sounds,including bilabial consonant sounds(p,b and m)and monosyllables Chuckles and laughs Expressive Language Development4-6mo 61 842014.3 Babbling has both long and short groups of sounds such as poly

25、syllabic babbling“lalala mamama tata“Jargon is present.Expressive Language Development7-12mo 62 842014.3 Has one to five words with meaning(hi,dog,dada,mama)around first birthdayExpressive Language Development12mo 63 842014.3 Says more words every month.Puts two words together(“More cookie,Wantjuice

26、,Me down).Expressive Language Development1-2yr64 842014.3 Uses two-or three-words to talk about and ask for things.Speech is understood by familiar listeners most of the time.Expressive Language Development2-3yr2movowel4moconsonant5moMono-syllable10mojargon12mowords24mSimple sentenceLanguage develop

27、ment(Average Age)7moPoly-syllable2-3yr expressive languageCritical periods 7-24mo receptive language66 842014.3Language-limit ageLanguageLimit agesSaying 3 words with meaning15 moSaying 25 words with meaning24mo2-word phrases30mo67 842014.3Personal-Social Development Interpersonal skillSelf-care abi

28、lity1-2 moSmile responsively At Birth Spontaneous SmileSocial skill development69 842014.36mo6mo Stranger anxietySocial skill development70 842014.35-8月月9mo9moWave bye-byeSocial skill development71 842014.311-12mo Indicate wants Social skill development72 842014.32yr play gamesSocial skill developme

29、nt73 842014.318mo Self-feedingPersonal skill development-Self-care74 842014.3Personal skill development-Self-care18-24moUndressing75 842014.3Personal skill development-Self-care2yrUsing the toilet Washing and drying his hands 76 842014.33yr DressingPersonal skill development-Self-care 2mosmile respo

30、nsively6mo strangers anxiety 9mowave bye-bye1yr indicate wants 2yrplay games 3yrput on T-shirtPersonal-social skill development(Average Age)78 842014.3Personal-social skill-limit agePersonal-socialLimit agesSmile responsively3 moIndicate wants15mo Gross MotorFine MotorLanguage Personal-Social4 domai

31、ns of Behavior DevelopmentDevelopmental screening and assessment toolsScreening toolsScreening tools：lDenver development screening test,DDSTl Human figure drawings，HFDlPeabody picture vocabulary test，PPVTAssessment tools:Assessment tools:lBayley scales of infant development,BSIDl Gesell development

32、scales，GDSlWechsler-preschool and primarly scale of intelligence,WPPSI Genetic factors Genes disease Chromosomes disease Environment factors Nutrition Diseases Living enviornment（air、sunlight）Influence factors on growth and development Environment factorsSleep and restFamilySocietybirth3mo 15moInflu

33、ence factors on growth and development83 842014.3References1.Behrman RE,Kliegman RM and Jenson HB.Nelson textbook of pediatrics.19th ed,2011.2.William B.Carey MD.Developmental-Behavioral Pediatrics:Expert Consult-Online and Print.4th ed,2009.3.Tom Lissauer.Illustrated textbook of paediatrics,3rd Ed 84 842014.3Thank