Normal psychomotor development

The progressive attainment of skills that involve both mental and muscular activity

• Formation of neural tube • Development of prosencephalon

• Process by which neural tube folds • ~3-4 weeks of gestation • NS begins in dorsal aspect of embryo as a plate of tissue • 2 lateral folds develop either side of neural plate • Then fold over and form neural crest • Epidermis forms, covering neural tube, which is now discrete • Occurs caudally

• Failure of anterior end of neural tube to fold • Meninges + skull don’t form, most common type involves forebrain • Hypothalamus + brain in contact with amniotic fluid • 75% stillborn, rest die in neonatal period

• Post tube defect, caudal part doesn’t close • Worst type of spina bifida • Lumbo-sacral commonly affected, sometimes thoracic lesions • Can get hydrocephalus higher up • Paralysis of legs as well

• Prosencephalon doesn’t split as it should • Remains as one sphere • Result in facial defects • No cleavage in the middle - single ventricle in middle • Happens ~5-6 wks gestation

• Neuronal proliferation • Neuronal migration • Neuronal organisation • Myelination These processes happen from second month of gestation right up until adult life

• Grows quickly before birth • Continues to grow quickly till 1 years of age • Starts to level off by 2 years of age (75% of adult weight) • Further development in puberty • Declines as we get older

at 6-12 months after birth

• Cerebral cortex primitive • Neurons poorly connected

Myelination of nerves and an increase in number of connections between cells. Myelination progresses: nervous control of various functions improve, continues throughout childhood.

• Inherited characteristics eg. cognitive potential and temperament • Antenatal + perinatal history • General health • Vision + hearing (sensory systems)

• Opportunities such as sensitive and supportive parenting + education • Threats such as social + economic deprivation • Experience and encouragement

• Innate • Incremental • Progressive • Responsive to stimuli • Interdependent

The age at which major skills that are crucial to a child’s progress in each of the 4 spheres of development are achieved

• Gross motor skills • Fine motor skills • Language comprehension • Expressive language • Hearing • Vision • Behaviour + emotional development • Social skills *grouped in pairs, all relate with each other

Reflex head turn; moves head side to side

• 5 months: roll back to front • 7-8 months: crawls/sits well • 10-11 months: cruises • 12 months: walks • 18 months: runs/kicks a ball • 2 yrs: can walk up + down stairs (1 step at a time) • 5 yrs: skips

Yes, there is a 9% incidence of bottom shuffling in comparison to crawl/stand/walk being 83%. Bottom shuffling is inherited and if a child is a bottom-shuffler, they tend to walk alone slightly later but it is a normal pattern.

• 1 m: tracks horizontally to midline • 3 m: unfisted for >50% of time; tracks 180 degrees; visual threat • 5 m: ‘rakes’ at bright object • 6 m: transfers object from 1 hand to other • 7 m: 3 finger pincer grip • 9 m: fine/neat pincer grip • 14 m: tower of 2 cubes, scribbles spontaneously • 18 m: tower of 4 cubes • 2 yr: copies line • 3 yr: copies circle • 6 yr: copies triangle

• Moro reflex • Rooting • Sucking • Grasp • Stepping • ATNR (asymmetrical tonic neck reflex/fencing reflex) Primitive reflexes begin to diminish at about 6 months as postural reflexes take hold as well as definitive motor actions

• newborn: alerts to bell • 2 m: cooing; searches w eyes for sound • 4 m: turn head to sound; laughs • 6 m: babbles • 8 m: mama/dada nonspecific • 9 m: understands “no” • 12 m: mama/dada specific, 3-5word vocab • 16 m: can point to several body parts • 2 yr: 50 word vocab, 2 word sentences • 2.5 yr: gives first + last names; uses plurals • 3 yr: 250 word vocab, intelligble speech 75% time to strangers

• newborn: regards face • 6wk: spontaneous social smile • 6 m: discriminates social smile • 7 m: stranger anxiety, peek-a-boo • 12 m: drinks from cup • 15-18 m: uses spoon, spills • 2 yr: washes + dries hands • 3 yr: uses spoon well, buttons • 4 yr: washes + dries face; engages in cooperative play • 5 yr: dresses without assistance

• Vision problems