Notes on growth & development

The Normal
Growth &
Development
Mrs. Babitha K Devu
Assistant Professor
SMVDCoN

Introduction
• The growth and development of the human
organism is a continuous process that begins
before birth; each stage depends upon the
preceding stages. The term developmental
sequence means that these changes are
specific, progressive and orderly and lead
eventually to maturity.
• Therefore, adults should be aware of the
interests of infants and children in learning, their
perseverance in carrying out the activity over a
period of time, and progress that is made.

Developmental Milestone?
• A developmental milestone is a skill that a
child acquires within a specific time
frame. Milestones develop in a sequential
fashion. This means that a child will need
to develop some skills before he or she
can develop new skills. For example,
children must first learn to crawl and to pull
up to a standing position before they are
able to walk. Each milestone that a child
acquires builds on the last milestone
developed.

Average Achievement Levels of Infants
Physical/ Biological Examples
1 Month
Weight: 4.4 kg ± 0.8 kg; gains 150
– 210 gm. a week
Length: Approx. 53 ± 2.5 cm;
increases about 2.5 cm a month.
HC: Increases about 1.5 cm in a
month
Pulse: 130 ± 20
Respiration: 35 ± 10
BP: 80/50 ± 20/10 mm Hg
Reflexes: Has well developed
primitive reflexes like sucking,
swallowing, moro etc. Dance and
doll’s eye reflexes fading. Breathes
through nose.
Reflexes

Motor
1 Month
Gross Motor:
Lies in flexed position.
When in prone pelvis is
elevated.
Head lags when baby is
pulled up.
Head sags forward in sitting.
Turns head to side in prone.
Makes crawling movement.
Fine Motor:
Holds hands in tight fists
Can grasp an object but
drops immediately.

Sensory Analytical & Spiritual
Development
1 Month
Startled by sounds
Attentive to speech of
others
Indefinite stare & follows a
bright object to the midline
of vision
Blinking reflex
Psychosocial: Trust Vs
Mistrust
Psychosexual: Oral Stage
Spiritual: Undifferentiated.

Moral/Cognitive
Development
Language/ Speech Play
1 Month
Preconventio
nal morality
Sensory
motor Stage
Respond to human voice
Open and close mouth
when adults speak
Utter small throaty
sounds
Crying pattern develops
Cooing starts
Repeat noises
made by infant
Provide soft,
cuddly toy
Swaddle &
soothing
massage
Respond to
crying signals
Talk and sing
softly at close
range

Physical/ Biological
2 Months
Posterior fontanel closed at 6 – 8 weeks of age
Weight and length increases as per 1 month infant

Motor
2 Months
Gross Motor:
Less flexed prone
position. Arms flexed, hip
flat, legs extended, head
in side.
No head droop in prone.
Head lags lessens when
forwarded to sitting.
Lift head 45 degree
Hold head erect when
held upright
Fine Motor:
Hands can be opened
Hold a rattle briefly

Development
2 Months
Turns head to side when a
sound occurs at ear level
Follows a dangling object or
moving light or person beyond
midline of vision
Beginning binocular fixation and
convergence to objects nearby.
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
2 Months
Preconventi
onal
morality
Sensory
motor
Stage
Alert expression when
listening
Soothed by mother’s voice
Cry pattern develops
Responds vocally to
caregivers voice: ah, eh,
uh, coos.
Same as 1
month
Offer a rattle
Place vertical
to view
different angle
of environment

3 Months
Weight: 5.7 ± 0.8 kg
Length: 60 ± 2 cm
Pulse: 130 ± 20
BP: 80/50 ± 20/10
Reflexes: Palmar grasp absent & landau reflex
appears.
Symmetric posture

Motor
3 Months
Gross Motor:
Very slight head lag
Sits, back rounded, knee
flexed when supported
Raises chest in prone
position
Hold head erect & steady
Fine Motor:
Hands open or closed
loosely
Holds hands in front of
face & stares
Active grasp & carry to
mouth

Development
3 Months
Turns head & looks in same
direction to locate sound
Turns eyes to marginal field of
vision (180 degrees)
Binocular coordination (vertical &
horizontal vision)
Beginning ability to coordinate
various sensory stimuli
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
3 Months
Preconventi
onal
morality
Sensory
motor
Stage
Looks in direction of
speaker
Cries less
Shows pleasure in making
many sounds
Vocalizes in response to
others: coos & chuckles
May laugh aloud
Same as 1 & 2
months
Encourage to
raise head in
prone position
Provide variety
of toys

4 Months
Drools between 3 and 4 months but unable to
swallow it.
Reflexes: Tonic neck, moro, sucking & rooting
(awake) are absent. Extrusion reflex fading.

Motor
4 Months
Gross Motor:
Symmetric body posture
Sits with adequate
support and Hold head
erect & steady
Lift head & shoulder at
90 degree on abdomen
Attempt to or rollover
from front to back
Sustains small portion of
own weight when held in
standing position
Activates arms at sight of
toys

Motor
4 Months
Fine Motor:
Hands predominantly
open
Brings hands together in
midline & plays with
fingers
Grasps object held near
hand but can’t pick it
when dropped
Carry to mouth
Thumb apposition in
grasping occurs between
3rd & 4th
Clutches clothing

Development
4 Months
Follow moving objects well
Fairly good binocular vision
Looks briefly for toys that
disappears
Accommodation begins to
develop, can accommodate
nearby objects
Can focus on small object &
recognizes familiar object
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
4 Months
Preconventi
onal
morality
Sensory
motor
Stage
Responds differently
Does not cry when
scolded
Laughs aloud
Very talkative to self,
people & toys
Talking & crying follow
each other quickly
Consonants b, g, h, k, n, p
Echoing sound
Talking,
laughing &
singing with
Moving toys
around to
follow
Make safe
area for
solitary play
comfort self by
sucking thumb

5 Months
Weight: At least twice the birth
Physical growth slowing down
Can breath through mouth when nose is obstructed

Motor
5 Months
Gross Motor:
Sits with slight support
Balances head well when sitting
Holds back straight when pulled up
Rolls from back to front
Pulls feet up to mouth when supine
Fine Motor:
Use thumb in partial apposition to
fingers
Try to reach objects beyond the
reach
Grasp either R/L hand (whole) &
hold 1 while looking for other

Development
5 Months
Localizes sound made below the
ear level
Looks after a dropped object
Inspects objects visually for a
long period of time
Can fixate on objects > 3 feet
away
Visual acuity – 20/200
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
5 Months
Preconventi
onal
morality
Sensory
motor
Stage
Respond when own name
is spoken
Squeals when happy
Vocalizes displeasure
when a desired object is
taken away
Consonant sounds
increase & with this
vowels appear like goo
Begins to mimic sounds
Same as 4
months
Provide
different
objects
Make variety
of sound near
ear
Hold infant in
standing and
bounce to
develop
balance

6 Months
Weight: 7.4 ± 1 kg; gains 90 – 150 g a week during
2nd 6 months
Length: 65.5 ± 3 cm; gains 1.25 cm a month during
2nd 6 months
HC: 43 cm; increases 0.5 cm a month during 2nd 6
months
Pulse: 120 ± 20
BP: 90/60 ± 28/10
Teething: 2 lower central incisors erupt ± 2 months
Begins to bite & chews

Motor
6 Months
Gross Motor:
Sits alone briefly
Back straight in high chair
Springs up & down when sitting
Lifts chest & upper abdomen &
bears weight on the arms &
hands
Turns completely with rest
periods
Sustains most all of own weight
in standing
Hitches – moves backward
when sitting by using the arms
& hands

Motor
6 Months
Fine Motor:
Grasps with
simultaneous flexion of
fingers; use fingers to
feed self
Retains transient hold on
two objects at same time
Drop one when other is
offered
Begins to transfer from
one hand to other
Manipulates small object
Banging begins
Holds own bottle

Development
6 Months
Localizes sound made above the
ear level
Retrieves a dropped object that
can be seen & reached
Enjoys more complex visual
stimuli
Moves in order to see an object
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
6 Months
Preconve
ntional
morality
Sensory
motor
Stage
Recognizes familiar words
Actively vocalizes
pleasure with cooing or
crowing
Cries easily with slight or
no provocation
Vocalizes several well –
defined syllables
Lallation or imperfect
imitation begins
Enjoys own vocalization
Talks to mirror image
Same as 4 & 5
months
Encourage
mirror looking &
repeat body
parts
Make funny
faces to imitate
Point out
Use no when
necessary
Provide hard toy
& walker

7 Months
Sucking & rooting reflexes disappear at 7 – 8
months when asleep
Parachute reflex appears between 7 – 9 months
Teething: Upper central & lower lateral incisors
erupt.
Ultimate colour of iris is established

Motor
7 Months
Gross Motor:
Sits alone, leaning forward
on hands
Control of trunk is more
advanced
Rolls more easily from
back to abdomen
Sustains all of weight on
feet when held in standing
position
Bounces actively when
held in standing position

Motor
7 Months
Fine Motor:
Holds 2 toys at once
Unidextrous
Successfully transfer
from one hand to other
Imitates simple acts of
others
Bangs objects
Uses a raking motion to
try to obtain small
objects
Holds cup

Development
7 Months
Head turns in a curving arch to
localize sound
Depth perception begin to
develop
Fixates on very small objects
and details
Discrimination between simple
geometric forms begins to
develop
Has preferences in taste for
foods
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitiv
e Development
7 Months
Preconvent
ional
morality
Sensory
motor
Stage
Recognizes own name
Responds with gestures
to words like “come”
Vocalizes eagerness ‘m-
m-m’ when crying
Imitates speech & voices
Makes polysyllabic vowel
words da, ma, ba
Babbling decreases
Some jargons
Same as 4,5
& 6 months
Provide for
biting &
chewing
safely
Encourage
banging &
clapping
Continue to
help in gaining
balance

8 Months
Beginning of a pattern in bowel & bladder
elimination

Motor
8 Months
Gross Motor:
Sits alone steady
Pulls self into standing position with
help
Hand – eye coordination is
perfected
Fine Motor:
Holds two objects while looking at
a third & persistently reaches for
objects beyond range
Releases objects voluntarily from
hand
Pincer grasp beginning to develop
Drink from cup with assistance

Development
8 Months
Recognizes familiar words and
sounds
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
8 Months
Preconventi
onal
morality
Sensory
motor
Stage
Stops actively when own
name is spoken
Beginning to understand
meaning of ‘no’
Shouts for attention
Continues syllables: da,
ma-ma
Hold, touch &
rock gently
Improve
balance in
sitting &
standing

9 Months
Plantar grasp absent
Teething: Upper lateral incisors erupt ± 2 months

Motor
9 Months
Gross Motor:
Raises to a sitting position
alone & stay longer period of
time
Recovers balance when
leaning forward, but not
sideways
Crawls instead of hitching (may
be done at 4 months also) but
abdomen touches the floor
Creeping: (Trunk is above &
parallel to floor)
Beginning to pull self to
standing position with support

Motor
9 Months
Fine Motor:
Bangs two objects together
Pokes objects with fingers
Uses thumb & index finger in
early pincer grasp
Has preferences for
dominant hands
Holds bottle with good hand
mouth coordination
Puts nipple in & out of mouth
at will
Drinks from cup with some
spilling
Attempts to use a spoon

Development
9 Months
Turns head to the source of
sound
Increased depth perception
Recognizes by looking or
moving towards familiar object
when named
Able to follow objects through
transition from one place to other
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
9 Months
Preconventi
onal
morality
Sensory
motor
Stage
Stops actively in response
to ‘no’
Responds to adults anger
Cries when scolded
Echolalia (exactly)
Association of words with
persons or objects
Same as 8
month
Encourage
exploration of
toys
Show picture
books
Encourage
crawling
Play ‘peek-a-
boo’

10 Months
Macula is well developed so that fine visual
discriminations can be made.

Motor
10 Months
Gross Motor:
Moves from prone to sitting position
May sit by falling down from
standing position
Sits steadily for indefinite period of
time.
Creeps wells
With support pulls to standing
position
Cruises well (walks sideways while
holding on to a supporting object
with both hands)
Makes stepping movements
forward when two hands are held

Motor
10 Months
Fine Motor:
Picks small objects up with
index finger and thumb
(pincer grasp)
Releases an object after
holding it
Brings the hands together

Development
10 Months
Marked interest in very small
objects
Searches for a lost toy with
greater persistence
Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
10 Months
Preconventi
onal
morality
Sensory
motor
Stage
Understand simple
commands: gives a toy
on a request that is
accompanied by gestures
May speak one word
besides "ma-ma" and "da-
da," such as "no," "hi”
Understands meaning of
"bye-bye" and waves
Imitates adult's inflection,
pitch variations
Imitates sounds of animals
Same as 8 & 9
months
Picture book
Encourage
cruising
Provide
opportunities
for holding and
releasing
objects

Motor
11 Months
Gross Motor:
Stands erect with minimal
support and lifts one foot to
take a step
Cruises: walks holding on to
furniture

Motor
11 Months
Fine Motor:
Explores toys and other
objects more carefully
Removes covers from boxes
Takes toy out of box or cup
Puts toy inside box or cup but
may not let go yet
Beginning to hold a crayon
and make a mark on paper

Development
11 Months
Tilts head backward to see
upward
Psychosocial:
Trust Vs Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
11 Months
Preconventi
onal
morality
Sensory
motor
Stage
Responds to simple
questions: for example,
"Where is the kitty?" by
pointing and looking
toward object
Imitates specific speech
sounds of others
Jargons well established
Same as 8, 9
& 10 months
Encourage
play with other
persons
Encourage
infant to stand
alone

12 Months
Weight 10 ± 1.5 kg (22 ± 3 pounds); has tripled birth weight
Length 74.5 ± 3 cm (29 ± 1.5 inches); length has increased
by almost 50 per cent from birth
Head circumference 46 cm (18 inches); head circumference
has increased by one third since birth
Brain weight has increased rapidly since birth, resulting in
significant developmental achievements
Head and chest are equal in circumference
Anterior fontanel closes between 12 and 18 months
Pulse: 115 ± 20
BP: 96/66 ± 30/24
Reflexes: Babinski disappears And landau fades
Teething: 6 – 8 deciduous teeth

Motor
12 Months
Gross Motor:
Stands alone for variable length
of time
Sits down from standing
position alone
Walks in few steps with help or
alone (hands held at shoulder
height for balance)
Improves competence in motor
skills through practice

Motor
12 Months
Fine Motor:
Good pincer grasp
Picks up small bits of food and transfers them to
mouth.
Enjoys eating with fingers
Attempts to put a small pellet into a narrow necked
bottle but does not succeed. Releases one or more
objects inside another object or container
Attempts to put one block on top of another but
does not succeed
Turns pages in a book but usually not one at a time
Drinks from a cup and eats from a spoon but still
requires some held
Holds crayon adaptively to make a stroke or a mark
on a piece of paper

Development
12 Months
Listens for recurring sounds
Full binocular vision well
established
Follows fast-moving object
with eyes
Discriminates simple
geometric forms: squares,
circles
Visual acuity: 20/100 to
20/50
Psychosocial:
Trust Vs Mistrust
Psychosexual: Oral
Stage
Spiritual:
Undifferentiated.

Moral/Cognitive
Development
12 Months
Pre
con
vent
iona
l
mor
ality
Sen
sory
mot
or
Sta
ge
Responds with gestures or
actions to more complex verbal
requests, such as "Please give it
to me“
May speak two or more words
besides "ma-ma" and "da-da“
Understands meaning of many
more words than can be spoken
Knows names of increasing
number of objects
Continues using jargon
Vocalization decreases as
walking increases
Same as 8, 9,
10 & 11 months
Provide large
crayons for
drawing
Provide block &
objects to put in
& out of
container
Push – pull toys
Encourage
walking with
one hand

15 Months
Legs appear bowed

Motor
15 Months
Gross Motor:
Assumes standing position
without support
Walks without support from 13
months of age
Looses balance when walking
around corners or stopping
suddenly
Kneels without support
Creeps up stairs
Throws small objects repeatedly
& picks them up again but may
fall
Cannot throw ball without falling

Motor
15 Months
Fine Motor:
Builds a tower 2-3 cubes
Opens boxes, pokes finger in hole
Scribbles spontaneously, makes
line with crayon
Pats pictures in books & begins to
turn pages
Inserts pellet in a narrow packed
bottles

Motor
15 Months
Self Care:
Feeding Skills
May give up bottle
Holds a cup with all fingers grasped
about it
Cannot fill the spoon well. Spoon is
likely to be turned upside down before
reaching mouth
Enjoys finger feeding
Dressing Skills
Sticks out arm & leg to help in
dressing
Removes socks
Toileting & Grooming skills
Indicates when diaper is wet or soiled

Development
15 Months
Sound localization indicated by
head movement in all planes
Binocular vision fully developed
Displays an intense and
prolonged interest in pictures
Can identify geometric forms &
place bound object into its
approximate place or hole
Psychosocial:
Autonomy vs
shame/doubt
Psychosexual:
Anal Stage
Spiritual: Intuitive -
Projective

Moral/Cognitive
Development
15 Months
Preco
nventi
onal
morali
ty
Sens
ory
motor
Stage
Comprehends more than can
communicate
Recognizes names of various parts of
body
Responds to familiar, simple commands
Says 4-6 words including names
Asks for objects by pointing
May use head shaking gesture to
denote "no“
Communicates "No" even when
following a request
Names familiar pictures
Walking
becom
es a
form of
play
Carries
a toy
while
walking
Musical
&
blocks
toys

18 Months (1 1/2 years)
Anterior fontanel closed (may be closed early too)
Abdomen protrudes
Physiological anorexia
Has sphincter control

Motor
Gross Motor:
Walks with somewhat wide
stance
Seldom falls
Walks sideways & backwards
Walks upstairs with one hand
held
Runs clumsily, falls often
Moves quickly from place to
place
Jumping attempted both feet
Seat self in small chair
Throw balls without falling over
hand

Motor
Fine Motor:
Builds Tower of 3-4 Cubes
Scribbles vigorously and imitates a
vertical stroke with crayon
Turn pages in a book 2-3 at a time
Puts block into hole
Transfer objects hand to hand at
will

Motor
Self Care:
Feeding Skills
Holds cup with both hands & Hands it
to caregiver, put sit down or drops it
on floor
Eats with spoon, may play with food
Negativism and high activity level may
interfere with eating
Dressing Skills
Removes simple garments
Complain when wet or soiled
Increased readiness for bowel &
bladder control
May smear faeces

Development
Can see pictures thus has
intense interest in pictures
Identifies various shapes
Convergence well established
Some depth perception
Psychosocial:
Autonomy vs
shame/doubt
Psychosexual:
Anal Stage
Projective

Moral/Cognitive
Development
Preco
nventi
onal
morali
ty
Sens
ory
motor
Stage
Identified pictures of familiar
objects when named
Identified one or more parts of
body when named
Speaks 10 real words
Uses words more than gestures
to express desires
About 25% of vocalizations are
intelligible
One word used to communicate
Enjoy solitary
play or parallel
play
Has favourite
toy
Push – pull toys
Small furniture's
Running &
chasing
Clay
Crayons
Dramatic play

24 Months (2 years)
Weight: 11.8 – 12.7 kg; has gained 1.8 – 2.7 kg during 2nd
year
Height: Approximately 82.5 – 85 cm, gained 10 – 12.5 cm in
2nd year. Adult height is twice height at 2 years of age
CC exceed HC. HC = 49 – 50 cm
Pulse: 110 ± 20
Respiration: 26 – 28
BP: 99/64 ± 26/24
Dentition: Approximately 16 teeth. Except reproductive &
endocrine physiological functioning is mature
Probably ready for beginning day time control of bowel &
bladder

Motor
24 Months (2 years)
Gross Motor:
More grown up, steady gait
Can walk with heel-toe gait
Walks backward well in imitation
Runs more quickly in more
controlled way; has fewer falls
Walks up & down stairs, both
feet on one step at a time,
holding onto a railing or the wall
Jumps crudely with both feet in
place
Kicks large ball without falling
Picks up object from floor
without losing balance

Motor
24 Months (2 years)
Fine Motor:
Builds a tower of 6-7 cubes
& train
Scribbles in more controlled
way
Imitates a circular and
horizontal stroke
Turn one page of a book at
one time
Opens door by turning door
knob; may run away
Unscrews lid of jar
Folds paper once imitatively

Motor
24 Months (2 years)
Self Care:
Feeding Skills
Drinks well from a small glass held in
one hand
Plays with food, can use straw
Imitates eating habits
May request certain foods
Dressing Skills
Pulls on own simple garments &
removes most of own clothing
Verbalizes toilet needs
Toilet-trained in daytime generally
May brush teeth with help
Attempts to wash self in tub or shower

Development
24 Months (2 years)
Accommodation well developed
Inserts square objects into its
appropriate place or hole
Visual acuity: 20/40
Psychosocial:
Autonomy vs
shame/doubt
Psychosexual:
Anal Stage
Projective

Moral/Cognitive
Development
24 Months (2 years)
Preco
nventi
onal
morali
ty
Preop
eratio
nal
Stage
Understands more complex
sentences
Enjoys stories with pictures
Obeys one directional prepositions
“in/on”
Has vocabulary of about 300 words
Refers to self by first name
Uses pronouns - 'I'/ 'me', 'you',
Ask “what’s, who’s that?”
Verbalizes need for toileting, food
or drink
About 66% vocalization are
intelligible
2 or 3 words sentence length
Parallel play
Creative play
Quiet play
Dramatic play

30 Months
Weight: Gains about 5 kg between 1 and 3 years; birth
weight quadrupled
Height: Grows about 6 – 8 cm
Dentition: Approximately 20 teeth. Except reproductive &
endocrine physiological functioning is mature
Day time control of bowel & bladder control possibly
established

Motor
30 Months
Gross Motor:
Stands on one foot alone
momentarily
Walks on tiptoe for few steps on
request
Walks up & down stairs, one foot
on a step
Jumps from step or loss chair
Jumps with both feet
Can throw a large ball overhand
Rides a walker or pedal car.

Motor
30 Months
Fine Motor:
Builds tower of 8 cubes
Makes vertical &
horizontal strokes but
may or may not join
them to make across
Holds crayon on with
Fingers instead of entire
hand
Good hand finder
coordination; moves
fingers

Motor
30 Months
Self Care:
Feeding Skills
Self feeding with occasional spilling
Gets a drink without assistance
Chews with mouth closed
Uses fork, but held in fist
Dressing Skills
Puts arm through large armhole
Buttons & un buttons large front
buttons
Help put things away
Has mastered daytime bladder control
Beginning night time bladder control
May go to toilet by self
Adequate attempt to wash hands

Development
30 Months
Visual acuity: 20/30
Recall visual images
Psychosocial:
Autonomy vs
shame/doubt
Psychosexual:
Anal Stage
Projective

Moral/Cognitiv
e Development
30 Months
Preco
nventi
onal
moral
ity
Preop
eratio
nal
Stage
Identifies five body parts when
named
Gives full name if asked
Refers to self by appropriate
pronoun
Uses pleural & past tense of
verbs
Talks constantly
Asks why?
Uses 4-5 words sentences
About 75% of vocalizations are
intelligible
Parallel play:
Helps put
things away
Creative play
Quiet play
Dramatic play

3 Years
Weight: Approximately 12.5 – 16.5 kg. Has gained 2.27 kg
during 3rd year
Height: Approximately 90.5 – 101.5 cm. Gained 8 cm in 3rd
year
Pulse: 105 ± 15
BP: 100/67 ± 24/25

Motor
3 Years
Gross Motor:
Walks a straight line
Walks backward & on tiptoes
Runs without looking at feet
Jumps from heights
Goes upstairs using alternate
feet
Catch the ball using extended
arms

Motor
3 Years
Fine Motor:
Builds a tower of 9-10
blocks
Copies a circle
Uses blunt scissors with
one hand to cut
Puts beads on strings
Can help with simple
household work

Motor
3 Years
Self Care:
Dressing Skills
Can put on coat without
assistance
Can undress self in most
instances
Toileting & Grooming
skills
Can go to toilet alone
Brushes teeth with help
Can pull pant up & down

Development
3 Years
Visual acuity 20/20 Psychosocial:
Initiative vs guilt
Psychosexual:
Phallic Stage
Projective

Moral/Cognitiv
e Development
3 Years
Preco
nventi
onal
moral
ity
Preop
eratio
nal
Stage
Has vocabulary of about 800 –
1000 words
Uses 4 word sentences
Talks incessantly
Asks many questions
Names figures in a picture
90% intelligible
Like things that
squish, move,
talk, make
noise
Climbing
apparatus
Transportation
toys

4 years
Weight: Approximately 13.5 – 19.5 kg. Gained 2.27 kg in 4th
year
Height: Approximately 95 – 109 cm, gained 8 cm in 4th year.
Doubling of height from birth length.
CC exceed HC. HC = 49 – 50 cm
Pulse: 100 ± 10
BP: 100/66 ± 20/15
Usually dry at night

Motor
4 years
Gross Motor:
Skips and hops on one foot
for 5 seconds
Jumps from greater heights
Pedals a tricycle quickly;
turn sharp corners
Climbs, ladder, trees,
playground equipment
Walks down stairs using
alternate footing

Motor
4 years
Fine Motor:
Cuts around picture with
scissors
Draws a simple face
Copies a square

Motor
4 years
Self Care:
Feeding Skills
Manages spoon with little spilling
Eats with fork held in fingers
Dressing Skills
Buttons side buttons, small buttons
Can put on shocks with help
Can lace shoes, but may not be able to
tie bow
May bathe self, with assistance,
Washes and dries hands without
supervision.

Development
4 years
Initiative vs guilt
Psychosexual:
Phallic Stage
Projective

Moral/Cognitive
Development
4 years
Preco
nventi
onal
morali
ty
Preop
eratio
nal
Stage
Understands directives
(On, under, in back, in
front)
Names one or more colours
correctly
Uses I
Uses 3-7 words sentences
Has a vocabulary of 1500
words
Count 1 to 5
Plays
cooperative
Interested in
world
Sliding, swing

5 years
Weight: Approximately 15.5 – 21.5 kg. Gained 2.27 kg in 5th
year
Height: Approximately 103 – 115 cm, gained 8 cm in 5th
year.
Pulse: 95 ± 15
BP: 100/60 ± 14/10
Adult head size reached
Anticipate immediate toilet needs

Motor
5 years
Gross Motor:
Skips & hops one
alternate feet
Throws and catches ball
well
Jumps rope and jumps
over object
Skates with good balance
Walks backward with heel
to toe
Balances on alternate feet
with eyes closed
Imitates dance steps if
taught

Motor
5 years
Fine Motor:
Copies a triangle & diamond
Copies letters, may be able
to write own name
Adds 7-9 parts to stick figure
Uses scissors, pencils very
well
Draw a three part man

Motor
5 years
Self Care:
Feeding Skills
Select fork over spoon
when appropriate
Dressing Skills
Can lace shoes
Toileting & Grooming
skills
Bathes Self
Combs hair
wipes self independently
Flushes toilet after each
uses

Development
5 years
Initiative vs guilt
Psychosexual:
Phallic Stage
Projective

Moral/Cognitive
Development
5 years
Preco
nventi
onal
morali
ty
Preop
eratio
nal
Stage
Has vocabulary of 2100 words
Uses sentences of 6-8 words
Names primary colours
Knows names of days of week,
months & other time associated
words
Can follow three commands in
succession
Plays
competitive
exercise
games
Team play
Construction
of dolls, toys

6 - 8 years
Weight: Approximately 17.5 – 25.5 kg. Gained 3.8 kg yearly
Height: Approximately 110 – 124 cm, gained 1.13 cm yearly
Pulse: 90 ± 15
BP: 100/60 ± 16/10
Dentition: Starts to lose temporary teeth; acquires 1st
permanent teeth i.e. Molars, medial incisors, lateral incisors
Tires easily

Motor
6 - 8 years
Gross Motor:
Rides bicycle without
training wheels
Runs, jumps, climbs,
hops
Constantly in motion
Coordination
improving

Motor
6 - 8 years
Fine Motor:
Knows right from left hand
Draws a person with 12-16
parts
Prints words; learns cursive
writing
Has improved eye-hand
coordination

Motor
6 - 8 years
Self Care:
Feeding Skills
6 Years - like to eat with fingers,
Talkative while eating
7 Years - Improved table manners,
less talking
Dressing & Grooming skills
Has a tendency to dawdle in bathtub
Needs to be reminded to wash
hands
Wears whatever is selected by
parents
Leaves clothes where they are
removed
Can brush and comb hair

Development
6 - 8 years
Industry vs
Inferiority
Psychosexual:
Latency Stage
Spiritual: Mythical –
Literal faith

Moral/Cognitive
Development
6 - 8 years
Preco
nventi
onal
morali
ty
Preop
eratio
nal
Stage
Follows series of 3 commands,
response dependent on mood
Responds to praise &
recognition
Can repeat sentences of 10-12
words
Uses all forms of sentence
structure
Develops a sense of humor,
enjoys telling jokes
Has a vocabulary of 2500 words
Like rough &
tumble play
Loves active
play
Prefers group
play
Doll play at a
height

8 – 10 years
Weight: Approximately 22 – 32 kg. Gained 3.8 kg yearly
Height: Approximately 121.5 – 136.5 cm, gained 1.13 cm
yearly
Pulse: 85 ± 10
BP: 100/60 ± 16/10

Motor
8 – 10 years
Gross Motor:
Perform tricks on bicycles;
races
Begins to participate in
organized sports
Throws a ball skilfully -
over hand or under hand

Motor
8 – 10 years
Fine Motor:
Uses both hands
independently
Draws a person with 18-
20 parts
Has increased
smoothness and speed
in fine motor control
Cursive writing improved

Motor
8 – 10 years
Self Care:
Feeding Skills
Handles eating utensils skilfully
Dresses self completely,
enjoys selecting own clothes
Unaware of dirty clothes
Needs to be reminded to brush
teeth

Development
8 – 10 years
Industry vs
Inferiority
Psychosexual:
Latency Stage
Literal faith

Moral/Cognitive
Development
8 – 10 years
Conventional
morality
Concrete
operational
Stage
Follows
suggestions better
than command
Begins to use
shorter and more
compact
sentences
Prefer
companionship
in play
Likes to
compete
Continue to
require
supervision in
play
Enjoy dramatic
play
Collection/hobbi
es develop

10 - 12 years
Weight: 10 years – Approximately 25.5 – 39.5 kg. Gains 3.8
kg yearly
12 years – Boys: 30 – 48 kg, Girls: 30 – 50 kg
Height: Approximately 131.5 – 147.5 cm
12 years Boys – 142 – 158 cm, Girls – 144 – 160 cm
Pulse: Boys - 90 ± 20; Girls - 85 ± 20 beats per minute
BP: 113/60 ± 18/10
Dentition: Acquires cuspids, first and second premolars
Secondary sex characteristics may begin to develop

Motor
10 - 12 years
Gross Motor:
Enjoys all physical
activities.

Motor
10 - 12 years
Fine Motor:
Coordination continues
to improve.

Motor
10 - 12 years
Self Care:
Feeding Skills
Criticizes table manners of parents.
May wear some clothes continually
Leaves clothes where they fall
Enjoy wearing current style of clothes
Needs constant reminding of personal hygiene (10
years)
Bathes frequently – prefers showers (12 years)

Development
10 - 12 years
Industry vs
Inferiority
Psychosexual:
Latency Stage
Literal faith

Moral/Cognitive
Development
10 - 12 years
Conventio
nal
morality
Formal
operationa
l Stage
Follows
suggestions better
than request; is
obedient
Oral Vocabulary of
7200 words;
reading
vocabulary of
50,000 words
Enjoys riddles
Uses numbers
beyond 100 with
meaning
10 years - Enjoys:
Large muscle activity &
outdoor activities
Reading, collection &
construction activities
12 years – Enjoys
parties, athletic sports,
reading mystery & love
stories.
Sex differences noticed
in play

• Biological Growth:
– Puberty – The pubescent period may be considered a
pause of 2 or 3 years between childhood and
adolescence. It is a period of rapid physical change and
personality growth when individuals achieve nearly their
adult bodily stature.
Weight & Height – Growth in height tends to decrease
each year from birth, but with the onset of pubescence
there is a rapid increase, or spurt, and the child becomes
tall.
Gain in weight is proportionately greater than
gain in height during early adolescence.

– Puberty
Body Proportions – In pubescence, the rate of growth of
various organ systems differs. The skeletal system often
grows faster than its supporting muscles, which tends to
cause clumsiness and poor posture.
Dentition – Second molar & cuspid and bicuspid teeth
erupt from 10 to 13 years of age.
Physiological Development – Physical changes in boys
include, in order of appearance, increase in the size of
the genitalia, swelling of the breasts, growth of pubic,
axillary, facial and chest hair, voice changes & production
of spermatozoa. Girls begins to menstruate.

– Adolescence – After the pubescent years, growth
slows and the change in body proportions occurs
more gradually. Adolescents must continue to
live with organ systems and functional capacities
of widely varying levels of maturity.
• Psychosocial or Emotional Development:
 Sense of Identity vs Diffusion & Intimacy vs
Isolation.

• Psychosexual Development:
– During adolescence the child passes through
Freud’s Genital period of development from
approximately 11 – 16 years. Masturbation is a
central concern in early adolescence, especially in
boys.
• Spiritual Development:
 Synthetic Conventional Stage
• Cognitive Development:
 Formal Operational Stage
• Moral Development:
 Conventional & Post Conventional level

• Language Development:
– Adolescents continue to learn new words and new
concepts, as well as the symbolic organization of
their culture.
• Play – Parents, school, individual interest, cultural and
moral attitudes of the community, and job market affect
the play and work interests of the pubescent and
adolescent.

Notes on growth & development

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Notes on growth & development