Growth and development of children: INTRODUCTION, DEFINITION, FACTOR AFFECTING GROWTH AND DEVELOPMENT, GROWTH PERIOD, PRINCIPALS OF GROWTH AND DEVELOPMENT, INDICATION OF GROWTH AND DEVELOPMENT, ASSESSMENT OF GROWTH AND DEVELOPMENT, DEVELOPMENTAL SCREENING, DOMAINS AND AREAS OF DEVELOPMENT, MILESTONES: GROSS AND FINE MOTOR DEVELOPMENT, LANGUAGE DEVELOPMENT, SOCIAL DEVELOPMENT, COGNITIVE DEVELOPMENT, DEVELOPMENTAL DELAY, SCREEING TOOLS.

1. Presented by:
Ms. Manisha Thakur
Child Health Nursing

2. INTRODUCTION
Growth is an essential feature of life of a child that
distinguishes him/her from an adult.
 The process of growth starts from the time of
conception and continues until the child grows into a
fully mature adult.

3. Cont…
 Growth & Development are closely related to one
another.
 Each child is having individualized growth &
development pattern.
 Promotion of child health & care of child depends
upon understanding of growth & development.
 So, understanding of growth & development is
necessary for nurses.

4. DEFINITION
 Growth denotes a net increase in the size or mass of the
tissues. It is largely attributed to the multiplication of cells
and increase in the intracellular substance.
 Development specifies maturation of functions. It is related to
the maturation and myelination of the nervous system and
indicates acquisition of a variety of skills for optimal
functioning of the individual.
 Maturation is an enhancement in ability & modification in
behavior & ability to function at a maximum level. It also
depend upon the genetic pattern.

5. Cont…
 Differentiation is the process by which early cells &
structures are systematically modified & altered to
achieve specific & characteristic physical & chemical
properties

6. FACTORS AFFECTING GROWTH AND
DEVELOPMENT
GENETIC FACTORS:
 Phenotype : The parental traits are usually
transmitted to the offspring. Thus, tall parents have
tall children and so on.
 Characteristics of parents: Parents with high I.Q. are
more likely to have children with higher level of
inherent intelligence. This is further enhanced
because of a greater degree of environmental
stimulation in homes of intelligent parents.

7. Cont…
 Race: Growth potential of children of different racial
groups is different to a varying extent.
 Sex: Boys are generally taller and heavier than girls at
the time of birth. At age of one year there is no
perceptible difference in their length and weight as
related to sex. The growth spurt occurs earlier in girls.
 Biorhythm and maturation: Daughters often reach
menarche at a similar age as their mother. They may
have a similar length of menstrual cycle.

8. FACTORS AFFECTING GROWTH AND DEVELOPMENT
 Genetic Disorders: Growth and Development are
adversely affected by certain genetic disorders. E.g.
Chromosomal abnormalities and gene mutation.
 Children of multiple pregnancies: Ultimate growth of
these children is related to the difference in birth
weights of twins. Smaller newborn babies are likely to
attain lower height and weight.

9. FACTORS AFFECTING GROWTH AND
DEVELOPMENT
Prenatal Period:
 The fetus grows in the maternal environment in utero.
 The health status of the mother has direct effect on the growth
of the fetus. Maternal tobacco and alcohol abuse produces fetal
growth restriction.
 Average birth weight of infants born to mothers receiving
nutrition supplements during pregnancy is higher than babies
born to mothers who did not receive nutritional support in the
antenatal period.

10. Cont…
 Obstetric disorders retard
fetal growth.
 Certain drugs can be
teratogenic.
 Maternal rubella during first
trimester of pregnancy
can cause fetal malformations.

11. ENVIORNMENTAL FACTORS:
Hormonal Influence on Growth:
 Thyroxine: Human fetus secretes thyroxine from 12th
week of gestation onwards. Its deficiency significantly
retards the skeletal maturation of fetus.
Administration of anti-thyroid drugs and iodides
during the later part of pregnancy may induce fetal
goiter and hypothyroidism.

12.  Insulin: It stimulates fetal growth. In mothers with
overt or latent diabetes, the fetus is usually large with
excessive birth weight. As maternal blood sugar is
high, the fetal blood sugar is also elevated. This leads
to hyperplasia of islets cells of fetal pancreas leading
to excessive insulin secretion resulting in macrosomia.

13. Cont…
Postnatal period: Environment experiences of the child after
birth determine the pace and pattern of growth and
development.
 Nutrition: PEM, Anemia and vitamin deficiencies retard
growth. Overeating and obesity accelerates somatic growth.
 Infections and Infestations: Decreases growth.

14. Cont…
Social factors:
 Socioeconomic level: Children from families with high
socioeconomic level usually have a superior nutritional state.
They suffer from fewer infections because of more hygienic
living conditions.
 Climate: The velocity of growth may alter in different seasons
and is usually high in spring and low in summer months.
Infections and infestations are common in hot and humid
climate.

15. Cont…
 Emotional factors: Children from broken homes and
orphanages do not grow and develop at an optimal rate.
Anxiety, insecurity, lack of emotional support and love from
family prejudice the neurochemical regulation of the growth
hormone. Children from broken homes and orphanages.
 Cultural Factors: Methods of child rearing and infant feeding
in community are determined by cultural habits and
conventions. There may religious taboos against
consumption of particular types of food stuffs. These affect
the nutritional state and growth performance of children.

16. Cont…
 Chemical Agents: Administration of androgenic hormones
may affect growth.
 Trauma: Fracture of the end of bone damages the growing
epiphysis and thus hampers the skeletal growth. Head injury
may cause brain damage and seriously jeopardize the mental
development of a child.

17. GROWTH PERIOD
 Prenatal Period:
 Ovum : from conception to 2 weeks.(0 -14 days)
 Embryo: 14 days to 8 weeks
 Fetus: 8 weeks to birth (8-40 weeks)
 Post natal period:
 Perinatal: From birth to 1 week.
 Neonate/ newborn: from birth to 4 weeks.(0-28 days)
 Infancy: from birth to 1 year (1 month – 1 year)

18. GROWTH PERIODS
 Toddler: 1-3 years
 Pre school child: 3-6 years (early childhood)
 School age: 6-12 yrs.( middle childhood)
 Adolescence: from puberty to adulthood
 Early adolescence : 12-14 years
 Middle Adolescence: 14-16 years
 Late adolescence: 16-20 years

19. PRINCIPLES/ LAWS OF GROWTH &
DEVELOPMENT
 Growth and development is a continuous and orderly process.
 Growth pattern of every individual is unique.
 Sequence of development is same but rate of development
varies : Different tissues of body grow at different rates. Growth
& development proceed by stages & its sequence is predictable
& same in all children. There may be difference in time of
achievement.

20. PRINCIPLES/ LAWS OF GROWTH &
DEVELOPMENT
 There is co-ordination between increase in size &
maturation of organ & system.
 They proceed in cephalocaudal (i.e from the head down
to tail) & proximodistal (i.e. from center or midline to
periphery) direction.
 Growth proceeds from the center or midline of the body
to the periphery in a proximo distal direction. Eg. During
antenatal period the limb buds develop before the
rudimentary fingers & toes.

21. PRINCIPLES/ LAWS OF GROWTH&
DEVELOPMENT
 Involuntary movements give way to voluntary responses.
 Initial mass activities & movements are replaced by specific
responses or actions by the complex process of
individualized changes.(Simple to complex)
 Progresses from dependence to independence.
 Growth & development depend on combination of many
interdependent factors especially by hereditary &
environment.

22. PRINCIPLES/ LAWS OF GROWTH&
DEVELOPMENT
 Society has strong influence on child’s growth &
development. Development is affected by cultural status.
 There is a positive correlation between physical, mental,
emotional development & they are interrelated.
 Growth is sometimes rapid & at times it slows down.

24. ASSESSMENT OF GROWTH & DEVELOPMENT
 Continuous & timely assessment of child’s growth
parameters are very essential to find out the deviations,
abnormalities & need for future care of children.
 Assessment of physical growth can be done by :
 Anthropometric measurement :weight, length/height,
circumferences.

25. Cont…
 Body mass index, body ratio, fontanel closure, skin
fold thickness, dentition & bone age.
 Nurses role is very important in these parameters
for good evaluation.

26. INDICATIONS OF DEVELOPMENTAL
ASSESSMENT
 Follow up of high risk neonates for early detection of
cerebral palsy and/or intellectual disability.
 Complete evaluation of children with developmental,
chromosomal or neurological disorders.
 To differentiate children with retardation in specific
fields of developmental opposed to those with global
retardation.
 Evaluation of children with learning disabilities.

27. Goal of Developmental Assessment
 The goal of developmental assessment is not only to
generate a diagnosis, but equally important to analyze
the pattern of strengths and weaknesses in the child,
family, and available developmental, educational, and
social support systems, in order to direct treatment.
 The maturation of central nervous system is
characterized by coordination of motor activity and as
infants grow they respond to their environment in a
purposeful manner with the help of special senses
(acoustic and auditory inputs), integrity of labyrinthine,
vestibular and musculoskeletal systems.

28. CONT…
 Children achieve neuro-motor milestones of development
at predictable ages within a narrow range of few weeks or
months.
 Development is dependent upon interaction between
innate genetic potential and environmental factors like
emotional security, love and attention, stimulating home
environment, optimal nutrition, ethnic and cultural factors.
 Neuro-motor retardation may occur due to gestational
immaturity, perinatal hypoxia, birth trauma, metabolic
disorders (inborn errors of metabolism), hypoglycemia,
kernicterus, intrauterine infections, postnatal CNS
infections, hypothyroidism, developmental and
chromosomal disorders.

29. Developmental Screening
 The American Academy of Pediatrics recommends that
all children be screened for developmental delays and
disabilities during regular well-child doctor visits at:
 9 months
 18 months
 24 or 30 months
 Additional screening might be needed if a child is at
high risk for developmental problems due to preterm
birth, low birth weight, or other reasons.

30. CONT…
 Developmental Screening Developmental delay
 Developmental delay occurs in up to 15% of children
under 5 years of age. This includes delays in speech and
language development, motor development, social-
emotional development and cognitive development.
 It is has been estimated that only about half of the
children with developmental problems are detected
before they begin school.

31. Different Domains of Development
 Gross motor development.
 Fine motor development.
 Social/ cognitive/ intellectual development.
 Speech and language development.
 Vision and hearing development.

32. AREAS OF DEVELOPMENT
 Motor-development: depends upon maturation of
muscular, skeletal & nervous system. It is usually termed as:
• Gross motor development – involves
control of child over his/her body by
increasing mobility. It includes head
holding, sitting, standing, walking,
climbing stairs etc.
• Fine motor development – depends
upon neural tract maturation. Initial
neurological reflexes are replaced by
purposeful activities. It includes eye
coordination, hand coordination & hand
to mouth coordination.

33.  Language development: The first signs of
communication occur when an infant learns that a
cry will bring food, comfort, and companionship.
Newborns also begin to recognize important sounds
in their environment, such as the voice of their
mother or primary caretaker.

34. AREAS OF DEVELOPMENT
 Personal & social development : It
includes personal reactions to his own
social & cultural situation with
neuromotor maturity &
environmental stimuli. It is related to
environmental and social skill as
social smile, recognition of mother,
use of toys, play & mimicry.
 Sensory development: it depends
upon myelination of nervous system &
responds to specific stimuli as taste,
smell, touch and hearing are initial
senses present in newborn babies.
The visual system is last to mature at
6-7 yrs.

35.  Intellectual development: depends upon genetic
inheritance and environmental influences through
mental maturation and achievement of intelligence.
 Moral development: respect of rules & sense of
justice.

36. AREAS OF DEVELOPMENT
 Spiritual development
 Emotional development.

37. Developmental Milestones
4 fields with a sequence of development
 Gross Motor - the development of locomotion
 Vision and fine manipulation - the development of eye-
hand control
 Hearing & speech - the development of language.
 Personal & social - integration of acquired abilities to
reflect understanding of environment.

38. Gross motor development
“Locomotion”
• Locomotion begins with head control.
• The gross motor development is development is assessed
by placing the babies in various postures and positions.
They are:-
• Ventral Suspension
• Prone Position
• Supine Posture and Sitting
• Vertical Suspension, Standing and Walking

39. Assessing Locomotion
S.no. Positions Months/years
1. Ventral suspension NB-3m
2. Sitting position NB-8m
3. Prone position NB-9m
4. Standing/forward walking 9m-18m
5. Running/backward walking 2 years
6. Balancing 3 years +

40. Ventral suspension
The examiner suspends the
infant in a prone position by
supporting the abdomen of the
baby on his palm. The extension
of neck and flexion of the
extremities is observed.

41. Cont…
 4 weeks- 6 weeks
 12 weeks
newborn Head hang completely and back is
rounded
4 weeks Head momentarily lifted up, elbow flexed
6 weeks Head held momentarily in the same plane as
rest of the body
8 weeks Head maintained in same plane as that of the
body and momentarily lifted beyond this.
12 weeks Head maintained well beyond the plane of
the rest of the body

42. Prone Position
Newborn Head is kept
to one side, pelvis is
raised, knees are drawn
up under the abdomen.

43. Cont..
 4-6 weeks- Hips and knees are partially extended, can lift chin
off the couch momentarily.
 8 weeks- Head maintained in midline with chin lifted off the
couch.
 16 weeks- Chest is maintained off the couch, arms are
stretched out in full extension.
 20 weeks- The body is supported on forearms.
 24 weeks- Weight is supported on hands, and baby rolls prone
to supine. Indian babies first learn roll from supine to prone
because they are usually not nursed in a prone position.

44. Supine Position and sitting
The infant is placed
supine on the couch
and pulled to sitting
position by lifting at
the forearms (traction
response).

45. Cont….
 Newborn- Complete head lag.
 4 weeks- Head maintained in plane of the body
momentarily when baby is held in a sitting position,
back is rounded. Chin may be lifted up momentarily.
 12 weeks- Head held up when supported in a position
but it tends to bob (bend) forwards.
 16 weeks- When pulled up, there is slight head lag
during the beginning and then head is flexed beyond
the plane of the body. When held in sitting position and
baby is swayed (swung), the head wobbles.

46. Cont….
 20 weeks- No head lag, head is stable without
wobbling (shaking) and back is straight. 24 weeks
When about to be pulled up, lifts head off the couch in
anticipation. Can sit supported in a pram (baby
carriage) or high chair.
 28 weeks- Can sit on the floor with hands forward for
support.
 32 weeks- Can sit momentarily on the floor without
support.
 36 weeks- steadily without support and can lean
forward and recover his balance.

47. Cont….
 40 weeks- Can sit up from supine position.
 48 weeks- Can turn side ways and twist around to pick
up an object.

48. Vertical suspension, standing and walking
 Newborn- Walking reflex for 2 to 3 weeks
 8 weeks- Can hold head up more than momentarily
 24 weeks- Puts almost all weight of the body on the legs
 28 weeks- Bounces with pleasure
 36 weeks- Pulls self to stand, can stand with support.
 44 weeks- Lifts one foot while standing
 48 weeks- Walks two hands held or on holding the
furniture.
 1 year- Walks few steps independently
 15 months- Creeps upstairs, can kneel without support.

49. cont…
 18 months –Run, can crawl up and down
the stairs without help, pull a wheeled toy
 2 years- Walks up and down the stairs
with two feet on each step, walks
backwards on imitation, picks up objects
from floor without falling, runs, can kick a
ball
 2 ½ years- Can walk tiptoes, jumps on
both feet
 3 years- Goes upstairs with one foot on
each step, jumps off the bottom step
 4 years - Comes down stairs with one foot
on each step, can skip on one foot
 5years - Skips on both feet, can jump over
low obstacles.

50. FINER MOTOR DEVELOPMENT
 Newborn- Grasp reflex is present.
 4 weeks- Hands mostly closed.
 8 weeks- Hands kept open more
often.
 12 weeks- Hands mostly open, grasp
reflex disappears, plays with rattle
when it is placed in the hand.
 16 weeks- Tries to reach objects but
overshoots, hands come together
during play.
 20 weeks- puts objects into mouth,
plays with toes.
 24 weeks- Drops one object when
other is given, holds rattle, picks up a
cube with crude palmer grasp.

51. Cont…
 28 weeks – transfer objects
from one hand to other, feeds
self with the biscuit, bangs
object with each other.
 40 weeks- Pincer finger thumb
fine grasp to pick a pellet.
 1 year- gives toy to examiner,
puts one object after another
into the basket.

52.  15 months- self feeds with the
cup, builds tower of 2,3 cubes,
holds two cubes in one hand.
 18 months- can self feed with
spoon, makes tower of 3, 4 cubes,
turns 2-3 pages of a book at a time.

53. Cont…
 3 years- makes tower of 9-10 cubes, can dress and
undress, can manage buttons, can draw a circle.
 4 years- copies a square and cross, make a bridge, can
dress self completely, catches a ball.
 5 years- copies a triangle, can tie shoe laces, can spread
butter on the toast.

54. SOCIAL AND ADAPTIVE DEVELOPMENT
 2 months –Social and interative
smile.
 3 months- Recognizes mother;
anticipates feeds.
 6 months- Recognizes strange/
stranger anxiety.
 9 months- Waves ‘bye-bye’
 12 months- Comes when called;
plays simple ball game
 15 months –Jargon speech
 18 months- Copies parents in task

55. Cont…
 2 years- Asks for food, drink,
toilet; pulls people to show toys
 3 years -Shares toys; knows full
name and gender
 4 years- Plays cooperatively in a
group; goes to toilet alone
 5 years- Helps in household
tasks; dresses and undresses

56. LANGUAGE DEVELOPMENT MILESTONES
 1 month- Turns head to sound.
 3 months- Cooing 6 months Monosyllables (‘ma’, ‘ba’)
 4 months- laugh loud
 6 months- monosyllables
 9 months- Bisyllables (‘mama’, ‘baba’)
 12 months- Two words with meaning.
 18 months- Ten words with meaning

57. Cont…
 24 months- Simple sentence, 2-3 words sentence.
 36 months- Telling a story
 4 years- says song or poem
 5 years- asks meaning of words

58. 0-1 Year: Cognitive Skills
 Responds to sounds (0-1 mo)
 Inspects hands (2-3 mo)
 Uses hands and mouth to explore
objects (3-6 mo)
 Can find a partially hidden object (4-
6 mo)
 Brings feet to mouth (5-6 mo)
 Attempts to obtain desired object
that is out of reach (5-9 mo)

59. Cont…
 Looks for familiar people/pets
when named (6-8 mo)
 Plays 2-3 minutes with one
object/toy (6-9 mo)
 Plays “peek-a-boo” (6-10 mo)
 Responds to simple requests
with gestures (7-12 mo)
 Throws objects, understands
“no” and responds (9-12 mo)
 Enjoys looking at picture books
(10-14 mo)

60. Developmental Delay
 During periodic visits of the child to the physician for
health assessment and immunization, the child should
always be screened for behavioral development by a
relatively simple method which could be performed
rapidly and accurately even by a non-professional
clinical assistant.

61.  If this behavioral assessment indicates delayed
development, the child should be examined in detail to
determine the cause for such delay.
 A developmental delay should be suspected if a child
is not able to perform the given tasks by the indicated
ages.

62. CONT…
 Developmental delay should be suspected if the child is
not able to :
 Pull up to sit by 4 months.
 Roll over by 5 months.
 Sit without support by 7-8 months.
 Stand holding on by 9-10 months.
 Walk by 15 months.
 Climb up or down the stairs by 2 years.
 Jump with both feet by 2.5 years.
 Stand momentarily on one foot by 3 years.
 Hop (step) by 4 years and walk in a straight line back and forth
or balance on one foot for 5-10 seconds by 5 years.

63. ASSESSMENT OF MUSCLE TONE
 Healthy newborn have
physiological hypertonia and there
is gradual reduction of muscle
tone during 1st year of life.
 Alterations in the muscle tone
especially hypertonia is common
in cerebral palsy.
 Muscle tone should be assessed
when baby is alert, wide awake,
not crying and should lie in
supine position with head in
midline.

64. Body posture
Square window
Arm recoil
Scarf sign

65. Heel to earPopliteal angle

68. DEVELOPMENTAL SCREENING TOOL
 A no. of parent completed questionnaire are available
for developmental screening like parents evaluation of
developmental status(PEDS) and age and stages
qustionnaire (ASQ).
 A smiplified developmental tool for angan wadi has
been introduced for 18-36 months of age for
anganwadi workers.

69. INDIAN ORIGIN INTERNATIONAL ORIGIN
 Trivandrum developmental
screening chart.
 Baroda developmental
screening test.
 ICMR psychosocial
developmental screening test
1. Parents evaluation of
developmental status.
2. Denver developmental
screening test ii.
3. Bayley infant neuro-
developmental screen
(bins).
4. Ages and stages
questionnaire
DEVELOPMENTAL SCREENING TOOLS

70. TRIVANDRUM DEVELOPMENTAL SCREENING
CHART
 Designed and developed at the child cevelopment centre,
govt. me
 It is used for developmental screening of children
below 2 years by paramedical health workers.
 Administration time: 5-7 mins
 It is based on 17 simple test items carefully chosen
from 67 motor items of Bayley scales of infant
development( baroda norms).

71.  A plastic ruler or a pencil is kept vertically to the level
of chronological age of the child being tested.
 If the child fails to pass any marker, the child is
considered to have developmental delay.
 Most suited for one year of age children.

74. BARODA DEVELOPMENTAL SCREENING TEST
 The test was developed by Promila Phatak in 1991 at
Department of Child Development, University of
Baroda.
 Items: 54
 Age : 0-30 months
 Screening domains: motor and cognitive
 Dr. Pathak selected items from Baley Scale of Infant
Development (1961)

78.  Age and format : 0-6 years and parent interview
 Items: 64 items
 Screening domains: gross motor, vision, hearing, fine
motor, gross motor and social skills.
 D:PEADITRICSGROWTH AND
DEVELOPMENTSTUDY ICMR.pdf
ICMR PSYCHOSOCIAL DEVELOPMENTAL SCREENING
TEST

79. PARENTS EVALUATION OF DEVELOPMENTAL STATUS
 Age and format: It includes o-8 years, parent report.
 Screening domains: Cognitive, language, gross motor,
social emotional behaviour.
 Items included: 10

80.  PEDS questions cover:
 speech and language
 how your child gets along with others
 learning for school (babies learn from the moment they are
born and it is important to support parents to help children
reach their full potential)
 what your child can do for themselves
 behavior
 how your child uses their hands, fingers, arms and legs
 health, and
 how you think your child is going overall.

81.  PEDS is used by health and education practitioners
by :
 childcare centres.
 preschools and kindergartens
 child and family health centres.
 community health centres.
 general practice clinics
 pediatric clinics
 schools
 early parenting centres.

84.  PEDS-brief-administration-and-scoring-guide.pdf

85.  DENVER DEVELOPMENTAL SCREENING TEST II
The Denver Developmental
Screening Test was introduced in
1967 to identify young children, up to
age six, with developmental problems.
A revised version, Denver II, was
released in 1992 to provide needed
improvements.
Age and format: o-6 years , directly
administered.
Screening domains: cognitive,
receptive, gross motor, fine motor,
social, language, personal.
Items included: 125

86.  DENVER 2

87.  Dr. Diane Bricker from the
University of Oregon heeds the
call to design economical, valid
and culturally sensitive
screening tools for young
children at risk for
developmental delays.
 Age and format: 1-66/3-66
months, parent report.
 Screening domains:
communication, gross motor,
fine motor, problem solving
and personal adaptive skills.
 Items: 22-36
AGES AND STAGES QUESTIONNAIRE

88. Feautres of ASQ
 are available in Arabic, Chinese, English, French,
Spanish, and Vietnamese
 take just 10–15 minutes for parents to complete and 2–3
minutes for professionals to score
 capture parents’ in-depth knowledge
 highlight a child’s strengths as well as concerns
 teach parents about child development and their own child’s
skills
 highlight results that fall in a “monitoring zone,” to make it
easier to keep track of children at risk
 can be completed at home, in a waiting room, during a
home visit, or as part of an in-person or phone
interview.

89.  Programs across the country rely on ASQ-3
because it’s
 highly valid, reliable, and accurate
 cost-effective
 easy to score in just minutes
 researched and tested with an unparalleled sample of diverse
children
 a great way to partner with parents and make the most of their
expert knowledge
 fun and engaging for kids

90.  There are two screeners in the ASQ family:
1. ASQ®-3, which looks at key areas of early development.
1-66 months for ASQ-3, 21 questions.
2. ASQ®:SE-2, which focuses on social-emotional
development. 3-66 moths for ASQ:SE, 8 questions
ASQ®-3 ASQ®:SE-2
1. Communication
2. Gross Motor
3. Fine Motor
4. Problem Solving
5. Personal-Social
1. Autonomy
2. Compliance
3. Adaptive functioning
4. Self-regulation
5. Affect
6. Interaction
7. Social-communication

91.  D:PEADITRICSGROWTH AND DEVELOPMENTAges
and Stages 3 Master Set.pdf

92. BAYLEY SCALE OF INFANT DEVELOPMENT
 BSID-II: Mental, Motor, and Behavior scales.
 Bayley-III revision includes Cognitive, Language,
Motor, Social-Emotional, and Adaptive Behavior
scales.
 Administration: 50 min for children aged 12 months
and younger to 90 min for children aged 13 months
and older.

93.  Bayley Scales of Infant and Toddler Development -
individually administered instrument
 assesses developmental functioning – infants & young
children – between 1 month and 42 months of age
 Five major areas of development
1. Cognitive
2. Communication
3. Motor
4. Social/Emotional
5. Adaptive

94.  Age and format: 3-24 months, directly administered.
 Screening domains: neurological process, expressive
and receptive, functional and cognitive.
 Items: 11-13
 The BINS was developed contemporaneously with the
Bayley Scales of Infant Development—Second Edition
(BSID-II)
 It consists of items from the BSID-II Scales that assess
cognitive, social, language, gross, and fine motor skills.

95.  The BINS consists of six item sets grouped by age (3 to 4
months, 5 to 6 months, 7 to 10 months, 11 to 15 months, 16 to 20
months, 21 to 24 months), each containing 11 to 13 items.
 Basic neurological functions/intactness (posture, muscle tone,
movement, asymmetries, abnormal indicators)
 Expressive functions (gross motor, fine motor, oral motor/verbal)
 Receptive functions (visual, auditory, verbal)
 Cognitive processes (object permanence, goal-directedness,
problem solving).
 The total number of items failed places the infant in a category of
low, moderate, or high risk for developmental delay.

96.  Each item in the BINS is scored “optimal” or
“nonoptimal,” based on a priori decision rules; the
number of optimal responses for a given item set are
then added to provide a summary score.
 The infant’s total score is then compared to the norms
in order to classify the infant into low, moderate, or
high risk for developmental delay or neurological
impairment

97. “It is a smile of a baby that makes life worth
living.”