Pediatric/Adolescent Development

Infant-18 months -

During the time from birth to around 18 months, children develops rapidly and hopefully learns to trust. This stage can be broken down in to 5 smaller stages; birth to 1 month, 1-month to 4 months, 4 months to 8 months, 8 months to 12 months, and finally 12 months to 18 months.

During first stage birth to 1 month, the child starts in physiological flexion. They begin to gain brief head control, primally lifting its head. They will roll partly to one side in supine. There are a number of reflexes present including ATNR, TLR, Galant, Palmar grasp, Plantar grasp, Rooting, Moro, Startle, Positive support, and Stepping. The child is starting to focus on object directly in the line of sight and hands are fisted. They are starting to discover the world around them.

The next stage is 1 month to 4 months, during this stage they are learning to adapt to their surroundings. The child is better able to control their head and are able to roll from prone to supine and supine to a side position. In prone, they are able to begin to bear weight on elbows and extend their arms. The ANTR reflex is strong during this stage. A number of reflexes are lost during this stage, that includes Galant, Palmar, Rooting, Positive support, and Stepping.

At 4 months to 8 months the child can maintain head control in a supported seated position. They begin to sit independently and roll from supine to prone. Toys become an important part of the development. Early in the stage the child will pivot in prone to reach for a toy and are able to grasp and release toys. They will use a rake motion to pick up small objects. The STNR reflex is gained during this time, however TLR, Moro, and Startle reflexes are lost. This is also a time where the child is interested in event caused by their actions.

Months 8 to 12, the child will begin to organize their thinking. They will start to crawl, creep, stand, and walk. Their fine motor skills are developing including pincer grasp and radial-digital grasp. By 9 months all primitive reflexes are lost. Children begin to understand simple words and respond to their name.

The final stage is 12 months to 18 months, in this stage the child begins to walk without support. They are able to throw a ball in sitting and may creep or hitch up the stairs. Stacking two cubes into a tower and dumping out a small container are new skills. Activities are intentional and goal directed. They can also understand that objects still exist when out of sight. Children with begin to speak at 13 months. Around 18 months children have will add 3 or more words to their vocabulary.

At birth, infants are completely dependent, this is why it is suggested that the first stage of Erikson's theory of psychosocial development is the most important. If caregivers provide everything the infant needs, they will gain trust, and feel safe. If the infant is not provided for they will develop mistrust. Erickson believed there needs to be a health balance of trust and doubt, when this happens the infant had hope.

The parents and caregivers are the most important role during this time. There is still a need to work on gaining the confidence of the infant.

2-3 years

Children begin to play at this stage, they are able to squat, walk backwards, kick a ball, walk up and down stairs, and propel ride on toys including a tricycle. The fine motor skills are continuing to develop; stacking blocks, turning knobs, and buttoning large buttons. Erikson's second stage is focused on autonomy vs. shame and doubt, the child develops a greater sense of personal control and independence. An important role in this development it potty training, success leads to autonomy while failure results in shame and doubt. Interventions and communication with this group should help them feel confident and avoiding self-doubt.

3 years -5 years

This stage this also called the preschool age, children are able to run and avoid obstacles, hop on one foot, and throwing and catching a small ball. They are able to copy circle and cross and use a scissors. The child's hand preference may be present. Erickson's stage 3 - Initiative vs. guilt takes place during this time. He states children will begin to assert their power during play and social interactions. Success during this stage will lead children to a sense of purpose.

5 years - 13 years

Children who are 5 - 13 years old are in the school age. Early on children are able to skip with alternating feet, gallop, and jump rope with rhythm and control. Printing is controlled and they are beginning to learn cursive writing. Near the end of this stage, children will show mature movement patterns and handwriting is developed. Industry vs. Inferiority is the Erikson's stage for this age group. Social interactions are important for school age children, success will help develop a sense of pride in their abilities. Encouragement will help to develop belief in their skills, without encouragement the child will have doubt.

13 years -21 years

The final stage in childhood is adolescence. Children will see rapid growth with boys seeing more size and strength to girls. Puberty begins during this time, with changes in center of gravity. Fingers will develop greater dexterity for fine tasks. Erikson's 5th stage is identity vs confusion, during this time teens begin to develop a sense of personal identity. This is the time for exploring their independence and who they are. If they are successful, they will be able to stay true to themselves, without it their sense of self will be weak, and they may feel confused.