Areas of Development

Cognitive Development:
This area defines a child’s ability to think, process information, learn and solve problems. There are several theories that describe the skills and processes associated with infant learning and taught in schools today. Such skills and information processing and are: object permanence (ability to understand that objects and events continue to exist even though the infant is no longer in contact with them), attention, symbolic play, imitation,conceptual ability, habituation (the repeated presentation of the same stimulus causing reduced attention over time), and memory. Several developmental tests are used today and were developed based on these theories. Some of the more common tests used are The Bayley Scales of Infant Development and The H.E.L.P. Checklist. Such tests evaluate an infant’s auditory and visual attention, manipulation of objects and toys, interaction with examiner and imitation, memory involved with object permanence (like finding hidden toy), goal-directed behavior involving persistence (like peg board, shape sorter), ability to follow directions, knowledge of object names and understanding concepts (such as concept of ‘one’).
Milestones associated with this area are: identifies self in mirror(15-16 months), identifies 6 body parts(22-24 months) and completes 3-4 piece puzzle (30-36 months).Children who are tested and found delayed in this area would be recommended to receive “Special Instruction” services either at home, in a classroom setting or both, depending on the child’s needs and age. A Special Education Teacher would be serviced to assist a child’s development in this area. Special Instruction in a classroom setting also overlaps with learning skills in each of the other areas as well due to many of the classroom activities.

Communication Development:
Language: In an infant’s first few months, sharp noises can show a startle response. At 3 to 6 months, infants can begin to show an interest in sounds, play with saliva, and respond to voices. In the next 3 to 6 months, babbling can begin and is determined mainly by biological maturation, not so much reinforcement, hearing, or care-giver-infant interaction. It has been found that deaf babies can begin to babble at this time. The purpose of a baby’s earliest communication is to attract attention from parents and others in the environment. This is usually accomplished by a baby making and breaking eye contact, by vocalizing sounds, or by performing manual actions such as pointing. All of these behaviors involve the aspect of language called pragmatics.
The environment can play a significant role in communication development. It is encouraged for babies to be bathed in language very early by speaking to them extensively, especially about what the baby is attending to at the moment.

    Communication is divided further into 3 areas when assessed:
    • Receptive Speech: This area is defined as a child’s ability to understand words as they are spoken to them. It involves understanding directions in steps, answering questions or responding appropriately when spoken to.
    • Expressive Speech: This area defines a child’s ability to produce sounds in expression of wants and needs; the child’s ability to appropriately speak. It involves vocalizing all needs, vocabulary building and identifying by name.
  • Oro-Motor: This is the physical aspect responsible for speech; it involves the oral mechanics behind sound production. Since this area of speech focuses on muscles of the mouth, movement of the tongue, reflexes and coordination, both Speech Therapists and Occupational Therapists work with children for this area.

Some of the milestones in infant communication are: babbling(3-6 months), first words understood(6-9 months), growth of receptive vocabulary(reaches 300 words or more by age 2), first instructions understood (9 months to 1 year), first word spoken(10-15 months), and the growth of spoken vocabulary(reaches 200-275 words by age 2).

Concepts expected with two-word statements by ages 18 to 24 months are:identification(‘see book’), location(‘toy there’), repetition(‘more’), nonexistence(‘all gone’), negation(‘not dog’), possession(‘my toy’), attribution(‘big car’), agent-action(‘mom move’), action-direct object(‘hit you’), action-indirect object(‘give dadda’), action-tool(‘cut knife’), and question(‘where ball?’).

Speech Therapists typically work with children delayed in this area either one to one at home, at a center, in a speech group, or in a classroom. Occupational Therapists overlap with respect to oro-motor, and Special Education Teachers overlap in this area with respect to working with a child’s speech in the classroom.

Physical Development (gross motor):
This area involves the development and coordination of large muscle groups. At birth, an infant does not have significant coordination of chest and arms, yet in the first month an infant should lift its head from a prone position. At about 3 months, an infant should hold its chest up and use its arms for support after being in a prone position. At 3 to 4 months, infants should roll over, and at 4 to 5 months, they should support some weight on their legs. Other skills associated with this area are rolling over, holding head up, walking, balance and ascending/descending stairs. The actual month at which the milestones occur varies by as much as 2 to 4 months, especially among older infants. What remains fairly uniform however, is the sequence of accomplishments. As each skill is learned, so does the level of independence as well.

Physical Therapists are serviced to work with children delayed in this area, typically on a one to one basis. A common condition that occurs in children who were breached or born of multiple births and in need of physical therapy, is torticollis. If a child is in a constraining position while in the womb, muscles can become tightened and in the case of torticollis, the neck muscle is tightened. In this case a child would be born with his/her head tilted to one side. Physical therapy for a few months, 2 or 3 times a week and some parental carry-over exercises could relieve this condition.

Hand/Eye Coordination (fine motor):
This area involves the delicate coordination of smaller muscles and muscle groups such as hands, fingers, mouth and eyes. Infants have hardly any control over fine motor skills at birth, although they have many components of what later become finely coordinated arm, hand, mouth and finger movements. Skills associated with this area involve reaching and grasping, manipulating objects, coloring with a crayon, grasping objects appropriately, following objects with eyes, and later, feeding oneself and being toilet trained. This area can also include two other areas of development:

  • Feeding: This area is focused on oro-motor development. By stimulating certain areas of the mouth with foods and therapeutic devices, a child may learn to coordinate the mouth muscles necessary for speech and eating various textured foods. Occupational and Speech Therapists work with children in this area.
  • Sensory Development: This area of development involves sensory integration; it involves how a child tolerates touching all textures like sand or water, tolerates loud noises, tolerates being touched, and tolerates being picked up off the ground. Occupational Therapists work with children in this area. Occupational Therapy focuses on these areas and may at times involve other therapies such as Speech and Physical Therapy. ¬†A child with delays in motor planning/coordination may need Physical, Occupational and Speech Therapies, for example.
Social/Emotional Development:

This area involves a child’s ability to display and identify emotions such as fear and anger, for example. It is also the area that involves attachment, temperament, how a child acts in social situations such as greeting people hello or goodbye, sharing attention with another, and looking at another for approval. Emotions are the first language that parents and infants communicate with before the infant acquires language. various emotions occur at different ages – for example, a social smile (4-6 weeks), surprise (3-4 months), and shame (6-8 months).

Attachment to a caregiver intensifies at about 6 to 7 months of age, and can be classified by three areas: secure – assumed optimal for development, avoidant, or resistant. An infant’s temperament (such as easy, difficult, or slow to warm up) is strongly influenced by biological factors but becomes more malleable with experience. Psychologists, Social Workers and classroom settings all play key roles in working with children delayed in this area.

Adaptive/Self Help Development:

This area involves a child’s independence, ability to do things for one’s self, and a child’s ability to adapt to the environment. As children progress in physical and coordination development, they have more opportunities to explore their environment and gain independence. Skills associated with this area are feeding oneself, opening door independently, unzips/zips zipper and going in potty independently, for examples. Occupational Therapists and Special Instruction Teachers typically work with delayed children in this area.

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