Debbie Richardson, M.S. Parenting Assistant Extension Specialist

1. Infant and Toddler DevelopmentPart 2: The First Six MonthsOklahoma Cooperative Extension ServiceCore In-Service November 4, 2008 10:00-11:30 a.m. Debbie Richardson, M.S. Parenting Assistant Extension Specialist Human Development & Family Science Oklahoma State University

2. Introduction • Welcome • Centra Instructions • Overview of In-service • Resource Materials Infant-Toddler Dev 2, D. Richardson

3. In-Service Objective Extension Educators will be able to describe growth, tasks, behaviors, and abilities of infants from birth through six months including physical, cognitive, sensory, and social development. Infant-Toddler Dev 2, D. Richardson

4. Infant DevelopmentGeneral Areas • Sensory (sight, hearing, etc.) • Gross motor (head control, sitting, walking) • Fine motor (holding a spoon, pincer grasp) • Language • Social Infant-Toddler Dev 2, D. Richardson

5. Infant Development • Depends on traits he/she was born with (nature) and what he/she experiences (nurture). • All areas of development are linked. Each depends on and influences the others. • What children experience, including how their parents respond to them, shapes their development as they adapt to the world. • Relationships are the foundation of a child’s healthy development. Infant-Toddler Dev 2, D. Richardson

6. Developmental Growth Sequence • Cephalo-caudal: proceeds head to foot • Control hands before feet • Think before acting • Gets teeth before he walks • Proximal-distal: proceeds from center outward • Trunk , then arms, then hands & feet • Large muscles to small muscles • Simple to complex: • Talks, reads, writes • Lifts head, sits up, creep, crawl, walk, run • Feed from bottle before eating finger foods Infant-Toddler Dev 2, D. Richardson

7. Developmental Milestones • Physical or behavioral signs of development or maturation of infants and children. • General guidelines…every baby’s growth is unique and all grow and develop at different rates. • Grow in spurts - a new behavior may appear one day and disappear for several days or weeks. • A child may also regress. Infant-Toddler Dev 2, D. Richardson

8. Sensory Development • All senses are developed by 7th month in utero. • From birth, an infant learns about people and things through the use of 5 senses: touch, sound, smell, taste, and sight. • Responsive to touch, temperature change, and pain. • At birth, can identify people by their odor and show responses to pleasant or unpleasant smells. • By 2 weeks, can distinguish between sweet and bitter taste; prefers sweet vs. sour. Infant-Toddler Dev 2, D. Richardson

9. Hearing • Turns eyes and head in general direction of sound as young as 3 days old. • Prefers low-frequency, rhythmic sounds and human voice. Selectively listens to higher-pitched voices. • By 3 weeks, recognizes voices go with particular people. • Vestibular (inner ear; balance) - responds to rocking, changing positions. • By 2 months, head turns side to side with sound at ear level. • By 3 months, determines where sounds are coming from; turns head to sounds. Infant-Toddler Dev 2, D. Richardson

10. Vision • Newborn sees within range of 8–12”; slightly blurred. • Can track an object moving horizontally about 6” above. • One eye may wander or both eyes don’t move together smoothly. Unable to perceive depth. • Can see light and dark contrasts, but cannot really distinguish color. • By 6 weeks, smoothly moves eyes together to follow an object. • By 2 months, both eyes can converge on objects up to 24”. • tracks moving objects up to 180o; prefers faces • Differentiates patterned stimuli from plain; discriminate colors. Infant-Toddler Dev 2, D. Richardson

11. Vision • By 3-4 months: • distinguishes objects from backgrounds with minimal contrast; gains ability to see detail. • accommodates, focuses eyes with changing object distance. • By 4-6 months: • vision is clearer • perceives relative distances • color vision develops. • turns head toward bright colors and lights. Infant-Toddler Dev 2, D. Richardson

12. Reflexes • Enable baby to react to environment. • Instinctual and serve as protection • All infants born with same reflexes but responses are individual. • Born with over 70 identified reflex behaviors. • Most will disappear between 3 to 6 months. • Most important associated with breathing & feeding. • Crying often seen as reflex that alerts others of needs. Infant-Toddler Dev 2, D. Richardson

13. Reflexes • Babinski: Toes fan outward when sole of foot is stroked. • Palmar grasp: Infant closes hand, "grips" your finger. • Rooting and sucking:When cheek, mouth, lips touched, turns head in search of nipple, mouth open, ready to suck. • Hand to mouth: When cheek or palm of hand is stroked, mouth roots and arm flexes to suck fist. • Blinking: Tightly shuts eyes to bright lights or loud noise. Infant-Toddler Dev 2, D. Richardson

14. Reflexes • Placing: Leg extends (pushes away) when stimulate sole of foot. • Stepping: When held upright and feet placed on a surface, lifts one leg then other like walking steps. • Moro (startle): Extends arms, legs, & arches back, then bends and pulls them in toward body, with brief cry; triggered by loud sounds, sudden moves. • Tonic neck: Arm extends in direction infant gazes, while opposite arm and leg flex inward. • Head lift: Lifts & turns head to side when on belly. Infant-Toddler Dev 2, D. Richardson

15. Newborns-Neonates • Ave weight: 5-10 lbs. Ave. length: 18-22 inches • In first few days, lose about 6-10% of weight and regains or surpasses birth weight within 10-14 days. • Head is relatively large, ¼ of total length. • Skull bones are separated, not fused: • allows bones to slide over each other passing through birth canal • accommodates rapid brain growth • soft spots on top of head – fontanels • All 20 baby teeth and a few permanent teeth are developing below gum. Infant-Toddler Dev 2, D. Richardson

16. Newborns-Neonates • Cannot support head without help; unable to support when pulled to a sitting position. • Can slightly lift and turn the head • Keeps hands fisted or slightly open, but can’t hold object. • Arms and legs are flexed into body, although can move and thrust all limbs. • Few expressions when awake. • Make cooing, crying and grunting sounds. Infant-Toddler Dev 2, D. Richardson

17. Newborns-Neonates • Tells parent voice from strangers. Makes eye contact. • Very brief memory. • Experience only emotions of contentment and distress. • When talked to by familiar caregiver, an interchange takes place that involves looking, listening, vocalizing, and motor movement. • Discovers self-soothing - can calm self by sucking thumb and looking at parents’ face or matching mobile. • Gaze aversion – shifts attention away when aroused to point of distress. Infant-Toddler Dev 2, D. Richardson

18. Second Month • Briefly holds rattle or other object then drops. • Roll part way from side to back. • Closure of posterior fontanelle (back of head). • Stepping and grasp reflexes disappear. • Strengthening neck muscles; less head lag. • On tummy, able to lift head almost 45 degrees. • Less flexing of the arms and legs while on tummy. Infant-Toddler Dev 2, D. Richardson

19. Second Month • Coos and makes small throat sounds like gurgling. • Smiles spontaneously;establishes eye contact. • Crying becomes differentiated. • Recognizes mother. Reacts to sight of breast/bottle. • Makes vocal response to familiar voices. • Learning to regulate their eating and sleeping patterns, and emotions which helps them feel content, safe and secure. • Joy becomes a differentiated emotion. Infant-Toddler Dev 2, D. Richardson

20. Third Month • Stretch arms and legs all the way out. • Sits when supported and can hold head steady. • Suck fingers & fists; holds up hand & looks at it. • Begins to play with hands; reaches for things with both hands and tries to hold them. Holds objects longer. • Roll from back to side. • Makes crawling movements. • Scratches surface with fingers. Infant-Toddler Dev 2, D. Richardson

21. Third Month • Tracks objects in circular path. • Glances between 2 objects (bell to rattle). • Vocalizes more, cries less, makes louder sounds. • Responds to voices; recognizes other familiar adults. • Laughs out loud; squeals. • Cries differently for different needs. • Starts to understand cause and effect (ex. “If I hit the mobile it moves” or smile, coo, babble then pause and wait for a response). • Imitation (e.g. sticking out tongue) Infant-Toddler Dev 2, D. Richardson

22. Fourth Month • 10-18 lbs. and 23-27”; slowing weight gain • Reflexes fading - Moro, tonic neck, rooting, grasping • Almost no head lag while pulled into sitting position. • Sits up straight if propped and supported. Stands with support. • Can raise head 90o when placed on tummy. • Rolls from side to side or front to back. Infant-Toddler Dev 2, D. Richardson

23. Fourth Month • Tries to reach objects with hands. Grasp & play with rattle when placed in hands, but can't pick it up. • Places and explores objects in mouth. Can hold toy and look at it steadily. • Wiggles, kicks arms and legs; plays with fingers, hands, toes. • Longer babbling, cooing sounds (aaah, oooh, eeeh). • Laughs; Returns a smile. Infant-Toddler Dev 2, D. Richardson

24. Fourth Month • Responds to peek-a-boo games. • Begins to show memory. • Demands attention by fussing. • Recognizes parent voice or touch. • Repeats actions for a reaction (e.g. hitting mobile). • Blows bubbles with mouth. • Teething may begin. Infant-Toddler Dev 2, D. Richardson

25. Fifth Month • Double birth weight. • May start to scoot or attempt to crawl. • Able to sit alone without support for only moments at first, then up to 30 seconds or more; improving balance. • Rolls from back to stomach. • On tummy, can push up with arms to raise the shoulders and head above surface and look around or reach for objects. Infant-Toddler Dev 2, D. Richardson

26. Fifth Month • Begins to grasp blocks or cubes using the ulnar-palmar grasp technique (pressing the block into palm of hand while flexing or bending wrist in). Doesn’t use thumb opposition. Bangs with a toy. • Begins wanting to explore their food and help feed themselves. • Understands own name. • Recognizes difference between lower voice of father and higher voice of mother. • Turns head toward a voice; responds to voices. • Begins to initiate interactions. Infant-Toddler Dev 2, D. Richardson

27. Sixth Month • Pulls self up in sitting position. • Stands with support and bears almost all weight. • Creeps like army crawl on tummy. • Able to sit in a high chair with a straight back. • Able to hold bottle for short periods. • Better at reaching and grasping; can pick up a dropped object; transfers objectfrom one hand to other. • Begins to realize that if an object is dropped, it is still there and looks for it (permanence). • Plays with toys. Infant-Toddler Dev 2, D. Richardson

28. Sixth Month • Teething; first tooth/teeth may appear. • Can locate sounds not made directly at the ear level. • Responds and vocalizes to own name. • Enjoys hearing own voice and experiments with own sounds; makes sounds (vocalizes) to mirror and toys; • Makes consonant sounds and sounds resembling one-syllable words. • Shows pleasure/displeasure with sounds; Prefers more complex sound stimulation. Infant-Toddler Dev 2, D. Richardson

29. Sixth Month • Begins to imitate actions and sounds. • Laughs and squeals. • Recognizes parents; distinguishes mother/father. • Can tell when adult is happy or angry by tone of voice. • Initiates social contacts by grabbing adult’s hair, face, clothes, glasses. • Raises arms to be picked up. • Differentiates fear from discontent. • Begins to fear strangers (stranger anxiety). Infant-Toddler Dev 2, D. Richardson

30. Communication • Newborns use their gestures, sounds and facial expressions to communicate their feelings and needs from day one. • Socializes by watching your face and exchanging looks. • Asks for a break by looking away, arching their back, frowning, or crying. Infant-Toddler Dev 2, D. Richardson

31. Smiling • Appears at about 1 week. • At 1 month, smiles are directed toward people. • By about 3 ½ months, will smile in response to a smile or attention; will smile more to a familiar face than an unfamiliar one. Infant-Toddler Dev 2, D. Richardson

32. Crying • Vitally important means of communication from birth. • Inherent biological response in most humans to crying insures the infant's survival. • Do not produce tears at first. • Use different cries when hungry, tired, bored, cold, pain, anger, stimulation. • At 2 months, will cry when left alone. • Amount of crying in the first 3 months varies in a healthy infant, from 1 - 3 hours a day. • Infants who cry more than 3 hours a day are often described as having colic. Colic is rarely due to a problem with the body. Infant-Toddler Dev 2, D. Richardson

33. 6 States of Consciousness Quiet Sleep: No movements; still & relaxed; slow regular breathing. Active Sleep: REM, eyes move beneath closed lids; twitches, facial expressions, whimpers; brain is very active, irregular breathing. Drowsiness: Between sleep and awake; still, quiet, eyes open and close; can be roused into wakefulness; may be a bit disorganized. Quiet Alert: Quiet and active to stimuli; intensely look at persons & objects; eyes open wide, bright expressions; little body movement; regular breathing. Active Alert: Highly active; bursts of uncoordinated movement; irregular breathing; face may be relaxed or tense; fussiness. Crying: Contorts face, emits distressing sounds; communicating needs; may move limbs. Infant-Toddler Dev 2, D. Richardson

34. Sleep • Most newborns - about 16-20 hours/day. • Older infants - about 14-16 hours/day. • Usually sleep in several periods during day and night ranging from less than an hour to many hours. Periods may be related to eating schedule. • Sleep/wake cycles occur in random intervals of 30-50 minutes at birth and gradually increase as the infant matures. Infant-Toddler Dev 2, D. Richardson

35. Sleep • Newborn babies do not have regular sleep patterns. • After a few months, many babies develop a more set schedule. Begin to sleep longer through night, yet still often wake up. • By 4 months, most will have one 5-6 hour period of uninterrupted sleep. • By 1 year, usually able to sleep through night with morning and/or afternoon nap. Infant-Toddler Dev 2, D. Richardson

36. Bodily Functions • Many are not stable in the first months after birth. • Variability is normal and differs from infant to infant. • Stress and stimulation can affect: Bowel movements Gagging Hiccupping Skin color Vomiting Yawning Temperature control Infant-Toddler Dev 2, D. Richardson

37. Bodily Functions • Periodic breathing (starts and stops again) is normal and not a sign of SIDS (sudden infant death syndrome). • Some will vomit after each feeding, but have nothing physically wrong with them; continues to gain weight and develop normally. • Some grunt and groan distressfully while making a bowel movement but produce soft, blood-free stools, and their growth and feeding remain good. This is due to immature abdominal muscles used for pushing and does not require intervention. Infant-Toddler Dev 2, D. Richardson

38. Feeding • Breast-fed infants will feed about every 2 hours. • Formula-fed infants should be able to go 3 hours between feedings. • During periods of rapid growth, they may feed more often. • An infant who is drinking enough will produce 6-8 wet diapers in a 24-hour period. Infant-Toddler Dev 2, D. Richardson

39. Wrap-up • Questions • Discussion • In-service evaluation • Follow-up • Next Session covers 6-18 months: November 13 Infant-Toddler Dev 2, D. Richardson

40. References • In addition to the provided resource materials listed on the in-service agenda, various textbooks and other reference materials used for this presentation are available upon request. Infant-Toddler Dev 2, D. Richardson