Family theory: be able to identify a family developmental stage by a
description.
Family theory: be able to identify a family developmental stage by a description.
• Stage 1: Beginning family- Married couple establish home but no children
Developmental Tasks: Establishing a satisfying home and marriage relationship and
preparing for childbirth
• Stage 2: Childbearing Family- From birth of 1st child until that child is 2 ½ years old
Developmental Task: Adjusting to increased family size and providing a
positive developmental environment
• Stage 3: Family with Preschoolers- Oldest child is between 2 ½ and 6
Developmental tasks (DT): coping with demands on energy and attention with less
privacy at home
• Stage 4: Family with School Children- When oldest child is between ages of 6 and 13
DT: Promoting educational achievement and fitting in with the community of
families with school-age children
• Stage 5: Family with Teenagers- Oldest child is between ages of 13 and 20
DT: Allowing and helping children to become more independent
• Stage 6: Launching Centre- When oldest child leaves family until the youngest leaves home
DT: Releasing young adults and accepting new ways of relating to them;
maintaining a supportive home base
• Stage 7: Empty Nest- From time children are gone till couple retires
DT: Renewing and redefining marriage relationship; preparing for retirement years
• Stage 8: Aging Family- From retirement till death of the marriage partner
DT: Adjusting to retirement; coping with death and living alone.
Growth/development: Identify normal vs. abnormal development if given a description of patient
behaviors. Define the diagnosis and meaning of Autism.
● Jean Piaget—developmental psychologist; cognitive development theories
● Piaget’s Theory:
• Sensorimotor (0-2 years): Development is driven by motor development;
coordination of senses with motor response, sensory curiosity. Language used for
demands and cataloging. Object permanence developed.
• Preoperational (2-7 years): Symbolic thinking, use of proper syntax and grammar to
express full concepts. Imagination and intuition are strong, but complex abstract
thought still difficult. Conservation developed.
Important milestones
Age Milestones
Newborn ● Vision is highly limited at birth (8-12 inches)
1
, ● Fixes on moving objects
● Prefers human face; establishes eye contact around one month of age
● Infant will tend to lay in flexed position; will turn head from side to side
● On horizontal suspension there will be some head sagging, but infant should
not be hypotonic
● All primitive reflexes should be present
• Moro, grasp, rooting, tonic neck, etc.
● Infant should regain birthweight by 2 weeks and grow 30 g/day until 4 months
of age
● (birth weight should double at this point) If they are premature, you have to
correct for that
● Reacts to voice by one month of age—if child is not reacting, think of hearing loss
● Crying peaks around 6 weeks of age (up to 3 hours per day)
1 month old Reacts to voice, establishes eye contact
2 months old ● Infant is able to differentiate among patterns, colors, and consonants, but due
to the baby’s yet-limited ability to communicate, this may be difficult to
notice
● Infant should be able to track an object horizontally at 180 degrees—can track
to midline
● Head lag should be gone and the head and trunk should be held in the same
plane on horizontal suspension
● Social smile
● Will listen to voice and make cooing sounds—cooing is vocal development,
not language
● Infant should be able to hold head steady while sitting in lap
● Infant should be able to raise head slightly when laying in prone
position— TUMMY
TIME!!
• Increases risk of SIDS if put to bed on stomach
4 months old • Recognizes hand
● Infant becomes noticeably more distracted by surroundings
● Infant explores own body, especially hands and mouth
● Sense of proprioception begins to mature
● Infant will begin to recognize emotions in others and may mirror such
emotions (sustained social smile & laughing)
● Object permanence has not yet developed, so peek-a-boo will amuse the infant
● Infant should be able to lift head above plane when held in horizontal
suspension
● Infant should be able to grasp objects like a rattle and may reach for objects
held above him/her
2
, ● Primitive reflexes may begin to disappear
• May be able to manipulate objects with both hands
• Inspect hands at midline
● Infant will show more purposeful motor activity
● Growth slows to 20 g/day until 1 yoa; birthweight should have doubled
● Infant will begin to show distinct facial expressions in various scenarios
● May show displeasure if social contact is broken—baby recognizes that
social contact is “bonding” and may get upset with separating
● Recognizes sight of food and often becomes excited
6 months old • Grasps, visualizes, manipulates objects
● As primitive reflexes disappear, infants have more ability to grasp,
visualize, manipulate, and explore objects
● Objects tend to go to the mouth first. This underscores the importance of
keeping small objects and unsafe toys away from the baby.
● Babies at this age enjoy dropping objects because they believe they have
made them disappear.
● Infant should be able to sit up without support but not necessarily in an
erect position
● May be able to roll over and crawl
● Primitive reflexes should be gone
● Infant should be able to transfer objects from hand to hand
● Infant will typically prefer mother or primary caretaker
● Stranger anxiety begins to develop
● Peek-a-boo is often fun for child as object permanence hasn’t developed yet
9 months old • Object permanence; recognizes name; consonant babbling
● Emergence of object permanence
• Will uncover object if hidden
● Infant will be able to recognize and respond to his/her name
● Language progresses to monosyllabic babbling or consonant voicing in
inflections that resemble the native language
● May say “mama’ or “dada”, however, it’s not clear if infant
necessarily knows the meaning or if it’s just mimicry
● Infant should be able to crawl and roll over by this point and sit straight
without support
● Pincer grasp develops
● Infant is often able to walk with assistance, holding on or both hands/arms
● Baby will often “cruise”, which helps the baby develop muscle strength for
walking
● Development of object permanence often makes separation more difficult as
child will realize caretaker has not disappeared but is gone
● Increased wariness of strangers
3
, ● Monosyllabic babbling –will reflect the inflection of the language that
they’re around
● Baby should understand “bye-bye” and may wave
1 year old ● Say or recognize a few words
(12 months) ● Baby should be able to say or recognize a word other than “mama’ or “dada”
● Cognitive development is particularly nurtured at this period as baby begins
to walk and navigate away from caretaker
● Birthweight should have tripled by first birthday; length increased by 50%;
head circumference increased by 10 cm
● Baby should be able to stand on his/her own
● Baby is cruising by this point, and is often able to walk, at least with one hand
held
● Often able to turn pages of a book—start exposing baby to picture books
● Makes postural adjustment to dressing
● May be able to respond to one step commands such as “give me”
● Tantrums often begin
• Tantrums lasting longer than 15 minutes or occurring more than
3x/day may reflect underlying medical, emotional or social problems
16 months old ● Follow some commands; indicate wants by pointing
● Classically, child should be able to build a 2 or 3 block tower
• 3 x baby’s age in years (roughly)
● While vocabulary is typically limited, the child is able to indicate what
he/she wants by pointing
• This is a very important way for the child to communicate until
his/her vocabulary expands further
● Child should be walking by 15 months of age, and if often able to run
● Child is often able to crawl up a stair(s)
● Should be able to scribble with a crayon
● Hugs parents and shows high preference to familiar people for comfort
• Preference towards strangers (i.e., you) for comfort is
particularly concerning for potential neglect or abuse
• May be useful to continue to complete physical exam on parent’s lap
for child’s comfort level
18 months old ● Classically, child should be able to build a 4 block tower
● Vocabulary should include at least 10 words and include at least one body part
● Child should be able to run by this point, but it will look bumbly
● Should be able to walk up and down stairs with hands held
● Often will be able to sit on a small, child-sized chair
● Able to kiss parent with a pucker
● Child exhibits self-awareness and may recognize self in mirror
4
description.
Family theory: be able to identify a family developmental stage by a description.
• Stage 1: Beginning family- Married couple establish home but no children
Developmental Tasks: Establishing a satisfying home and marriage relationship and
preparing for childbirth
• Stage 2: Childbearing Family- From birth of 1st child until that child is 2 ½ years old
Developmental Task: Adjusting to increased family size and providing a
positive developmental environment
• Stage 3: Family with Preschoolers- Oldest child is between 2 ½ and 6
Developmental tasks (DT): coping with demands on energy and attention with less
privacy at home
• Stage 4: Family with School Children- When oldest child is between ages of 6 and 13
DT: Promoting educational achievement and fitting in with the community of
families with school-age children
• Stage 5: Family with Teenagers- Oldest child is between ages of 13 and 20
DT: Allowing and helping children to become more independent
• Stage 6: Launching Centre- When oldest child leaves family until the youngest leaves home
DT: Releasing young adults and accepting new ways of relating to them;
maintaining a supportive home base
• Stage 7: Empty Nest- From time children are gone till couple retires
DT: Renewing and redefining marriage relationship; preparing for retirement years
• Stage 8: Aging Family- From retirement till death of the marriage partner
DT: Adjusting to retirement; coping with death and living alone.
Growth/development: Identify normal vs. abnormal development if given a description of patient
behaviors. Define the diagnosis and meaning of Autism.
● Jean Piaget—developmental psychologist; cognitive development theories
● Piaget’s Theory:
• Sensorimotor (0-2 years): Development is driven by motor development;
coordination of senses with motor response, sensory curiosity. Language used for
demands and cataloging. Object permanence developed.
• Preoperational (2-7 years): Symbolic thinking, use of proper syntax and grammar to
express full concepts. Imagination and intuition are strong, but complex abstract
thought still difficult. Conservation developed.
Important milestones
Age Milestones
Newborn ● Vision is highly limited at birth (8-12 inches)
1
, ● Fixes on moving objects
● Prefers human face; establishes eye contact around one month of age
● Infant will tend to lay in flexed position; will turn head from side to side
● On horizontal suspension there will be some head sagging, but infant should
not be hypotonic
● All primitive reflexes should be present
• Moro, grasp, rooting, tonic neck, etc.
● Infant should regain birthweight by 2 weeks and grow 30 g/day until 4 months
of age
● (birth weight should double at this point) If they are premature, you have to
correct for that
● Reacts to voice by one month of age—if child is not reacting, think of hearing loss
● Crying peaks around 6 weeks of age (up to 3 hours per day)
1 month old Reacts to voice, establishes eye contact
2 months old ● Infant is able to differentiate among patterns, colors, and consonants, but due
to the baby’s yet-limited ability to communicate, this may be difficult to
notice
● Infant should be able to track an object horizontally at 180 degrees—can track
to midline
● Head lag should be gone and the head and trunk should be held in the same
plane on horizontal suspension
● Social smile
● Will listen to voice and make cooing sounds—cooing is vocal development,
not language
● Infant should be able to hold head steady while sitting in lap
● Infant should be able to raise head slightly when laying in prone
position— TUMMY
TIME!!
• Increases risk of SIDS if put to bed on stomach
4 months old • Recognizes hand
● Infant becomes noticeably more distracted by surroundings
● Infant explores own body, especially hands and mouth
● Sense of proprioception begins to mature
● Infant will begin to recognize emotions in others and may mirror such
emotions (sustained social smile & laughing)
● Object permanence has not yet developed, so peek-a-boo will amuse the infant
● Infant should be able to lift head above plane when held in horizontal
suspension
● Infant should be able to grasp objects like a rattle and may reach for objects
held above him/her
2
, ● Primitive reflexes may begin to disappear
• May be able to manipulate objects with both hands
• Inspect hands at midline
● Infant will show more purposeful motor activity
● Growth slows to 20 g/day until 1 yoa; birthweight should have doubled
● Infant will begin to show distinct facial expressions in various scenarios
● May show displeasure if social contact is broken—baby recognizes that
social contact is “bonding” and may get upset with separating
● Recognizes sight of food and often becomes excited
6 months old • Grasps, visualizes, manipulates objects
● As primitive reflexes disappear, infants have more ability to grasp,
visualize, manipulate, and explore objects
● Objects tend to go to the mouth first. This underscores the importance of
keeping small objects and unsafe toys away from the baby.
● Babies at this age enjoy dropping objects because they believe they have
made them disappear.
● Infant should be able to sit up without support but not necessarily in an
erect position
● May be able to roll over and crawl
● Primitive reflexes should be gone
● Infant should be able to transfer objects from hand to hand
● Infant will typically prefer mother or primary caretaker
● Stranger anxiety begins to develop
● Peek-a-boo is often fun for child as object permanence hasn’t developed yet
9 months old • Object permanence; recognizes name; consonant babbling
● Emergence of object permanence
• Will uncover object if hidden
● Infant will be able to recognize and respond to his/her name
● Language progresses to monosyllabic babbling or consonant voicing in
inflections that resemble the native language
● May say “mama’ or “dada”, however, it’s not clear if infant
necessarily knows the meaning or if it’s just mimicry
● Infant should be able to crawl and roll over by this point and sit straight
without support
● Pincer grasp develops
● Infant is often able to walk with assistance, holding on or both hands/arms
● Baby will often “cruise”, which helps the baby develop muscle strength for
walking
● Development of object permanence often makes separation more difficult as
child will realize caretaker has not disappeared but is gone
● Increased wariness of strangers
3
, ● Monosyllabic babbling –will reflect the inflection of the language that
they’re around
● Baby should understand “bye-bye” and may wave
1 year old ● Say or recognize a few words
(12 months) ● Baby should be able to say or recognize a word other than “mama’ or “dada”
● Cognitive development is particularly nurtured at this period as baby begins
to walk and navigate away from caretaker
● Birthweight should have tripled by first birthday; length increased by 50%;
head circumference increased by 10 cm
● Baby should be able to stand on his/her own
● Baby is cruising by this point, and is often able to walk, at least with one hand
held
● Often able to turn pages of a book—start exposing baby to picture books
● Makes postural adjustment to dressing
● May be able to respond to one step commands such as “give me”
● Tantrums often begin
• Tantrums lasting longer than 15 minutes or occurring more than
3x/day may reflect underlying medical, emotional or social problems
16 months old ● Follow some commands; indicate wants by pointing
● Classically, child should be able to build a 2 or 3 block tower
• 3 x baby’s age in years (roughly)
● While vocabulary is typically limited, the child is able to indicate what
he/she wants by pointing
• This is a very important way for the child to communicate until
his/her vocabulary expands further
● Child should be walking by 15 months of age, and if often able to run
● Child is often able to crawl up a stair(s)
● Should be able to scribble with a crayon
● Hugs parents and shows high preference to familiar people for comfort
• Preference towards strangers (i.e., you) for comfort is
particularly concerning for potential neglect or abuse
• May be useful to continue to complete physical exam on parent’s lap
for child’s comfort level
18 months old ● Classically, child should be able to build a 4 block tower
● Vocabulary should include at least 10 words and include at least one body part
● Child should be able to run by this point, but it will look bumbly
● Should be able to walk up and down stairs with hands held
● Often will be able to sit on a small, child-sized chair
● Able to kiss parent with a pucker
● Child exhibits self-awareness and may recognize self in mirror
4
