Gross motor skills
| | |
|Infant and Toddler Growth and Development |
|One month |May hold up head momentarily. |
|Two months |Lifts head when placed on stomach. Holds up head briefly when held in a seated or standing position. |
|Three months |Holds head and shoulders up when placed on stomach. Puts weight on forearms. |
|Four months |Holds head up well in sitting position. Can lift head to a 90-degree angle when placed stomach. May start to roll over. |
|Five months |Has full head control. When pulled by hands to a sitting position, the head stays in line with body. |
|Six months |Rolls over (front to back first). Reaches with arms. Sits with support. |
|Seven months |Can stand with support. May sit without support for short periods. Pushes upper part of body up while on stomach. |
|Eight months |Stands while holding onto furniture. Sits well unsupported. Gets up on hands and knees; may start to crawl backwards. |
|Nine months |Crawls first by pulling body forward with hands. May move around a room by rolling. |
|Ten months |Pulls up to standing. Is very steady while sitting; moves from sitting to crawling position and back. Crawls well. |
|Eleven months |"Cruises," walking while hanging onto furniture. Walks with two hands held. |
|Twelve months |Walks with one hand held. May walk with hands and feet. Stands unsupported for longer periods of time. |
| | |
|Fifteen months |Walks without help. Crawls up stairs. Gets into a standing position without support. |
|Eighteen months |Seldom falls while walking. Can walk and pull toy. Runs. Climbs stairs holding railing. May walk backward. |
|Two years |Kicks a ball. Walks up and down stairs, two feet per step. |
|Two & half years |Jumps with both feet. Jumps off step. Can walk on tiptoe. |
|Three years |Goes upstairs one foot per step. Stands on one foot briefly. Rides tricycle. Runs well. |
|Four years |Skips on one foot. Throws ball well overhand. Jumps a short distance from standing position. |
|Five years |Hops and skips. Good balance. Can skate or ride scooter. |
SOURCE: Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 5th ed. and Child Development Institute, .
Healthy Growth and Development
Infancy (Birth to 1 year)
❖ Learning to walk
❖ Learning to eat solid foods
❖ Beginning to talk and communicate with others
❖ Beginning to have emotional relationships with parents, brothers and sisters
❖ Developing stable sleep and feeding patterns
Toddlerhood (1 to 3 years)
❖ Tolerating separation from parents and primary care-givers
❖ Gaining control of bowel and bladder function
❖ Using words to communicate
❖ Becoming less dependent on parents or primary care-givers
Ways to provide age specific care:
❖ Educate parents about the need for checkups, screenings, and immunizations
❖ Ensure the child’s safety and comfort, i.e. crib rails up, offer age-appropriate toys, cuddle an upset child, and talk in soothing tones.
❖ Explain procedures to parents. Allow time for questions. Let the child touch equipment or try it on a doll or stuffed animal.
❖ Keep the child with parents if possible. Involve parents in care.
❖ Have parents demonstrate procedures back to you to show understanding.
❖ Discuss parents’ questions and concerns about caring for their child. Teach about feeding, hygiene, safety, and other ways to promote healthy development.
Preschool (3 to 6 Years)
❖ Increasing the ability to communicate and understand others.
❖ Performing self-care
❖ Learning gender differences and developing sexual modesty.
❖ Learning right from wrong.
❖ Learning to play with others.
❖ Developing family relationships.
Ways to provide age specific care:
❑ Continue to stress to parents the need for checkups, screenings, and immunizations.
❑ Explain procedures and objects in ways the child can understand. Avoid words that might be scary. Show how equipment is used. Use visual aids. Give the child chances to help.
❑ Reassure the child that the procedure is not a punishment.
❑ Give the child chances to express feelings and ask questions.
❑ Encourage the parents to bring a security object (special blanket or toy).
❑ Ask the parent about any concerns that they may have.
❑ Ask the child questions about school and friends.
❑ Teach about healthy eating, hygiene and safety.
School age (6 to 12 Years)
❑ Developing social and physical skills needed for playing games.
❑ Learning to get along with children of the same age and background.
❑ Developing a conscience and morals.
❑ Developing a good feeling and attitude about oneself.
❑ Developing greater muscle strength, coordination, and balance.
Ways to provide age specific care:
❖ Continue to remind parents about the need for immunizations, checkups, and screenings.
❖ Ask the child about school and friends, interests, accomplishments, and concerns.
❖ Allow the child and parents to ask questions.
❖ Explain procedures and equipment in advance. Use correct terms and visual aids.
❖ Respect privacy.
❖ Praise cooperative behavior.
❖ Teach the child about healthy and safe behaviors (including not using alcohol, tobacco, or drugs)
❖ Encourage parents to talk with their child about these things and other important issues like sexual development.
Adolescence (12 to 18 years)
❑ Accepting changes in the body and appearance.
❑ Developing appropriate relationships with males and females of the same age.
❑ Accepting the male or female role appropriate for one’s age.
❑ Becoming independent from parents and adults.
❑ Developing morals, attitudes, and values needed to function in society.
Ways to provide age specific care:
❑ Emphasize the continued need for checkups, screenings, and immunizations.
❑ Provide privacy for procedures and teaching.
❑ Discuss concerns. Encourage involvement in care and decisions.
❑ Encourage parents to stay involved in their child’s life.
❑ Teach healthy habits (nutrition, exercise, hygiene, and safety). Also teach about avoiding pregnancy and health risks, such as sexually transmitted diseases and alcohol, tobacco, and other drug use.
Young Adulthood (18 to 40 years)
❑ Choosing education and a career.
❑ Selecting a partner.
❑ Learning to live with a partner.
❑ Becoming a parent and raising children.
❑ Developing a satisfactory sex life.
Ways to provide age specific care:
❑ Emphasize the continued need for checkups, screenings, and immunizations.
❑ Encourage patients to keep in contact with family and friends.
❑ Assess the patient for stress related to new adult roles.
❑ Encourage the patient to talk about feeling and concerns. About how illness or injury may affect plans, family, finances.
❑ Involve the patient and close family members in decision making and education.
❑ Educate about healthy life style practices.
❑ Explain the benefits of knowing this information.
Middle Adulthood (40-65 Years)
❑ Adjusting to physical changes.
❑ Having grown children.
❑ Developing leisure-time activities.
❑ Adjusting to aging parents.
Ways to provide age specific care:
❑ Emphasize the continued need for checkups, screenings, and immunizations.
❑ Encourage as much self-care as possible.
❑ Allow time to talk about frustrations, accomplishments, dreams, and any concerns about illness. Talk about stress.
❑ Provide help with resources to meet healthcare costs.
❑ Educate about healthy lifestyles (stress management, weight management, etc)
❑ Educate about procedures and the safe use of medications.
❑ Educate about advance directives.
Late adulthood (65 years and older)
❑ Adjusting to decrease strength and loss of health.
❑ Adjusting to retirement and reduced income.
❑ Coping with a partners’ death.
❑ Developing new friends and relationships.
❑ Preparing for one’s own death.
Ways to provide age specific care:
❑ Emphasize the continued need for checkups, screenings, and immunizations.
❑ Encourage healthy habits (nutrition, exercise, hygiene, etc.) and social activity.
❑ Educate about safety measures (including fall prevention, safe medication use, and using caution with hot water).
❑ Provide a safe, comfortable environment. Allow time for rest.
❑ Give the patient chances to reminisce, to help promote a positive self-image.
❑ Speak clearly and avoid background noise during teaching. Use larger print materials and ensure enough light. Give information in short segments and avoid rushing.
❑ Talk about family and other support systems.
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