Postnatal Visual, Motor, and Cognitive Development

At what age does a baby have the potential to see 20/20?

6 months

When does the peak of CSF reach adult levels?

4 years

When does the overall CSF reach adult levels?

7-9 years

How is color vision at 0-3 weeks?

Dominated by rods

How is color vision at 8 weeks?

Rudimentary trichromatic color discrimination

How is color vision at 3 months?

Basic color discrimination (cones have developed)

When does OKN develop?

Birth

When does fixation develop?

Birth

When do pursuits develop?

2 months (slow target)

When does fixation reach adult levels?

2 months

When do pursuits reach adult levels?

3 months

When do horizontal saccades develop?

Birth (but hypometric)

When do horizontal saccades reach adult levels?

5 months

When does vertical up saccades develop?

4-6 weeks

When do vertical up saccades reach adult levels?

5 months

When do vertical down saccades develop?

3 months

When do vertical down saccades reach adult levels?

5 months

Consistently inaccurate saccades after _____ is considered abnormal.

6 months

When does accommodation develop?

Shortly after birth

When does accommodation reach adult levels?

4 months

How do infants overcome poor accommodation?

Smaller pupil, large depth of focus

When are eye movements coordinated in newborns?

3-6 months

When do we expect alignment in newborns?

3-6 months

when should an IET be evaluated?

After 2-3 months

When should a CET be evaluated?

At any age

When is accommodative and fusional vergences present?

1 month (and continue to improve over time)

When should NPC be present up to 10 inches in newborns?

Birth

When should NPC be TTN in newborns?

6 months

When does Randot stereopsis develop?

3-4 months

When is stereopsis well developed?

6 months

When is stereopsis at adult levels?

7 years

How does visual field change as we age?

Newborns have a circular field of view, then slowly expand in the first 2 months of life, with rapid expansion after 2 months

When is the superior VF at adult levels?

1 year

The process that the human eyes undergo, allowing them to grow in a coordinated manner

• Significant changes occur in the structure of the eye from birth to adulthood

• The goal: to maintain emmetropia while the visual system grows & develops

Emmetropization

When do the largest changes in emmetropization occur?

The first 12 months

When are emmetropization changes largely complete by?

17-18 months

How long does emmetropization occur?

Up to 5-6 years

When is children’s RE distribution similar to adults?

6-8 years

What is the average RE for infants 0-1 years?

+2.00 ± 2.00 D

What is the average RE at 2 years?

+1.20 D

When is hyperopic emmetropization complete?

2 years

When is myopic emmetropization complete?

4-5 years (we often see it increase again in school age)

Rank race/ethnicity from most to least common to have hyperopia…

1. Caucasian

2. Hispanic

3. African American

   1. Other

Rank race/ethnicity from most to least common to have myopia…

1. Asian

2. Hispanic

3. African American

4. Caucasian

When does astigmatism finish emmetropizing?

3-4 years

What type of astigmatism is most likely to emmetropize?

ATR

What type of astigmatism is least likely to emmetropize?

Oblique

Astigmatism moves from ___ to ___.

ART to WTR

Rank race/ethnicity from most to least common to have astigmatism…

1. Hispanic

2. Asian

3. Caucasian

4. African American

What race/ethnicity has a higher prevalence of astigmatism and does not emmetropize as well?

American Indian

What gross motor development would we expect at 1-3 months?

Holds head up

What gross motor development would we expect at 3-6 months?

Rolls over

What gross motor development would we expect at 6-9 months?

Sits up

What gross motor development would we expect at 9-12 months?

Creeps/crawls

What gross motor development would we expect at 12-14 months?

Walks without assistance

What fine motor skills should a baby have at 1 year old?

Exhibiting pincer grasp

What fine motor skills should a baby have at 2 years old?

• Scribbling

• Stacking 6 block tower and 3-4 block train

• Placing circle/square/triangle in a a form board

• Imitate vertical stroke

What fine motor skills should a child have at 3 years old?

• Beginning to button clothes

• Stack 9 block tower and build 3 block bridge

• Complete most of 6 form board

  • Imitating a circle or cross and copying a circle

What fine motor skills should a child have at 4 years old?

• Catching a ball

• Build 6 6-block building

• Complete the 6-form board

• Copying a cross, beginning to copy a square

• Naming and identifying differences between shapes

What memory skills should a baby have at 1 year old?

Developing verbal memory

What memory skills should a baby have at 2 years old?

Developing 2-3 words and 2 digit memory

What memory skills should a child have at 3 years old?

• Developing 5-7 word memory

• Counting to 3

What memory skills should a child have at 4 years old?

Developing 9-12+ word and 4 digit memory

What language skills should a baby have at 1 year old?

Babbling consistently

What language skills should a toddler have at 2 year old?

Using simple 2 word sentences

What language skills should a child have at 3 year old?

Using simple 3-5 word sentences

What language skills should a child have at 4 year old?

• Names primary colors

• Understands simple number concepts

• Able to follow 3 individual commands

• Can develop complex sentences

What auditory perception should a baby have at 1 year old?

Repeating sounds made by the parent

What attention skills should a baby have at 1 year old?

Starting to be more selective in response to external stimuli

What attention skills should a toddler have at 2 years old?

Exhibiting single-channeled attention

What attention skills should a child have at 3 years old?

Developing ability to switch attention from one stimulus to another in sequence

What attention skills should a child have at 4 years old?

Developing ability to switch attention from one stimulus to another in sequence

What body image/laterality/directionality should a baby have at 1 year old?

Beginning to demonstrate a preference for one hand in eating

What body image/laterality/directionality should a toddler have at 2 years old?

Beginning to identify body parts

What body image/laterality/directionality should a child have at 3 years old?

Identifying most body parts

What body image/laterality/directionality should a child have at 4 years old?

• Able to be taught to discriminate L/R orientation

• Aware sides are different, unaware of their location