In Utero Development & Motor Development Theories

Learning Objectives

  • Describe sensory development in utero and after birth

  • Discuss theories of motor development

Important Definitions

  • Gestation

    • Extremely Preterm (EP): <28 weeks’ gestation

    • Very Preterm (VP): 28 to <32 weeks’ gestation

    • Moderate-Late Preterm (MLP): 32 to <37 weeks’ gestation

    • Term: 37 to <42 weeks’ gestation

  • Adjusted/Corrected Age: Adjusted for preterm birth

Birth Weight Classifications

  • Extremely Low Birth Weight (ELBW): <1,000g

  • Very Low Birth Weight (VLBW): <1,500g

  • Low Birth Weight (LBW): <2,500g

  • Normal Birth Weight: 2,500g to 4,500g

Fetal Development

  • Fetal Period: 9 weeks until birth

  • Developmental Milestones:

    • Organs refined and enlarged

    • 15 weeks: Movement patterns initiated

    • Respond to extra-uterine stimuli

    • Establishment of circadian rhythms

Sensory Development

Systems Involved:

  • Tactile System

    • Development: Cephalic to caudal

    • Importance:

    • Source of emotional satisfaction

    • Enhances parent-infant bonding

    • Examples: Kangaroo care for preterm infants

    • Oral-tactile input is most organizing for babies

  • Vestibular System

    • Function: Position in space interpreted and integrated, guiding movement/function

    • Milestones:

    • Fully myelinated by 20 weeks

    • Development of righting reactions continues until puberty

    • Head down position is established prior to birth

  • Gustatory System (Taste)

    • Development:

    • Taste buds at 13 weeks gestation

    • 7,000 taste buds present at birth

    • Behavior: Newborns show preferences for sweeter tastes, smiling and sucking more with sweetness

  • Olfactory System (Smell)

    • Development:

    • Olfactory bulb neurons mature by 20 weeks gestation

    • Babies can detect mother's smell by 28 weeks

  • Auditory System

    • Development Complete: By 24 weeks gestation; further maturation until 3-4 years

    • Hearing threshold reaches adult levels by term age

  • Visual System

    • Maturity: Least mature at birth; structure develops by 23-24 weeks

    • Milestones:

    • Eyelids separate at 34 weeks

    • Pursue soft light and move eyes horizontally and vertically

    • Recognition: Newborns can recognize faces and develop color vision by 6 months

Motor Development Theories

Types of Theories:

  • Maturational/Hierarchical Theories

    • Focus on CNS maturation as the driving force of development

  • Behavioral Theories

    • Use conditioned behavior, emphasizing the stimulus-response approach

    • Example: Moving a distractible child to a quieter environment

  • Dynamic Systems Theories

    • Suggest development is non-linear and results from intrinsic and extrinsic factors

Normal Variation in Development

  • No single normal pathway for motor skills and developmental phases

  • Spectrum of development leads to varied skill acquisition, sequence, and duration

Family-Centred Practice

  • Recognizes the vital role of the family in the child’s development

  • Principles:

    • Collaborative relationships between families and professionals

    • Recognition of family choices and cultural values

    • A strength-based approach

  • Benefits of Family-Centred Practice:

    • Improves outcomes in neonatal intensive care

    • Increases caregiver confidence for low birth weight infants

    • Reduces length of hospital stay and re-hospitalization rates

Conclusion

  • Motor development and sensory experiences in utero heavily influence postnatal growth and development. Emphasis on family involvement and understanding theories support effective interventions for children.