Infancy
birth to 2 years
Infancy – physical growth
At 2 months fetus head is ½ of full size. This is because the brain is the first part of the fetus to develop.
Newborns –
Weight increases, initially measured weekly – average 7.6 Ibs/3.4 kg
Head circumference – measured every 2-4 weeks
Height increases – body’s length from head to toe – 48/50cm
A paediatric consultant or experienced community midwife will check the baby’s reflexes, such as grip and sucking
Health visitors are the type of nurse who monitor developmental from 0 to 5 years (red book)
Growth chart
These are used to monitor growth of infants
Centile lines show how infant compare to average
Why does this exist?
To identify any deviation from normal growth patterns
Early interventions can be used to help with issues – eating
Rapid growth
A child’s growth is normally rapid during the first 2 years of life and slows down in early childhood. It then suddenly speeds up again during puberty.
Baby reflexes
Reflexes exist to help babies survive, e.g. root reflex (sucking – to feed), palmar grasp reflex and startle/motor reflex.
Patterns of growth
As a baby’s brain matures in capabilities, so do their muscles. This means changes which follow a pattern, in the same order, are the same for all.
Gross motor skills – Are muscle actions involving bigger muscles like the torse and limbs; arms and legs
Rolling over – 4-7 months
Lift head and chest – 3-5 months
Sit up – 6-9 months
Stand unaided – 9-12 months
Cruise – 9-12 months
Crawl*- 7-10 months
Walk unaided – 12-15 months
Run – 15-18+ months
Milestones
A milestone is a measurable change that marks progress and is the term used for an infant’s development.
These milestones are sequences that are expected and occur in an average age range.
These are not just physical, for example, teeth appearing and learning to stand on one leg and language skills and recognising strangers.
Fine Motor Skills
Fine motor skills are the precise movement of the hands, fingers, wrists, feet, and toes that involve the coordination of muscles, joints, and nerves. Initially, a baby has no conscious control over these movements; however, some reflexes demonstrate strength, e.g., grip.
Control of movement
By 6 months old, your baby will be able to reach and grab a toy they want
They will also start picking up things so they can put them in their mouths
Fine motor skills develop in a sequential manner as the brain develops.
Examples of milestones
Bring hands to mouth (0-6 months)
Starts pointing (6-12 months)
Clapping hands (12-18 months)
Builds block towers (18-24 months)
Fine motor skills require:
Coordination – coordinating fingers, eyes, and brain to perform a skill
Dexterity – ability to use fingers to perform delicate fine movements
Infancy – intellectual
The more an infant's brain is stimulated the more it will develop (genie)
Intellectual development –
Memory recall
Problem solving
Decision making
Moral development
Language
Nature and/or nurture
The earliest developmental theories were rooted in biology, believing genetics dictated intellect. The focus was ‘nature.’
However, social psychologists in the 20th century increasingly argued that environmental factors such as parent styles, education, observing role models and peers shape our minds.
It is estimated that intelligence typically ranges from 50% to 80%. (nature)
Identical twins raised apart generally show higher IQ (nature)
High socioeconomic status environments provide more intellectual stimulation and educational recourses (nurture)
Schools also play a role in IQ as the average IQ score has risen over the 20th century (nurture)
Gene-environmental correlation; individuals with high genetic potential often seek out more stimulating environments, which further enhances their intelligence (both)
I think that both nature and nurture play a role in a child's intellect because modern estimations show that intelligence is 50% to 80% inherited by genetics. Research has also shown that identical twins raised apart generally show the same IQ; it is never the exact same score. This is because different socioeconomic status environments provide different stimulation and educational resources. Higher socioeconomic environments provide more intellectual stimulation and educational resources.
Baby's surroundings
Infants are learning about the environment through interaction with it. Use their senses to absorb information.
Initially a baby cries when feeling discomfort such as hunger, wet or cold.
As the baby becomes more aware of their surroundings, they develop different cries that often, those close to them can distinguish.
Later, the baby can use a cry for its advantage, to be picked up and fussed.
Developmental aspects
Language development, which is essential for organising thoughts
Problem solving is an important skill that requires both working things out and making predictions about what might happen
Memory is required to storing, recalling, and retrieving information
Moral development allows for reasoning and making choices and informs the individual how to act in given situations and then how to act towards self and others
Language acquisition
The start of language development occurs when a baby begins to have more control over their mouth and tongue movements.
Cooing: occurs when babies are 6/8 weeks old. This represents increased control over the vocal cords, which are muscles.
Babbling is an important stage that occurs between 6 to 9 months, patterns of speech and conversation.
Non-verbal beginnings
Their non-verbal communication indicates their willingness to use language.
First words
By the end of the first year, signs of word recognition are usually evident.
Words which are likely to be recognised include names of family members and those words relating to context.
Infants should be encouraged to communicate – supports normal language development
Parents talking to them
Playing
Reading
Song time
Nursery rhymes
Infants should encourage them to communicate from an early age because stimulation is essential for normal language and cognitive development. The case of Genie Wiley clearly shows this importance as she was severely isolated and deprived of language during early childhood and as a result, she struggled to fully acquire language even after being rescued.
Language milestones
Emotional infancy
Emotional development is about developing a sense of self.
Self-esteem is being built
Research suggests early bonding and experiences heavily influence adult behavior and sense of identity and emotional literacy
The beginning
Babies hear their mum before birth and are once born because they are familiar with their parent's smell. However, they can be passed from person to person for the first 6 weeks and not be distressed at the change.
From 6 weeks their eyesight improves, and they start to bond with main care givers. This is the start of forming a safe and secure attachment.
What is bonding?
Bonding is the process which builds a positive relationship overtime.
Strong, secure attachments allow adults with positive self-esteem, emotional literacy, and positive values and morals.
John Bowlby (1906-1990) – psychologist
Studied young men who had broken the law and researched their early life experience. A significant percentage had a difficult relationship with their parents. This sparked his interest in further researching attachment.
Reasons why attachment could be broken/damaged
Neglect
Abuse
Divorce
Parents dying
Parents leaving
Alcohol/drug misuse
Baby being premature
Foster care
Illness/disability
Mental health
It is important that all infants should have the opportunity to form attachments
Bowlby’s idea suggests that attachment is a survival instinct.
It is biologically driven
Innate
Bowlby's 4 phases
Phase 1
Birth to 3 months
From the time they are born, infants show a preference for looking at human faces and listening to human voices.
During the first two to three months of life, infants respond to people, but they don’t distinguish between them
The baby encourages attachment by babbling, crying, grasping, and sucking
Phase 2
3 to 6 months
They start to differentiate between people, and they begin to reserve their attachment behaviors for the people they prefer
If they cry, their favorite people are better able to comfort them
Babies' preferences are restricted to two to three individuals
Phase 3
6 months to 3 years
Babies' preference for a specific individual becomes more intense, infants will have separation anxiety
Once babies learn to crawl, they will also attempt to actively follow their favorite person
Starting at about 7 or 8 months old, babies will also start to fear strangers
Phase 4
3 years until childhood ends
Children start to recognise that they are not the sole interest of their care givers
Bowlby summary
Infants are biologically pre-programmed to form attachments, an innate survival need
Infancy is a critical period for forming attachments
Early months – form 1 primary carer attachments
Disruption to this attachment has a negative impact on development
In adulthood, may cause anxiety, difficulty in forming relationships, depressive disorders, delinquency
Critics of Bowlby
Could be outdated
Heavy emphasis on the mother
Downplays the role of the father
Can infants form 2 or more strong attachments
Lack of scientific evidence of biological need for attachment
Mary Ainsworth – attachment theory
Ainsworth studied infant-parent separation for a better understanding the stages of attachment
Ainsworth and her colleagues observed 100 infants from middle-class American families between the ages of 12 and 18 months.
The infants were observed when they would be separated from their mother and then being reunited with her.
Attachment patterns
Secure attachment
Infants who are securely attached use their caregiver as a secure base from which to explore the world
They will venture out to explore away from the caregiver, but if they're frightened or in need of reassurance, they will return
If the caregiver leaves, the infant will get upset
The child is confident that their caregiver will return
Avoidant attachment
Children who exhibit avoidant attachment are insecure in their attachment to the caregiver
Will not become overly distressed when care giver leaves
Once the caregiver returns the child will deliberately avoid the caregiver
Resistant attachment
They become extremely upset when the parent leaves
When the caregiver returns their behavior will become inconsistent
May seem happy initially but can become resistant fi the caregiver attempts to pick them up
Disorganised attachment
Displayed by children who have been subject to abuse, neglect or other inconsistent parenting practices
These children to be disoriented or confused
Responsiveness
Schaffer and Emerson found that babies form attachments to caregivers who are responsive to their signals.
The study involved observing 60 babies in their homes in Glasgow over the first 18 months of their lives.
Quality of time rather than quantity.
Emotionally secure
It is a feeling of positivity, confidence, and calmness. Builds resilience.
How do we get it?
Having a loving and healthy foundation, establishing trust
Social infancy
Main care is a term given to people or a person who is responsive to the child's needs.
Socialisation
Infants need to learn how to interact with others and form relationships.
I also need to learn about societies' normal and acceptable behaviors.
The process of socialisation is through family, meeting needs, and playing.
Main carer = role models
Early play 0-6 months
Referred to as unoccupied solo play, aged 0-6 months is not really engaged or actively playing with others at all.
They may remain stationary and be engaged in random movements with no objective.
This is an important setting stage for future play exploration and development.
Solitary play 6-18 months
During this stage of play, children will often play alone, with toys different from those of others and be uninterested or unaware of what others around them are doing.
This stage of play is most seen among young toddlers between the ages of 10 months and 3 years.
Share and cooperation
Parents or carers guidance and input can encourage a child to share with others and cooperate, such as waiting whilst a parent gets a drink.
Health conditions – infancy
Babies are building their immune system from birth.
It is common for infants to pick up infections.
Conjunctivitis – inflammation or infection, transparent membrane that lines the eyelid and eyeball. The eye may weep, the child may wake up will crustily eyelashes which are stuck together, and it may or may not be painful.
Treatment is bathing the eyes and perhaps antibiotic drops by prescription.
Ear infection
An ear infection is an inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds behind the eardrum. It often causes fever and high temperatures.
Treatment is antibiotics and over the counter pain relief. While ear infections themselves are not contagious, the colds or other illnesses that often are the initial cause.
Chickenpox is a highly contagious disease caused by the varicella-zoster virus, which is a viral infection that causes an itchy, blister-like skin rash. The virus is in water droplets in every breath exhaled.
Pre: incubation period 14-16 days
Stage 1: small spots appear
Stage 2: the spots become blisters
Stage 3: the blisters become scabs
Contagious – the spots are usually accompanied by a fever and an unhappy baby.
A person with chickenpox is contagious from 1-2 days before the rash appears until all the blisters have crusted over. This usually happens 5-7 days after the rash starts.
Children with certain health conditions may have a vaccination.
Treatment is about making the infected child feel more comfortable.
Vaccinations
In the UK, babies and toddlers are offered a schedule of vaccinations of viral and bacterial infections that can cause serious harm or even death. Herd immunisation is the vaccinating of 95% of the population to prevent outbreaks of contagious infections which left unchecked, would pass from person to person. It basically means when enough people in an area have immunity to (protection from) a disease that it no longer spreads easily. Herd immunity works only if 95% of population are immune if its below 95% there may be localised outbreaks.
At around 8 weeks old, Infants are given the vaccine DTaP/IPV/Hib/HepB in the thigh which treats diphtheria, haemophiles, tetanus, whooping cough, polio, influenzae type B. They then get the MenB vaccine which treats Meningitis group B in their left thigh. They also receive the rotavirus vaccine by their mouth.
Diphtheria is a serious bacterial infection that can affect the nose, throat, and skin. It can be fatal in around 30% of cases for unvaccinated individuals.
Polio is an illness caused by a virus that mainly affects nerves in the spinal cord or brain stem.
Tetanus is a serious bacterial infection that causes muscle spasm and stiffness, often starting in the jaw. This bacterium can produce a toxin that attacks the brain and spinal cord. This bacterium can be found in soil.
Pertussis (whooping cough) is an infection of the lungs and breathing tubes. It spreads very easily and can be serious. Pregnant women also receive this vaccine.
Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV) that can be acute (short-term) or chronic (long-term). Causes liver damage and cirrhosis and in rare cases fatal. Passed on through bodily fluids e.g. Blood or semen mainly in adulthood.
Meningitis (meningococcal group B) is a type of bacteria that can cause meningitis and sepsis, which is a life-threatening reaction to an infection.
At 12 weeks old you receive the diphtheria combination vaccine and rotavirus vaccine but also Pneumonia vaccine in the thigh.
Booster vaccines
One year old receives Hib and Meningococcal group C booster vaccine, Pneumococcal booster vaccine and MenB booster vaccine.
The purpose of the second vaccines is because babies need booster vaccines to increase the protection they’ve already received from initial immunisations. This is standard for many vaccines where the immunity provided decreases over time.
Measles, mumps and rubella (German measles) - measles can kill, mumps can cause infertility in males and birth deformities in pregnancy if not caught early.
Hearing checks
A newborn hearing screening is a test that checks a baby’s hearing and is usually performed within the first month.
Early intervention can help babies with hearing loss to communicate, do well in school, and get along with other children.
Automated otoacoustic emission (AOAE)
A soft earpiece is placed in the baby’s ear and clicking sounds are played.
The equipment measures the echo response in the baby’s ear.
Eyesight check
A newborn will have an examination which looks at the appearance and movement
It is done between 6 to 8 weeks old; a GP or health visitor will check for any problems that may not have been identified at birth when a baby has an eye open for longer than a newborn.
Red and pupil reflex test
A light is shone into the baby’s eyes to check for red reflection, which should be symmetrical and bright in both eyes. A white reflection could indicate an eye problem.
Practice questions
1 Mark Question
State one reason why growth charts are used in infancy. (1 mark)
2 Mark Question
Identify two gross motor milestones typically achieved before 12 months. (2 marks)
3 Mark Question
Explain one reason why early stimulation is important for intellectual development in infancy. (3 marks)
4 Mark Question
Describe how fine motor skills develop during the first two years of life. (4 marks)
5 Mark Question (Application)
Mia is 10 months old. She cries when her father leaves the room but is quickly comforted when he returns. She crawls towards him and clings to him when unfamiliar visitors enter the house.
Explain what Mia’s behaviour suggests about her attachment type. (5 marks)
6 Mark Question (Application)
A health visitor notices that Jacob, aged 18 months, is below the 5th centile on the growth chart for weight. His mother reports he is a fussy eater.
Discuss why monitoring growth using centile charts is important in this situation. (6 marks)
6 Mark Question (Theory Comparison)
Discuss the nature versus nurture debate in relation to intellectual development in infancy. (6 marks)
8 Mark Question (Extended Response)
Evaluate Bowlby’s theory of attachment. (8 marks)
You should include:
Key features of the theory
Evidence supporting the theory
At least two criticisms
8 Mark Question (Application & Analysis)
Ella was born prematurely and spent her first 4 months in hospital with limited physical contact from her parents. At age 3 she struggles with separation anxiety, has difficulty forming friendships and shows signs of low self-esteem.
Analyse how early attachment experiences may have influenced Ella’s emotional and social development. (8 marks)
8 Mark Question (Holistic Development)
Discuss how physical, intellectual and emotional development are interconnected during infancy. (8 marks)
You should refer to:
Motor development
Brain development
Attachment
Exploration and learning