Overview Age Motor Language Social NEONATE(0-3 mos) 0-1 mo moro grasp and reflex, visual tracking crying minimal 2 mos holds head up, swipes at objects cooing social smile INFANT (3-12 mos) 3 mos lifting head and chest, moro reflex disappears 4 mos rolls from prone to supine,grasps objects orients to voice colic resolves in most babies by this age laughs 6 mos sits upright babbles stranger anxiety 9 mos crawls, pull-to-stand, pincer grasp, eats with fingers mama-dada (nonspecific) waves bye-bye, responds to name TODDLER(12-24 mos) 12 mos stands mama-dada (specific) picture book 15 mos walks, uses cup several words temper tantrums 18 mos walks up stairs, throws ball names objects toilet-training begins 24 mos runs 2-word sentences, several hundred word vocabulary follows 2-step commands PRESCHOOL (3-6 years) 36 mos rides tricycle (3yrs), eats with utensils 3-word sentences Clinical correlate selective mutism selectively mute in specific settings knows first and last name average age of potty training SCHOOL AGE (6-11 years) development of conscience (super-ego), has same-sex friends ADOLESCENCE(Girls-11yrs, Boys-13 yrs) abstract reasoning, the formation of personality, may have friends of opposite sex Feeding patterns From birth to six months of age, breastfeeding has preferred the source of nutrition All breastfed infants should be supplemented with vitamin D Preterm breastfed infants should be additionally supplemented with iron Solid foods introduced at six months of age Cow's milk introduced at 12 months of age Cyclic vomiting syndrome - an idiopathic disorder in 4-7 yr old children repeated, stereotypical bouts of acute vomiting accompanied by severe nausea, lethargy, and possibly fever, pallor, diarrhea, headache, and/or photophobia with a return to normal health between episodes diagnosis of exclusion supportive therapy for management; amitryptiline may be useful in the prevention children outgrow by teenage years Physical activity should be encouraged at a young age to develop habits children should engage in activities they enjoy with structured time allocated weight lifting is appropriate in young children with proper form and instruction Breath-Holding Spells Introduction breath-holding spells may be cyanotic or pallid Epidemiology incidence 4.6% age can occur between 6 months to 6 years of age most cases occur before 18 months of age Prognosis usually resolves by school age iron supplementation may reduce the breath-holding spell frequency in patients who are anemic or iron-deficient Breath-Holding Spells Type Trigger Clinical Features Treatment Cyanotic (~80% of cases) Emotional insults such as pain anger frustration Typically the patient vigorously cries, which is followed by forced expiration and breath-holding resulting in cyanosis patients often collapse and lose consciousness and can become limp May be associated with generalized clonic jerks opisthotonos bradycardia Education and reassurance Pallid (~20% of cases) The patient may become quiet, which is followed by breath-holding in the expiratory phase that results in pallor brief loss of consciousness loss of muscle tone diaphoretic There is cardiac bradycardia Tonic rigidity may be seen References