Developmental Stages and Milestones

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Ashley Powell
MSN,RN,PCN
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Included In This Lesson

Study Tools For Developmental Stages and Milestones

Pediatric Growth Charts (Cheatsheet)
Age-Related Play Milestones (Image)
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Outline

Overview

  1. There are certain developmental milestones that should be achieved at each age group.

Nursing Points

General

  1. Developmental milestones include
    1. Growth
      1. Weight
      2. Anatomical and Physiological changes
    2. Motor Development
    3. Language Development
  2. At each stage, there may also be unique threats to safety due to the child’s specific motor and language abilities

Assessment

  1. Infancy (1-12 months)
    1. Growth
      1. Doubles birth weight by 6 months, triples by one year
      2. Posterior fontanel closes between 6-8 months
      3. Anterior fontanel closes between 12-18 months
      4. 6-8 teeth by 1 year of age
    2. Motor Development
      1. Sits without support 6-8 months
      2. Rolls completely over 6 months
      3. Stands alone 10-12 months
    3. Language Development
      1. Cries, smiles, coos by 3 months
      2. Produces chained syllables by 6 months
      3. Says two or more words by 1 year
      4. Understands meaning of “no” by 11 months of age
      5. Can follow simple directions at 1 year
    4. Threats to Safety
      1. Suffocation
      2. Falls
      3. Burns
  2. Early Childhood (1-3 years)
    1. Growth
      1. Gains 4-6 pounds a year
      2. Grows 3 inches a year
      3. Head circumference equal to chest circumference by 1-2 years
    2. Motor Development
      1. Builds tower of 8 blocks high
      2. Can copy a circle on paper
    3. Language Development
      1. 300 words by age 2
      2. Speaks in multi-word sentences by age 2
  3. Preschool (3-6 years)
    1. Growth
      1. Gains 5 pounds per year
      2. Grows 2-3 inches per year
    2. Motor Development
      1. Hop on one foot
      2. Draws a person
    3. Language Development
      1. Vocabulary of 2,100 words by age 5
      2. Uses fantasy in stories
      3. Know name and address
  4. School Age (6-12 years)
    1. Growth
      1. Gains 5-7 pounds a year
      2. Brain growth is complete by age 9-10
      3. Growth of 2 inches a year
      4. Loss of teeth
    2. Motor Development
      1. Writes in cursive
      2. Rides bike and plays active games

Patient Education

  1. Notify the child’s pediatrician if the child is not achieving these developmental milestones appropriately

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Transcript

Developmental milestones are important to understand because we need to know as we’re assessing a pediatric patient if they’re doing what they should be doing at a given age. Okay, if they’re not doing what they should be doing, is there some sort of developmental or some sort of musculoskeletal issue that we need to address with this patient. So, let’s talk about some of the developmental milestones that you need to know by age.

For infancy, we’re talking 1 – 12 months. Okay, really, these newborn patients, what they should be doing, first of all, they should be growing, okay? That’s the big thing they need to be doing. We need to double their weight by 6 months and triple their weight by 1 year. That’s their birth weight. Okay, so, if they were born at 8 pounds, by 6 months, they should be about 16 pounds. Okay, and then by a year, they should be 24 pounds. Their fontanels should start closing with, their posterior ones, closing by 8 months and their anterior fontanels closing by about 18 months. And by 1 year, they should start having a handful of teeth. Motorwise, they should be able to sit without support by about 6 or 8 months and they should be able to roll completely over by 6 months and stand up by a year. And remember, these are goals, okay, so, if they accomplish some things sooner, that’s great, you know. If they, if it takes them a little bit longer, we need to be assessing the whole picture, okay? Are they sitting up? Are they rolling? Are they having problem standing? You know, and what do we need to look at with these patient? For language development, they need to be crying and smiling and cooing at 3 months. And those need to be appropriate. Okay, they need to be smiling at people and they need to be looking at people and cooing. And they should understand the meaning of ‘no’ by 11 months, and by about a year, they should be able to follow very simple directions. You know, very simple words, very simple directions. Some of the biggest threats to safety for children of this age are suffocation, falls and burns. So, you can educate your parents that, you know, you need to be careful with plastic bags, with toys, they can get things down their throat, they can get lodged in their trachea and you know, they can fall, or they can get burned on stoves and different things, irons and stuffs like that.

For early childhood, let’s talk about early childhood. That’s for ages 1 – 3 years. They should be gaining 4 – 6 pounds a year and they should be growing about an inch or 3 inches a year. Their head circumference is equal to their chest circumference by 1 to 2 years. And motor development, they should be able to build a tower of about 8 blocks high and can copy a circle on paper. So, if you draw a circle down, they should be able to you know, by 3 years, be able to trace that circle and they should be able to start building towers at that age. Language development should be about 300 words by age 2. So, they should be talking a bit more. You know, at age 2, they should be able to say a few words here and there and be able to just you know, understand basic language, okay?

For our little bit older patient, for our preschool patient, okay, this is a patient who’s 3 – 6 years old who’s just getting ready, you know, in preschool, and getting ready to start school. They should be gaining a little bit more weight. They should be getting about 5 pounds per year and they should be growing about 2 – 3 inches per year. Their motor development. They should be getting a little bit more skillful, okay? They should be able to hop on 1 foot, they should be able to draw a person, you know, a little stick figure. They should know where the head goes, where arms go, where feet go, what goes on the face. Are they able to put those things in the right position on the face, the eyes, the nose, ears, all that. They should be able to know really what’s going on with the face. Their vocabulary should be increasing quite a bit with being able to speak about 2,000 words by the age of 5. They should understand fantasy. They should understand, you know, what is fantasy and be able to differentiate that between real life and be able to use fantasy as they tell a story. They should know their name and their address, that’s something that parents should be able to teach them, especially before, just as a safety thing before they start school, they should be able to know, you know, their name, where they live, etc.

And then, the school age child. So, 6 – 12 years old. They’re gonna be gaining quite a bit more weight. They’re gonna be gaining 7 pounds per year and getting quite a bit bigger. Their brain growth is actually compared complete by about 10 years old and they’re gonna be growing a little bit less, you know, their growth is kinda slow at this point, until they get, you know, to adolescence. And they’ll start losing their teeth. Motor development, they should be able to write in cursive and they should be able to ride bikes, and play active games, and run around and do all those things that, you know, you think the child would know developmental delays is doing out, you know, they are playing tag, jumping, hopping, skipping, all that stuff.

So, that’s really kind of growth and development by age. And those are kinda the big points that you need to kinda need to understand and you need to know and really kinda hit on the big points on each of those growth, motor development and language and then think about some of the safety issues with each of these age groups.

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Pediatric

Concepts Covered:

  • EENT Disorders
  • Immunological Disorders
  • Intraoperative Nursing
  • Shock
  • Gastrointestinal Disorders
  • Lower GI Disorders
  • Postpartum Care
  • Basic
  • Respiratory Disorders
  • Endocrine and Metabolic Disorders
  • Developmental Considerations
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Musculoskeletal Disorders
  • Fundamentals of Emergency Nursing
  • Adult
  • Concepts of Population Health
  • Factors Influencing Community Health
  • Renal and Urinary Disorders
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Integumentary Disorders
  • Urinary Disorders
  • Central Nervous System Disorders – Brain
  • Neurologic and Cognitive Disorders
  • Newborn Complications
  • Musculoskeletal Trauma
  • Infectious Disease Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Pregnancy Risks
  • Communication
  • Neurological Emergencies
  • Pediatric
  • Oncologic Disorders
  • Preoperative Nursing
  • Acute & Chronic Renal Disorders
  • Developmental Theories
  • Emergency Care of the Neurological Patient
  • Medication Administration
  • Perioperative Nursing Roles

Study Plan Lessons

Acute Otitis Media (AOM)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Anti-Infective – Carbapenems
Appendicitis
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Breastfeeding
Brief CPR (Cardiopulmonary Resuscitation) Overview
Care of the Pediatric Patient
Celiac Disease
Cleft Lip and Palate
Conjunctivitis
Constipation and Encopresis (Incontinence)
Day in the Life of a Peds (Pediatric) Nurse
Dehydration
Developmental Considerations for the Hospitalized Individual
Developmental Stages and Milestones
Dysrhythmias for Certified Emergency Nursing (CEN)
Fever Case Study (Pediatric) (30 min)
Flight Nurse
Forensic Nurse
Growth & Development – Infants
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Immunizations (Vaccinations)
Imperforate Anus
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Life Support Review Course Introduction
Malnutrition (Failure to Thrive, Malabsorption Disorders) for Progressive Care Certified Nurse (PCCN)
Nephrotic Syndrome Case Study (Peds) (45 min)
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Pediatric Asthma
Nursing Case Study for Type 1 Diabetes
Nutrition Assessments
Nutritional Requirements
Omphalocele
Oncology nurse
Pain Management and Procedural Sedation for Certified Emergency Nursing (CEN)
Patients with Communication Difficulties
Pediatric Advanced Life Support (PALS)
Pediatric Bronchiolitis Labs
Pediatric Dosage Calculations
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatric Vital Signs (VS)
Pediatrics Course Introduction
Perioperative Education Documentation for Certified Perioperative Nurse (CNOR)
Peritoneal Dialysis (PD)
Piaget’s Theory of Cognitive Development
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
RN to MSN
Seizure Disorders for Certified Emergency Nursing (CEN)
Seizure Management in the ER
Tips & Advice for Pediatric IV
Tonsillitis
Umbilical Hernia
Visitor Supervision for Certified Perioperative Nurse (CNOR)
Vitals (VS) and Assessment
Vomiting