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Inadequate dietary intake, insufficient interactions with caregivers, or both during this phase of life may alter experience-dependent processes that are critical to brain development and skills achievement of a child.
In this chapter we see how a child's early development also depends on factors outside the child's head-on the opportunities a child has to use his senses, mind, and body to learn about the things and people around him. On the next page is a true story that shows how a severe physical disability can lead to slow mental development, and how a family found ways to help their child develop more fully. The village workers helped Enrique's family make a special chair for him, with a cushion and hip strap to help him sit in a good position. Later, they added wheels to the chair.With his new chair, Enrique was able to sit and watch everything that was going on around him. Enrique's story shows how development of the body, mind, and senses all influence each other.
Early Stimulation'Stimulation' means giving a child a variety of opportunities to experience, explore, and play with things around her. The younger the child is when a 'stimulation program' begins, the less retarded or delayed he will be when he is older. In order to know how well a child is developing and in which areas she may need special help, we can compare her development with that of other children.
Every child develops in 3 main areas: physical (body), mental (mind), and social (communication and relating to other people). Before she can begin to walk, a baby needs to go through a series of developmental stages, or 'levels'. Later, we can encourage her to lift and turn her head, and then reach out, toward different sounds. When she begins to sit, again we can help her to recognize different sounds and reach toward them. It is important for parents to realize that a child develops control and use of her body in a certain order:HEAD CONTROL - TRUNK CONTROL (SITTING AND BALANCE) - STANDING AND WALKINGThis is true even for an older child.
We must help Nina's mother realize that Nina first needs help with other important developmental steps before she will be ready to learn to walk.
Decide what are the next steps forward, so that the child can build new skills on the ones she has now, in the same order in which a normal child develops.
The chart on the next 2 pages shows some of the steps or 'milestones' of normal child development.
Let us suppose that a village health worker wants to help Nina's mother figure out what she needs to do next to help her 3-year-old daughter develop early abilities. Perhaps they can begin to work with sitting and creeping, but probably she will not progress much with these until she gets better head control. To use the Child Development Chart for recording a child's progress, every month or two you can add new circles to the chart. THE NEED FOR EARLY STIMULATIONThe parents and family are the key to the development and early learning of any child. When a child is delayed, he needs stimulation and activities to help develop all areas of his body and mind. The goals of an early stimulation program are to help the child become as able, self-sufficient, happy, and kind as possible.
Observe the child closely to evaluate what he can and cannot do in each developmental area. Decide what new skill to teach or action to encourage that will help the child build on the skills he already has.
Divide each new skill into small steps: activities the child can learn in a day or two, and then go on to the next step.
A special learning program, if well-planned and carefully done, can help a delayed child progress much more than she would without help. GENERAL GUIDELINES FOR HELPING A CHILD'S DEVELOPMENTHow a family member or rehabilitation worker relates to a child when trying to teach her new skills can make a big difference in her whole development. Praising success works much better (and is much kinder) than scolding or punishing failure. CAUTION: Avoid giving sweets or food as prizes - especially if the child is fat (see box on Page 340). Many retarded children (especially those with Down syndrome) love to copy or imitate the actions of others. Even at early stages of development, it is a mistake to always place in his hands what a child wants. Children learn best and cooperate more when they enjoy and are excited by what they are doing. This is the "Golden Rule of Rehabilitation." When a child has trouble doing something or seems slow or clumsy at it, parents often want to 'help' by doing it for her. Some children may refuse to try, or will be afraid of new playthings, aids, or special seating.
Copyright (c) 2007-2015 Japanese Society for Rehabilitation of Persons with Disabilitiesi??JSRPDi?‰All Rights Reserved. Toddler growth takes place at an amazing pace and you soon begin to wonder where all the time has been lost, while watching your baby grow into a strong child. Toddler growth spurt charts are available at every book or medical store and they are of great help in assessing the amount of growth that has been experienced by your toddler. You notice that your child has outgrown certain items of clothing, indicating that growth has taken place.

PLUS: Ask your breastfeeding questions, give answers, read tips from breastfeeding moms, and more! Motor skills are developed and mastered to get around, while language development is to communicate socially.
Provision of essential nutrition is important too for child growth.Normal child growth and development of motor skills go hand in hand. Moreover, skills developed in one domain influence and are influenced by the skills developed in all the other domains.Children progress through childhood development at their individual pace. Mostly we looked at disabilities that come from inside a child's head- conditions where the brain has been damaged, is too small, or for other reasons is not able to work as quickly as other children's brains.
We look at the stages or steps of normal child development, and at ways we can help or 'stimulate' a child to learn and do things more quickly. They taught his mother and sister how to help him sit in a way that would keep his body from stiffening so much.
Enrique was slow to develop mentally because he did nothing but lie on his back in a corner. It involves body movement and the use of all the senses-especially seeing, hearing, and touching.Early stimulation is necessary for the healthy growth of every child's body and mind. Often parents of an older child who is delayed will try to help her learn more advanced skills (which other children her age are learning) before she is ready. Several times each day she holds Nina in a standing position and moves her forward, so that her feet take stiff, jerky steps on tiptoe. In each area of development, she notes the different things Nina can do, the things she cannot do yet, and the things she is just beginning or trying to do, but still has trouble with. You can use it to figure out where a child is in her development, and to plan the next steps that she needs help with. The use of her hands is still somewhat behind for her age, but this may partly be because of her poor head control. Children who are developmentally slow need the same stimulation (talking to them, music, games, adventure, and love) that any child needs. Movement, body control, strength, and balance: these will help the child move about, do things, play, and work. Use of the hands: increased hand control, and coordination of the hands with what the child sees, allows the child to develop many skills.
Communication: listening, understanding what is said, and learning to speak, or to communicate in whatever way is possible. Interaction with other people: smiling, playing, behaving appropriately, and learning to 'get along' with others.
Basic activities for daily living: eating, drinking, dressing, and control of bowel and bladder (peeing and shitting).
It is especially useful for children who have difficulty relating to different parts of their body or knowing where they are. Instead, use the child's desire as a chance to have him use his developing body skills and language skills to get what he wants-by reaching, twisting, rising, creeping, or whatever he is learning to do.7.
However, for the child's development, it will help her more to let her do it herself -providing encouragement but assisting only in ways that let her do more for herself.9. Teaching is important, but so is giving the child a chance to explore, test his own limits, and do things for and by himself.10. If another child tries it first, and shows he likes it, the child will often want to try it also.
They are also used as a tool to check the percentile of growth that your toddler lies in, taking into consideration his or her age and birth weight in to consideration. The pain felt in the limbs, especially at night, are indicative of the process of growth that is taking place. It is therefore impossible to precisely specify the age at which a child should achieve a given skill.Traditionally, these charts are only for the first 6 years of life. Our concern is not only to help children who are 'mentally retarded', but those whose development is slow, or 'delayed', for whatever reason.Usually children whose minds are slow to develop are also slow in learning to use their bodies. He could also sit at the table and eat with the family (although his mother still had to feed him). His mind did not have the 'stimulation' (activity, exercise, and excitement) it needed to grow strong.
For the non-disabled child, stimulation often comes naturally and easily, through interaction with other people and things. This encourages her to use her arms and hands so that she can then learn to lift herself to sit. Her mother does not know that this stepping is an 'early reflex' normally only seen in young babies (see Page 311). Next, her mother compares what Nina can and cannot do with what other children Nina's age can do.
Just because a child has not developed certain skills by the ages shown does not mean he is backward or has a problem. As soon as it stops being fun, stop the activity for a while, or change it in some way, to put new adventure and excitement into it.
Help her only as much as is needed.For example, if the child has trouble putting on clothes because of spasticity, help by bending her shoulders and back forward, but let her pull on her clothes herself. Toddler growth spurts are sometimes painful and children need comforting from time to time. The charts presented below show the internationally accepted average age at which a child should attain the specific developmental skills. They begin later than other children to lift their heads, roll, sit, use their hands, stand, walk, and do other things. He spent most of his young life lying on his back, legs stiffly crossed like scissors, head pressed back, looking up at the roof and the mud brick walls. But it is often more difficult for the disabled child to experience and explore the world around him. It means that in some ways Nina's development is still at the level of a 1 - to 3-month-old baby. She can then decide at what level her child is at in each area of development, and what are the next steps to work toward.

Her seeing and hearing seem about normal, and her mental development is at about 2 years.Then they put a square around the next developmental step after each circle.
With her head supported in a good position, they can give her games and things to do to help her develop better use of her hands. A toddler growth spurt is caused by the changing of the skeletal system, giving the body its shape and size. They are physically delayed because of their delayed mental development.In other children the opposite is true. The village workers helped the teacher make a book holder attached to Enrique's chair, and a head band with a wire arm so that he could turn the pages.
For his mind and body to develop as early and fully as possible, he will need extra care and special activities that provide easy and enjoyable ways to learn. All this helps her to develop balance and to shift her weight from side to side-skills she will soon need for standing and walking. But, they are careful not to keep her head supported for long, because that will not help her to learn to support it herself.
Praise him, hug him lovingly, or give him a little prize when he does something well (or when he makes a good effort). The most common toddler growth spurt symptoms include immense pain felt in the limbs because of the process of growth. Parents may be required to massage the legs and hands to relieve a certain amount of the pain. Their minds are basically complete and undamaged, but certain physical disabilities make it harder and slower for them to develop the use of their minds.For example, a child who is born deaf but whose brain is normal will have difficulty understanding what people say, and in learning to speak. When at last his body was placed so he could see and experience more of the world around him, and relate more to other people, his mind developed quickly.
Normally, the stimulation that a child needs to advance through these stages comes from ordinary day-to-day interaction with people and things.However, a child who has a disability may need special help to keep progressing. Making her 'take steps' will only keep active the early reflex which she needs to lose in order to learn to really walk. Because Nina's poor head control is holding her back in other areas, they decide to work mostly with this (see Page 302), and also to help her with rolling and twisting her body (see Page 304). Also, they are careful to provide only the least amount of support needed to give her better control of other parts of her body.
Besides this, giving the toddler a hot water bath can also help to soothe some of the discomfort being experienced as the child grows. With a little help and imagination, he learned to do many things that he and his family never dreamed he could.We saw how Enrique's physical disability slowed down his mental development.
Notice that in the above example, the child's ability to see makes her see things and want to reach for things and explore. They will reduce the support as her control improves.Because Nina's eyes, ears, mind, and speech seem to be developing fairly well, these will probably be what she learns to use best as she grows older. One of the most important things during toddler development that parents should keep in mind is the fact that at times, such as these, children need moral support and comforting more than anything else in the world. Wilsona€™s disease, Huntingtona€™s choreaLysosomal storage diseaseWish to know yet more on developmental milestones?
Because language is so important for the full development of the mind, in some ways she may seem 'mentally slow' for her age. They haven’t a clue about why they are experiencing such pain, and assuring them that all will be well, will work wonders. However, if the child is taught to communicate her wishes and thoughts through 'sign language' at the age when other children learn to speak, her thinking power (intelligence) will often develop normally (see Chapter 31). They use pictures, songs, stories, play, and a lot of stimulation to help her develop her mind. Giving them enough time for rest and allowing them to stretch out their hands and legs will relieve a certain amount of the pain. After all, the mind directs the body, yet depends on the body's 5 senses (sight, hearing, touch, taste, and smell) for its knowledge of people and things. To prevent her from falling behind, we must look for other ways to encourage her to learn and do things. Massaging their bodies down with soothing oils is another effective way of easing the discomfort being experienced.
At age seven-if his mother understood him correctly-he asked her for a gun to kill himself.Soon after this, Enrique's mother and his older sister took him to a team of village rehabilitation workers in a neighboring village.
We can do this through touch and sound, adapting the type of stimulation we use to the child's particular stage of development. Try to play with the child at about the same time each day, and to put his toys, tools, clothes, and so on, in the same place. Children need time for rest and should be given an ample amount of time to do so, thereby enabling their bodies to relax and grow without any complications, such as extreme pain and fatigue. Sometimes it is better to help her gain skill and confidence in only 1 or 2 areas at a time. But he desperately needed to communicate more with other people and see what was going on around him, to be included in the life of his family and village.
And they need the chance to explore their own bodies and the world about them as fully as they can. His mother had tried many times to sit him in a chair, but his body would stiffen and he would fall off or cry.
Change the activities a little every day, so that the child and her helpers do not get bored. Look for ways to turn all activities into games that both the child and you enjoy.Be practical. Whenever possible choose skills and activities that will help the child become more independent and be able to do more, for himself and for others.

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