Overview of Early Childhood Development

The first five years of life are an important time for growth and development. Development refers to the change in a child that occurs during the life span. The changes occur in an orderly sequence involving physical, emotional and cognitive development.

Physical development refers to changes in the body involving weight, size, gross motor, fine motor, vision, hearing and perceptual development.

Motor development occurs in a predictable and orderly sequence. Gross motor development refers to the large muscles which are used for head control, walking, sitting, running, jumping, climbing and riding a bike. Fine motor development refers to the small muscles of the fingers and hands for activities such as grasping objects, holding, cutting, drawing, buttoning and writing. Below are some fine motor developmental milestones with corresponding age:

• Early hand movement in infants are reflexive such as the grasp reflex. By the time they are 5-6 months, they can reach for toys with both hands, rakes with fingers and can bring hand to mouth.
• By 7 months, they can pick up small objects like cheerios. The child should also be transferring objects from hand to hand and bringing toys to mouth. The child can grab his or her feet while on his/her back, uses both hands to reach and play, pick up a small toy with one hand and will reach for a toy with both hands that is out of reach.
• By 9 months, the child can isolate the index finger to probe objects and push a toy back and forth.
• By 12 months, a child can remove a large knob puzzle piece from the board, stacks rings on a stand and turn pages of a cardboard book, clap with both hands, eat and drink without difficulty, attempt to feed self with spoon, pick up cereal with finger and thumb and eat it, hold a bottle, drink from a cup, begin to scribble, begin to throw a ball in forward motion and manipulate and pick up small objects with a finger to thumb to grasp.   
• By 16-18 months, they are should be able to scribble spontaneously with a crayon using a cylindrical grasp (all the fingers are together like a cup), pull apart pop beads and place a small peg in a hole. At 18 months, a child should be able to stack 4-8 blocks, remove socks and shoes; walk independently, lean over and pick up an object and attempt to kick a large ball.
• At age 2, a child can eat a variety of foods and food textures, eat with a fork without spilling, drink from a cup without spilling, turn the pages of a book, thread beads or a shoelace, flip light switches or toy switches, copy a line messily, stack toys to build a tower, and line up some toys or objects in a row.
• At age 3, they should be able to make horizontal and vertical lines and copy a circle.  They should also be showing a hand preference by the time they are four and hold a pencil/crayon with thumb and fingers placed correctly on the crayon. Attempt to cut paper with children’s scissors, thread a bead or shoe lace and line up toys in a row. The child may also be trying to ride a tricycle at this age.
• At the age of four, the child should have a mastery of a variety of grips so that they can wrap their hand around a pencil enabling them to copy simple shapes messily, draw person with 3 body parts, color mostly within the lines. The child should also have bimanual control which enable a child to use both hands to perform a task such as holding a paper and cutting with scissors. The child at age 4 should also be able to go the bathroom mostly independently.
• At the age of five, a child should be able to trace a line with a pencil, draw a line across paper, draw a person with several body parts, cut in a straight line with children’s scissors, copy simple shapes and designs such as square, triangle and *, copy letter of his/her own name and dress and undress mostly independently including buttons and zippers.

Sensory-Perceptual Development also plays and important role in the child’s development which is the information that is collected from the environment through the senses: touch, taste, smell, sight and hearing. The child’s brain begins to store this information in order to gain concepts such space and body relationships within the environment. When the information from the environment is not being processed appropriately a child may be at risk for sensory integration dysfunction which can in turn impact the child’s ability to learn and willingness to try new foods, acquire language and explore his/her environment. Things to look for are over sensitivity and avoidance to certain foods, noises or touch/textures as well as the child’s reactions such as hyper-reactions to certain noises, foods and touch/textures.

Speech and Language: Communication also develops in a orderly sequence.  Language skills are divided into receptive and expressive language.  Receptive Language refers to what a child understands such as vocabulary, following directions and pointing to pictures.  Expressive language refers to what a child can communicate either by words, signs or gestures.  Speech skills are the skills required to produce certain sounds, often called articulation or phonology.  

Speech and Language skills are evident in infants as listening and responding to talking and cooing, playing predictive games such as peek-a-boo, and beginning to understand language by responding to simple requests such as “no no” or “come with me”.  By the age of two a child should point to pictures in books, point to body parts, and have a vocabulary of 10-20 words, echo your speech and intonation patterns, talk in 1-2 word phrases and follow some simple directions.  At the age of three a child should know their name, sing songs/nursery rhymes, speak in 3-4 word sentences, and have a vocabulary of close to 1000 words.  By the age of four a child should point to colors and simple shapes, ask many questions, learn to share in small groups and stays on task for 12-15 minutes.  Speech skills are also a developmental process with early sounds such as m, n, p, f, b, w, and y present by age three.  At age four sounds k, g, d, s, sh, ch, and l, should be present.  Typically sounds v, th, and r aren’t expected until the age of six.

So, now that you know what to look for and you feel like there is a concern regarding your child’s development, then the first step would be to consult your pediatrician. 

A child’s pediatrician will perform a basic developmental checklist at well visits to make sure that a child is developing within the normal limits. When the child is not, a child may be referred to a therapy provider.   An occupational therapist can do a screening or an evaluation to determine if there is a need for treatment and will help the child facilitate the fine motor and sensory-perceptual development. A Speech and Language Pathologist can also screen/evaluate to help the child develop age appropriate speech and language skills.  A Speech Language Pathologist can also assist with feeding issues with children that are caused by structural abnormalities or texture sensitivities.  

Occupational therapists (OTs), occupational therapy assistants (OTAs) and Speech Language Pathologist (SLPs)  provide services to infants, toddlers and children who have or are at risk for developmental delays or disabilities. These therapy practitioners work as a part of a multi-disciplinary team such as with other occupational therapists, speech therapists, physical therapists, teachers, parents, psychologists in a variety of settings such as child care settings, schools, private clinics, homes and hospitals.

Occupational therapy is concerned with a child’s ability to participate in daily life activities or “occupations”.  OTs and OTAs use their expertise to help children with social-emotional, physical, cognitive, communication, adaptive behavior and sensory integration challenges.  Through the use of play, occupational therapy practitioners can design interventions that promote healthy development to help a child acquire new skills.

Speech Therapy is concerned with a child’s ability to communicate.  Communication can come in many different forms. Whether a child is able to speak, sign or use an augmentative device it is an important to be able to communicate with others.  SLP’s use their expertise to help children, whether they have severe communication delays  or  simple speech errors,  improve their speech and language skills.

We hope that you have learned more about early childhood development by coming today and for even more information about Occupational Therapy or Speech Therapy, please visit the website for The American Occupational Therapy Association, The American Speech and Language Hearing Association or our website.

Crossway Pediatric Therapy is available to provide screenings at your preschool. Call 704-847-3911 to schedule.

Shelley Portaro, OTR/L
Jennifer Lowder, COTA/L
Heather Skeen, SLP-CCC