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Human beings

develop in 4
different aspects
of growth. The
areas are all
so when one is
affected it may
influence the


Physical development involves both the growth

Emotional and motor (movement) skills of the child.
Growth refers to a measurable change in size, such as height and weight.
Development refers to an increase in physical, emotional, social, or intellectual
skills. Boys may lag behind girls in growth and development as much as 2 years.
The satisfactory growth of a child is measured in
“percentiles” on a chart. A percentile is a statistical
value on a scale of one hundred that indicates whether
a distribution is above or below it. If a child’s weight
falls on the 50th percentile for his age, that means 50%
of all other children his age weigh more, and 50% of all
other children his age weigh less. If a child’s height
falls on the 90% percentile for his age, it means that
10% of all children his age will be taller than he is, and
90% of all children his age will be shorter than he is.
Factors influencing how
children grow: genetic
potential, medical problems,
and nutritional status
An additional factor influencing
development: practice
Development follows an orderly,
step-by-step sequence in three
different patterns:
Cephalo-caudal development is a
“head-to-foot” pattern. Prenatally
and at birth the newborn’s head is
proportionately larger; development
continues downward.
Proximal-distal (proximodistal)
development is an “inward-to-
outward” pattern. Development
starts at the trunk of the body and
moves further outward.
Simple-to-complex development is
a pattern relating to the difficulty
of tasks. Babies start with simply
eating and sleeping and progress
from there. Tasks involving a
combination of motions is more
As the muscles of the eye
strengthen in the newborn,
eyesight improves rapidly.
Along with that comes an
improvement in two abilities
that influence physical
Depth Perception is the ability to
recognize that an object is three-
dimensional, not flat. This ability
is not present at birth, but
appears sometime during the
second month and improves over
a number of years.

Hand-eye coordination is the ability to move the hands and fingers precisely in
relation to what is seen through vision. This helps in the satisfactory
performance of many skills , including eating, catching a ball, coloring, tying
shoes, writing, threading a needle, playing a keyboard, and playing sports.
Motor skills, often referred to
as locomotion, are abilities
that depend on the use and
control of muscles. Mastering
these skills, although
seemingly just a physical
development skill, relies
heavily on intellectual, social,
and emotional development.

The first motor skills to be developed

are the “gross” motor skills. These
involve the use of larger muscles in
the body such as the trunk, neck,
arms, and legs. Skills might include
running, jumping, hopping, skipping,
throwing, and catching.
Balance and
coordination depend
Balance is the ability to maintain a position. on the interaction of
Coordination is the capacity to move through a set multiple body organs
of movements, from simple to complex, as well as and systems including
repetition. Both balance and coordination are the eyes, ears, brain
necessary for performance of gross motor skills. and nervous system,
cardiovascular system,
and muscles.
Rolls tummy-to-back
at 5 months and back-
to-tummy at 6 months.
Continuous steps alternating feet.
Arms are in opposition to legs:
If the right foot is forward, swing the left arm forward.
This pattern of right leg
forward – left arm forward
was first seen in crawling.
As the right hand moved
forward – the left leg moved
forward. As speed, balance,
and coordination improve,
the child will run.

Walking involves a smooth

transfer of weight from the
heel to the toe. When a child
walks toe first, they appear to
have a light, bouncing
motion. (Runway models do
this deliberately to add sway
to their walk.)
The crawling infant simply crawls
upstairs on hands and knees, and
comes back down backwards.

Until the child can

climb up and
downstairs without
assistance, a gate
may be used at the
top and bottom of
the stairway to
prevent falls.
There are two patterns of stair-climbing:
1. Marking time – the child will step up
with one foot, then bring the other foot
up to the same step; repeat (this
occurs first)
2. Alternating feet – the child will step up
on one step with one foot, then bring the
next foot up to the step above the first;
repeat (this follows marking time)
In order to kick a ball successfully, the arms are
needed to maintain balance, and a backswing
motion in the kicking leg should develop and be a
help rather than a hindrance.
To successfully throw a ball, the body should rotate,
weight should shift from one foot to another (in a right-
handed throw, the weight shifts from the right foot to
the left foot), the arm should be back and to the side
and follow-through after the throw.
Catching a ball is an excellent way to
observe proximal-distal development. The
child begins by trapping the ball between the
trunk of the body and the arms. He then
moves to use of the arms and hands, and
still later to the hands and fingers.
Dribbling a ball cannot be done successfully
until the eye muscles improve and depth
perception become apparent. The child must see
the ball, judge the distance of the ball, and hit the
ball on it’s way UP (complex eye-hand
coordination). To hit the ball on the way “down”
makes a “slapping” sound does not allow for
extended dribbling.
To dribble and
walk or run at the
same time
increases the level
of complexity of
this task.

To control the
direction of the
ball, the fingers
must be employed.
Series of step-hops changing lead foot
after hop.
One knee is raised.
Arms swing from shoulders, one forward,
one back, in opposition to knee that is
raised in front.
This is a combination of motions and an
advanced motor skill.
Rhythmic step-leap movements
leading with the same foot forward throughout.
Front foot steps forward
and back foot pulls up to front foot with a
Arms in opposition, (as described in marching).

Once again,
galloping is a
of motions,
making it an
motor skill.
Done by standing
on one foot and
jumping up off the
floor with a pause
in between.
For balance,
hands on waist or
arms outstretched
to sides.

Both feet leave floor and land at the same time.
Bend knees and press feet into floor to begin and land.
Arms outstretched to sides for balance
After the gross motor skills, the
“fine” motor skills develop. These
skills involve the use of smaller
muscles in the body, such as
those of the eyes, hands, fingers,
feet, and toes.
Many “fine” motor skills require
increased manual dexterity.
Dexterity is skilled use of the
hands in manipulation of objects.

By the age of 5, most children have

practiced and established a
preference for using their right or left
hand. A few people will be
ambidextrous, meaning they are able
to use both hands with equal skill.
Mitten grasp:
the palm and
fingers oppose
the thumb

Pincer grasp: thumb and

forefinger opposition
Children may prefer to use,
or demonstrate more
accuracy with larger
crayons or pencils until the
pincer grasp is well-defined.
In order to outline a
picture in a coloring book
or accurately print their
name on a line, the child
must have improved eye-
hand coordination and fine
motor skills. They must
see the line, and judge the
placement of the letters on
the line. If perception is
not defined, letters will
“float” above or below the
line. A well-defined pincer
grasp to hold the writing
instrument is necessary
for consistently well-
formed letters.

The child in the picture is

demonstrating the correct
position for holding a
writing instrument.
need to be
outside or in
Physical activity simply means a large
movement of the body that uses indoor area
energy. The health guidelines on the to play.
food pyramid recommend a minimum
of 30 minutes of moderate or vigorous
exercise each day.

Limit time for TV

watching and computer
time or video games.
Physical activity, or lack
of it, can become a
Physical development is both qualitative and quantitative, and
sequential. When problems occur, they may be:
1. Medical issues (causes such as disease and birth defects)
2. Anatomical issues (such as muscle tone and flexibility)
3. Idiopathic (unknown causes)

Occupational therapy
(regular periods of suitable
productive activity as
treatment) and physical
therapy (therapy to increase
muscle tone, flexibility, and
range of motion) are
available for children with
delayed or atypical motor
Having good posture
means that your bones
are properly aligned,
Bad posture, including rounded which is necessary for
shoulders, rounded upper back, head muscles, joints, and
jutting forward, arched lower back ligaments to work
and/or protruding butt may cause properly and keep internal
chronic back pain. organs in the right
position for effective

Proper posture is indicated when the line

between the shoulders is level, not tilted. The
head should be held straight with no tilting or
turning to one side. The bumps on the spine
should be in a straight line down the center of
the back.

“Backpack syndrome” is associated with

backpacks weighing more than 10% of the child’s
body weight (5% for children under the age of 10).
The child should not have to lean forward or have
rounded shoulders when carrying a backpack.
Scoliosis is an abnormal
curvature of the spine. It occurs
more frequently in girls than boys,
and tends to strike as children
enter adolescence when the
growth rate is rapid.

It is easy for parents to mistake

scoliosis for bad posture or
slumping. Instead of developing
straight up and down, the spine
may bulge to one side forming a
“C” or may curve twice, forming
an “S”.

Treatment may vary according to the severity of the deformity. Exercises may
be adequate in most cases, while braces or surgery are rarely necessary.
Scoliosis may cause fatigue, breathing difficulties, and backaches.

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