STAGES OF GROWTH AND DEVELOPMENT

NORMAL INFANT

ONE MONTH
BIOLOGICAL
Weight: 4.4 +/- 0.8 kg. Gains above 680 gms a month or 150 to 210 gms a week. Length: Approximately 53 +/2.5 cms. Increases about 2.5 cms a month during first 6 months. Pulse: 130 +/- 20 bpm.

MOTOR
Gross motor: Lies in flexed position. When prone, pelvis is elevated but knees are not beneath abdomen as they were after birth. Head lags when baby pulled from a supine to a sitting position. Head sags forward when baby is held in sitting position.

SENSORY
Startled by sounds (Moro reflex) Attentive to the speech of others. Indefinite stare at surroundings. Fixates on objects brought in front of eyes. Notices faces especially and bright objects, but only if they are in the line of vision. Protective blinking in response to bright light.

ONE MONTH
BIOLOGICAL
Respirations: 35 +/- 10 bpm. Blood pressure: 80/50 +/- 20/10 mm Hg. Reflexes: Primitive reflexes govern movements. Has well developed sucking, rooting, swallowing and extrusion reflexes. Moro reflex and asymmetric tonic neck reflex is seen.

MOTOR

SENSORY

May lift periodically Follows a bright when held over object to the adults shoulder or midline of vision if placed in prone 6 to 8 inches from position. eyes. Cervical curve begins to develop as infant learns to hold head erect. Turns head to the side when prone. Makes crawling movements when prone on flat surface.

ONE MONTH
BIOLOGICAL MOTOR SENSORY
Dance and dolls Pushes with the feet against hard surface eye reflexes fading. to move forward.

Physiologic immaturity. Breathes through nose.

Fine motor: Holds hand in tight fists. Can grasp an object placed in hand but drops it immediately.

TWO MONTHS
BIOLOGICAL
Posterior fontanel closed at 6-8 weeks of age.

MOTOR

SENSORY

Gross motor: Turns head to the Less fixed prone side when a position; arms sound occurs at flexed, hips flat, legs ear level. extended, head in When on back midposition or side. follows a dangling No head droop when object or a suspended in prone moving light position. beyond the Less head lag when midline of vision. pulled from a supine Beginning to sitting position. binocular fixation Lifts head almost a and convergence 45 degrees above a to objects nearby. flat surface when lying prone.

TWO MONTHS
BIOLOGICAL MOTOR
Holds head erect in midposition when held upright. Turns from side to back. Fine motor: Hands may be open. Holds a rattle briefly when placed in hand.

SENSORY

THREE MONTHS
BIOLOGICAL
Weight: 5.7 +/- 0.8 kg Length: 60 +/- 2 cms. Pulse: 130 +/- 20 bpm Respirations: 35 +/- 10 bpm. Blood pressure: 80/50 +/20/10 mm Hg.

MOTOR

SENSORY

Gross motor: Turns head and Symmetric posture of looks in same head and body. direction to locate Very slight head lag sound. when pulled from When on back supine to sitting turns eyes to a position. dangling object or Sits, back rounded, a moving light to knees flexed when marginal field of supported in sitting vision (180 position. degree). Raises chest, usually supported on forearms, when in prone position.

THREE MONTHS
BIOLOGICAL MOTOR SENSORY
Holds head erect and Binocular coordination steady. (vertical and Reflexes: Fine motor: horizontal vision) Grasping reflex Hands open or close when an object is absent. loosely. moved from right Landau reflex Holds hands in front to left and up and appears; an infant of face and stares at down in front of suspended in them. face. horizontal prone Holds object put in Regards toy position with the hand with active dangled in midline head flexed grasp. of chest promptly. against the chest Carries object or hand reflexly draws the to mouth at will. legs up against the Reaches for bright objects but misses abdomen. them.

THREE MONTHS
BIOLOGICAL MOTOR SENSORY
Loses interest in objects that are suddenly removed from the perceptual vision. Blinks at objects that threaten the eyes. Beginning ability to coordinate various sensory stimuli.

FOUR MONTHS
BIOLOGICAL
Drools between 3 and 4 months of age, indicating increased production of saliva; unable to swallow it therefore, it runs from mouth.

MOTOR
Gross motor: Symmetric body postures predominant. Sits with adequate support. Enjoys being propped up. Holds head erect and steady when placed in sitting position. Lifts head and shoulders at a 90 degree angle when on abdomen and looks around.

SENSORY
Follows moving objects well with eyes. Even the most difficult types of eye movements are present. Fairly good binocular vision. Looks briefly for the toy that disappears. Accommodation begins to develop. Can accommodate to nearby objects.

FOUR MONTHS
BIOLOGICAL MOTOR SENSORY
Can focus on small objects. Stares at rattle placed in hand and takes it to mouth. Recognizes familiar objects, such as feeding bottle and toys. Beginning handeye coordination. Comforts self by sucking thumb or pacifier. Attempts to roll or actually rolls over from front to back. Sustains small portion of own weight when held in standing position. Activates arms at sight of preferred toy. Reflexes: Fine motor: Tonic neck, Moro, Holds hand sucking and predominantly open. rooting reflexes Brings hand together in absent; extrusion midline. Plays with fingers. reflex fading.

FOUR MONTHS
BIOLOGICAL MOTOR
Grasps objects held near hand. Cannot pick it up when dropped. Grasps objects with both hands. Attempts to reach objects with hands but overshoots them. Objects are carried to mouth. Thumb apposition in grasping occurs between third and fourth months. Fingers and clutches clothing.

SENSORY

FIVE MONTHS
BIOLOGICAL
Weight: At least twice the birth weight.

MOTOR
Gross motor: Sits with slight support. Balances head well when sitting. Holds back well when pulled to a sitting position. Pushes whole chest off a flat surface when prone. Rolls from back to front.

SENSORY
Localizes sounds made below the ear. Looks after a dropped object. Inspects objects visually for a lengthening period of time. Can fixate on objects more than 3 feet away. Visual acuity, 20/200.

FIVE MONTHS
BIOLOGICAL MOTOR
Sustains more of own weight when held in standing position. Pulls feet up to mouth from supine. Physical growth Fine motor: Uses thumb in partial slowing down. Can breathe through apposition to fingers mouth when nose is more skilfully. Tries to obtain objects obstructed. beyond reach. Grasps objects independently of direct stimulation of the palm of the hand.

SENSORY

FIVE MONTHS
BIOLOGICAL MOTOR
Grasps object with whole hand, either right or left. Holds one object while looking at another.

SENSORY

SIX MONTHS
BIOLOGICAL MOTOR SENSORY
Weight: Gross motor: Localizes sounds 7.4 +/- 1 kg. Sits alone briefly if made above the Gains about 340 placed in a favourable ear. gms a month or 90 leaning position on Retrieves the to 150 gms a week hard surface. Holds dropped object during second six arm out. that can be seen Back is straight when and reached. months. sitting in high chair. Moves in order to Length: Pulls to a sitting see an object. 65.5 +/- 3 cms position. Gains about 1.25 Springs up and down cms a month when sitting. during second 6 Lifts chest and upper months. abdomen when prone, putting the weight on the arms and hands.

SIX MONTHS
BIOLOGICAL MOTOR SENSORY
Head circumference: Turns completely over, 43 cms. with rest periods Increases about during the turn. Infant 0.5 cm per month must be protected in second 6 from falling. Sustains most all of months. own weight when held in standing position. Hitches-moves backward when in a sitting position by using the arms and hands.

SIX MONTHS
BIOLOGICAL
Pulse: 120 +/- 20 bpm. Respirations: 31 +/- 9 bpm. Blood pressure: 90/60 +/28/10 mm Hg. Teething: Two lower central incisors erupt. Begins to bite and chew.

MOTOR
Fine motor: Grasps with simultaneous flexion of fingers; begins to use fingers to feed self a cracker. Retains transient hold on two objects, one in each hand. Drops one object when another is offered. Begins to transfer objects from one hand to the other.

SENSORY

SIX MONTHS
BIOLOGICAL MOTOR
Manipulates small objects. Begins to bang objects that are held. Holds own bottle but may prefer for it to be held.

SENSORY

SEVEN MONTHS
BIOLOGICAL MOTOR SENSORY
Head turns in a curving arch to localize sounds. Depth perception beginning to develop. Fixates on very small objects and details. Discrimination between simple geometric forms begins to develop. Has preference in taste for foods. Reflexes: Gross motor: Sucking and Sits alone on hard rooting reflexes surface, leaning disappear at 7 to 8 forward on hands. months when Lifts head as if trying asleep. to sit up when supine. Control of trunk is more advanced. Rolls more easily from back to abdomen. Sustains all of weight on feet when held in standing position.

SEVEN MONTHS
BIOLOGICAL
Parachute reflex appears between 7 to 9 months. An infant suspended in a horizontal prone position and lowered suddenly will extend the hands forward to provide protection from falling. This reflex continues indefinitely.

MOTOR

SENSORY

SEVEN MONTHS
BIOLOGICAL
Teething: Upper central incisors erupt. Lower lateral incisors erupt. Ultimate colour of iris is established.

MOTOR
Fine motor: Holds two toys at once. Approaches a toy and grasps it with one hand. Transfers a toy from one hand to the other. Imitates simple acts of others. Bangs objects that are held. Uses a raking motion to try to obtain small objects. Holds cup.

SENSORY

EIGHT MONTHS
BIOLOGICAL
Beginning of a pattern in bowel and bladder elimination.

MOTOR

SENSORY

Gross motor: Recognizes Sits alone steadily. familiar words Pulls self to standing and sounds. position with help. Hand-eye coordination is perfected so that random reaching and grasping no longer occur. Fine motor: Holds two objects while looking at third.

EIGHT MONTHS
BIOLOGICAL MOTOR
Persistently reaches for objects beyond range of grasp. Releases objects from hands voluntarily. Complete thumb apposition. Pincer grasp begins to develop, using the fingers against the lower portion of the thumb. Eats finger foods, such as crackers, that can be held in one hand. Drinks from cup with assistance.

SENSORY

NINE MONTHS
BIOLOGICAL
Reflexes: Plantar grasp absent.

MOTOR
Gross motor: Raises to a sitting position alone with good coordination. Sits steadily for longer period of time. Recovers balance when leaning forward, but not sideways. Crawls instead of hitching. Then starts creeping. Beginning to pull self to standing position alone while holding on to the furniture.

SENSORY
Head turns directly to source of sound. Increased depth perception. Recognizes by looking or moving toward familiar object when named. Able to follow objects through transition from one place to another.

NINE MONTHS
BIOLOGICAL
Teething: Upper lateral incisors erupt.

MOTOR
Fine motor: Bangs two objects together. Pokes objectives with fingers. Uses thumb and index finger in early finger grasp Has preference for the use of one dominant hand Holds own bottle with good hand-mouth coordination.

SENSORY
Head turns directly to source of sound. Increased depth perception. Recognizes by looking or moving toward familiar object when named. Able to follow objects through transition from one place to another.

NINE MONTHS
BIOLOGICAL MOTOR
Puts nipple in and withdraws it from mouth at will. Drinks from cup with some spilling. Attempts to use a spoon but spills contents.

SENSORY

TEN MONTHS
BIOLOGICAL
Macula is well developed so that fine visual discriminations can be made.

MOTOR

SENSORY

Gross motor: Marked interest Moves from prone to in very small sitting position. objects. May sit by falling Searches for a down from standing lost toy with position. greater Sits steadily for persistence. indefinite period of time. Does not want to lie down unless sleepy. Creeps well. Pulls to standing position well, holding on to crib rail or other support.

TEN MONTHS
BIOLOGICAL MOTOR
Cruises well. Walks sideways by holding on to a supportive object with both hands. Makes stepping movements forward when two hands are held.

SENSORY

Fine motor: Picks small objects with index finger and thumb. Releases an object after holding it. Brings the hands together.

ELEVEN MONTHS
BIOLOGICAL
None

MOTOR

SENSORY

Gross motor: Tilts head Stands erect with minimal backward to see support and lifts one foot upward. to take a step. Cruises well. Fine motor: Explores toys and other objects more carefully. Removes covers from boxes. Takes toys out of box or cup. Puts toy inside box or cup but may not let go yet. Beginning to hold a crayon and make a mark on paper.

TWELVE MONTHS
BIOLOGICAL
Weight: 10 +/- 1.5 kg Has tripled birth weight. Length: 74.5 cms +/- 3 cms. Length has increased by almost 50% from birth.

MOTOR
Gross motor: Stands alone for variable length of time. Sits down from standing position alone. Walks in few steps with help or alone. Improves competence in motor skills through practice. Fine motor: Good pincer grasp. Picks up small bits of food and transfers them to mouth.

SENSORY
Listens for recurring sounds. Fully binocular vision well established. Amblyopia may develop with lack of binocularity. Follows fastmoving object with eyes. Discriminates simple geometric forms: squares, circles.

TWELVE MONTHS
BIOLOGICAL
Head circumference: 46 cms. Increased by one third since birth. Brain weight has increased rapidly since birth, resulting in significant developmental achievements. Head and chest are equal in circumference. Anterior fontanel closes between 12 and 18 months.

MOTOR

SENSORY

Enjoys eating with Visual acuity: fingers. 20/100 to Attempts to put a small 20/50 pellet into a narrownecked bottle but does not succeed. Releases one or more objects inside another object or container. Attempts to put one block over the other but do not succeed. Turns pages in a book but usually not one at a time.

TWELVE MONTHS
BIOLOGICAL MOTOR SENSORY
Pulse: Drinks from a cup and eats from a spoon but 115 +/- 20 bpm. Respirations: still requires some help. 30 +/- 10 bpm. Blood pressure: Holds a crayon 96/66 adaptively to make a +/stroke or a mark on a 30/24 mm Hg. piece of paper. Reflexes: Babinski reflex disappears. Landau reflex disappears between 12 to 24 months. Teething: Has 6 to 8 deciduous teeth.

TWELVE MONTHS
BIOLOGICAL
Lumbar curve and the compensating dorsal curve develops as walking continues. Physiologic stability achieved and maintained during first year.

MOTOR

SENSORY

FIFTEEN MONTHS
BIOLOGIC
Legs appear bowed.

MOTOR & SELF-CARE

Gross motor: Assumes standing position without help. Walks without support at 13 months, wide-based gait. Loses balance while walking around corners or stopping suddenly. Kneels without support. Creeps up stairs. Throws small objects repeatedly and picks them up again, but may fall. Cannot throw ball without falling.

SENSORY
Sound localization indicated by head movement in all planes. Binocular vision fully developed. Looks at pictures intently for prolonged period of time. Can identify geometric forms and place round object into its appropriate place or hole.

FIFTEEN MONTHS
BIOLOGIC MOTOR & SELF-CARE
Fine motor: Builds a tower of 2-3 cubes. Open boxes. Pokes finger in hole. Scribbles spontaneously. Makes line with crayon. Pats pictures in books and begins to turn pages. Insert pellet in narrow-necked bottle. Self-care: Feeding skills: May give up bottle. Holds a cup with all fingers grasped about it, is apt to tip the cup rather than head, causing some spilling.

SENSORY

FIFTEEN MONTHS
BIOLOGIC MOTOR & SELF-CARE
Grasps a spoon and inserts it into a dish. Cannot fill the spoon well; spoon is likely to turn upside down before reaching mouth. Assist child by feeding with a second spoon. Enjoys finger feeding. Leaves dish on tray when fed. Dressing skills: Sticks out arm and leg to help in dressing. Removes socks. Toileting and grooming skills: Indicates when diaper is wet or soiled.

SENSORY

EIGHTEEN MONTHS (1.5 YRS)

BIOLOGIC MOTOR & SELF-CARE SENSORY
Can see better thus has intense interest in pictures. Identifies various shapes. Convergence well established. Some depth perception. Anterior Gross motor: fontanel Walks with somewhat wide stance, closed but increasingly more like adult Abdomen gait. Seldom falls. protrudes. Walks sideways and backward. Physiologic Walks upstairs with one hand held. anorexia due Runs stiffly, often falls. to decreased Moves quickly from place to place. growth. Jumping attempted using both feet. Has May fall in initial attempts as body sphincter is propelled forward. Seats self in small chair. control. Climbs on furniture. Gets into everything: explores drawers, closets and wastebaskets. Pulls and pushes toys.

EIGHTEEN MONTHS (1.5 YRS)

BIOLOGIC MOTOR & SELF-CARE
Pushes light furniture around room. Throws ball overhand without failing.
Fine motor: Builds tower of 3-4 cubes. Scribbles vigorously. Imitates a vertical stroke with crayon. Turns pages in a book-2 or 3 at a time. Dumps pellet from bottle. Puts block into hole. Transfers objects hand to hand at will.

SENSORY

EIGHTEEN MONTHS (1.5 YRS)

BIOLOGIC MOTOR & SELF-CARE
Self-care: Feeding skills: Holds cup with both hands. Hands it to caregiver, puts it down or drops it on the floor. Finger feed proficiently. Eats with spoon; turns spoon in mouth. Spills frequently. May play with food. Negativism and high activity level may interfere with eating. Dressing skills: Removes simple garments and unzips garments.

SENSORY

EIGHTEEN MONTHS (1.5 YRS)

BIOLOGIC MOTOR & SELF-CARE
Toileting and grooming skills: May complain when wet or soiled or give indication of need to toilet. Increased readiness for bowel and bladder control. Possibly early control of bowel movements. May smear faeces.

SENSORY

BIOLOGIC Weight: Approximately 11.8 12.7 kg. Has gained 1.8 to 2.7 kg during second year.

24 MONTHS ( 2 YRS ) MOTOR & SELF-CARE Gross motor: More grown up, steady gait. Can walk with heel-toe gait. Walks backward well in imitation. Runs more quickly in more controlled way; has fewer falls. Walks up and down stairs, both feet on one step at a time, holding on to a railing or wall. Jumps crudely with both feet in place. Kicks large ball without falling. Picks up objects from floor without losing balance.

SENSORY Visual acuity 20/40. Accommodation well developed. Inserts square objects in its appropriate place or hole. May develop esotropia (strabismus).

24 MONTHS ( 2 YRS ) BIOLOGIC MOTOR & SELF-CARE Height: Fine motor: Approximately Builds a tower of 6-7 cubes. 82.5 to 85 cms. Makes cubes into a train, one Has gained 10 to behind the other. 12.5 cms in Scribbles in more controlled second year. way than at 18 months. Adult height is Imitates a circular stroke. twice height at 2 Imitates a horizontal stroke. Turns pages of books one at a years of age. time. Opens doors by turning the door knob, may run away. Unscrews lid of the jar. Folds paper once imitatively. Is proud of accomplishment of motor skills.

SENSORY

24 MONTHS ( 2 YRS ) BIOLOGIC MOTOR & SELF-CARE Chest circumference: Self-care: Exceeds head circumference. Feeding skills: Anterior posterior Drinks well from a small diameter less than glass held in one hand. lateral diameter. Puts spoon in mouth occasionally with one Head circumference: hand, but without turning 49 to 50 cms. it. Spills moderately. Pulse: Plays with food. 110 +/- 20 bpm (average 100 bpm. Can use straw. Imitates eating habits of Respirations: others. 26 28 bpm. May request certain Blood pressure: foods. 99/64 +/- 26/24 mm Hg.

SENSORY

BIOLOGIC Reflex: Landau reflex completely disappear. Dentition: Approximately 16 temporary teeth. Physiologic functioning, with the exception of reproductive and endocrine, is mature. Abdomen protrudes less than at 18 months.

24 MONTHS ( 2 YRS ) MOTOR & SELF-CARE Dressing skills: Pulls on own simple garments- coats, elastic pants (with help over hips), shoes (laces untied). Removes most of own clothing.

SENSORY

Toileting and grooming skills: Verbalizes toilet needs. Usually bowel-trained with occasional accidents. Usually urinates when taken to toilet. Toilet-trained in daytime generally.

24 MONTHS ( 2 YRS ) BIOLOGIC MOTOR & SELF-CARE Probably ready for May still smear stool. beginning daytime May brush teeth with help. control of bowel and Attempts to wash self in tub bladder. or shower.

SENSORY

30 MONTHS
BIOLOGIC
Weight: Gains about 5 kg between 1 and 3 yrs. Birth weight quadrupled by 2.5 yrs.

MOTOR & SELF-CARE

SENSORY

Gross motor: Visual acuity: Stands on one foot 20/30. alone momentarily. Convergence Walks on tiptoe for few smooth. steps upon request. Recalls visual Walks up and down images. stairs, one foot on one step, alternating feet. Jumps well in place with both feet off floor. Jumps from step or low chair. Can throw a large ball overhand 4 to 5 feet. Rides a walker or pedal car.

30 MONTHS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Height: Fine motor: Grows about 6-8 Builds tower of 8 cubes. cms during third Adds chimney to train of cubes. year. Makes vertical and horizontal strokes but may or may not join them to make a cross. Imitates circular strokesforms closed figure. Holds crayon with fingers instead of entire hand. Good hand finger coordination; moves fingers.

30 MONTHS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Dentition: Self-care: Full set of 20 temporary teeth. Feeding skills: Self-feeding with Daytime bowel and occasional spilling. bladder control Pours from pitcher; possibly often spills. Gets a drink without established. assistance. Distinguishes between finger and spoon food. Chews with mouth closed. Uses fork, but it is held in fist.

30 MONTHS
BIOLOGIC MOTOR & SELF-CARE
Dressing skills: Puts arm through large armhole. Buttons one large front button. Unbuttons large front buttons. Helps put things away. Toileting and grooming skills: Usually has mastered daytime bladder control. Beginning night-time bladder control. Accidents common. May go to toilet by self (for bowel movements, 26 months; for urination, 30 months. Needs assistance while wiping. Adequate attempt to wash hands. Partially dries hands, upon reminder.

SENSORY

3 YEARS
BIOLOGIC
Weight: Approximately 12.5 16.5 kg. Has gained 2.27 kg during third year.

MOTOR & SELF-CARE

SENSORY

Gross motor: Visual acuity Walks a straight line. 20/20. Walks backward. Walks on tiptoes. Runs without looking at feet. Catches ball with extended arms. Kicks a ball. Jumps from a height of several inches. Rides tricycle using pedals; turns wide corners.

3 YEARS
BIOLOGIC
Height: Approximately 90.5 101.5 cms. Gained 8 cms. in third year.

MOTOR & SELF-CARE

Fine motor: Builds a tower of 9 10 blocks. Copies a circle. Uses blunt scissors with one hand to cut. Shows preference for handedness. Puts beads on string. Can help with simple household tasks.

SENSORY

3 YEARS
BIOLOGIC
Pulse: 105 +/- 15 (avg. 95) bpm

MOTOR & SELF-CARE

Self-care:

SENSORY

Respirations: 25 +/- 5 bpm. Blood pressure: 100 +/- 24 67 + 25 mm Hg.

Dressing skills: Can put on coat without assistance. Can undress self in most instances.
Toileting and grooming skills: Can pull pants up and down. Can go to toilet alone. Brushes teeth with help.

4 YEARS
BIOLOGIC
Weight: Approximately 13.5 19.5 kg. Has gained 2.27 kg during the fourth year.

MOTOR & SELF-CARE

SENSORY

Gross motor: Visual acuity Runs on tiptoes. 20/20 Balances on one foot 3 5 seconds. Jumps from greater heights. Pedals a tricycle quickly; turns sharp corners. Catches ball with extended arms and with hands. Hops on preferred foot. Climbs ladders, trees and playground equipment. Alternates feet when descending stairs.

4 YEARS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Height: Fine motor: Approximately 95 Copies a square. 109 cms. Draws a simple face. Has increased 8 Cuts around pictures with cms in fourth scissors. year. Has doubled birth length. Pulse: Self-care: 100 +/- 10 bpm Feeding skills: (avg. 92) Respirations: Manages spoon with little spilling. 24 +/- 4 bpm. Blood pressure: Eats with fork held in fingers. 100/66 +/- 20.

4 YEARS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Usually dry at night. Dressing skills: Buttons side buttons, small buttons. Can put on socks with help. Puts on shoes (not laces) without help. Knows back from front of clothes.

Toileting and grooming skills: May bathe self, with assistance. Washes and dries hands without supervision.

5 YEARS
BIOLOGIC
Weight: Approximately 15.4 21.4 kg. Has gained 2.27 during the fifth.

MOTOR & SELF-CARE

SENSORY

Gross motor: Visual Skips, alternate feet. acuity Jumps rope and jumps over 20/20. objects. Walks a balance beam. Imitates dance steps if taught. Catches a ball smoothly with hands. Balances on one foot 8-10 seconds. Roller skates. Height: Fine motor: Approximately Copies a triangle. 103 115 cms. Crosses vertical lines. Gained 8 cms in Copies letters; may be able to print own name. fifth year. Draws a three-part man.

5 YEARS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Pulse: Self-care: 95 +/- 15 (avg. 90) Feeding skills: bpm. Selects fork over spoon when Respirations: appropriate. 22 +/- 3 bpm. Blood pressure: Dressing skills: 100/60 +/- 14/10 May be able to lace shoes. mm Hg. Manages zippers in back. Head size: Adult size nearly Toileting and grooming skills: achieved. Wipes self independently. Anticipates Flushes toilet after each use. immediate toilet Bathes self. needs Combs hair with help. Can blow nose when asked.

6-8 YEARS
BIOLOGIC
Weight: Approximately 17.5-25.5 kg. Gains 3.8 kg yearly.

MOTOR & SELF-CARE

SENSORY

Height: Approximately 110-124 cms. Gains 1.13 cms yearly.

Gross motor: Visual acuity Rides bicycle without 20/20 training wheels. Runs, jumps, climbs, hops. Constantly in motion. Clumsy and awkward. Coordination improving. Fine motor: Knows right from left hand. Draws a person with 12-16 parts. Prints words; learns cursive writing. Has improved eye- hand coordination.

6-8 YEARS
BIOLOGIC
Pulse: 90 +/- 15 bpm. Respirations: 21 +/- 3 bpm. Blood pressure: 100/60 +/- 16/10 mm Hg. Dentition: Starts to lose temporary teeth; acquires first permanent molars, medial and lateral incisors.

MOTOR & SELF-CARE

Self-care: Feeding skills: At 6 yrs, likes to eat with fingers, stuffs food into mouth, talkative while eating. More interested in eating at the beginning of the meal. At 7 yrs, improved table manners, less talkative, may bolt food.

SENSORY

6-8 YEARS
BIOLOGIC
Tires easily.

MOTOR & SELF-CARE

Grooming and dressing skills: Self-care managed; has a tendency to dawdle in bathtub. Needs to be reminded to wash hands. May need some help with dressing. Wears whatever is selected by parents. Leaves clothes where they are removed. Can brush and comb hair.

SENSORY

8-10 YEARS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Weight: Gross motor: Visual acuity Approximately Performs tricks on bicycles; 20/20 22-32 kg. races. Gains 3.8 kg Begins to participate in organized sports. yearly. Throws a ball skilfully, overhand and underhand. Height: Fine motor: Approximately Uses both hands 121.5-136.5 independently. cms. Draws a person with 18-20 Gains 1.13 cms parts. Has increased smoothness and yearly. speed in fine motor control. Prints fluently, cursive writing improved.

8-10 YEARS
BIOLOGIC MOTOR & SELF-CARE SENSORY
Pulse: Self-care: 85 +/- 10 bpm. Feeding skills: Respirations: Handles eating utensils 20 +/- 3 bpm. skilfully. Blood pressure: Dressing and grooming skills: 102/60 Dresses self completely; enjoys +/selecting own clothes. 16/10 mm Hg Unaware of dirty clothes. Needs to be reminded to brush teeth.

10-12 YEARS
BIOLOGIC
Weight: 10 years: Approximately 25.5-39.5 kg. Gains 3.8 kg yearly. 12 years: Boys: 30-48 kg. Girls: 30-50 kg.

MOTOR & SELF-CARE

Gross motor: Enjoys all physical activities.

SENSORY
Visual acuity 20/20.

10-12 YEARS
BIOLOGIC
Height:

MOTOR & SELF-CARE

Fine motor: Coordination continues to improve.

SENSORY

10 years: Approximately 131.5147.5 cms. 12 years: Boys: 142-158 cms. Girls: 144-160 cms. Pulse: Self-care: 10 years: 90 +/- 20 bpm. 12 years: Boys: 90 +/- 20 bpm. Girls: 85 +/- 20 bpm.

Feeding skills: Criticizes table manners of parents.

10-12 YEARS
BIOLOGIC
Respirations: 19 +/- 3 bpm.

MOTOR & SELF-CARE

SENSORY

Dressing and grooming skills: May wear some clothes Blood pressure: continually. 10 years: 109/58 +/ Leaves clothes where 16/10 mm Hg. they fall. 12 years: 113/59 +/ Enjoys wearing current 18/10 mm Hg. style of clothes. Needs constant Dentition: reminding of personal Acquires cuspids, first hygiene. and second premolars. Bathes frequentlySecondary sex characters prefers showers (12 yrs). may begin to develop.

EARLY ADOLESCENCE 12-13 YEARS

BIOLOGIC
Weight: Male: Approximately 38-60 kg. Female: Approximately 40-60 kg. Height: Male: Approximately 154172 cms. Female: Approximately 153167 cms. Pulse: 65 +/- 8 bpm.

MOTOR & SELF-CARE

Clumsiness occurs due to rapid physical growth. Motor function comparable to adult. Eye-hand coordination at adult level. Possesses manual dexterity.

SENSORY
Visual acuity 20/20.

EARLY ADOLESCENCE 12-13 YEARS

BIOLOGIC
Respirations: 19 +/- 3 bpm. Blood pressure: Male: 114/68 +/- 10/14 mm Hg. Female: 112/66 +/- 10/12 mm Hg.

MOTOR & SELFCARE

SENSORY

Dentition: Eruption of second molars. Secondary sex characters develop. Individual differences in rate of physical growth and development of pubescent children of same chronologic age.

MIDDLE ADOLESCENCE- 14-16 YEARS

BIOLOGIC MOTOR & SELFCARE SENSORY
Weight: Motor functions Visual Male: comparable to that acuity: Approximately 50-60 kg. of adult. 20/20. Female: Eye-hand coordination at adult Approximately 42-64 kg. Height: level. Male: Possesses manual Approximately 164-180 cms. dexterity. Female: Approximately 155-169 cms. Pulse: Male: 63 +/- 8 bpm. Female: 66 +/- 8 bpm.

MIDDLE ADOLESCENCE- 14-16 YEARS

BIOLOGIC
Respirations: 17 +/- 3 bpm.

MOTOR & SELF-CARE

SENSORY

Blood pressure: Male: 116/70 +/- 12/14 mm Hg.

Female: 114/70 +/- 14/12 mm Hg.

LATE ADOLESCENCE-17-21 YEARS

BIOLOGIC
Weight: Male: Approximately 56-80 kg. Female: Approximately 48-72 kg. Height: Male: Approximately 163182 cms. Female: Approximately 156170 cms. Pulse: 70 +/- 10 bpm.

MOTOR & SELF-CARE

SENSORY

Motor functions Visual comparable to that of acuity: adult. 20/20. Eye-hand coordination at adult level. Possesses manual dexterity.

LATE ADOLESCENCE-17-21 YEARS

BIOLOGIC
Respirations: 17 +/- 3 bpm. Blood pressure: 126/74 +/- 26/16 mm Hg.

MOTOR & SELF-CARE

SENSORY

Dentition: Eruption of third molars (wisdom teeth).