Infancy: The First Three Years

Physical Development

Measures of neonatal health and responsiveness

1. Apgar scale
- Apgar scale is a standard measurement of a newborn’s condition within the
first five minutes after birth.
- It assesses appearance, pulse, grimace, activity and respiration.
- Score of 7 to 10 indicates that the baby is in good condition. A score below 4
means the baby needs immediate lifesaving treatment.

2. Brazelton Neonatal Behavioral Assessment Scale is used as a sensitive index of

neurological competence in the week after birth and also used widely as a measure
in many research studies on infant development.
- It assesses twenty reflexes along with reactions to circumstances such as the
infant’s reaction to a rattle. The examiner rates the newborn, or neonate, on
each of 27 categories.
- A very low Brazelton score can indicate brain damage or it might reflect stress
to the brain that might heal in time. However, if an infant merely seems
sluggish in responding to social circumstances, parents are encouraged to give
the infant attention and become more sensitive to the infant’s needs

Newborn’s capacities

1. Physical Appearance and Characteristics

- At birth, 95% of full-term babies weigh between 5½-10 pounds and are
between 18-22 inches long.
- Boys tend to be slightly longer and heavier than girls
- A firstborn child is likely to weigh less at birth than later-borns.
- Size at birth is related to race, sex, parents’ size, and the mother’s nutrition and
health.
- Size at birth tends to predict relative size later in childhood.
- In the first few days, neonates lose as much as 10% of their body weight,
mainly because of a loss of fluid.
2. Physiological Functioning
- A neonate’s heartbeat is fast and irregular (about 120 to 150 beats per minute).
- Blood pressure does not stabilize until about the 10th day.
- Most babies start to breathe as soon as they are exposed to air. If breathing
does not occur within about 5 minutes, the baby may suffer permanent brain
injury caused by anoxia.
- When the baby’s bowels and bladder are full, their sphincter muscles open
automatically; a baby will not be able to control these muscles for many
months.
 - Jaundice may occur as a result of immature liver. This is treated by exposure
to fluorescent light.
- The brain is immature in which there are still large parts of it dysfunctional.
The most functional is the brain stem, which controls breathing, digestion, and
reflexes.
- Newborns maintain their body temperature by having fat layers under their
skin and by increasing their activity when temperature drops.

3. Vision
- Newborns can see objects clearly between 7 and 15 inches away, but they lack
of acuity until 6 months of age.
- They prefer to look at faces rather than objects. By 1 month, they can
differentiate their mother's face from those of others.

4. Hearing
- Babies can hear sounds since in the uterus. After birth, their hearing is only
slightly less sensitive then adults.
- They can detect the direction of sounds and discriminate different intensity,
pitch, and sounds.
- They can distinguish their mother's voice from others'.

5. Smell and Taste

- Newborns can distinguish the smell of their mothers from others.
- They are also able to differentiate among various taste stimuli. It is found that
newborns have the innate preference for sweet solutions rather than the sour,
bitter and salty food.

6. Reflexes
- Infants are built-in reactions to certain stimuli. In these reflexes infants have
adaptive responses to their environment before they have had the opportunity
to learn.
- The sucking reflex is an example of a reflex that is present at birth but later
disappears.
- The sucking and rooting reflexes disappear when the infant is about 3 to 4
months old. They are replaced by the infant’s voluntary eating. The sucking
and rooting reflexes have survival value for newborn mammals, who must
find the mother’s breast to obtain nourishment.
- The moro reflex is a vestige from our primate ancestry, and it too has survival
value. This reflex, which is normal in all newborns, also tends to disappear at
3 to 4 months of age. Steady pressure on any part of the infant’s body calms
the infant after it has been startled. Holding the infant’s arm flexed at the
shoulder will quiet the infant.
- Other reflexes are Darwinian, Babkin, Babinski, tonic neck, walking and
swimming.
Newborn’s states

1. Alert inactivity
- The baby is calm with eyes open and attentive.
- The baby seems to be deliberately inspecting the environment.

2. Waking activity
- The baby’s eyes are opened but they seem unfocused.
- The arms or legs move in burst of uncoordinated motion.

3. Crying
- The baby cries vigorously, usually accompanied by agitated but uncoordinated
motion.
- There are three types of cries: basic cry, mad cry, and pain cry.

4. Sleeping
- The baby alternates from being still and breathing regularly to moving gently
and breathing irregularly.
- Their ayes are closed throughout.

Principles of physical development

1. There are two principles of physical development:

- Cephalocaudal principle refers to growth that occurs from head to tail.
- Proximodistal principle refers to growth and motor development proceed from
the center of the body outward.

2. Height and Weight

- Ninety-five percent of full-term newborns are 18 to 22 inches long and weigh
between 5 ½ and 10 pounds.
- In the first several days of life, most newborns lose 5 to 7 percent of their body
weight before they learn to adjust to neonatal feeding. Once infants adjust to
sucking, swallowing, and digesting they grow rapidly, gaining an average of 5
to 6 ounces per week during the first month.
- They double their birthweight by the age of 4 months and nearly triple it by
their first birthday. Infants grow about 1 inch per month during the first year,
reaching approximately 1½ times their birth length by their first birthday.
- Proper nutrition and adequate sleep are essential to healthy growth.
- Infants’ rate of growth is considerably slower in the second year of life.
- By 2 years of age, infants weigh approximately 26 to 32 pounds.
- They gain a quarter to half a pound per month during the second year.
- By 2, they have reached about one-fifth of their adult weight.
- At 2 years of age, the average infant is 32 to 35 inches in height, nearly one-
half of their adult height.
3. Gross and fine motor skills
- Gross motor skills refer to physical skills that involve large muscles such as
jumping and running
- Fine motor skills refer to the abilities such as buttoning and copying figures,
which involve the small muscles and eye-hand coordination.

Gross Motor Development Age

Lift head 2 weeks
Chest up, use arms for support 2-4 months
Roll over 2-5 months
Support with legs 3-6.5 months
Sit without support 5-8 months
Stand with support 5-10 months
Pull self to stand 6-10 months
Walk using furniture 7-13 months
Stand alone 10-14 months
Walk alone 11-14 months

4. Function of the brain in the physical development

- Brain starts to develop during the embryonic stage of pregnancy.
- At birth, more than 100 billion neurons or nerve cells are already formed but
not fully developed.
- Neurons undergo two complementary processes: integration and
differentiation.
- Through integration process, the neurons that control various groups of
muscles coordinate their activities.
- Differentiation refers to the process by which neurons acquire specialized
structure and function.
- Human brain consists of three major parts:
a. Hindbrain
- medulla
- pons
- cerebellum
b. Midbrain
c. Forebrain
- thalamus
- hypothalamus
- limbic system (amygdala, hippocampus, septal area,
cingulate cortex)
- cerebral cortex / cerebrum
- Cerebral cortex / cerebrum can be divided into four lobes: frontal lobes,
parietal lobes, temporal lobes, and occipital lobes). It also can be divided into
two hemispheres: left and right hemispheres. The left and right hemispheres
are joined by the corpus callosum.
Cognitive Development
1. Piagetian Perspective: Sensorimotor Stage
- This perspective emphasizes the qualitative changes in the ways children
think.
- The sensorimotor stage occurs from birth to age 2.
- This stage involves learning to respond through motor activity to the various
stimuli that are presented to the senses.
- The task during this stage is learning to coordinate sensorimotor sequences to
solve simple problems.
- There are six substages in the sensorimotor period:
a. Stage one (0-1 month)—exercising reflexes.
b. Stage two (1-4 months)—primary circular actions.
c. Stage three (4-8 months)—secondary circular actions.
d. Stage four (8-12 months)—purposeful coordination of secondary
schemes.
e. Stage five (12-18 months)—tertiary circular reactions.
f. Stage six (18-24 months)—mental solutions.
- During the sensorimotor stage, infants develop object permanence, imitation,
and deferred imitation.

2. Language Development
- Human infants can communicate long before they can use spoken language.
- They have various types of cries and nonverbal body language.
- Children around the world seem to follow the same timetable and sequence of
language development.
- During the prelinguistic period (before children verbalize), they seem to
understand far more than they can express.
- Sequence of language development during infancy:
Age Language Development
Newborn Crying

2 months Starts making vowel-like cooing sounds

4 months Smiles, coos with pitch modulations, makes vowel-like sounds

interspersed with consonant sounds
6 months Starts babbling, intersperses vowels with consonants

8 months Often uses two-syllable utterances such as “mama” or “baba,” imitates

sounds
10 months Understands some words; gestures (may say “no” and shake head); uses
holophrases (single words with different meanings)
12 months Understands simple commands; uses more holophrases such as “baby,”
“bye-bye,” and “hi”; may imitate sounds of dog “bow-wow;” has some
control over intonation
18 months Has vocabulary of 3-50 words; may use 2-word utterances (telegraphic
speech); still babbles; uses words with several syllables with intricate
intonation pattern
24 months Has vocabulary over 50 words; uses 2-word phrases; interested in
verbal communication
- The number of new words that children learn depends a lot on how much parents
talk to their infants.
- Word production and comprehension increases dramatically during the second
year of life.
- Motherese: The tendency of adults to adjust their speech when talking with
children.

Psychosocial Development

1. Attachment
- Attachment is the feeling that binds a parent and child together.
- All infants need to form a secure emotional attachment to someone.
- To feel emotionally secure, children need warm, loving, stable relationships
with a responsive adult on whom they can depend.
- Children can develop close attachments to more than one person. However,
this does not mean that caregivers can be constantly changed.
- On average, attachments to specific persons do not develop until about 6-7
months of age.
- Before this age, infants are not upset over separation. Specific attachments are
at their maximum from 12-18 months of age.
- Before attachments to parents can take place, three things must occur:
a. Infants must learn to distinguish human beings from inanimate objects.
b. Infants must learn to distinguish between human beings so that they can
recognize their parents as familiar and strangers as unfamiliar.
c. Infants must develop a specific attachment to one person.

- Nonattached children have delayed attachment development, may make no

distinction between their own parents and other members of the household or a
caretaker. They are very unemotional and distant.
- Insecurely attached children are so dependent on their parents that they won’t
let them out of their sight at all.
- After infants develop attachments to specific persons, they begin to show signs
of distress when these persons leave them (separation anxiety).
- Separation anxiety varies with individual children, depending on the age and
the length of separation. The effects of long-term separation can be
serious/traumatic.
- Distress over separation is greatest after 6 months and until about 3 years of
age.
- Children show various forms of reunion behavior. Some children are very
dependent and possessive; others are angry; others are emotionally cold.

2. Emotions
- Children are not born afraid, except for two fears: fear of loud noises and fear of
falling.
- Children’s fears may be conditioned by actual experiences or taught by parents; or
they may arise out of children’s vivid imaginations and limited experience and
understanding, from seeing and hearing scary stories, or out of the actions of other
children.
- Emotions develop according to a biological timetable.
- They believe that all emotions are present at birth, but observers are not always
aware that these various feelings are being expressed.
- Also, the feelings that are being expressed depend a lot on what is experienced
and when.
- Emotional responses are partly learned, fairly constant and stable.
- Emotional expression and behavior in infancy tell us something about the
personality of the child later in life.

3. Psychosocial Theory by Erikson

i. Erik Erikson proposes that the basic psychosocial task of infancy is the
development of trust and autonomy between 1 and 2 years of age. One of the
parenting tasks is to decide how much freedom to allow and how much control
to exercise.
ii. Requirements for the development of trust and security:
a. Regular and adequate feedings
b. Sufficient sucking (relaxed and unhurried feeding time)
c. Cuddling and physical contact
iii. Some causes of distrust and insecurity include:
a. parental deprivation
b. tension
c. exposure to frightening experiences
d. criticism
e. overprotection
f. overindulgence

iv. Margaret Mahler emphasizes the importance of mother-child relationship:

a. Autistic phase (birth-2 months): Infants are only aware of the mother as an
agent to meet their basic needs.
b. Symbiotic phase (2-5 months): Infants establish dependency on their mother,
building a solid foundation for later growth and independence.