Growth & Development Across Childhood - Cheat Sheet
Your last-minute revision companion for paediatric growth and development — the foundation of paediatric nursing practice and one of the most consistently tested areas of the NLE. Memorise the key developmental milestones, theorist stages, physical parameters, and anticipatory guidance by age.
PRINCIPLES OF GROWTH & DEVELOPMENT
Important facts
- Development is ORDERLY & SEQUENTIAL but occurs at INDIVIDUAL PACE — never force milestones.
- Development proceeds from SIMPLE to COMPLEX and GENERAL to SPECIFIC.
- CRITICAL/SENSITIVE PERIODS exist when the child is most receptive to learning a skill — missed windows may delay acquisition.
- Absence of primitive reflexes at birth OR persistence beyond expected age = neurologic concern (red flag for NCM assessment).
- Use developmental patterns to assess normalcy, time anticipatory guidance (RA 9173 nursing practice standard), and plan age-appropriate interventions.
Key definitions
Growth
Example
Newborn weighs 3.5 kg → doubles to 7 kg by 6 months.
Measurable increase in size: weight, length/height, head circumference (NCM Level I assessment).
Development
Example
Infant progresses from palmar grasp (4–6 mo) → pincer grasp (9–10 mo).
Progressive acquisition of skills and function: motor, language, cognitive, psychosocial.
Cephalocaudal Direction
Example
Lifts head (2 mo) → sits with support (6 mo) → walks (12–15 mo).
Development proceeds head-to-toe; head control before trunk control, trunk before lower limbs.
Proximodistal Direction
Example
Whole-hand grasp → palmar grasp → pincer grasp (fine finger control).
Development proceeds centre-to-periphery; midline outward (shoulder control before hand control).
Diagrams to know
- Cephalocaudal sequence (head → trunk → legs)
- Proximodistal sequence (midline → periphery)
- Developmental progression overlays: Erikson, Freud, Piaget by age group
PHYSICAL GROWTH PARAMETERS — MUST MEMORISE
Formulas
Birth weight × 2 = weight at ~4–6 months
Meaning
Expected doubling of birth weight by mid-infancy.
Watch out
If infant does NOT double birth weight by 6 months, investigate feeding, absorption, or organic disease. Common NLE trap: confusing 'doubling by 6 mo' with 'by 4 mo' — the range is 4–6 months.
When to use
Assessing adequate growth in infant 0–6 months (NCM Level I physical assessment).
Birth weight × 3 = weight at ~12 months (1 year)
Meaning
Expected tripling of birth weight by end of first year.
Watch out
Failure to triple by 12 months indicates poor growth — assess breastfeeding, solid introduction at 6 mo, and organic causes (GI infections, malabsorption).
When to use
1-year well-baby visit assessment; determining if infant is on normal growth trajectory.
Birth weight × 4 = weight at ~24 months (2 years)
Meaning
Expected quadrupling of birth weight by age 2.
Watch out
Weight gain slows after first year; growth rate is NOT linear. Do not expect continued rapid gains — by 2 years, growth rate normalises.
When to use
2-year developmental and nutritional assessment; evaluating toddler growth adequacy.
Birth length + 50% = length at ~12 months
Meaning
Length increases approximately 50% in the first year (e.g., 50 cm → 75 cm).
Watch out
Birth length ~50 cm (standard), not 45 cm. Confusion here = incorrect milestone calculation.
When to use
Assessing linear growth in infants; cross-checking height/length milestones.
Birth length × 2 = length at ~4 years
Meaning
Length roughly doubles by age 4 years.
Watch out
This is a LONG-term milestone — do not expect doubling by 2 years.
When to use
Preschool growth assessment; identifying growth delays in older children.
Physiologic weight loss in first 3–5 days = 5–10% of birth weight; regained by day 10–14
Meaning
Normal newborns lose fluid (meconium, minimal intake); expected and self-limited.
Watch out
Loss >10% or failure to regain by day 14 = concern for feeding problems, dehydration, or pathology. NLE favourite: distinguish normal from pathologic loss.
When to use
Newborn assessment (NCM Level I); reassuring parents that weight loss is normal.
Infant weight gain: ~20–30 g/day (or ~150–210 g/week) in first 5–6 months
Meaning
Expected daily/weekly weight gain rate for young infants.
Watch out
Rate varies based on feeding type (breastfed infants may gain slightly differently than formula-fed); individual variation is normal. Do not expect exact figures.
When to use
Monitoring breastfed or formula-fed infant growth; detecting failure to thrive.
Common values
Value
3–3.5 kg
Symbol
BW
Quantity
Birth weight
Value
~50 cm
Symbol
BL
Quantity
Birth length
Value
34–35 cm
Symbol
HC₀
Quantity
Birth head circumference
Value
5–10% of BW
Symbol
PWL
Quantity
Physiologic weight loss
Value
By day 10–14
Symbol
Timing
Quantity
Regain of birth weight
Value
4–6 months
Symbol
2× BW
Quantity
Weight doubling
Value
12 months
Symbol
3× BW
Quantity
Weight tripling
Value
24 months
Symbol
4× BW
Quantity
Weight quadrupling
Value
~1 cm/month
Symbol
ΔHC
Quantity
HC increase per month (year 1)
Value
~1–2 years
Symbol
Age of equalisation
Quantity
HC = CC (equalisation)
Important facts
- Head circumference increases ~1 cm/month in the first year — use this for monthly tracking.
- At BIRTH: Head circumference EXCEEDS chest circumference (HC > CC) — a critical assessment finding.
- By ~1–2 YEARS: Head circumference and chest circumference EQUALISE (HC ≈ CC).
- Newborn weight loss of 5–10% in first few days is PHYSIOLOGIC; regained by day 10–14.
- Breastfed infants may regain birth weight slightly later (~2–3 weeks) than formula-fed infants — both normal.
- After rapid gain in year 1, weight gain SLOWS considerably in years 2–3 — NOT a sign of failure to thrive.
- Use DOH growth charts and Operation Timbang (ECCD framework) to track infant growth in community/RHU settings.
Key definitions
Average Newborn Weight
Example
A 3.2 kg newborn is within normal limits; a 2.3 kg newborn requires close monitoring for complications.
3–3.5 kg (~3,000–3,500 g); weights <2.5 kg = low birth weight (LBW), >4 kg = macrosomia.
Average Newborn Length
Example
Newborn measured at 48 cm = slightly short; 52 cm = slightly long; both normal variation.
~50 cm (range 45–55 cm); measure supine from head to heel.
Average Newborn Head Circumference
Example
At birth, HC >CC (HC 34 cm, CC 32 cm); by age 2, HC ≈ CC (~50 cm).
~34–35 cm; slightly GREATER than chest circumference at birth; they equalise at ~1–2 years.
Diagrams to know
- Growth curve trajectory: weight gain year 1 (steep) vs year 2–3 (gradual)
- HC vs CC relationship over time (birth to 2 years)
HEAD CIRCUMFERENCE & FONTANELLES
Formulas
HC at birth: 34–35 cm (>CC); HC at 1–2 yr: 45–50 cm (≈CC)
Meaning
Head circumference growth and relationship to chest circumference over time.
Watch out
At BIRTH, HC MUST be >CC — if HC <CC at birth, suspect abnormality. By 1–2 yrs, they should be approximately equal.
When to use
Assessing normal head growth; identifying microcephaly or hydrocephalus.
Common values
Value
Diamond-shaped
Symbol
AF
Quantity
Anterior fontanelle shape
Value
Triangular
Symbol
PF
Quantity
Posterior fontanelle shape
Value
12–18 months
Symbol
Timing
Quantity
Anterior fontanelle closure
Value
~2 months (6–8 weeks)
Symbol
Timing
Quantity
Posterior fontanelle closure
Important facts
- POSTERIOR fontanelle closes FIRST: ~2 months (6–8 weeks) — test this in multiple-choice items.
- ANTERIOR fontanelle closes LAST: ~12–18 months — longer open period for ICP assessment and growth.
- Palpate fontanelles with infant calm, sitting upright, not crying — crying elevates ICP and gives false impression of bulging.
- Bulging fontanelle = red flag for increased ICP (meningitis, encephalitis, hydrocephalus, head trauma) — urgent referral (RA 9173: refer to appropriate level of care).
- Sunken fontanelle = sign of dehydration — assess fluid intake, output, urine colour, mucous membranes, and initiate rehydration.
- Delayed closure of anterior fontanelle (>18 mo) may indicate hypocalcaemia, hypothyroidism, or skeletal dysplasia.
- Premature closure of fontanelles (before stated ages) may suggest microcephaly or skeletal abnormality.
Key definitions
Anterior Fontanelle
Example
Bulging anterior fontanelle in a screaming, feverish infant = may indicate raised ICP from meningitis or other pathology (NANDA: Risk for increased intracranial pressure).
Diamond-shaped soft spot at junction of coronal and sagittal sutures; closes ~12–18 months; palpate for ICP assessment.
Posterior Fontanelle
Example
Posterior fontanelle may be difficult to palpate in many normal newborns; absence of posterior fontanelle closure by 3 months warrants investigation.
Smaller, triangular soft spot at junction of sagittal and lambdoid sutures; closes ~2 months (6–8 weeks).
Bulging Fontanelle
Example
Fever + lethargy + bulging fontanelle = meningitis until proven otherwise; refer immediately (NCM Level III emergency care).
Tense, full soft spot indicating increased intracranial pressure (ICP); palpate with infant calm and sitting upright.
Sunken Fontanelle
Example
Diarrhoea for 2 days + sunken fontanelle + weak cry = moderate-to-severe dehydration (NANDA: Deficient fluid volume); initiate rehydration per DOH protocols.
Depressed soft spot indicating dehydration, hypovolaemia, or malnutrition.
Diagrams to know
- Anterior and posterior fontanelle locations and shapes on infant skull
- Timeline of fontanelle closure: posterior 2 mo, anterior 12–18 mo
TEETH & DENTAL MILESTONES
Formulas
(Age in months) − 6 = approximate number of deciduous teeth
Meaning
Quick estimation rule for counting deciduous teeth between 6 months and 2.5 years.
Watch out
This rule is an ESTIMATE and works for ~6 months to ~2.5 years; do NOT use for very young infants (<6 mo, no teeth) or after 3 years (approaching full set of 20). Common error: applying it outside this age range.
When to use
Dental screening; assessing if child has normal number of erupted teeth for age.
Common values
Value
~6 months
Symbol
Timing
Quantity
First tooth eruption
Value
Lower central incisors
Symbol
Position
Quantity
First teeth (location)
Value
20 teeth
Symbol
Total
Quantity
Complete deciduous set
Value
2.5–3 years
Symbol
Timing
Quantity
Age for complete deciduous dentition
Important facts
- First deciduous teeth erupt at ~6 MONTHS (lower central incisors first) — critical NLE milestone.
- Tooth eruption timeline varies greatly; some normal infants erupt first tooth at 4 months, others at 8+ months.
- Use formula (Age in months − 6) to estimate tooth count for ~6 mo–2.5 yr age range.
- All 20 deciduous teeth should be present by ~2.5–3 years — complete by age 3.
- Eruption does NOT directly correlate with readiness for solid foods; complementary feeding begins at 6 months regardless of tooth presence.
- Delayed tooth eruption may indicate nutritional deficiency (calcium, vitamin D), systemic illness, or genetic factors — assess if delayed beyond 12 months.
Key definitions
First Deciduous Tooth Eruption
Example
6-month-old with no teeth yet = slightly delayed but normal variation; if no teeth by 12 months, assess for nutritional deficiency or developmental delay.
Erupts at ~6 months (range 4–8 months); lower central incisors erupt first.
Complete Deciduous Dentition
Example
3-year-old with full set of 20 deciduous teeth = normal; 4-year-old still missing 3–4 teeth = delayed (assess for systemic factors).
All 20 deciduous (milk) teeth erupted by ~2.5–3 years of age.
Diagrams to know
- Deciduous tooth eruption timeline (by month and type: incisors, canines, molars)
- Deciduous vs permanent dentition comparison
ERIKSON'S PSYCHOSOCIAL DEVELOPMENT — BY AGE
Important facts
- Erikson's stages directly map to age groups — this is heavily tested on NLE.
- INFANT (Trust): Consistent caregivers, prompt feeding/comfort response, physical contact (holding, soothing).
- TODDLER (Autonomy): Offer simple choices, allow self-feeding/self-care, establish routines, tolerate rituals, avoid power struggles.
- PRESCHOOL (Initiative): Encourage imaginative play, allow planning/decision-making, give responsibility (simple chores), praise efforts.
- SCHOOL-AGE (Industry): Support completion of projects, praise achievement, encourage collections/hobbies, model persistence.
- ADOLESCENT (Identity): Respect privacy, support peer relationships, allow expression of values/opinions, avoid identity-shaming.
- Nursing implication (RA 9173): Tailor communication and interventions to child's psychosocial stage to reduce anxiety and promote cooperation.
Key definitions
Trust vs Mistrust (Infant: 0–1 year)
Example
Infant whose cries are answered promptly develops trust; infant repeatedly left crying develops mistrust and anxiety (NANDA: Ineffective coping related to unmet needs).
Consistent, prompt meeting of needs (feeding, comfort, response to crying) builds trust; inconsistency/neglect fosters mistrust and insecurity.
Autonomy vs Shame & Doubt (Toddler: 1–3 years)
Example
Toddler refuses to cooperate with dressing = normal autonomy; nurse offers simple choices ('red shirt or blue shirt') to support autonomy while achieving goal.
Child asserts independence; negativism ('No!'), temper tantrums, toilet training are NORMAL; excessive control/criticism causes shame and self-doubt.
Initiative vs Guilt (Preschool: 3–6 years)
Example
Preschooler asks to help with meal prep = initiative; supportive response ('you can stir the pot') vs dismissal ('you'll make a mess') shapes sense of initiative or guilt.
Child initiates activities, uses imagination, proposes plans; excessive criticism produces guilt; encouragement fosters initiative and purpose.
Industry vs Inferiority (School-age: 6–12 years)
Example
School-age child completes a school project successfully = industry/competence; repeated failure or mockery = inferiority (NANDA: Low self-esteem).
Child wants to produce and achieve; success with real tasks, collections, projects builds competence; failure/criticism fosters inferiority complex.
Identity vs Role Confusion (Adolescent: 12–18 years)
Example
Teen experimenting with different friend groups and styles = normal identity exploration; supportive family/environment fosters healthy identity; rejection/rigidity causes confusion.
Developing stable sense of self, sexual identity, values; peer group is central; support privacy and independence; crisis leads to confusion about identity/role.
Diagrams to know
- Erikson's stages mapped to age groups with key nursing interventions
- Progression from Trust → Autonomy → Initiative → Industry → Identity
FREUD'S PSYCHOSEXUAL STAGES — BY AGE
Important facts
- Freud's stages are less frequently tested than Erikson or Piaget but appear in NLE items about psychosexual development and fixation.
- Fixation occurs when a child gets 'stuck' in a stage due to deprivation or indulgence — may manifest as regression under stress.
- ORAL fixation may present as oral behaviours (smoking, overeating, talkativeness) in older children/adults.
- ANAL fixation may present as obsessive-compulsive traits, need for control, or stubbornness.
- Oedipal conflict resolution is key to superego (conscience) development and identification with same-sex parent.
- Latency period is relatively quiet sexually — if child shows excessive sexual interest during latency, assess for abuse or developmental concern.
Key definitions
Oral Stage (Infant: 0–1.5 years)
Example
Infant soothes self through pacifier/thumb-sucking = normal oral gratification; abrupt weaning = potential fixation on oral behaviours.
Mouth is zone of pleasure; sucking, eating, mouthing objects satisfy needs; weaning and oral deprivation cause conflict.
Anal Stage (Toddler: 1.5–3 years)
Example
Toddler resists toilet training or becomes obsessed with bodily functions = normal anal-stage behaviour; authoritarian toilet training may cause fixation or regression.
Bowel/bladder control is zone of pleasure; toilet training is central conflict; issues with control/compliance may reflect anal fixation.
Phallic Stage (Preschool: 3–6 years)
Example
Preschooler says 'I'm going to marry daddy/mommy' = normal Oedipal phase; resolution leads to healthy same-sex identification and superego (conscience) development.
Genitals are zone of awareness; Oedipal/Electra complex (opposite-sex parent attraction) is central; same-sex parent identification develops.
Latency Stage (School-age: 6–12 years)
Example
School-age child focuses on academics, sports, friendships, and collections rather than sexual exploration = normal latency; minimal sexual interest is expected.
Sexual drives dormant; energy redirected to learning, skills, peer relationships, and social roles.
Genital Stage (Adolescent: 12+ years)
Example
Adolescent develops romantic interest in peers, explores sexual identity, and moves toward adult relationships = normal genital stage; support healthy expression and safe practices.
Sexual maturation and adult sexuality emerge; object choice (romantic interest in opposite-sex peer) and mature sexual expression develop.
Diagrams to know
- Freud's psychosexual stages timeline (0–adult) with zones of pleasure and key conflicts
PIAGET'S COGNITIVE DEVELOPMENT — BY AGE
Common values
Value
~8–9 months
Symbol
Sensorimotor peak
Quantity
Object permanence milestone
Value
2–7 years (Preoperational)
Symbol
Age range
Quantity
Egocentrism peaks
Value
~7–11 years (Concrete Operational)
Symbol
Age range
Quantity
Conservation mastered
Value
11 years+ (Formal Operational)
Symbol
Age range
Quantity
Abstract thinking emerges
Important facts
- Object permanence (Sensorimotor, ~8–9 mo) is the BASIS for separation anxiety and the game of peek-a-boo — highly tested on NLE.
- Egocentrism (Preoperational) explains why preschoolers believe illness is punishment for bad thoughts; nurse must reassure child it's not their fault.
- Magical thinking (Preoperational) means preschooler may fear that hospital equipment or procedures have magical/harmful powers — concrete explanations and play preparation help.
- Conservation (Concrete Operational) means school-age child understands quantities remain same despite appearance change — use this for health teaching (e.g., liquid medication amounts).
- Formal Operational thinking allows adolescent to understand abstract health concepts (contraception, disease prevention, ethics) — tailor education accordingly.
- Nursing implication: Match explanations to child's cognitive stage. Preschoolers need simple, concrete, non-threatening language; school-age children can understand cause-and-effect; adolescents can discuss abstract health concepts.
Key definitions
Sensorimotor Stage (0–2 years)
Example
Infant sees toy, object hidden under blanket, infant looks for it = object permanence achieved (~8–9 mo); before this age, 'out of sight = out of mind'; this underlies SEPARATION ANXIETY.
Infant learns through senses and motor movement; no abstract thinking; key milestone is OBJECT PERMANENCE (~8–9 months) — understanding that objects exist when out of sight.
Preoperational Stage (2–7 years)
Example
Preschooler believes that thinking about getting sick CAUSES sickness; believes thunder is caused by people talking; cannot understand another person's perspective (egocentrism).
Child uses symbols (language, images) but thinking is illogical; key features are EGOCENTRISM (sees world only from own view), MAGICAL THINKING (believes thoughts can cause events), ANIMISM (attributes life to objects).
Concrete Operational Stage (7–11 years)
Example
Child understands that pouring water from wide glass to tall glass does NOT change the amount (conservation); can sort objects by colour, size, or shape.
Logical thinking about CONCRETE (not abstract) objects; masters CONSERVATION (mass/volume unchanged despite shape change) and CLASSIFICATION (grouping by attributes).
Formal Operational Stage (11 years and beyond)
Example
Adolescent can solve algebra problems, reason about morality/philosophy, and imagine future scenarios without concrete reference.
ABSTRACT and HYPOTHETICAL reasoning develops; can think about possibilities, test hypotheses, and reason about abstract concepts.
Diagrams to know
- Piaget's cognitive stages with key characteristics and nursing applications
- Timeline showing sensorimotor → preoperational → concrete → formal progression
PRIMITIVE REFLEXES (NEWBORN) — APPEARANCE & DISAPPEARANCE
Common values
Value
~3–4 months
Symbol
Timing
Quantity
Moro reflex disappearance
Value
~3–4 months
Symbol
Timing
Quantity
Rooting reflex disappearance
Value
~3–4 months
Symbol
Timing
Quantity
Palmar grasp disappearance
Value
~3–4 months
Symbol
Timing
Quantity
Tonic neck reflex disappearance
Value
~3–4 months
Symbol
Timing
Quantity
Sucking reflex (involuntary component)
Value
~8–10 months
Symbol
Timing
Quantity
Plantar grasp disappearance
Value
Until ~1–2 years
Symbol
Timing
Quantity
Babinski reflex normal upgoing response
Value
~4–8 weeks
Symbol
Timing
Quantity
Stepping reflex disappearance
Important facts
- Primitive reflexes PRESENT at birth and DISAPPEAR on predictable timeline — heavily tested on NLE.
- ABSENCE of reflex at birth = neurologic red flag (e.g., no Moro = possible CNS injury, hypoxia).
- PERSISTENCE of reflex BEYOND expected age = neurologic red flag (e.g., Moro still present at 6 months = cerebral palsy concern).
- Babinski reflex is NORMAL in infants (upgoing toes) but ABNORMAL in older children/adults; do NOT confuse with pathology.
- By ~3–4 months, most reflexes (Moro, rooting, palmar, tonic-neck, sucking) have disappeared — replaced by voluntary cortical control.
- Plantar grasp persists longer (~8–10 mo); Babinski persists until ~1–2 years then transitions to normal downgoing adult response.
- Assessment of primitive reflexes is part of NEWBORN PHYSICAL EXAM (NCM Level I) — critical for identifying neurologic abnormalities early.
Key definitions
Primitive Reflex
Example
Moro reflex present at birth, disappears by ~3–4 months; persistence beyond 6 months suggests cerebral pathology — red flag for NCM neurologic assessment.
Automatic motor response present at birth, mediated by brainstem/spinal cord; disappears within specific timeframe as cortical control develops; absence or persistence signals neurologic concern.
Moro (Startle) Reflex
Example
Newborn startled by loud noise extends and abducts arms, then brings them back together = normal Moro reflex; absent Moro = neurologic concern (hypoxic injury, CNS malformation).
Sudden movement/loud noise causes arms to abduct rapidly then embrace the body (as if catching self); elicited by dropping the head suddenly or jarring crib.
Rooting Reflex
Example
Stroke newborn's cheek, baby turns toward finger and opens mouth = intact rooting reflex; absent rooting may indicate difficulty feeding or neurologic compromise.
Stroke cheek or lip → head turns toward stimulus and mouth opens (feeding behaviour); essential for breastfeeding/bottle-feeding.
Sucking Reflex
Example
Newborn sucks on nurse's gloved finger = normal sucking reflex; provides basis for breastfeeding/bottle feeding.
Touch lips/palate → infant sucks; present at birth; continues voluntarily after a few months but involuntary component disappears.
Palmar Grasp Reflex
Example
Place finger in newborn's palm, baby grasps with surprising strength = intact palmar reflex; weak/absent grasp = neurologic concern.
Object placed in infant's palm → fingers curl around it tightly; strong enough at birth to support baby's weight briefly.
Plantar Grasp Reflex
Example
Press on infant's sole, toes curl = normal plantar grasp; persists into toddlerhood = delayed neurologic development.
Pressure on sole of foot → toes curl/flex (similar to palmar grasp but for feet); disappears ~8–10 months.
Tonic Neck Reflex (Fencing Position)
Example
Turn newborn's head to right, right arm extends and left arm flexes = tonic neck reflex; persists beyond 3–4 months = neurologic concern.
Turn head to one side → same-side arm and leg extend, opposite side flex (boxing/fencing position); develops more by 1–2 months.
Babinski Reflex
Example
Stroke infant's sole, toes spread upward = NORMAL Babinski reflex; if same response persists in 10-year-old child = abnormal (sign of upper motor neuron lesion).
Stroke sole of foot upward → toes FAN OUTWARD (dorsiflex) and big toe dorsiflexes; NORMAL in infants; becomes downgoing in older children/adults (abnormal upgoing response = sign of CNS pathology).
Stepping/Dance Reflex
Example
Hold newborn upright, feet touch surface, baby 'steps' → normal; reflex disappears, then resumes as learned behaviour when child is ready to walk.
Hold infant upright with feet touching floor → infant makes stepping motions; disappears ~4–8 weeks; resumes as voluntary walking at ~12–15 months.
Diagrams to know
- Primitive reflex disappearance timeline (birth to 24 months)
- Moro, rooting, palmar, tonic-neck, Babinski, plantar, stepping reflex descriptions and expected ages
GROSS MOTOR MILESTONES BY AGE — MEMORISE THESE
Common values
Value
~2 months
Symbol
Milestone
Quantity
Head control
Value
~4–6 months
Symbol
Milestone
Quantity
Rolling prone to supine
Value
~6 months
Symbol
Milestone
Quantity
Sits with support
Value
~7–8 months
Symbol
Milestone
Quantity
Sits without support
Value
~9 months
Symbol
Milestone
Quantity
Crawling
Value
~10 months
Symbol
Milestone
Quantity
Pulls to stand
Value
~12 months
Symbol
Milestone
Quantity
Stands alone
Value
~12 months
Symbol
Milestone
Quantity
First steps
Value
~15 months
Symbol
Milestone
Quantity
Walks well alone
Value
~18 months
Symbol
Milestone
Quantity
Runs
Value
~3 years
Symbol
Milestone
Quantity
Tricycle
Value
~4 years
Symbol
Milestone
Quantity
Hops one foot
Value
~5 years
Symbol
Milestone
Quantity
Skips/jumps rope
Important facts
- 2 MONTHS: Lifts head when prone (from mattress level); social smile appears (not reflexive).
- 4 MONTHS: Rolls from prone (front) to supine (back); head control steady, no head lag when pulled to sit.
- 6 MONTHS: Sits with support (leans on hands); rolls both ways (prone ↔ supine); grasps and transfers objects hand-to-hand.
- 7–8 MONTHS: SITS WITHOUT SUPPORT (unsupported sitting); major milestone for developmental assessment.
- 9 MONTHS: CRAWLS (typically creeping on hands and knees, though some babies scoot); PINCER GRASP develops (thumb-to-forefinger precision grip).
- 10 MONTHS: PULLS TO STAND (holding onto furniture); begins cruising (walking along furniture).
- 12 MONTHS: STANDS ALONE briefly; may take FIRST STEPS; says 2–3 words besides mama/dada.
- 15 MONTHS: WALKS ALONE WELL; loses the 'toddler waddle' by 18 months as gait matures.
- 18 MONTHS: RUNS (stiffly, legs wide apart); CLIMBS STAIRS with help (both feet per step).
- 2 YEARS: Walks up and down stairs with both feet per step; runs well; follows simple instructions.
- 3 YEARS: RIDES A TRICYCLE; climbs stairs ALTERNATING FEET (left-right-left pattern); hops slightly.
- 4 YEARS: HOPS ON ONE FOOT; throws overhand with accuracy; catches ball with hands (not chest).
- 5 YEARS: SKIPS, JUMPS ROPE; hops alternating feet easily; excellent balance and coordination.
Diagrams to know
- Gross motor milestone progression timeline (birth to 5 years)
- Relationship between sitting (6 mo) → crawling (9 mo) → walking (12–15 mo) sequence
FINE MOTOR & LANGUAGE MILESTONES
Common values
Value
~4–6 months
Symbol
Milestone
Quantity
Palmar grasp develops
Value
~9–10 months
Symbol
Milestone
Quantity
Pincer grasp develops
Value
~12 months
Symbol
Milestone
Quantity
First word (mama/dada)
Value
~12 months
Symbol
Milestone
Quantity
2-word vocabulary
Value
~2 years
Symbol
Milestone
Quantity
2-word phrases
Value
~50+ words
Symbol
Quantity
Quantity
Vocabulary at 2 years
Value
~50% understandable to strangers
Symbol
Percentage
Quantity
Speech intelligibility at 2 years
Value
~3 years
Symbol
Milestone
Quantity
3-word sentences
Important facts
- ~3–4 MONTHS: Hands mostly open; purposeful grasping begins.
- ~4–6 MONTHS: Palmar grasp develops; infant brings objects to mouth (mouthing/exploration).
- ~6 MONTHS: Transfers objects hand-to-hand; raking grasp (fingers rake toward palm) appears.
- ~9–10 MONTHS: NEAT PINCER GRASP (thumb-forefinger) — enables picking up small foods, exploration, and self-feeding.
- ~12 MONTHS: 2–3 words vocabulary (besides mama/dada); understands simple commands like 'no', 'bye-bye'.
- ~2 YEARS: 2-WORD PHRASES or short sentences ('Mommy up', 'more milk'); vocabulary ~50+ words; about HALF of speech understandable to strangers.
- ~3 YEARS: 3-word sentences ('I want milk'); speech mostly understandable to strangers; asks questions ('why?', 'what?').
- Language development varies widely; bilingual children may mix languages or show slightly delayed single-language vocabulary (normal).
- Receptive language (understanding) is AHEAD of expressive language (speaking) — child understands more than can say.
Key definitions
Palmar Grasp (3–4 months)
Example
3-month-old grasps rattle placed in hand = normal palmar grasp; transfer object hand-to-hand by 6 months.
Infant grasps object placed in palm with whole hand; precedes pincer grasp; progress from reflexive to purposeful.
Pincer Grasp (9–10 months)
Example
9-month-old picks up cereal with thumb-forefinger = neat pincer grasp; essential for independent eating.
Thumb and forefinger (or two fingers) grasp small objects with precision; major fine motor milestone enabling self-feeding and exploration.
Language Development Milestones
Example
3-month-old coos ('ooh', 'ahh'); 6-month-old babbles ('ba-ba', 'da-da'); 12-month-old says mama/dada with meaning; 2-year-old uses 2-word phrases.
Progressive acquisition of receptive (understanding) and expressive (speaking) language from cooing → babbling → words → phrases → sentences.
Diagrams to know
- Fine motor progression: palmar grasp → raking grasp → pincer grasp
- Language milestone progression: cooing → babbling → first words → phrases → sentences
PLAY BY AGE (SOCIAL PLAY CLASSIFICATION)
Important facts
- Play type is DEVELOPMENTAL STAGE-DEPENDENT and CANNOT be rushed — match play to age group.
- INFANT: solitary play; bright, safe, mouthing-safe toys (mobiles, rattles, soft blocks, black-and-white cards).
- TODDLER: parallel play; push-pull toys, blocks, toy vehicles, sand/water play; minimal interactive toys.
- PRESCHOOL: associative play; dramatic play (dress-up, play kitchen, doctor kit), tricycles, simple puzzles, art materials; encourage imaginative play and social interaction.
- SCHOOL-AGE: cooperative play; team sports, board games, card games, collections (cards, models); rules and competition are important.
- Therapeutic play is a KEY NURSING INTERVENTION for anxiety reduction and procedure preparation (NCM Level I).
- During hospitalisation, provide age-appropriate play to maintain normality and reduce stress — not 'busy work' but developmentally appropriate play.
- Play assessment is part of DEVELOPMENTAL SCREENING — observing child's play reveals cognitive, social, and motor abilities.
Key definitions
Solitary Play (Infant: 0–2 years)
Example
Infant in playpen with toys shaking rattles, mouthing objects alone = solitary play; normal and age-appropriate for infancy.
Infant plays alone; does not interact with other children; plays with individual toys (rattles, mobiles, soft toys).
Parallel Play (Toddler: 1–3 years)
Example
Two toddlers in sandbox: both playing with buckets and shovels but not sharing or coordinating play = parallel play; normal for toddler age group.
Toddler plays ALONGSIDE other children WITHOUT interaction or joint play; each child plays independently with own toys, often imitating the other's actions.
Associative Play (Preschool: 3–6 years)
Example
Three preschoolers playing 'house': one is cooking, one is shopping, one is cleaning; they interact but have no unified plan = associative play.
Child plays WITH other children, interacts, but plays lack formal organisation or shared goal; includes imitative/dramatic play, dress-up, tricycles.
Cooperative Play (School-age: 6–12 years)
Example
School-age children playing baseball: organised teams, rules, assigned positions, working toward winning = cooperative play.
Organised play with rules, roles, and shared objectives (team games, board games, sports); children work toward common goal.
Therapeutic Play
Example
Before surgery, nurse gives child a doll and stethoscope: 'You can listen to your teddy's heart just like the doctor will listen to yours' = therapeutic play for coping.
Guided play used to help child prepare for procedures, express emotions, or reduce anxiety; nurse allows child to manipulate equipment on doll or stuffed animal.
Diagrams to know
- Play type progression by age: solitary → parallel → associative → cooperative
- Toy recommendations by age group and developmental stage
NUTRITION & FEEDING MILESTONES
Common values
Value
6 months
Symbol
Guideline
Quantity
Exclusive breastfeeding duration
Value
6 months
Symbol
Age
Quantity
Complementary feeding start
Value
2 years and beyond
Symbol
Duration
Quantity
Breastfeeding continuation
Value
3–5–7 days
Symbol
Wait period
Quantity
Interval between new foods
Value
Until 12 months
Symbol
Age
Quantity
Honey introduction (avoid)
Value
After 12 months
Symbol
Age
Quantity
Whole cow's milk introduction
Important facts
- EXCLUSIVE BREASTFEEDING for FIRST 6 MONTHS — no water, no other foods (DOH/WHO guideline, Garantisadong Pambata policy).
- Complementary feeding introduced at 6 MONTHS while breastfeeding continues to 2 years and beyond.
- First food: iron-fortified cereal (rice, maize); follow with vegetables, fruits, protein foods.
- Introduce ONE NEW FOOD at a time; wait 3–5–7 days between new foods to identify allergies.
- Infant-led weaning (baby self-feeds finger foods) is increasingly recognised as developmentally appropriate; standard spoon-feeding also valid.
- AVOID HONEY in first 12 months — risk of infant botulism (spores may germinate in infant's GI tract).
- AVOID WHOLE COW'S MILK before 12 months — high protein/minerals may stress immature kidneys; use breast milk or infant formula.
- CHOKING HAZARDS in toddlers: small round firm foods (nuts, grapes, cherry tomatoes, popcorn, whole hot dogs) — cut lengthwise before offering.
- Egg, peanuts, fish, shellfish, tree nuts: introduce early and frequently (even in infants <6 months) per latest guidelines to reduce allergy development.
- Salt and sugar: minimise in infant/toddler foods; avoid processed/added sugars; establish healthy taste preferences early.
Key definitions
Exclusive Breastfeeding (0–6 months)
Example
6-month-old has received ONLY breast milk since birth (no water, no formula) = exclusive breastfeeding; meets DOH guideline.
Infant receives ONLY breast milk; NO water, formula, other foods, or drinks (except prescribed medicines/vitamins); DOH/WHO standard for 6 months.
Complementary Feeding (6 months+)
Example
6-month-old begins iron-fortified cereal and mashed banana WHILE continuing breastfeeding; breastfeeding continues to 2+ years = complementary feeding practice.
Introduction of foods/liquids other than breast milk WHILE continuing breastfeeding; recommended to start at 6 months; continued breastfeeding to 2 years and beyond.
First Food Introduction
Example
Introduce rice cereal at week 1, then after 3–5 days introduce mashed sweet potato; slow introduction allows detection of allergic reaction.
Start with single-ingredient, iron-fortified cereal (rice, maize) at 6 months; offer one new food every 3–5–7 days to detect allergies/sensitivities.
Diagrams to know
- Feeding progression timeline: exclusive breastfeeding 0–6 mo → complementary feeding 6 mo–2+ years
- First foods introduction sequence: cereals → vegetables → fruits → proteins
ANTICIPATORY GUIDANCE (SAFETY) BY AGE
Common values
Value
<120°F (48.9°C)
Symbol
Safety
Quantity
Water heater temperature
Value
<6 cm apart
Symbol
Safety
Quantity
Crib slat spacing
Value
<5 cm diameter
Symbol
Choking hazard
Quantity
Small toy size danger
Value
Until 2 years minimum
Symbol
Age
Quantity
Rear-facing car seat duration
Important facts
- INFANT (0–12 months): Leading risks are ASPIRATION/CHOKING, FALLS, SIDS, SUFFOCATION.
- • 'Back to sleep' positioning (supine sleep) to reduce SIDS risk.
- • Firm mattress, no pillows/blankets/bumper pads in crib.
- • Rear-facing car seat (safest position); never front-facing before 2 years.
- • Remove small objects, plastic bags, cords from reach; avoid small toys/rattles <5 cm.
- • Never prop bottles; always supervise feeding.
- • Crib safety: slats <6 cm apart, firm mattress, no drop sides.
- TODDLER (1–3 years): Risks from mobility and curiosity: POISONING, DROWNING, FALLS, BURNS, MOTOR VEHICLE INJURIES.
- • Poison control number on refrigerator; secure all medicines, cleaning products, plants in locked cabinet.
- • Gates on stairs (top AND bottom); corner guards, safety locks on cabinets.
- • Constant supervision near water (bathtub, pool, bucket); drowning occurs silently and quickly.
- • Hot water heater <120°F (48.9°C); keep toddler away from hot stove, hot liquids.
- • Car seat/booster; never leave child unattended in car.
- PRESCHOOL (3–6 years): Risks from independence and increasing activity: TRAFFIC/ROAD SAFETY, PLAYGROUND INJURIES, DROWNING, BURNS, STRANGER DANGER.
- • Teach road safety: hold hand, look both ways, wait for pedestrian signal.
- • Playground supervision; appropriate equipment for height/age.
- • Water safety (swimming lessons, life jacket near water); never assume child can swim.
- • Begin teaching stranger safety (identify trusted adults, bodily autonomy).
- • Car safety continues; car seats/boosters age-appropriate.
- SCHOOL-AGE (6–12 years): Risks from sports/activities: SPORTS/BICYCLE INJURIES, MOTOR VEHICLE, PLAYGROUND, WATER SAFETY.
- • Bicycle helmet EVERY ride (model helmet use).
- • Sports safety gear appropriate to sport (padding, mouthguards, helmets).
- • Seat belt use in car (continues from earlier).
- • Water safety (swimming proficiency, buddy system, lifeguard presence).
- • Fire safety: home escape plan, meeting place, never hide in fire.
- ADOLESCENT (12–18 years): Risks from increased independence and risk-taking: MOTOR VEHICLE CRASHES, SUBSTANCE USE, SEXUAL RISK-TAKING, VIOLENCE/SUICIDE.
- • Safe driving: no texting, minimal passengers, sober driving, seat belt use.
- • Substance use prevention: education, open communication, consequences.
- • Sexual health: contraception, STI prevention, consent, healthy relationships.
- • Suicide prevention: warning signs, mental health support access.
- • Peer pressure management; healthy coping strategies.
Key definitions
Anticipatory Guidance
Example
At 4-month well-baby visit, teach about rolling and falling risks; at 9-month visit, teach about crawling hazards and poisoning prevention.
Proactive teaching to parents/caregivers about expected developmental milestones, safety hazards, and injury prevention BEFORE the child reaches that stage.
Diagrams to know
- Injury risk progression by age: aspiration → poisoning → traffic → MVC/substance use
- Anticipatory guidance timeline: what to teach at each well-child visit
CLASSIC DEVELOPMENTAL THEORISTS — QUICK COMPARISON
Important facts
- THREE theorists dominate NLE: ERIKSON (psychosocial) → FREUD (psychosexual) → PIAGET (cognitive).
- Strategy: Memorise the STAGE that corresponds to each age group across all three theorists — this enables rapid comparison and exam success.
Diagrams to know
- Three-theorist comparison table by age group
PHILIPPINE CONTEXT — DOH & HEALTHCARE DELIVERY
Important facts
- DOH and RA 9173 (Philippine Nursing Practice Act) mandate nurses to provide anticipatory guidance and developmental assessment in community and hospital settings.
- Growth monitoring at RHU is PRIMARY PREVENTION tool — detects malnutrition, stunting, and developmental delays early.
- Nurses use growth charts and milestone checklists during well-baby visits — critical for NCM Level I practice.
- Breastfeeding is promoted for 6 months exclusive, then complementary feeding to 2+ years per DOH/Garantisadong Pambata.
- Developmental screening is integrated into immunisation visits — missed milestones trigger referral for early intervention.
- Community health nurses (barangay health workers under supervision) perform basic developmental checks; refer to RHU or hospital for formal assessment.
Key definitions
Garantisadong Pambata (Guaranteed Child Health Package)
Example
Well-baby visits at RHU: monthly 0–1 year, then quarterly until 5 years; includes growth assessment, developmental screening, immunisation, anticipatory guidance.
DOH comprehensive child health programme providing free health services to all children; includes immunisation, growth monitoring, nutrition, developmental screening.
Operation Timbang (Weighing Operation)
Example
Monthly or quarterly weighing at RHU/barangay; weight plotted on chart; trends flagged for referral and nutrition intervention.
National weighing programme identifying malnourished children in communities; uses growth charts to detect failures in growth.
ECCD (Early Childhood Care and Development)
Example
RHU developmental screening using milestones; parenting classes on child development and safety; referral of delayed children to specialist services.
DOH framework promoting development 0–8 years through growth monitoring, developmental stimulation, parental education, and child protection.
Diagrams to know
- DOH child health service delivery pathway: RHU → referral to hospital/specialist
Must remember
- WEIGHT MILESTONES: Doubles by 4–6 mo, TRIPLES by 12 mo, QUADRUPLES by 24 mo. Failure = red flag for poor growth / failure to thrive.
- ERIKSON BY AGE: Infant=Trust, Toddler=Autonomy, Preschool=Initiative, School-age=Industry, Adolescent=Identity. Heavily tested on NLE.
- PRIMITIVE REFLEXES: Most disappear ~3–4 months (Moro, rooting, palmar, tonic neck). Absence at birth or persistence beyond age = neurologic red flag. Babinski upgoing is NORMAL until ~1–2 years.
- OBJECT PERMANENCE (~8–9 months): Basis for separation anxiety and peek-a-boo. Infant understands objects exist when hidden.
- FONTANELLES: Anterior fontanelle diamond-shaped, closes 12–18 months. Posterior fontanelle triangular, closes ~2 months. Bulging=↑ICP; sunken=dehydration.
- FIRST TOOTH erupts ~6 MONTHS (lower central incisors first). Formula: (Age in months − 6) = number of teeth for 6 mo–2.5 yr age range.
- PIAGET COGNITIVE STAGES: Sensorimotor (0–2, object permanence), Preoperational (2–7, egocentrism/magical thinking), Concrete Operational (7–11, conservation), Formal Operational (11+, abstract reasoning).
- EXCLUSIVE BREASTFEEDING 0–6 MONTHS; complementary feeding at 6 months; breastfeeding continues to 2+ years. NO honey in first 12 months.
- ANTICIPATORY GUIDANCE: Aspiration/SIDS (infant, supine sleep) → Poisoning/drowning (toddler, gates, locks) → Road/stranger safety (preschool) → Sports/bike helmets (school-age) → MVC/substance use (adolescent).
- DEVELOPMENT IS CEPHALOCAUDAL (head-to-toe) AND PROXIMODISTAL (centre-to-periphery), orderly but INDIVIDUAL PACE. Never force milestones; assess and reassure, never diagnose delay based on one visit.
Last minute tips
- ERIKSON/FREUD/PIAGET QUESTION? Make a 3-column table by age group — Erikson stage, Freud stage, Piaget stage. This organisation will answer ~90% of developmental theory questions. Do NOT try to memorise all 15 stages separately; focus on the AGE GROUP first.
- WEIGHT FORMULA CONFUSION? Remember: double (2×) is EASIER to achieve in months 4–6 than 0–4. Triple (3×) is the big jump at 12 months. Quadruple (4×) happens by 2 years. If a baby is NOT tripling by 12 months, investigate feeding, absorption, and organic disease.
- PRIMITIVE REFLEX TIMING? The MORO/ROOTING/PALMAR all disappear together ~3–4 months as a group. BABINSKI is NORMAL (upgoing) in infants until 1–2 years — do NOT pathologise normal infant Babinski; it becomes abnormal (sign of CNS disease) only in older children/adults. Test: 'A 10-year-old has upgoing Babinski' = ABNORMAL pathology present.
- ANTICIPATORY GUIDANCE BY AGE? Think about the MOBILITY and INDEPENDENCE of the child at each stage: infant (limited movement, risks from immobility and aspiration) → toddler (mobile, curious, risks from exploration) → preschool (faster, independent, risks from play/environment) → school-age (sports/activity risks) → adolescent (peer/independence risks). Match safety teaching to the child's CAPABILITIES at that age.
- PLAY BY AGE QUESTION? If child is ALONE = solitary (infant); ALONGSIDE peers = parallel (toddler); WITH peers but unorganised = associative (preschool); ORGANISED team play = cooperative (school-age). Do NOT confuse parallel (alongside without interaction) with associative (with interaction but no rules) — the key difference is WHETHER the children interact.
Comparison tables
ERIKSON vs FREUD vs PIAGET — BY AGE GROUP
| Age Group | Erikson (Psychosocial) | Freud (Psychosexual) | Piaget (Cognitive) |
|---|---|---|---|
| Infant (0–1 year) | Trust vs Mistrust | Oral | Sensorimotor (object permanence ~8–9 mo) |
| Toddler (1–3 years) | Autonomy vs Shame & Doubt | Anal | Sensorimotor → Preoperational |
| Preschool (3–6 years) | Initiative vs Guilt | Phallic (Oedipal/Electra) | Preoperational (egocentrism, magical thinking) |
| School-age (6–12 years) | Industry vs Inferiority | Latency | Concrete Operational (conservation, classification) |
| Adolescent (12–18 years) | Identity vs Role Confusion | Genital | Formal Operational (abstract reasoning) |
PLAY TYPE BY AGE (SOCIAL PLAY CLASSIFICATION)
| Age Group | Play Type | Key Feature | Examples / Toys |
|---|---|---|---|
| Infant (0–2 yrs) | Solitary | Plays alone; no peer interaction | Rattles, mobiles, soft toys, black-white cards |
| Toddler (1–3 yrs) | Parallel | Plays alongside peers without interaction | Push-pull toys, blocks, toy vehicles, sand play |
| Preschool (3–6 yrs) | Associative | Plays with peers; imitative/imaginative but unorganised | Dramatic play (dress-up, play kitchen), tricycles, puzzles |
| School-age (6–12 yrs) | Cooperative | Organised play with rules and shared goals | Team sports, board games, card games, collections |
| Any age (therapeutic use) | Therapeutic Play | Guided to reduce anxiety, prepare for procedures | Equipment on doll/stuffed animal, role-play scenarios |
PRIMITIVE REFLEXES — APPEARANCE & DISAPPEARANCE
| Reflex | How Elicited / Seen | Present at Birth? | Disappears By |
|---|---|---|---|
| Moro (Startle) | Sudden movement/loud noise → abduct arms then embrace | Yes | ~3–4 months |
| Rooting | Stroke cheek → head turns toward stimulus | Yes | ~3–4 months |
| Sucking | Touch lips → sucks | Yes (involuntary) | ~3–4 months (involuntary component) |
| Palmar Grasp | Object in palm → fingers curl | Yes | ~3–4 months |
| Tonic Neck ('Fencing') | Turn head to side → same-side arm/leg extend | Yes | ~3–4 months |
| Plantar Grasp | Pressure on sole → toes curl | Yes | ~8–10 months |
| Babinski | Stroke sole upward → toes fan/dorsiflex | Yes (NORMAL upgoing) | ~1–2 years (then becomes adult downgoing) |
| Stepping/Dance | Hold upright, feet touch surface → stepping motions | Yes | ~4–8 weeks |
WEIGHT MILESTONES — CALCULATION & ASSESSMENT
| Milestone | Formula / Target | Timing | Clinical Significance / Concern If Missed |
|---|---|---|---|
| Birth weight | ~3–3.5 kg | At delivery | <2.5 kg = LBW (prematurity, growth restriction); >4 kg = macrosomia (maternal diabetes, genetic) |
| Physiologic weight loss | 5–10% of BW | First 3–5 days | >10% or failure to regain by day 14 = feeding problem, dehydration, pathology |
| Regain birth weight | Return to BW | By day 10–14 | Delayed regain = poor latch, insufficient milk transfer, pathology |
| Weight DOUBLES | 2× BW | 4–6 months | Failure = poor growth, feeding issue, malabsorption, organic disease |
| Weight TRIPLES | 3× BW | 12 months | Failure = failure to thrive, inadequate nutrition, developmental concern |
| Weight QUADRUPLES | 4× BW | 24 months | Failure = persistent growth inadequacy, need for intervention |
GROSS MOTOR MILESTONES — QUICK REFERENCE BY AGE
| Age | Motor Milestone | Position/Ability |
|---|---|---|
| 2 months | Head lift | Prone, lifts head from mattress; social smile |
| 4 months | Rolling prone to supine | Can roll front to back; steady head, no head lag |
| 6 months | Sits with support | Leans on hands; rolls both ways |
| 7–8 months | Sits without support | Unsupported sitting; major milestone |
| 9 months | Crawls; pincer grasp | Hand-knee crawling; thumb-forefinger grasp |
| 10 months | Pulls to stand | Holds furniture; begins cruising |
| 12 months | Stands alone; first steps | Brief independent standing; may take steps |
| 15 months | Walks well alone | Independent walking; toddles but improving |
| 18 months | Runs; climbs stairs | Stiff-legged running; climbs with help (both feet/step) |
| 2 years | Stairs; running | Up/down stairs (both feet per step); runs well |
| 3 years | Tricycle; stairs alternating | Rides tricycle; climbs stairs alternating feet |
| 4 years | Hops one foot; throws overhand | Hops on one foot; throws with accuracy |
| 5 years | Skips; jumps rope | Skips easily; hops alternating feet |
Diagrams
Growth & Development Across Childhood — Comprehensive Overview
Comprehensive mind map showing all major domains of growth and development (physical, theorists, motor, play, nutrition, safety) and their key milestones and concepts by age group. Use this to organise your thinking before diving into specific sections.
Developmental Milestones Timeline — Birth to 5 Years
Visual timeline of major motor and language milestones from birth to 5 years, colour-coded by developmental domain. Useful for quick reference and seeing the progression of skills over time.
Erikson's Psychosocial Development — Nursing Interventions by Age
Flowchart linking each age group to Erikson's stage and the key nursing care priorities/interventions that support healthy development. Useful for understanding how to tailor nursing care to child's developmental stage during hospitalisation and community care.
Piaget's Cognitive Development Stages — Child's Thinking Abilities
State diagram showing Piaget's four cognitive stages, key characteristics of thinking at each stage, and specific nursing communication strategies appropriate to each stage. Essential for understanding how to teach and interact with children at different developmental levels.
Anticipatory Guidance — Safety Teaching by Age Group
Comprehensive flowchart showing age-appropriate injury risks and specific safety teaching points for each developmental stage. Use this to quickly identify what safety education to provide at each well-child visit or when counselling families in community/hospital settings.
Primitive Reflexes — Quick Assessment Guide (Newborn to 2 Years)
Practical assessment flowchart for primitive reflexes from birth to 2 years, including red flags (absent reflex at birth, persistent beyond expected age) and appropriate actions. Critical for NCM Level I neurologic assessment of newborns and young infants.