Development Skills Training for the 1-2 month old: Difference between revisions
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== Introduction == | == Introduction == | ||
Significant development can be seen during the infant stage of 1-2 months olds. As infants stay awake longer and become more alert, their behaviour becomes less spontaneous and more intentional allowing them to interact within their physical and social environment.<ref name=":0">Versfeld, P. Family Development Skills Training for the 1-2 Month Old Course. Physioplus. 2022.</ref> | |||
== | == Generalized Body Movement == | ||
During the first two months of life, generalized body movements are characterized as writhing (forceful and tense) appearance involving the entire body.<ref name=":0" /> <ref name=":1">Hadders‐Algra M. [https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.13540 Neural substrate and clinical significance of general movements: an update. Developmental Medicine & Child Neurology]. 2018 Jan;60(1):39-46.</ref> Speed and amplitude of movement range from low to moderate and are varied and complex. <ref name=":2">Doroniewicz I, Ledwoń DJ, Affanasowicz A, Kieszczyńska K, Latos D, Matyja M, Mitas AW, Myśliwiec A. [https://www.researchgate.net/publication/344829871_Writhing_Movement_Detection_in_Newborns_on_the_Second_and_Third_Day_of_Life_Using_Pose-Based_Feature_Machine_Learning_Classification Writhing movement detection in newborns on the second and third day of life using pose-based feature machine learning classification]. Sensors. 2020 Jan;20(21):5986.</ref> Around two months old, movements transition from writhing to fidgety. These complex and varied movements are characterized by variable acceleration, small amplitude and moderate speed.<ref name=":0" /> <ref name=":1" /><ref name=":2" /> The presence and character of fidgety movements are good indicators of the integrity of the infant's nervous system.<ref name=":0" /> | |||
== | In contrast, abnormal findings during this phase include: | ||
# Lack of movement diversity | |||
# Movements where the limbs and trunk move stiffly as one unit <ref name=":1" /> | |||
=== Self-Perception === | |||
Self-perception is the ability to sense one’s own body either through proprioception (moving head and limbs in space) or haptic (touching a surface). Newborns display an early sense of their body and personal space which allows them to navigate their social and physical world. During these first two months, newborn vision is poor limiting their understanding of the world outside their personal space, therefore motor and sensory experiences centred around their body are predominant. Exploratory and repeated movements and postures provide self-knowledge about their body.<ref>DiMercurio A, Connell JP, Clark M, Corbetta D. [https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02613/full A naturalistic observation of spontaneous touches to the body and environment in the first 2 months of life.] Frontiers in psychology. 2018 Dec 18;9:2613.</ref> | |||
=== Tummy Time === | |||
Due to the high incidence of sudden infant death syndrome (SIDS), in 1992 the American Academy of Pediatrics recommended babies be placed supine to sleep. This has significantly reduced SIDS cases by 40%, however, babies showed slower achievement of motor milestones. To discourage motor delay, parents are encouraged to provide tummy time 30 minutes a day for physical activity. Tummy time is awake prone playtime on the floor supervised by an adult. Unfortunately, tummy time recommendations are followed by only 30% of parents despite the positive association with prone playing and gross motor development. Research studies reveal significant differences in prone and nonprone infants in achieving the following gross motor development milestones: | |||
* Rolling | |||
* Crawling on belly | |||
* Crawling on all fours | |||
* Supported sitting | |||
* Unsupported sitting | |||
* Pulling to stand | |||
These achievements in gross motor development with tummy time infants continued to 3 years old. <ref>Hewitt L, Kerr E, Stanley RM, Okely AD. [https://ana.org.nz/wp-content/uploads/2020/05/Tummy-Time-and-Infant-Health.pdf Tummy time and infant health outcomes: a systematic review. Pediatrics]. 2020 Jun 1;145(6).</ref> | |||
=== Posture === | |||
Infants 1-2 months old gain increasing control over trunk position in sitting with support at the hips.<ref name=":0" /> With support at their hips, they can maintain a semi-erect position of their trunk. (speaker) Musculature synergies that are direction-specific adapt to varied situations to control posture. When an infant leans forward, the dorsal muscles are activated to maintain balance. As the infant performs goal-directed tasks such as reaching, the body sways to preserve stability.<ref>Boxum AG, La Bastide‐Van Gemert S, Dijkstra LJ, Furda A, Reinders‐Messelink HA, Hadders‐Algra M. [https://pure.rug.nl/ws/portalfiles/portal/62477360/Boxum_et_al_2018_Developmental_Medicine_26_Child_Neurology.pdf Postural control during reaching while sitting and general motor behaviour when learning to walk.] Developmental Medicine & Child Neurology. 2019 May;61(5):555-62.</ref> | |||
=== Reaching and Grasping === | |||
When infants during the 1-2 month period attempt to reach for objects they use large range swiping movements of the upper extremities. Their hands will come close to the object, but they mostly do not make contact. The elbows and fingers are seen in extension during these swiping motions. Towards the end of this period, the newborn gains more control of reaching as they can steady their head and trunk better when moving their upper extremities. As they gain control, they are able to bring their hand into contact with the toy allowing them to explore the texture and structure of the object. <ref name=":0" /> | |||
Initially, infants used a closed fist when reaching for objects. Around 4 months old, infants will transition to an open hand in anticipation of contacting the object. Research shows that reaching for an object is dependent upon location and age. Provine and Westernman (1979)<ref name=":3">Chinn LK, Noonan CF, Hoffmann M, Lockman JJ. Development of infant reaching strategies to tactile targets on the face. Frontiers in psychology. 2019 Jan 21;10:9.</ref> demonstrated a success rate of reaching for an object by age in the following scenarios: | |||
* Ipsilateral reaching - 100% at 9 weeks | |||
* Midline reaching - 93% at 17 weeks | |||
* Contralateral reaching; 100% at 18-20 weeks | |||
As the infant ages during the first year of life, their ability to reach in external space becomes faster and more efficient. Reaching precedes grasping demonstrating a proximodistal sequence in development.<ref name=":3" /> | |||
=== Social Interaction === | |||
Infants between 1-2 months old demonstrate social and communication behaviour in the following ways: | |||
* Socially | |||
** Smiling | |||
** Eye contact | |||
** Turning heads toward voices/sounds | |||
** Interest in faces | |||
** Recognizing faces | |||
* Communication | |||
** Crying for different needs | |||
** Producing a range of pre-speech sounds<ref name=":0" /> | |||
Infants involved in social interaction will make pre-speech sounds such as coos, squeals, grunts and vowel-like sounds. Subsequently, mothers, fathers and caregivers communicate with infants using a higher pitch, and slower speech rate referred to as “baby-talk” or motherese. Studies show infants have a preference for this infant-directed speech by noting they are more responsive, looking longer at the speaker and remembering the speaker more often if they used motherese. The greater the responsiveness from the infant to the speaker through this motherese communication can help maintain a positive adult-infant interaction.<ref>Saint-Georges C, Chetouani M, Cassel R, Apicella F, Mahdhaoui A, Muratori F, Laznik MC, Cohen D. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800080/ Motherese in interaction: at the cross-road of emotion and cognition?(A systematic review)]. PloS one. 2013 Oct 18;8(10):e78103.</ref> | |||
== Resources == | == Resources == | ||
Revision as of 18:38, 31 January 2022
Introduction[edit | edit source]
Significant development can be seen during the infant stage of 1-2 months olds. As infants stay awake longer and become more alert, their behaviour becomes less spontaneous and more intentional allowing them to interact within their physical and social environment.[1]
Generalized Body Movement[edit | edit source]
During the first two months of life, generalized body movements are characterized as writhing (forceful and tense) appearance involving the entire body.[1] [2] Speed and amplitude of movement range from low to moderate and are varied and complex. [3] Around two months old, movements transition from writhing to fidgety. These complex and varied movements are characterized by variable acceleration, small amplitude and moderate speed.[1] [2][3] The presence and character of fidgety movements are good indicators of the integrity of the infant's nervous system.[1]
In contrast, abnormal findings during this phase include:
- Lack of movement diversity
- Movements where the limbs and trunk move stiffly as one unit [2]
Self-Perception[edit | edit source]
Self-perception is the ability to sense one’s own body either through proprioception (moving head and limbs in space) or haptic (touching a surface). Newborns display an early sense of their body and personal space which allows them to navigate their social and physical world. During these first two months, newborn vision is poor limiting their understanding of the world outside their personal space, therefore motor and sensory experiences centred around their body are predominant. Exploratory and repeated movements and postures provide self-knowledge about their body.[4]
Tummy Time[edit | edit source]
Due to the high incidence of sudden infant death syndrome (SIDS), in 1992 the American Academy of Pediatrics recommended babies be placed supine to sleep. This has significantly reduced SIDS cases by 40%, however, babies showed slower achievement of motor milestones. To discourage motor delay, parents are encouraged to provide tummy time 30 minutes a day for physical activity. Tummy time is awake prone playtime on the floor supervised by an adult. Unfortunately, tummy time recommendations are followed by only 30% of parents despite the positive association with prone playing and gross motor development. Research studies reveal significant differences in prone and nonprone infants in achieving the following gross motor development milestones:
- Rolling
- Crawling on belly
- Crawling on all fours
- Supported sitting
- Unsupported sitting
- Pulling to stand
These achievements in gross motor development with tummy time infants continued to 3 years old. [5]
Posture[edit | edit source]
Infants 1-2 months old gain increasing control over trunk position in sitting with support at the hips.[1] With support at their hips, they can maintain a semi-erect position of their trunk. (speaker) Musculature synergies that are direction-specific adapt to varied situations to control posture. When an infant leans forward, the dorsal muscles are activated to maintain balance. As the infant performs goal-directed tasks such as reaching, the body sways to preserve stability.[6]
Reaching and Grasping[edit | edit source]
When infants during the 1-2 month period attempt to reach for objects they use large range swiping movements of the upper extremities. Their hands will come close to the object, but they mostly do not make contact. The elbows and fingers are seen in extension during these swiping motions. Towards the end of this period, the newborn gains more control of reaching as they can steady their head and trunk better when moving their upper extremities. As they gain control, they are able to bring their hand into contact with the toy allowing them to explore the texture and structure of the object. [1]
Initially, infants used a closed fist when reaching for objects. Around 4 months old, infants will transition to an open hand in anticipation of contacting the object. Research shows that reaching for an object is dependent upon location and age. Provine and Westernman (1979)[7] demonstrated a success rate of reaching for an object by age in the following scenarios:
- Ipsilateral reaching - 100% at 9 weeks
- Midline reaching - 93% at 17 weeks
- Contralateral reaching; 100% at 18-20 weeks
As the infant ages during the first year of life, their ability to reach in external space becomes faster and more efficient. Reaching precedes grasping demonstrating a proximodistal sequence in development.[7]
Social Interaction[edit | edit source]
Infants between 1-2 months old demonstrate social and communication behaviour in the following ways:
- Socially
- Smiling
- Eye contact
- Turning heads toward voices/sounds
- Interest in faces
- Recognizing faces
- Communication
- Crying for different needs
- Producing a range of pre-speech sounds[1]
Infants involved in social interaction will make pre-speech sounds such as coos, squeals, grunts and vowel-like sounds. Subsequently, mothers, fathers and caregivers communicate with infants using a higher pitch, and slower speech rate referred to as “baby-talk” or motherese. Studies show infants have a preference for this infant-directed speech by noting they are more responsive, looking longer at the speaker and remembering the speaker more often if they used motherese. The greater the responsiveness from the infant to the speaker through this motherese communication can help maintain a positive adult-infant interaction.[8]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Versfeld, P. Family Development Skills Training for the 1-2 Month Old Course. Physioplus. 2022.
- ↑ 2.0 2.1 2.2 Hadders‐Algra M. Neural substrate and clinical significance of general movements: an update. Developmental Medicine & Child Neurology. 2018 Jan;60(1):39-46.
- ↑ 3.0 3.1 Doroniewicz I, Ledwoń DJ, Affanasowicz A, Kieszczyńska K, Latos D, Matyja M, Mitas AW, Myśliwiec A. Writhing movement detection in newborns on the second and third day of life using pose-based feature machine learning classification. Sensors. 2020 Jan;20(21):5986.
- ↑ DiMercurio A, Connell JP, Clark M, Corbetta D. A naturalistic observation of spontaneous touches to the body and environment in the first 2 months of life. Frontiers in psychology. 2018 Dec 18;9:2613.
- ↑ Hewitt L, Kerr E, Stanley RM, Okely AD. Tummy time and infant health outcomes: a systematic review. Pediatrics. 2020 Jun 1;145(6).
- ↑ Boxum AG, La Bastide‐Van Gemert S, Dijkstra LJ, Furda A, Reinders‐Messelink HA, Hadders‐Algra M. Postural control during reaching while sitting and general motor behaviour when learning to walk. Developmental Medicine & Child Neurology. 2019 May;61(5):555-62.
- ↑ 7.0 7.1 Chinn LK, Noonan CF, Hoffmann M, Lockman JJ. Development of infant reaching strategies to tactile targets on the face. Frontiers in psychology. 2019 Jan 21;10:9.
- ↑ Saint-Georges C, Chetouani M, Cassel R, Apicella F, Mahdhaoui A, Muratori F, Laznik MC, Cohen D. Motherese in interaction: at the cross-road of emotion and cognition?(A systematic review). PloS one. 2013 Oct 18;8(10):e78103.
