The Psychomotor Development of the Child - 1st Year

Laws Characterizing Psychomotor Development:

• The Law of Differentiation from a Motor Perspective: Transition from involuntary motor activity, archaic reflex (diffuse, spontaneous) to voluntary motor activity (precise and adapted). It is subject to 2 laws:

1. The Cephalo-Caudal Law: The muscles closest to the cephalic part are under voluntary control the earliest.

2. The Proximo-Distal Law: The muscles of the limbs are under voluntary control earliest when they are close to the axis of the body (from the center to the periphery).

• Law of Differentiation from a Psychic Perspective:

1. Psychologically: The child gradually detaches from the mother, becoming a subject.

2. Intellectually: The child discovers objects by putting them in their mouth and then establishes new relationships with the objects.

3. Communication and Language: Initially calls the mother by crying and later will say "Mom, I'm hungry".

• Law of Variability:

Progress is neither uniform nor continuous. There are also variations from one child to another. There can be rapid progress, stagnation, pauses, regressions... throughout development.

Factors Influencing Psychomotor Development:

• Anatomical and neurological equipment

• Neurological maturation

• Heredity

• Relational and emotional life

• Position in the sibling order

• Parents' educational choices

• Natural environment...

Experience leaves traces; it is memorized and then transposed to other actions/situations.

In interaction with the surrounding world, the child develops nerve connections through the process of myelination.

This process is most effective if the child himself is the initiator of the action taken: "It is action that helps intelligence to build" – Piaget. The richness of experimentation depends on the quantity and quality of the proposed stimulations.

The success that brings pleasure to the child will motivate them. This is referred to as self-satisfaction.

E. Pickler: The child has the capacity to reach different stages of development of their own initiative, without adult stimulation.

Pedagogy:

• Stable and predictable environment

• Consideration of each child's personal and family history

• Adult intervention based on observation

• Respect and support for the child's autonomous activity

• Adult attention to the child's manifestations and initiatives + support through words and gestures in the child's self-awareness

• Adjustment to the evolving needs of the child

Mastering motor skills influences a child's development = develops self-confidence and self-esteem.

Every stage of development prepares and organizes the following one; it is a continuum.

2 Types of Motor Skills:

• Gross Motor Skills: Development of muscle tone + posture + movements.

• Fine Motor Skills: Grasping

3 Axes of Evolution in Development:

1. Evolution towards locomotion

2. Evolution towards grasping

3. Evolution towards communication

A. Bullinger: Sensorimotor Approach. The tonic-postural behaviors of the infant are based on motor aspects and sensory dimensions that are associated with the interactions the baby has with their environment. It relies on the observation of the child and their natural postures.

Sensorial Flows = continuous intake of information captured by the infant:

• through sensory receptors

• through proprioceptive receptors = deep sensitivity at the level of ligaments and muscles.

Tonic-postural regulation allows the child to find an equilibrium between flexions and extensions of the trunk. It is important for adults to help the child find this balance, which will facilitate comfortable feeding later on (to avoid hyperextension that does not favor eye-grasp coordination).

MOTOR DEVELOPMENT IN THE FIRST MONTH:

• Present archaic reflexes (non-coordinated, jerky, involuntary...)

• Hypertonia of the limbs, flexion

• Axial hypotonia (head tilting back when sitting)

• Experiences gravity and is sensitive to imbalances (MORO)

• Crawling movements on the belly

• State of wakefulness: moves constantly

• Short immobilization when there is a new perception

• Turns head based on sounds

• Follows an object placed in front of their eyes with eyes and head

• Oral-labio-lingual motor skills + tongue protrusion = richness of expression

• Movements in response to internal or external stimuli

Coordination of Vision and Grasping:

• Grasping

• Vision: can follow a large object for 90°

• Powerful sucking: eye-hand-mouth coordination

Communication/Socialization:

• Language = guttural sounds, crying

• Alternation of well-being/tension

• Hears but poorly locates sounds

• Responsive to their mother's voice

• Interested gaze at human faces

• Most developed sense = TOUCH

Role of the Pediatric Nurse:

• Observe the child and look for the postures they enjoy

• Observe the interactions between parents and child

• Facilitate the mother-baby meeting = help the mother perceive her child's reactions and respond + respect the child's rhythm (sleeps 16h/24).

• Adapt gestures and carrying of the baby = observe the child + create an envelope with clothes, voice... + slow gestures + support head-neck-back-seat + child on their back.

MOTOR DEVELOPMENT AT 3 MONTHS:

Head and Trunk:

• Holds head up by 3 months (abnormal if not done before 4-5 months).

• Lying on belly: supports their forearms + lifts head between 45 and 90°

Limbs:

• Regression of archaic reflexes

• Learns to synchronize and organize increasingly varied and wide movements (pedal actions...)

• 4 months: Beginning of rolling to the side

Coordination of Vision/Grasping:

• Baby shows interest in their hands when on their back: play mat

• Looks at hands

• 3-4 months: disappearance of Grasping

• Bringing hands together, same with feet on the body's midline

• Working on eye-hand-mouth coordination

• Beginning of the construction of spatial and object representation

Communication - Socialization:

• Distinguishes sounds and voices

• Cooing

• Interested in everything around, uses body language

• Around 2 months: Responsive smile (= First organizer of social relationships - Spitz). The baby understands they are a being distinct from other objects or people.

Before 2 months, the baby smiles only in sleep or shows a relaxation reaction.

Role of the Pediatric Nurse:

• Prioritize eye contact and verbalizing gestures.

• Gentle and firm gestures

• Utilize the child’s natural movements in care

• Create a safe environment (mat, bed, toys...)

• Promote the eye-hand-mouth connection

• Respect their autonomy

• Value the child

MOTOR DEVELOPMENT FROM 4 TO 6 MONTHS:

Postural-Motor Development:

• Sits on its side around 4 months

• 5-6 months: Turns over onto the belly accidentally

• 6-7 months: Rolls over from belly to back

• Strengthens the trunk

• When on their belly, they support themselves on their forearms and lift their trunk + raises arms and legs

MOTOR DEVELOPMENT FROM 6 TO 8 MONTHS:

"From Rolling to Crawling"

Up to 6 months, the baby acquires ease on their back which allows:

• Development of manipulation with their hands

• Discovery of other parts of their body (feet around 6 months)

Increased activity: they turn from belly to back without issues.

Wide variety of movements acquired through trials, attempts...

Ease of the body, absence of tension

Variety of positions

Evolution Towards Locomotion:

• Inversion of tonic state: Axial hypertonia and limb hypotonia

• From 7-8 months: starts to use rolling movements to move

• The child crawls using their arms for pulling + legs for propulsion

• They can approach and distance themselves from adults

• Constructs their body schema through experimentation

• Develops intentionality

• 8 months: some children can sit stably (sometimes at 12 months). GREAT IMPORTANCE of intermediate postures for achieving ease.

MOTOR DEVELOPMENT FROM 9 TO 12 MONTHS:

"Towards Crawling and Standing"

• The child raises themselves into a crawling position on their knees

• Climbs a lot

• Some children will never crawl on hands and knees but will scoot on their bottoms or crawl.

• Repeats movements "I stand up, I sit down"

MOTOR DEVELOPMENT FROM 10 TO 20 MONTHS:

"From First Steps to Steady Walking"

• Production and control of successive imbalances to initiate walking (modification of the center of gravity).

• Renewed exercise

Role of the Adult:

• No overly direct intervention

• Share in the child's pleasure

• Be attentive to them but do not do it for them

• Give the child the time and space necessary for the emergence of their potential

• Arrange the space to allow the child to be active

• Avoid materials that place the child in a position not achieved by themselves (bouncers, sitting aids...)