Skip to 0 minutes and 11 secondsHANNAH KUPER: Before we begin to discuss developmental disability, let us first think about child development and physical growth. Development is not to be confused with physical growth, which is the process by which our bodies increase in size resulting in increased height, weight, and so forth. Development is a much more complex process. We tend to define development as a progressive series of changes shown by a child as a result of maturation and experience. As children grow up, they will acquire new skills, knowledge, and behaviours. Examples would include learning to walk, talk, and play. This interactive dynamic process will occur in a relatively orderly, continuous manner according to a predictable pattern, both in terms of sequence and timeline.

Skip to 1 minute and 1 secondFor example, a child first learns to sit, then crawl, walk, and run. The changes will allow children to adapt to the demands of their environment and engage in everyday activities. By developing everyday skills, children can learn to become more independent of their parents. We often think about child development as a series of rigid, structured steps. But it's important to recognise that children will develop at their own pace and in their own way. No two children develop the same skill at the exact same time, nor do they perform these skills in exactly the same way.

Skip to 1 minute and 37 secondsThere are, however, important common themes, such as development in different domains, the influence of nature and nurture, and the concept of developmental stages that most children go through at similar ages. We'll be discussing these common themes in more detail throughout this presentation. So first, let's think about how children will experience development across a number of different areas and domains of functioning. As they grow, children develop larger muscles and bone tissue, allowing them to move around and manipulate their environment. Under the influence of sensory feedback and higher motor control from the brain, children are able to acquire and develop motor skills.

Skip to 2 minutes and 18 secondsThese skills are split into two categories: gross motor skills and fine motor skills. Gross motor skills are those related to large muscle groups, such as the arms and legs, which typically contribute to major skills, such as maintaining posture, walking, jumping, and throwing. Fine motor skills involve the smaller muscle groups, such as those in the hands and fingers, which will help a child develop skills like holding and drawing. By developing gross and fine motor skills, children can begin to explore and interact further afield, giving them new opportunities to learn and develop skills. In this way, physical development will contribute to and influence our next area, cognitive development. As children grow, they improve their understanding of the world through their cognitive development.

Skip to 3 minutes and 6 secondsCognitive development typically refers to a child's ability to recognise, process, and organise information that we receive through their interaction with the world around them and perform complex tasks. This development includes a variety of aspects, such as memory, problem-solving, and decision making. Children use this information to build upon existing skills and continue their development. As we have mentioned, cognitive development is closely linked to physical development. When a child's physical development progresses, they can begin to explore further afield, interacting with new places and people, giving them the opportunity to develop new cognitive skills. Linked to this development is the acquisition of communication and language. This is more than just developing the ability to talk.

Skip to 3 minutes and 53 secondsThis is the ability to perceive, understand, and communicate with others and use language.

Skip to 3 minutes and 59 secondsThere are two sets of communication skills: receptive communication and expressive communication. Receptive communication is a child's ability to understand the message from another person, or in other words, understand what someone is saying. Expressive communication is the ability to convey a message to another person. This is not limited to speech and can include facial expressions and signs, writing, and sounds. In this way, the development of communication skills is closely linked to a child's other developmental skills, including vision, hearing, motor skills, for instance, the ability to create sounds with the tongue and mouth, and affects a child's cognitive development. Communication development also links closely to our next area of social and emotional development.

Skip to 4 minutes and 48 secondsSocial and emotional development is an important domain as a child picks up social cues and shows communicative intent, developing friendships and relationships and with it an understanding and experience of values, expectations, emotions, behaviours, self-esteem. Development of these skills is complex as children become involved in increasingly complex social interactions and group activities as they grow up. Developing appropriate social skills will impact on their school success, inclusion, and participation within their community. Yet again, the different aspects of social and emotional development are linked to other areas. For instance, developing communication skills will stimulate a child's social and emotional development as the opportunities to interact with others and form relationships are enhanced.

Skip to 5 minutes and 38 secondsAs you will have gathered, these developmental domains are not isolated processes. Development in all domains occurs simultaneously, and they continually interact with one another. Development in one area will promote and reinforce development in another area. Learning to hear helps a child to communicate, which helps her to develop relationships, which will further improve her communication skills. This is a key concept and one we will revisit throughout the course. So what stimulates development? Does development depend on a child's biologically innate attributes? Or are environmental influences more important? This debate is often referred to as nature versus nurture. On one side, theorists in the nature camp argue that development is innate and follows a genetically-programmed path.

Skip to 6 minutes and 27 secondsAdvocates of this concept believe that skills and behaviours will develop naturally as a child grows, regardless of environmental influences, and so are similar across the world. On the other hand, theorists in the nurture camp would argue that a child's development is primarily influenced by their interaction with their environment, their social relationships, and surrounding culture. John Watson famously said, children are a "blank slate", ready to be moulded by positive and negative environmental experiences. This side of the argument emphasises the role and impact of caregiving. In reality, not many contemporary theories fall on either side of these extremes as it is clear that both nature and nurture are important.

Skip to 7 minutes and 10 secondsToday, theories of child development tend to incorporate arguments of both nature and nurture and the relationship between them. This follows the bio-psychosocial model in which we recognise that biological, psychological, and social factors, that is, nature and nurture, interact to influence a child's developmental progress. It also recognises that environmental exposures can result in modifications of genetic expression resulting in intrinsic and long-lasting effects. Keep these interactions in mind as we begin to think about support for children with developmental disabilities in a healthcare setting. Before we do, let's discuss the concept of typical development. Typical development is usually thought of as a series of developmental stages or milestones.

Skip to 7 minutes and 56 secondsThese developmental milestones refer to the behaviours or skills achieved by a child within a typical age range. Examples of developmental milestones include walking, running and smiling, babbling, speaking. The sequence in which skills are accomplished is considered to be fairly consistent, especially in early childhood. Although every child will develop at their own rate, developmental stages and milestones are typically achieved by a certain age. For example, children will generally begin to walk between the ages of 9 to 18 months of age. Individual variation will always occur. But if a child is not walking at, say, 24 months, we would consider this outside of typical development. This pattern is true throughout the world.

Skip to 8 minutes and 39 secondsIf you're interested in learning more about common milestones across each of the areas of development, please take a look at the links in the 'See Also' section at the bottom of the page.

Overview of child development

Following on from the animated video in the previous step, Professor Hannah Kuper (Lead Educator) will give an overview of child development and different developmental domains, as well as factors that will influence a child’s developmental progress.

Child development is a huge topic and, unfortunately, we only have time to cover the basics in this course. If you are interested to learn more, we recommend reading the documents in the ‘See Also’ section at the bottom of this page and those provided in the next step.

Discussion

  • How do you think parents can support their child’s development?
  • How can a healthcare professional support a child’s development? How can they provide support to parents?

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This video is from the free online course:

Integrated Healthcare for Children with Developmental Disabilities

London School of Hygiene & Tropical Medicine