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As toddlers and preschoolers become increasingly verbal, they may begin to stumble over their words-raising concerns about stuttering. As a parent, how do you know when disfluencies are a normal part of development and when to be more concerned? Read on.

What are Typical Disfluencies?

It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions). In fact, about 5% of all children are likely to be disfluent at some point in their development, usually between ages 2 ½ and 5. It is also very typical for a child to go back and forth between periods of fluency and disfluency. Sometimes, this can occur for no apparent reason, but often this happens when a child is excited, tired, or feels rushed to speak.

Learning language rules:

During this time, children are expanding their vocabularies rapidly and learning complex language rules. These rules allow children to change simple messages ("Mommy juice") into longer, more complicated sentences that require more motor coordination to produce smoothly ("Mommy put the juice in the blue cup"). It's only natural that there may be some disruptions along the way.

Is It Truly Stuttering?

For most toddlers and preschoolers, most disfluencies go away on their own after a short period of time. In other cases, disfluencies persist and the signs of stuttering become more obvious. Getting professional help early offers the best chances for reducing stuttering. But how can parents tell the difference between typical disfluency that will go away and the early signs of non-typical disfluencies that may indicate stuttering?

Here are some ways to differentiate typical disfluency from stuttering:

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If your child is truly stuttering, he or she may hold out the first sound in a word, saying "Ssssssssometimes we stay home," or repeat the sound, as in "Look at the b-b-b-baby!" In addition, children who stutter often develop other mannerisms such as eye blinking, tense mouth, looking to the side, and avoiding eye contact.

Risk Factors for Stuttering:

There are other risk factors that can help predict whether fluency problems will continue for longer than a few months.

Family history is the biggest predictor of whether a child is likely to stutter.

Gender. Young boys are twice as likely as young girls to stutter, and elementary school-age boys are 3 to 4 times more likely to stutter than girls.

Age of onset. Children that start having difficulties at age 4 are more likely to have a persistent stutter than those who begin stuttering at a younger age.

Co-existing speech and/or language disorders increase the likelihood a child may stutter.

Getting Help:

If you are concerned about your child's speech, talk with your pediatrician about getting a speech and language evaluation. A complete evaluation from a certified speech-language pathologist can help you to better determine if the stuttering is likely to persist.

Speech-language pathologists will help parents determine the best course of action (e.g., closely monitoring the child's fluency, enrolling in treatment services, and/or parent education). The American Speech-Language-Hearing Association (ASHA) offers a searchable database of these professionals. In addition, a list of clinicians who specialize in stuttering can be found here.

Treatment Approaches for Stuttering:

Early treatment for stuttering is very important, as it is more likely to be eliminated when a child is young (before entering elementary school). There are two main treatment approaches for stuttering:

Indirect treatment is when the speech-language pathologist helps the child's parents on how to modify their own communication styles. Indirect approaches are effective at reducing or even eliminating stuttering in many young children.

Direct treatment involves the speech-language pathologist working with the children themselves either one-on-one or in small groups, giving them specific speech strategies for easing into words and reducing tension during stuttering events. In addition, direct treatment may involve helping the child to differentiate between smooth (fluent) and bumpy (stuttered) speech.

After age 7, it becomes unlikely that stuttering will go away completely. Still, after age 7, treatment can be very effective at helping a child effectively manage stuttering-helping develop skills necessary to handle difficult situations (e.g., teasing and bullying) and participate fully in school and activities. For older children, speech treatment is still beneficial, encouraged, and effective in helping to reduce the severity and impact of stuttering.​

What Parents Can Do:

Here are some ways parents can help:

Reduce communication stress. There are different techniques to put less pressure on a child in a speaking situation. Rephrasing questions as comments (using " You played outside today at school. It must have been fun!" instead of "What did you do at school?") is one effective approach. Parents can also do their best to reduce situations that trigger their child's stuttering.

Talk about it. When children are aware of their stuttering, it is best to be open and talk about it in a positive way. Let them know it is okay to have "bumpy speech." If a child does not seem to be aware of the problem, there is no need to bring it up until you are seeing a speech-language pathologist.

Practice patience. Give children time to finish what they are saying. Don't rush or interrupt them. Don't tell them to "slow down" or "think about what you want to say." Phrases such as those are generally not helpful to children who stutter.

Model good speech habits. While telling a child how to talk is generally not helpful, parents can model speech habits that help with stuttering, such as slowing down their own speed when they talk, putting in more pauses between sentences, and speaking in a relaxed manner.

Seek a professional. There are many ways to find a speech-language pathologist. A child's pediatrician can provide a recommendation. Children younger than 3 can receive a free evaluation through their local Early Intervention Program. If a child is older than 3, parents can contact their local public school for a free evaluation. Parents also have the option to seek out a private speech-language pathologist with a child at any age. A searchable database of these professionals is available here. A list of stuttering specialists is available here. ​

Follow Your Instincts:

If you continue to have concerns about your child's speech, ask for a reevaluation or referral for additional formal testing.

Additional Information & Resources:

Copyright © 2015 American Academy of Pediatrics and American Speech-Language-Hearing Association

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stutter~ stuttering~ preschool language~ stumble over words~ toddler language~ trouble talking~ getting words out~ stumble over words~ speech development~ slp~ speech therapist~ disfluency~ disfluencies in children's speech~ is it stuttering~ genetics

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Stuttering in Toddlers & Preschoolers: What's Typical, What's Not?

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As toddlers and preschoolers become increasingly verbal, they may begin to stumble over their words-raising concerns about stuttering. As a parent, how do you know when disfluencies are a normal part of development and when to be more concerned? Read on. It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions).

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Your baby is able to communicate with you long before they speak a single word! A baby's cry, smile, and responses to you help you to understand their needs. Learn how children communicate and what to do when there are concerns about delays in development.

Milestones during the first 2 years

Children develop at different rates, but they usually are able to do certain things at certain ages. Following are general developmental milestones. Keep in mind that they are only guidelines. If you have any questions about your baby's development, ask your child's doctor-the sooner the better. Even when there are delays, early intervention can make a significant difference.

By 1 year most babies will

Look for and be able to find where a sound is coming from.

Respond to their name most of the time when you call it.

Look where you point when you say, "Look at the _________."

Babble with intonation (voice rises and falls as if they are speaking in sentences).

Take turns " talking" with you-listen and pay attention to you when you speak and then resume babbling when you stop.

Say "da-da" to dad and "ma-ma" to mom.

Say at least 1 word.

Point to items they want that are out of reach or make sounds while pointing.

Between 1 and 2 years most toddlers will

Follow simple commands, first when the adult speaks and gestures, and then later with words alone.

Get objects from another room when asked.

Point to a few body parts when asked.

Point to interesting objects or events to get you to look at them too.

Bring things to you to show you.

Point to objects so you will name them.

Name a few common objects and pictures when asked.

Enjoy pretending (for example, pretend cooking). They will use gestures and words with you or with a favorite stuffed animal or doll.

Learn about 1 new word per week between 11/2 and 2 years.

By 2 years of age most toddlers will

Point to many body parts and common objects.

Point to some pictures in books.

Follow 1-step commands without a gesture like "Put your cup on the table."

Be able to say about 50 to 100 words.

Say several 2-word phrases like "Daddy go," "Doll mine," and "All gone."

Perhaps say a few 3-word sentences like "I want juice" or "You go bye-bye."

Be understood by others (or by adults) about half of the time.

When milestones are delayed

If your child's development seems delayed or shows any of the behaviors in the following list, tell your child's doctor. Sometimes language delays occur along with these behaviors. Also, tell your child's doctor if your baby stops talking or doing things that he or she used to do.

Doesn't cuddle like other babies

Doesn't return a happy smile back to you

Doesn't seem to notice if you are in the room

Doesn't seem to notice certain noises (for example, seems to hear a car horn or a cat's meow but not when you call his or her name)

Acts as if he or she is in his or her own world

Prefers to play alone; seems to "tune others out"

Doesn't seem interested in or play with toys but likes to play with objects in the house

Has intense interest in objects young children are not usually interested in (for example, would rather carry around a flashlight or ballpoint pen than a stuffed animal or favorite blanket)

Can say the ABCs, numbers, or words to TV jingles but can't use words to ask for things he or she wants

Doesn't seem to be afraid of anything

Doesn't seem to feel pain in a typical fashion

Uses words or phrases that are unusual for the situation or repeats scripts from TV

Delays in language

Delays in language are the most common types of developmental delay. One out of 5 children will learn to talk or use words later than other children their age. Some children will also show behavioral problems because they are frustrated when they can't express what they need or want.

Simple speech delays are sometimes temporary. They may resolve on their own or with a little extra help from family. It's important to encourage your child to "talk" to you with gestures or sounds and for you to spend lots of time playing with, reading to, and talking with your infant or toddler. In some cases, your child will need more help from a trained professional, a speech and language therapist, to learn to communicate.

Sometimes delays may be a warning sign of a more serious problem that could include hearing loss, developmental delay in other areas, or even an autism spectrum disorder (ASD). Language delays in early childhood also could be a sign of a learning problem that may not be diagnosed until the school years. It's important to have your child evaluated if you are concerned about your child's language development.

What your child's doctor might do

Sometimes more information is needed about your child before your child's doctor can address your concerns. The doctor may

Ask you some questions or ask you to fill out a questionnaire.

Interact with your child in various ways to learn more about his or her development.

Order a hearing test and refer you to a speech and language therapist for testing. The therapist will evaluate your child's speech ( expressive language) and ability to understand speech and gestures ( receptive language).

Refer your child for evaluation through an early intervention program.

What to expect after the doctor's visit

If your child's doctor tells you not to worry (that your child will "catch up in time") but you are still concerned, it's OK to get a second opinion. You can ask your child's doctor for a referral to a developmental specialist or a speech and language therapist. You may also contact an early intervention program for an evaluation if your child is younger than 3 years, or your local school district if he or she is 3 or older.If what your child says ( expressive language) is the only delay, you may be given suggestions to help your child at home. Formal speech therapy may also be recommended.

If both what your child understands ( receptive language) and what he or she says are delayed and a hearing test is normal, your child will need further evaluation. This will determine whether the delays are caused by a true communication dis order, generalized developmental delays, an ASD, or another developmental problem.

When an ASD is the reason for language delays, your child will also have difficulty interacting with other people and may show some or all of the concerning behaviors listed previously. If there is concern your child might have an ASD, your child will usually be referred to a specialist or a team of specialists for evaluation and treatment of an ASD or a related disorder. The specialist(s) may then recommend speech therapy and may suggest other ways to improve social skills, behavior, and the desire to communicate.

Programs that help children and families

If your child has delays or suspected delays, your child's doctor will probably refer you to an early intervention program in your area. The staff there might do additional evaluations and reassure you that your child's development is normal or tell you that your child would benefit from some type of intervention. Your child does not need to have a diagnosis of a developmental problem to receive services through this program.

If your child is younger than 3 years, the referral may be to an early intervention program in your area. Early intervention programs are sometimes called "Part C" or "Birth to Three" programs. Early intervention is a federal- and state-funded program that helps children and their families. You may also contact the early intervention program yourself.

If your child qualifies for services, a team of specialists will work with you to develop an Individual Family Service Plan (IFSP). This plan becomes a guide for the services your child will receive until 3 years of age. It may include parent training and support, direct therapy, and special equipment. Other services may be offered if they benefit your child and family. If your child needs help after 3 years of age, the early intervention staff will transition your child to services through your local school district.

If your child is 3 years or older, the referral may be to your local public school. You may also contact the local public school directly. If your child is eligible, the school district staff will, with your input, develop an Individual Education Plan (IEP). This plan may provide some of the same services as the early intervention program but focus on school services for your child. The level of services also may be different. If your child continues to need special education and services, the IEP will be reviewed and revised from time to time.

Remember

As a parent, follow your instincts. If you continue to have concerns about your child's development, ask for a reevaluation or referral for additional formal testing.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned on this page. Web site addresses are as current as possible, but may change at any time.

More information

Is Your Toddler Communicating With You? (Copyright © 2019 American Academy of Pediatrics)

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language delay~ speech~ talking~ development~ language~ baby~ toddler~ communication~ first words~ developmental delay~ milestones~ autism

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Language Delays in Toddlers: Information for Parents

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Delays in language are the most common types of developmental delay. One in 5 children will show a developmental delay in the speech or language area.

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Child development involves the biological, psychological and emotional changes that occur in human beings between birth and the conclusion of adolescence. Childhood is divided into 3 stages of life which include early childhood, middle childhood, late childhood ( preadolescence). Early childhood typically ranges from infancy to the age of 6 years old. During this period, development is significant, as many of life's milestones happen during this time period such as first words, learning to crawl, and learning to walk. There is speculation that middle childhood or ages 6-13 are the most crucial years of a child's life. Adolescence is the stage of life that typically starts around 15 years of age, all the way up until legal adulthood. In the course of development, the individual human progresses from dependency to increasing autonomy. It is a continuous process with a predictable sequence, yet has a unique course for every child. It does not progress at the same rate and each stage is affected by the preceding developmental experiences. Because genetic factors and events during prenatal life may strongly influence developmental changes, genetics and prenatal development usually form a part of the study of child development. Related terms include developmental psychology, referring to development throughout the lifespan, and pediatrics, the branch of medicine relating to the care of children.

There are various definitions of periods in a child's development, since each period is a continuum with individual differences regarding starting and ending. Some age-related development periods and examples of defined intervals include: newborn (ages 0-4 weeks); infant (ages 4 weeks - 1 year); toddler (ages 12 months-36 months); preschooler (ages 3-5 years); school-aged child (ages 6-13 years); adolescent (ages 14-19).

Promoting child development through parental training, among other factors, promotes excellent rates of child development. Parents play a large role in a child's activities, socialization, and development. Having multiple parents can add stability to a child's life and therefore encourage healthy development. Another influential factor in children's development is the quality of their care. Child-care programs may be beneficial for childhood development such as learning capabilities and social skills.

The optimal development of children is considered vital to society and it is important to understand the social, cognitive, emotional, and educational development of children. Increased research and interest in this field has resulted in new theories and strategies, with specific regard to practice that promotes development within the school system. Some theories seek to describe a sequence of states that compose child development.

Also called "development in context" or " human ecology" theory, ecological systems theory, originally formulated by Urie Bronfenbrenner specifies four types of nested environmental systems, with bi-directional influences within and between the systems. The four systems are microsystem, mesosystem, exosystem, and macrosystem. Each system contains roles, norms, and rules that can powerfully shape development. Since its publication in 1979, Bronfenbrenner's major statement of this theory, The Ecology of Human Development has had widespread influence on the way psychologists and others approach the study of human beings and their environments. As a result of this influential conceptualization of development, these environments - from the family to economic and political structures - have come to be viewed as part of the life course from childhood through adulthood.

Jean Piaget was a Swiss scholar who began his studies in intellectual development in the 1920s. Piaget's first interests were those that dealt with the ways in which animals adapt to their environments and his first scientific article about this subject was published when he was 10 years old. This eventually led him to pursue a Ph.D. in zoology, which then led him to his second interest in epistemology. Epistemology branches off from philosophy and deals with the origin of knowledge. Piaget believed the origin of knowledge came from Psychology, so he travelled to Paris and began working on the first "standardized intelligence test" at Alfred Binet laboratories; this influenced his career greatly. As he carried out this intelligence testing he began developing a profound interest in the way children's intellectualism works. As a result, he developed his own laboratory and spent years recording children's intellectual growth and attempted to find out how children develop through various stages of thinking. This led Piaget to develop four important stages of cognitive development: sensorimotor stage (birth to age 2), preoperational stage (age 2 to 7), concrete-operational stage (ages 7 to 12), and formal-operational stage (ages 11 to 12, and thereafter). Piaget concluded that adaption to an environment (behaviour) is managed through schemes and adaption occurs through assimilation and accommodation.[2]

Sensorymotor: (birth to about age 2)

This is the first stage in Piaget's theory, where infants have the following basic senses: vision, hearing, and motor skills. In this stage, knowledge of the world is limited but is constantly developing due to the child's experiences and interactions. According to Piaget, when an infant reaches about 7-9 months of age they begin to develop what he called object permanence, this means the child now has the ability to understand that objects keep existing even when they cannot be seen. An example of this would be hiding the child's favorite toy under a blanket, although the child cannot physically see it they still know to look under the blanket.

Preoperational: (begins about the time the child starts to talk, about age 2)

During this stage of development, young children begin analyzing their environment using mental symbols. These symbols often include words and images and the child will begin to apply these various symbols in their everyday lives as they come across different objects, events, and situations. However, Piaget's main focus on this stage and the reason why he named it "preoperational" is because children at this point are not able to apply specific cognitive operations, such as mental math. In addition to symbolism, children start to engage in pretend play in which they pretend to be people they are not (teachers, superheroes). In addition, they sometimes use different props to make this pretend play more real. Some deficiencies in this stage of development are that children who are about 3-4 years old often display what is called egocentrism, which means the child is not able to see someone else's point of view, they feel as if every other person is experiencing the same events and feelings that they are experiencing. However, at about 7, thought processes of children are no longer egocentric and are more intuitive, meaning they now think about the way something looks instead of rational thinking.

Concrete: (about first grade to early adolescence)

During this stage, children between the age of 7 and 11 use appropriate logic to develop cognitive operations and begin applying this new thinking to different events they may encounter. Children in this stage incorporate inductive reasoning, which involves drawing conclusions from other observations in order to make a generalization. Unlike the preoperational stage, children can now change and rearrange mental images and symbols to form a logical thought, an example of this is reversibility in which the child now has the ability to reverse an action just by doing the opposite.

Formal operations: (about early adolescence to mid/late adolescence)

The final stage of Piaget's cognitive development defines a child as now having the ability to "think more rationally and systematically about abstract concepts and hypothetical events". Some positive aspects during this time is that child or adolescent begins forming their identity and begin understanding why people behave the way they behave. However, there are also some negative aspects which include the child or adolescent developing some egocentric thoughts which include the imaginary audience and the personal fable. An imaginary audience is when an adolescent feels that the world is just as concerned and judgemental of anything the adolescent does as they are; an adolescent may feel as if they are "on stage" and everyone is a critic and they are the ones being critiqued. A personal fable is when the adolescent feels that he or she is a unique person and everything they do is unique. They feel as if they are the only ones that have ever experienced what they are experiencing and that they are invincible and nothing bad will happen to them, it will only happen to others.

Vygotsky was a Russian theorist, who proposed the sociocultural theory. During the 1920s-1930s while Piaget was developing his own theory, Vygotsky was an active scholar and at that time his theory was said to be "recent" because it was translated out of Russian language and began influencing Western thinking. He posited that children learn through hands-on experience, as Piaget suggested. However, unlike Piaget, he claimed that timely and sensitive intervention by adults when a child is on the edge of learning a new task (called the zone of proximal development) could help children learn new tasks. This technique is called "scaffolding," because it builds upon knowledge children already have with new knowledge that adults can help the child learn. An example of this might be when a parent "helps" an infant clap or roll her hands to the pat-a-cake rhyme, until she can clap and roll her hands herself.

Vygotsky felt that development was a process and saw periods of crisis in child development during which there was a qualitative transformation in the child's mental functioning.

Attachment theory, originating in the work of John Bowlby and developed by Mary Ainsworth, is a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for understanding interpersonal relationships between human beings. Bowlby's observations of close attachments led him to believe that close emotional bonds or "attachments" between an infant and their primary caregiver is an important requirement that is necessary to form "normal social and emotional development".

Erikson, a follower of Freud's, synthesized both Freud's and his own theories to create what is known as the "psychosocial" stages of human development, which span from birth to death, and focuses on "tasks" at each stage that must be accomplished to successfully navigate life's challenges.

Erikson's eight stages consist of the following:

Trust vs. mistrust (infant)

Autonomy vs. shame (toddlerhood)

Initiative vs. guilt (preschooler)

Industry vs. inferiority (young adolescent)

Identity vs. role confusion (adolescent)

Intimacy vs. isolation (young adulthood)

Generativity vs. stagnation (middle adulthood)

Ego integrity vs. despair (old age)

John B. Watson's behaviorism theory forms the foundation of the behavioral model of development 1925. Watson was able to explain the aspects of human psychology through the process of classical conditioning. With this process, Watson believed that all individual differences in behavior were due to different learning experiences. He wrote extensively on child development and conducted research (see Little Albert experiment). This experiment had shown that phobia could be created by classical conditioning. Watson was instrumental in the modification of William James' stream of consciousness approach to construct a stream of behavior theory. Watson also helped bring a natural science perspective to child psychology by introducing objective research methods based on observable and measurable behavior. Following Watson's lead, B.F. Skinner further extended this model to cover operant conditioning and verbal behavior. Skinner used the operant chamber, or Skinner box, to observe the behavior of small organisms in a controlled situation and proved that organisms' behaviors are influenced by the environment. Furthermore, he used reinforcement and punishment to shape in desired behavior.

In accordance with his view that the sexual drive is a basic human motivation, Sigmund Freud developed a psychosexual theory of human development from infancy onward, divided into five stages. Each stage centered around the gratification of the libido within a particular area, or erogenous zone, of the body. He also argued that as humans develop, they become fixated on different and specific objects through their stages of development. Each stage contains conflict which requires resolution to enable the child to develop.

The use of dynamical systems theory as a framework for the consideration of development began in the early 1990s and has continued into the present century. Dynamic systems theory stresses nonlinear connections (e.g., between earlier and later social assertiveness) and the capacity of a system to reorganize as a phase shift that is stage-like in nature. Another useful concept for developmentalists is the attractor state, a condition (such as teething or stranger anxiety) that helps to determine apparently unrelated behaviors as well as related ones. Dynamic systems theory has been applied extensively to the study of motor development; the theory also has strong associations with some of Bowlby's views about attachment systems. Dynamic systems theory also relates to the concept of the transactional process, a mutually interactive process in which children and parents simultaneously influence each other, producing developmental change in both over time.

Stages of development may overlap or be associated with specific other aspects of development, such as speech or movement. Even within a particular developmental area, transition into a stage may not mean that the previous stage is completely finished. For example, in Erikson's discussion of stages of personality, this theorist suggests that a lifetime is spent in reworking issues that were originally characteristic of a childhood stage. Similarly, the theorist of cognitive development, Piaget, described situations in which children could solve one type of problem using mature thinking skills, but could not accomplish this for less familiar problems, a phenomenon he called horizontal decalage.

Rather than acting as independent mechanisms, genetic and environmental factors often interact to cause developmental change. Some aspects of child development are notable for their plasticity, or the extent to which the direction of development is guided by environmental factors as well as initiated by genetic factors. When an aspect of development is strongly affected by early experience, it is said to show a high degree of plasticity; when the genetic make-up is the primary cause of development, plasticity is said to be low. Plasticity may involve guidance by endogenous factors like hormones as well as by exogenous factors like infection.

One kind of environmental guidance of development has been described as experience-dependent plasticity, in which behavior is altered as a result of learning from the environment. Plasticity of this type can occur throughout the lifespan and may involve many kinds of behavior, including some emotional reactions. A second type of plasticity, experience-expectant plasticity, involves the strong effect of specific experiences during limited sensitive periods of development. For example, the coordinated use of the two eyes, and the experience of a single three-dimensional image rather than the two-dimensional images created by light in each eye, depend on experiences with vision during the second half of the first year of life. Experience-expectant plasticity works to fine-tune aspects of development that cannot proceed to optimum outcomes as a result of genetic factors working alone.

In addition to the existence of plasticity in some aspects of development, genetic-environmental correlations may function in several ways to determine the mature characteristics of the individual. Genetic-environmental correlations are circumstances in which genetic factors make certain experiences more likely to occur. For example, in passive genetic-environmental correlation, a child is likely to experience a particular environment because his or her parents' genetic make-up makes them likely to choose or create such an environment. In evocative genetic-environmental correlation, the child's genetically caused characteristics cause other people to respond in certain ways, providing a different environment than might occur for a genetically different child; for instance, a child with Down syndrome may be treated more protectively and less challengingly than a non-Down child. Finally, an active genetic-environmental correlation is one in which the child chooses experiences that in turn have their effect; for instance, a muscular, active child may choose after-school sports experiences that create increased athletic skills, but perhaps preclude music lessons. In all of these cases, it becomes difficult to know whether child characteristics were shaped by genetic factors, by experiences, or by a combination of the two.

Asynchronous development occurs in cases when a child's cognitive, physical, and/or emotional development occur at different rates. Asynchronous development is common for gifted children when their cognitive development outpaces their physical and/or emotional maturity, such as when a child is academically advanced and skipping school grade levels yet still cries over childish matters and/or still looks his or her age. Asynchronous development presents challenges for schools, parents, siblings, peers, and the children themselves, such as making it hard for the child to fit or frustrating adults who have become accustomed to the child's advancement in other areas.

1. What develops? What relevant aspects of the individual change over a period of time?

2. What are the rate and speed of development?

3. What are the mechanisms of development - what aspects of experience and heredity cause developmental change?

4. Are there typical individual differences in the relevant developmental changes?

5. Are there population differences in this aspect of development (for example, differences in the development of boys and of girls)?

When thinking about conducting psychological research on infants and children, there are certain key aspects of infants that need to be considered before embarking on research. The five key challenges to conducting research with infants are that infants:

1. cannot talk

2. have a limited behavioral repertoire

3. cannot follow instructions

4. have a short attention span

5. develop rapidly so methods need to be updated at different ages and developmental stages

The Preferential-Looking Techique was a breakthrough made by Robert L. Fantz in 1961. In his experiments, he would show the infants in his study two different stimuli. If an infant looks at one image longer than the other, there are two things that can be inferred: the infant can see that they are two different images and that the infant is showing preference to one image in some capacity. Depending on the goal of the experiment, infants may prefer to look at the novel and more interesting stimulus or they may look at the more comforting and familiar image.

Another way that children are studied is through brain imaging technology. One example used a lot in child development studies is Magnetic Resonance Imaging (MRI). These machines can be used to track brain activity, growth, and connectivity in children Brain development can be tracked from when a child is a fetus with this new technology. Another common type of brain imaging can be collected with electroencephalography (EEG). This technology can be used to diagnose seizures and encephalopathy, but considering conceptual age of the infant is important for analyzing the results.

Most of the ethical challenges that exist in studies with adults exist within children. However, there are some notable differences in ethical research that should be addressed when designing studies for children. An important consideration is that children should give their consent to participate in research. Because of the inherent power structure in most research settings, researchers must consider study designs that protect children from feeling coerced. Children are not allowed to give consent, so parents must give their informed consent for children to participate in research. Children can give their assent, which should be reliably checked by both verbal and nonverbal cues throughout their participation. Be mindful of different Institutional Review Board (IRB) expectations relating to studies with infants, children, and minors when planning a study.

Child development is not a matter of a single topic, but progresses somewhat differently for different aspects of the individual. Here are descriptions of the development of a number of physical and mental characteristics.

For North American, Indo-Iranian (India, Iran), and European girls

For North American, Indo-Iranian (India, Iran), and European boys

Thelarche (breast development) 10.5y (8y-13y)

Pubarche (pubic hair) 11y (8.5y-13.5y)

Growth spurt 11.25y (10y-12.5y)

Menarche (first menstrual bleeding) 12.5y (10.5y-14.5y)

Wisdom tooth eruption 15.5y (14y-17y)

Adult height reached 15.5y (14y-17y)

Gonadarche (testicular enlargement) 11.5y (9.5y-13.5y)

Pubarche (pubic hair) 12y (10y-14y)

Growth spurt 13y (11y-15y)

Spermarche (first ejaculation) 13.5y (11.5y-15.5y)

Wisdom tooth eruption 17y (15y-19y)

Completion of growth 17y (15y-19y)

Physical growth in stature and weight occurs over the 15-20 years following birth, as the individual changes from the average weight of 3.5 kg and length of 50 cm at full term birth to full adult size. As stature and weight increase, the individual's proportions also change, from the relatively large head and small torso and limbs of the neonate, to the adult's relatively small head and long torso and limbs. The child's pattern of growth is in a head-to-toe direction, or cephalocaudal, and in an inward to outward pattern (center of the body to the peripheral) called proximodistal.

Genetic factors play a major role in determining the growth rate, and particularly the changes in proportion characteristic of early human development. However, genetic factors can produce maximum growth only if environmental conditions are adequate. Poor nutrition and frequent injury and disease can reduce the individual's adult stature, but the best environment cannot cause growth to a greater stature than is determined by heredity.

Individual differences in height and weight during childhood are considerable. Some of these differences are due to family genetic factors, others to environmental factors, but at some points in development they may be strongly influenced by individual differences in reproductive maturation.

The American Association of Clinical Endocrinologists defines short stature as height more than 2 standard deviations below the mean for age and gender, which corresponds to the shortest 2.3% of individuals. In contrast, failure to thrive is usually defined in terms of weight, and can be evaluated either by a low weight for the child's age, or by a low rate of increase in the weight. A similar term, stunted growth, generally refers to reduced growth rate as a manifestation of malnutrition in early childhood.

Abilities for physical movement change through childhood from the largely reflexive (unlearned, involuntary) movement patterns of the young infant to the highly skilled voluntary movements characteristic of later childhood and adolescence.

"Motor learning refers to the increasing spatial and temporal accuracy of movements with practice". Motor skills can be divided into two categories: first as basic skills necessary for everyday life and secondly, as recreational skills such as skills for employment or certain specialties based on interest.

The speed of motor development is rapid in early life, as many of the reflexes of the newborn alter or disappear within the first year, and slow later. Like physical growth, motor development shows predictable patterns of cephalocaudal (head to foot) and proximodistal ( torso to extremities) development, with movements at the head and in the more central areas coming under control before those of the lower part of the body or the hands and feet. Types of movement develop in stage-like sequences; for example, locomotion at 6-8 months involves creeping on all fours, then proceeds to pulling to stand, "cruising" while holding on to an object, walking while holding an adult's hand, and finally walking independently. By middle childhood and adolescence, new motor skills are acquired by instruction or observation rather than in a predictable sequence. There are executive functions of the brain (working memory, timing measure of inhibition and switching) which are important to motor skills. Critiques to the order of Executive Functioning leads to Motor Skills, suggesting Motor Skills can support Executive Functioning in the brain.

The mechanisms involved in motor development involve some genetic components that determine the physical size of body parts at a given age, as well as aspects of muscle and bone strength. The main areas of the brain involved in motor skills are the frontal cortex, parietal cortex and basal ganglia. The dorsolateral frontal cortex is responsible for strategic processing. The parietal cortex is important in controlling perceptual-motor integration and the basal ganglia and supplementary motor cortex are responsible for motor sequences.

According to a study showing the different relationships between limbs of the body and coordination in infants, genetic components have a huge impact on motor development (Piek, Gasson, Barrett, & Case (2002)). Intra-limb correlations, like the strong relationship and distance between hip and knee joints, were studied and proved to affect the way an infant will walk. There are also bigger genetic factors like the tendency to use the left or right side of the body more, predicting the dominant hand early. Sample t-tests proved that there was a significant difference between both sides at 18 weeks for girls and the right side was considered to be more dominant (Piek et al. (2002)). Some factors, like the fact that boys tend to have larger and longer arms are biological constraints that we cannot control, yet have an influence for example, on when an infant will reach sufficiently. Overall, there are sociological factors and genetic factors that influence motor development.

Nutrition and exercise also determine strength and therefore the ease and accuracy with which a body part can be moved. Flexibility is also affected by nutrition and exercise as well. It has also been shown that the frontal lobe develops posterio-anteriorally (from back to front). This is significant in motor development because the hind portion of the frontal lobe is known to control motor functions. This form of development is known as "Portional Development" and explains why motor functions develop relatively quickly during typical childhood development, while logic, which is controlled by the middle and front portions of the frontal lobe, usually will not develop until late childhood and early adolescence. Opportunities to carry out movements help establish the abilities to flex (move toward the trunk) and extend body parts, both capacities are necessary for good motor ability. Skilled voluntary movements such as passing objects from hand to hand develop as a result of practice and learning. Mastery Climate is a suggested successful learning environment for children to promote motor skills by their own motivation. This promotes participation and active learning in children, which according to Piaget's theory of cognitive development is extremely important in early childhood rule.

Typical individual differences in motor ability are common and depend in part on the child's weight and build. Infants with smaller, slimmer, and more maturely proportionated builds tended to belly crawl and crawl earlier than the infants with larger builds. Infants with more motor experience have been shown to belly crawl and crawl sooner. Not all infants go through the stages of belly crawling. However, those who skip the stage of belly crawling are not as proficient in their ability to crawl on their hands and knees. After the infant period, typical individual differences are strongly affected by opportunities to practice, observe, and be instructed on specific movements. Atypical motor development such as persistent primitive reflexis beyond 4-6 months or delayed walking may be an indication of developmental delays or conditions such as autism, cerebral palsy, or down syndrome . Lower motor coordination results in difficulties with speed accuracy and trade-off in complex tasks.

Children with Down syndrome or Developmental coordination disorder are late to reach major motor skills milestones. A few examples of these milestones are sucking, grasping, rolling, sitting up and walking, talking. Children with Down syndrome sometimes have heart problems, frequent ear infections, hypotonia, or undeveloped muscle mass. This syndrome is caused by atypical chromosomal development. Along with Down syndrome, children can also be diagnosed with a learning disability. Learning Disabilities include disabilities in any of the areas related to language, reading, and mathematics. Basic reading skills is the most common learning disability in children, which, like other disabilities, focuses on the difference between a child's academic achievement and his or her apparent capacity to learn.

Regardless of the culture a baby is born into, they are born with a few core domains of knowledge. These principals allow him or her to make sense of their environment and learn upon previous experience by using motor skills such as grasping or crawling. There are some population differences in motor development, with girls showing some advantages in small muscle usage, including articulation of sounds with lips and tongue. Ethnic differences in reflex movements of newborn infants have been reported, suggesting that some biological factor is at work. Cultural differences may encourage learning of motor skills like using the left hand only for sanitary purposes and the right hand for all other uses, producing a population difference. Cultural factors are also seen at work in practiced voluntary movements such as the use of the foot to dribble a soccer ball or the hand to dribble a basketball.

Cognitive/intellectual

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Cognitive development is primarily concerned with ways in which young children acquire, develop, and use internal mental capabilities such as problem-solving, memory, and language.

Cognitive development has genetic and other biological mechanisms, as is seen in the many genetic causes of intellectual disability. Environmental factors including food and nutrition, the responsiveness of parents, daily experiences, physical activity and love can influence early brain development of children. However, although it is assumed that brain functions cause cognitive events, it has not been possible to measure specific brain changes and show that they cause cognitive change. Developmental advances in cognition are also related to experience and learning, and this is particularly the case for higher-level abilities like abstraction, which depend to a considerable extent on formal education.

The ability to learn temporal patterns in sequenced actions was investigated in elementary-school-age children. Temporal learning depends upon a process of integrating timing patterns with action sequences. Children ages 6-13 and young adults performed a serial response time task in which a response and a timing sequence were presented repeatedly in a phase-matched manner, allowing for integrative learning. The degree of integrative learning was measured as the slowing in performance that resulted when phase-shifting the sequences. Learning was similar for the children and adults on average but increased with age for the children. Executive function measured by Wisconsin Card Sorting Test (WCST) performance as well as a measure of response speed also improved with age. Finally, WCST performance and response speed predicted temporal learning. Taken together, the results indicate that temporal learning continues to develop in pre-adolescents and that maturing executive function or processing speed may play an important role in acquiring temporal patterns in sequenced actions and the development of this ability.

Newborn infants do not seem to experience fear or have preferences for contact with any specific people. In the first few months they only experience happiness, sadness, and anger. A baby's first smile usually occurs between 6 and 10 weeks. It is called a 'social smile' because it usually occurs during social interactions. By about 8-12 months, they go through a fairly rapid change and become fearful of perceived threats; they also begin to prefer familiar people and show anxiety and distress when separated from them or approached by strangers.

Separation anxiety is a typical stage of development to an extent. Kicking, screaming, and throwing temper tantrums are perfectly typical symptoms for separation anxiety. Depending on the level of intensity, one may determine whether or not a child has separation anxiety disorder. This is when a child constantly refuses to separate from the parent, but in an intense manner. This can be given special treatment but the parent usually cannot do anything about the situation.

The capacity for empathy and the understanding of social rules begin in the preschool period and continue to develop into adulthood. Middle childhood is characterized by friendships with age-mates, and adolescence by emotions connected with sexuality and the beginnings of romantic love. Anger seems most intense during the toddler and early preschool period and during adolescence.

Some aspects of social-emotional development, like empathy, develop gradually, but others, like fearfulness, seem to involve a rather sudden reorganization of the child's experience of emotion. Sexual and romantic emotions develop in connection with physical maturation.

Genetic factors appear to regulate some social-emotional developments that occur at predictable ages, such as fearfulness, and attachment to familiar people. Experience plays a role in determining which people are familiar, which social rules are obeyed, and how anger is expressed.

Population differences may occur in older children, if, for example, they have learned that it is appropriate for boys to express emotion or behave differently from girls, or if customs learned by children of one ethnic group are different from those learned in another. Social and emotional differences between boys and girls of a given age may also be associated with differences in the timing of puberty characteristic of the two sexes.

In addition to the course of development, previous literature has looked at how race, ethnicity, and socioeconomic status has affected child development. Some studies seem to speak to the importance of adult supervision of adolescent youth. Literature suggested that African Americans child development was sometimes differentiated on the basis of cultural socialization and racial socialization. Further, a different study found that immigrant youth tended to choose majors focusing on the fields of science and math more often than not.

Language serves the purpose of communication to express oneself through a systematic and traditional use of sounds, signs, or written symbols. There are four subcomponents in which the child must attain in order to acquire language competence. They include phonology, lexicon, morphology and syntax, and pragmatics. These subcomponents of language development are combined to form the components of language, which are sociolinguistics and literacy. Currently, there is no single accepted theory of language acquisition but various explanations of language development have been accumulated.

The four components of language development include:

Phonology is concerned with the sounds of language. It is the function, behavior, and organization of sounds as linguistic items. Phonology considers what the sounds of language are and what the rules are for combining sounds. Phonological acquisition in children can be measured by accuracy and frequency of production of various vowels and consonants, the acquisition of phonemic contrasts and distinctive features, or by viewing development in regular stages in their own speech sound systems and to characterize systematic strategies they adopt.

Lexicon is a complex dictionary of words that enables language speakers to use these words in speech production and comprehension. Lexicon is the inventory of a language's morphemes. Morphemes act as minimal meaning-bearing elements or building blocks of something in language that makes sense. For example, in the word "cat", the component "cat" makes sense as does "at", but "at" does not mean the same thing as "cat". In this example, "ca" does not mean anything.

Morphology is the study of form or forms. It is the mental system involved in word formation or to the branch of linguistics that deals with words, their internal structure and how they are formed.

Pragmatics is the study of relationships between linguistic forms and the users of those forms. It also incorporates the use of utterance to serve different functions and can be defined as the ability to communicate one's feelings and desires to others.

A child learns the syntax of their language when they are able to join words together into sentences and understand multiple-word sentences said by other people. There appear to be six major stages in which a child's acquisition of syntax develops. First, is the use of sentence-like words in which the child communicates using one word with additional vocal and bodily cues. This stage usually occurs between 12 and 18 months of age. Second, between 18 months to two years, there is the modification stage where children communicate relationships by modifying a topic word. The third stage, between two and three years old, involves the child using complete subject-predicate structures to communicate relationships. Fourth, children make changes on basic sentence structure that enables them to communicate more complex relationships. This stage occurs between the ages of two and a half years to four years. The fifth stage of categorization involves children aged three and a half to seven years refining their sentences with more purposeful word choice that reflects their complex system of categorizing word types. Finally, children use structures of language that involve more complicate syntactic relationships between the ages of five years old to ten years old.

Infants begin with cooing and soft vowel sounds. Shortly after birth, this system is developed as the infants begin to understand that their noises, or non-verbal communication, lead to a response from their caregiver. This will then progress into babbling around 5 months of age, with infants first babbling consonant and vowel sounds together that may sound like "ma" or "da". At around 8 months of age, babbling increases to include repetition of sounds, such as "da-da" and infants learn the forms for words and which sounds are more likely to follow other sounds. At this stage, much of the child's communication is open to interpretation. For example, if a child says "bah" when they're in a toy room with their guardian, it is likely to be interpreted as "ball" because the toy is in sight. However, if you were to listen to the same 'word' on a recorded tape without knowing the context, one might not be able to figure out what the child was trying to say. A child's receptive language, the understanding of others' speech, has a gradual development beginning at about 6 months. However, expressive language, the production of words, moves rapidly after its beginning at about a year of age, with a "vocabulary explosion" of rapid word acquisition occurring in the middle of the second year. Grammatical rules and word combinations appear at about age two. Between 20 and 28 months, children move from understanding the difference between high and low, hot and cold and begin to change "no" to "wait a minute", "not now" and "why". Eventually, they are able to add pronouns to words and combine them to form short sentences. Mastery of vocabulary and grammar continue gradually through the preschool and school years. Adolescents still have smaller vocabularies than adults and experience more difficulty with constructions such as the passive voice.

Vocabulary typically grows from about 20 words at 18 months to around 200 words at 21 months. From around 18 months the child starts to combine words into two-word sentences. Typically the adult expands it to clarify meaning. By 24-27 months the child is producing three or four-word sentences using a logical, if not strictly correct, syntax. The theory is that children apply a basic set of rules such as adding 's' for plurals or inventing simpler words out of words too complicated to repeat like "choskit" for chocolate biscuit. Following this there is a rapid appearance of grammatical rules and ordering of sentences. There is often an interest in rhyme, and imaginative play frequently includes conversations. Children's recorded monologues give insight into the development of the process of organizing information into meaningful units.

By three years the child begins to use complex sentences, including relative clauses, although still perfecting various linguistic systems. By five years of age the child's use of language is very similar to that of an adult. From the age of about three children can indicate fantasy or make-believe linguistics, produce coherent personal stories and fictional narrative with beginnings and endings. It is argued that children devise narrative as a way of understanding their own experience and as a medium for communicating their meaning to others. The ability to engage in extended discourse emerges over time from regular conversation with adults and peers. For this, the child needs to learn to combine his perspective with that of others and with outside events and learn to use linguistic indicators to show he is doing this. They also learn to adjust their language depending on to whom they are speaking. Typically by the age of about 9 a child can recount other narratives in addition to their own experiences, from the perspectives of the author, the characters in the story and their own views.

Child Age in Months

Language Skill

0-3

Vocal play: cry, coo, gurgle, grunt

3-

Babble: undifferentiated sounds

6-10

Babble: canonical/reduplicated syllables

13-15

Expressive jargon, intonational sentences

13-19

10-word vocabulary

14-24

50-word vocabulary

13-27

Single-word stage and a few sentences, two-to-three-word combinations, Articles: a/the, Plural: -s

23-24

Irregular past: went, modal and verb: can/will, 28 to 436-word vocabulary, 93-265 utterances per hour

25-27

Regular past: -ed, Auxiliary "be": -'m, -'s

23-26

Third-person singular: -s, 896 to 1 507-word vocabulary, 1 500 to 1 700 words per hour

Although the role of adult discourse is important in facilitating the child's learning, there is considerable disagreement among theorists about the extent to which children's early meanings and expressive words arise. Findings about the initial mapping of new words, the ability to decontextualize words, and refine meaning of words are diverse. One hypothesis is known as the syntactic bootstrapping hypothesis which refers to the child's ability to infer meaning from cues, using grammatical information from the structure of sentences. Another is the multi-route model in which it is argued that context-bound words and referential words follow different routes; the first being mapped onto event representations and the latter onto mental representations. In this model, parental input has a critical role but the children ultimately rely on cognitive processing to establish subsequent use of words. However, naturalistic research on language development has indicated that preschoolers' vocabularies are strongly associated with the number of words addressed to them by adults.

There is no single accepted theory of language acquisition. Instead, there are current theories that help to explain theories of language, theories of cognition, and theories of development. They include the generativist theory, social interactionist theory, usage-based theory ( Tomasello), connectionist theory, and behaviorist theory ( Skinner). Generativist theories refer to Universal Grammar being innate where language experience activates innate knowledge. Social interactionist theories define language as a social phenomenon. This theory states that children acquire language because they want to communicate with others; this theory is heavily based on social-cognitive abilities that drive the language acquisition process. Usage-based theories define language as a set of formulas that emerge from the child's learning abilities in correspondence with its social cognitive interpretation and understanding of the speakers' intended meanings. Connectionist theories is a pattern-learning procedure and defines language as a system composed of smaller subsystems or patterns of sound or meaning. Behaviorist theories define language as the establishment of positive reinforcement, but is now regarded a theory of historical interest.

Communication can be defined as the exchange and negotiation of information between two or more individuals through verbal and nonverbal symbols, oral and written (or visual) modes, and the production and comprehension processes of communication. According to First International Congress for the Study of Child Language, "the general hypothesis [is that] access to social interaction is a prerequisite to normal language acquisition". Principles of conversation include two or more people focusing on one topic. All questions in a conversation should be answered, comments should be understood or acknowledged and any form of direction should, in theory, be followed. In the case of young, undeveloped children, these conversations are expected to be basic or redundant. The role of a guardians during developing stages is to convey that conversation is meant to have a purpose, as well as teaching them to recognize the other speaker's emotions. Communicative language is nonverbal and/or verbal, and to achieve communication competence, four components must be met. These four components of communication competence include: grammatical competence (vocabulary knowledge, rules of word sentence formation, etc.), sociolinguistic competence (appropriateness of meanings and grammatical forms in different social contexts), discourse competence (knowledge required to combine forms and meanings), and strategic competence (knowledge of verbal and nonverbal communication strategies). The attainment of communicative competence is an essential part of actual communication.

Language development is viewed as a motive to communication, and the communicative function of language in-turn provides the motive for language development. Jean Piaget uses the term "acted conversations" to explain a child's style of communication that rely more heavily on gestures and body movements, rather than words. Younger children depend on gestures for a direct statement of their message. As they begin to acquire more language, body movements take on a different role and begin to complement the verbal message. These nonverbal bodily movements allow children to express their emotions before they can express them verbally. The child's nonverbal communication of how they're feeling is seen in babies 0 to 3 months who use wild, jerky movements of the body to show excitement or distress. This develops to more rhythmic movements of the entire body at 3 to 5 months to demonstrate the child's anger or delight. Between 9-12 months of age, children view themselves as joining the communicative world. Before 9-12 months, babies interact with objects and interact with people, but they do not interact with people about objects. This developmental change is the change from primary intersubjectivity (capacity to share oneself with others) to secondary intersubjectivity (capacity to share one's experience), which changes the infant from an unsociable to socially engaging creature. Around 12 months of age a communicative use of gesture is used. This gesture includes communicative pointing where an infant points to request something, or to point to provide information. Another gesture of communication is presented around the age of 10 and 11 months where infants start gaze-following; they look where another person is looking. This joint attention result in changes to their social cognitive skills between the ages of 9 and 15 months as their time is spent increasingly with others. Children's use of non-verbal communicative gestures foretells future language development. The use of non-verbal communication in the form of gestures indicate the child's interest in communication development, and the meanings they choose to convey that are soon revealed through the verbalization of language.

Language acquisition and development contribute to the verbal form of communication. Children originate with a linguistic system where words they learn, are the words used for functional meaning. This instigation of speech has been termed pragmatic bootstrapping. According to this, children view words as a means of social construction, and that words are used to connect the understanding of communicative intentions of the speaker who speaks a new word. Hence, the competence of verbal communication through language is achieved through the attainability of syntax or grammar. Another function of communication through language is pragmatic development. Pragmatic development includes the child's intentions of communication before he/she knows how to express these intentions, and throughout the first few years of life both language and communicative functions develop.

Delays in language is the most frequent type of developmental delay. According to demographics 1 out of 5 children will learn to talk or use words later than other children their age. Speech/ language delay is three to four times more common in boys than in girls. Some children will also display behavioral problems due to their frustration of not being able to express what they want or need.

Simple speech delays are usually temporary. Most cases are solved on their own or with a little extra attribution from the family. It's the parent's duty to encourage their baby to talk to them with gestures or sounds and for them to spend a great amount of time playing with, reading to, and communicating with their baby. In certain circumstances, parents will have to seek professional help, such as a speech therapist.

It is important to take into considerations that sometimes delays can be a warning sign of more serious conditions that could include auditory processing disorders, hearing loss, developmental verbal dyspraxia, developmental delay in other areas, or even an autism spectrum disorder (ASD).

There are many environmental causes that are linked to language delays and they include situations such as, the child is having their full attention on other skills, such as walking perfectly, rather than on language. The child may have a twin or a sibling in which their age are relatively close, and may not be receiving the parent's full attention. Another circumstance could be a child that is in a daycare that provides few adults to be able to administer individual attention. Perhaps the most obvious component would be a child that suffers from psychosocial deprivation such as poverty, malnutrition, poor housing, neglect, inadequate linguistic stimulation, or emotional stress.

Language delay can be caused by a substantial number of underlying disorders, such as intellectual disability. Intellectual disability takes part for more than 50 percent of language delays. Language delay is usually more rigorous than other developmental delays in intellectually disabled children, and it is usually the first obvious symptom of intellectual disability. Intellectual disability accounts to global language delay, including delayed auditory comprehension and use of gestures.

Impaired hearing is one of the most common causes of language delay. A child who can not hear or process speech in a clear and consistent manner will have a language delay. Even the most minimum hearing impairment or auditory processing deficit can considerably affect language development. Essentially, the more the severe the impairment, the more serious the language delay. Nevertheless, deaf children that are born to families who use sign language develop infant babble and use a fully expressive sign language at the same pace as hearing children.

Developmental Dyslexia is a developmental reading disorder that occurs when the brain does not properly recognize and process the graphic symbols chosen by society to represent the sounds of speech. Children with dyslexia may encounter problems in rhyming and separating sounds that compose words. These abilities are essential in learning to read. Early reading skills rely heavily on word recognition. When using an alphabet writing system this involves in having the ability to separate out the sounds in words and be able to match them with letter and groups of letters. Because they have trouble in connecting sounds of language to the letter of words, this may result difficulty in understanding sentences. They have confusion in mistaking letters such as "b" and "d". For the most part, symptoms of dyslexia may include, difficulty in determining the meaning of a simple sentence, learning to recognize written words, and difficulty in rhyming.

Autism and speech delay are usually correlated. Problems with verbal language are the most common signs seen in autism. Early diagnosis and treatment of autism can significantly help the child improve their speech skills. Autism is recognized as one of the five pervasive developmental disorders, distinguished by problems with language, speech, communication and social skills that present in early childhood. Some common autistic syndromes are the following, being limited to no verbal speech, echolalia or repeating words out of context, problems responding to verbal instruction and may ignore others who speak directly.

Although there are a large number of studies contemplating the effect of maternal depression and postnatal depression of various areas of infant development, they are yet to come to a consensus regarding the true effects. There are numerous studies indicating impaired development, and equally, there are many proclaiming no effect of depression on development. A study of 18-month-olds whose mothers had depressive symptoms while they were 6 weeks and/or 6 months old indicated that maternal depression had no effect on the child's cognitive development at 18 months. Furthermore, the study indicates that maternal depression combined with a poor home environment is more likely to have an effect on cognitive development. However, the authors conclude that it may be that short term depression has no effect, where as long term depression could cause more serious problems. A further longitudinal study spanning 7 years again indicate no effect of maternal depression on cognitive development as a whole, however it found a gender difference in that boys are more susceptible to cognitive developmental issues when their mothers had depression. This thread is continued in a study of children up to 2 years old. The study reveals a significant difference on cognitive development between genders, with girls having a higher score, however this pattern is found regardless of the child's mother's history of depression. Infants with chronically depressed mothers showed significantly lower scores on the motor and mental scales within the Bayley Scales of Infant Development, contrasting with many older studies. A similar effect has been found at 11 years: male children of depressed mothers score an average of 19.4 points lower on an Intelligence Quotient IQ test than those with healthy mothers, although this difference is much lower in girls. 3 month olds with depressed mothers show significantly lower scores on the Griffiths Mental Development Scale, which covers a range of developmental areas including cognitive, motor and social development. It has been suggested that interactions between depressed mothers and their children may affect social and cognitive abilities in later life. Maternal depression has been shown to influence the mothers' interaction with her child. When communicating with their child, depressed mothers fail to make changes to their vocal behaviour, and tend use unstructured vocal behaviours. Furthermore, when infants interact with depressed mothers they show signs of stress, such as increased pulse and raised cortisol levels, and make more use of avoidance behaviours, for example looking away, compared to those interacting with healthy mothers. The effect of mother-infant interaction at 2 months has been shown to affect the child's cognitive performance at 5 years. Recent studies have begun to identify that other forms of psychopathology that may or may not be co-morbidly occurring with maternal depression can independently influence infants' and toddlers' subsequent social-emotional development through effects on regulatory processes within the child-parent attachment. Maternal interpersonal violence-related post-traumatic stress disorder (PTSD), for example, has been associated with subsequent dysregulation of emotion and aggression by ages 4-7 years.

The use of cocaine by pregnant women is not the only drug that can have a negative effect on the fetus. Tobacco, marijuana, and opiates are also the types of drugs that can affect an unborn child's cognitive and behavioral development. Smoking tobacco increases pregnancy complications including low birth rate, prematurity, placental abruption, and intrauterine death. It can also cause disturbed maternal-infant interaction; reduced IQ, ADHD, and it can especially cause tobacco use in the child. Parental marijuana exposure may have long-term emotional and behavioral consequences. A ten-year-old child who had been exposed to the drug during pregnancy reported more depressive symptoms than fetuses unexposed. Some short-term effects include executive function impairment, reading difficulty, and delayed state regulation. An opiate drug, such as heroin, decreases birth weight, birth length, and head circumference when exposed to the fetus. Parental opiate exposure has greater conflicting impact than parental cocaine exposure on the infant's Central Nervous System and autonomic nervous system. There are also some negative consequences on a child that you wouldn't think of with opiates, such as: less rhythmic swallowing, strabismus, and feelings of rejection.

Poor nutrition early in life contributes to stunting, and by the age of two or three can be associated with cognitive deficits, poor school achievement, and poor social relationships later in life Malnutrition is a large problem in developing nations, and has an important effect on young children's weight and height. Children suffering malnutrition in Colombia weighed less than those living in upper class conditions at the age of 36 months (11.88 kg compared to 14 kg), similarly, malnourished children were shorter than well-nourished children, again at 36 months (85.3 cm in malnourished children; 94 cm in well-nourished children Malnutrition during the first 1000 days of a child's life can cause irreversible physical and mental stunting. Infections and parasites related to poor sanitation and hygiene can impact absorption of nutrients in the gut. Adequate sanitation and hygiene (rather than just access to food) play a critical role in preventing undernutrition, malnutrition and stunting and ensuring normal early childhood development. Malnutrition has been indicated as a negative influence on childhood Intelligence Quotient IQ. Although it is now suggested that this effect is nullified when parental IQ is considered, implying that this difference is genetic.

Socioeconomic status is measured primarily based on the factors of income, educational attainment and occupation. Current investigations into the role of socioeconomic factors on child development repeatedly show that continual poverty is more harmful on Intelligence Quotient IQ, and cognitive abilities than short-lived poverty. Children in families who experience persistent financial hardships and poverty have significantly impaired cognitive abilities compared to those in families who do not face this issue. Low income poverty can cause a number of further issues shown to effect child development, such as poor academic success, less family involvement, iron deficiency, infections, a lack of stimulation, malnutrition and lead poisoning due to lead paint found on the walls of some houses. Child blood levels of lead increase as income decreases. Income poverty is associated with a 6-13 point reduction in IQ for those earning half of the poverty threshold compared to those earning twice the poverty threshold. That being said, children coming from households featuring continual or temporary poverty still perform lower than children in middle-class families.

Mother's employment is associated with slightly lower test scores, regardless of socioeconomic status. However, those whose working mother is of a higher socioeconomic status experience more disadvantages because they are being removed from a more enriching environment than a child care. Obviously, the quality of child care is a factor to be considered. Low income children tend to be cared for by grandparents or extended family and therefore form strong bonds with family. High income children tend to be cared for in a child care setting or in home care such as a nanny. If the mother is highly educated, this can be a disadvantage to the child. Even with quality of care controlled for, studies still found a negative correlation between full-time work within the first year and child development. Children whose mothers work are also less likely to receive regular well-baby doctor visits and less likely to be breastfed, which has been proven to improve developmental factors. Effects are felt more strongly when women resume full-time work within the first year of the child's life. These effects may be due in part to pre-existing differences between mothers who return to work and those who do not such as differences in character or reason for returning to work.

Diarrhea caused by the parasitic disease Giardiasis is associated with lower IQ. Parasitic worms (helminths) are associated with nutritional deficiencies that are known to be a risk to child development. In particular, intestinal parasitism being one of the most neglected tropical diseases in the developed world. Harboring of this parasite could adverse several health implications in children affecting childhood development and morbidity. Prolongued exposure to faecally-transmitted infections (FTIs), including environmental enteropathy, other intestinal infections, and parasites during early childhood can lead to irreversible stunting. Reducing the prevalence of the parasite can be a benefit in child growth, development, and educational outcome.

High levels of lead in the blood is associated with attention deficits, while arsenic poisoning has a negative effect on verbal and full Intelligence Quotient IQ. Manganese poisoning due to levels in drinking water is also associated with a reduced IQ of 6.2 points between the highest and lowest level of poisoning. Prenatal exposure to various pesticides including organophosphates, and chlorpyrifos has also been linked to reduced IQ score. Organophosphates have been specifically linked to poorer working memory, verbal comprehension, perceptual reasoning and processing speed.

When a child is unable to meet their developmental goals, because they have not been provided with the correct amount of care, stimulation or nutrition this situation is commonly referred to as child neglect. It is the most widespread form of child abuse. Neglect accounted for 78% of all child abuse cases in the United States in 2010 alone. Scientific studies show that exposure to child neglect can have lifelong consequences for children.

Assessing and identifying neglect pose a number of challenges for practitioners. Given that neglect is a dynamic between the child's development and levels of nurturance, the question in identifying neglect, becomes one of where do you start, with the child's development or with the levels of nurturance?

Some professionals identify neglect by measuring the developmental levels of a child, for if those developmental levels are normal, one can, by definition, conclude that a child is not being neglected. Areas of development that could be measured include weight, height, stamina, social & emotional responses, speech and motor development. All these features go up to make a medical assessment of whether a child is thriving, so that a professional looking to start an assessment of neglect, might reasonably start with information collected by a doctor. Infants are often weighed and measured when seen by their physicians for well-baby check-ups. The physician initiates a more complete evaluation when the infant's development and functioning are found to be delayed. What this suggests is that social work staff could consult medical notes to establish if the baby or child is failing to thrive, as a first step in a pathway towards identifying neglect. If developmental levels are subnormal, then the identification of neglect then requires the professional establish if those subnormal levels of development can be put down to the level of nurturance experienced by the child. One needs to discount that the developmental delay was caused by some genetic condition or disease, which do not have their basis in a lack of nurturance.

The method, which focuses on the stimulation provided by the carer, can be subject to critique. Neglect is about the child's development being adversely affected by the levels of nurturance, but the carers' provision of nurturance is not always a good indicator of the level of nurturance received by the child. Neglect may be occurring at school, outside of parental care. The child may be receiving nurturance from siblings or through a boarding school education, which compensates for the lack of nurturance provided by the parents.

Neglect is a process whereby children experience developmental delay owing to experiencing insufficient levels of nurturance. It has been argued that in principle, this means that when starting an assessment of neglect by identifying developmental delay one needs to then check the levels of nurturance received by the child. Certainly, where guidance on identifying neglect does urge for practitioners to measure developmental levels, some guidance urges practitioners to focus on how developmental levels can be attributed to parental behaviour. However, the narrow focus on parental behaviour can be criticised for unnecessarily ruling out the possible effect of institutionalised neglect, e.g. neglect at school.

If one starts by concluding that the levels of nurture received by the child are insufficient, one then needs to consider the developmental levels achieved by the child.

Further challenges arise, however. Even when one has established developmental delay and exposure to low levels of nurture, one needs to rule out the possibility that the link between the two is coincidental. The developmental delay may be caused by a genetic disorder, disease or physical, sexual or emotional abuse. The developmental delay may be caused by a mixture of underexposure to nurture, abuse, genetics, and disease.

Early intervention programs and treatments in developed countries include individual counselling, family, group counselling and social support services, behavioural skills training programs to eliminate problematic behaviour and teach parents "appropriate" parenting behaviour.

Video interaction guidance is a video feedback intervention through which a "guider" helps a client to enhance communication within relationships. The client is guided to analyse and reflect on video clips of their own interactions. Video Interaction Guidance has been used where concerns have been expressed over possible parental neglect in cases where the focus child is aged 2-12, and where the child is not the subject of a child protection plan.

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Child development involves the biological, psychological and emotional changes that occur in human beings between birth and the conclusion of adolescence. Childhood is divided into 3 stages of life which include early childhood, middle childhood, late childhood ( preadolescence). Early childhood typically ranges from infancy to the age of 6 years old.

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Did you know that injuries are the leading cause of death of children younger than 4 years in the United States? Most of these injuries can be prevented.

Often, injuries happen because parents are not aware of what their children can do. Children learn fast, and before you know it your child will be jumping, running, ridinga tricycle, and using tools. Your child is at special risk for injuries from falls, drowning, poisons, burns, and car crashes. Your child doesn't understand dangers or remember "no" while playing and exploring.

Falls

Because your child's abilities are so great now, he or she will find an endless variety of dangerous situations at home and in the neighborhood.

Your child can fall off play equipment, out of windows, down stairs, off a bike or tricycle, and off anything that can be climbed on. Be sure the surface under play equipment is soft enough to absorb a fall. Use safety tested mats or loose-fill materials (shredded rubber, sand, woodchips, or bark) maintained to a depth of at least 9 inches underneath play equipment. Install the protective surface at least 6 feet (more for swings and slides) in all directions from the equipment.

Lock the doors to any dangerous areas. Use gates on stairways and install operable window guards above the first floor. Fence in the play yard. If your child has a serious fall or does not act normally after a fall, call your doctor.

Firearm Hazards

Children in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder. It is best to keep all guns out of the home. If you choose to keep a gun, keep it unloaded and in a locked place, with ammunition locked separately. Handguns are especially dangerous. Ask if the homes where your child visits or is cared for have guns and how they are stored.

Burns

The kitchen can be a dangerous place for your child, especially when you are cooking. If your child is
underfoot, hot liquids, grease, and hot foods can spill on him or her and cause serious burns. Find something safe for your child to do while you are cooking.

Remember that kitchen appliances and other hot surfaces such as irons, ovens, wall heaters, and outdoor grills can burn your child long after you have finished using them. If your child does get burned, immediately put cold water on the burned area. Keep the burned area in cold water for a few minutes to cool it off. Then cover the burn loosely with a dry bandage or clean cloth. Call your doctor for all burns. To protect your child from tap water scalds, the hottest temperature a the faucet should be no more than 120°F. In many cases you can adjust your hot water heater.

Make sure you have a working smoke alarm on every level of your home, especially in furnace and sleeping areas. Test the alarms every month. It is best to use smoke alarms with long-life batteries, but if you do not, change the batteries at least once a year.

Poisonings

Your child will be able to open any drawer and climb anywhere curiosity leads. Your child may swallow anything he or she finds. Use only household products and medicines that are absolutely necessary and keep them safely capped and out of sight and reach. Keep all products in their original containers.
If your child does put something poisonous in his or her mouth, call the Poison Help Line immediately. Attach the Poison Help Line number (1-800-222-1222) to your phone. Do not make your child vomit.
And Remember Car Safety

Car crashes are the greatest danger to your child's life and health. The crushing forces to your child's brain and body in a collision or sudden stop, even at low speeds, can cause injuries or death. To prevent these injuries, correctly USE a car safety seat EVERY TIME your child is in the car. If your child weighs more than the highest weight allowed by the seat or if his or her ears come to the top of the car safety seat, use a belt positioning booster seat.

The safest place for all children to ride is in the back seat. In an emergency, if a child must ride in the front seat, move the vehicle seat back as far as it can go, away from the air bag.

Do not allow your child to play or ride a tricycle in the street. Your child should play in a fenced yard or playground. Driveways are also dangerous. Walk behind your car before you back out of your driveway to be sure your child is not behind your car. You may not see your child through the rear view mirror.

Remember, the biggest threat to your child's life and health is an injury.​

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tipp~ safety~ safe~ safety for your child~ children~ parents~ prevention~ injury prevention~ hazards~ 2-years-old~ 3-years-old~ 4-years-old

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Did you know that injuries are the leading cause of death of children younger than 4 years in the United States? Most of these injuries can be prevented. Often, injuries happen because parents are not aware of what their children can do.

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Helpful Tips for Reading to your Toddler

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Helpful Tips for Reading to your Toddler

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​Even toddlers can enjoy books and learn from sharing books with you. Sharing books with your children can help them learn to talk better and get them ready to listen and learn in school.

Making Books A Part of Your Child's Bedtime Routine:

Set aside 10 to 20 minutes with the TV off for sharing books as part of your regular bedtime routine. Regular bedtime routines started when children are young help prevent future bedtime struggles. Teaching your children how to fall asleep alone by putting them in bed awake helps prevent future night wakings.

2 Year Olds Can:

Choose a book to share.

Enjoy sharing the same book over and over and over again!

Repeat some of the words and phrases you say or read.

Ask you questions, such as: "What's that?"

Enjoy a trip to your local public library for Story Time or to borrow some books.

What Parents Can Do:

Find a quiet, comfortable place for book sharing.

Use book-sharing as a way to calm and comfort your child.

Start a conversation by repeating an important word your child has just said, You can say: "Balloon. Lots of balloons. The girl has lots of balloons." Then wait for your child to say something more.

Count pictures and wait for your child to repeat the numbers after you.

Respond with enthusiasm to your child's questions and comments.

3 Year Olds Can:

Name the books they want to share with you.

Pretend to read a favorite book aloud to you.

Tell you how a story is like things they have seen or done.

Ask you questions about books you are enjoying together.

"Correct" you if you skip a word or page in a favorite book.

Tell you the story in a favorite book in their own words.

What Parents Can Do:

Find a quiet, comfortable place for book sharing.

Ask your child to tell you about the pictures and the story.

Respond with enthusiasm to your child's questions and comments.

Ask your child to show you all the things in a picture that are alike in some way. You can say: "Can you find all the blue things?" or "Show me all the things that can fly."

Point out colors, shapes, numbers in their books.

Take your child to the local public library to borrow books or to enjoy Story Time.

Committee on Early Childhood (Copyright © 1994 American Academy of Pediatrics)

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book~ books~ reading~ learning to read~ read~ bedtime~ story~ stories~ toddler~ 2 year old~ 3 year old~ school~ word~ words~ language development~ library

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How to Share Books with 2 and 3 Year Olds

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​Even toddlers can enjoy books and learn from sharing books with you. Sharing books with your children can help them learn to talk better and get them ready to listen and learn in school. Set aside 10 to 20 minutes with the TV off for sharing books as part of your regular bedtime routine.

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9 Things to Say During Potty Training | Parenting Tips & Advice | PBS KIDS for Parents

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Potty training is a major milestone for both children and adults, and knowing what to say during this journey is important. Here are nine things to say to your toddler during potty training.

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8 Apps That Support Children's Social-Emotional Growth | Parenting Tips & Advice | PBS KIDS for Parents

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Discover apps that support children's social and emotional skills and offer helpful tips and advice for parents.

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Milestones

Milestones are scientifically-supported behavioral or physical checkpoints seen in infants and children as they grow and develop. All of our developmental milestones are validated by American Academy of Pediatrics findings.

Abilities

Abilities are additional skills your child should be developing. When reviewing abilities, look at your child's overall behavior to gauge their progress.

Be sure to adjust for prematurity. If your child is missing any milestones, be sure to talk with your healthcare provider.

Missing one or two abilities should not cause alarm, as every child develops differently. However, if they are missing multiple abilities, be sure to talk with your healthcare provider.

Key Milestones
By 15 Months:

May use 5-10 words

Combines sounds and gestures

Imitates simple words and actions

Consistently follows simple directions

Shows interest in pictures

Can identify 1-2 body parts when named

Understands 50 words

By 18 Months:

Responds to questions

Continues to produce speech-like babbling

Points at familiar objects and people in pictures

Understands "in" and "on"

Responds to yes/no questions with head shake/nod

Repeats words overheard in conversation

Doesn't babble

Doesn't hold eye contact

Doesn't respond when name is called

Doesn't make any attempts to communicate

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Milestones for 13-18 Month Olds | Track Toddler Milestones

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Milestones are scientifically-supported behavioral or physical checkpoints seen in infants and children as they grow and develop. All of our developmental milestones are validated by American Academy of Pediatrics findings. Abilities are additional skills your child should be developing. When reviewing abilities, look at your child's overall behavior to gauge their progress.

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Developmental Checklist for 2 months- 5 years old

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Developmental Checklist for 2 months- 5 years old

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TN Developmental Checklist