Introduction to Child
Development
Dr Neil Wigg
Executive Director
Community Child Health Service
Children’s Health Services
August 2010
Why child development?
• Developmental disorders affect functioning and
thus health
• Overlap of chronic conditions (especially
neurologic) and developmental disorders
• Management of medical conditions in childhood is
influenced by developmental status
• Developmental disorders have a biologic basis and
often have life-long implications
• Examples of successful medical & other
interventions
definitions
• Defect - abnormality of structure
• Deformity - deviation from normal
shape or form
• Disability - loss/absence of function
or skill
• Handicap - condition which impedes
development, opportunity,
expectation or activity
Clinical approaches
• Based on “objective, observable”
elements
• Assessment: history
observation of behaviour
examinations (hearing/vision)
formal tests - age referenced
• developmental diagnosis
Prevalence of Developmental
Disorders
• Intellectual impairment ~1% (includes
impaired adaptive function)
• Global Developmental Delay 3%
• “Slow Learner” 10-12%
• Autism Spectrum Disorder 0.6%
• Attention Deficit Hyperactivity Disorder
3-5%
• Speech & Language Disorder 5-10%
• Permanent Sensorineural Deafness 0.2%
Intellectual Impairment
• Cognitive functioning on standardised
testing of IQ <70
AND
Impaired adaptive functioning (related
to social adjustment, self-care and
practical problem solving)
Case example
• Jonathon age 7
• Extreme behaviour difficulties in
year2 at regular school
• Moderate Intellectual impairment
• “normal” adaptive/self-care skills
Autism Spectrum Disorder
• Childhood Autism
• Asperger Syndrome
• Pervasive Developmental Disorder –
not otherwise specified
• ?Rett’s Syndrome
[Disorders of language, social skills,
perception and repetitive/obsessive
behaviours]
Case example
• Jordan age 4 –abilities to read and
write
• Jordan age 5 – coping with Special
Education Development Unit
• Jordan age 6 – over-achieving in a
Special School environment
Case example
• Joseph age 6 in year 1 at local State
School
• Knowledge of electromagnetism
• Social rules
• Coping with sport
ADHD
• Criterion based
• Use of standard classifications eg
DSM4 or ICD10 etc
• Inattentive AND impulsive/overactive
behaviours
• More than one setting
• Interferes with functioning
Developmental Disorders
• Note high level of co-morbidity
For example, children with ADHD frequently
have developmental co-ordination disorder
(DCD), and specific learning disabilities
Overlap of ASD with Obsessive Compulsive
Disorder and Intellectual Impairment
“rule of thumb – 1/3 one disorder, 2/3 more
than one disorder”
Nature of Development
- domains
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motor - gross motor and fine motor
communication - speech and language
personal-social + emotion
cognitive + moral
adaptive - problem solving, self
regulation
Nature of Development
- theoretical perspectives
•
•
•
•
•
•
Neuro-developmental
Psychodynamic
Cognitive/structural
Social/learning
Transactional
etc, etc
(early) Human Development is
•
•
•
•
•
•
Dynamic
Sequential
Increasingly complex
Purposeful
Contingent
“on-going”
Nature of Development
- key clinical issues
• range of normal
• delayed/advanced development
• disordered development
Concept of developmental
health
• Early life determinants (Barker
hypothesis)
• Life course trajectories of health
• Neurobiology of brain growth –
sensitive periods for development
• Impact of early interventions
Synthesis of current research
“From Neurons to Neighborhoods. The
Science of Early Childhood
Development”
JP Shonkoff & DA Phillips (Editors)
Board of Children, Youth and Families
US 2000
core concepts
1. Human development is shaped by a
dynamic and continuous interaction
between biology and experience
2. Culture influences every aspect of
human development and is reflected
in childrearing beliefs and practices
designed to promote healthy
adaptation
core concepts
3. The growth of self-regulation is a
cornerstone of early childhood
development that cuts across all
domains of behaviour
4. Children are active participants in
their own development, reflecting the
intrinsic human drive to explore and
master one’s environment.
core concepts
5. Human relationships, and the effects of
relationships on relationships, are the
building blocks of healthy development.
6. The broad range of individual differences
among young children often makes it
difficult to distinguish normal variations
and maturational delays from transient
disorders and persistent impairments.
core concepts
7. The development of children unfolds along
individual pathways whose trajectories are
characterised by continuities and
discontinuities, as well as a series of
significant transitions.
8. Human development is shaped by the
ongoing interplay among sources of
vulnerability and sources of resilience.
core concepts
9. The timing of early experiences can
matter, but, more often than not, the
developing child remains vulnerable to
risks and open to protective
influences throughout the early years
of life into adulthood.
core concepts
10 The course of development can be
altered in early childhood by
effective interventions that change
the balance between risk and
protection, shifting the odds in
favour of more adaptive outcomes.
Shonkoff & Phillips 2000
Current directions
The Rudd/Gillard Government has
• A broad Early Childhood agenda
• A focus on developmental health
• Introduced the Australian Early
Developmental Index (AEDI) nationwide
In summary ~
When considering the development of
any child think about
skills
social competence