PERKEMBANGAN BAYI Newborn are called Neonate. First four weeks of life (neonatal period) ◦ A time of transition from the uterus, where a fetus is supported entirely by the mother to an independent existence. When neonate are first born: ◦ ◦ ◦ ◦ ◦ Covered by fluid from amniotic sac Blood from placenta Brownish fluid from own faeces. Covered with lanugo (fuzzy prenatal hair) Covered with vernix caseosa (cheesy varnish) Size and Appearance ◦ ◦ ◦ ◦ New babies have distinctive feature a large head and a receding chin On the head Fontanels (the soft spots) Newborns have a pinkish cast skin so thin that it barely covers the capillaries through which blood flows. Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth than laterborns Weight : 2.8 -3.2 kg Length : 51-53 cm (Boy > girl) Head Circumference: 30-33 cm Breathing: Blood pressure become stable in 10 days. ◦ ◦ Initially fast, short & irregular Later more stable & with rhythm Medical and Behavioral Screening 1. Apgar Scale 2. The Brazelton Neonatal Behavioral Assessment Scale 3. Checks are also done for any structural or physical deformities (eg. spinal defect, cleft palate) Silver nitrate or tetracycline is usually dropped into neonate eyes to prevent from bacterial infection while passing through birth canal. Apgar Scale is a standard measurement of a newborn’s condition Introduced by Dr. Virginia Apgar Access newborn 1 min after birth 5 min after birth Assess: Appearance (colour) Pulse (heart beat rate) Grimace (reflex) Activity (muscle tone) Respiration (breathing) Sign 0 1 2 Appearance Blue, pale Body pink, extremities blue Entirely Pink Pulse Absent Slow (below 100) Rapid (over 100) Grimace No response Grimace Coughing, sneezing, crying Activity Limp Weak, inactive Strong, active Respiration Absent Irregular, slow Good, Crying Score: Above 7 = (good/normal) 4 -7 = average, need monitoring 3 & Below = need immediate attention, high risk situation ◦ The Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Dr. Berry Brazelton) serves 3 purpose: As an index of neurological integrity after birth To predict future development To assesses neonates' responsiveness to their physical and social environment ◦ Screening done on 3rd day and repeat again after several days. Test on four distinct areas: ◦ ◦ ◦ ◦ Social behavior (interactive behaviors in the home) Motor behaviors (reflexes & muscle activities) Control of physiology (baby’s ability to quiet himself) Stress response (startle reaction) High score a neurologically well developed infant Low score a sluggish infant who need help in responding to social situations, or possible brain damage. Reflexes an inborn, automatic response to a particular form of stimulation. Full term newborns come equipped with a variety of reflexes for use in dealing efficiently with stimuli present in their environment. Some reflexes are necessary for survival (eg. Rooting & sucking reflexes) Reflexes are probably genetic in origin & include a timing mechanism that allows them to fade away after a period of time. Reflexes Eliciting Stimulus Response Developmental duration Babinski Gentle stroke along Toes fan out: big toe sole of foot (heel - toe) reflexes Disappears by end of first year Moro Sudden lost of support Disappear in 6 months Palmer Grasp Rod of finger pressed Object grasp against infant’s palm Disappear in 3-4 months Rooting Object lightly brushes infant’s cheek Disappear in 3-4 months Sucking Insert Finger in mouth Rhythmic sucking Walking Held baby upright. Sole of feet placed on hard surface Arms extended, then brought towards each other Baby turns towards object and attempts to suck Disappear in 3-4 months Infant step forward as if Disappear in walking 3-4 months Stroke cheek near corner of mouth or object brushes the area Infant respon by turning head toward stimulation Disappears at 3 weeks when child begins to be able to voluntarily turn head Helps infant find nipple Hold infant horizontally on back and let head drop slightly or produce sudden loud sound against surface supporting infant Infant response is to make an embracing motion by arching back, extending legs, throwing arms outward and then bringing them in toward the body Disappear at 6 months Probably in human evolution helped baby cling to mother Spontaneous grasp of adult’s finger Disappears at 3-4 months to allow reaching and grasping Prepares infant for voluntary grasping Turn baby's head to one side while lying on back Infant responds by lying in a “fencing position” with one arm extended in front of eyes on side to which head is turned other arm is flexed Disappears at 4 months May prepare infant for voluntary reaching PATTERNS OF GROWTH Children grow faster during the first years, especially during the first few months. This rapid growth rate tapers off during the second and third years Influences on Growth Genes interact with environment, i.e. nutrition and living conditions, general health and well-being Well-fed, well-cared-for children grow taller and heavier than less well nourished and nurtured children Better medical care, immunization and antibioticsbetter health Nourishment ◦ Breast milk is almost always the best food for newborns and is recommended for at least the first 12 months ◦ Parents can avoid obesity and cardiac problems in themselves and in their children by adopting a more active lifestyle for the entire family--and to breastfeed their babies First 3 years of life is critical to baby’s brain development. Before & after birth brain growth is fundamental to future development. It is estimated that about 250,000 brain cells are form every minute in the uterus. By birth, almost 100 billion nerve cell are formed, but not fully develop. Smiling, babbling, crawling, walking, and talking are possible due to rapid development of the brain, particularly the cerebral cortex Early experience can have lasting effects on emotional development and the capacity of the central nervous system to learn and store information Sometimes corrective experience can make up for past deprivation States of arousal are different degrees of sleep and wakefulness Infants move in and out of 5 states throughout the day and night: ◦ ◦ ◦ ◦ ◦ Regular sleep Irregular sleep Drowsiness Alert Activity Waking activity and crying Striking individual differences in daily rhythms exist that affect parents’ attitudes toward and interactions with baby. (Sensory &Perceptual Process) 24 Touch Hearing Vision Taste Smell 25 Touch seems to be the first sense to develop Sensitivity to touch, pain, and temperature change is well-developed at birth. Pain experienced during the neonatal period may sensitize an infant to later pain, perhaps by affecting the neural pathways that process painful stimuli Reflexes reveal sensitivity to touch. Touch helps stimulate physical and emotional development. 26 Babies are born with the ability to communicate their taste preferences to caregivers. Infant facial expressions indicate they can distinguish among several tastes. Newborns' rejection of bitter tastes is probably another survival mechanism, since many bitter substances are toxic 27 The responsiveness of infants to the smell of certain foods is similar to that of adults showed that some odor preferences are innate. A newborn infant is attracted to the odor of her own mother’s lactating breast helps to find food source and to identify own mother a survival mechanism. Newborns can identify the location of an unpleasant odor and turn head away. A preference for pleasant odors seems to be learned in uterus and during the first few days after birth 28 Even newborns can smell, taste, and feel These skills are useful in recognizing parents and in feeding 29 Lipsitt, Engen & Kye (1963) : Baby showed negative response to the smell of ammonia. Steiner : Baby showed diff. facial expression when exposed to different type of scent. Mac Farlane (1977): Baby can differentiate between own mother’s milk and other mothers’ milk. Schmidt & Beauchamp (1988) : Baby’s ability to smell is almost equivalent to a 3 years old ability to smell. Harris & friends: By aged 4 mths old, baby like the taste of salt 30 Well developed at birth Hearing is functional before birth ability to discrimination sound develops rapidly after birth Hearing key to language development so hearing impairments should be identified as early as possible ◦ Infants respond with changes in heart rate to loud sounds (even in the womb) ◦ Can hear wide range of sounds but are more responsive to some than others. ◦ Newborns prefer complex sounds such as voices and noises to pure tones. 31 Newborns prefer speech that is highpitched and expressive. Infants hear well, though not quite as accurately as adults Infants’ hearing is best for sounds that have pitches in the range of human speech Infants use sound to locate objects 32 4–6 months Sense of musical phrasing “Screen out” sounds from non6 months native languages 7–9 months Recognize familiar words, natural phrasing in native language Can detect words that start with 10 months weak syllables De Casper & Fifer (1980): Baby can differentiate mother’s voices from others thru’ baby sucking pattern. Birnhold & Benacerraf (1983): 28th week baby showed his/her response thru facial expression. Wertheimer (1961) : Baby able to follow source of sound thru’ the “clicker” test. 34 Vision is the least developed sense at birth Newborns cannot focus their eyes very well and their visual acuity fineness of discrimination, is limited Newborns explore their environment by scanning it for interesting sights & tracking moving objects. They can’t yet discriminate colors, color vision will improve in a couple of months. Visual perception is poor at birth but improves to 20/100 by age 6 months Binocular vision using both eyes to focus 35 Brain development helps infants reach adult levels of vision skills: 2 months: Focus and color vision 6 months: acuity, scanning & tracking 6–7 months: depth perception 36 3 weeks Poor contrast sensitivity. Prefer large simple patterns Can detect fine-grained detail. 2 months Prefer complex patterns. Can detect patterns even if 4 months boundaries are not really present Can detect objects if two-thirds of 12 months drawing is missing 37 Birth – 1 Sensitivity to motion cues month 2–4 Sensitivity to binocular cues months 5 –12 months Sensitivity to pictorial cues. Wariness of heights 38 Langlois & friends (1990): Babies are more attracted to attractive and beautiful human faces. Fantz (1993): Babies prefer to look at pictures of human. Aslin (1987): 4 days old babies can differentiate between green and red. Babies prefer blue and red as compared to other colors. Gibson & Walk (1960): Visual cliff experiment. 6 mth babies has already develop in-dept perception in visual. 39 40 41 By 1 month, can integrate sight and touch By 4 months, can integrate sight and sound 4- and 7-month-olds can match facial appearance (boy or man) with sound of voice 42 Maturity affect infant perceptual and motor abilities. Milestones of Motor Development Babies first learn simple skills and then combine them into increasingly complex systems of action ◦ Week 1 : Motor ability progress ◦ Month 1: Chin lift ◦ Month 2: Reach for object Newborn are not able to control their body movement no coordination. Most movements are due to inborn reflexes (rooting, moro, palmer grasp etc) Humans begin to walk later than other species, possibly because babies' heavy heads and short legs make balance difficult How Motor Development Occurs: Maturation in Context According to Thelen, normal babies develop the same skills in the same order because they are built approximately the same way and have similar physical challenges and needs Cultural Influences on Motor Development Chances to explore their surroundings motor development likely to be normal Some cultures actively encourage early development of motor skills Training Motor Skills Experimentally Gesell concluded that children perform certain activities when they are ready, and training gives no advantage Interaction of biology and environment are involved in infant motor development Baby's ability to interact with other people Develops thru regular interaction with babies,: ◦ Feeding ◦ Cleaning ◦ Caring/loving Newborn can imitate facial expression.