Assessment of Growth and Development During Infancy and Early Childhood

A prime function of the pediatrician is to monitor the developmental status of his or her patients. Sensitive monitoring demands a broad knowledge of developmental processes and issues and the ability to assess the data made available from the clinical examination accurately and efficiently. Areas of Developmental Assessment Developmental assessment is made in four broad areas during early childhood: physical or physiologic, neurodevelopmental, cognitive, and psychosocial. PHYSICAL OR PHYSIOLOGIC DEVELOPMENT This area comprises the changes in physical size, shape, and function that come with age. Many of these changes can be measured, such as height, weight, skinfold thickness, head circumference, body surface area, blood counts, enzyme activities, and hormone levels. These measurements can be compared with standard values that indicate the range of normal findings. NEURODEVELOPMENTAL MATURATION This area comprises changes in behavior that evolve with the passage of time, particularly those changes that depend primarily upon maturation. They include some reflex activities and many gross and fine motor skills, including visuomotor and other intersensory functions. These behaviors are assessed primarily by observation, often informally, but sometimes (when more critical appraisal is required) in a carefully structured setting. COGNITIVE DEVELOPMENT Cognitive development and neurodevelopmental maturation are closely related, and it is sometimes difficult to distinguish between them in the infant and young child.