Cognitive Development

Intellectual development depends on learning that involves three elements: the attention, information processing and memory (which includes both the encoding and retrieval of information). Intellectual development is reflected in the promotion of capacity to understand, reason and make judgments. The standardized intelligence tests measure general intelligence two forms of school-age children: verbal and performance (or non-verbal). These standardized tests are not available to measure intelligence infant. How then, can we recognize the attributes of intelligence verbal and non-verbal in infants? Over the past two decades, the discovery of visual habituation techniques for assessing the infants' attention was seen as a breakthrough in the study of infant cognition. It is illustrated by a study that describes 4-day-old infants to listen in a long series of "see-bee-lee" sounds. When a novel is "yes" sound is heard, the children responded with a change in heart rate and faster, stronger sucking on a pacifier, indicating that very young infants can perceive differences in vowel sounds.

More complex studies using simultaneous visual and auditory stimuli also indicate that infants are able to organise perceptions across sensory modalities (cross-modal matching), without the language skills to describe them. For example, 11 months, infants were presented in a sequence of continuous pure tones and interrupted. Two photos were in the infant view throughout the experiment: one contains a continuous line, the other a dotted line. Infants always correspond good visual stimulus to the hearing, inferring cross-modal matching and some rudimentary understanding of the concept of interruptedness. The use of these techniques, it has been shown that infants less than 1 year can form a wide range of categorical representations quite complex, including the faces, colors, geometric shapes, and the orientation of lines.

Attempts to measure the responses of infants, such as those described above, rely on sophisticated technologies, including infrared photography to monitor eye gaze and child pupillary dilation, video facial reactions, and electrophysiological monitoring in heart rate and evoked potentials. The primary pediatrician can best estimate infant intelligence by assessing problem-solving and language milestones. Language is the best indicator of intellectual potential, problem solving is the best measure. Their gross motor development less correlated with the cognitive potential, most children who are diagnosed with mental retardation later walk at the time.

RED FLAGS IN MOTOR DEVELOPMENT

It is important to start the engine to the assessment by observing the infant. Pay special attention to the hand; fisting persistent at the age of 3 months is often the earliest indication of the neuro-motor dysfunction. Spontaneous postures (eg, froglegs and scissoring) to provide visual cues to hypotonia / weakness and spasticity hypertonus, respectively. Delays in thea ppearance of postural responses announce the future delays in motor development voluntary. A baby is unable to sit or walk independently, without intact mechanisms for the protection and balance. Models of movement may indicate abnormal pathology. For example, in early turnover (1 to 2 months), firing directly into a booth at 4 months (instead of a sit), W-sitting, bunny hopping, and persistent toe walking may indicate spasticity. Hand domination before the age of 18 months should encourage clinicians to consider the contralateral upper extremity for weakness associated with hemiparesis.

Analysis of the information collected in these areas, it is relatively easy for the clinician to reassure himself (and parents) about a child's motor and identifying those motor skills at an early age. When a discrepancy engine has been identified, further evaluation of its exact nature and the cause is essential. This ensures almost always return to a team subspecialist or subspecialty. Based on the clinical examination and history, the usually astute clinician may decide which category falls the engine trouble: 1) static central nervous system disorders, 2) progressive diseases, 3) and spinal nerves Peripheral injuries, or 4) the structural defects.

FINE MOTOR DEVELOPMENT

In the first year of life, development of fine motor skills is highlighted by the evolution of a clamp seized. During the second year of life, the child learns how to use objects as tools for functional play. There are many steps in the realization of these two powers, some of them are illustrated in Exhibit 2GB. Earlier this month, the upper extremities help balance and mobility. As the balance in a sitting position and improves the infant assumes bipedal mobility, hands become available for handling objects of their ultimate function. Primitive reflexes are integrated, and the upper extremities under the cortical control. Reaching becomes more precise, and objects are placed in the mouth for oral exploration. That development is progressing distal to proximal, reaching and manipulative skills are further strengthened, and precise manual exploration replaces oral exploration. During the second year, fine motor is evaluated by observing how the hands use objects as tools (eg for building blocks and crayons for drawing). The close association between gross and fine motor skills in the first year of life evolves in a similar relationship between problem solving and fine motor skills during the second year. One skill allows or encourages the development of the other. If progress in the manual dexterity is slow, which may hinder cognitive development through the manipulation of objects.

GROSS MOTOR DEVELOPMENT

Motor Development gross proceeds from a sequence of steps outlined (starting with the head and ending with rotation), at the meeting, then through a standing / ambulating sequence . Landmark motor do not take into account the quality of removal of a child. These sequences should be considered in the context of the part of the engine of the neurological examination, including observations of the station and approach, where the qualitative elements can be assessed. However, the neurological assessment of tone, strength, deep tendon reflexes, and coordination is difficult, in very young children because of the subjective nature of the evaluation and the infant's limited ability to cooperate. Clinical experience is essential for obtaining accurate and useful information.

Solicitation reflexes requires patience and repeated, yet gentle, trial and error. Tonus muscle (passive resistance) and strength (resistance) is a challenge to distinguish in the opposite infant. The best clues can be obtained from observation, not handling. Spontaneous or generated motor activity (for example, weight-bearing in sitting or standing) require sufficient strength. Thus, the weakness can be better appreciated by the observation of the quality of posture and transition stationary movements. The sign Gower (arising from sitting on the floor to standing with their hands through "back" his legs) is a classic and the pelvic bones and indicative quadriceps muscle weakness. Not before 2 or 3 years, does neurological examination become easier and more effective cooperation improves.

Station returns to the posture assumed in sitting or standing and should be considered in earlier, lateral and posterior perspectives, looking for the alignment of the body. Gait refers to the march and is discussed in progress. Initially, toddlers, walks with a broad base, slightly crouched, weapons removed and slightly elevated. Forward staccato progression is more than good. Movements gradually become more fluid, the base shrinks, and the swing arm is changing, leading to an adult walk model of 3 years.

The engine neuromaturational markers are primitive reflexes that develop during pregnancy and usually between the third and sixth month after birth, and postural responses, which are not present at birth, but develop sequentially between 3 and 10 months old. The Moro, labyrinthine tonic, asymmetric tonic neck, and positive support reflexes are most useful in clinical. As with all true reflexes, each requires a specific sensory stimuli to generate the stereotypical motor response. Normal infants demonstrate such postures inconsistently and transiently; those who have neurological central (ie brain) injury show stronger and more sustained primitive reflex posture. Primitive reflexes are a little difficult to assess, even in expert hands. The emergence of postural responses at the beginning of the movie, after 2 to 3 months of age is easier to get in the clinic and can provide a great idea of neuro-motor integrity of young infants. Reactions postural are sought in each of the three main categories: rehabilitation, protection and balance. These movements are much less stereotyped as primitive reflexes, and they require a complex interaction between the cerebral and cerebellar cortical adjustments to a barrage of sensory inputs (proprioceptive, visual, vestibular). They are easy to obtain in the normal infant, but apparently are much slower in the newborn who damage the central nervous system.