Infant growth and development.

1. Chris Plauche Johnson, MEd, MD* 2. Peter A. Blasco, MD† 1. 2. *Associate Professor of Pediatrics, The University of Texas Health Sciences Center, San Antonio, TX 3. 4. †Associate Professor of Pediatrics, Johns Hopkins University, Baltimore, MD 1. Infant development occurs in an orderly and predictable manner that is determined intrinsically. It proceeds from cephalic to caudal and proximal to distal as well as from generalized reactions to stimuli to specific, goal-directed reactions that become increasingly precise. Extrinsic forces can modulate the velocity and quality of developmental progress. 2. Each developmental domain must be assessed during ongoing developmental surveillance within the context of health supervision.Generalizations about development cannot be based on the assessment of skills in a single developmental domain (ie, one cannot describe infant cognition based on gross motor milestones). However, skills in one developmental domain do influence the acquisition and assessment of skills in other domains. 3. Speech delays are the most common developmental concern seen by the general pediatrician, yet they often are not well understood or diagnosed expediently. A sound understanding of the distinction between an isolated speech delay (usually environmental and often can be alleviated) and a true language delay (a combined expressive and receptive problem that implies more significant pathology) will help the clinician refer appropriately for precise diagnosis and appropriate management. 4. It is essential to understand normal development and acceptable variations in normal developmental patterns to recognize early patterns that are pathologic and that may indicate a possible developmental disability. 5. Assessment of the quality of skills and monitoring the attainment of developmental milestones are essential to early diagnosis of developmental disabilities and expedient referral to early intervention programs. “Infant” is derived from the Latin word, “ infans ,” meaning “unable to speak.” Thus, many define infancy as the period from birth to approximately 2 years of age, when language begins to flourish. It is an exciting period of“ firsts”—first smile, first successful grasp, first evidence of separation anxiety, first word, first step, first sentence. The infant is a dynamic, ever-changing being who undergoes …