Motor And Communication Development In Pre-Schoolers

by Eitan Kilchevsky

Development of an infant in the first years of life is a complex, dynamic and exciting process to watch. With the increasing use of metabolic screening (which we wrote about in a previous issue of The Bee) and hearing screening, deviation from normal development can be suspected earlier and managed in a timely fashion. Developmental guidance available today does not focus only on children with low IQ or other deviations; it is felt that developmental guidance be optimized for all children.

Parents should be aware of their child’s developmental progress, have a general idea of normal behavior and development at different ages, be concerned when the child’s status is abnormal and be able to verbalize their concern to the pediatrician or family practitioner.

Changes in speech and language are the most dramatic transformation during the preschool years. Staring as unintelligible, speech progresses to language which allows the infant to ask questions, share feelings and start learning. By two years of age the child’s vocabulary may reach 150 to 500 words and by  2-1/2 years sentences become more complicated. If by two years of age the child has a vocabulary of less than 50 words or can not put two words together, parents should express concern to the health care provider.

Comprehension should also be evaluated in the young child. The two-year-old should be able to respond to parental command. At one year of life the infant may understand “simple requests” such as giving the examiner a toy the child is holding. At about 18 months the child should be able to follow instructions such as putting an object on a table (done by about 50 percent of infants at this age and by about 100 percent at two years of age.) Body parts should be named by about 15-18 months.

At two years the child may refer to himself/herself by name and know first and last name by three years of age. By three the child should also be able to count to three and by five years, up to ten.

Motor skills are also important to follow. By two years of age the child walks slightly bent and may be able to walk backwards. Climbing out of the crib can be seen at 2-1/2 years and jumping to 30 inches by three years. Climbing stairs one step at a time is seen around two years and alternating steps at three years. Three hops in place can be done at three years and at five years of age the child can hop forward up to two feet. Skipping is achieved by five years and riding a tricycle by three years.

The years between three and six are called “preschool” because they are important in preparing the child for the tasks required in school. Parents are anxious at times about their child’s readiness for school. Reading (which is not expected before age six years), rhyme games and development of social skills will help the parents prepare their child for acquiring education and will make his/her studying more enjoyable.

Dr Kilchevsky is a member of the Pediatrics Department at Danbury Hospital.