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LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Describe a child’s developmental progression across each developmental domain.
Discuss the interrelatedness of a child’s development between developmental domains.
Describe the influence of environment on a child’s development.
Identify red flags related to the development of a child indicating the need for future evaluation or referral to a pediatrician.
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Children’s development is complex, and each child develops at their own pace, but typically within the same time frame and along the same trajectory as their peers. Caregivers often ask us to identify if a child is developing typically and, if not, when they will gain a certain skill or why they do not have the same motor skills as other children. Physical therapists must not only understand the typical progression of motor development but also be aware of the multitude of factors that influence the child’s development. We must analyze movement and identify the child’s challenges to determine if therapy services are needed and, if so, how to facilitate the achievement of the particular skill to assist the child as they participate in their daily activities and routines.
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Besides thoroughly understanding the development of movement, therapists must consider the context in which movement is developing. Each child has a multitude of factors that influence their growth. Therapists must be aware of the individual (temperament, cognition, and genetics) and environmental factors that influence the child’s development (Figure 2-1). Environmental factors are the physical (eg, space and terrain), social (eg, interactions with people), and attitudinal (eg, attitudes of family, community members, and peers toward supporting and encouraging participation) components that can either enhance or limit the child’s participation in naturally occurring activities.1 Also at the environmental level, therapists must consider the child’s microsystem (home, family, and siblings), exosystem (day care, school, and extended family), and macrosystem (culture, community, and health care resources) level influences on the child.2
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Each of these layers affects the child, their behavior, and their family and influences the family’s values and beliefs. As physical therapists, we must be aware of these child and environmental factors and their contributions to the child’s attainment of ...