DEVELOPMENT IN THE FIRST YEAR OF LIFE

NEWBORN
1.Gross Motor and Posture
In a prone position, the head is shown turned to the side, and the arms are close to the chest with the elbows fully flexed. The hips and knees are flexed under the buttocks. Note that the hands are tightly closed.
In a supine position, the baby is lying in a flexed position, and the ahnds are now open. Continual fisting at this age is always abnormal.
On ventral suspension, the head droops below the plane of the body, the hips are fully flexed and the limbs hang down,
When pulled to sit (baby is shown at 10 days), take note of the marked head lag.

2.Vision and Fine Motor
The baby is shown fixating on the mother's face.

* Moro Reflex... While the head is held in the examiner's hands, a sudden extension of the neck results in abduction and extension of the arms with extension of the fingers, and subsequent flexion of the fingers and arms which are then adducted. The symmetric Moro reflex requires the head to lie in the midline.

6-8 WEEKS
1. Gross Motor and Posture
In prone position, the pelvis is flatm and the arms are flexed with the elbows away from the body. The hips are more extended than previously, and the chin is off the couch.
In supine position, the baby's arms are slightly flexed, the knees are apart and the soles of the feet are facing upward. Note that there is no assymetry.
On ventral suspension, the head is in the same plane as the body, and the hips are extended.
On 'standing', the baby is shown standing with his body straighteneed. Take note of the position of the extended legs, with the weight on the feet and no scissoring (adductor spasm).

Primitive Reflexes..
Rooting Reflex
Gentle stimulation of the cheek causes the baby to turn to suck. Two important features here... a good suckling response and a red retinal reflex.

Grasp Reflex
The grasp reflex may be elicited in the hands or the feet. Note the strength of the grip.

Asymmetric Tonic Neck Reflexes (ATNR)
Lateral turning of the head results in extension of the arm on the same side, with flexion of the limbs on the oposite side ('fencing' position). Persistence of this reflex beyond 4 months is abnormal. Occasionally, the reflex is absent at birth but is present by the end of the first month.

Walking / placing reflex
Stimulation of the dorsal aspect of the foot results in walking movements.

2. Vision and Fine Motor
In the supine position, the baby fixes on and follows the movement of a toy horizontally through an angle of 180 degrees. To elicit this response, use a bright red ball held 50cm from the baby's eyes.

3. Hearing..
may be assessed by parental questionnaire. At-risk babies should be referred to expert audiological opinion.

4. Social Interaction//
is observed as consolability and smiling, which is nearly always present by 6 weeks.