MODULE 2: PHYSICAL AND MOTOR DEVELOPMENT OF CHILDREN AND

ADOLESCENTS

Intended Learning Outcomes:

At the end of this chapter, the students are expected to:

1. Identify the physical and motor development in childhood and adolescence

2. Describe brain development during childhood and adolescence
3. Give the factors affecting development
4. Differentiate exceptional development in terms of:
 Physical and sensory disabilities
 Attention deficit hyperactivity disorders

Learning Activities:

Physical changes in height and weight happen at a comparatively slower rate in the
preschool years than in infancy. Normally, a child adds about 2 to 3 inches in height and about 6
pounds in weight yearly. Alongside with the physical changes are the changes in motor
development. More than the ability to walk the child is also able to acquire skills and begin to
explore as part of his acquired independence.

I. Physical and Motor Development

A. EARLY CHILDHOOD (2-4 years old) – overall growth is clearly in height and
weight measures
 GROWTH- manifested at the earliest stage

Principles of Development

 Cephalocaudal trend( starts in the head region and precedes downward ending in feet
 Brain and neck develop earlier than legs and trunks

 Proximo Distal pattern (development occurs from center outward).

 Internal organs develop earlier than the arms and hands

 According to Tanner (1990 as cited by Hetherington, et al., 2006) genetic factors strongly
influence physical characteristics.

BETWEEN AGES 6-12

 Children grow 2-3 inches in high and 6 pounds each year.

 Large muscles are coordinated and acquired more skills

 Acquired hand- eye coordination (activities involving vision with body movement).

 Among school-aged children, this development is seen the fine motor coordination as
exemplified in writing, drawing, cutting, and other related school tasks.

B. MIDDLE CHILDHOOD

 Growth spurts between ages 6 ½, 8 ½ and 10 years in girls and between 7, 9,

and 10 ½ boys)

 Motor Development. As children age, coordination both in fine motor skills and
tose involving large-muscle improves.
 C. ADOLESCENCE – the early sign of maturation

Sharp increase in height and weight

 Girls – age 9 ½ and 14 ½ .

 Boys – 10 ½ and 16
 Adult height is attained at age:
 girls – 14 or 15
 Boys – 18

MANIFESTATIONS OF PHYSICAL DEVELOPMENT IN ADOLESCENCE

MALE FEMALE
Wider shoulder Widening of the pelvis (make child-bearing
easier)
Longer legs, forearms (relative to trunk and Accumulation of fat layers under the skin that
upper arms) results to a more rounded appearance

Puberty

 Brings about the physical differences that differentiate females and males

 Secondary changes include the growth of pubic hair, the development of the breasts in
females and growth of facial hair in males

 Principal sign of sexual maturation in boys is the sperm in the urine

 Spermarche - first ejaculation of semen containing ejaculate for the males

 Menarche - beginning of the menstrual cycle for the female. Menstruation-most dramatic
sign of sexual maturation for girls.

II. Brain Development

A. Early Childhood
 The brain continues to develop after birth. It double in weight after 6 months at which
time it weight about half that of the adult brain.

 Brain development – an even pace occurring between 3 and 10 months between 15 and
24 months

 There are 100 billion neuron or brain cell present at birth which conduct nerve impulses.

 The neurons are nourished by glial cell which are responsible for the increase in brain
size.

 The glial cell outnumber neurons 10 to 1 but are smaller that neurons, thus, making up
only about half of the brain tissue.

 Another important function of the glial cells, is the production of myelin, a fatty
substance that forms the covering of the neurons, the long filament extending out from
the cell body by which the neuron makes contact with other nerve cell, thereby
transmitting neural messages.

 Myelination of nerve fibers grows at different paces for different parts of the brain.

 The sensory and motor areas are the primary sites of brain growth during the first spurt,
associated with the noted improvements in fine motor skills and eye-hand-coordination
B. Middle Childhood
 Ninety-five percent(95%) of brain growth is reached by the time a child reaches the age
of 9. Such growth is characterized by the interrelated processes namely: cell proliferation
and cell pruning.

CELL PROLIFERATION
 takes place during the several years of life. It consists of the over production of
neurons and interconnections.

CELL PRUNING
 is a continuous process in the childhood phase. It involves the selective
elimination of excess cells and the cutting back of the connections.

 The two processes afford fine-tuning of neural development through experience such that
frequent interconnections are retained while the infrequent are pruned.

 Another significant change in middle childhood is the ability to identify and act the
relationship between objects in space. This results from the lateralization of spatial
perception, occurring at the right cerebral hemisphere. Lateral perception in particular of
faces and objects starts at age 6. However, complex lateral perception is not very strongly
lateralized not until aged 8.

 A behavioral test of the lateralization of spatial perception involves relative right -left
orientation, or the ability to identify what is right and what is left.

C. Adolescence
 the period of life when a child develops into adult
 it is one of the most rapid phases of human being
 biological maturity precedes psychosocial maturity

Brain Development
 In the teenage years there are two major growth spurt occurring between ages 13-15.
Hence the cerebral cortex becomes thicker and more efficient, more energy produce and
consumed by the brain during this spurt than in the following years.

 the spurt takes place in parts of the brain that control spatial perception and motor
functions, that’s the reason why mis-teens adolescents abilities in these areas far exceed
those of school aged children

 second brain growth spurt beginning around age 17 and which continues into early
adulthood.

 second brain growth spurt has frontal lobes of the cerebral cortex as focus of
development.

Developmenta Pre adolescence Early adolescence

l 9-12 years (girls) 12-14 years (girls)
Domain 10-13 years (boys) 13-15 years (boys)

body  growth spurt  menstruation in girls

 secondary sex characteristic  ejaculation in boys
 sensation seeking
brain  more logical thinking  abstract thinking
 craving for new
information
sexual  exploration of sex roles  increased sexual arousal and
experimentation

emotional  increased self-
consciousness
 need for greater privacy
social  academic, social demands
 increased gradual
separation from parents
 increased peer pressure
 sexual preferences explored
gender norms consolidated
 high level self-consciousness
 increased stress
 separation from parents-
dependency
on friends
 more time spent alone and in
peer groups
 interest in opposite sex “friends”
 new social privileges expected
 susceptibility to peer pressure
at peak

Environmental Influences on Development of the Brain

• life experiences whether better or worse have lasting effects on the capacity of the central
nervous systems to learn and store information.

• this is why an enriched environment can enhance the growth and structure of the brain.

III. FACTORS AFFECTING DEVELOPMENT: Maternal Nutrition, Child Nutrition,

Early Sensory Stimulation

Human development is affected by both genetic and environmental influences.

1. Maternal Nutrition
 One important factor affecting development is maternal nutrition. Mother supplies all the
nutrients to the inborn fetus through the food intake so that she should take care of her
diet for her sake and that of the fetus. It is important that she gets a continuous supply of
fresh vegetables, fruits, minerals, and vitamins needed.

2. Child Nutrition
 Adequate nutrition contributes to a continuous brain growth, rapid skeletal, and muscular
development. It is not the amount of food that children eat but what they eat that
contributes to healthy living.

3. Early Sensory Stimulation

 Children under 6 years of age tend to be farsighted, because their eyes have not matured
and are shaped differently from those of adults. After that age, the eyes not only are more
mature but can focus better.

 Minority of children’s vision does not develop properly. About 10 percent of 6-years-olds
have defective near vision, and 7 percent have defective distant vision, the latter number
jumps to 17 percent by 11 years of age.

FACTORS THAT AFFECT GROWTH

1. Genetic History
 According to Lynne Levistky, M.D., chief of the pediatric endocrine unit of
Massachusetts General Hospital in Boston, the child’s genetic history influences to a
large extent his growth. As a matter of fact, it is number one in the list. By just looking at
the parents’ height, the rate of growth of the child can more or less be predicted.

2. Nutrition
 It is another factor that affects growth. “Without a good diet, kids won’t grow normally,”
says Jo Anne Hattner, R.D., a pediatric specialist at the American Dietetic Association.
Sometimes parents miss an assuring and wholesome calories for the child, thus, derailing
his chances for a healthy diet.
3. Medical Conditions
 Children born with or develop serious medical conditions can have stunted growth if not
treated. Some of these are: gastrointestinal disorders such as celiac disease; food
allergies; thyroid problems; hormone deficiency; heart, kidnet, or liver ailments; and
certain chromosomal abnormalities.

4. Exercise
 Regular physical activity promotes growth by strengthening bones and muscles.
However, caution should be observed in doing high-impact sports like running and
gymnastics because they too, can impede growth if done excessively. Moreover, they can
cause trauma to developing bones.

5. Sleep
 About 70 to 80 percent of growth hormone is secreted during sleep, says Paul Saenger,
M.D., a pediatric endocrinologist at Children’s Hospital at Montefiore Medical Center,
in New York City.

6. Emotional Well-Being
 Children must nurtured with love, patience, and understanding. They need a supportive
family environment. When children experience anxieties brought by emotional neglect
and too much tension growth is also stunted.

IV. Exceptional Development: Physical Disabilities, Sensory Impairments, Learning

Disabilities, and Attention Deficit Hyperactivity Disorders

A. PHYSICAL DISABILITIES
 Are temporary or permanent impairments such as paralysis, stiffness or lack of motor
coordination of bones, muscles or joints so that they need special equipment or help in
moving about.

Crippling(severe or permanent) disabilities include the following:

a. Impairment of the bone and muscle systems- fractures (orthopedic handicap)

Orthopedic- means relating to problems affecting people’s joints and spines.

b. Impairment of the nerve and muscle systems- cerebral palsy (dysfunction system)
CEREBRAL PALSY- is a condition caused by damage to a baby’s brain before or during its
birth, which makes its limbs and muscles permanently weak.

c. Deformities or absence of body organs and systems necessary for mobility like in the case of
the club-foot and paraplegics.

CAUSES OF HANDICAPS

1. PRENATAL FACTORS- these are factors that affect normal development before and after
conception, virtually lasting up to the first trimester of life. Specifically these include the
following:

a. Genetic or chromosomal aberrations. This results from blood incompatibility of the

husband and wife. There is a transfer of defective genes from parent to offspring.

b. Prematurity. Birth of the fetus is earlier than 9 months of pregnancy.

c. Infection. This is caused by bacteria or virus on the fetus in the womb of the mother, the
germs usually comes from highly communicable diseases like rubella and venereal diseases
(such as syphilis and gonorrhea which are passed on by sexual intercourse) and neonatal sepsis-
caused infection from either directly from the mother or the outside environment like poorly
sanitized delivery room, infected hospital gadgets, and many others.
d. Malnutrition. Insufficient intake of food nutrients necessary to sustain growth and
development of the fetus and the mother.

e. Irradiation. Pertains to the exposure of the pregnant mother to radioactive elements like x-
ray. Exposure of the mother also affects the fetus.

f. Metabolic Disturbances. Inability of the mother or the fetus to make use of food intake.

g. Drug Abuse. Entry of large quantities of medicines into the body thus affecting the fetus.
Thalidomide (is a drug which used to be given to pregnant women, before it was discovered that
it resulted in babies being born with wrongly shaped arms and legs.

2. PERINATAL FACTORS- these are the factors that cause crippling conditions during the
period of birth.

a. Birth injuries. These are injuries suffered by the newborn baby. Injury to the spine
(backbone) will cause paralysis (kernicterus).

b. Difficult labor. Hard and prolonged labor before the actual birth which interrupts the oxygen
intake of mother to fetus.

c. Hemorrhage. Profuse bleeding of the mother during birth which might be caused by damage
of the uterus.

3. POSTNATAL FACTORS – these are factors causing crippling conditions after birth.

a. Infections. These are caused by illness like diphtheria, typhoid, meningitis, encephalomyelitis
and rickets.

 DIPHTHERIA- is a dangerous infectious disease, which causes fever and difficulty in

breathing and swallowing.

 TYPHOID- is a gland in your neck that produces chemicals, which control the way your
body grows and functions.

 MENINGITIS- is a serious infections illness which affects your brain and spinal cord.

b. Tumor and abscess in the brain (is a painful swelling containing pus in brain). They destroy
the brain cells connected with movement thus impairing mobility.

c. Fractures and dislocations. These are destructions of mobility organs either through falls and
other accidents causing bone fractures or dislocations.

d. Tuberculosis of the bones(is a serious infections disease that affects someone’s lungs and
other parts of their body). TB germs are likely to attack the bones of the very young causing
crippling conditions.

e. Cerebrovascular injuries. These are injuries in the head region enough to cause brain
damage.

f. Post seizure or post- surgical complications. These are convulsions after the delivery of the
baby which cause crippling conditions.

g. Arthritis, rheumatism. These are diseases affecting the spinal column and the muscles of
locomotion at the back.

B. SENSORY IMPAIRMENTS
 In terms of severity of impairment, there are two classes of visual handicaps; visual
impairment and blindness.
1. Visual Impairment. It is a visual problem that calls for specific modification or adjustments
in the student’s educational programs. Major and minor alterations can be done in the
instructional environment

2. Blindness is the inability of the person to see anything. When vision is 20/200 or less in the
better eye with correction or when the visual field is significantly less than what is normal, then
there is blindness.

 Visually impaired refers to those who were previously labelled blind and partially
sighted. Those with visual impairment lack sufficient visions to effect a normal
functioning in school.

 Visually handicapped is a form of visual impairment which, even with correction, still
cannot achieve a normal educational performance. The term includes the partially seeing
and the blind.

 Partially sighted children are those with “low vision.” They are able to use print, with or
without aids, as their main medium for performing in school.

 Low vision students are able to see but the visual impairment interfere with using vision
for learning.

 Blind students are those with so little vision and can learn through the use of Braille.

COMMON VISUAL PROBLEMS

1. Reduced visual acuity- poor sight

2. Amblyopia- lazy eye

3. Hyperopia- farsightedness

4. Myopia- nearsightedness

5. Astigmatism- imperfect vision

OTHER VISUAL IMPAIRMENTS

1. Albinism - rapid, involuntary side movement of the eyeball or nystagmus

2. Cataracts - the lens of the eyes changes from a clear, transparent structure to a cloudy or
opaque one.

3. Macular degeneration - the central part of the retina which is called MACULA is affected. The
remaining peripheral vision can see large objects and colors but not to read.

4. Diabetic retinopathy - it is the leading cause of new cases of blindness and characterized by
hemorrhage (bleeding) of the tiny vessels of the retina. As a consequence, vision is blurred or
distorted.

5. Glaucoma - t is characterized by increase pressure within the eye, gradual loss of vision,
beginning with the peripheral vision.

6. Retinitis pigmentosa - is an inherited condition which begins with the loss of night vision and
leads to gradually decreasing peripheral vision. The dark pigment of the retina , essential for
vision , is slowly lost causing a gradual reduction in the visual field.

7. Retinopathy of prematurity (deterioration of the retina) – this is caused by the high level of
oxygen required for survival of premature infants who would not have previously survived.
  Visual impairments impact on the individual’s development. Students with visual
impairments are visually uncoordinated in their movement caused by the inability to
develop the needed physical skills.

 Sensory deprivation also exists in terms of the reception of sounds from the environment.
When the auditory problem is severe and beyond correction, it is considered an auditory
handicap. This will affect the range and volume of sounds that can be received by the
individual. When hearing is impaired, there is limited functioning of the auditory system.

 Students with auditory handicaps are hearing impaired which most always manifests in
their poor language development. They are short of language skills needed to be able to
communicate.

 Reading problems go hand in hand with severe hearing loss and differences in reading
performance caused primarily by decoding problems, diminished interest and lack of
related experiences.

 Hearing impairment is a generic term for hearing disability which may either be mild or
profound. Hearing impairment subsumes the term deaf and hard of hearing.

 Deaf individuals are those whose hearing disability precludes successful processing of
linguistic information through hearing with or without a hearing aid.

 Hard of hearing individuals are those who use hearing aid and therefore can have hearing
adequate for the processing of linguistic information.

 Deafness can either be prelingual or postlingual and sensory.

a. Prelingual – is deafness present at birth or occurring before language or speech development.

b. Postlingual – deafness occurs after speech of language development. Sensory neural deafness
is caused by the physical impairment of the inner ear, the perioheral hearing nerve, and other
parts of the auditory system that extends to the cortex of the brain

CAUSES OF DEAFNESS

1. Prenatal causes

a. Toxic conditions

b. Viral disease – mumps, influenza, rubella

c. Congenital defects such as lack/closure of the external canal or even the ear and the oval
window.

2. Prenatal causes

a. injury sustained during delivery such as pelvic pressure injury resulting from use of forceps
and intracranial hemorrhage

b. anoxia or lack of oxygen due to prolonged labor.

c. heavy sedation due to overdose of anesthesia in twilight deliveries

d. blockage of the infant’s respiratory passage

3. Postnatal causes
a. disease , ailments, conditions such as meningitis, external otitis (inflammation of the outer
car), otitis media (after characterized by running ) or the infection of the middle ear, impacted or
hardened earwax (cerumen) , which may lead to infection.

b. accidents/trauma falls, head bumps, overexposure to high frequency sounds and extremely
loud explosions, puncturing of eardrum, difference in pressure between air outside and that one
inside the middle ear due to changes in altitude, undrained water in the ear due to frequent
swimming.

Other Causes

a. Heredity

b. Prematurity

c. Malnutrition

d. RH factor – blood incompatibility of parents

e. overdosage of medicine

Classification of Hearing Impaired Children

1. According to age at onset of deafness

a. Congenitally deaf- those born deaf

b. Adventitiously deaf- those born with normal hearing but became deaf due to accident
or illness.

2. According to language development

a. Prelingually deaf- those born deaf but loss hearing before speech and language were
developed.

b. Postlingually deaf- those who became deaf after the development of speech and
language.

3. According to place of impairment

a. Conductive hearing loss- Impaired hearing due to interference in sound transmission to
and through sense organ, in particular in the outer or middle ear.

b. Sensory neural hearing loss- impairment due to the abnormal inner ear or auditory
nerve or both

c. Mixed hearing loss- a combination of the conductive and sensory neural hearing loss.
This is sometimes called a flat loss as depicted in the audiogram.

4. According to degree of hearing loss

• Slight
• Mild
• Moderate
• Severe
• Profound

C. LEARNING DISABILITIES

 Learning disabilities include problems among children related to disorders in

understanding or using spoken and/or written language
  Learning Disabilities are also referred to as perceptual handicaps, brain injury, brain
dysfunction, developmental aphasia and specific sensory motor dysfunction.

 At the preschool level, learning disabilities may come in the form of problems related to
pre academic skills, gross motor, fine motor, visual, auditory, and tactile/kinesthetic
perception, and expressive language.

 The learning disabilities could be symptoms of worldwide problems. Today, such is

called sensory integration or sensory dysfunction.

SENSORY INTEGRATION

 refers to the of the ability of the individual to process information coming from the
environment and makes use of the information in the process. The senses are: auditory,
tactile, vestibulary (Balance center in the inner ear), proprioceptive (muscles, joints, and
tendons), and visual.

This definition provides identification of students qualified for educational services depending
on three conditions:

1. Normal intelligence - This refers to child’s performance at above normal range using
non-verbal measures which include language concepts.

2. Academic achievement deficit – Condition where child shows academic achievement

deficit in at least one subject, such as oral expression, listening, comprehension,
mathematical calculations and spelling.

3. Absence of other handicapping conditions (exclusion criteria). There must be no

manifestation of visual or hearing impairment, mental retardation, severe cases of
emotional disturbance, and cultural neglect.
Learning disabilities is characterized by poor academic performance, social and
psychological problems, and delayed physical development.

The different types of learning disabilities are:

1. Dyslexia – reading

2. Dysgraphia – writing

3. Visual agnosia – sight

4. Motor aphasia – speaking

5. Dysarthria – stuttering

6. Auditory agnosia – hearing

7. Olfactory agnosia – smelling

8. Dyscalculia - math

General causes of learning disability:

1. Problematic pregnancies, occurring before, during and delivering causing injury whether
minimal or severe to brain and brain dysfunction.

2. Biochemical imbalance caused by intake of food with artificial food colourings and
flavourings.

3. Environmental factors caused by emotional disturbance, poor quality of instruction and lack of
motivation.
D. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

 Interferes with an individual’s ability to focus (inattention), regulate activity level

(Hyperactivity), and inhibit behaviour (impulsivity). Among children and adolescents, it
is one of the most common learning disorder. The young from ages 9-17 are affected for
at least six months and are more common in boys than girls. This syndrome is manifested
early in the preschool or early elementary years but can persist into adolescents and
occasionally into adulthood.

 Children with ADHD need assessment from health care professionals with the help of
parents and teachers. There is no specific test for ADHD but it can be diagnosed through
a series of psychological tests, physical examination, and observing child’s behavior in
day to day setting. Recently, ADHD has been classified into three subtypes :

A. Predominantly inattentive

B. Predominantly hyperactive-impulsive

C. Combined type

 Children with inhibited behavior, inattentive, and without focus tend to be withdrawn,
polite and shy. In the absence of hyperactivity, they are likely referred to as having
ATTENTION DEFICIT DISORDER (ADD).

 ADD and ADHD are therefore categorized as different disorders in the presence of
symptomatic differences.

Behavioral Differences between ADHD and ADD

ADHD ADD
Decision-making Impulsive Sluggish
Attention-seeking Short off Modest
Egotistical Shy
Relishes in being the worst Often socially withdrawn
Assertiveness Bossy Under-assertive
Often irritating Overly polite and docile
Recognizing Intrusive Honors boundaries
boundaries Occasionally rebellious Usually polite and obedient
Popularity Attract new friends but has Bonds but does not easily
difficulty bonding attract friends
Associated diagnoses Oppositional defiance Depression
Conduct disorder

What causes ADHD?

 ADHD is neurologically based medical problem caused by a number of factors. The

exact causes are however unknown. According to some research studies, the disorder
results from an imbalance in certain neurotransmitters (most likely dopamine and
serotonin). These substances help the brain to achieve focus and regulate behavior.
Certainly, parents and teachers do not cause this disorder; but may lessen or worsen the
effects of the disorder.

 ADHD is associated with symptoms in children like difficulties in pregnancies and

problem deliveries. The risk is compounded by maternal smoking and exposure as well to
environmental toxins.

Is ADHD Inherited?
  Probably, when the disorder runs in the family there is likely to have genetic
predispositions. Usually, children with ADHD have atleast one close relative who has
ADHD.

Is it possible to have ADHD-like behavior and not ADHD?

 Yes. There are children who manifest the symptoms of the disorder but actually do not
have the disorder. However, there are other causes like the inability to adjust and adapt to
what is acceptable behavior in school or even in some environments. Further, behavior
may seem peculiar to ADHD but children can be taught the appropriate behavior.
Reactions or responses resulting from situations that create hyperactivity can be
controlled not necessarily through medication but modification of the causes of the stress.

Can Schools Inadvertently Enhance ADHD-Like Behavior?

 Most children are to cope with changes in in the environment that come at a pace faster
than what they expect. For that matter, schools are expected to come up with instructional
approaches that will provide better opportunities lo learn effectively. Schools and
classroom operations can inadvertently create of enhance ADHD-like behavior in
students when:

 Teachers tend to cover curriculum too fast, not realizing students need more time

 Teachers resort to teacher talk as the prevailing mode of instruction without regard to the
students learning preference (some are visual learners, some kinesthetic and the like)

 Room arrangement provide isolation, like row by row formation rather than collaboration
(students in this kind of classroom situation have the tendency to make mischief)

 Discipline in arbitraty and unfair coming from different kinds of teachers with different
personalities and rules and expectations.

 There are few opportunities to move around(too much stuff to cover, so students just sit
and listen)

 Classroom atmosphere is not conductive to learning (it’s either too hot or too dark)

 There is no interaction-taking place, the reason why boredom sets in.

 Classroom emotional climate causes stress.

What Do Educators Need To Consider?

 First, educators must start identifying areas where difficulties occur. Once pinpointed,
interventions can be done in the areas concerned. For example, an ADHD student may
find difficulties in absorbing instructions, while another can absorb but cannot go through
the task itself. These situations call for two different interventions. The interventions
should be applied on a case-to-case basis, for a more effective learning results. With the
right intervention, performance can be expected to improve.

 Teachers need to be active, positive and well-versed in a problem solving. Other

important traits are understanding and patience, and most especially a passion for
teaching that uses compassion and not discrimination.