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Child Development: Introduction
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Two decades ago, the United Nations Convention on the Rights
of the Child called for all countries that each child attains their
utmost potential.1 Despite the recognition that
most causes of developmental difficulties in children are preventable with
known interventions, up to 200 million children in developing countries
are not achieving their optimal developmental potential.2,3 The
Global Disease Control Priorities Project states that approximately
10% to 20% of individuals around the world have
developmental difficulties.4 In the United States,
12% to 16% of young children have developmental
and/or behavioral difficulties.5,6
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Primary health care encounters provide opportunities to support
child development and optimize the development of all children by preventing
avoidable developmental difficulties. This chapter provides information
on the principles of monitoring and supporting early childhood development
in the primary care setting and for promoting healthy socioemotional development
and parent-child relationships. Chapter 12 offers
more in-depth information on developmental screening.
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Optimal development refers to the health and emotional, cognitive,
communicative, social, and motor functioning of a child who is reared
in an environment free of known and preventable risks that are detrimental
to development and scientifically and ethically known to be conducive to
age-appropriate functioning and participation in life. This definition
is based on the philosophy of the World Health Organization International Classification
of Functioning, Disability, and Health and emphasizes functioning
and participation in life.8Developmental
difficulties in this chapter are the problems that interfere
with or prevent the optimal development of children (eg, hunger
and social deprivation, neglect by a mother who is emotionally unavailable
because of depression, disease such as cerebral palsy or autism).
The term monitoring child development is adopted
from the definition of developmental surveillance and requires regular
evaluation of a spectrum of issues that impact upon a child's developmental
function to assure early recognition of issues that may impact upon
a child's optimal development. All aspects of normal physical development,
as well as cognitive, language and motor function, caregiving environment,
socioemotional function and ability to engage in age-appropriate
activities need to be assessed.9,10
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In clinical practice, monitoring of development and promoting
optimal social-emotional development and parent–child interactions
is a seamless process.
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Key Constructs
on Child Development
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The biopsychosocial model recognizes that much, if not all, human
disease and disability is a function of the interaction among biologic
processes and the environment. In contrast, the biomedical model
that was applied in the past viewed ailments as the consequence
of episodic, endogenous factors. Physical health and development
are viewed as inseparable components of a child’s well-being
since the factors that cause poor health (eg, undernutrition) also
affect child development. Similarly, factors that cause poor development
(eg, unresponsive caring environments) also influence child health.
The World Health Organization refers to this phenomenon as “a
critical ...