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Child Development: Introduction

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

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.

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

In clinical practice, monitoring of development and promoting optimal social-emotional development and parent–child interactions is a seamless process.

Key Constructs on Child Development

Biopsychosocial Model

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 ...

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