Prematurity and developmental psychology

What is developmental psychology?

Developmental psychology is the study of the changes that occur in humans throughout life, and deals with the parent-child relationship. This field deals with and examines changes in a wide variety of topics including: physical development, which includes motor abilities and other psycho-physiological processes, cognitive development, social development, emotional development, problem solving ability, language acquisition, conceptual understanding, moral understanding and identity formation. The work of the developmental psychologist is divided into two main aspects:

Prevention and treatment of behavioral problems, social and mental problems in children and at the same time accompanying the child's parents during the treatment. Premature birth is an unexpected event that affects the feelings of the parent and the premature baby born prematurely. The quality of the parent-child relationship may be accompanied by many anxieties, pressures and tensions and there is room for psychological intervention as early as possible.

Diagnosing the cognitive, motor, social and emotional abilities of the child according to the age group in which he is, and giving a recommendation on methods of treatment to reduce gaps.

Premature babies and developmental psychology - what is the difference in terms of development between premature babies and other babies?

The significant difference between premature babies and babies born on time is slower development in premature babies during the first two years of their lives, and therefore their development up to the age of two should be examined according to the corrected age and not the chronological age. Immaturity, regulation difficulties, eating and sleeping difficulties can cause tension and stress in the parents.

Below are a number of milestones that a baby should achieve according to his corrected age:

1-3 months: looks intently at close people, makes eye contact (from 2-3 weeks old), scans the environment when held upright and when there is no face in his field of vision. Social smile (4-6 weeks) with making sounds in response to playing with him (from 6 weeks old).

4-6 months: In terms of vision, very alert to near and far. reaches for toys, holds tightly and looks at them closely, passes them from hand to hand, is interested in moving his hands and feet and looking at them, puts everything in his mouth, looks at objects that move or fall within his field of vision, both eyes work as a team (at this stage, in a squint state, however slight and transient, the doctor should be asked for clarification on the matter), utters different sounds to himself and others when satisfied, while using a syllable or two and a wide range of sound levels, shouts to attract attention (from 5 months of age). Still friendly with strangers but sometimes shows some shyness or even a little anxiety when the stranger gets too close to him or suddenly.

7-12 months: Visual ability for near and far improves rapidly. Picks up balls between the finger and thumb with increasing skill. Watching a spinning ball. Searches for falling and hidden toys as he watches. Deliberately produces sounds that sound like speech sounds as a means of interpersonal communication. Mumbles long, repetitive strings of syllables (dehdehdehgheghe) to himself for self-amusement when alone (from age 7 months) and to other people. Clearly distinguishes strangers from familiar people and requires reassurance before accepting their advances towards him. Plays "Koko" and imitates clapping, towards the age of one does this when requested and sometimes spontaneously.

What is early childhood psychological diagnosis?

A psychological diagnosis is designed to give a comprehensive and broad picture of the child's various abilities in various areas, for example: motor skills, language, thinking, communication, memory, day-to-day functioning and more. The diagnosis allows us to determine the level of functioning of the baby according to the age group to which it belongs (in the case of premature babies, the calculation is made according to corrected age up to two years of age), and to receive a full assessment of the baby's abilities, which include its strengths and weaknesses. The diagnosis is made in the form of a game, with the help of age-appropriate toys, drawings and colorful pictures.

Why is it important to get a diagnosis?

As mentioned, the development of premature babies is slower than babies born on time, and therefore follow-up is necessary to make sure that the premature baby narrows and catches the gap during the first two years of his life. With the help of a psychological diagnosis, it is possible to identify if the baby is at developmental or health risk. In the diagnosis, the possibility of the presence of a disability will be checked, the required achievements will be evaluated in comparison to the age group to which the baby belongs, and depending on what is found - a treatment plan will be built in order to help him reduce gaps and use his full potential.

What are the signs that it is recommended to get to the initial diagnosis faster and even proactively (with reference to the corrected age)?

Any delay in the developmental axis must be a "red light" that requires a thorough developmental examination.

Development at a young age, especially in a premature baby, is very fast, therefore any stoppage over time in the acquisition of skills and, of course, withdrawal or loss of acquired skills, should be a reason to seek urgent diagnosis or follow-up.

Linguistically, babies produce sounds, then mumble, forming syllables which become intentional syllables. At the age of one, there should be at least two intentional words, while between the ages of one and two there is a very rapid development of understanding and expressing language. Therefore, a baby who does not have any syllables or intentional words at the age of one, or who is stopped at the stage of a few words until the age of two does not acquire conjunctions or enrich his vocabulary, requires clarification about his communication rule.

Non-verbal communication also has milestones from infancy. A baby needs to make eye contact, imitate facial expressions and before the age of two months start to smile in response to a smile. Later, a rich body language develops which includes: gestures of pointing, clapping, greeting, yes and no movements with the head, as well as referring to the body language of others. Difficulties in self-expression or lack of regard for the gestures of others may be early signs of a communication disorder.

Simultaneously with the improvement in the motor control ability of babies, together with the development of object investigation and curiosity, the ability to play develops - first at the level of object investigation and later on symbolic play and reciprocal play. Lack of curiosity, dysfunctional use of toys such as exploring small parts or excessive interest in wheels, lack of development of reciprocal or symbolic play are significant symptoms of communication difficulties.

In addition to these areas, unusual behaviors, with multiple repetitions of a movement, some act or areas of interest, for example: repeated movements of waving, turning, repeatedly opening and closing lights, or drawers - all of these require further investigation.

Examples of "red lights" in the baby's development according to corrected age

  • Doesn't respond to nearby voices or everyday sounds at 6-8 weeks old.
  • Does not make consistent eye contact, and does not smile socially at the age of 3 months.
  • Does not show normal interest in people or toys at 3-4 months.
  • Does not look, stares into space, is focused for a long time on an object or light and does not look away towards people older than 3 months.
  • Significant sleep difficulties at any age beyond what is expected.
  • Eating difficulties with excessive pickiness and difficulty adapting to new textures.
  • Hypersensitivity to touch or indifference to touch.
  • Abnormal reactions in intensity to noises.
  • Lack of response to noise or environmental stimuli.
  • Does not use frequent babbling, with consonants and vowels (such as bhava, ma, ga) at ten months of age, with a response to someone else's speech.
  • Does not respond to his name at the age of one year.
  • Does not use gestures to show his wishes (pointing, hello, kiss) at 1 year old.
  • Does not say single words or even parts of words at the age of one.
  • Lack of progress in language development, motor communication in a period of more than three months in the first and second year.

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