SIGMUND FREUD AND THE PSYCHOANALYTIC THEORY

Infantile (ORAL) stage

Freud advanced a theory of personality development focussing on the effects of the sexual pleasure drive on a person's emerging personality. According to his theory, parts of the personality develop as we move through a series of psychosexual stages. Each stage is characterised by different demands for sexual gratification and different ways of achieving that gratification.

If as growing humans, we do not receive an appropriate amount of gratification – receiving either too little or too much – we may become fixated in a particular stage. That is, we continue to have the same demand for gratification that we had at that stage throughout the rest of our lives. This condition is thought to produce a variety of adult behaviours.

The oral stage in psychology is the term used by Sigmund Freud to describe the child's development during the first eighteen months of life, in which an infant's pleasure centers are in the mouth.

This is the infant's first relationship with its mother; it is a nutritive one. Suckling and eating, however, compose the earliest memories for infants in every society. This stage holds special importance because some, especially those in tribal societies commonly found in the Southwest Pacific and Africa, consider the stomach to be the seat of emotions.

Oral stage drivesA newborn is governed only by its drives. Only the id is present at this

stage, so the infant seeks immediate gratification, achieved through its mouth – feeding, crying, and oral exploration of the world using the mouth and the tongue.

Result of oral stage disturbanceAccording to Freud, disturbance of the oral stage may result in a

permanent fixation on the oral channel for gratification. Orally-fixated people often seek gratification through smoking, thumb-sucking, nail-biting and chewing objects like pens and pencils. A predilection for oral sex is also seen as an indication of an oral personality. Typical resulting personality traits include impatience, passivity, greediness, dependence and a preoccupation with giving and taking.

Support for the concept of the oral personality comes from Martin Jacobs et al. (1966) who found smokers were significantly more oral than non-smokers. Jacobs et al used the Rorschach ink blot test – a projective test in which what we say we see in the image is meant to reflect our own personality, motivations and inner conflicts. The Rorschach Oral Dependency scale (used by Jacobs et al.) measures the degree to which people see food, aggressive and dependency images in the inkblots. (However, the validity of Rorschach Inkblot tests is a matter of fierce debate. Hans Eysenck's (1959) criticisms led to disillusionment with it in British psychological circles.)

Seymour Fisher & Roger Greenberg (1977) found oral receptive types crave approval and support from significant others. In contrast Steven Huprich et al (2004) found sexual psychopaths high in oral aggression. The researchers were attempting to distinguish between sex murderers, non-sexual psychopaths and non-violent paedophiles in terms of orality. As predicted sexual psychopaths emerged as significantly higher in oral aggression while the non-violent paedophiles were higher in oral dependency.

Temperament of both the mother/caregiver and the child will have an effect here.The impact of temperament is perhaps better reflected in Paul Kline & R. Storey’s 1977 slant on the oral personality, in which they proposed 2 oral types: oral optimistic (a variation on oral receptive) and oral pessimistic (a variation on oral aggressive).

Oral stage fixations1. Oral receptive (optimistic) personality - brought on by too much

nursingOral receptive people are often cheerful, unrealistically optimistic

and very self-centred yet can’t bear the disapproval of others. Through the defence mechanism of sublimation, they may show an interest in languages, be a compulsive talker and be good at ventriloquism. The language used to describe overly-dependent people may reflect their orality - eg: leech. Very gullible people may be called suckers.

Oral optimistic was characterised as having dependency, liking, fluency, sociability, liking of novelty and relaxation were clustered together as traits.

2. Oral aggresive (pessimistic) personality - brought on by not enough nursing and/or by early weaning

Oral aggressive people are often perceived as greedy and acquisitive, envious, pessimistic, cynical, sarcastic, scornful and contemptuous.Oral pessimistic was characterised as having independence, verbal aggression, envy, coldness and hostility, malice, ambition and impatience clustered together as traits.

There is nothing like enough substantive evidence to postulate cause-and-effect.

Nursing implications:1. Provide oral stimulation through feeding & use of pacifiers.2. Do not discourage thmbsucking at this point.3. For newborns and infants up to age 6 months, breastfeeding provides more oral stimulation than bottle feeding, so it is encouraged.4. Be attentive of the infant's needs.5. Delaying gratification can be useful to develop ego.6.

MULTIDIMENSIONAL STAGES OF DEVELOPMENTIn Infants

SOCIAL-EMOTIONAL DEVELOPMENT

At this age, your infant's emotional and social development is one and the same¡ªand it grows from your infant's relationship with the mother, who is usually the primary caregiver.Infants' emotions are seen when they feel pleasure or distress in different situations. A well-fed, sleepy, and comfortable baby will be very peaceful. This satisfied state can quickly give way to frantic crying when an infant is hungry, uncomfortable or has a wet diaper.As an infant's brain develops, they will smile and coo when they like something. They will become excited about people, toys, and food. They will also let you know they're unhappy if they dislike their bath, have to wait for food, or are left sitting in their car seat or stroller for too long.Infants are quite remarkable in that they demonstrate more potential and ability at birth than anyone ever thought possible. Infants, like adults, learn by taking information in through their senses. The primary sense used by infants is sight, followed by hearing, and touch.

Once the infant begins taking in information through the senses, s/he must begin the process of interpreting and giving meaning to that information. This is called perceptual development and the four primary concepts used to describe the information in a visual sense are contours, patterns, forms, and configurations. A contour is a transition in brightness or hue. A pattern is any visual field with contours. Forms are those aspects of a pattern or object that remain constant during transformation. Finally, configurations are arrangements of contours, patterns, and forms into some perceptual whole.One of the first patterns or objects that becomes the focus of interest, and thus, an instrument in learning is the human face. Infants are fascinated with human faces and before the infant can even understand language or the environment, s/he begins to understand the meaning of certain expressions on the primary caregiver's face. These visual social cues give the infant information about how s/he should be perceiving the world, whether it be with laughter, fear, apprehension, or another human emotion that is being expressed by the caregiver.

One to Two Months of Age:?During the first 3 months, an infant's socialization is based around activities of feeding, sleeping, elimination, and body positioning. The infant also begins early stages of learning to self-regulate. In other words, to tune out when there is too much stimulus and the arouse when something of interest comes about.?The infant will do such things as react to a sheet being put over his or her face and show recognition to mother or other familiar and favorite caregivers.?Seems to recognize your voice and quiets if crying?Increases or decreases sucking behavior in response to sound

Three to Four Months of Age:?Smile when you appear?Quiet or smile when spoken to?Seem to recognize your voice?Cry differently for different needs?Reaches for familiar people.?Identifying self in mirror.?Plays by pulling something over face (peek-a-boo).?Plays while propped with toys for 10-15 minutes.

Five to Six Months of Age:

?Sometime between 4-6 months, the infant begins exchanging interactions with the caregiver. The child may smile in response to being smiled at, as well as begin to play simple back and forth games, such as peek-a-boo. The infant also begins cooperating with spoon feeding, dressing, and other daily activities. Common behaviors you might see include:?Smiles at self in mirror.?Discriminates strangers from familiar people.?Works for toy out of reach.?Reaches for self in mirror.?Use his or her voice to express pleasure and displeasure?Move his or her eyes in the direction of sounds?Respond to changes in the tone of your voice?Notice that some toys make sounds?Pay attention to music

Seven to Nine Months of Age:?During the 7-9 month time period, the infant begins to initiate activities. The infant will work to gain the caregiver's attention, will strain to reach an object out of reach on the floor, and to perform other behaviors to manipulate the environment. Some common behaviors include:?Clings to familiar people and hides face.?Plays with or reaches for self or object in mirror by 12 months.?Cooperates with adult in games.?Bites and chews toys.?Turns and looks in direction of sounds?Listens when spoken toHighlight: Stranger AnxietyStranger anxiety is said to occur when infants feel uncomfortable or frightened by someone they have not met before (unknown person), It occurs even when the child is with a trusted caregiver and a safe environment. On average it begins at eight months and continues until 18 months. It is usually seen infant earlier than separation anxiety.Stranger anxiety builds gradually. As early as 4 months, infants can already discriminate caregivers from strangers. They begin to prefer caregivers and become wary when strangers approach. But at 7-8 moths, it occurs more often and is clearly displayed. This is because they are already more aware with their environment, people around them and the relationships they have with them. At 1 year of age, infant develops more and better physical and cognitive skills. They may run to their parents and grab hold of them or demand to be carried/picked up.

Signs: sudden quietness while looking fearfully to the strangerbecome emotional, cry loudly, and fussNursing implicationsTeach the parent to: Hold children when introducing them to othersTeach family, friends and strangers to approach the baby slowly and let child warm himself up. Speaking calmly and slowly may helpTry to introduce more new people to the childTake them to public places where they could interact with a lot of people e.g. groceries, parksBe patient and do not rush child to learn his socialization skills sice doing so may make him more sensitive to new people.Respect child's fear. Ignoring or dismissing will only make the feeling worseDon't label the child, such as shy or fearful or call him ridiculous or childishWorry about the child's feelings, not the strangers feelingsStrange terror is a more intense form of stranger anxiety. A child may be very agitated with one stranger and may avoid all strangers. Behaviors suggesting such include: Hiding when unfamiliar persons are present, even if the person is not trying to interact with the childFacial expressions of worry expected in an older childBeing extremely upset in the presence of a strangerLoud screaming or back arching when approached or being comforted by a strangerLong periods of extreme stillness and wariness in front of a stranger.Tell parents/caregivers that if this interferes with child's normal daily life, consult a pediatrician or a professional.Highlight: Separation anxietySeparation anxiety happens as the infant's sense of individuality is gradually developing. As a newborn, a child has no sense of himself as an individual. He thinks that the caregiver and hinself are one. Over time, as the baby grows physically and develops mentally (cognitively), s/he will begin to realize he is separate from the caregiver and that you can leave him/her alone. This new understanding of separateness can make him anxious. This begins to occur some time between six to eight months lasting well up to 2 years age. He knows that you can leave him, but he doesn't know that you'll always come back, so he's likely to burst into tears when you leave, even for a minute.Nursing implications: Teach parents to resist the urge to sneak away unnoticed by the baby which is not helpful in the develompent of the child's ability to cope. Instead, say goodbye and go while he's watching.Ten to Twelve Months of Age:?During the ten to twelve month period, the infant begins checking self need against caregiver availability. In other words, the infant will look to the

primary caregiver and cry when hungry, or look for the caregiver to comfort a hurt or when bored. Common behaviors at this age include:?Recognizes familiar people from a distance of 20 feet.?Beginning to demand independence.?Demands personal attention.?Mouthing toys and items less.?Understand simple instructions and begins to respond to requests (e.g. "Come here" or "Want more?")?Turn and look in the direction of sounds?Respond to "no"Adapted from: Allen, K. E. & Marotz, I. (1989). Developmental profiles: Birth to six. Delmar Publishers Inc.

LANGUAGE & SPEECH DEVELOPMENT

A child begins to make small, cooing (dovelike) sounds by the end of the first month. A 2-month-old child differentiates a cry. For example, caregivers can distinguish a cry that means ¡°hungry¡± from one that means ¡°wet¡± or from one that means ¡°lonely.¡± This is an important milestone in development for an infant and also in marking how far a parent has progressed in the task of learning the infant¡¯s cues. A first-time parent has more difficulty making the distinction in crying than one who has experienced this before. An infant¡¯s ability to make throaty, gurgling, or cooing sounds also increases at this time. In response to a nodding, smiling face or a friendly tone of voice, a 3-month-old child will squeal with pleasure. This is an important step in development because it makes a baby even more fun to be with. Parents spend increased time with infants at this age, not just to care for them but because they enjoy their company.By 4 months, infants are very ¡°talkative,¡± cooing, babbling, and gurgling when spoken to. They definitely laugh out loud. By 5 months, an infant says some simple vowel sounds (for example, ¡°goo-goo¡± and ¡°gah-gah¡±). At 6 months, infants learn the art of imitating. They may imitate a parent¡¯s cough, for example, or say ¡°Oh!¡± as a way of attracting attention.The amount of talking infants do increases at 7 months. They can imitate vowel sounds well (for example, ¡°oh-oh,¡± ¡°ah-ah,¡± and ¡°oo-oo¡±). By 9 months, an infant usually speaks a first word: ¡°da-da¡± or ¡°ba-ba.¡± Occasionally a mother may need reassurance that ¡°da-da¡± for daddy is an easier syllable to pronounce than ¡°ma-ma¡± for mommy. German mothers report the first word their babies say is ¡°here,¡± as that is ¡°da¡±

in German. By 10 months, an infant masters another word such as ¡°bye-bye¡± or ¡°no.¡± By 12 months, infants can generally say two words besides ¡°ma-ma¡± and ¡°da-da¡±; they use those two words with meaning.

Birth¨C3 Months?Startle upon hearing loud sounds?Makes pleasure sounds (cooing, gooing)?Cries differently for different needs (differentiates a cry, 2mo.)?Smiles when sees you

4¨C6 Months?Babbling sounds more speech-like with many different sounds, including p, b and m?Chuckles and laughs?Vocalizes excitement and displeasure using his/her voice?Makes gurgling sounds when left alone and when playing with you

7 Months¨C1 Year?Try imitating words?Say a few words, such as "dada," "mama" and "uh-oh"?Babbling has both long and short groups of sounds such as "tata upup bibibibi"?Uses speech or non-crying sounds to get and keep attention?Uses gestures to communicate (waving, holding arms to be picked up)?Imitates different speech sounds?Has one or two words (hi, dog, dada, mama) around first birthday, although sounds may not be clear

Nursing Implications?Remind the mother to check the child's ability to hear, and pay attention to ear problems and infections, especially when they keep occurring.?Reinforce the baby's communication attempts by looking at him or her, speaking, and imitating his or her vocalizations.?Repeat his or her laughter and facial expressions.?Teach the baby to imitate actions, such as peekaboo, clapping, blowing kisses, pat-a-cake, itsy bitsy spider, and waving bye-bye. These games teach turn taking that is needed for conversation.?Talk while you are doing things, such as dressing, bathing, and feeding (e.g., "Mommy is washing Sam's hair"; "Sam is eating carrots"; "Oh, these carrots are good!").

?Teach the caregiver to talk about where s/he is going, what s/he will do once you get there, and who and what s/he'll see (e.g., "Sam is going to Grandma's house. Grandma has a dog. Sam will pet the dog.").?Teach animal sounds (e.g., "A cow says 'moo'").?Tell the primary caregiver to communicate with the child in the language s/he are most comfortable using.

http://www.asha.org/public/speech/development/01.htm#sthash.dgiw60zi.dpufhttp://www.mayoclinic.org/healthy-living/infant-and-toddler-health/in-depth/language-development/art-20045163

PLAY DEVELOPMENT

Babies do much more than sleep, eat, and fill their diapers. From the moment they¡¯re born, infants respond to their environment ¨C to mom¡¯s touch, to dad¡¯s voice, to the pattern of the lights on the ceiling, to the sounds of toys and music. These first months are a crucial time for parents and caregivers to stimulate their baby¡¯s development through one-on-one interaction. Babies enjoy having interesting things to look at. They zoom in on contrasting patterns, such as black and white stripes and targets. Mobiles with bright objects hung over a changing table or bassinet will fascinate baby. Musical toys selected just for babies will calm baby during fussy periods. Soft rubber and plastic handles are great for baby to get his hands on as he learns to grasp objects. Toys provide a great way for the caregiver to focus baby¡¯s attention and promote specific developmental milestones.

Parents often ask what toys their infant would enjoy. Because1-month-olds can fix their eyes on an object, they are interestedin watching a mobile over their crib or playpen. Mobiles are best if they are black and white or brightly coloredand light enough in weight so they move when someone walks by. They should face down toward the infant, not toward an adult standing beside the crib. Musical mobiles provide extra stimulation. One-month-old children also spend a great deal of time watching their parent¡¯s face, appearingto enjoy this activity so much a face may become their favorite ¡°toy.¡± Help parents understand they are not spoiling infants by sitting and holding them for long periods of time in their early months. Parents will enjoy recalling such calm moments later, when they are stacking blocks, winding up toys, or playing table games with their growing child.

Hearing is a second sense that is a source of pleasure for children in early infancy. Even newborns ¡°listen¡± to the sound of a music box or a musical rattle. They stir and seem apprehensive at the sound of a raucous rattle.Two-month-old infants will hold light, small rattles for a short period of time but then drop them. They are very attuned to mobiles or cradle gyms strung across their crib. They continue to spend a great deal of time just watching the people around them.

Three-month-old children can handle small blocks or small rattles. Four-month-old children need a playpen or a sheet spread on the floor so they have an opportunity to exercise their new skill of rolling over. Rolling over is so intriguing it may serve as a ¡°toy¡± for the entire month.Five-month-old infants are ready for a variety of objects to handle, such as plastic rings, blocks, squeeze toys, clothespins, rattles, and plastic keys. All these should be small enough an infant can lift them with one hand, yet big enough the baby cannotpossibly swallow them.A 6-month-old child can sit steadily enough to be ready for bathtub toys such as rubber ducks or plastic boats. Because they are starting to teethe, infants enjoy a teething ring to chew on at this time.Because 7-month-old children can transfer toys, they are interested in items such as blocks, rattles, or plastic keys that are small enough to be used for this. As their mobility increases, they begin to be more interested in brightly colored balls or toys that previously rolled out of reach.Eight-month-old children are sensitive to differences in texture. They enjoy having toys that have different feels to them, such as velvet, fur, fuzzy, smooth, or rough items.The 9-month-old infant needs the experience of creeping. This means time out of a crib or playpen so there is room to maneuver. Many 9-month-olds begin to enjoy toys that go inside one another, such as a nest of blocks or rings of assorted sizes that fit on a center post. Some are more interested in pots and pans that stack rather than toys.By 10 months, infants are ready for peek-a-boo and will spend a long time playing the game with their hands or with a cloth over their head that they can reach and remove. They can clap and are also ready to play patty-cake. These games have a positive value, just as laughing out loud did for the 3-month-old child. They make a baby feel like an active part of the household. A family feeling begins to grow as the babycan participate in active games.

At 11 months, children have learned to cruise or walk along low tables by holding on. They often find this so absorbing they spend little time doing anything else during the month.Twelve-month-old infants enjoy putting things in and taking things out of containers. They like little boxes that fit inside one another or dropping small blocks into a cardboard box. As soon as they can walk, they will be interested in pull toys. A lot of time may be spent listening to someone saying nursery rhymes or listening to music.

Birth to 3 months - all hands and mouth

GMD During the first few months of life, the baby¡¯s body begin to ¡°loosen up¡± from a tightly flexed posture to a more open and relaxed tone. He will begin to stretch his arms and legs out more, and develop the beginnings of head control. Leg strength will increase and baby will be able to briefly bear his weight while standing.?Enjoy some face to face ¡°tummy time¡± together on the floor to strengthen baby¡¯s neck.?Lay your baby underneath a play gym to give those swinging arms and kicking legs something to connect with. Sit next to the baby to cheer him on.?Babies are soothed by gentle rocking movements, whether in the arms or snuggled quietly in an infant seat.?Encourage baby to reach and roll by placing a favorite toy nearby (begins at 3 months).

FMD The baby¡¯s hands will gradually change from a tight-fisted tone to more open and relaxed palms that are ready to grab everything nearby. Baby will begin to purposefully reach toward objects and will learn to suck on his/her fingers.?From fingers to toys, babies love to taste everything they can get their hands on. Encourage the baby to explore objects with all his senses.?Practice baby¡¯s reaching skills by gently shaking a toy within her reach. Be ready to offer more handy toys as baby drops each one.?Keep the grasp.

VD At birth babies can see clearly around 10 to 12 inches (about the distance from your breast to your face). Baby¡¯s vision is perhaps his most perceptive sense at this early age. Over these first few months your baby will begin to focus on you, then follow moving objects as they pass before him.

?Dark and light contrasting colors are the best way to stimulate baby¡¯s visual senses. Surround baby with these during his quiet alert time.?Be sure to stay close to the infant baby as you interact. Around 12 inches is the perfect distance away to engage his eyes.?Practice baby¡¯s visual tracking skills by slowly moving a toy, or your own smiling face, back and forth before her eyes.?Movement will easily catch the baby¡¯s eye. Engage baby¡¯s attention with gentle hand and finger movements when beginning to interact.

SCD In these early months baby will begin to smile spontaneously, then smile responsively to your attention. The baby will begin to show interest in his surroundings and learn to interact with objects and people.?Babies will learn cause and effect.?Baby will learn to manipulate objects around him. Hold baby near a mobile or other hanging toy and let him learn to move the pieces around.?Bath time can be a fun way to interact with the infant and encourage social smiles and giggles. While you wash, be sure to laugh, sing, talk, rub and tickle your baby to promote responsiveness.

HLD Over these first months, the infant begins to react to sounds by startling and then eventually moving the eyes toward noises. The baby¡¯s cries will become his first language and take on various meanings. Smiling will turn to laughter and baby will begin to ¡°coo¡± and ¡°goo¡±.?Babies are intrigued when they create sounds on their own. Show baby the various sounds his toys can make and he will thrill as he experiences the sounds on his own.?Soothing music has a calming effect on the baby. Quietly sing or hum along with a musical toy during play.?A caregiver¡¯s voice is comforting to baby. As you go about your day, stay connected by talking to your baby to let him know you are near.?Sounds will make baby¡¯s playtime more fun. Hand and foot rattles are a great way to thrill baby as she kicks his legs and waves his arms.

Play tips:?Visual Stimulation with dark and light contrasting patterns?Use sounds to engage baby in play?Floor time for two is a great way to connect with the baby?Babies love to taste everything as they explore?Keep those curiously grasping hands

4 ¨C 6 Months ¨C Reaching & RollingAround the age of four months, the development of binocular vision ¨C the eyes learning to work together on depth perception ¨C makes reaching and grasping possible. Mom may have to put away her dangly earrings for the next several months, and parents who wear glasses must be on the alert for babies who grab and fling these intriguing objects to the floor. Give baby interesting things to hold and explore with his hands at this age: lightweight rattles that are easy to grasp, a plastic or rubber ring to hold with both hands, toys that make noise when you squeak or shake them, small plush animals or dolls. Rattles that attach to babies¡¯ ankles add excitement to kicking. At five to six months, babies begin to enjoy more time on the floor.

GMD During these months baby will gain more upper body strength and balance so he can progress toward sitting. Baby¡¯s interest in his surroundings will prompt him to roll to the side and eventually all the way over. Tummy time will be more fun for baby as he begins to push up and eventually starts to scoot forward.?Babies begin to purposefully wave their arms and kick their feet. Give baby some play time in a bouncer seat so he can learn how his movements make him bounce.?Baby will begin to respond to playful interaction by waving his arms and legs. Foot and wrist rattles will reward his antics with interesting sounds. Clap and cheer baby on and he will respond with more excitement.?Encourage your baby to reach and roll over by placing a favorite toy next to him just out of reach.?Have some more floor time with baby as he learns to push himself up on his elbows. This newly acquired position gives baby a better view of his surroundings.?Baby will soon begin to tummy-crawl. Place some toys just out of reach to spur baby forward.

FMD Baby¡¯s accuracy steadily improves through these months until he can reach out and grab toys precisely. The baby will transfer objects back and forth between hands and play with toys in a more purposeful way. Baby¡¯s sensitive fingers will learn to explore different textures and smaller objects.?Curious baby¡¯s little fingers will be intrigued by movable toy parts, gadgets and varying textures. Show the fun features on each new toy.

?Baby begins to reach out for anything and everything placed within his reach. Keep baby¡¯s hands busy by engaging him with a toy whenever on the move together in a baby sling, stroller or car seat.?A fun floor-time exercise is to dangle a favorite toy in front of baby to practice his hand coordination and aim.?Baby¡¯s two-handed grabbing skills will mature into a skillful one-handed reach. Challenge baby with two toys at once so he goes for one with each hand.?Babies begin to explore various body parts. One of the first is hands and fingers. Little finger puppets make this even more fun, and your own fingers can join baby in this playtime.?Transferring objects back and forth between hands is an important coordination skill at this stage. Keep babies hands busy with favorite toys to enhance this learning.?Take time to read through activity books together. These are great for practicing baby¡¯s reaching skills.

VD Baby can now see clearly at a greater distance. This will enhance his interaction with caegiver and his surroundings. Baby develops better binocular vision which makes his play with toys more accurate. Baby will try to make frequent eye contact with the caregiver to connect during playtime.?Baby¡¯s visual tracking skills improve during this stage. Moving mobiles are a great way to enhance this skill. Watch as the baby follows the hanging toys in a full circle.?Flashing colorful lights will draw baby¡¯s attention. These are even more fun when baby can activate lights and music on his toys.?Mirror play is a fun way for baby to begin to explore her own features as well as yours. Keep several mirrored toys handy.

SCD During these months babies will show more decision-making during play. She will attempt to pick up two toys at a time and take more time to study and understand each toy. Baby will respond more to interaction and begin to mimic facial gestures and moods. Baby will laugh more responsively to stimulation.?As baby plays, he begins to exercise his decision-making skills. As baby is engaged with one toy, place another before him. Watch as he decides to put aside one toy in favor of another, and back again.?Show the baby the features of each new toy to help him discover toys are not just for chewing on.

?Baby will respond more socially to care giver's antics. Take as much time as you can everyday for interactive play to develop responsiveness and communication skills.?Your baby will begin to communicate her need for relief from teething pain. Keep plenty of ¡°teethable¡± toys on hand to soothe baby¡¯s aching gums.

HLD Babies will begin to use body language to express their needs. Baby sounds become more varied as infant explores his vocal abilities. You will see him respond more readily to voices, and turn more accurately toward interesting sounds.?You can use sounds to engage your baby in play. Toys that rattle, squeak, crinkle or beep will help your baby focus in and locate objects by their familiar sounds.?Help your baby learn cause and effect by showing her how to make sounds with each toy.?Play ¡°find the toy¡± with your baby by making some familiar toy sounds out of baby¡¯s sight. Keep making noise to help your baby learn to focus on and locate sounds.?Talk or sing to your baby as you move about your day. This will help baby recognize and be comforted by your familiar voice.?Babies love to ¡°sing¡± along with their caregivers. The more you interact verbally with baby, to more he will learn to imitate your speech sounds.?Singing and music are perfect ways to delight your baby while in the stroller or car seat

6-12 months - Baby on the MoveSitting up without support gives babies a new outlook on life. And once they¡¯ve mastered this skill, they will eagerly move on towards crawling. Toys placed just out of reach will motivate them to lunge forward and discover ways to rock and scoot and move along the floor. As babies¡¯ fine motor skills improve, they can pick up smaller objects, so be sure to provide small toys that fit comfortably in baby¡¯s hands. An assortment of these on the high chair tray will keep baby occupied for a long time. This is also a great age to introduce simple activity books, and as baby grows, so should the complexity of these interactive books. As babies approach one year, fill and dump container play will keep them busy for hours. Object permanence is a concept that will be learned at this age, so hiding games become lots of fun. Babies will also show more interest in mirror play. And don¡¯t forget to bring on the balls. Lightweight foam balls are fun for rolling and gentle tossing with a caregiver. Some babies will show readiness to stand and even

begin walking. Walker toys that baby can hold onto and push across the room are perfect for this stage.

GMD During these months, significant advances in motor development take place. Babies progress from learning to sit well to leaning forward into a crawling position. They will learn to pull themselves up into a standing position to cruise along furniture, and some go-getters will even begin walking before age one.?As infant becomes an expert at sitting, make a ¡°play circle¡± together with your legs while you sit facing each other during play. This is perfect for block play and container play.?Entice a sitting baby to lean forward into a crawling position by putting his favorite toys just beyond his reach. Musical toys and rattles are great for this.?A crawling baby will love to play ¡°fetch¡± as you roll her favorite ball across the room.?Once baby is sitting comfortably, baths take on a whole new meaning. Turn these wash times into a splashing fun time as you help baby become comfortable in the water.?Play ¡°treasure hunt¡± with a crawling baby. Place his favorite blocks around the room and encourage him to gather them up.

FMD Babies begin to use their fingers more skillfully, and will eventually master the thumb-and-finger pincer grasp on tiny objects. Picking up blocks and other small toys with one hand will become second nature, and you will commonly see a toy in each hand while baby looks around for a third. Eventually baby will begin container play and spend hours putting things in and dumping them out again.?At this age, babies are more easily entertained during a long car ride with a few favorite toys to keep their hands busy.?Colorful balls are a great tool for baby¡¯s playtime to work on his one-handed grasping and ¡°fill and dump¡± container play.?During bath time, add a few floating bath toys to the water to keep baby¡¯s reaching hands busy while you wash off the day¡¯s dirt.?Surround sitting baby with his favorite blocks or other small objects so he can practice his reach and grab.?The baby can begin to appreciate different touch sensations with his fingers. Offer as many different textures as you can.?Discovering baby¡¯s toes and pulling them up to his mouth is a fun exercise. Put some foot rattles onto baby¡¯s feet to encourage this discovery.

?Activity books are a great outlet for baby¡¯s curious fingers and will get the child interested in books at a young age.

SCD Baby¡¯s responsiveness to caregiver¡¯s interactions becomes more rewarding, and baby will frequently ¡°flirt¡± with whoever is looking his way. During these months baby will begin to respond specifically to his own name. Waving and clapping are fun skills that baby will pick up. Baby¡¯s inquisitive nature will prompt him to systematically explore every interesting nook and cranny of his domain. Baby-proofing becomes increasingly important.?Playing peek-a-boo is a perfect game to exercise baby¡¯s social responses. A large ball, toy doll, or even your own hands to hide behind work great.?Babies begin to mimic your actions. Bath is a perfect time to show the baby how to have a splashing fun time.?Clapping hands is another way a baby will thrill to imitate. Be sure to cheer her on.?Baby will be intrigued with the concepts of ¡°in¡± and ¡°out¡±. Help the baby understand container play by showing him how to play with a bucket and blocks.?Infants begin to pick and choose between toys. While he is engaged with a toy in each hand, place a third in front of her to exercise her decision-making skills.?Waving bye-bye can be made even more fun and social using colorful finger puppets.?Mirrors are a fun way to interact with your baby. Explore your reflections together.

HLD During these months baby¡¯s cute little ¡°coos¡± and ¡°goos¡± will mature into babbling with consonant sounds. Baby will begin to talk her own language of jabbering as she imitates the language patterns of those around her. A few precocious talkers may even surprise you with their first word before age one. Baby¡¯s understanding of various phrases will begin, such as ¡°No¡± and ¡°Come see daddy¡±. Baby will continue to be intrigued by sounds that she can create on her own during play.?Banging two wooden blocks together is a great way for a baby to learn how to create sounds. Grab two blocks and play along.?Sounds are a great way to draw a baby into playtime. Dropping or shaking her wooden blocks in a plastic bucket is sure to get her attention.?Banging, shaking, and blowing musical toy instruments will become a favorite activity for the baby. Get her started early and cheer on her ¡°talent¡±.

?Musical toys will continue to interest a baby. Hum and sing along and s/he will try to mimic you and join in with his own ¡°singing¡±.

You might be concerned about the child's development if child does not:?Show alarm or startle in response to loud noises.?Suck and swallow with ease.?Grasp with equal strength in both hands.?Make eye-to-eye contact when awake and being held.?Quiet soon after being picked up.?Roll head from side to side when placed on stomach.Adapted from: Allen, K. E. & Marotz, I. (1989). Developmental profiles: Birth to six. Delmar Publishers Inc.

CHILDPROOFING AND CHILD SAFETY (Infants)

Suffocation and ChokingAvoid sleeping with an infant in the same bedInfants should never be placed on top of/surrounded with soft surfaces/materials like sofas, large soft toys,water beds as well pillows, blankets, comfortersKeep toys away from a sleeping babyBabies should sleep on their backsCrib bars should not be more than 2 3/8 inches apart to prevent infants from getting their heads stuck in betweenKeep crib from plastic sheets, large stuffed toys, toys with small pieces, pillowsDo not dress baby with clothes with drawstringsKeep toys with long strings/cords from infant's reach to prevent strangulationDo not attach pacifiers to ribbons and wear on infants neckPlace the bed away from windows especially those with coverings and pull cordsAvoid small (and hard) foods which could lodge on the infants thoat esp. when they are lying down, e.g. raisins, candies, nuts, small pieces of hotdogsKeep floors, beds, table and cabinet tops with minute objects they could mouth, e.g. coins, rings, nails, tacks among others

Injuries, Falls and BurnsToys should not be too heavy enough to heart if it falls on the babyDo not leave baby on chairs, beds or bouncy upholsteriesInstall baby gates especially on stairsAlways check baby's bathwater temperature before putting the baby into bath, which should be 100F (37C)Keep matches away from reach of infantsNever ignite lighters or matches in front of themDo not

leave cigarettes unattended, smoke or dring hot beverages while holding an infantStoves and hot water taps should be proofed. They are not always hot. Children can touch them once safely and the next time receive a severe burnKeep cords out of their way so they can't pull, trip or chewCover wall outlets with safety capsKeep appliances unplugged and the cords out of the child's reachUse corner and edge bumpers

DrowningNever leave a child unsupervised in the bathtub. If you must leave the room for a telephone call or to answer the door, wrap the child in a towel and take him or her with you. Don't leave a small child alone with any container of liquid, including wading pools, scrub buckets, and toilets.The tub should be just enough to cover the baby's legs at about 3 inches waterUse nonslip mats on bathrooms and toiletsNever take your eyes off the infant when near a body of water

PoisoningKeep all toxic items out of reach and locked in cabinetsRemove piosonous plants in the home and garden, e.g. philodendrons, poison ivies, etc.Keep a contact number of a poison center or nearby health facility

AccessHave trashcans with child-proof coversLatch cabinets and other furnitures within child's reachAvoid using placemats and long draping tableclothes