http://doi.org/10.33698/NRF0045 – Suraj j masih ,karobi das ,baljit kaur
Abstract: a descriptive cross-sectional study was carried out at village dadu majara, UT, Chandigarh to assess the developmental milestones and the health of toddlers. A total of 160 children between the age group of 12-24 months comprished the sample of the study .the achieved developmental milestones were assessed with the help of the denver development screening test.majority of the children were able to achieve the developmental milestones .some of the activities that the children had difficult according to their age were broad jump,pedaling tricycle ,jumping in place (gross motor),imitating vertical line,tower of 4 and 8 cubes (fine motor),points one named body part,naming a picture ,use of plurals and combining two different words (language) and body part,naming a picture ,use of plurals and combining two different words (language) and removing gannents (personal social ) .the physical health assessment revealed that children were suffering from varied degrees of malnutrition from grade I to iv .about 15.6% of subjects were found with abnormal physical characteristics. Iiinesses (15 days prior to the study ) were mostly fever,cough ,loose stools ,prickly heat, vomting and enlarged cervical lymph nodes.
Key Words :
Introduction
- Developmental milestones health , toddlers healthy children the future of children has been consider as an integral part of national development .the national policy too recognizes children as the nations supreme important asset. The most basic care ,given to the child is monitoring his growth and development .if optimizing chances of a child attaining full potential is the corner stone of childcare then assessment of developmental milestones must be mandatory.Developmental assessment is the process the technique of quota sampling Designed to understand the competencies of technique used for selecting children the child ,care giver and environment ,which between the age groups of 12-15 is likely to help a child in making full use of months,18-21 months and 21-24 months.developmental delay should be a mandatory the total children who met the eligibility responsibility of the care giving physician criteria were 333 and after that purposive and community health nurse ,since they sample of 160 children were taken for the are the first medical professionals to come study. each group had a sample of 20 male in contact with the child .assessment should and 20 female children .thus 80 male and identify the strength and weakness of the child`s 80 female children was taken from the,abilities and will help in early intervention for key in fonnant ,and they were told that developmental problems. data would be kept confidential and no invasive Procedures would be done.
Objective The main objective of the study was to Assess the developmental milestones and health of the toddle
Socio –demographic profile of the parents The education level of both the parents was generally low.
Materials and methods : many of the mothers The setting for the study was Dadu Majara 42 (26.3%) and fathers 17 (10.6%) were Colony of Chandigarh U.T,which is a low illiterate .only 8(5%) mothers 14 (8.8%) Socio-economic community,besides being of the fathers were graduates while very a resettled colony.an interview schedule was few parents were post graduates. majority Prepared for recording demographic profile of the mothers 139 (86.9%) were housewives of parents; the finding also show that majority of the Guidelines were prepared for assessment private jobs and 48 (30%) had their own of the fathers i.e.,62 (38.8%)were doing business.per capital income of family ranged Developmental milestones (DDST),Health from Rs150-Rs 2500 with a mean of Rs.977 Assessment Proforma for physical examination. majority 63 (39.4%) of them were in the From head to toe and proforma for recording of range of Rs.501-1000.almost one-fourth Anthropometric measurement validity of the (25.6 %) had less than Rs.500 as per capital tool was established in consultation with experts income.From the departments of community medicine,
Physical health Characteristics: paediatricsAnd national institute of nursing abnormal physical health characteris- education . a descriptive And cross sectional found durning physical examination were design was applied. Thin appearance in 3 subjects, a sickly table 1 shows the distribution of present Appearance in one subject, one subject`s illness within the last 15 days prior to the Head was found small in size and 3 children study. fever was the most common illness Had brown and brittle hair. Anterior fontanelle found in 54 (33.75%) subjects. While 52 Was found abnormally open even after the age (32.5%) subjects were found with enlarged Of 18 months in 25 (15,6%)subjects .one subject cervical lymph nodes,45 (8.1%) children Who had rickets was found with open coronal had cough,25 (15.6 %) had loose stools And lambdoidal sutures at the age of 18 months. And 12 (7.5%) had prickly heat as the One child had pigeon-shaped chest, while 1 had study was conducted in peak of summer Haemangioma on the chest.genital abnormality but few of them had running nose ,sorewas dectected in two male children (one had throat ,chest congestion ,boils , vomiting hypospadias and another had phimosis). Chest congestion, tongue coated etc. Congenital abnormalities detected were Clubfoot and agenesis.
Table- 1: distribution of subjects according to illness during 15 days prior to study
| Age in months
Type of illness |
12-15 15-18 18-21 21-24 total
f(%) f (%) f(%) f (%) f(%) n=40 n= 40 n=40 n=40 n=160 |
| Fever
Enlarged cervical lymph nodes
Cough Loose stool Prickly Vomiting Running nose Chest Congestion Sore throat Boils on skin Dandruff Boils on scalp Boils on abdomen Injury
Coated tongue Redness below eye Boil on eye lid Enlarged axillary gland |
21(52.5) 14(35.0) 8(20.0) 11(27.5) 54(33.7)
11(27.5) 11(27.5) 15(37.5) 15 (37.5) (52(32.5)
18(45.0) 11(27.5) 7 (17.5) 9(22.5) 45 (32.5) 12(30.0) 8 (20.0) 1 (02 .5) 4 (10.0) 25 (15.6) 5(12.5) 3(7.5) 2(5.0) 2(5.0) 12.(7.5) 4(10.0) 1(2.5) 1(2.5) 2(5.0) 8 (5.0) – 2(5.0) 1 (2.5) 4(10.0) 7 (4.4) 1(2.5) 2(5.0) 2(5.0) 1(2.5) 6(3.8) 2 (5.0) – 1(2.5) 2(5.0) 5.(3.1) 1(2.5) 2(5.0) 1(2.5) – 4(2.5) 1(2.5) 2(5.0) 1 (2.5) – 4(2.5) 1(2.5) 1(2.5) 2(1.2) 1(2.5) – 1(2.5) – 2(1.2) – – 1(2.5) – 1(0.6)
1(2.5) – – – 1(0.6) 1(2.5) – – 1(2.5) 2(1.2) – – 1(2.5) 1(0.6)
– 1(2.5) – – 1(0.6) |
Nutritional status Table-2 shows the nutritional status malnutrition, 33(20.6%) had second-degree Of the subjects. The results of the study reveal malnutrition ,6(3.8%) had third –degree That only 64(40%) children had normal Malnutrition And One Child was severely Nutritional status while rest (60%) was malnourished of fourth –degree in the 15-18 Malnourished with varied degrees .it can months age group .it could be observed that Be further seen that 56 (35%) had first number of children decreases in the subsequent degree increased degree of malnutrition.
Table-2 : Nutrional Status Of Subjects
| Age in months
Type of illness |
12-15 15-18 18-21 21-24 total
f(%) f (%) f(%) f (%) f(%) n=40 n= 40 n=40 n=40 n=160 |
| Normal
Total malnourished 1stdegree malnutrition 2nddegreemalnutrition 3rd degree malnutrition 4thdegree malnutrition
|
15.3(37.5) 18 (45.0) 20(50.0) 11(27.5) 64(40.0)
25 (62.5) 22(55.0) 20(50.0) 29 (72.5) 96(60.0) 18(45.0) 10(25.0) 15(37.5) 13(32.5) 56(35.0) 5(12.5) 10(25.0) 5(12.5) 13(32.5) 33(20.6) 2(5.0) 1(2.5) – 3(7.5) 6(3.8) – 1(2.5) – – 1(0.6) |
Achievement of developmental milestones The achieved developmental milestones steps by crawling .but 27 children of 15-18,As regards to the gross motor activities in all 36 subjects 18-21,and 39 subjects in 21-24 The four age groups were studied .study months could throw ball overhead .majority Reveals that skill increased as the age increased. (39)subjects of 15-18 months and all(40)in In 12-15 months all the children were able to do 18-21 and 21-24 months were able to kick the ball forward .only 13 children aged 18-21 and 20 children of 21-24 months,28 children were able to balance Activities like walk while holding furniture and stand on one foot and 27 subjects were able to put on Momentarily ,but 34 children were able to stand well shoes without tying laces .most difficult task in Alone 28 children were able to stoop and recover this age group was pedal tricycle and broad jump, And walk well but 25 children of same age followed thus only 5 and 4 children were able to demonstrate By 37 children of 15-18 months were able to walk it.(table-3).backward. whereas 39 children of 12-15,14-18 and 18-21 could walk up
Table-3: Achieved Gross Motor Developmental Milestones of Study Subjects
| Age in months
Gross motor milestones |
12-15 15-18 18-21 21-24
n=40 n= 40 n=40 n=40 |
| Walk holding furniture
Stand momentarily Stand alone well Stoop and recover Walk well Walk backwards Walk up steps (crawing ) Throw ball overhead Kick ball forward Jump in place Balance on one foot for I second Put on shoes Pedal tricycle Broad jump |
40 – – –
40 – – – 34 – – – 28 – – – 28 – – – 25 37 – – 39 39 39 – – 27 36 39 – 39 40 40 – – 13 20 – – – 28 – – – 27 – – – 5 – – – 4 |
(-) not applicable since these activities were not included in the specified age group
Table – 4 shows the developmental group of 18-21 months, but none of the children Milestone in fine motor area.all the Children of age 21-24 months could make a tower of were able to scribble spontaneously in Age cubes.
Table -4: achieved fine motor developmental milestones of study subjects
N= 160
| Age in months
Fine motor milestones |
12-15 15-18 18-21 21- 24
n=40 n= 40 n=40 n=40 |
| Scribbles spontaneously
Tower of 2cubes Dump raisin after demonstration Tower of 4 cubes Imitates vertical line up to 300 Tower of 8 cubes |
38 39 40 –
23 35 – – 30 37 39 37 5 29 37 – – 5 10 – – 3 |
(-) not applicable since these activities were not included in the specified age groups
Table 5 depicts the developmental months group 7 children could point the body Milestones of language .it was found parts but 18-21 months 11 subjects could That All 38 subjects aged 12-15 months do the same task.all subjects were able to Followed By 36 subjects aged 18-21 months follow directions ,whereas use of plurals Were able to say 3 words other than ma da. Seemed a difficult task as only two subjects While in 12-15 aged 21-24 months could do it.
Table-5: Achieved language developmental milestones of study subjects
N=160
| Age in months
Language Skill |
12-15 15-18 18-21 21-24
n=40 n= 40 n=40 n=40 |
| Say 3 words other than ma .da
Points one named body part Combines two different words Follows direction 2 out of 3 Name one picture Uses plurals |
38 36 40 –
7 6 11 – 6 10 26 30 30 33 35 40 – 8 15 24 – – 0 2 |
(-) not applicable since these activities were not included in the specified age groups
Table-6 shows the achieved personal social to drink from cup. only 4 subjects aged 12-15 Developmental tasks of children .it depicts that months and 3 subjects 15-18 months and 11 Majority tasks of children under study were aged 18-21 months were able to remove at least Able to imitate household tasks of the subjects` one garment .majority of children of all age group Aged 12-15 months only 23 subjects `were able were able to play interactive games, whereas 38 to use spoon and spill little .majority of subjects children aged 21-24 months were easily could play ball with examiner,33 subjects were separated from mother and 38 children of same able to indicate wants and all children of same age age could wash and dry hands.
Table -6 : Achieved personal social developmental milestones of subjects N=160
| Age in months
Personal social Skills |
12-15 15-18 18-21 21-24
n=40 n= 40 n=40 n=40 |
| Plays ball with examiner
Indicate wants (not crying ) Drinks from cups Imitates house hold task Removes garments Uses spoon spills little Helps in house hold tasks Play in interactive games Washes and dry hands Separate from mother easily |
39 – – –
33 – – – 40 – – – 37 38 38 – 4 3 11 – 23 34 32 40 – 34 38 – – – 39 40 – – – 38 – – – 38
|
(-) not applicable since these activities were not included in the specified age groups
Discussion :The study was descriptive in nature and up in their own home, where the The population taken for the study was of a opportunities to learn motor skills is not Low socioeconomic status .the study revealed only given but encouraged. majority.The majority of the study subjects were able to of the children were able to able to Achieve the development milestones according achieve the developmental To Their age. The one who could not achieve milestone like walking by holding, them Could be because of their low socioeconomic furniture ,standing momentarily Conditions , lack of stimulation, motivation from ,walking well, kicking the ball The parents, family conditions or health status forward ,scribbling spontaneously,Of toddlers or other contributing factors ,which following two out of three directionsWere out of the purview of the present study. drinking from cup .the activities This Has also been supported by the Havighurst all(100%) children could do theory. This theory attributes the mastery of the successfully were standing momentarily task as Achievement of Milestones to be walking by holding furniture and dependent upon The opportunity to learn. Lack kicking the ball forward (in gross of motivation of Dependent upon the opportunity motor) ,scribble spontaneously (in to learn .lack Of motivation of institutional children fine motor); able to say more than who had Little handling by attendants have been 3 words other than ma,ma,da,da reportedTo be slow in crawing ,sitting and standing (in language),and all the subjects in as compared To the babies brought children found 21-24 months could follow directions difficult to Achieve were ,broad jump, pedal tricycle, well and were able to achieve these jump In place ,tower of 4 cubes ,imitate vertical milestones at 21-24 months.in line ,tower of 8 cubes ,use plurls ,name one personal social activities all (40) were picture ,Combining two different words and able to use spoon and play interactive removing garments.One child having rickets game .the activities which the in present was not able to achieve any Developmental study ,during the physical health task as per age Requirements.A comparative assessment ,children were found to suffer study on two groups Of Negro children motor from varied degree of malnutrition development and its Relation to child rearing ranging from varied degree of practices suggests that Gross motor development malnutrition in the age group of 15-18 is not a racial character But it is related to the way months was suffering from rickets in which the child is Cared for. The infant from and also had the Mongolian signs viz lower socio-economic Group shows average gross slanting eyes and marked problem ,motor acceleration.Significant difference were like small head,with open coronal and also found in the Way the two groups of children lambdoidal suture and thin extremities were handled.The result of this study supports which may have been the consequen- the fininding Of present study where there has ces of the grade iv malnutrition .past also been Average motor development.Studie illnesses reported by most of the from different parts of the country indicate The parents were related to respiratory superiority of Indian children in attaining motor illnesses. iiinesses in children Development task .it was noticed the lighter weight reported within 15 days prior to Of Indian children attain earlier developmental the study were fever (54%) ,enlarged Milestones in comparison their western cervical lymph nodes (32.5%) ,cough counterparts. They tend to walk earlier than (28.1%) ,loose stools (15.6%),prickly their counterparts .The finding of the present heat (7.5%) ,vomiting (5%) ,etc .thus study also show similar results ,though 60 % the leading cause of morbidity in of the children were found malnourished . these children between 1-2 years a majority of them were able to achieve were respiratory infections, skin gross motor development tasks. Diseases ,gastrointestinal diseases and malnourishment, which is supported by the study which reported that the big three among the killer among toddlers were ,malnutrition ,diarrhea and pneumonia .study done a study of physical development of temporary on the effect of illness on growth delhi children reveals that the infant weight shows that illness tends to slow and height depends on the family socio-down the rate of growth while economic condition .the children under study chronic illness might.belonged to low class but their mean weight affect the child’s final heights.ranged from 8.5-9.6 kg.about 60% of children suffered from malnutrition from grade I-IV mean height of children was 72.5-79.4 cm.which is comparable to normal standard.Thus nutrition plays agreater role than the Genetic factor in influencing the growth rate. The results of the present study are Comparable to the Indian standards as Regards physical health and anthropometric Measurements .the reson for it.may be that They are residing in UT of Chandigarh ,which Provides adequate health facilities and also Because of the contribution of the anganwadies. A study on health appraisal of 1-6 years Children showed that 41.8% were normally Nourished ,39.8% were inlst grade ,16.0%In 2 nd grade and 2.4% had III rd grade of Malnourishment and out of 113 children 14.4% had suffered from one or more illness During the last three months, and pyrexia was The common illness .the health and nutritional Status of children in the present study were found To be same as regards to the weight, malnutrition and illness of children thus ,it was observed that in-spite of their morbidity status and malnutrition the children were comparable and found more advanced than the standard of ICMR,which could be the consequence of availability of health facilities in and around the community where the was carried .
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Karobi Das, Baljit Kaur