Child development

Health Visiting and School Nursing Child development

Information on development from conception through to adulthood, what professionals are reviewing at different stages, why, and what will happen if a child or young person is having any difficulties. Advice on helping to support development for all the family, and the benefits of doing so. Useful links to video clips, local and national information and guidance.

An ASQ (Ages and Stages Questionnaire) is a parent-completed questionnaire that reliably identifies developmental progress of children from one month to 5½ years.

ASQs assess the following developmental areas: communication, gross motor skills (big/ whole body movements), fine motor skills (use of fingers), problem solving abilities and personal-social skills. This can help to detect early on if there is a developmental delay so intervention and support can be offered.

The Health Visiting team offer 2 routine developmental reviews for children, the first takes place just before your child’s first birthday and a second at 2 to 2 ½ years. At these appointments you may want to ask for support regarding any developmental or behaviour concerns you may have.

2 questionnaires are sent to parents/carers before the review, each questionnaire involves 30 questions about the child’s abilities. Each questionnaire takes 10–15 minutes for parents to complete and just 2–3 minutes for professionals to score. The review can take place in either the home environment or in a clinic setting. The visit generally takes 45-60 minutes to complete.

The questionnaire is only part of the review; there will be additional time to discuss all aspects of general health and wellbeing such as diet, home safety, toilet training and behaviour support.

Once your child starts school, they will have a further developmental review. The Ages and Stages Questionnaire (ASQ-3) screens and assesses the developmental performance of children in the areas of communication, gross motor skills, fine motor skills, problem solving, and personal-social skills. It is used to identify children that would benefit from in-depth evaluation for developmental delays. You will receive this questionnaire in your child’s book bag from school a couple of months before their 5th birthday. This will allow the School Nurses to have a sound overall picture of your child and whether there are areas that may need further development.

Important brain development occurs in the first years of a child’s life.

As a parent or guardian, you can support your child’s early development by providing a safe and nurturing environment, with gentle care, touch, speech, and play.

Antenatal (before your child is born) – Your child’s brain has already started developing. All five senses begin to function before birth and sensory experiences (e.g. what they hear) can help shape the brain and nervous system.

0-6 months – Significant ‘wiring’ of the brain occurs in the first years of a child’s life and your baby’s brain is developing as a result of the relationships and experiences they are exposed to each day. Babies learn through observing their parents and caregivers, and how they react to various movements and sound such as crying, yelling, smiling and cooing.

6-9 months – By nine months your child’s brain has already undergone a rapid growth spurt that helps form connections between what they see, hear, feel and taste. Playtime and interactions with parents and family members provide key learning opportunities for early development.

3 years –The early years are a rapid period of brain development. Engaging with your child and providing a safe and caring environment has a significant positive impact on your child’s development.

4-5years – By school, a child’s brain development is built upon the solid foundation created in the first four to five years. It is much easier for children to take advantage of learning environments, such as school, if they have had a nurturing home environment and learning experiences. is Europe’s largest advice and support website for fathers.

A developmental milestone is an ability that is achieved by most children by a certain age. All children develop at different rates dependant on their family’s background, their personality and how they are parented. Developmental milestones can involve physical, social, emotional, cognitive, and communication skills.

You can get information and advice about this on the Birth-to-five development timeline. This is an interactive guide to child development from birth to five years old, including videos and advice to help parents, which can be found on the NHS website.

As a parent, your relationship with your child is important to help your child to develop mentally, physically and emotionally into adulthood. A baby that experiences regular and sensitive care learns that they are worthy of that care.

If you are worried about any area of your child’s development please contact your health visitor or school nurse for advice and support.

The Family Information Service (FIS) Directory provides information for families and people working with them in Torbay.

Babies sometimes develop a flattened head when they’re a few months old, usually as a result of them spending a lot of time lying on their back.

This is known as flat head syndrome and there are 2 main types:

  • Plagiocephaly – the head is flattened on one side, causing it to look asymmetrical (both sides of the head look different); the ears may be misaligned and the head looks like a parallelogram when seen from above, and sometimes the forehead and face may bulge a little on the flat side.
  • Brachycephaly – the back of the head becomes flattened, causing the head to widen, and occasionally the forehead bulges out.

Always discuss these symptoms with your Health Visitor. However, these problems are quite common and in most cases they aren’t a major cause for concern, as they don’t have any effect on the brain and the head shape will often improve by itself over time. Your baby won’t experience any pain or other symptoms, or any problems with their general development.

If you need further information, support or advice please look at the NHS website or call your Health Visiting team.

Portage is a team of specially trained helpers who visit children with special needs in their own homes to work with parents and children on areas of development through play. Portage staff also provide support to help ensure a smooth transition for children starting nursery and school. Portage is aimed at children and families within Torbay that:

  • Have a child under the age of 5
  • Has a disability or special needs
  • Need support from 3 or more professionals but including your G.P. or health visitor.

Your Portage Home Visitor will be your first point of contact. They will make sure you have all the appropriate information that you need and more importantly that you understand it.

They will ensure that all the people you are in contact with most meet regularly. A written plan will be reviewed at these meetings to ensure you are receiving the best service to suit your needs.

Parents share with the home visitor their understanding of their child’s individual abilities and support needs. The Portage Home Visitor will help the parents complete a developmental profile which will help with identifying the child’s strengths and goals for future learning.

Premature babies and development

Premature birth can affect the way your child develops and the earlier your child was born, the higher the risks, so your Midwife and Health Visitor will provide additional monitoring and support to ensure your baby develops as normally and healthily as possible. Should your child need additional support there are specialist services to support you as parents. However, it’s all about striking a balance: every child develops in their own unique way.

Development milestones are based on averages. Not meeting given milestones is not just an issue for pre-term babies. Term babies sometimes do not meet development milestones either.

Dads and premature babies

Your beautiful baby has arrived. But they were born prematurely or sick and they need special care. Your joy over your baby’s birth may be mixed with worry and heartache.

The birth of a premature or sick baby is stressful and difficult for all family members. You may worry about your baby and your partner as well as other children at home, demands from your job, and financial concerns.

While each father develops his own way of coping with the birth of a premature or sick infant, this information may help make this difficult time a bit easier.

  • Expect strong emotions
  • Overwhelming love and pride in your new baby
  • Express yourself

The birth of a sick child can put stress on the relationship between you and your partner as well as your relationships with other family members.

It’s important to share your feelings with your partner throughout your baby’s illness, so that you can support each other and come through this experience a stronger team.

Men and women sometimes cope differently. Some men tend to keep their feelings to themselves in order to spare their partner.

Puberty is when a child’s body begins to develop and change as they become an adult. Girls develop breasts and start their periods, and boys develop a deeper voice and start to look like men.

The average age for girls to begin puberty is 11, while for boys the average age is 12. But there’s no set timetable, so don’t worry if your child reaches puberty before or after their friends. It’s completely normal for puberty to begin at any point from the ages of 8 to 14. The process takes about four years overall. (The NHS website)

Your child’s Red Book is usually given to you when you meet your Health Visitor at your Antenatal contact.

It is a personal record of your child’s health, growth and development.

You can record important milestones relating to your child’s growth or anything you wish to remember, such as advice you have been given by your health professional.

We ask you to keep it safe and bring it with you when you see health professionals with, or about your child.

Information about the National Child Measurement Programme height and weight checks and healthy lifestyle changes.

Find support, guidance and information for parents and carers of children and young people with special educational needs and disabilities.

I CAN is a national charity which has a lot of advice about helping your child’s speech development and what to expect with their speech development at what ages.

Torbay Speech and Language Therapy department run an open referral system. This means anyone can refer a child, you do not need to ask a professional to do this for you. However, they do not accept referrals without parents’ knowledge and permission.

You can self-refer by downloading and completing a referral form and sending it to the Speech and Language Therapy Service (details on referral form).

Adolescence refers to the period of physical and psychological development between childhood and adulthood. The beginning of adolescence is around the onset of puberty, which brings dramatic alterations in hormone levels and consequent physical changes.

Puberty onset is also associated with profound changes in drives, motivations, psychology, and social life; these changes continue throughout adolescence.

Teenager’s brains change a lot before they reach adulthood. This includes the brain getting better at recognising emotions.

During teenage years, young people are not using their brains in the same way adults might, they often make decisions based on emotion, impulses and aggression – adults use more problem solving skills.

There are lots of interesting YouTube videos about teenage brain and behaviour development.

Children learn to walk at different ages, (usually around 10-18 months). Parents/carers often worry what is ‘normal’; if you do have any concerns please look at these video clips and discuss further with your health visitor or GP.

Normal variation in children’s walking – Flat Feet

Normal variations of children’s walking – Toe walking

Normal variations of children’s walking – In-toeing

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