6 DIANNE KOONTZ LOWMAN and JEAN W. SOLOMON After studying this chapter, the reader will be able to accomplish the following: • Explain the importance of knowing and understanding the characteristics of typical development while working in the pediatric occupational therapy arena. • Discuss the relationship among typical development, areas of performance, and contexts. • Define and briefly describe the periods of development. • Describe the general principles of development. • Apply the general principles of development and justify a developmental sequence of skill acquisition in performance and areas of occupation. The OT practitioner must understand development and the process of typical development. The sequence of acquisition in relation to occupational performance skills and areas is the foundation for OT assessment of and intervention with children who have special needs. The sequence of skill acquisition is predictable in the typically developing child.1 The OT practitioner’s knowledge of normal development guides the order of expectations and choice of activities for children who are not developing typically. In atypical development, delays in performance skills may make it difficult or impossible for a child to perform activities of daily living (ADLs), engage successfully in play activities, or acquire functional work and productive skills. The OT practitioner identifies deficits in the occupational performance skills (e.g., motor and process skills) that interfere with a child’s occupational performance. The practitioner relies on knowledge of typical development to assist the child in developing useful, functional skills. An OT practitioner who is attempting to grasp the basics of normal development must consider general pediatric terms, the predictable sequence of skill acquisition in normal development, the principles of development, and the relationship between development and context. An understanding of the general terms used by pediatric therapists is necessary for effective communication. The pediatric therapist also needs to know the predictable sequence of skill acquisition in a typically developing child. The OT practitioner must understand the relationship between typical development and the occupational performance contexts as delineated in the American Occupational Therapy Association’s (AOTA’s) Occupational Therapy Practice Framework: Domain and Process (2nd edition).3 A basic understanding of the terms used by OT clinicians who work in pediatrics helps practitioners and other individuals working in the area of pediatrics to communicate effectively. Normal is defined as that which occurs habitually or naturally.2 In this chapter, “normal” is used interchangeably with “typical” in the discussions on development. Development is the act or process of maturing or acquiring skills ranging from simple to more complex.2 Growth is the maturation of a person.2 Because the concepts of development and growth are analogous, these terms are used interchangeably in this chapter (Box 6-1). The normal development of skills in terms of performance and areas of occupation occurs in a predictable sequence.1,4,5,7 The OT practitioner uses knowledge of typical development while working with children who have special needs in order to identify the areas in which there are deficits and develop a plan to improve their ADLs, play, and academic skills. Although developmental checklists and other tools may help a practitioner identify the presence or absence of certain skills, understanding the process of how and why children are able to develop these skills is more useful in the clinical setting. For example, an OT practitioner may use an observational checklist to determine whether a child can independently finger-feed himself or herself. A practitioner who has knowledge of normal development and its predictable sequence of events understands that children usually learn to eat with their fingers before learning to eat with a spoon. Therefore, if a child is not yet finger-feeding, the practitioner would not introduce spoon-feeding (depending on the circumstances). Knowledge and understanding of normal development guide the OT practitioner in the intervention planning process. OT practitioners need to understand the relationship between typical development and context. Because the events of normal development are sequential and predictable, the chronological age of the child (i.e., how old the child is) has an impact on the child’s level of skill development in performance and areas of occupation.1,4,5,7 Although practitioners obviously cannot change the age of a child, they can offer age-appropriate activities during intervention sessions. Being familiar with age-appropriate activities helps OT practitioners choose tasks for therapy sessions with children. For example, a practitioner may use colored blocks while performing fine motor and sorting activities with a 3-year-old child, but the use of blocks would not be suitable in a session with a 14-year-old adolescent. It would be more appropriate to have the adolescent use objects like coins for fine motor and sorting activities. Although normal development is predictable and sequential, the rate of skill acquisition varies among children. This variability greatly depends on the context and environment (Box 6-2). These contexts include cultural, personal, temporal, virtual, physical, and social factors.3
Principles of normal development
General considerations
Definitions of terms
Predictable sequence of skill acquisition
Relationship between typical development and context
< div class='tao-gold-member'>
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
Principles of normal development
Only gold members can continue reading. Log In or Register to continue
