Child Development: Growth and Early Learning Stages

Early childhood, spanning from before birth to age 8, is a critical period of development characterized by rapid brain and body growth. This stage lays the groundwork for a child's future learning, relationships, and overall well-being.

The Foundational Years: Early Childhood Development

Early childhood is a pivotal period of child development that begins before birth through age 8. This is a period of rapid brain and body development. In the first few years of life, more than 1 million new neural connections are formed every second (Center for Developing Child). The experiences and opportunities offered in early childhood lay the foundation for how children grow, learn, build relationships, and prepare for school.

Brain Development and Neural Connections

Advances in neuroscience over the last two decades have provided new insights regarding the processes of early brain development and their long-term implications for development and learning. Neural connections in the brain-which are the basis for all thought, communication, and learning-are established most rapidly in early childhood.14 The processes of forming new neural connections and pruning the neural connections that are not used continue throughout a person’s lifespan but are most consequential in the first three years.15 When adults are sensitive and respond to an infant’s babble, cry, or gesture, they directly support the development of neural connections that lay the foundation for children’s communication and social skills, including self-regulation.

The Interplay of Biology and Environment

A child does not grow in a silo. The health of their family, community, safety of their environment as well as the systems and policy all interact to affect the trajectory and health of a child. The interplay of biology and environment, present at birth, continues through the preschool years and primary grades (kindergarten through grade 3). This has particular implications for children who experience adversity. No group is monolithic, and data specific to communities provides a deeper understanding of children’s experiences and outcomes. Some children appear to be more susceptible than others to the effects of environmental influence-both positive and negative-reflecting individual differences at play. For children facing adverse circumstances, including trauma, the buffering effects of caring, consistent relationships-with family and other community members but also in high-quality early childhood programs-are also important to note.22 This emerging science emphasizes the critical importance of early childhood educators in providing consistent, responsive, sensitive care and education to promote children’s development and learning across the full birth-through-8 age span. The negative impacts of chronic stress and other adverse experiences can be overcome.

Domains of Development

Early childhood educators are responsible for fostering children’s development and learning in all these domains as well as in general learning competencies and executive functioning, which include attention, working memory, self-regulation, reasoning, problem solving, and approaches to learning. There is considerable overlap and interaction across these domains and competencies. For example, sound nutrition, physical activity, and sufficient sleep all promote children’s abilities to engage in social interactions that, in turn, stimulate cognitive growth. Changes in one domain often impact other areas and highlight each area’s importance. For example, as children begin to crawl or walk, they gain new possibilities for exploring the world. This mobility in turn affects both their cognitive development and their ability to satisfy their curiosity, underscoring the importance of adaptations for children with disabilities that limit their mobility. Likewise, language development influences a child’s ability to participate in social interaction with adults and other children; such interactions, in turn, support further language development as well as further social, emotional, and cognitive development. A growing body of work demonstrates relationships between social, emotional, executive function, and cognitive competencies26 as well as the importance of movement and physical activity.27 These areas of learning are mutually reinforcing and all are critical in educating young children across birth through age 8. Intentional teaching strategies, including, and particularly, play (both self-directed and guided), address each domain. Kindergartens and grades 1-3 tend to be considered elementary or primary education, and, as such, may have increasingly prioritized cognitive learning at the expense of physical, social, emotional, and linguistic development.

The Role of Play

Play promotes joyful learning that fosters self-regulation, language, cognitive and social competencies as well as content knowledge across disciplines. Play (e.g., self-directed, guided, solitary, parallel, social, cooperative, onlooker, object, fantasy, physical, constructive, and games with rules) is the central teaching practice that facilitates young children’s development and learning. Play develops young children’s symbolic and imaginative thinking, peer relationships, language (English and/or additional languages), physical development, and problem-solving skills. All young children need daily, sustained opportunities for play, both indoors and outdoors. Play helps children develop large-motor and fine-motor physical competence, explore and make sense of their world, interact with others, express and control their emotions, develop symbolic and problem-solving abilities, and practice emerging skills. Indeed, play embodies the characteristics of effective development and learning described in principles 4 and 5-active, meaningful engagement driven by children’s choices. Although adults can be play partners (for example, playing peekaboo with an infant) or play facilitators (by making a suggestion to extend the activity in a certain way), the more that the adult directs an activity or interaction, the less likely it will be perceived as play by the child. When planning learning environments and activities, educators may find it helpful to consider a continuum ranging from children’s self-directed play to direct instruction.31 Neither end of the continuum is effective by itself in creating a high-quality early childhood program. Effective, developmentally-appropriate practice does not mean simply letting children play in the absence of a planned learning environment, nor does it mean predominantly offering direct instruction. In the middle of the continuum is guided play. Educators create learning environments that reflect children’s interests; they provide sustained time and opportunities for children to engage in self-directed play (individually and in small groups). Guided play gives educators opportunities to use children’s interests and creations to introduce new vocabulary and concepts, model complex language, and provide children with multiple opportunities to use words in context in children’s home languages as well as in English. Despite evidence that supports the value of play, not all children are afforded the opportunity to play, a reality which disproportionately affects Black and Latino/a children.34 Play is often viewed as being at odds with the demands of formal schooling, especially for children growing up in under-resourced communities.35 In fact, the highly didactic, highly controlling curriculum found in many kindergarten and primary grades, with its narrow focus on test-focused skill development, is unlikely to be engaging or meaningful for children; it is also unlikely to build the broad knowledge and vocabulary needed for reading comprehension in later grades. Instead, the lesson children are likely to learn is that they are not valued thinkers or successful learners in school.

Complexity and Variability in Development

A pervasive characteristic of development is that children’s functioning, including their play, becomes increasingly complex-in language, cognition, social interaction, physical movement, problem solving, and virtually every other aspect. Increased organization and memory capacity of the developing brain make it possible for children to combine simple routines into more complex strategies with age.39 Despite these predictable changes in all domains, the ways that these changes are demonstrated and the meanings attached to them will vary in different cultural and linguistic contexts. Development and learning also occur at varying rates from child to child and at uneven rates across different areas for each child. Children’s demonstrated abilities and skills are often fluid and may vary from day to day based on individual or contextual factors. For example, because children are still developing the ability to direct their attention, a distraction in the environment may result in a child successfully completing a puzzle one day but not the next. Even as infants, children are capable of highly complex thinking.45 Using information they gather through their interactions with people and things as well as their observations of the world around them, they quickly create sophisticated theories to build their conceptual understanding. They recognize patterns and make predictions that they then apply to new situations. Infants appear particularly attuned to adults as sources of information, underscoring the importance of consistent, responsive caregiving to support the formation of relationships.46 Cultural variations can be seen in these interactions, with implications for later development and learning. For example, in some cultures, children are socialized to quietly observe members of the adult community and to learn by pitching in (often through mimicking the adults’ behaviors).47 In other cultures, adults make a point of getting a child’s attention to encourage one-on-one interactions. Throughout the early childhood years, young children continue to construct knowledge and make meaning through their interactions with adults and peers, through active exploration and play, and through their observations of people and things in the world around them. Educators recognize the importance of their role in creating a rich, play-based learning environment that encourages the development of knowledge (including vocabulary) and skills across all domains. Educators understand that children’s current abilities are largely the result of the experiences-the opportunities to learn-that children have had. In addition to learning language and concepts about the physical phenomena in the world around them, children learn powerful lessons about social dynamics as they observe the interactions that educators have with them and other children as well as peer interactions. Early childhood educators need to understand the importance of creating a learning environment that helps children develop social identities which do not privilege one group over another. They must also be aware of the potential for implicit bias that may prejudice their interactions with children of various social identities.49 Educators must also recognize that their nonverbal signals may influence children’s attitudes toward their peers.

Fostering Motivation and a Sense of Belonging

Children’s motivation to learn is increased when their learning environment fosters their sense of belonging, purpose, and agency. This principle is drawn from the influential report How People Learn II and is supported by a growing body of research that affirms principles espoused more than 100 years ago by John Dewey.51 The sense of belonging requires both physical and psychological safety. Seeing connections with home and community can be a powerful signal for children’s establishing psychological safety; conversely, when there are few signs of connection for children, their psychological safety is jeopardized. Equally important is encouraging each child’s sense of agency. Opportunities for agency-that is, the ability to make and act upon choices about what activities one will engage in and how those activities will proceed-must be widely available for all children, not limited as a reward after completing other tasks or only offered to high-achieving students. Ultimately, motivation is a personal decision based on the learner’s determination of meaningfulness, interest, and engagement.53 Educators can promote children’s agency and help them feel motivated by engaging them in challenging yet achievable tasks that build on their interests and that they recognize as meaningful and purposeful to their lives. Studies have found that some children are denied opportunities to exercise agency because they are mistakenly deemed unable to do so.54 For educators, supporting a child’s agency can be especially challenging when they do not speak the same language as the child or are not able to understand a child’s attempts to express solutions or preferences. As noted earlier regarding brain development, children’s feelings of safety and security are essential for the development of higher-order thinking skills, so fostering that sense of belonging is essentially a brain-building activity. Beginning in infancy, educators who follow children’s lead in noticing their interests and responding with an appropriate action and conversation (including noting when interest wanes) are helping children develop self-confidence and an understanding that their actions make a difference. Educators can involve children in choosing or creating learning experiences that are meaningful to them, helping them establish and achieve challenging goals, and reflecting on their experiences and their learning.

Integrated Learning

Children learn in an integrated fashion that cuts across academic disciplines or subject areas. Based on their knowledge of what is meaningful and engaging to each child, educators design the learning environment and its activities to promote subject area knowledge across all content areas as well as across all domains of development. Educators use their knowledge of learning progressions for different subjects, their understanding of common conceptions and misconceptions at different points on the progressions, and their pedagogical knowledge about each subject area to develop learning activities that offer challenging but achievable goals for children that are also meaningful and engaging. These activities will look very different for infants and toddlers than for second- and third-graders and from one community of learners to another, given variations in culture and context. Recognizing the value of the academic disciplines, an interdisciplinary approach that considers multiple areas together is typically more meaningful than teaching content areas separately. This requires going beyond superficial connections. Educators shape children’s conceptual development through their use of language. For example, labeling objects helps young children form conceptual categories; statements conveyed as generic descriptions about a category are especially salient to young children and, once learned, can be resistant to change.56 It is also important for educators to monitor their language for potential bias. For example, educators who frequently refer to “boys” and “girls” rather than “children” emphasize binary gender distinctions that exclude some children. Educators can also encourage children’s continued exploration and discovery through the words they use. From infancy through age 8, proactively building children’s conceptual and factual knowledge, including academic vocabulary, is essential because knowledge is the primary driver of comprehension. The more children (and adults) know, the better their listening comprehension and, later, reading comprehension.

Developmental Milestones: A Guide for Parents

Understanding your child’s changing growth and development milestones is an important part of parenting. As infants and children progress through a series of growth stages, they may encounter common physical or emotional challenges. The pediatric experts at CHOC created a series of guides by age and stage, so you can better understand what your child is going through and spot any issues along the way.

Read also: Unlocking Student Potential

What are Developmental Milestones?

Skills such as taking a first step or smiling for the first time are called developmental milestones. Development Skills and Milestones Children reach milestones in how they play, learn, speak, act and move. All children develop at their own pace, but these milestones give you a general idea of the changes to expect as your child grows. Developmental milestones can be categorized by the following:

Speech and Language
Dressing Skills
Fine Motor and Visual Motor Skills
Grooming Skills

Monitoring Physical Development: Growth Charts

Kids grow at their own pace. There are a wide range of healthy shapes and sizes among children. Genetics, gender, nutrition, physical activity, health problems, environment and hormones all play a role in a child’s height and weight, and many of these can vary widely from family to family.

How Doctors Use Growth Charts

Doctors consider growth charts along with a child’s overall well-being, environment and genetic background. Your child’s doctor may also consider:

Is the child meeting other developmental milestones?
Are there any other signs that a child is not healthy?
What height and weight are the child’s parents and siblings?
Was the child born prematurely?
Has the child started puberty earlier or later than average?

Different Charts for Different Children

No. Girls and boys are measured on different growth charts because they grow in different patterns and at different rates. One set of charts is used for babies, from birth to 36 months. Another set is used for kids and teens ages 2-20 years old. Also, special growth charts can be used for children with certain conditions, such as Down syndrome, or who were born early.

Potential Problems

Keeping an eye on growth charts may help you or your child’s doctor spot any potential growth issues. Some patterns to look out for include:

When a child’s weight or height percentile changes from a pattern it’s been following. For example: If height and weight have both been on the 60th percentile line until a child is 5 years old, and then the height drops to the 30th percentile at age 6, that might suggest a growth problem because the child is not following his or her usual growth pattern. But changing percentiles doesn’t always mean there’s a problem. Many kids may show changes in growth percentiles at some points in development, when it’s normal for growth rates to vary more from child to child. This is particularly common during infancy and puberty.
If a child’s height progression is very different from what is expected by his or her midparental height calculation.
If there is an abnormally low or high body mass index (BMI <5% or >85%).

Growth charts are a helpful tool, but it is important to know that they do not paint a full picture of your child’s development or overall health. If you have any questions or concerns about your child’s growth - or growth charts - talk with your pediatrician.

Stages of Child Development

Children change rapidly as they grow. Many of these changes are physical. Other changes are cognitive, which means the changes affect the way children think and learn. Child development often occurs in stages, with the majority of children hitting specific developmental landmarks by the time they reach a certain age.

Defining the Stages

Scholars have different opinions on the exact number of stages of development children go through on their way to becoming adults. In 1936, for example, Swiss developmental psychologist Jean Piaget worked out a theory that describes four main stages of child development: Birth through 18 - 24 months, a “preoperational” that includes toddlerhood and early childhood through the age of 7, a “concrete operational” stage from ages 7 - 12, and adolescence. Failing to reach some of the milestones may signal a developmental disability. Because of screening techniques child development specialists use, most people with developmental disabilities receive a diagnosis by the time they reach adolescence.

Key Milestones in Each Stage

Newborn (First Month): During the first month of life, newborns exhibit automatic responses to external stimuli. In other words, a newborn will turn her head toward your hand when you stroke her cheek or grab your finger when you place it in her hand. Newborns may show signs developmental disabilities, such as spina bifida, genetic disorders and fetal alcohol syndrome.
Infancy (First Year): Infants develop new abilities quickly in the first year of life. At three to six months, an infant can control his head movements and bring his hands together. By six to nine months old, an infant can sit without support, babble and respond to his name. Slow development in infants may be signs of Down’s syndrome and other developmental disabilities.
Toddler Years (One to Three Years): As children reach the ages between one and three years, toddlers learn to walk without help, climb stairs and jump in place. The Centers for Disease Control and Prevention (CDC) recommends screening for autism at 18 to 24 months, or whenever a parent or health care professional has a concern.
Preschool Years (Three to Five Years): Between the ages of three and five years, children refine their motor skills. Signs of developmental disabilities, such as cerebral palsy, may appear during this stage of development.
School Age (Six to Twelve Years): School age children are six to 12 years old. They are capable, confident, independent and responsible. Peer relationships, particularly relationships with friends of the same gender, are important to school age children.

Addressing Concerns and Seeking Support

Concerned about your child's development? You know your child best. Don't wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child's doctor, share your concerns, and ask about developmental screening. Call your state or territory's early intervention program to find out if your child can get services to help. If you worry that your child is falling behind, contact RISE, innovative human services network originally established in 1987. RISE offers a variety of helpful services for people with disabilities, including day programs, employment assistance, managed care, residential settings, and home and community based services.

Resources for Pediatric Providers

AAP has released a new resource Early Childhood Social-Emotional Development Billing and Coding that details billing and diagnosis codes recommended for use by pediatric providers, followed by case vignettes examples of social-emotional development coding in practice. This document is designed for all pediatric providers, including pediatricians, family medicine, integrated mental health professionals, and other specialists who work with children ages 0-5. Take the online education course titled Infant and Early Childhood Mental Health: Relational Foundations for Lifelong Health funded by the Perigee Fund to learn and apply an infant and early childhood mental health principles to promote, prevent risks, and intervene to support healthy early childhood development. The first 1,000 learners can access the course for free using code SAVE5. The intended audience is pediatricians, family medicine, and their teams, and others that care for infants and young children’s health and family well-being. Call today to schedule an appointment with one of our pediatricians.

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