Attention, communication and hand skills: newborn to onset of sitting

Will 5w swiping 4.jpgInfants are born with a natural curiosity about the world and the ability to pay attention to interesting objects (especially faces and hands) that come into their field of vision and will even stick out their tongues after watching a caregiver do the same.
 

Within weeks they start to reach for and explore with their hands interesting objects that catch their attention and by 8 months when they start to sit they have developed quite sophisticated ability for sustained attention to a task and the ability to manipulate toys using a full range of hand actions.

This development of sustained attention and visual and manual exploration of toys is strongly influenced by the infant’s social environment.  A responsive and rich environment which provides many opportunities that are just right for the infant’s level of development promotes optimal development of attention and fine motor skills.

This is particularly true for infants who are born premature and those who are risk for autism or have form of developmental delay. For these infants early and responsive intervention to promote social, attention and fine motor skills is very important for ensuring optimal development.

Long term follow up studies have shown that premature infants have a greater risk of developing attention and fine motor problems when they enter school. Early intervention has been shown to reduce this risk.

Importance of face-to-face conversations

Newborn looking 2_2.jpgFrom birth infants are able to imitate other people’s mouth movements and soon start to mirror the expressions on their caregiver’s faces.

Infants love to have conversations with their caregivers. Mothers are very good at setting up turn taking in these conversations: they say something and then give the infant a chance to respond. By 3-4 months infants are adding their own voice to the conversation as they coo and gurgle in response. These conversations provide the infant with their first experience of sustaining their attention on a task for minutes at a time.

Reaching, grasping and manipulation

W 4m playing hands in bouncy chair.jpgWithin weeks newborn infants start to reach towards their carer’s faces and interesting objects within reach. Early reaching is a bit of a hit and miss affair, but soon the infant manages to grasp and explore toys that are suspended within easy reach.

At 3-4 months infants are able to hold the head steady in the midline and bring the hands together to hold and explore toys.  What is quite remarkable is how, by this age, infants have developed the ability to pay careful and sustained attention to what they are doing with their hands: they prod, grasp, pull, and push the toy.

This exploration of toys teaches them a great deal about the relationship between what things look like, how they feel and how they respond to being manipulated.

Lots of experience with manipulating toys also provides the brain and the hand muscles with the experience they needs to control the movements of the fingers for the basic grasping actions. 

Early action: newborn to sitting 

Newborn moments of repose and visual contact

Hands lightly fisted when lying quietly
Looks intently at interesting objects - this is sometimes called visual reaching. 
Visually tracks moving toy.

Newborn repose W 5w.jpg    Newborn looking 2.jpg    

Looks with interest at caregivers face 

Responds to caregivers voice.  Will imitate mouth movements if prompted by caregiver. 

 W 5w conversation_1.jpg

Swipes at toys in reaching distance

Fingers are extended. 
Sometimes manages to grasp toy.

Will 5w swiping 2.jpg    Will 5w swiping 4.jpg  

Looks at own hands with great interest 

Also watches hands of social companion. 

W 4m hands to midline.jpg   T 13 w watching hands 1.jpg

Brings both hands to mouth

From 2-3 months infants can hold their heads steady in the mid-ling and bring their hands to their mouths. 

W 4m hands to mouth.jpg

Watches and reaches towards caregiver's face 

Faces interest infants. Infants love to have conversations with caregivers. 

 T 18w reachinh face.jpg

Reaches  for, feels and grasps toys with two hands 

Hand not shaped to match the toy. Grasp is still hit and miss. 

 W 4m 22 feb grasp skills 1_1.jpg    W 4m 22 feb grasp skills 2.jpg 

Uses fingers to explore a toy 

Watches own actions carefully - this helps the infant to make connections in the brain between what he sees and what he feels. 

W 4m playing hands in bouncy chair.jpg

Holds a toy in one hand briefly

Will hold and shake a rattle when it is placed in the hand. Grip is not secure. Drops toy quickly. 

 W 4m hold and shakes rattle.jpg