As early as 1948, health was defined in the World Health Organization’s Constitution as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
　　In this definition, the concept of health goes beyond disease control and takes into account all aspects of human well-being including both physical and psychological well-being. When it comes to the health of children, this concept also includes all aspects of child development.
　　Children carry forward the values of our culture and society. They help build up our country and are our hope for the future. They help with the advancement of the society. Therefore, it is very important to help children develop healthy physical, mental and social lives.
　　In 1990, the World Summit for Children adopted The World Declaration On The Survival, Protection And Development Of Children. On behalf of UNESCO, Dr. Myers suggested that saving lives and giving meaning to lives go hand in hand. This means it is important to give equal attention to both the survival and the development of children.
　　For some years now, technologically advanced countries have placed an emphasis on early childhood development. These countries have put early childhood development as their first priority in the long term sustainability of the countries and their human resources. Developing countries must not only pay attention to children’s right to survival, but also to children’s intellectual development and social proficiency.
　　Early childhood is a very critical stage of mental and physical development that lays the foundation for the child’s ability to mature. Therefore, giving children the appropriate protection, care, and education is essential.
　　One goal of the Millennium Declaration is to give all children the best possible start in life.
　　In 2001, UN Secretary-General Kofi Annan made a speech where he outlined these points: All children around the world have the right to expect the best possible start in life, the right to receive a good basic education, and the right to the opportunity to develop his or her full potential and become useful to society.
　　Early Childhood Development includes 1) physical development and 2) psychological development.
　　The five elements of early childhood development include: health, nutrition, education, protection, and environment.
　　Early Childhood Nurturing consists of caregivers providing daily care, essential resources such as time, food, hygiene, knowledge and skills, and offering loving relationship
　　Some crucial factors that contribute to the nurture of children include: 1) the caregivers’ educational background; (2) breast feeding and supplemental nutrition; (3) attention to their psycho-social development; (4) making and storage of food; (5) hygiene habits and hygienic facilities; and (6) sanitation.

Assessment is essential for the protection and advancement of children during their early development.
The purpose of this assessment is to:
　　•Evaluate the child’s physical development
　　• Identify possible problems and special needs in the child’s development
　　• Analyze the causes, including environmental factors, of the problems and special needs
　　• Monitor the implementation of interventions
　　• Assess the results of the intervention.

•Weight
　　Weight is the most important and most reliable index used to check a child’s physical development and nutritional condition.
　　1、The advantages of weight measurement are:
　　Acute or chronic malnutrition can be detected by the child’s weight at a specific age
　　It is objective and repeatable.
　　It is convenient and comparatively inexpensive
　　This technique is easy to learn.

•Weight Increase Index
　　In China, the average weight of a newborn baby is between 3.2 and 3.3 kg.
From 0 to 1 years old is total weight gain averages about 6.5 kg.
　　1 month: weight gain of 0.5 - 1.5 kg
　　2 - 3 months: weight gain of 0.9 - 1.25 kg
　　4 - 6 months: weight gain of 0.45 - 0.75 kg/month
　　7 - 12 months: weight gain of 0.22 - 0.37 kg/month
　　From age 1 to 2 years old the weight gain averages 2.0 - 2.5 kg/year.
　　From ages 2 to 10 years old the weight gain averages 2.0 kg/year.
　　It is very important to monitor weight regularly as follows:
　　Younger than 6 months once a month
　　6 - 12 months once every two months
　　1 - 2 years once every three months
　　3 - 6 years once every six months

•Height
　　Height reflects a person’s bone growth rate. Changes in height are only observed over a long period of time. It will only go up but not go down. If the height increases slowly or stops, this may indicate chronic malnutrition or illness.
　　•Height Increase Index
　　In China, the average length of a newborn baby is about 50 cm.
　　From 0 to 1 year old to total hight increase averages about 25cm
　　0 - 3 months: height increase of 3.5 cm per month
　　3 - 6 months: height increase of 2.0 cm per month
　　6 - 12 months: height increase of 1.0 - 1.5 cm per month
　　From ages 1 to 2 years old the height increase averages 10-12 cm per year.
From 2 years old to the beginning of puberty average height increases 5 - 8cm per year.
　　• Head Circumference
　　Head circumference is the size of head. The growth rate of the head circumference is closely related to brain development.
　　An abnormality of head circumference of a baby whether too big or too small, can be detected by regular check ups during infancy. If the head circumference is too big, it may indicate hydrocephalus or rickets, etc. If the head circumference is too small, it may indicate delayed mental development. Just like weight and height, head circumstance varies from person to person. Regular measurement of head circumference, motor skills and speech development during infancy can help identify mental delays. In that case, appropriate interventions can be implemented in a timely manner.

•Head Circumference Increase Index
　　In China, the average head circumference of a newborn baby is about 34 cm. The younger the child, the faster the growth rate.

From ages 0 to 1 year old average increase in head circumference is 13 cm per year.
　　0 - 1 month: 2.8 cm
　　1 - 2 months: 1.9 cm
　　2 - 3 months: 1.4cm
　　4 - 6 months: 3.0 cm per 3 months
　　7 - 9 months: 2.0 cm per 3 months
　　10 - 12 months: 1.5 cm per 3 months
　　From ages 1 to 2 years the average increase in head circumference is 2 cm per year.
　　From ages 2 to 3 years the average is 1 cm per year.
　　Assessment Standards of Physical Development
　　The assessment standards were developed based on the criteria of children in good health and who received good nutrition and good care, accurate measurement, and a large sample size.
　　China National Growth Standard
　　International Growth Standard

　　•Physical Development Assessment
　　Deviation (Standard Deviation)
　　Percentile
　　The advantages of using percentiles are:
　　It is easy to observe growth rate and changes in growth.
　　Dynamic measurement is possible because the method is simple, the curve is smooth, and the age.
　　The results are easy to interpret and to understand. The usage of the measurement is easy for parents to learn as well.
　　Percentiles can be used to measure data over a widely dispersed area.
2. Measurement of Psychological Development
　　1) Motor skills development (gross motor skills and fine motor skills)
　　2) Intellectual development
　　3) Speech development
　　4) Social and emotional development
　　5) Personality development
　　•Methods of Measuring Psychological Development
　　1) Instruments and Standardized Tests
　　2) Systematic Observation
　　•Assessing Intelligence
　　Intelligence is comprehensive in nature and includes perception, memory, and especially the ability to observe. Abstract thinking is a core aspect of intelligence and creativity is at advanced level of the human intellect.
　　•Intelligence Testing
　　Intelligence tests are used by psychologists to assess the intellectual abilities of people. They use some indirect methods such as observation of the child’s behaviors and analyze it after data collection.
　　Commonly used methods are intellectual evaluation tests, psychological evaluation tests, and proficiency evaluation tests.
　　The psychological evaluation test is an evaluation of infants’ psychological development.
　　The evaluation includes these five areas: gross motor skills, fine motor skills, perceptual ability, language, and social ability.
　　The results called a Developmental Quotient (DQ).
　　DQ = developmental age/actual age x 100
　　The most commonly used psychological evaluation tests
　　1. International:
　　Bayley Scales
　　Gesell Test
　　Denver Developmental Screening Test (DDST)
　　2. National:
　　CDCC
　　0 - 6 years old: Children Neuro-psychological Development Test
　　Motor Skills Development
　　Gross motor skills are comprised of the movement of head, neck, body, and limbs.
　　Fine motor skills include the movement of fingers and eye-hand coordination. Fine motor skills are the basis for writing, drawing and working.
　　Perceptual ability is an infant’s ability to take in outside stimulation and interpret it. For example, this includes the way an infant perceives an object and the surrounding environment; the ability to solve problems by using different skills, and the ability to adapt to different environments. Perceptual abilities are the result of an infant’s use of sight, hearing, gross motor skills, and fine motor skills. We can learn much about an infant’s intellectual abilities through direct observation of these activities.
　　Perception is one of the ways an infant use his/her mind.
　　Language is a psychological activity unique to human beings. It is a means of communication and a tool for self-expression. As an infant learns language, he/she acquires an effective way to communicate with adults and to accumulate knowledge.
　　Verbal language
　　Language expression, reading, and writing.
　　Social development
　　Social development is the ability to socialize with other people. It is the way a child responses to society. A child’s social behavior reflects his/her psychological development.
　　Social behaviors include the ability to socialize with other people, the ability to be self-sufficient, the ability to adapt to the outside world, and ability to use common sense.
　　Emotional development
　　Concept of self
　　Basic emotions
　　Emotions due to the stimulation of the five senses
　　Self image
What a 0 - 3 month can do:
　　•knows about the world by using the five senses
　　•eyes follow a person or an object
　　•reacts to human faces and bright colors
　　•stretches arms and legs; knows the existence of arms and legs
　　•raises his/her head; turns to the source of sound.
　　•cries; calms down when held
　　•smiles
　　•starts to feel the existence of his/herself
What a 0 - 3 month old baby needs:
　　•disease prevention; protection from any harm
　　•good nutrition (breast feeding is the best choice)
　　•good health maintenance (immunization, nutritional supplements, personal hygiene)
　　•attachment and bonding with adults
　　•adults who respond to the infant’s signals
　　•different objects to see, touch, hear, smell and taste
　　•someone who holds, rocks and sings to him/her
What a 4 - 6 month old baby can do:
　　•smiles all the time
　　•loves to be with parents and older kids
　　•repeats some movements that interest him/her
　　•listens attentively
　　•responds to talking
　　•giggles and tries to make sounds
　　•explores his/her hands and feet, puts things into his/her mouth
　　•rolls over; sits up and jumps on the bed with help
　　•uses hands to grab things
What a 4 - 6 month old baby needs:
　　•to explore the outside world
　　•appropriate language stimulation
　　•toys to play with every day
What a 7 - 12 month old baby can do:
　　•remember simple things
　　•know about him/herself; know about different body parts, recognize familiar voices
　　•respond to his/her own name, understand simple everyday words
　　•say first meaningful words
　　•explore, bang, and shake objects
　　•find hiding things, puts things into containers
　　•sit up
　　•crawl; stand and walks with help
　　•is shy or uncomfortable when seeing strangers
What a 7 - 12 month old baby needs:
　　•supplemental nutrition
　　•someone to tell him/her stories and read to him/her
　　•a safe environment to explore
What a 1-2 year old child can do:
　　•imitate adults
　　•learn how to talk; understand other people’s talking and thinking
　　•listen to stories; plays games with toys
　　•walk steadily; climb stairs, run
　　•be independent but still prefers to be with familiar people
　　•know what belongs to whom
　　•make friends
　　•solve problems
　　•is proud of what he/she has done
What a 1 - 2 year old child needs:
　　•learn new skills; continue to develop language and thinking skills
　　•learning to become independent
　　•self control
　　•learning to take care of him/herself
　　•a space to create and explore
　　•play with other children
　　•read or listen to stories everyday
　　•health maintenance including eliminating internal parasites if necessary
What a 2 - 3 year old child can do:
　　•loves to learn new skills
　　•develops more language skill
　　•is very active, cannot sit still
　　•can control hands and fingers movement
　　•gives up easily
　　•is more independent, but still depends on adults
　　•explores freely in a familiar environment
What a 2 - 3 year old child needs:
　　•choices in order to make decisions
　　•play make-believe game
　　•sing favorite songs
　　•guess simple riddles
What a 3 - 5 year old child can do:
　　•concentrate longer
　　•play silly, make noises
　　•is talkative, asks a lot of questions
　　•wants to have grown-up things
　　•shows his/her artistic potential
　　•carefully tests his/her own ability and courage
　　•shows real emotions in make-believe games
　　•wants to be with friends; doesn’t want to be left alone
　　•sometimes shares and takes turns
What a 3 - 5 year old child needs:
　　•fine motor skill development
　　•language development through talking, reading and singing
　　•five sense development through different activities
　　•learning how to work with, share with and help other people
　　•learning how to write and read
　　•learning through games and other activities
　　•learning to take responsibility and make choices
　　•learning self-control, persistence, and cooperation
　　•developing self-esteem and to be proud of him/herself
　　•self expression (through drawing and play dough
　　•fostering creativity
　　•participation in rhythmic activities and listening to music
The characteristics of children with developmental delays:
　　•do not respond to stimulation or attend to other people
　　•physical, social, and emotional delays
What a developmentally delayed child needs:
　　•a warm and caring environment; caretakers need to seek help when needed
　　•caretakers must spend more time with him/her, play and talk to him/her; caretakers can massage the child if necessary to play and communicate with other children．

Attention to Early Childhood
　　We need to provide a loving and nurturing environment with good care (medical support and health maintenance), good nutrition, appropriate stimulation, emotional support, and play opportunities in order for the children to mature.