Child development: What to expect

There’s nothing more fascinating than watching a child grow and develop. Especially to a parent, each milestone from early stages on is amazing. Even though kids develop at their own pace, for children to have a healthy life, experts say that monitoring and paying attention to their growth and development is vital.

Understanding a child’s growth and development is an important part of parenting. As children go through growth stages, they encounter physical and emotional trials.

Prof Joseph Mucumbisti, a paediatrician at Oshen King Faisal Hospital in Kigali, and president of Rwanda Heart Foundation, says early childhood development includes emotional, social and physical growth of infants, which has a direct effect on their general progress and the adults they will become.


Mucumbisti says that growth and development include physical changes that occur from infancy to adolescence, and changes in emotions.

This growth, he says, includes personality, behaviour, intellect and speech.

Dr Jean Paul Rukabyarwema, a paediatrician in developmental behavioural paediatrics (DBP) at Muhima Hospital, says child development implies changes that occur in the child over time.

He says these changes are continuous from conception to maturity; and its sequence is the same in all children, though its rate varies from one child to another. 

Claudine Uwajeneza, a paediatrician at Glein Clinic in Remera, says there are five main areas of growth, including cognitive development which is the child’s ability to learn and solve problems.

Social and emotional development is another stage, and this includes expression and management of emotions, and the ability to establish positive and rewarding relationships with others.

Another stage, she says, is speech and language development, which involves learning mechanisms and outcomes from birth to five years of age. Here, she says, by age five, children should be able to master the sound system and grammar of their language.

Uwajeneza says another stage is the motor skill development, where children learn to use their smaller muscles, like muscles in the hands, fingers, and wrists.

Also, Uwajeneza says, there is gross motor development (physical) which requires whole body movement and involves the large muscles of the body that perform everyday functions, like standing, walking, running, and sitting upright.

She adds that this also includes eye-hand coordination skills such as ball skills (throwing, catching, and kicking), among others.

Rukabyarwema explains that infancy and childhood are dynamic periods of growth and change. Neurodevelopment and physical growth proceed in a sequential and predictable pattern that is intrinsically determined.

“Development does not happen on a clear-cut timetable or in concrete stages; and what appears to be true at one age can change over time, therefore it’s vital for every parent to monitor the development of their children stage by stage,” he says.

Infancy and childhood are dynamic periods of growth and change. /Net 


Rukabyarwema says since child development occurs in a serial and predictable pattern, following regulations that can be explored, discovered, confirmed, reconfirmed and celebrated is important.

He notes that these laws, however, are described as developmental milestones, and these provide a systematic approach to observe the progress of a child’s development over time.

“Attainment of a particular skill builds on the success of earlier skills. Delays in one developmental domain may impair development in another domain,” he says.

Rukabyarwema adds that a deficit in one domain may compromise the assessment of skill levels in another domain, even though development in the second domain is normal.

Due to this, he says, it is important to follow child development, using appropriate tools for early detection of developmental delay, hence, introduce early intervention to promote early childhood development.


Rukabyarwema says there are things that determine a child’s development, mostly genetic factors, as they predict how the child will mature.

For instance, he says, there are children who are born with genetic disorders like Down syndrome, among others.

Another factor, Rukabyarwema says, is the general wellbeing of the child, as health influences development. Mucumbisti says social and cultural factors also play a big role in the development of a child.

He says that growth could be affected by the environment a child is in.

Other factors include parental connect and nutrition.

Early childhood development is necessary to uphold the right of every child to survive and thrive. /File 



Dr Rukabyarwema says the stages and activities done by a child are divided in categories of development. For the gross motor, one should be concerned if a child of four months is not able to control his/her head.

Another thing, at nine months, a child who is not able to sit on his/her own should be cause for concern, and help from medics should be sought before it’s too late.

“At 18 months, if a child is not able to walk, that is a problem because normally, at least by 12 months, a baby should be able to walk,” he observes.

For social and emotional development, he says a six-month-old child who can’t smile or show any expression in most cases could be suffering from autism.  

Before a year, one should be able to detect if a child can make eye contact or smile.

At nine months, they should have vocal sounds.

At 15 months, he says, they should make pointing gestures and at 18 months, if they can’t speak, play or make gestures, they should be taken for a check-up. 

Lastly, Rukabyarwema says, at two years, a child should be able to make a two word sentence.


Mucumbisti says there are tools that paediatricians use to see if a child is performing well, as far as their development is concerned.

He says this should be done at nine, 18, 24 or 30 months. It can be done any time during the development of the child.

World Health Organisation (WHO) and UNICEF (United Nations Children’s Fund), and many other partners, this year launched the ‘Nurturing Care Framework’. The agenda builds upon state-of-the art evidence of how child development unfolds and of the effective policies and interventions that can improve early childhood development.

This will also promote development milestones of infants.

Packages include adequate nutrition to ensure children are eating a balanced diet to prevent malnutrition, stunting and other conditions resulting from poor nutrition.

The agenda also outlines the major threats to early childhood development, how nurturing care protects young children from the worst effects of adversity and promotes physical, emotional and cognitive development, and, what families and caregivers need to provide nurturing care for young children.

According to WHO, investing in early childhood development is one of the best investments a country can make to boost economic growth, promote peaceful and sustainable societies, and eliminate extreme poverty and inequality. Equally important, investing in early childhood development is necessary to uphold the right of every child to survive and thrive.

Experts share their views

Parents should be sensitised on how to prevent stunting as this is a major part of child development. Stunting affects both a child’s physical and mental health, with consequences on their school performance and overall development.

Dr Daniel Gahungu, General practitioner


Small measures such as ensuring children’s safety at home or when playing should be adopted by parents. Also, monitoring their growth and identifying any negative changes is vital.

Dr Raymond Awazi, Paediatrician


Ensuring that each and every child gets full immunisation is important as far as child development is concerned. Instruction to young mothers is also important on how to raise their children.

Joseph Uwiragiye, Nutritionist


Ensuring that children get treated in time when they fall sick is important. On the other hand, medics should ensure that they give the right medication at the right time.

Dr John Muganda, Gynaecologist



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