Which of the following milestones develops first?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Mirror play is a social and visual milestone that typically emerges between 4 to 6 months of age.
This milestone precedes the gross motor skills of crawling and creeping, and the fine motor skill of pincer grasp.
Crawling, where the infant pulls themselves with their arms while their belly is on the ground, usually develops between 7-9 months.
Creeping, moving on hands and knees, follows crawling at around 9-10 months.
The pincer grasp, a fine motor skill, develops last among these options, starting around 9 months and maturing by 12 months.

Option B: Crawling is a gross motor milestone that typically develops between 7 and 9 months, which is later than mirror play (4-6 months).
Option C: Creeping (moving on hands and knees) occurs around 9-10 months, after both mirror play and crawling.
Option D: The pincer grasp is a fine motor skill that develops between 9 and 12 months, making it one of the later milestones among the choices.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Sequence of Infant Developmental Milestones as background academic context rather than a clinical decision trigger.
Nurses use developmental milestones to screen infants during well-child visits. Tools like the Denver Developmental Screening Test (DDST) help identify potential delays.
Educating parents about the normal sequence and timing of milestones is a key nursing role. It helps parents provide age-appropriate stimulation and identify warning signs.
What if? If a 7-month-old infant shows no interest in their reflection (mirror play), it could be a soft sign for a visual or social-cognitive delay, warranting closer observation and follow-up.

How to Approach the Question

First, identify that the question is asking for the earliest developmental milestone from the given options.
Recall the typical age range for each milestone: Mirror play (social/visual), Crawling (gross motor), Creeping (gross motor), and Pincer grasp (fine motor).
Mirror play typically occurs around 4-6 months.
Crawling occurs around 7-9 months.
Creeping occurs around 9-10 months.
Pincer grasp develops from 9-12 months.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 1 p. 174-176

E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 27-29, 29-31

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Attempt every question from this paper in a timed mock, then review the full solution for each one.