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Paeds Topicsgrowth-development-and-behaviour

Paeds · growth-development-and-behaviour

Normal cognitive, emotional and behavioural development

Also known as Cognitive development · Emotional development · Behavioural development · Self-regulation · Executive function development · Temperament

Fellowship approach to normal cognitive, emotional and behavioural development from infancy through adolescence: age bands, temperament, executive function, self-regulation, red flags, counselling, screening triggers and multi-board exam performance.

high12 referencesUpdated 11 July 202610 min readVerification in progress

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Target exams

RACP General PaediatricsRACP DWERACP DCERCPCH Progress+MRCPCH TheoryMRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics

Red flags

  • Loss of previously acquired cognitive, language or social skills
  • Behaviour that risks serious injury to self or others
  • Marked functional collapse at home and school with no safe adult buffer
  • Suicidal ideation, self-harm or acute safety crisis in a young person
  • Suspected severe neglect, trauma or maltreatment driving developmental stall

Life stages

neonateinfanttoddlerpreschoolschool-ageadolescentyoung-adult-transition

Care settings

preventive-medical-homecommunity-schooloutpatientwardtelehealth

Clinical exam formats

written-onlyracp-dce-long-caseracp-dce-short-casemrcpch-developmentmrcpch-history-managementmrcpch-communicationrcpsc-structured-oral

Board mappings

  • General and Community Paediatrics
  • Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 10: Clinical assessment and management – developmental and behavioural paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
  • Clinical Applications
  • Long Cases
  • Short Cases
  • 2. Professional skills and knowledge: Communication
  • 4. Professional skills and knowledge: Patient management
  • Neurodevelopment and Neurodisability
  • Foundation of Practice (FOP)
  • Applied Knowledge in Practice (AKP)
  • Development
  • History
  • Communication
  • General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
  • General Pediatrics Content Outline — Domain 5: Mental and Behavioral Health
  • General Pediatrics Content Outline — Domain 6: Psychosocial Issues
  • Patient Care 4: Clinical Reasoning
  • Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
  • ACGME developmental-behavioral pediatrics experience
  • Medical Expert
  • Development, Behaviour and Mental Health
  • Pediatrics: Foundations EPA — communicating assessment findings and management plans to patients and/or families
On this page
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Your progress

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Practise this topic

  • Short-answer question1
  • Viva station1
  • Clinical case1

Target exams

RACP General PaediatricsRACP DWERACP DCERCPCH Progress+MRCPCH TheoryMRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics

Red flags

  • Loss of previously acquired cognitive, language or social skills
  • Behaviour that risks serious injury to self or others
  • Marked functional collapse at home and school with no safe adult buffer
  • Suicidal ideation, self-harm or acute safety crisis in a young person
  • Suspected severe neglect, trauma or maltreatment driving developmental stall

Life stages

neonateinfanttoddlerpreschoolschool-ageadolescentyoung-adult-transition

Care settings

preventive-medical-homecommunity-schooloutpatientwardtelehealth

Clinical exam formats

written-onlyracp-dce-long-caseracp-dce-short-casemrcpch-developmentmrcpch-history-managementmrcpch-communicationrcpsc-structured-oral

Board mappings

  • General and Community Paediatrics
  • Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 10: Clinical assessment and management – developmental and behavioural paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
  • Clinical Applications
  • Long Cases
  • Short Cases
  • 2. Professional skills and knowledge: Communication
  • 4. Professional skills and knowledge: Patient management
  • Neurodevelopment and Neurodisability
  • Foundation of Practice (FOP)
  • Applied Knowledge in Practice (AKP)
  • Development
  • History
  • Communication
  • General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
  • General Pediatrics Content Outline — Domain 5: Mental and Behavioral Health
  • General Pediatrics Content Outline — Domain 6: Psychosocial Issues
  • Patient Care 4: Clinical Reasoning
  • Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
  • ACGME developmental-behavioral pediatrics experience
  • Medical Expert
  • Development, Behaviour and Mental Health
  • Pediatrics: Foundations EPA — communicating assessment findings and management plans to patients and/or families
The fellowship answer

Know the age band. Name the skill. Decide if this is normal variation, temperament or a signal to act. Cognitive, emotional and behavioural development travel together. Infants learn through relationships. Toddlers test limits while their self-control is still immature. School-age children need working memory and planning. Adolescents can think abstractly while emotion intensity still outruns control. Your job is to describe what is expected, strengthen co-regulation, and escalate when skills stall, regress or put safety at risk. [1] [2] [3] [4]

Three ways families present

What you hear

    What you sort

      This page owns normal cognitive, emotional and behavioural development. Cross-link motor development, language and social communication, autism recognition, ADHD, global delay, tantrums and formal assessment tools rather than hiding full disorder chapters here. [1] [2]

      C.O.P.E. at the bedside

      Check age-expected skills · Observe play, attention and emotion recovery · Parent concern taken seriously · Escalate on regression, safety risk or persistent impairment. [1] [2] [7]

      Overview & Definition

      Parents rarely say “executive function.” They say the child cannot wait, cannot calm, cannot plan or cannot get along. Cognitive development is how a child thinks, remembers, solves problems and understands others’ minds. Emotional development is how feelings are recognised, expressed and recovered from. Behavioural development is how those skills show up in daily life with caregivers, peers and school. [3] [4]

      Temperament is the child’s early biological style of reactivity and regulation. It is not a disease label. A high-reactive infant may cry hard and need more help to settle. That child can still develop well with responsive caregiving. [9]

      Self-regulation is the growing capacity to manage attention, emotion and behaviour toward a goal. Young children borrow regulation from adults. That borrowed support is co-regulation. Later, more control becomes internal. School readiness depends heavily on these skills. [4]

      Executive functions are core control skills: holding information in mind (working memory), stopping an automatic response (inhibitory control), and shifting strategy (cognitive flexibility). They underpin learning, social behaviour and emotional control across childhood. [3]

      Use evidence-informed milestones for surveillance. Lists should reflect skills most children of that age have achieved, not folklore averages that falsely reassure. [1]

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      References12ShowHide
      1. [1]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
      2. [2]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
      3. [3]Diamond A Executive functions. Annual review of psychology, 2013.PMID 23020641
      4. [4]Blair C School readiness and self-regulation: a developmental psychobiological approach. Annual review of psychology, 2015.PMID 25148852
      5. [5]Garner AS Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics, 2012.PMID 22201148
      6. [6]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
      7. [7]Weitzman C Promoting Optimal Development: Screening for Mental Health, Emotional, and Behavioral Problems: Clinical Report. Pediatrics, 2025.PMID 40850690
      8. [8]Weitzman C Promoting optimal development: screening for behavioral and emotional problems. Pediatrics, 2015.PMID 25624375
      9. [9]Gartstein MA Temperament development in infancy: What we have learned about the origins of individual differences in the past 25 years. Infant behavior & development, 2025.PMID 40554909
      10. [10]COUNCIL ON COMMUNICATIONS AND MEDIA Media and Young Minds. Pediatrics, 2016.PMID 27940793
      11. [11]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
      12. [12]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428

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