'When I was a child,
I talked like a child,
I thought like a child,
I reasoned like a child.'[1]

As I grew, I put off some childish traits but built on others. Now as a paediatrician, I spend much of my time observing children going through the same process. Article six of the UN Convention on the Rights of the Child asks member states to 'ensure to the maximum extent possible the survival and development of the child'.[2]

I have tried to understand the process from a biblical perspective, drawing on my understanding of the Christian faith, observations of children, and reading of medical and Christian literature.

Jesus Christ started life as a fertilised human embryo. He went through embryogenesis and fetal development before being born into this world. There is no reason to assume that he did not follow the same predictable process as all children. Following normal patterns of motor, language, social and cognitive development, he moved from complete parental dependence to increasing maturity and independence.

Luke tells us that Jesus spent three days in the temple, questioning and learning. Like all adolescents, Jesus had to work out his own identity. Luke concludes: 'Jesus grew in wisdom and stature, and in favour with God and men'.[3]

I believe child development could be defined as a series of overlapping categories within four domains: mental (wisdom), physical (stature), social (favour with men) and spiritual (favour with God). This view encompasses a biblical understanding of the nature of mankind and our purpose in this world without negating our current understanding of the process of and factors influencing child development.

Wisdom - Mental development

Cogito, ergo sum. I think, therefore I am. Descartes' words reflect how man is distinguished from all other creatures. Our cognitive development involves various components, including memory, logical thought and questioning. Mental development seems to underlie most other aspects of development. An infant's inquisitiveness leads him to explore: fixing and following, reaching out and grasping, putting objects in his mouth, crawling and walking. Inquisitiveness extends to questions: 'what' as he learns to identify things, then the persistent 'whys' of the pre-school child trying to understand his world.

Stature - Physical development

Physical growth is an awe-inspiring process.[4]

Beginning at conception, almost all tissue differentiation occurs in utero with growth continuing throughout childhood, especially during the first year and puberty. Motor skills develop along with growth. The development of an upright stance frees the hands for manipulation. The baby therefore goes through parallel processes: changing from a supine posture, through sitting, to independent walking; concurrently learning to grasp and manipulate objects. Thus we have three aspects of motor development: posture, mobility and manipulation.

Favour with men - Social and Emotional development

The newborn baby focuses on physical needs. Nevertheless, he soon displays different emotions, crying when upset, calming when comforted. Around eleven months, he clings to his parents, becoming wary of strangers. His emotions start to reflect feelings (both positive and negative) as well as physical needs. With time, he gives names to emotions and expresses them in a variety of ways. A healthy child will be allowed to do this although most societies place some restrictions on when and how.

Humans have complex social patterns involving communication and relationships. Both verbal and non-verbal communications develop, with increasing capacity to express ourselves and understand others. Alongside this, social development involves increasing independence and responsibility. Development of self-care skills (such as feeding, toileting and personal hygiene) brings increasing responsibilities towards others. Parents are familiar with the 'terrible twos' when toddlers start to test out their independence. The underlying change from dependent infant to independent adult must progress.

Much of our emotional and behavioural development as children hinges on the balance between desire for independence and ongoing need for dependence, love and security. This mirrors our relationship with God: a desire to be our own master coupled with a longing to know and be loved by him.

Favour with God - Spiritual development

Spiritual development has three aspects: awareness of self, God and others. Unlike other aspects of childhood changes, it can occur in one of two directions: towards God and his purposes or away from him. It is a complex process that will not be complete until we are transformed into the likeness of God.[5]

I will briefly highlight those areas that are pertinent to children.

Awareness of self

A young baby plays with his fingers and toes; a toddler is fascinated by the different bits he sees in the bath. Emotional awareness develops along with likes and dislikes, a sense of wonder and appreciation of beauty. He still needs help in interpreting conflicting emotions such as joy and sadness. He begins to understand how others view him, in relation to who he is and to how he acts. Hopefully, he will grow up knowing that he is loved and valued for who he is, not just for what he does or doesn't do. Emotional well-being is highly dependent on having positive self-esteem; this is crucial to our appreciation of how God views us.

Awareness of God

All children go through a stage of questioning. 'Where did I come from?' reflects a deeper longing to know what lies behind it all. A child can also learn that God is the Creator. His understanding of God is influenced by what he sees of him in his parents, along with their beliefs and culture. Most children learn that their parents love and care for them, even when they aren't visible. Sadly, some children grow up in an environment that portrays a very distorted image of God: their parents don't display the qualities of consistency, love and nurture that reflect God's nature. Generally though, parental shortcomings are more than balanced by attitudes and actions that portray some of God's positive attributes.

A child's relationship with God changes as he grows, reflected to some extent in the way he relates to his parents. He starts off knowing God, moves to loving and trusting him, finally submitting to his will out of love and respect. Children finding faith describes how spiritual development is influenced by parental and other factors to determine very different outcomes.[6]

Awareness of others

Social development has been briefly described. However, spiritual development adds a further component to this in terms of respect and love for others. Most religions and cultures value life and acknowledge human rights. The biblical view starts by looking at responsibilities rather than rights. 'Love your neighbour as yourself' should be the goal of our spiritual development.[7]

We learn to recognise that all people are made in God's image and loved by him. Love for others does not come naturally, as it goes against the child's developing independence. It needs to be nurtured and will include awareness and respect for others regardless of their background, character or beliefs, and a particular concern for the vulnerable expressed through justice and compassion.

Summary

Doctors have traditionally focused their attention on five aspects of child development: cognitive skills, gross and fine motor abilities, language, and personal-social development.[8,9,10]

These reflect the uniqueness of humans: upright stance and bipedal locomotion, fine motor skills for manipulation, unique depth of communication and expression, and complex social structures. However, the Christian viewpoint suggests that such an understanding is incomplete. What sets us apart from all other creatures is being made in the image of God, being spiritual beings with a purpose. 'It is in the nature of the developing body to be continually active, of the developing mind to be intensely curious and of the developing personality to seek good relationships with other people.'[11]

We could add that it is in the nature of the developing spirit to seek God. Understanding some of the spiritual development that underlies our social, emotional and cognitive development can help in appreciating some of the struggles children experience. It can also help us direct children's development, the goal being healthy adults with positive self-esteem, sense of purpose, knowledge of God and respect for others.