Prenatal care impacts the development of the child both before and after birth. Some of the birth mothers of children in substitute care may have had little or no prenatal care and/or may have abused drugs or alcohol. Given these conditions, many of the children in substitute care will have developmental delays as well as problems developing healthy self-esteem.

There is a wide range of typical behavior, and at any particular age twenty-five percent of children will not have reached the behavior or skill, fifty percent will be showing it, and twenty-five percent will already have mastered it.

Children will also grow faster or slower in different areas of development. For example, a child may be very advanced in language development but less advanced, or even delayed, in motor coordination. A child may be chronologically 5 years old but socially 2 years old.

Growth is continuous, but it is not always steady and does not always move smoothly forward. You can expect children to slip back or regress occasionally.

Culture, certain trends and values each influence what is defined as typical or normal development.