5/21/2014
Objectives
Growth & Development
At the end of this session students will be able to:
Define the terms growth, development, maturation and
personality.
2. Discuss the factors influencing growth and development.
3. Explain the patterns of growth and development.
1.
Prepared by: M. Cole
August, 2013
2
Objectives
Growth and development
contd
4. Explain physical and physiological changes in the major body
systems that take place during the process of growth and
development.
Growth and development begin with birth.
As infants and children grow and mature, they pass
through predictable stages of development.
5. Describe the basic divisions of childhood.
Growth
Growth and development
The term growth and development both refer to a dynamic
process.
Is physical change and increase in size.
Can be measured quantitatively.
Often used interchangeably, these terms have
different meanings.
Indicators of growth includes height, weight, bone size, and
dentition.
Growth and development are interdependent interrelated
processes.
Growth rates vary during different stages of growth and
development.
5/21/2014
Growth contd
Development
The growth rate is rapid during the prenatal, neonatal, infancy
and adolescent stages and slows during childhood.
Is an increase in the complexity of function and skill
progression.
Physical growth is minimal during adulthood.
Is the capacity and skill of a person to adapt to the
environment.
Development is the behavioural aspect of growth.
Maturation
Personality
Is a physiologically determined pattern for growth and
development.
Relates to increase in competence and adaptability to
function at a higher level.
Sum of all an individuals traits
(Murphy, 1932 as cited in John, Robins and Pervin, 2008, p. 7)
The sum/total of the physical, mental, emotional, and social
characteristics of an individual
(Dictionary.com, 2010)
Personality
10
Factors influencing growth and
development
contd
The unique self
The organized system of attitudes and behavioral disposition
by which an individual feels, thinks, acts, impresses and
establish relationship with others.
Nature and nurture are important in determining individual
patterns of development.
Genetics
Gender
Health
11
Nutrition
Socio-cultural
Interpersonal
relationship
Environment
12
5/21/2014
Genetics
Has to do with the how normal and abnormal traits/genes are
transmitted from one generation to the next.
Biological traits including some behavioural traits, gender, race,
eye colour, height potential, certain diseases or illness are
directly linked to genetic inheritance
Gender
Inheritance determines learning styles & temperament
A child gender is established when sex chromosomes join
Girls tend to be born lighter (by an ounce or two) and
shorter than boys (by an inch or two).
Girls tend to surge ahead of boys as they begin puberty
earlier (6 months to 1 year).
Boys tend to be taller and heavier than girls.
13
14
Gender
Influences physical characteristic, male/female genitalia
development, body development, hair distribution, some
diseases or illness are gender related (e.g. scoliosis more
common in females)
An early influence of gender in children involve survival
rate; premature girls have higher survival rate than
premature boys
Gender
Social effects on gender gender identity (speaks to how
the interaction with family, activities and societal values
affect how children perceive themselves as a specific
gender)
15
16
Environment
Health
A child who inherits a genetically transmitted disease will not
grow as rapidly as a healthy child depending on the type of
illness & therapy/care.
17
The physical condition of the newborn is influenced by the
prenatal environment.
The health of the mother at the time of conception & the
amount, quality and type of diet during pregnancy are
important for foetal development
Infections and diseases can result in foetal malformation
18
5/21/2014
Environment
Environment
A clean stable environment with adequate nutrition and
health care allows a child to focus energy on healthy growth.
Socioeconomic level
Ordinal position in family
Health
The profile of the family characteristics affects the
development of children
Teratogens
A tense environment in which a child feels unloved, or an
insecure environment where there is limited nutrition
interferes with the growth and development process.
19
20
Nutrition
Balance amounts of essential nutrients have a great
significant role in growth & development
Poor nutrition of the mother during pregnancy may limit the
childs growth and development from the moment the child is
born.
Socio-cultural
Health care and nutrition attract a cost; children born to
families of low economical status may not receive adequate
nutrition or health supervision.
Cultural norms determine how the child expected to achieve
particular milestones
Lack of the essential dietary nutrients result in inadequate
physical growth, energy and stamina.
21
22
Nature/Heredity
Socio-cultural
Childbearing practices, food habit, traditional beliefs, social
taboos, attitudes towards health, standards of living,
educational levels etc. influences a child growth and
development
23
Heredity has to do with the innate qualities/factors that have
been inherited such as appearance, temperaments and
abilities.
Determines the limits of each individual childs capacity to
achieve optimal structural & functional maturity.
24
5/21/2014
Nature
Nurture/Environment
contd
Others include:
eye colour
height
cognitive ability to learn
(do math or a language)
patience or temper
genetics
gender
family history of
chronic/non-communicable
diseases & mental illness.
Has to do with the personal
experiences determining or causing individual
differences in physical and behavioral traits.
This excludes genetics.
25
26
Nurture contd
Patterns of growth and development
Focuses on the environment that the child is raised in, including:
parenting
early schooling
the home
eating habits
interactions with people
family values & norms
Directional
Cephalocaudal
Proximodistal
Sequential
Differentiation
Developmental pace
cultural beliefs & practices
nutritional & consumption practices
in general
socio-cultural factors
interpersonal relationships
environmental influences
27
28
Cephalocaudal
Proximodistal
This development proceeds from head throughout the body
and towards the feet.
This development proceeds from the centre of body outward to
the extremities from general to specific.
Brain/head development: head is larger relative to the rest of
the body
Brain/spinal cord and organs in the trunk develop before arms
and legs; motor control of trunk occurs before arms and legs
E.g. infant must be able to raise his head before he can sit up.
E.g. An infant close his hand and grasp before he has finger
pinch.
29
30
5/21/2014
Growth Pattern
Cephalocaudal
Sequential
Proximodistal
Growth in height occurs in sequence from small to large,
development occurs in a predictable order
Progression occasionally occurs in a different order but most
children will follow a predictable sequence of growth and
development
E.g. majority of children sit before creeping, creep before
standing
1
Retrieved from http://www.authorstream.com/Presentation/samarsen-326986-growth-development-introduction-science-technology-ppt-powerpoint/
31
32
Developmental pace
Differentiation
This is the process by which behaviours and physical
structures become more specialized
Physical reactions become less global and more specific.
A stage in mental, neuromuscular or social maturation of an
infant or young child, generally marked by the attainment of a
capacity or skill.
E.g. 2-4 months, holds rattle in hand, looks at and plays with
own fingers and readily brings object to hand and mouth.
E.g. An infant gets burnt on the finger will flash the finger, cry show sign of
distress in response to pain whereas a toddler may cry and show signs of
distress but does not thrash around (Ranthus, n.d)
33
Principles
34
Principles contd
contd
1.
Growth is an orderly process, occurring in systematic fashion
2.
Rates and patterns of growth are specific to certain parts of
the body
3.
Wide individual differences exist in growth rates
35
4.
Growth and development are influenced by multiple factors
5.
Development proceeds from the simple to the complex and
from the general to the specific
6.
Development occurs in a cephalocaudal and a
proximodistal progression
36
5/21/2014
Principles
Basic development of
childhood
contd
7.
There are critical periods for growth and
development
8.
Rates in development vary
9.
Development continues throughout the
individual's life span
Stage
Characteristics
Neonate
birth to 28 days
Requires high level of care in
daily activity.
Infant
29 days to 1 year
Requires high level of care in
daily activity.
Toddler
1-3 years
Increase motor ability and
independent behaviour.
37
38
Basic development of childhood contd
Stage
What are the changes
that occur during Growth
and
Development ?
Characteristics
Preschool child
3-5 years
Has refined gross motor, fine
motor ability, and language ability.
School child
5-12 years
Has growing intellectual skills,
physical ability and independence.
Adolescent
12-18 years
Has cognitive thoughts that are
mature, identity formation and
peer influence.
40
39
Neonate
Neonate
Weight
Height
Head/chest
circumference
6-8 lbs
(2750-3629 g); gains
5-7 oz (142-198 g)
weekly for first six
months.
20 inches (50 cm)
grows 1 (2.5 cm) inch
monthly for first six
months
33-35.5 cm (13-14 inches),
head circumference slightly
larger than chest increases
by inch (1.25 cm) for
first six months.
contd
Prefers visual stimuli of mobiles, faces, black and white
patterns, mirrors (sight not fully developed).
Hearing well developed at birth. Use of auditory stimuli
such as music boxes, soft voices is encouraged.
41
42
5/21/2014
Neonate
Infant
contd
Moves legs and arms
contd
Weight
Height
Head/chest
circumference
Both are equal. Brain about
2/3 adult size.
Can lift head slightly off bed when in
prone position
Doubles birth weight by 6
months and triple by 1
year.
Increases in height in the 1st year
by 50% (from birth height of 20
inches to 30 inches [50.8 76.2]).
Startle and rooting reflex are
predominant
During 1st 6 months
average weight gain of 2
lbs/month, during 2cd 6
months about 1 lb per
month.
During the early months growth
more apparent in the trunk and in
the 2cd half more apparent in the
extremities.
43
44
Developmental characteristics: Infant
Physical
PHYSICAL
Anterior fontanel (soft and flat in a normal infant) closes at
12 to 18 months
Posterior fontanel (soft and flat in a normal infant) closes by
2 to 3 months
contd
Appetite (physiological anorexia); 20 teeth
Naps; daytime bowel/bladder control at 3 years and night
control by 35 years
Taste preferences; walks by 14 months; runs by 18 months
Mastery of gross and fine motor movements
45
Infant
46
Infant
contd
2-4 months
Holds rattle in hand, looks at and plays with own fingers and
readily brings object to hand and mouth
Needs assistance to sit up
Moro reflex fading in strength
contd
2-4 months contd
47
Can turn from side to side and return
Decrease in head lag when pulled to sit position, head midline
with some bobbing
Follows objects, turns head to look towards voices and faces
48
5/21/2014
Infant
Infant contd
4-6 months
contd
4-6 months contd
Grasp rattle and other objects at will, drops and picks
up others
Mouth objects
Hold bottle
Grasp with whole hand and manipulates objects
Can sit alone in the tripod position
Head held steady during sitting
No further lagging of head when pulled to sitting position
Turns from abdomen to back (4 months) and back to
abdomen (6 months)
49
Infant
50
Head control
contd
4-6 months contd
Supports much of weight when held standing
Watches objects as they fall and responds to sound
Newborn
51
Infant
6-8 months
Bangs objects held in hand
Move objects from one hand to the other
Begins pincer grasp
52
Infant
contd
Age 6 months
(Growth and Development, n.d.)
contd
6-8 months contd
Inborn reflexes diminished
Sits alone steady without support
Bounces on leg when placed in the standing position
Recognizes name and respond by looking and smiling
Enjoys playing with small and complex objects
53
54
5/21/2014
Sitting Up
Infant contd
8-10 months
Age 2 months
Picks up small objects and grasp well using pincer
Crawls/put whole body along floor
Creeps using hand and knees to keep trunk off floor
Pulls self to standing and sitting
Age 8 months
(Growth and Development, n.d.)
55
56
Infant contd
Fine motor development
8-10 months contd
Understand words such as no
Able to say mama and dada plus an additional word
Recognizes sounds without difficulty
6-month-old
57
Infant
12-month-old
58
(Growth and Development, n.d.)
Ambulation
contd
10-12 months
May hold crayon/pencil and mark on paper
Able to place objects in container through holes
Stands alone, walks while holding on to furniture and sits
down from standing
Nine to 12-months
59
(Growth and Development, n.d.)
13 month old
60
10
5/21/2014
Toddler
Eruption of primary teeth
Weight:
Gains 5-6 (2.5 kg) lbs/year
Height:
Gains 5 inches/year
Losses subcutaneous fat changes from plumb baby to lean
child with more muscle
Head/chest circumference:
Chest has grown greater than head
From Wong, D. (1999). Whaley and Wongs nursing care of infants and children, ed 6, St Louis: Mosby. Data from McDonald RE, Avery
DR: Dentistry for the child and adolescent, ed. 6, St. Louis, 1994, Mosby.
61
Toddler
62
Toddler
contd
By the end of two years
contd
By the end of three years
Builds tower of four blocks, scribbles on paper, undress self
and throws ball
Draws circle and other basic forms, learns to pour and
learning to dress self
Able to run, walk up and down stairs
Able to jump, kick ball and throws ball overhead
63
64
Speech milestones
1-2 months: coos
2-6 months: laughs and squeals
8-9 months babbles: mama/dada as sounds
10-12 months: mama/dada specific
Speech milestones contd
65
18-20 months: 20 to 30 words 50% understood by
strangers
22-24 months: able to construct two word sentences, knows
>50 words, 75% understood by strangers
30-36 months: almost all speech understood by strangers
66
11
5/21/2014
Bowel and bladder control: toddler
Bowel and bladder control: toddler
Signs that a toddler is ready for toilet-training include:
contd
muscle coordination with walking,
communicating with parents,
awareness of a wet or soiled diaper,
holding urine for 2 hours,
and interest in pleasing parents
By age 3, the toddler achieves fairly good bowel and bladder
control
The toddler may stay dry during the day but may need a
diaper at night until about age 4
Bowel control develops before bladder control
67
68
Preschool child
Preschool child contd
Weight:
Gains about 4.5 lbs (2 kg) a year
Height:
Minimal, 2-3.5 inches (6-8 cm) a year.
Able to use scissors, button clothing, brush teeth etc
Throws ball, climbs well and ride bicycle
Able to use spoon and fork
Head/chest circumference:
Not routinely measured on physical examination beyond 2
years
69
School child
Bowel and bladder control: Preschooler
By age 4, the preschooler has daytime control of bowel and
bladder but may experience bed-wetting accidents at night
By age 5, the preschooler achieves both bowel and bladder
control, although accidents may occur in stressful situations
70
Weight:
Gains 3-5 lbs (1.3-2.2 kg) annually
Height:
Gains 1-2 inches (2.5-5 cm) annually
71
72
12
5/21/2014
Eruption of secondary teeth
School child contd
Plays ball games, cards and board games
Can skate, ride bicycle
Enjoys craft projects
Jump rope
Can read
Able to concentrate for longer period on activities by
filtering out sounds
From Wong, D. (1999). Whaley and Wongs nursing care of infants and children, ed 6, St Louis: Mosby. Courtesy of Bruce Carter, DDS,
Texas Childrens Hospital, Houston, TX
73
Adolescent
74
Adolescent - Physical
Weight:
Boy - 15-65 lbs (7-30 kg)
Girl 15-55 lbs (7-25 kg)
Male puberty:
1216 years; enlargement of scrotum,
testes and penis
pubic, axillary, facial and body hair
nocturnal emissions and mature spermatozoa
voice deepens
95% of height by 15 years
Height:
Boy - 4-12 inches (10-30 cm)
Girl - 2-8 inches (5-20 cm)
75
76
Adolescent
Adolescent Physical contd
contd
Well developed skills
Attempts new sport activities
Muscle development continues
Increase in communication and time spent with peers
Apply abstract thoughts and analysis in conversation
Female puberty:
1014 year; breasts develop
pubic and axillary hair
first menstruation (menarche); ovulation about 12 months
after menarche
95% of height by menarche
77
78
13
5/21/2014
References
Reading assignment:
Atherton, J.S., (2010). Learning and teaching; Piaget's developmental theory. Retrieved from
http://www.learningandteaching.info/learning /piaget.htm
Physical changes that occur at each stage
Boeree, C. G., (2009). Retrieved from http://webspace.ship.edu/cgboer/genpsypiaget.html
1.
2.
chapter 28 and 29 Pilliteri text
chapter 40 - Lippincott manual
Child Development Institute. (2010). Retrieved from
http://www.childdevelopmentinfo.com/development/pl1.shtml
79
References
80
References
Hatfield, N. T. (2008). Broadribb's Introductory Pediatric Nursing (7th ed.). China:
Wolters Kluwer Health, Lippincott Williams and Wilkins.
Growth and development (n.d.). Retrieved from http://nursingcrib.com/nursing-notesreviewer/human-growth-and-development-theories/
John, O.P., Robins, R.W., & Pervin, L.A. (2008). Handbook of personality: Theory and
research. New York: The Guilford Press.
Growth and Development (n.d.). Retrieved from
http://www.authorstream.com/Presentation/samarsen-326986-growthdevelopment-introduction-science-technology-ppt-powerpoint/
London, M.L., Wieland Ladewig, P.A., Ball, J.W., & Bindler, R.C. (2007). Maternal and
child nursing care (2cd ed.). New Jersey: Prentice Hall.
Growth and development. (2003). Saunders online resources. USA: Elsevier Science.
[Power Point Slides]. Retrieved from http://online.darton.edu/NCLEXRN/htmdocs/study_set.htm
Pillitteri, A. (2010). Maternal and child health nursing: Care of the childbearing and
childbearing family (6th ed.). Philadelphia: Wolters Kluwer Health, Lippincott
Williams and Wilkins.
81
82
References
Personality. (2010). Dictionary.com. Retrieved from
http://dictionary.reference.com/browse/personality
Rathus, S.A. (2008). Childhood and adolescence: Voyages in development (3rd
ed.). Belmont: Thomson, Wadsworth.
Stein, A.M. (2005). NCLEX-RN Review (5th ed.). New York: Thompson Delmar
Learning.
Vitale, B.A. (2007). NCLEX RN notes: Core review and exam prep. United states
of America: F.A Davis Company.
83
14
