Growth and Development
Infancy Early Childhood Middle Childhood Adolescent
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Growth
It is the change in size resulting from increase in the number or size of cells of the body. It is therefore quantitative increase in the size of the body and can be measured in terms of centimeters and kilometers.
Growth
cont
Weight Body weight is probably the best index of nutrition and growth. Changes in weight occur before changes in other aspects of growth.
Growth
cont
The average weight at birth is approximately 3.2 kg (7lbs) Initially newborn lose up to 10% of birth weight. It occurs due to loss of meconium, urine, physiological edema and less intake. The increase in weight approximately 30g/day or 200g/week during first three months and 150g/week up to one year.
Growth
cont
Height (length) The child length at birth is approximately 50 cm. It increases by 25 cm in the first year of life. at 3 years of age, the average child is 3 feet (90 cm) tall and at 4 years, 40 inches (100 cm) tall.
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Growth
cont
Head circumference Measurement of head circumference serve as an estimate of brain growth. It increases rapidly during infancy. If brain size does not increase normally then head size remain small. Normally head circumference is larger than the chest circumference at birth. Chest circumference increase in size to became equal to head circumference at one year of age and is larger thereafter.
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Factor affecting on growth and development
Nutritional status Climate Season Illness and activity Gender Genetic Inheritance77
Development
It is the quantitative, functional maturation of the organ systems. It can be assessed in terms of acquisition of skills and ability to adapt to new situations as the nervous system mature.
Development
cont
Development is assessed under four headings: Gross motor Fine motor and vision Hearing and speech Social behavior
Stages of Growth and Development
Infancy
Middle Childhood
Neonate Infancy
Birth to 1 month
School age 6 to 12 years Adolescent 13 years to approximately 18 years
1 month to 1 year
1-3 years 3-6 years
Late Childhood
Early Childhood
Toddler
Preschool
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Principles of Growth and Development
Growth is an orderly process, occurring in systematic fashion. Rates and patterns of growth are specific to certain parts of the body. Wide individual differences exist in growth rates. Growth and development are influences by are influences by a multiple factors.
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Principles Continued
Development proceeds from the simple to the complex and from the general to the specific. Development occurs in a cephalocaudal and a proximodistal progression. There are critical periods for growth and development. Rates in development vary. Development continues throughout the individual's life span.
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Growth Pattern
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Growth Patterns
The childs pattern of growth is in a head-to-toe direction, or cephalocaudal, and in an inward to outward pattern called proximodistal.
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Why developmental assessment?
Early detection of deviation in childs pattern of development Simple and time efficient mechanism to ensure adequate surveillance of developmental progress Domains assessed: cognitive, motor, language, social / behavioral and adaptive
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Gross Motor Skills
The acquisition of gross motor skill precedes the development of fine motor skills. Both processes occur in a cephalocaudal fashion
Head control preceding arm and hand control Followed by leg and foot control.
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Gross Motor Development
Newborn: barely able to lift head 6 months: easily lifts head, chest and upper abdomen and can bear weight on arms
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Head Control
Newborn
Age 6 months
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Sitting up
2months old: needs assistance 6 months old: can sit alone in the tripod position 8 months old: can sit without support and engage in play
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Sitting Up
Age 2 months
Age 8 months
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Ambulation
9 month old: crawl 1 year: stand independently from a crawl position 13 month old: walk and toddle quickly 15 month old: can run
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Ambulation
13 month old
Nine to 12-months
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Fine Motor - Infant
Newborn has very little control. Objects will be involuntarily grasped and dropped without notice. 6 month old: palmar grasp uses entire hand to pick up an object 9 month old: pincer grasp can grasp small objects using thumb and forefinger
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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 18-20 months: 20 to 30 words 50% understood by strangers 22-24 months: two word sentences, >50 words, 75% understood by strangers 30-36 months: almost all speech understood by strangers
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Hearing
BAER hearing test done at birth Ability to hear correlates with ability pronounce words properly Always ask about history of otitis media ear infection,
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Fine Motor Development
6-month-old
12-month-old
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Red Flags in infant development
Unable to sit alone by age 9 months Unable to transfer objects from hand to hand by age 1 year Abnormal pincer grip or grasp by age 15 months Unable to walk alone by 18 months Failure to speak recognizable words by 2 years.
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Fine Motor - toddler
1 year old: transfer objects from hand to hand 2 year old: can hold a crayon and color vertical strokes
Turn the page of a book Build a tower of six blocks
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Fine Motor Older Toddler
3 year old: copy a circle and a cross build using small blocks 4 year old: use scissors, color within the borders 5 year old: write some letters and draw a person with body parts
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Toddler
Adele Piliterri, Child Health Nursing, Lippincott
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Toddler
Safety becomes a problem as the toddler becomes more mobile.
Pilliterri, Lippincott
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Toddlers
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Issues in parenting - toddlers
Stranger anxiety should dissipate by age 2 to 3 years Temper tantrums: occur weekly in 50 to 80% of children peak incidence 18 months most disappear by age 3 Sibling rivalry: aggressive behavior towards new infant: peak between 1 to 2 years but may be prolonged indefinitely Thumb sucking Toilet Training
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Pre-School
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Fine motor and cognitive abilities
Buttoning clothing Holding a crayon / pencil Building with small blocks Using scissors Playing a board game Have child draw picture of himself
Pre-school tasks
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Red flags: preschool
Inability to perform self-care tasks, hand washing simple dressing, daytime toileting Lack of socialization Unable to play with other children Able to follow directions during exam Performance evaluation of pre-school teacher for nursery readiness
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Pool Safety
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School-Age
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School Years: fine motor
Writing skills improve Fine motor is refined Fine motor with more focus
Building: models legos Sewing Musical instrument Painting Typing skills Technology: computers
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School performance
Ask about favorite subject How they are doing in school Do they like school By parent report: any learning difficulties, attention problems, homework Parental expectations
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Red flags: school age
School failure Lack of friends Social isolation Aggressive behavior: fights, fire setting, animal abuse
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School Age: gross motor
8 to 10 years: team sports Age ten: match sport to the physical and emotional development
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School Age
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School Age: cognitive
Greater ability to concentrate and participate in self-initiating quiet activities that challenge cognitive skills, such as reading, playing computer and board games.
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13 to 18 Year Old
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Adolescent
As teenagers gain independence they begin to challenge values Critical of adult authority Relies on peer relationship Mood swings especially in early adolescents
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Adolescent behavioral problems
Anorexia Attention deficit Anger issues Suicide
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