1. Child Growth & Development

7/21/2019 1. Child Growth & Development

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GROWTH &GROWTH &

DEVELOPMENT INDEVELOPMENT IN

CHILDRENCHILDREN

Martira MaddeppungengMartira Maddeppungeng

DEPARTMENT OF CHILD HEALTH,DEPARTMENT OF CHILD HEALTH,HASANUDDIN UNIVERSITYHASANUDDIN UNIVERSITY

DR. AHIDIN SUDIROHUSODO HOSPITALDR. AHIDIN SUDIROHUSODO HOSPITAL


2/98

ChildrenChildrenHa!e a t"pi#a$ #%ara#teri&ti#Ha!e a t"pi#a$ #%ara#teri&ti# ' a$(a"&' a$(a"&

gr)(t% * de!e$)p+ent ' dierent r)+ t%egr)(t% * de!e$)p+ent ' dierent r)+ t%e

adu$tadu$t..C%i$drenC%i$dren i& n)t a +iniature ) t%e adu$ti& n)t a +iniature ) t%e adu$t T%e $a( pr)te#ti)n ) #%i$dT%e $a( pr)te#ti)n ) #%i$dN). -N). - "ear"ear -//--//- SSe#ti)n 0 r)+ t%e $a( pr)te#ti)n ) #%i$d 1e#ti)n 0 r)+ t%e $a( pr)te#ti)n ) #%i$d 1

e!er" #%i$d i& entit$ed t) 2e a2$e t) $i!e,e!er" #%i$d i& entit$ed t) 2e a2$e t) $i!e,gr)(t%, de!e$)p and parti#ipating t) t%egr)(t%, de!e$)p and parti#ipating t) t%e+anner 2)rn+anner 2)rn


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Child :Child : conception 18 yearsconception 18 years(Convention of Child(Convention of Child

Right /CRC and Indonesian Child ProtectionRight /CRC and Indonesian Child Protection

Right)Right)

Based on :Based on :

anatomical groth (epipyphise clossing! reprod"ctiveanatomical groth (epipyphise clossing! reprod"ctive

system mat"ration etc# )system mat"ration etc# ) Psychosocial development (adolescentPsychosocial development (adolescent ad"lthood)ad"lthood)

C%i$d n)t a +iniature ) adu$tC%i$d n)t a +iniature ) adu$t$$$$

Spe#ii# a&pe#t&Spe#ii# a&pe#t&11 gr)(t% and de!e$)p+entgr)(t% and de!e$)p+ent


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CHILDRENCHILDREN%ope%ope&he parents&he parents

&he nation&he nation

&he orld&he orld


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ROWTH-DEVELOPMENT

ROWTH-DEVELOPMENT

IN CHILDRENN CHILDREN

3ROTH3ROTH t%e #%ange ) $arge, a+)unt,t%e #%ange ) $arge, a+)unt,+ea&ure& )r di+en&i)n ) t%e #e$$ &tage,+ea&ure& )r di+en&i)n ) t%e #e$$ &tage,

)rgan and indi!idua$)rgan and indi!idua$ 44 2)d" (eig%t, 2)d" $engt%2)d" (eig%t, 2)d" $engt%,, 2)ne age2)ne age,,

#ir#u+eren#e %ead#ir#u+eren#e %ead,, #ir#u+eren#e ) t%e ar+#ir#u+eren#e ) t%e ar+

DEVELOPMENTDEVELOPMENT in#rea&ing ) t%e &5i$$ inin#rea&ing ) t%e &5i$$ in&truture and 2)d" un#ti)n (%i#% +)re&truture and 2)d" un#ti)n (%i#% +)re#)+p$e6, regu$ar pattern, #an 2e )re#a&ted,#)+p$e6, regu$ar pattern, #an 2e )re#a&ted,t%e re&u$t ) pr)#e&& +aturati)nt%e re&u$t ) pr)#e&& +aturati)n


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Stages of growth-

tages of growth-

deveo!"e#t

eveo!"e#t

I.I.The periods ofThe periods ofprpreenatal (intra uterin)natal (intra uterin) is divided 2 :is divided 2 :

a.a. T%e peri)d& ) e+2r")T%e peri)d& ) e+2r") #)n#epti)n#)n#epti)n77 age )age )

eig%t (ee5&eig%t (ee5&

2.2. T%e peri)d& )T%e peri)d& ) ))etu&etu& age ) nine (ee5&age ) nine (ee5&77

t%e 2irt%t%e 2irt%

44 Ear$"Ear$" FF))etu&etu&8989 (ee5&(ee5&7 tri+e&ter -:7 tri+e&ter -:

acceleration groth! forming of physic! 'odyacceleration groth! forming of physic! 'ody

appliance have 'een formed start toappliance have 'een formed start to

f"nctionf"nction 44 Ad!an#ed )etu&Ad!an#ed )etu& final trimester of grothfinal trimester of groth

tae place fastly e*istence of groth oftae place fastly e*istence of groth of

f"nctions of Ig + transfer! the acc"m"lationf"nctions of Ig + transfer! the acc"m"lation

of fat of esensial (,mega - and ,mega .)of fat of esensial (,mega - and ,mega .)


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Stages of growth-

tages of growth-

deveo!"e#teveo!"e#t

II .II .The periods ofThe periods ofpostnatal (postnatal (after birthafter birth))

;.;. T%e peri)d& )T%e peri)d& )ne)nata$ne)nata$ 8/4-


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..T%e peri)d& ) pre%))$T%e peri)d& ) pre%))$ 8-4=8-4= "r"r:: &ta2$e )&ta2$e )t%e gr)(t%t%e gr)(t%, #)rp)rea$ a#ti!it" in#rea&e * t%e, #)rp)rea$ a#ti!it" in#rea&e * t%e

in#rea&ing ) &5i$$ed * pr)#e&& ) t%in5ingin#rea&ing ) &5i$$ed * pr)#e&& ) t%in5ing

0.0. T%e peri)d& ) %))$T%e peri)d& ) %))$ 88 =4;/=4;/ "r"r,, . T%e peri)d& ) ad)$eentT%e peri)d& ) ad)$eent 88;/4;


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T%e #%ara#teri&ti# ) gr)(t%T%e #%ara#teri&ti# ) gr)(t%

1#1# Change of meas"reChange of meas"re physicalphysical

increasing of the 'ody organincreasing of the 'ody organ

improvement of re0"irement of 'odyimprovement of re0"irement of 'ody

increasedincreased

## Change of proportionChange of proportion head of thehead of the

ne'orn 'a'y relative have the 'iggerne'orn 'a'y relative have the 'igger

proportion than age f"rproportion than age f"rtthermore#hermore#

Center 'ody in "m'ilic"s! ad"lt asCenter 'ody in "m'ilic"s! ad"lt as

high as p"'is symphisishigh as p"'is symphisis


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T%e #%ara#teri&ti# ) gr)(t%T%e #%ara#teri&ti# ) gr)(t%-#-# &he vanish of old maring&he vanish of old maring grothgroth

processprocess disappearing of the thym"sdisappearing of the thym"s

gland! fall o"t of the milteeth! thegland! fall o"t of the milteeth! thevanish of primitive reflectsvanish of primitive reflects

2#2# 3ppear of the ne maring3ppear of the ne maring thethe

mat"ration effect of organ f"nctionmat"ration effect of organ f"nction permanet toothpermanet tooth!! the maring ofthe maring of

secondary se*secondary se*


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Pro!ort$o# of %od he$ght

ro!ort$o# of %od he$ght


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-//

;


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Curve growth patternCurve growth pattern

Pattern groth of generalPattern groth of general

Pattern groth of organ limfoidPattern groth of organ limfoid

Pattern groth of 'rain headPattern groth of 'rain head

PPattern groth of organ reprod"ceattern groth of organ reprod"ce


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Patter# growth of ge#eraPatter# growth of ge#era

CharacteristicCharacteristic'ody length'ody length

4ast "ntil age yr4ast "ntil age yrsta'ilsta'ilee((infl"ence ofinfl"ence ofgroth hormone)groth hormone)

P"'ertP"'ertyy effecteffect hormonhormone of se*e of se*

the groth go on 0"iclythe groth go on 0"icly

stoppingstopping


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3a+2ar ;. @ur!a $au 5enai5an tinggi 2adan ana5 $a5i4$a5i

de M)nt2ei$$ard

Men#

ap

ait i n

ggi,#+

per t

a%un

--

-/

;. Fe+a$e pu2i# %air de!e$)p+ent. e!ual "aturit# ratin$ % (&R %) : Prepu2erta$B n) pu2i# %air.

SMR - 1 Straig%t %air i& e6tending a$)ng t%e $a2ia and, 2et(een rating& - and , 2egin& )n t%e

pu2i&. SMR 1 Pu2i# %air %a& in#rea&ed in uantit", i& dar5er, and i& pre&ent in t%e t"pi#a$ e+a$e

triang$e 2ut in &+a$$er uantit". &R ': Pu2i# %air %a& in#rea&ed in uantit", i& dar5er, and i& +)re

den&e, #ur$ed, and adu$t in di&tri2uti)n 2ut $e&& a2undant. &R :A2undant, adu$t4t"pe patternB

%air +a" e6tend )nt) t%e +edia$ a&pe#t ) t%e t%ig%&. 8Fr)+ Danie$ A, Pau$&%)#5 ?G. Ap%"&i#ian& guide t) &e6ua$ +aturit" rating. atient Care Ma" /,;99, (it% per+i&&i)n. I$$u&trati)n

2 Pau$ Sin %4R)


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Fig ;. Ma$e genita$ and pu2i# %air de!e$)p+ent. Rating& )r pu2i# %air and )r genita$ de!e$)p+ent #andier in a t"pi#a$ 2)" at an" gi!en ti+e, 2e#au&e pu2i# %air and genita$ia d) n)t ne#e&&ari$"de!e$)p at t%e &a+e rate. e!ual "aturit# ratin$ % (&R %): Prepu2erta$B n) pu2i# %air. 3enita$iaun#%anged r)+ ear$" #%i$d%))d. &R 2: Lig%t, d)(n" %air de!e$)p& $atera$$" and $ater 2e#)+e&dar5. Peni& and te&te& +a" 2e &$ig%t$" $argerB r)tu+ 2e#)+& +)re te6tured. &R * : Pu2i# %air%a& e6tended a#r)&& t%e pu2i&. Te&te& and r)tu+ are urt%er en$argedB peni& i& $arger, e&pe#ia$$"in $engt%. &R ' : M)re a2undant pu2i# %air (it% #ur$ing. 3enita$ia re&e+2$e t%)&e ) an adu$tBg$an& %a& 2e#)+e $arger and 2r)ader, r)tu+ i& dar5er. &R : Adu$t uantit" and patter+ )

pu2i# %air, (it% %air pre&ent a$)ng t%e inner 2)rder& ) t%e t%ig%&. T%e te&te& and t%e r)tu+ areadu$t in &ie. . 8Fr)+ Danie$ A, Pau$&%)#5 ?G. A p%"&i#ian& guide t) &e6ua$ +aturit" rating.4


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Fig ;9. Se6 +aturit" rating& ) 2rea&t #%ange& in ad)$eent gir$&. 8C)urte&" )

M Tanner, M.D., In&titute ) C%i$d Hea$t%, Depart+ent ) 3r)(t% and

De!e$)p+ent, Uni!er&it" ) L)nd)n, L)nd)n, Eng$and:


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Fig -/. A.Seuen#e ) pu2erta$ e!ent& in +a$e&. ?.Seuen#e ) pu2erta$

e!et& in e+a$e&. 8Fr)+ R))t A. End)#rin)$)g" ) pu2ert". +

ediatr ;9B

3ENITAL >

PU?IC HAIR 0

PU?IC HAIR

PU?IC HAIR -

3ENITAL

3ENITAL -

3ENITAL 0

PHV

?REAST >

MENARCHE

PU?IC HAIR >

?REAST 0

PU?IC HAIR 0

?REAST

?REAST -

PU?IC HAIR -

PHV

PU?IC HAIR

A ?


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Ch$d rowth

h$d rowth

Increases ofIncreases of physical sizesphysical sizes

1.1. heightheight2.2. weightweight3.3. head circumferencehead circumference4.4. etcetcIncreases of cells, matrixes, connective tissues,Increases of cells, matrixes, connective tissues,

bones, muscles, organ systems etc.bones, muscles, organ systems etc.

eterminant factors of growtheterminant factors of growth internal !internal !

geneticgenetic! father, mother, grandpa,! father, mother, grandpa,grandmagrandma

intrauterine processintrauterine process! nutrition, disease,! nutrition, disease,drug, polution, toxin ,drug, polution, toxin ,

externalexternal!!nutrition, disease, polution,nutrition, disease, polution,

exercise, emotional supportexercise, emotional support


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3ddition of 'ody length3ddition of 'ody length

&rimester I&rimester I : !8 2!2 cm /: !8 2!2 cm / monthsmonths

&imester II&imester II : 1!7 !. cm /: 1!7 !. cm / monthsmonths&rimester III&rimester III : 1!- 1!. cm /: 1!- 1!. cm / monthsmonths

&rimester I&rimester I : 1! 1!- cm /: 1! 1!- cm /monthsmonths


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I#f'e#(e of ge#et$( to

#f'e#(e of ge#et$( to

%od he$ght

od he$ght

Range of predictional final height at 18 years oldRange of predictional final height at 18 years old

Boys = (Boys = (Father + mother height + 13 cmFather + mother height + 13 cm )) ++ 8,5 cm8,5 cm22

Girls = (Girls = (Father + mother height 13 cm)Father + mother height 13 cm) ++8,5 cm8,5 cm

22


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Body weightBody weight

Infl"enced 'yInfl"enced 'y::

+eneti+eneticc((clanclan))

Intae n"tritionIntae n"trition((eateat!! drindrin!! ssnnacac))

3'sor'tion of intestine3'sor'tion of intestine escretionescretion

Physical activityPhysical activity

?eta'olism of the 'ody?eta'olism of the 'ody! hormon! hormonee

Chronic diseaseChronic disease((heart! "rinary tract infection!heart! "rinary tract infection!

t"'erc"losist"'erc"losis))

content ater and 'ody fatcontent ater and 'ody fat


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Additi)n ) 2)d"Additi)n ) 2)d"(eig%t(eig%t

&rimester I : =55 1555 gram/&rimester I : =55 1555 gram/monthmonth

&imester II : ;55 .55 gram/&imester II : ;55 .55 gram/

monthmonth

&rimester III : -;5 2;5 gram/&rimester III : -;5 2;5 gram/monthmonth

&imester I : ;5 -;5 gram/&imester I : ;5 -;5 gram/monthmonth


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Cir#u+eren#eCir#u+eren#e %ead%ead

Re$ating t) gr)(t% ) 2rain !)$u+eRe$ating t) gr)(t% ) 2rain !)$u+e

Cir#u+eren#e %ead +)re 2iggerCir#u+eren#e %ead +)re 2igger8+a8+a##r)r)##eep%a$"p%a$"::

J +i$d +enta$ retardati)n+i$d +enta$ retardati)n J J &e!ere +enta$&e!ere +enta$ retardaretardati)nti)n 88Lober 0Lober 0

riestl#riestl#, ;9


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Age 2rain20 weak ~ 100 g

Born ~ 400 g

18 month ~ 800 g

3 year ~ 1100 g

Adult ~ 1400 g


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.I


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. E@ ell no"rished ell no"rished

L 9 E@ "ntil - E@ mild9moderateL 9 E@ "ntil - E@ mild9moderate

maln"tritionmaln"trition

L 9 - E@ severe maln"tritionL 9 - E@ severe maln"trition


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Head C$r('"ferre#(e

ead C$r('"ferre#(e


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Head C$r('"ferre#(e

ead C$r('"ferre#(e

C'rves

'rves

Boys +irls


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/ead )ircumferrence

)) #acrocephal %follow up2F ys'!

-- normal IJ,) mild mental retardation, severe mental retardation%Dober riestly, 1-1'

#icrocephal !mentally retarded


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&&&% "e#elo$mental +creening

1#@


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1% "*N:* &&+ross motor4ine motor! vis"alEpeech! lang"age! hearing!

comm"nicationEocial! emotional! 'ehavio"r


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5$#ter!retas$+6

#ter!retas$+6

DormalDormal

9 delay (9)! ma* 1 C9 delay (9)! ma* 1 C

E"specE"spec

9 or more C and or 1 or more @9 or more C and or 1 or more @


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2 -*"&AT&) +.6-T'6+ )/*)7(&+T


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2% -*"&AT&) +.6-T'6+ )/*)7(&+T6ur$hy ! =ellineck 145

;or ages: 2 1' yearsContents :6$ items of child behaviour" answer by parent"$ minutes

never score +,sometimes score 1,often always score *,

Interpretation: score> *8 should be reffered

Good sensitivity & e@cellent specifity Glascoe" 1##',


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IV7 8a"$ ed'(at$o#

V7 8a"$ ed'(at$o#

+roth and development+roth and development

D"trition! imm"nisation! play! stim"lation!D"trition! imm"nisation! play! stim"lation!ed"cationed"cation

Protection from riss of :Protection from riss of : Bio9physics haFardBio9physics haFard:: infection! pol"tion!infection! pol"tion!

accident! addictionaccident! addiction Psychosocial haFardPsychosocial haFard:: a'"se! neglect!a'"se! neglect!

e*ploitatione*ploitation!!

Child Right ConventionChild Right Convention


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DISORDER

ISORDER

ROWTH-

ROWTH-

DEVELOP

EVELOP

@elay speech/lang"age@elay speech/lang"age

PalsyPalsy Cere'ralCere'ral

@on@onsindromesindrome Ehort stat"reEhort stat"re

a"tisa"tistic spectr"m disordertic spectr"m disorder

?ental retardation?ental retardation

3ttention defisit disorder hyperactifity (3@@%)3ttention defisit disorder hyperactifity (3@@%)


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1. Child Growth & Development

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