Unit. 3 Growth and Development

Shristi AryalAssistant Lecturer

Growth

Growth denotes a net increase in the size or mass of tissue. Its largely attributed to multiplication of cells and increase in the intracellular substances. “Growth is the quantitative or measurable aspect of an individual’s increase in physical measurement”. (Waechter and Blake,1976)

Development Development specifies maturation of

functions. Its related to maturation and myelination of nervous system and indicates acquisition of a variety of skills for optimal functioning of the individual.

3.2 Factors affecting growth and developmentThe primary factors which influences growth

and development are:1. Genetic inheritance2. Environmental influence

1. GeneticsThe basic genetic make up of an individual is casted since the moment of conception of sperm and ovum. In addition to physical characteristics such as eye color and height potential, inheritance determines other characteristics such as learning style and temperament. Although each child is unique, certain gender related characteristics influence normal growth and development. An individual may also inherit a genetic defect or defects, which may result in disability or illnes at birth or later in life. • Gender • Phenotype

2. Neuro-Endocrine Factors

Neuro endocrine system produces a no. of releasing and inhibitory hormones that influence growth. Most hormones affect growth in some extent. Important hormones influencing growth are growth hormone, thyroid hormone, androgen and insulin.• Growth Hormone: Promotes growth of bone

and soft tissue and especially for linear growth.

Contd..• Thyroid Hormone: thyroxine hormone produced

from 12th week of gestation is essential for skeletal maturation in fetal period and growth of bone, teeth and brain. It also regulates BMR so control rate of growth of body cells.

• Sex hormone: hormones such as androgen, estrogen, progesterone influence development of bone, reproductive organs and secondary sexual characteristics. Insulin is essential for fetal growth as well as for child growth by regulating glucose utilization by tissue, protein synthesis and transport to cells and tissue for growth.

3. Nutrition Nutrition is the single most environmental factor

influencing growth. Dietary factor regulate growth at all stages of growth and development. Growth is influenced by nutritional status. Similarly, child’s appetite fluctuates in response to growth variable. During infancy, pubertal period nutrition requirement is high and growth is also high. Adequate quality nutrition is closely related to good health throughout the life and early maturation of childhood. In other hand children suffering from protein energy malnutrition, anemia and vitamin deficiency have growth retardation.

4. Diseases and infections

Impaired growth and development is one of the feature of heredity disorder. Persistent systemic and local infections like TB, respiratory infection, diarrhea cause growth impairment.

Many chronic illness like chronic kidney disease (CKD) congenital heart disease are associated with varying degree of growth failure.

5. Environmental hazards

The velocity of growth may differ in different seasons. Infection and infestation rate is usually higher in hot and humid climate. Weather also determines agricultural productivity, availability of food which has positive impact in growth and development.Chemical present in environment such as lead, mercury, tobacco, radiation etc creates carcinogenicity, enzymatic effect. Children exposed to these substance through contaminated water air, food, or physical environment.

Contd..

Climate and season: growth rate is higher in late summer and autumn and slower in spring and early winter.

6. Interpersonal relationshipRelationship with significant others play critical role in development particularly emotional, social, intellectual and overall personality development.

Contd..

The mothering person is the single most dominant person during early infancy, who provides the infant’s basic needs of food, warmth, comfort and love.

Similarly , parents are most influential in helping the child’s psychosocial and psychosexual development. Siblings are the child’s first peer.

Contd.. When child tends to have failure to establish

interpersonal relationship with all family members they experience emotional deprivation which is characterized by delay in growth and development.

In the same way the child reared in fearful and hostile environment, disordered family environment exhibit poor growth even though they are free of disease. It is due to endocrine imbalance related to psychological factor.

7. Social factor

Children from families with high socioeconomic status usually have good nutritional status. They suffer from fewer infectious disease. So they have good growth and developmental status.Certain cultural practices related to child rearing practices may influence child’s growth and development.

8. Prenatal FactorsPrenatal factors refers to maternal condition. Maternal condition such as under nutrition and anemia are associated with intra uterine growth retardation. Obstetrics condition such as pregnancy induced hypertension, pre eclampsia also cause growth retardation. Likewise, chronic medical disease like CKD,CHF also cause fetal growth retardation.Drugs intake in 1st trimester causes congenital defects. Maternal infection like rubella, syphilis, cytomegalo virus infection may be transmitted to the fetus and may retard growth

9. Exercise

Exercise and activity increase the circulation, promotes physiological activity and physiological growth, like muscle and bone coordination.

3.3 Principles of growth and developmentGrowth and development in a person occurs in a

logical and sequential pattern from conception. Its maneuvered by some general rules or principles. They are:

1. Directional Trend• Cephalocaudal• General to specific• Proximal to distal2. Simple to Complex3. Sequential

Contd..4. Interrelationship between various aspects of

growth and development5. Individual rates of growth and development6. Different tissues of the body grow at different

rates -general body growth -the brain growth -the growth of gonads -lymphoid growth7. Developmental Pace (speed/ rate)

3.4 Developmental stage of children

Theoretical foundation of personality development are based on:•Erickson’s stage of psychosocial theory•Freud’s psychosexual developmental theory•Kohlberg’s stage of moral development•Piaget’s phase of cognitive development•Fowler’s stage of faith (Spiritual development)

Erickson’s stage of psychosocial theoryStage Age Central

task+ Resolution - Resolution

Infancy 0-12mth Trust vs Mistrust

Learns to trust others

Mistrust, withdrawal, separation

Toddler 1-3yrs Autonomy vs shame and Doubt

Self control without loss of self esteem, ability to cooperate & express oneself

Compulsive, self restraint or compliance, willfulness and defiance

Preschooler 3-6yrs Initiative vs Guilt

Learns to become assertive, ability to evaluate one’s behavior

Lack of confidence, pessimism, fear of wrong doing, over control & restriction

Contd..Schooler 6-12yrs Industry vs

InferiorityLearns to create, develop & manipulate, develop a sense of competence & preservance

Loss of hope, sense of being mediocre, withdrawal from peers and schoolers

Adoloscent 12-18yrs Identity vs role isolation

Coherent , sense of self, plays to actualize one’s abilities

Feeling of confusion, indecisiveness and possible antisocial behavior

Freud’s psychosexual developmental theoryS.N stage Age characteristics

1. Oral 0-1yrs Centre of pleasure; mouth (major source of gratification and explanation)

2. Anal 1-3yrs Source of pleasure: anus and bladder (sensual satisfaction and self control)

3. Phallic 3-6yrs Centre of pleasure: child’s genitalia (masturbation) major conflict Oedipus (father) and Electra complex (mother)

4. Latency 6-12yrs Energy directed to physical and intellectual activities, sexual impulses repressed, relationship between peers of same sex

5. Genital 12-18yrs Energy directed towards full sexual maturation and function and development of secondary sexual characteristics

Kohlberg’s stage of moral developmentS.N Phase Age Description

1. Preconvention level 0-2yrs Good is what I like and want.

2. Conventional level 2-7yrs If punished wrong, if rewarded right.

3. Post conventional, autonomous or principled level

7-11yrs If you give me something, I will do it.

Piaget’s phase of cognitive develpomentS.N Phase Age Description

1. Sensory motor phase

0-2yrs Sensory organs and muscles becomes more functional.

2. Pre operational• preconceptual

stage• Intuitive stage

2-7yrs Emerging abilities to think• Egocentric, uses symbols• Classify objects, unable to break down

3. Concrete operational

7-11yrs Learns to reason about event in here and now

4. Formal operational 11+ Able to see relationship and to reason in the abstract

Fowler’s stage of faith(spiritual development)S.N

Phase Age Description

1. Undifferentiate faith

0-1 Trust, hope, love, complex with environment (no meaning of culture and values)

2. Intituitive projective faith

1-6 Initiates parenteral behavior and attitude about religion and spirituality (blindly follows parents)

3. Mythical literal faith

6-12 Accepts existence of a deity religion and moral belief, divine power (believes god and divine power)

4. Synthetic conventional faith

12-16 Questions , values and religion belief is an attempt from own identity, child starts asking question regarding god and its belief, child getting conflict and curios

5. Intituitive reflective faith

16+ Trust on own culture and responsible for what we do in case of culture

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