GROWTH AND DEVELOPMENT

DEFINITION• GROWTH

• The term growth denotes a net increase in the size,

or mass of the tissue.

• It is a quantitative change in the child’s body.

• It is largely attributed to multiplication of cells and

increase in the intracellular substance.

• It can be measured in Kg, pounds, meters, inches, ….. etc

DEVELOPMENT

• Development specify maturation of functions. It is related to the maturation and myelination of the nervous system and indicates acquisition of a variety of skills for optimal functioning of the individual

• It is a qualitative change in the child’s functioning.

• It can be measured through observation.

Growth Pattern

Growth Patterns

The child’s pattern of growth is in a head-to-toe direction, or cephalocaudal, and in an inward to outward pattern called proximodistal.

PRINCIPLES OF DEVELOPMENT

• Development is a continous process from conception to maturity

• Development depends on the maturation and myelination of nervous system.

• The sequence of the development is the same for all children, but the rate of development varies from child to child

• Development follows a direction and uniform pattern

• Development proceeds from general to specific responses

DEVELOPMENTAL AGE PERIODS

• Infancy– Neonate

• Birth to 1 month– Infancy

• 1 month to 1 year• Early Childhood

– Preschool• 1-4 years

• Middle Childhood– School age– 5 to 12 years

• Late Childhood• Adolescent– 13 years to approximately 19 years

FACTORS AFFECTING GROWTH AND DEVELOPMENT

FETAL STAGEGenetic potentialSex Fetal hormonesFetal growth factorsPlacental factors Maternal factors

POST NATAL PERIOD

• Sex• IUGR• Genetic factors• Hormonal influences• Nutrition• Infections• Chemical agents• Trauma

SOCIAL FACTORS:

• Socioeconomic level• Poverty• Natural resources• Climate• Emotional factors• Cultural factors• Parental education

Physical Growth

Weight

Calculating infant’s Weight Infants from 3 to 12 months

Weight = Age in months + 9 2 Wt of 7 months old infant = 7+9 = 16 = 8 kg 2 2

Formula to calculate normal weight of children over 1 year of age is

Age in years X 2+8 = ….. kg.e.g., The weight of a child aging 4

years = 4 X 2 + 8 = 16 kg

Height

• Length increases about 3 cm /month during the 1st 3 months of age,

• then it increases 2 cm /month at age of 4-6 months,

• Then, at 7 – 12 months, it increases 1 ½ cm per month

After 1 yrs of age

• During 1–2 years, the child's height increases by 1cm/month.

The toddler's height increases about 10 to 12.5cm/year.

Formula to calculate normal height

Age in years X 5 + 80 = cm.e.g., the length of 2 years old child = 2 X 5 + 80 = 90cm

Head circumference

• It increases about 2 cm /month during the 1st 3 months,

• Then, ½ cm/month during the 2nd 9 months of age.

• Posterior fontanel closes by 6-8 w of age.• Anterior fontanel closes by 12-18 months of age.• The head increases 10 cm only from the age of 1

year to adult age.

Chest circumference

By the end of the 1st year, it will be equal to head circumference.

• During preschool years, chest circumference continues to increase in size and exceeds head circumference.

ERRUPTION OF TEETH

PERMANENT TEETH

Molar 6 to 7 years

Central and lateral incisors

6 to 8 years

Canines and premolars

9 to 12 years

Second molars 12 years

Third molars 18 years or later

DEVELOPMENT

GROSS MOTOR DEVELOPMENT

• 6 WEEKS – DEVELOP HEAD CONTROL

• 20 WEEKS – COMPLETE NECK CONTROL

• 6 MONTHS – CHILD CAN BEAR ALMOST ALL HIS WEIGHT

• 9 MONTHS- _ begins to stand holding on the furniture

• 10 – 11 months – start cruising around the furniture

• 12- 13 months _ stands independently.

Pre-school

At 15 months, the toddler can:• Walk alone.• Creep upstairs.• Assume standing position without falling.• Hold a cup with all fingers grasped around it.

At 18 months:• Hold cup with both hands.• Transfer objects hand-to hand at will.

ContinuousAt 24 months: •Go up and down stairs alone with

two feet on each step.•Hold a cup with one hand.•Remove most of own clothes.•Drink well from a small glass held in

one hand.

At 30 months: the toddler can:

•Jump with both feet.•Jump from chair or step.•Walk up and downstairs, one foot

on a step.•Drink without assistance.

FINE MOTOR DEVELOPMENT

• Hand eye coordination

• 12-20 weeks – child observes his own hands (hand regard)

• 4 months – hand of the children come together at midline as he plays

Offer a red cube to the child

• 5-6 months : infant reaches and holds the cube in a crude manner using the ulnar aspect of his hand

• 6-7 months : transfer objects from one hand to other

• 8-9 months : child is able to grasp from the radial side of the hand

By offering pellets, finer hand skills are assessed

• 9-10 months : child approaches the pellet by an index finger and lifts it using – thumb opposition

HAND TO MOUTH COORDINATION

• 6 months : child can take a biscuit to his mouth and chew

• 1 year : tries to feed self from a cup but spills some of the content

DRESSING

• 1 year : child starts to pull off mittens, caps and socks

Pre-school

• 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

• 3 year old: copy a circle and a cross – build using small blocks

• 4 year old: use scissors, color within the borders

Social development

• 1 month _ child intently watches his mother when she talks to him

•6-8 weeks : social smile

• 3 months : enjoys looking around and recognizes the mother

• 6 months : vocalizes and smiles at his mirror image and imitates acts such as cough or tongue protrusion

• 6-7 months : stranger anxiety

• 9 months : waves ‘bye- bye’. Repeats any performance that evokes an appreciative response from the observers

1 year : he can understand simple questions like ‘ where is your papa?’

Social development: Preschooler

• The is very social being but still egocentric.• He imitates parents.• Notice sex differences and know own sex.• As he grows old• Tolerates short separation• Less dependant on parents

The school–age child Continues to be egocentric.• Wants other children to play with him.• Insists on being first in every thing• Becomes peer oriented.• Improves relationship with siblings.• Has greater self–control, confident, sincere.• Respects parents and their role.• Joints group (formal and informal).• Engage in tasks in the real world.

LANGUAGE

• 1 month – alerts to sound• 3 month – coos ( musical vowel sounds)• 4 months – laugh aloud• 6 months – monosyllables (ba- pa –da), ah-

goo sounds• 9 months – bisyllables (mama, baba, dada)• 12 months – 1-2 words words with meaning

• 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

VISION

• 1 month – baby can fixate on his • mother as she talks to him• 3-4 months : child can fixate intently on an

object shown to him (grasping with eye)• 6 weeks : binocular vision begins and is well

established by 4 months• 6 months : child adjusts his position to follow

object of interest• 1 year : follow rapidly moving objects

HEARING

• 3-4 months : child turns his• head towards the source of sound• 5-6 months : child turns the head to one side

and then downward if a sound is made sound below the level of ears.

• 10 months : child directly looks at the source of diagonally