The document discusses physical growth and development in children from birth through adolescence. It describes the key stages of development, including the newborn period, infancy, toddlerhood, preschool years, middle childhood, and adolescence. Several indicators of physical growth are examined, including weight, height, head circumference, and mid-upper arm circumference. Growth charts and the Tanner stages are presented as methods to monitor physical maturation from childhood to adolescence.
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Physical Growth and Development.pdf
1. PAEDIATRICS AND CHILD HEALTH
• Paediatrics and Child Health
• Physical Growth and Development
Dr. Chongo Shapi (BSc.HB, MBChB, CUZ)
- Medical Doctor.
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 1
2. Physical Growth
• Is the net increase in the size or mass of
tissues
• Largely attributed to multiplication of cells
(hyperplasia) and increase in the intracellular
substance
• Hypertrophy contributes to a lesser extent to
the process of growth
• Fastest between 0 and 2 years
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 2
3. Development
• Is basically maturation of functions
• Is related to the maturation and myelination
of the nervous system
• Indicates acquisition of a variety of skills for
optimal functioning of the individual
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 3
4. The Newborn
• The newborn (neonatal) period begins at birth
and includes the 1st month of life
• During this time, marked physiologic transitions
occur in all organ systems and the infant learns
to respond to many forms of external stimuli
• Infants thrive physically and psychologically only
in the context of their social relationships
• Therefore, any description of the newborn's
developmental status has to include
consideration of the parents' role as well
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 4
5. The First Year of Life
• 1st year of life = infancy period
• The 1st yr of life is marked by physical growth,
maturation, acquisition of competence, and
psychologic reorganization
• These changes qualitatively change a child's
behaviour and social relationships
• Children acquire new competences in all
developmental domains
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 5
6. The Second Year of Life
• The skills emerging in the 2nd yr of life shape the
child's sense of self and others
• The child has a newly found independence; the
ability to walk allows separation, yet the child
continues to need secure attachment to the
parents
• At approximately 18 mo of age, the emergence
of symbolic thought and language causes a
reorganization of behaviour, with implications
across many developmental domains
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 6
7. The Preschool Years
• The ages between 2 and 5 yr are governed by the
emergence of language and exposure of children
to an expanding social sphere
• As toddlers, children learn to walk away and
come back to the secure adult or parent
• As preschoolers, they explore emotional
separation, alternating between stubborn
opposition and cheerful compliance, between
bold exploration and clinging dependence
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 7
8. The Preschool Years
• Increasing time spent in classrooms and
playgrounds challenges a child's ability to
adapt to new rules and relationships
• Preschool children know that they can do
more than ever before, but they are also very
aware of the constraints imposed on them by
the adult world and their own limited abilities
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 8
9. The Middle Childhood
• During middle childhood (6–9 yr of age), children
increasingly separate from parents and seek
acceptance from teachers, other adults, and peers
• Self-esteem becomes a central issue, as children
develop the cognitive ability to consider their own
self-evaluations and their perception of how others
see them
• For the first time, they are judged according to their
ability to produce socially valued outputs, such as
getting good grades, playing a musical instrument,
or hitting home runs
• Children are under pressure to conform to the style
and ideals of the peer group
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 9
10. Adolescence
• Between 10 and 20 yr of age, young people undergo
rapid changes in body structure and physiologic,
psychologic, and social functioning
• Hormones set this developmental agenda together
with social structures designed to foster the
transition from childhood to adulthood
• Adolescence proceeds across three distinct periods
1. Early: 10-13 years
2. Middle: 14-16 years
3. Late: 17-20 years
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 10
11. Adolescence
• Each of these periods is marked by a characteristic
set of salient biologic, psychologic, and social issues
• Specifically, pubertal changes follow a predictable
sequence
• Individual variation is substantial, in both the timing
of somatic changes and the quality of the experience
• Gender and subculture profoundly affect the
developmental course, as do physical and social
stressors
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 11
12. The Tanner Stages
• Is also known as the Tanner scale or Sexual Maturity
Rating (SMR) scale
• Is a scale of physical development in children and
adolescents and has 5 stages
• The scale defines physical measurements of development
based on external primary and secondary sex
characteristics such as the size of the breasts, genitalia,
testicular volume and development of pubic and axillary
hair
• The scale was first identified by James Tanner, a British
paediatrician, and thus bears his name
• Due to natural variation, individuals pass via the Tanner
stages at different rates, depending in particular on the
timing of puberty
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 12
13. The Tanner Stages
• Adolescence = 10-20 years
a. Early adolescence: 10-13 yrs
- SMR= 1-2
b. Middle adolescence: 14-16 yrs
- SMR = 3-5
c. Late adolescence: 17-20 yrs
- SMR= 5
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 13
19. Illustration of Tanner scale for boys
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 19
20. Indicators of Growth
1. Weight for age
2. Height for age
3. Weight for height
4. Head circumference
5. Mid-upper arm circumference (MUAC)
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 20
21. INDICATORS FOR GROWTH
i. Weight for age;
• Most widely used
• Does not distinguish between acute (wasting)
and chronic ( stunting ) weight loss.
• On average, birth weight doubles by 5-6
months, and triples by 12 months
NB: Underweight = low weight for age
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 21
22. ii. Height for age.
• Assesses linear growth
• Important in determining stunting
NB: Stunting = low height for age
iii. Weight for height
• Useful in distinguishing between acute (wasting)
and chronic ( stunting ) malnutrition
NB: Wasting = low weight for height
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 22
23. Formulas for Approximate Average Weight and Height
of Normal Infants and Children
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 23
24. Approximate Anthropometric Values in Relation To Age
Age Wt (Kg) Length or height
(cm)
Head
Circumference
Birth 3 50 34
6mo 6 (doubles in 5mo) 65 42
1 yr 9 (triples) 75 45
2 yr 12 (quadruples) 85 47
3 yr 14 95 49
4 yr 16 100 50
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ. 24
25. Height for Age Curves
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 25
26. iv. Head circumference
• Good measure of brain growth especially in the
first 2 years
• Of great value in follow-up of low birth weight
infants, and in children with abnormalities of the
CNS
v. Mid-upper arm circumference (MUAC)
• Useful in assessing nutritional status of infants
and young children.
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 26
27. MUAC
Age MUAC cut-off point for
underwt. (< reference
value) in cms
MUAC cut-off point for
severe malnutrition
(<reference value)
6-12 months
12 11.5
1-5yrs
13 11.5
6-9yrs
14 13.5
10-14yrs
18.5 16
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 27
28. • Normal head circumference at birth is 34-36cm.
• Increases by:
- 2cm/month for the first 3 months
- 1cm/month in the period 3-6months
- 0.5cm/month in the period 6-12 months
• Overall, HC increases by about 10cm in the first
year of life.
• Can help identify children at risk of mental
retardation because of poor brain growth
(microcephaly) or too large a head with
hydrocephalus.
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 28
29. Growth Monitoring in Children:
The Under five Clinic
• Growth and Developmental Assessment
- The growth chart
- Neurological assessment
- Mile stones
• Nutrition
• Immunization
2/21/2013 Dr. Chongo Shapi, BSc.HB, MBChB, CUZ 29
