Growth & developmemt

1. Chapter 3- Growth and
Development
By Eyayalem M

2. Growth and Development
• Growth: is an increase in size of the whole body or its parts. It starts
from the day of fertilization.
• Development: is an increase in skills and ability to function.
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3. Growth and Development
• Maturation:
:- is the process of attaining the combination of physical, emotional,
moral, and cognitive abilities that enable a person to function and
adapt to the environment; or it refers to the total way in which a
person grows and develops.
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4. • 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.
• There is a positive correlation between physical,
mental and emotional development of a child.

5. Growth Pattern

6. 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.

7. For ease of understanding growth and development may
be divided in to two broad categories.
1. Physical growth and development:
- Refers to change in physical size (physical growth) or
appearance (physical development).
- It includes body measurements (anthropometric
measurements), dentition, and skeletal and sexual
development.
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8. 2. Neurological/mental growth and development:
- refers to the growth and development parts, which are
dependent to the maturity of the nervous system.
(Intelligence, motor, emotional, social, and speech
development)
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9. Physical growth and development
• The following measurements are important in assessing
physical growth and known as anthropometric
measurements.
1- Weight:
- Normal- birth weight = 2.5- 4.0 kg, with loss of 5-10%in
the 1st week, and it is
regained at the age of 10th to 14th day.
- Then increases 25gm/day in the 1st 3 months and 15
gm/day in the remainder of the 1st year.
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10. • - Birth weight doubles at 5-6 months, triples at 1 year,
and quadriples at 2 years of age.
 For 3 to 12 months old child:
• Body weight in kg = ½ (age in month + 9)
For 1 to 12 years old child:
• Body weight in kg = (age in years X 2) + 8
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11. Height/Crown-heel length:
• Under 5 years of age height is measured in lying
position and is known as crown to heel length, which
is approximately 0.5 cm more than the standing
height.
• Length at birth= 50 cm,
• at 6 month = 65 cm,
• at 1 year = 75 cm,
• at 2 years = 85 cm,
• at 3 years = 95 cm,
• at 4 years = 100 cm, then increases about 5-6
cm/year
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12. Height
• For 2 to 12 years old child:
- Expected height in cm = (age in years x 6) + 77 cm
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13. • Note: Rapid increase in height and weight occur during
period of fetal (2nd half) life, infancy, and puberty.
• Normally, males are heavier and longer than females
till the age of 11 years and then, the females gain
superiority (mature earlier than boys).
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14. 3-Head Circumference
• Is an indirect estimation of size of the brain.
• Brain grows very rapidly during infancy and early
childhood so that it achieves almost adult size by 5
years of age.
• Measure at the level of supraorbital ridges and occipital
prominence.
• At birth = 35 cm, at 1 year = 45 cm, at 2 years= 48 cm, at
5 years = 50 cm ,at 12 years = 52 cm
•
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15. 4- Chest Circumference
• Measure at the level of breast nipples and right angle
to vertebral column during mid respiration.
• It is by 2 cm less than head circumference at birth.
• At 1-year chest circumference is equal to head
circumference, then the chest continues to grow
relatively faster than the head.
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16. Other measurements
• Mid upper arm circumference and skin fold
measurements (at the triceps muscle using a skin fold
caliper) are useful measurements for nutritional
assessment of children
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17. Dentition
Two types of teeth
• Temporary (Deciduous, milk teeth):
• 20 in number
• The 1st temporary teeth, the lower central incisors
erupt at about 6-8 months of age
• The last to erupt are the second molars (at 20-30
months of age of the child)
• Estimation of number of temporal teeth:
• Expected number of temporary teeth = age in month –
6
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18. 5. Dentition /eruption of teeth

19. • Permanent Teeth: the 6-year molars erupt first and the 3rd molars
erupt last at the age of 17- 25years.
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Dentition

20. Neurological/ mental development
• See table “b” for personality development (emotional
development based on Erickson’s theory)
• Ability to understand and deal effectively with a problem
requiring abstract thinking is assessed after 5 yeas of age.
Example: Denver test for IQ (Intelligent Quotient)
IQ = Mental age x 100
Chronological age
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21. Neurological/ mental development
• A child with IQ < 75 % is considered as having mental
retardation.
• Age periods and developmental milestones
• The development of a child can be assessed from different points
of view.
• What he can do in the way of moving around (motor
development)
• How he talks and makes his wants known (language)
• How he fits into his family and community (social behavior)
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22. Age periods and developmental
milestones
The development of a child can be assessed from
different points of view.
• What he can do in the way of moving around (motor
development)
• How he talks and makes his wants known (language)
• How he fits into his family and community (social behavior)
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23. AGE GROSS MOTOR LANGUAGE PERSONAL -SOCIAL
Birth Lies in a flexed
attitude
Cries -
1 mo. Prone:-Lifts head
momentarily.
Supine:-Head lag on
pull to sitting
position.
Vocalizes (throat
sounds), not crying.
Smiles responsively.
3 mo. Sitting position:-
Holds head steady.
Prone:-Lifts head &
shoulders
Squeals-vocalizes with
pleasure.
Initiate vowels
Smiles spontaneously.
6 mo. Sits without
support.
Turns to voice,
can say few
monosyllables ‘da’,
‘ba’
Resists toy pull.
Starts showing
preference for mother.
9 mo. Crawls, pulls to
standing position.
Says ‘mama’, ‘dada’
etc. (non specific)
Responds to sounds of
name, waves bye-bye.
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24. 1 yr. Walks with one
hand held or
holding furniture.
Few words besides
‘mama’, ‘dada’.
At-13moths:-
vocabulary of three
words
Plays simple ball games,
May understand
meaning of “where is
your shoe?’ etc.
May kiss on request.
15 –16mo. Walks alone,
crawls upstairs
Jargon (own
language); vocabulary
of six words
Indicates desires or
needs by pointing.
18 mo. Walks upstairs one
hand held, runs
stiffly.
Two word phrase.
An average
vocabulary of 20
words.
Feeds self, may
complain when wet or
soiled (starts sphincter
control).
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25. 2 yrs. Runs well, walks up
and down stairs, one
step at a time.
Makes a 3 word
phrase or sentence;
approximately,
vocabulary of 270
words.
Helps to undress, listens
to stories with pictures.
3 yrs. Goes upstairs
alternating feet,
stands on one foot,
rides tricycle.
Mastery of personal
pronouns ‘I Want a
ball’; approximately,
vocabulary of 900
words; makes a 4
word phrase
Plays simple games,
helps in dressing, and
washes hands.
4 yrs. Hops on foot,
throws ball
overhead.
Tells a story;
approximately,
vocabulary of 1540
words; makes a 5
word phrase
Plays with other
children (beginning of
social interaction), goes
to toilet alone.
5yrs. Skips. Names four colors,
repeats sentence of 10
syllables.
Dresses, undresses,
helps in household.
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26. b) Stages of Personality Development (Based on Erickson’s theory)
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Stage Approximat
e-mate
age
Psychosocial
Crises
Significant
persons
Tasks
Infancy 0-1 Sense of trust Vs.
Mistrust
Maternal
person
Getting, Tolerating frustration in
small does,
Recognizing mother as distinct
from others & self.
Toddler 1-3 Sense of autonomy
Vs. Shame & doubt
Parental
persons
Trying out own powers of speech,
Beginning acceptance of reality Vs.
pleasure principle.
Preschool 3-6 Sense of initiative
Vs. guilt
Basic family Questioning,
Exploring own body &
environment,
Differentiation of sexes.
School 6-12 Sense of industry
Vs. inferiority
Neighborhood,
School
Learning to win recognition by
producing things, Exploring,
Collecting, Learning to relate to
own sex.
Adolescence 12 - 18 in
females
13 – 19 in
males
Sense of identity
Vs. identity
diffusion
Peer groups
and out
groups;
models of
leadership
Moving toward heterosexuality,
Selecting vocation,
Beginning separation from family,
Integrating personality (altruism,
etc.)

27. Factors affecting growth and development
• Genetic
1. Sex
2. Race and nationality
• Environmental
1. Prenatal
Maternal
nutrition/Infections
2. Postnatal

28. Genetic factors
• Characteristics such as height, body structure, color of skin,
eyes and hair depends upon inherited genes from parents.
• Some familial diseases also affected the growth of children

29. Environmental factors
1. Prenatal factors
Intrauterine environment is an important
predominant factor of growth and development.
Maternal malnutrition
Maternal infections
Maternal substance abuse
Maternal illness
Hormones- Thyroxine es the skeleton growth
Uterine malformations

30. 2. Postnatal environmental factors
Growth pattern
Nutrition
Childhood illness
Acute illness
Physical environment
Psychological environment
Cultural influences
Socio economic status
Climate and season
Play and exercises

31. The end