2. Learning objectives
By the end of this lecture, the student will be able
to:
• Define growth, development and maturation.
• Describe the principles of growth and
development.
• List factors affecting growth and development.
• explain types of growth and development.
• Identify the importance of growth and
development for nurses.
• Identify the stages of development.
3. Growth
• Growth refers to an increase in
physical size of the whole body or
any of its parts.
• It is describe a quantitative
change in the child’s body.
• It can be measured in Kg, pounds,
meters, inches, ….. etc
4. Development
• Development refers to a progressive
increase in skill and capacity of
function.
• It is a qualitative change in the
child’s functioning.
• It can be measured through
observation.
5. Maturation
• it is the process of developing to a
desired level in developmental
skills or body cells.
8. 1. Growth and development are
continuous processes.
2. Growth and development have
predictable sequences.
3. Growth and development go through
a fixed, precise order, they do not
progress at the same rate.(↑ periods of
growth in early childhood and
adolescents and ↓ periods of growth in
middle childhood)
9. 4. Not all body parts grow in the
same rate at the same time.
5. Each child grows in his/her own
unique way.
6. Each stage of Growth and
development is affected by the
preceding types of development.
10. Principles of Growth & Development
7. Growth and development proceed
in regular, related direction, which
reflect the physical development
and maturation of neuromuscular
functions.
11. • These directions are:
• Cephalocaudal:
The growth proceed from head
down to toes.
• Proximodistal:
The growth proceed from the
centre or midline of the body
to peripherally.
16. I. Heredity:
A. Heredity of the parent
B. Sex of children determine their
pattern of growth.
C. Race and nationality.
17. II. Environmental factors
A) Prenatal environment
1. Factors related to mothers during
pregnancy
2. Factors related to fetus
B) Postnatal environment:
1. External environment:
2. Internal environment
18. A) Prenatal environment
1. Factors related to mothers during
pregnancy:
oNutritional deficiencies
oDiabetic mother
oInfection with German measles
oSmoking
oUse of drugs
20. B) Postnatal environment:
1. External environment:
• Socio-economic status of the family.
• Child’s nutrition.
• Child’s ordinal position in the family
• Number of sibling in the family.
• Family structure.
• Climate and season.
22. Types of growth and
development
Types of growth:
• Physical growth as; weight, height,
head and chest circumference.
• Physiological growth as; vital signs.
23. Types of development:
1. Motor development (cross motor
and fine motor)
2. Cognitive development
3. Emotional development
4. Social development
5. Moral development
6. Language development
25. Most recent classification
1.Prenatal period: from conception
to birth:
• Embryonic stage: conception to 8
weeks
• Fetal stag: 8 weeks to birth
2.Infancy period: from birth to 12
month:
• Neonatal stage: birth to 4 weeks
• Infancy stage :1 month to 12 months
26. 3.Early childhood: from 1 to 6 years:
• Toddler:1 to 3 years
• Preschool:3 to 6 years
4.Middle childhood: from 6 to 12
years
5.Late childhood: from 10 to 18
years:
• Prepubertal period:10 to 13 years
• Adolescence period:13 to 18 years
27. Old classification
STAGE AGE
1-Newborn ( neonate ) 1st 4 weeks
2-Infancy stage 1st year
3-Toddler stage 1-3 years
4-Preschool stage 4-6 years
5-School stage 7-12 years
6-Adolescence stage 13- 18 years
30. HOME WORK
• Go to the following Internet site: http://
www.dbpeds.org. Go to “Pediatric
Development and Behavior.” Under “Hot
Topics,” click on “Developmental Screening
Module.” Read the section regarding
developmental screening.
a. What is the main objective for doing
developmental screening?
b. Who should be screened using developmental
screening tools?
c. What are the five major pitfalls of developmental
screening?
33. • Newborn stage is the first 4 weeks
or first month of life.
• It is a transitional period from
intrauterine life to extra uterine
environment.
34. Normal Newborn Infant
Physical growth:
Weight
• Weight = 2.700 – 4 kg
• Wt loss 5% -10% by 3-4 days
after birth (why??)
• Wt gain by 10th days of life
• Gain ¾ kg by the end of the 1st
month
35. Height
• Boys average Ht = 50 cm
• Girls average Ht = 49 cm
• Normal range for both (47.5- 53.75
cm)
Head circumference
• After birth 33-35 cm
• Skull has 2 fontanels (anterior &
posterior)
36. Anterior fontanel
• Diamond in shape
• Between 2 frontal and 2 parietal bones
• 3-4 cm in length and 2-3 cm width
• It closes at 12-18 months of age
Posterior fontanel
• Triangular shape
• Located between occipital and 2 parietal
bones
• Closes by the end of the 1st month of age
42. Newborn Senses
Touch
• It is the most highly developed sense.
• It is mostly at lips, tongue, ears, and
forehead.
• The newborn is usually comfortable
with touch.
43. Vision
• Pupils react to light
• Bright lights appear to be unpleasant
to newborn infant.
• Follow objects in line of vision
44. Hearing
• The newborn infant usually makes
some response to sound from birth.
• Ordinary sounds are heard well before
10 days of life.
• The newborn infant responds to sounds
with either cry or eye movement,
cessation of activity and / or startle
reaction.
45. Taste
• Well developed as bitter and sour
fluids are resisted while sweet fluids
are accepted.
Smell
• Only evidence in newborn infant’s
search for the nipple, as he smell breast
milk.
46. Motor Development
Gross motor development
• The newborn's movement are random,
diffuse and uncoordinated.
• Reflexes carry out bodily functions and
responses to external stimuli.
51. • It is the period which starts at the end
of the first month up to the end of the
first year of age.
• Infant's growth and development
during this period are rapid.
52. Physical growth
A) Weight:
The infant gain:
• Birth to 4 months: ¾ kg/month.
• 5 to 8 months :1/2 kg/month.
• 9 to 12 months :1/4kg/month.
• Double birth W at 4-5 months
• Triple birth W at 9-12 months
54. B) Length:
• 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.
55. C) Head circumference
• It increases about 2 cm /month during
the 1st 3 months,
• Then, ½ cm/month during the 2nd 9
months of age.
D) Chest circumference
• By the end of the 1st year, it will be
equal to head circumference
57. Dentition
• Eruption of teeth starts by 5–6 months
of age. It is called "Milky teeth" or
"Deciduous teeth" or "Temporary
teeth".
58.
59. Motor Development
• At 2 months
• Hold head erects in mid-position.
• Turn from side back.
• At 3 months the infant can:
• Hold head erects and steady.
• Open or close hand loosely.
• Hold object put in hand
61. At 4 months, the infant can:
• Sit with adequate support.
• Roll over from front to back.
• Hold head erect and steady while in
sitting position.
• Bring hands together in midline and
plays with fingers.
• Grasp objects with both hands.
62. At 5 months, the infant can:
• Balance head well when sitting.
• Site with slight support.
• Pull feet up to mouth when supine.
63. At 6 months, the infant can:
• Sit alone briefly.
• Turn completely over ( abdomen to
abdomen ).
• Lift chest and upper abdomen when
prone.
• Hold own bottle.
64. At 7 months, the infant can:
• Sit alone.
• Hold cup.
• Imitate simple acts of others.
At 8 months, the infant can:
• Site alone steadily.
• Drink from cup with assistance.
• Eat finger food that can be held in one
hand.
65. At 9 months, the infant can:
• Rise to sitting position alone.
• Crawl (i.e., pull body while in prone
position).
• Hold one bottle with good hand-mouth
coordination
66. At 10 months, the infant can:
• Creep well (use hands and legs).
• Walk but with help.
• Bring the hands together.
At 11 months , the infant can:
• Walk holding on furniture.
• Stand erect with minimal support
67. At 12 months , the infant can:
• Stand-alone for variable length of time.
• Site down from standing position
alone.
• Walk in few steps with help or alone
(hands held at shoulder height for
balance).
• Pick up small bits of food and transfers
them to his mouth
68. Emotional development:
• His emotions are instable, where it
is rapidly changes from crying to
laughter.
• His affection for or love family
members appears.
69. • By 10 months, he expresses several
beginning recognizable emotions,
such as anger, sadness, pleasure,
jealousy, anxiety and affection.
• By 12 months of age, these emotions
are clearly distinguishable.
70. Social development
• He learns that crying brings attention.
• The infant smiles in response to smile
of others.
• The infant shows fear of stranger
(stranger anxiety).
• He responds socially to his name.
71. • According to Erikson, the infant
develops sense of trust.
• Through the infant's interaction with
caregiver (mainly the mother),
especially during feeding, he learns to
trust others through the meeting of
basic needs
Trust vs. miss trust
72. Language development
• 1-2 months: coos
• 2-6 months: laughs and squeals
• 8-9 months babbles: mama/dada as sounds
• 10-12 months: “mama/dada specific”
• 18-20 months: 20 to 30 words – 50%
understood by strangers
• 30-36 months: almost all speech understood
by strangers.
74. At any age Parent concern about any regression in
previous acquired skills
At 10 week No smiling
At 6 month Persistent primitive reflexes
Presenting squinting – hand preference –
little interest in people and toys
At 10 – 12
months
No sitting - no pincer grasp
At 18 month Not walk dependently - less than 6 words
– persistent mouthing and drooling
At 2 ½ years No 2- 3 sentences
At 4 years Un intelligible speech
78. Introduction
• Reflexes in term infants indicate
normal neurological functioning.
• Neurological development
continues until approximately 2
years of age, when myelination is
complete.
80. Rooting Reflex
Stimulation:
• touch or stroke cheeks near the
mouth corner.
Infants Response
• infant turns head in direction of
touched area to find food.
Development Patterns
• It disappear at 3 - 4 months.
81. Sucking Reflex
Stimulation
• touching infant mouth or lips.
Infants Response
• Infant shows sucking movement.
Development Patterns
• Disappears after 3 to 4 months
82. Swallowing Reflex
Stimulation
• When food reach posterior of
mouth.
Infants Response
• Infant shows swallowing
movement.
Development Patterns
• It does not disappear.
84. Grasp Reflex
A. Palmer Grasp Reflex
Stimulation
Touching palm of infant by any object.
Infants Response
• Infant holds anything put in his
hands, closing fingers around it.
86. B. Planter Grasp Reflex
• Stimulation
• touches the sole of foot by any object.
• Infant response
• Toes grasp around object .
• Development Patterns
• It disappears 8 – 9 months, It can
continue during sleep.
88. Infant response:
• loss of support, he makes aimless
muscular activity where he abducts
and extends hands open and
fingers extended, legs slightly
flexed.
Development Patterns
• It disappears at 4 months.
89. Babinski Reflex
stimulation
• stroke lateral aspect of the sole with
relatively sharp object, e.g., finger nail,
from heal towards little toes and across
foot to big toe.
Infant response
• dorsi flexion, fanning of toes and
hyperextension of great toe will happen.
91. Tonic – Neck Reflex
Stimulation
• Infant in supine position, turn his head
at one side.
Infant response
• infant extends arm and leg of the other
side.
Development Patterns
• It disappears at 18 – 20 weeks.
92. Dancing Reflex(Step-in-
place)
stimulation
• hold infant in vertical position, feet
touches firm, flat surface.
Infant response
• infant rapidly alternates flexion and
extension of legs as in stepping.
Development Patterns
• It disappears at 3 – 4 months
93.
94. [kassala university – baccalaureate of high
nursing]
Certificate of Completion
•is hereby granted to:
•[2nd level – semester 2]
•to certify that they have completed to satisfaction
[infant and neonatal
reflexes]
Granted: December 17, 2023
{ost. Murtada – msc pediatric nursing}
