This document discusses growth and development in children. It defines growth as a quantitative increase in physical size while development refers to qualitative improvements in skills and abilities. The document outlines the major stages of growth from infancy to adolescence and lists factors that can influence development such as genetics, prenatal environment, nutrition, and socioeconomic status. It also provides examples of developmental milestones in areas like gross motor skills, fine motor skills, language, and social skills that children typically reach at certain ages from birth to 2 years old.

1. GROWTH & DEVELOPMENT
IN CHILDREN
JD KABAMBA

2. Objectives
1. General Objective:
Be able to discuss growth and development of children.
2. Specific Objectives:
• Define growth and development
• Mention the principles of growth and development.
• Identify the importance of growth and development.
• List factors affecting growth and development.
• Define maturation
• Mention types of growth and development.
• Identify the stages of development.

3. PHYSICAL GROWTH

4. Stages of Growth and Development
1. Infancy
• Neonate: Birth to 28 Days
• Infancy: 1 month to 1 year
2. Early Childhood
• Toddler: 1-3 years
• Preschool: 3-6 years
3. Middle Childhood
• School age: 6 to 12 years
4. Late Childhood
• Adolescent: 13 years to 18 years

5. Definition
• Growth refers to an increase in physical size of the whole body or any
of its parts.
• It is simply a quantitative change in the child’s body.
• It can be assessed in any known weight and size measurement units.

6. Principles of Growth
•Continuous process
•Predictable Sequence
•Don’t progress at the same rate (↑ periods of GR in early childhood
and adolescents & ↓ periods of GR in middle childhood)
•Not all body parts grow in the same rate at the same time.
•Each child grows in his/her own unique way.
•Each stage of G&D is affected by the preceding types of development.

7. The child’s pattern of growth is in:
1. A head-to-toe direction, or cephalo-caudal
2. An inward to outward pattern called proximo-
distal.

8. Changes in bodily proportions with age

9. Importance of Growth and Development
• Knowing what to expect of a particular child at any given age.
• Gaining better understanding of the reasons behind illnesses.
• Helping in formulating the plan of care.
• Helping in parents’ education in order to achieve optimal
growth & development at each stage.

10. Factors affecting growth and development
1. Hereditary
Different characteristics of growth and development like
intelligence, aptitudes, body structure, height, weight, etc are
highly influenced by heredity.
2. Environmental factors
- Prenatal
- Post-natal

11. Factors affecting growth and development (cont’d)
Pre-natal environment
1. Maternal Factors ( during pregnancy) :
- Nutritional deficiencies
- Diabetic mother
- Exposure to radiation
- Infection with German measles
- Smoking
- Use of drugs
2. Factors related to fetus
- Mal-position in uterus
-Faulty placental implantation

12. Factors affecting growth and development (cont’d)
Post-Natal Environment
1. External environment:
- socio-economic status of the family
- child’s nutrition
- climate and season
- child’s ordinal position in the family
- Number of siblings in the family
- Family structure (single parent or extended family … )
2. Child’s intrinsic environment:
- Child’s intelligence
- Hormonal influences
- Emotions

13. Types of growth
1. Physical growth
-Height / Length
- Weight
- Fronto-occipital circumference
2. Physiological growth ( vital signs)
- Heart /pulse rate
- Respiratory rate

14. 1. Physical growth
1.1 height / length
Birth: 50 cm
Length increases about:
24/1 cm during the 1st year of life, then it increases by
24/2 cm during the 2nd year of life ( half of adult height attained)
It will further increase by
24/3 cm during the 3rd year of life, And finally by
24/4 cm during the 4th year of life when they double the birth length: 100 cm.
They will then increase their height by 5 cm /year till they reach their determined final height.

15. 1.2 Weight
Birth weight: 2.500 – 3.500 kg ( Average 3.000 kg)
They loose 5 % to 10 % of weight by 3-4 days after birth as result of :
• Withdrawal of hormones from mother.
• Loss of excessive extra cellular fluid.
• Passage of meconium (faeces) and urine.
• Limited food intake.
By day 10, they would revert back to their birth weight.
As a rule of thumb, the infant gains :
- Birth to 4 months → 750g /month (20 -30 g/day)
- 5 to 8 months → 500g / month
- 9 to 12 months → 250g /month
The infant will double his birth wt by 4-6 months , triple it by 9-12 months then 4x by 2 years
They would then increase their weight by 2 kg / year until final adult weight.

16. 1.3 Fronto-occipital Circumference (FOC)
The newborn skull has 2 soft spots called fontanelles:
- Anterior : diamond in shape and closes by 12 – 18 months of age
- Posterior: delta –shaped and closed by 1 month of age
Average FOC at birth: 35 cm ( 33 – 37 cm)
Increases by 2 cm / month for the first 3 months of life
Then 0.5 cm / month for the next 9 months of life to reach ~ 45 cm at 1 year.
By 5 years : almost the adult size

20. DEVELOPMENTAL GROWTH

21. During the first three years of life, humans transition from complete
physical dependence to independence with a majority of basic self-
help and mobility skills.

22. 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.

23. MATURATION
• Maturation results in an increase in competency and adaptability.
• Maturation is a stage of completion of growth and strengthening of acquired
mental, social and emotional development.
• Maturation is essentially a process of refinement and modification from within
and inborn ripening and progress of capacities of the organism.
• Maturation brings growth and development occuring simultaneously and in a
time bound manner.
• It involves both structural and functional changes in the body as well as brain.
• Maturation involves internal and external changes in the body as well as brain.
Direct exposure to the environment sharpens the knowledge of the baby for
achievement of maturation.

24. These milestones or skills are built across the main areas of child development
which are:
1. Gross motor skill
2. Fine motor skill
3. Cognitive
4. Social and Emotional
5. Speech and Language

25. 1. Gross motor skills involve movements of the large muscles of the arms, legs, and
torso.
2. Fine motor skills are the ability to make movements using the small muscles in
our hands and wrists.
3. Cognitive skills occupy a vital role in an individual's overall development, as they
include some of the brain's core functions such as thinking, reading, learning,
retaining information, and paying attention and are used to solve problems,
remember tasks and make decisions.
4. Social emotional skills are the set of abilities that regulate our thoughts,
emotions, and behaviour.
5. Speech is making the sounds that become words (the physical act of talking).
Language is the system of using words to communicate. It includes using words
and gestures to say what we mean, and understanding what others say.

26. Gross Motor Skills
• Gross motor development follows two principles: head to toe and trunk to
extremities.
• This means that the gross motor skills develop in the head before the
development starts in the arms, and feet. Thus, a child learns to hold his head up
before he learns to sit and walk. Also, the development begins in the middle and
moves outward. Hence, a child learns to control his arms before his hands.
• The gross motor development starts at birth and is most intense during the first
years of life. Many conditions, such as cerebral palsy or Parkinson’s disease, can
affect the gross motor skills.

27. NEWBORN SENSES
1. Touch: The most highly developed sense, is mostly at lips, tongue, ears, and
forehead.
2. Vision: Pupils react to light , Bright lights appear to be unpleasant to newborn
infant, Follow objects in line of vision.
3. Hearing: Usually makes some response to sound from birth.
The newborn infant responds to sounds with either cry or eye
movement, cessation of activity and / or startle reaction.
4. Taste: Well developed as bitter and sour fluids are resisted while sweet fluids are
accepted.
5. Smell: Only evidence in newborn infant’s search for the nipple, as he smell breast milk.

28. Dentition:
Eruption of teeth starts by 5–6 months of age. It is
called "Milky teeth" or "Deciduous teeth" or
"Temporary teeth".

30. Development Milestones
Age (mo) Gross Motor Fine Motor Social Skills Language
By 3
Held head erect
and steady
Opens hands
Spontaneously
Hold object put in
hand
Smiles
appropriately
Coos, laughs
By 6
Sits with no
support.
Transfers
Objects/ Palmar
grasp
Shows likes
and dislikes
Babbles
By 9
Crawls/Pulls to
stand
Pincer grasp
Plays peek-a-
boo
Imitates sounds
By 12
Walks with one
hand held
Picks and transfer
food to the mouth
Comes when
called
1-2 meaningful
words
By 18
Walks upstairs
with assistance
Feeds from a
spoon
Mimics actions
of others
At least 6 words
By 24 Runs
Builds a tower
of six blocks
Plays with
others
2-3 word
sentences

31. REFERENCES
• Gesell, A., & Ilg, F. L. (1949). Infant and child in the culture of today. In Child
development.
• New York: Harper & Row.
• Gottesman, Irving I., and Daniel R. Hanson. 2005. Human Development: Biological
and
• Genetic Processes. Annual Review of Psychology 56: 263–286.
• Gottlieb, Gilbert. 1991. Experiential Canalization of Behavioral Development:
• Theory. Developmental Psychology 27: 4–13.
• Turkheimer, Eric, Andreana Haley, Mary Waldron, et al. 2003. Socioeconomic
Status
• Modifies Heritability of IQ in Young Children. Psychological Science 14 (6): 623–
628.