The document summarizes the key aspects of pediatrics including: 1) Pediatrics focuses on the growth, development, health and treatment of diseases in children from fetal stage to adolescence. 2) It discusses the different age groups in pediatrics and health considerations for each including fetal period, neonatal period, infancy, toddler's age, preschool age, school age and adolescence. 3) The document outlines indicators used to evaluate physical growth in children such as body weight, height, head circumference, chest circumference and their normal values and patterns of growth.

1. PEDIATRCS MBBS.weebly.com

2. Pediatrics is a medical sciences of researching on : ● The growth and development of children. ● The physical and psychological health ● Prevention and treatment of diseases , from the fetal to adolescence

3. Age Group Distribution And The Principles Of Health Care 1. FETAL PERIOD 2. NEONATAL PERIOD (neonatal infant) 3. INFANCY (infant period) 4. TODDLER'S AGE 5. PRESCHOOL AGE 6. SCHOOL AGE 7. ADOLESCENCE

4. 1. FETAL PERIOD Time-- From fertilized ovum to birth : about 294 days ( 40 wk from fertilization) ※ Early period of gestation (1st trimester) : from fertilization to 12 th wk. ● organs of systems formed ● heart beat by the end of 4 wk ● fetus formed about 8-10 wk ● sex distinguished ● important period of fetal, deformation by many factors (infection, radiation, chemistry, genetics, etc)

5. ※ Middle period of gestation (2nd trimester) : from 13th wk to 28th wk. ● organs growth rapidly ● function of organs maturate gradually. ● by the end of 28th wk, weight ≈ 1000 g, alive birth.

6. ※ Later period of gestation (3rd trimester) : From 29 th wk to 40 th wk ● increase in size of fetus involves primarily subcutaneous tissue and muscle mass. ● function of organs mature further

7. fetal development hindered: still birth, abortion, premature labor, congenital malformation, etc.

8. Health care of pregnant and fetus is very important: Fetus live dependent to mother. maternal health, nutrition, emotion, circumstance, diseases impact fetal development greatly. Mother invaded by harmful factors ( physical or chemical injury, malnutrition, infection, drugs and psycholgical wound, immune reaction)

9. 2. NEONATAL PERIOD Time --from the ligature of umbilical cord at birth to 28 days. (<7 d , early period of neonate). Character : independent to mother, circum-stance change greatly.

10. Health care : emphasize the nursing (warmth, feeding, cleaning, sterilization, separation).

11. ※ Prenatal period --from the end of 28th wk of pregnancy to 7 days after birth (weight ≥1000g). Include 3 period: later gestation, the course of delivery, early neonate. ● Fetus undergo a great change. ● High prenatal mortality (still birth, birth death and neonate death). ● prenatal mortality is the criterion of evaluating the quality of obstetrics and pediatrics

12. 3. INFANCY (infant period) Time-- from deletion of UC to 1 yr old Character : ● The fastest period of growth and development. ● High demands of energy and nutrition but immature digestive function -> malnutrition, disturbance of digestion. ● Immature immunity -> infective and infectious diseases.

13. Health care : ● Advocate breast feeding ● reasonable nutrition and supplemental food. ● planning inoculation vaccination ● Training good habit of hygiene ● prevent infection and wound

14. 4. TODDLER'S AGE Time-- from the end of l yr to 3 yr old Character: ● Slower speed of growth and development ● Extended range of activity, increased contact with people and things ● intelligence development faster: increased language, thinking, adaptive, social ability. ● Poor ability of recognizing danger ● Easy to suffer from infection

15. Health care ● prevention of accident wound and the toxic ● pay attention to feeding and nutrition to prevent malnutrition ● prevention of infectious and infective diseases

16. 5. PRESCHOOL AGE Time--from the end of 3 rd yr. to enter school (6 ～ 7 yr old) Character : ● physical growth and development steady ● intelligence development fast, understanding gradually ● curious and like mimic ● express language, thinking and emotions by language ● changeable character

17. Health care: ● Train good morality and good habit of hygiene, learning and work. ● pay attention to the hygiene of eyes and mouth ● Prevention of infection diseases, nephritis and rheumatic disease ● Prevention of accidence and wound

18. 6. SCHOOL AGE Time--from 6 ～ 7 yr old to 12 (girl) ～ 13(boys) yr old Character : ● except genital system, organs of systems are similar to the adult level. ● morphology of brain is similar to adult ● more mature intelligent development ● Important period of getting knowledge and receiving education. ● Education for the development of the good morality, intelligence, physics, beauty and labor.

19. Health care : ● Train correct posture of sitting, standing and walking, reason schedule of live, study and exercise. ● prevention of near sight and dental caries. ● pay attention to the change of emotion and behavior, to avoid nervousness.

20. 7. ADOLESCENCE Time--girls from 11 ～ 12 yr old to 17 ～ 18yr old boys from 13 ～ 14 yr old to 18 ～ 20 yr old Character : ● Faster physical growth and development (2 nd peak) ● Reproductive system develop fast, and mature gradually. ● Unstable psychology, behavior and mind, Great impact from social contact

21. Health care : ● provide enough nutrition and rest, encourage do more exercise ● Strengthen education and guidance to establish good morality ● pay attention to education of physiology and hygiene ● prevention of goiter and hypertension

22. THE BASIC AND CLINICAL FEATURES OF PEDIATRICS

23. 1. The character of basic medicine ⑴ ANATOMY ※ Changing continuously with age in appearance(weight,height, head circumference, etc ) body proportions, bone development (fontanels, ossification centers), teeth, the size and position of organs, and skin, muscles, nouves and lymphatic system. ※ familiar with the normal regularity, help to judge the normal or abnormal

24. ⑵ PHYSIO-BIOCHEMISTRY ● The normal values change: HR, BP, RR, haematology, component of body fluid ● Functions mature gradually ● Immature function, easy to suffer from diseases ● high metabolism and immature renal function -> disturbance of water and electrolyte.

25. ⑶ IMMUNITY ※ Immune function of skin, mucous, lymphatic system, and cytokines mature with the age increase. physiologic low immunity of infancy ->easy suffer from infection. ● Ig G from mother disappear 3 ～ 5 mo, active IgG reach adult level in 6 ～ 7 yr. old-> respiratory and digestive system infection ● Ig M cannot transit ->easy to sepsis of G - in neonates ● S Ig A deficiency in respiratory ● Lower cytokines factors (complement, migration factor, etc) and phagocyte ability

26. ⑷ PATHOLOGY response to pathogenic factors is different : ● pneumonococcus ->bronchopneumonia in infants, lobar peumonia in adult ● Vit D deficiency -> ricket (infants), achondroplasia (adult)

27. 2. CLINICAL FEATHUR ⑴ Disease Pattern ※ The kinds of diseases are quite different from adult: congenital, hereditary, infective diseases more common. ● Congenital heart diseases (children) atherosclerosis heat diseases (adult). ● acute leukemia (children), malignent tumor (adult). ● hyperbillirubinemia of the newborn, febrile convulsion not in adult

28. ⑵ CLINICAL MANIFESTATION ● Onset acute or abrupt ● Clinical course: repeat (relapse), fluctuate, change fast. ● Lacking limitation ability->easy to complicate septicemia, while the prime focal infection is not discovered ● Severe infection in newborn or weak infants: hypothermia, refuse to eat, dull expression, WBC↓.

29. ⑶ DIAGNOSIS ● cannot complain and describe symptoms diagnosis based on the history ( from parent),epidemic data, signs and lab data ● Clinical manifestation and the kinds of diseases are special to every age period, pay attention to age when diagnosis,

30. same symptom － different diagnosis ● Convulsion in neonates : birth trauma asphyxia, intracranial hemorrhage and congenital abnormalities ● <6 mo infants : vitamin D deficiency or CNS infection ● >3 yr old (no fever): epilepsy

31. ⑷ TREAMENT ● Doses of drug change with age or weight ● Some methods special in children ● Fluid therapy is special ● Poor immunity, modulation and adaptive capability->complications. pay attention to complication when treat origin disease ● Well nursing and support treatment are important

32. ⑸ PROGNOSIS ● Recovery fast by prompt and proper treatment ● Vigorous recovery ability of tissue and organs->less sequels ● Exacerbation fast ->death

33. 3. Character of prevention Prevention is very important in pediatrics ● plan immunization is the most important one->eliminate or decrease infectious disease ● Monitoring the growth and development-> find problem and correct them ● Hereditary consult->prevent the development of some diseases ● Neonatal screen prevent some diseases development. ● prevent some adult diseases from child

34. GROWTH AND DEVELOPMENT

35. THE REGULARITY OF GROWTH AND DEVELOPMENT Growth: grow up of body and organs, quantitative increment Development: functional maturity of cells, tissues and organs, qualitative changes. Both can't be separated definitively.

36. Some regularity of development ⑴ Development is a continuous course but the speed of development varies in different stage. there are two peaks : first & 2 nd peak. ⑵ Unbalance development of different organs or systems: nerve system earlier, genital system later, lymph system fast in early period and then shrunk.

38. ⑶ General regularity of development from up to down: lift head, chest, sit, stand, walk from proximal to distal: arm->hand, leg-> foot from gross to fine: hold object by palm-> finger from simple to complex: draw line->circle -> picture of person from elementary to advanced : see, feel, recognize, remember, think, analyze, judge.

39. ⑷ individual variation of development influence on sex, hereditary, environment, cultural factors. with age increase, difference obviously.

40. THE INFLUENCE FACTORS OF DEVELOPMENT ⑴ Heredity(inheritance): The feature, potentiality, trends and limitation ⑵ Sex ⑶ Nutrition ⑷ Conditions of pregnant mother: environment, nutrition, emotion, diseases ⑸ Living environment: sun light, fresh air, clean water; living schedule, nursing, education, exercise. ⑹ Diseases: Acute or chronic diseases, endocrine diseases, congenital diseases.

41. Indicators of Physical Growth 1.THE GROWTH BEFORE PUBERTY ⑴ BODY WEIGHT ● The sum of all tissues (bone, organs, muscle, fat) and body fluid reflect the physical growth, esp. nutrition. The basis of calculating dose of drugs and fluid infusion.

42. ● Body weight: at birth, 3 kg (2.5 ～ 4kg); decrease 3 ～ 9 ％ 1st wk; fast increase 1 ～ 6 mo (1st peak); 1yr old 9 kg, 2yr old 12 kg; 2 ～ 12yr old 2 kg/yr; fast increase in adolescence (2nd peak)

43. ● The formulas for average weight of normal infants and children. 1 ～ 6 mo: Wt (kg) ＝ Wt at birth ＋ mo×0.7(kg) 7 ～ 12 mo: Wt (kg) ＝ 6(kg) ＋ mo×0.25(kg) 2 ～ 12 yr: Wt (kg) ＝ Age×2(kg) ＋ 7(8)(kg) 10 ％ individual difference

47. ⑵ INCREASE OF STATUS ① body height(standing height) ● The length from the top of head to sole (foot- plate), an index of evaluating bone growth. ● Height 50 cm at birth; increment of 1st yr 25 cm(1st peak), (<6 mo 2.5 cm/mo, >6 m 1.5 cm/mo) , 75 cm at 1yr old; 85 cm at 2 yr old; after 2 yr old, 5 ～ 7cm ／ yr; fast in adolescence (2 nd peak).

48. ● The formulas for average height of normal children (2 ～ 12 yr old) Height (cm) ＝ Age (years)×7 ＋ 70 cm ● Height include 3 parts : head, spine, lower extremities. The proportion of head, trunk, lower extremities different with age. In 1st yr head increase fastest, spine secondary, In adolescence, lower extremities increase mainly,

51. ● Upper segment : from head top to the upper border of pubic symphysis. ● Lower segment : from the upper border of symphysis pubis to sole. ● Midpoint: At birth: on umbilicus, 2yr old: below umbilicus, 6 yr old: on the midpoint between umbilicus and pubic, 12 yr old : on the upper border of pubic symphysis (upper segment ＝ lower).

52. ② SITTING HEIGHT ● The length from head top to ischial bone (head ＋ spine) ● The regularity of sitting height increase≈ upper height, Sitting height ／ body height decrease with age increased. ③ Span: distance of finger-tip represent the growth of the long bone of upper extremities

53. (3)HEAD CIRCUMFERENCE (HC) ● The length surrounding a circle of head via upper border of eyebrow bow and occipital node. ● Related closely to brain development . ● Head circumference: 34 cm at birth, 44 cm in 6 mo, 46 cm in 1 yr old, 48 cm in 2 yr old, 50 cm in 5 yr old. ● HC=1/2Ht+10cm

55. (4)CHEST CIRCUMFERENCE (CC) ● The length of a circle of chest. (lower border of nipple). ● Related closely to the development of lung and bone, muscle, and fat of thorax. ● Chest circumference: 32 cm at birth, 46 cm by the end of 1 yr ( ＝ head), after 1 yr old, > head circumference. (5) UPPER ARM CIRCUMFERENCE(UAC) <1yr 、 fast, 1~5yr. Slow(1 ～ 2cm) as a index of evaluating nutrition >13.5cm good, <12.5cm poor

56. Proportion of body and the symmetry ⑴ Proportion of head and stature Changes during the growth ⑵ Weight by stature ● Weight-for-height W/H ● Weight(kg)/height(cm) ×1000--Quetelet index ● Weight(kg)/height(cm)×10 4 --Kaup index

58. ⑶ Trunk-leg ratio ● Sitting height/standing height ● represent the growth of lower extremities ● at birth(0.67)->14 yr (0.53) ● Some diseases (hypothyrodism) affect the ratio ⑷ span and height ● span < height(1 ～ 2cm) ● if span> height (Marfan syndrome)

59. 2. GROWTH ON PUBERTY ● 2 nd peak height velocity(PHV) ● Sex difference (boy later 2yr, increase/yr> girl) ● girl 8cm/yr. boy 9cm/yr ● weight increase parallel with the height

60. 3. Assessment of growth ⑴ The express methods of the measure value 1) Express method of statistics and cut off point ● Dispersion method x ± SD: ±2SD, 95.4% ● Percentage method: P 3 ~P 97 , 94% ● Z score=(x – x ) /SD ● mean Value method: M≈x 、 P 50

61. 2) The express of result ● Grade dividing ● growth chart

63. ⑵ The contents of the growth evaluation. 1) Development level ● growth value vs conference ● premature: correct fetal age to 40 wk. Ht 40mo, HC 18mo. wt 24mo catch up the growth of mature neonates

64. 2) Growth velocity ● continuously measure an index during a period 3) proportion of body: ● weight by stature weight for height, W/H ● trunk-leg ratio (sitting W/H)

65. What is the pediatrics ? ● The growth and development of children. ● The physical and psychological health ● Prevention and treatment of diseases , from the fetal to adolescence Remind of 1

66. Remind of 2 AGE PERIOD 1. FETAL PERIOD 2. NEONATAL PERIOD 3. INFANCY 4. TODDLER'S AGE 5. PRESCHOOL AGE 6. SCHOOL AGE 7. ADOLESCENCE

67. Remind of 3 Some regularity of development ⑴ Development is a continuous course but the speed of development varies in different stage. there are two peaks : first & 2 nd peak. ⑵ Unbalance development of different organs or systems: nerve system earlier, genital system later, lymph system fast in early period and then shrunk.

68. Remind of 3 ⑶ General regularity of development from up to down: lift head, chest, sit, stand, walk from proximal to distal: arm->hand, leg-> foot from gross to fine: hold object by palm-> finger from simple to complex: draw line->circle -> picture of person from elementary to advanced : see, feel, recognize, remember, think, analyze, judge.

69. Remind of 3 ⑷ individual variation of development

70. Remind of 4 Indicators of Physical Growth ⑴ BODY WEIGHT (2) body height (standing height) (3)HEAD CIRCUMFERENCE (HC) (4)CHEST CIRCUMFERENCE (CC) (5) UPPER ARM CIRCUMFERENCE(UAC)

71. Remind of 4 Proportion of body and the symmetry ⑴ Proportion of head and stature ⑵ Weight by stature ⑶ Trunk-leg ratio ⑷ span and height

72. Remind of 5: the chart

73. DEVELOPMENT OF SYSTEMS

74. 1.DEVELOPMENT OF BONES ⑴ Development of Cranial bone ● Evaluation base on head circumference, fontanels, cranial sutures. ● Anterior fontanel : a rhombic gap composed of the border of parietal and frontal bones. Length 1.5 ～ 2 cm at birth, increase gradually, after 6 mo, decrease with ossification gradually, closed 12 ～ 18 mo.

75. ● Posterior fontanel : a triangular gap composed of the border of parietal and occipital bones. very small or closed at birth, finally closed 6 ～ 8 wk. ● Cranial sutures: still separated at birth, closed 3 ～ 4 mo.

77. Anterior fontanel : closed early or too small--microcephalia; closed later or large--ricket or cretinism; full (plump) -- cranial pressure↑ (hydrocephalus, encephalitis, cephalitis meningitis, tumor of brain); sunken (depression)--dehydration, severe emaciation (wasting).

78. (2).DEVELOPMENT OF SPINAL COLUMN ● reflect to the development of spinal bones, faster during 1st yr. ● 3 mo when lift head, cervical vertebra forward protruding (1st bend) ; 6 mo when sitting, thoracic vertebra backward protruding (2nd bend) ; after 1 yr when walking, lumbar vertebra forward protruding (3 rd bend) ● 3 bends help body balance. abnormal posture or diseases-> spind deformity.

79. (3) DEVELOPMENT OF LONG BONES ● Growth of long bones : ossification of meta-physical cartilage and osteogenesis of sub- periosteum. The fusion of diaphyseal epiphysis--the mark of the end of long bone growth. ● Growth of flat bones : ossification of periosteum.

80. ● Evaluation of bone development status: Ossification centers--bone age In neonates: ossification center of heal, ankle and femoral bone appeared.

81. Generally X-Ray of left hand is taken : neonates: no ossification center in wrist, 3 mo : capitate bone and hamate bone, 1 yr old : lower radial epiphysis. 2 ～ 2.5 yr old : pyamidal (triangulur) bone, 3 yr old : lumar bone

82. 3.5 ～ 5 yr old : large and small mulangular bone 5 ～ 6 yr old : scaphoid 6 ～ 7 yr old: lower ulnar epiphysis 9 ～ 10 yr old: postular bone In 10 yr old, all (10) ossification have been appeared.

83. from 1 ～ 9 yr old: the number ＝ year(s)+1 ● Significance: retarded bone age--deficiency of growth hormones, hypothyroidism, renal tubular acidosis; advanced bone age--- central precocious puberty, congenital adenalhyperplasia

85. 2. DEVELOPMENT OF TEETH ● Two sets of teeth: deciduous teeth (20), permanent teeth (32) ● Eruption of deciduous teeth: appear at 4 ～ 10 mo, complete before 2.5 yr old ● The order of deciduous teeth: ①lower central incisors, ② upper central incisors, ③ upper lateral incisors, ④ lower lateral incisors, ⑤ lower first molars, ⑥ upper first molars, ⑦ lower cuspids, ⑧ upper cuspids, ⑨upper second molars, ⑩ lower second molars.

87. ● After 6 yr old : 1 st permanent tooth (1st molar) erupt From 7 ～ 8 yr old on, deciduous teeth shed as eruption order, instead by permanent teeth : the 1st and 2nd bicuspid instead of the 1st and 2nd molars, 2nd molars erupt in 12 yr old, 3 rd molars (wisdom teeth) erupt after 18 yr old ● Eruption of teeth; a physiologic phenomenon. some symptoms may occur in some babies : low fever, ptyalism, salivation, restless sleep, irritation. ● Retard eruption or bad quality of teeth : malnutrition, ricket, hypothyroidism, down's syndrome.

88. 3. Development of fat tissue and muscle ⑴ Development of fat tissue ● number increase and bulk enlargement of the fat cell ● subcutaneous fat measurement ⑵ Develop of skeletal muscle ● increase of the number and bulk of muscle fiber ● closely related to the nutrition, live style and physical exercise

89. 3. DEVELOPMENT OF GENITAL SYSTEM ● regulate by hypothalamus-pituitary-gonad axis ● pre-adolescence ( female 9~11yr , male 11~13 yr ) physical growth acceleration, sexual sign appear ● mid-adolescence (14~16 yr old) 2 nd peak of physical grow, all sexual sign appear ● later-adolescence (female 17~21yr, male 19~24yr finish of genital development ● Precocious puberty:girl<8yr, boy <10yr delayed puberty: girl >14yr, boy>16yr.

90. NEURODEVELOPMENT AND SYCHODEVELOPMENT

91. 1. DEVELOPMENT OF SENSE PERCETION ⑴ Visual sense (vision) Neonate : has visual function and light reflex of pupilla, tremor of eye ball some time 2nd mo: stares at object with primary coordination of head and eye, follows moving object 90 。 . 3~4 mo: has coordination of head and eye, follows moving object 180 。

92. ⑵ Hearing (audition) sense poor at birth, good in 3~7 day. turns head to origin of sound (directional capability) 3 rd mo. 4yr old audition development complete ABR measure hearing capability. ⑶ Taste sense sensitive at bith. ⑷ Smell (olfactory) sense has smell sense at birth, unpleasant expression to strong smells by the end of 1 mo, can identify good or bad smell 3 ～ 4 mo, more sensitive 7 ～ 8 mo,

93. ⑸ Sense of skin (tactile, pain, warmth sense and deep sense) at birth, tactile and warmth sensitive in oral and perior area, second in eye, palm, sole; pain sense retarded in neonate, improve in 2nd mo; warmth sense good at birth.

94. ⑹ Reflex ● inborn reflex at birth: rooting, sucking swallowing, grasp, Moro ● conditioned reflex: 2 W: the 1st conditioned reflex appear 2 m: conditioned reflex relate to vision, audition, taste, smell 3~4m: inhibitory conditioned reflex formation

95. 2. MOTOR DEVELOPMENT The regular of motor development: from upper to lower, from the proximal to the distant, non-ordinate to coordinate,from front motion to reverse motion ( 1) Gross motor ① lift head : neonate, 1~2 second; 3 mo, steady; 4 mo, turn head ② roll over: neonate, in born from lateral position to supine position. 4~5mo, lateral to supine, 7~8 mo active from lateral to supine ③ sitting : 6 mo can sit, 8 mo steady

96. ④ creeps : 3~4 mo, hand support, 8 mo, creeps forward; 12 mo, creeps with hand and knee ⑤ stand and walk : neonate: stepping reflex 5~6 mo. Stand supported by arm 8 mo. Stand a moment 10 mo. deliberate stepping 15 mo. Walk independent (walk alone)

97. ( 2) Fine activity Neonate : make a fist of hands 3~4 mo : grasp reflex disappear play the hands, want grasp object 6~7 mo : transfer object hand to hand 9~10 mo : thumb-finger grasp 12~15 mo : can use spoon, scribbles

98. 3. LANGUAGE DEVELOPMENT ● A high nervous activity, peculiar in human being ● Express thinking, idea, related with intelligence ● Basic conditions : organ, hearing sense, language center, contact with people ● 3 step : sound production, understand, expression ● From a word->simple sentence ->complex sentence

99. Table Development of Language Age(mo) Reception language expression language 6 self name crying “ yi ya” 12 name of family members hand express “ good by”, “give me” mama, papa 15 name of body hand express simple word group two words simple order 18 name of people, thing, picture hand express name of body(part) 15~20 words simple order know family member 24 name of people, thing, picture hand express name of body(> 7 parts) words increase simple order know unfamiliar people 36 all name of things use words correctly position sentence of 2~4 words Conception of 2 phases sex differentiate

100. 4. PSYCHOLOGICAL DEVELOPMENT ● psychological process: the cognition process, emotion, willing ● psychological character: personality tendency, personality psychological feature ● not psychological phenomenon in early neonate. ● Psychological active when reflexes formation

101. (1)DEVELOPMENT OF ATTENTION ● the begin of cognitive process ● unconscious attention: nature occur based on cognition process. ● conscious attention: self aware has purpose. ● unconscious attention mainly in infancy, conscious attention develop gradually. 5 ～ 6 yr old, control attention

102. ⑵ Development of Memory a complex neuro-activity course of the storage and read out of message ● 3 system: feeling, short and long memory (recognition, reappear) ● In infancy, only recognition, not reappearance, the reappearance ability increase with age increase ● young children, only flax memory, abstract logical memory develop with age

103. ⑶ DEVELOPMENT OF THINKING a high neuro-activity of recognizing the essence of matter and master its development regularity through understand, memory and analysis. kinds: formal thinking, abstract logical thinking ● 1~3 yr. Primary thinking ● 3 ~ yr. Primary abstract thinking ● 6~11 yr. Synthesis analysis, classification compare

104. ⑷ DEVELOPMENT OF IMAGINATION ● Imagination : a new thinking activity created in brain ● 1~2 yr. image begin ● 3 yr ～ . primary image ● school age. image develop fast

105. ⑸ DEVELOPMENT OF MOOD AND EMOTIDN ● Mood : the expression produced from things or idea ● Emotion: the experience in heart produced from the relationship of persons or things based on the mood ● In young children, manifestation of emotion and mood--short time, strong response easy change, expressive and true; with age increase, emotion and mood response steady gradually.

106. ⑹ DEVELOPMENT OF WILL ● will : a psychological course, actively overcome difficulties to achieve target. ● will begin in young children and develop gradually. ● Formation of will related with environment, people and circumstances within which the child lives.

107. ⑺ DEVELOPMENT OF PERSONALITY AND CHARACTER ● synthesis model of psychological activity. ⑻ EARLY PERSONAL-SOCIAL BEHAVIOR ● synthesis manifestation of psychological function every age period

108. EVALUATION OF PSYCHODEVELOPMENT 1. CONCEPTS ⑴ Intelligence: the ability of knowing the world and respond to the changes of conditions ⑵ Intelligent quotient (IQ) primary based on mental age (MA) Intelligence reach the level of the age Deviation IQ (DIQ): express by standard score DIQ=100±15z ⑶ Development quotient (DQ ) Evaluating the neuro-psycho development of young children, include sense, motor, language, personal-social, etc.

109. 2. PSYCHOMETRY ⑴ Screen of single development ① Direction of vision-space ② Relation of time-order ③ Test of memory ④ Test of language

110. ⑵ TEST OF ABILITY 1) SCREENING TESTS ① Denver developmental screening test(DDST) 103 items, 4 capability areas(social, language, fine-, gross-adaptive), < 6 yr old. ② Peabody picture vocabulary test (PPVT) 120 pictures, each has 4 pictures-vocabulary, for 4 ～ 9 yr old. ③ Draw –α– man Draw a person─evaluation for 5 ～ 9.5 yr old

111. 2)DIAGNOSTIC TESTS ① Bayley infantile development scale 163 neurodevelopment scale, 81 motor scale, 24 infantile behavior record, for 2 ～ 30 mo. ② Gesell development scale ● for 4 wk ～ 3 yr old; ● 5 aspects: gross motor, fine motor, adaptive, language, social ● Express by DQ

112. ③ Standford-Binet intelligent scale ● for 2 ～ 18 yr old ● concrete knowledge: recognition, identification, memory. ● abstract knowledge : thought, logic, quantity and vocabulary. ● evaluate learning faculty diagnosis and degree classification of mental retardation

113. ④ Wechsler preschool and primary scale of intelligence (WPPSI) ● for 4 ～ 6.5 yr old ● contents: words and expression, operation -> express by IQ ⑤ Wechsler intelligence scale for children revised (WISC-R) ● for 6 ～ 16 yr old ● contents: word and expression, operation.

114. ⑶ ADAPTATION TEST social living ability scale for infant-student of primary school ● for 6 mo ~ 15 yr. 6 kind ability for every age period: independent living ability, motor ability, home work, contact (with people), attend collective activity, self administration

115. DISTURBANCE OF PHYSICAL GROWTH 1.DEVIATION OF GROWTH (1) Deviation of weight ① Overweight + 2SD (97th percentage) ② Underweight – 2SD (3th percentage)

116. ⑵ deviation of height ① Tall status + 2 SD (97th percentage) ② Stunt ( short body length) – 2 SD ( <3 rd percentage) ⑶ Deviation of HC ① Over HC + 2 SD (> 97%) ② Small HC － 2 SD (< 3%)

117. DISTURBANCE OF PSYCHOLOGICAL BEHAVIOR 1. BEHAVIOR PROBLEM OF CHILDHOOD (1)BREATH HOLDING an abnormal behavior of apnea. most in 6 ～ 18 mo, disappear before 5 yr old occur in emotion change sharply (2)BITING THUMB physiologic habit in yong infants, disappear with age, if continue to older children psychological disturbance

118. (3)ENURESIS urinary incontinence after 5 yr old primary enuresis : retardation of the control ability of urination, no organ diseases, most for night time wetting secondary enuresis : secondary to urinary tract diseases, diabetes millitus, neurologic abnormalities.

119. (4) DEFIANCE, TEMPER TANTRUMS mainly 18mo ～ 3yr children ⑸ LYING ⑹ SLEEP DISORDERS

120. 2. LEARNING DISABILITY ● a special development disability. ● obvious difficulty in acquiring and applying the listen, speak, read, write, count, inference.

121. 3. LANQUAGE AND SPEECH DELEY ● In normal or disorder children ● Language screening for 1.5~2.0 yr old help early diagnosis, treatment, improve prognosis ● Language expression delay: 2 yr old can’t say word 3 yr old can’t say simple sentence

122. 4. MENTAL RETAARDATION ● A symptom of know and unknown disorders ● Factor(s) interfere the normal development of brain->abnormal function of adoption ● IQ-2 SD with deficit of adoption IQ-1.01~2.0 SD ? IQ-2.01~3.0 SD mild IQ-3.01~4.0 SD severe IQ-5.01~ very severe

123. Conclusion 1 AGE PERIOD 1. FETAL PERIOD 2. NEONATAL PERIOD 3. INFANCY 4. TODDLER'S AGE 5. PRESCHOOL AGE 6. SCHOOL AGE 7. ADOLESCENCE

124. Conclusion 2 T he regularity of development ⑴ Development is a continuous course but the speed of development varies in different stage. ⑵ Unbalance development of different organs or systems: ⑶ General regularity of development ⑷ individual difference of development

125. General regularity of development from upper to lower: from proximal to distant: from gross to fine: from simple to complex: from junior to senior

126. Conclusion 3 PHYSICAL GROWTH body weight body height head circumference anterior fontanel teeth

127. BODY WEIGHT at birth, 3 kg (2.5 ～ 4kg); 1yr old 9 kg, 2yr old 12 kg; 2 ～ 12yr old 2 kg/yr 1 ～ 6 mo: Wt (kg) ＝ Wt at birth ＋ mo×0.7(kg) 7 ～ 12 mo: Wt (kg) ＝ 6(kg) ＋ mo×0.25(kg) 2 ～ 12 yr: Wt (kg) ＝ Age×2(kg) ＋ 7(8)(kg)

128. body height (standing height) ● Height 50 cm at birth; <6 mo 2.5 cm/mo, >6 m 1.5 cm/mo) , 75 cm at 1yr old; 85 cm at 2 yr old; after 2 yr old, 5 ～ 7cm ／ yr;

129. HEAD CIRCUMFERENCE 34 cm at birth, 44 cm in 6 mo, 46 cm in 1 yr old, 48 cm in 2 yr old, 50 cm in 5 yr old.

130. Anterior fontanel Length 1.5 ～ 2 cm at birth, increase gradually, after 6 mo, decrease with ossification gradually, closed 12 ～ 18 mo.

131. TEETH ● Two sets of teeth: deciduous teeth (20), permanent teeth (32) ● Eruption of deciduous teeth: appear at 4 ～ 10 mo, complete before 2.5 yr old

132. Conclusion 4 Neurodevelopment & sychodevelopment 1.Sense 2.Motor 3. Language 4. Psychological activity

133. Behavioral and psychological development Age Motor Language Social development 1 month Hands fisted clench on contact Turning head to sound Stares indefinitely at surroundings, regards observer’s face 3 month Neck holding, Grasping things Cooing Recognized mother, eyes follow slowly the moving object 6 month Sitting without support, reaching things Monosyllables (ma’ba’) Smiles at mirror image, transfer toy from one hand to the another 9 month Standing with support, holding things Saying bisyllables (mama, dada) Waves hands to show good-bye, spontaneously rings bell

134. Behavioral and psychological development Age Motor Language Social development 1 year Standing without support Two words with meaning, giving toy on request Plays a simple ball game, cooperates in dressing 2 year Walking upstairs, turning pages of books Using pronouns, simple sentence Verbalizes toilet needs consistently 3 year Riding tricycle, holding crayons with fingers Using plurals, telling a story Feeds self well, knows a few rhymes or songs 5 year Jumping freely, tying shoelaces Knowing 4 colors, commenting on pictures Dresses and undresses without assistance, asks meaning of words