Childhood is a period where the needs vary according to age.
For a pediatric nurse when dealing with children they should be aware of the needs of a healthy child.
There are a many differences between children and adults like physiological, anatomical, cognitive, social and emotional. These all impact on the way of illness and disease present in children and young people, as well as the way healthcare is provided. Adult have completed period of growth and development and in children growth and development ongoing So as nurses it is necessary to understand these differences to deliver the care accordingly.
Defines and explains the Physical, Physiological, Gross motor and fine motor, Sensory, Language and Speech Development, Needs of a toddler and accident prevention in toddlers
Childhood is a period where the needs vary according to age.
For a pediatric nurse when dealing with children they should be aware of the needs of a healthy child.
There are a many differences between children and adults like physiological, anatomical, cognitive, social and emotional. These all impact on the way of illness and disease present in children and young people, as well as the way healthcare is provided. Adult have completed period of growth and development and in children growth and development ongoing So as nurses it is necessary to understand these differences to deliver the care accordingly.
Defines and explains the Physical, Physiological, Gross motor and fine motor, Sensory, Language and Speech Development, Needs of a toddler and accident prevention in toddlers
Growth and development is a very important aspect of childcare. understanding growth and development enhances the ability of the child healthcare provider to properly attend to the needs of the children under his/her care. The concept of growth and development helps with early detection of both medical, social and psychological problems in a child. it makes for early intervention in child healthcare.
In Paediatrics, Growth and Development are very important. Growth is the assessment of child's nutritional status. This lecture is the backbone of Paediatrics.
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In the context of childhood development, growth is defined as an irreversible constant increase in size, and development is defined as growth in psychomotor capacity. Both processes are highly dependent on genetic, nutritional, and environmental factors. Development refers to functional or behavioral changes. Growth is biological. Development is social, emotional, cognitive, moral, and other domains of function.Human development is a lifelong process of physical, behavioral, cognitive, and emotional growth and change. In the early stages of life—from babyhood to childhood, childhood to adolescence, and adolescence to adulthood—enormous changes take place. Throughout the process, each person develops attitudes and values that guide choices, relationships, and understanding. Sexuality is also a lifelong process. Infants, children, teens, and adults are sexual beings. Just as it is important to enhance a child’s physical, emotional, and cognitive growth, so it is important to lay the foundation for a child’s sexual growth. Adults have a responsibility to help young people understand and accept their evolving sexuality. Growth and development includes not only the physical changes that occur from infancy to adolescence, but also some of the changes in emotions, personality, behavior, thinking and speech that children develop as they begin to understand and interact with the world around them. Skills such as taking a first step or smiling for the first time are called developmental milestones.
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June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
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2. 2
Growth
• It is the process of physical maturation resulting
an increase in size of the body and various organs.
It occurs by multiplication of cells and an increase
in in intracellular substance. It is quantitative
changes of the body.
3. 3
Development
• It is the process of functional and physiological
maturation of the individual. It is progressive
increase in skill and capacity to function. It is
related to maturation and myelination of the
nervous system. It includes psychological,
emotional and social changes. It is qualitative
aspects.
6. Cephalocaudal direction
• The process of
cephalocaudal direction
from head down to tail.
This means that
improvement in structure
and function come first
in the head region, then
in the trunk, and last in
the leg region.
6
7. Proximodistal direction
The process in
proximodistal from
center or midline to
periphery direction.
development proceeds
from near to far -
outward from central
axis of the body
toward the extremities
7
8. 8
General to Specific
• Children use their cognitive and language skills to reason
and solve problems.
• Children at first are able hold the big things by using both
arms, In the next part able to hold things in a single hand,
then only able to pick small objects like peas, cereals etc.
• Children when able to hold pencil, first starts draw circles
then squares then only letters after that the words.
11. 11
• Growth and development depend upon
multiple factors or determinates.
• They influence directly or indirectly by
promoting or hindering the process.
13. 13
Genetic factors
• Genetic predisposition is the importance
factors which influence the growth and
development of children.
• Sex
• Race and Nationality
14. 14
Prenatal factors
• Intrauterine environment is an important
predominant factor of growth and
development. Various conditions influence
the fetal growth in utero.
16. 16
Postnatal factors
• Growth potential
• Nutrition
• Childhood illness
• Physical
environment
• Psychological
environment
• Cultural influence
• Socio economic
status
• Climate and season
• Play and exercise
• Birth order of the
child
• Intelligence
• Hormonal influence
21. 21
Assessment of growth
• Assessment of physical growth can be done by
anthropometric measurement and the study of
velocity of physical growth.
• Measurement of different growth parameters is
the importance nursing responsibility in child
care.
22. 22
Weight
• weight is one of the best criteria for assessment of
growth and a good indicator of health and nutritional
status of child.
• Among Indian children, weight of the full terms
neonate at birth is approximately 2.5 kg to 3.5kg.
• there is about 10% loss of weight first week of life,
which regains by 10 days of age.
24. 24
Cont…
• Then, weight gain is about 25- 30 gm per day for
1st 3 month and 400gm/ month till one year of
age.
• The infants double weight gain their birth weight
by 5month of age, trebled by one year, fourth
time by two years, five times by three year, six
times by five year, seven times by seven year
and ten times by ten year.
• Then weight increases rapidly during puberty
followed by weight increase to adult size.
25. 25
Length and height
• Increase in height indicates skeletal growth.Yearly
increments in height gradually diminished from
birth to maturity.
• At birth average length of a healthy Indian
newborn baby is 50 cm.
• it increases to 60 cm at 3 months, 70 cm of 9
month and 75 cm at one year of age.
26. 26
Cont
…
• In second year, there is 12 cm increase, third
year it is 9 cm, fourth year it is 7 cm and in fifth
year it is 6 cm.
• so the child double the birth by 4 to 4.5 years of
age afterwards there is about 5 cm increase in
every year till onset of puberty.
29. Body Mass index (BMI)
• It is an important criteria which helps to assess the
normal growth or its deviations i.e. malnutrition or
obesity.
Weight in Kg
BMI =
(Height in meter) 2
• BMI remains content up to the age of 5 years. If the
BMI is more than 30 kg/m2, it indicates obesity and if
it is less then 15Kg/m2 , it indicates malnutrition.
29
31. 31
Head circumference
• It is related to brain growth and development of
intracranial volume. Average head circumference
measured about 35 cm at birth.
• At 3 months it is about 40 cm, at 6 month 43 cm, at
one year 45cm, at 2 years 48 cm, at 7 year 50 cm and
at 12 years of age it is about 52 cm, almost same a
adult.
32. 32
Cont
…
• If head circumference increase more than 1 cm in
two weeks during the first 3 month of age then
hydrocephalus should be suspected.
• Head circumference is measured by ordinal tap,
placing it over the occipital protuberance at the
back, above the ear on the side and just over the
supraorbital ridges in front measuring the point of
height circumference.
34. 34
Fontanelle Closure
• At birth, anterior and posterior fontanelle are
usually present. Posterior fontanelle closes early
few weeks(6-8week) of age.
• The anterior fontanelle normally closes by 12-
18 months of age. Early closure of fontanelle
indicates craniostenosis due to premature closure
of skull sutures.
36. 36
Chest circumference
• chest circumference or thoracic diameters is an
importance parameter of assessment of growth and
nutrition status.
• At birth it is 2-3cm less than head circumference. At
6 to 12 months of age both become equal.
• After first year of age, chest circumference is greater
than head circumference by 2.5 cm and by the age of 5
year, it is about 5 cm larger than head circumference.
37. 37
Cont
…
• Chest circumference is measured by placing the
tape measure around the chest at level by placing
the tape measure around the chest at the level of
the nipple, in between inspiration and expiration.
39. 39
Mid Upper Arm Circumference(MUAC)
• This measurement helps to asses the nutritional
status of younger children.
• There is growth due to inadequate nutritional,
which can be this simple particle and useful
measurement.
40.
41. 41
Cont
….
• The average MUAC at birth is 11 to 12 cm, at
one year of age it is 12 to 16 cm, at 1 to 5 years it
is 16 to 17 cm, at 12 years it is 17 to 18 cm and at
15 years it is 20 to 21cm.
42. 42
Eruption of teeth
• There is a variation for the time of eruption of teeth.
First teeth commonly the lower central incision may
appear in 6 to 7 months of age.
• It can be delayed even up to 15 months, which also
can be considered within the normal range of time for
teething.
• So dentition is not dependable parameters for
assessment of growth.
• There are ‘two sets of teeth, temporary teeth bigger in
size for two sets of teeth.
43. Age Type Total number of teeth
Temporary teething
6 – 12 months Incisors(central and lateral) 2-8
12 – 15 months First moral 8- 12
15 – 24 months Canines( cuspids) 12 – 16
24 – 30 months Secondary moral 16 - 20
Permanent teething
6 -7 years First permanent molars 24
7 10 years Replacement of temporary
10 -12 years Replacement of temporary
molar by premolars
12 – 15 years Secondary permanent molars 28
16 years Third permanent molars 32
43
44. 44
Osseous growth
• Bony growth follows a definite pattern and time
schedule from birth to maturation.
• It is calculated by the appearance of ossification
center by X – ray study.
• Skeletal maturation or bone growth is an indicator
of physiological development and continue up to 25
years of age.
45. 45
Growth monitoring
• Assessment of growth may be done by
longitudinal & cross sectional studies. The
common parameters used for growth
monitoring include, head circumference, chest
circumference, UL/LS ratio. The following are
the 3 members used for comparisons:-
46. 46
Cont
…
• Use of mean/median values.
• Use of percentile
• Use of indices as weight for height &
weight for age.
• Common reference values-
–WHO reference value
–Indian standards-
47. 47
Indian standards-
• ICMR under took a national wide cross
sectional study during the year 1956- 1965.
this tool is widely used in India as the
reference value to assess growth.
49. 49
Assessment of Development
• Normal development is a complex process
& has a multitude of facets. However, it is
convenient to understand & assess
development under the following domains.
51. 51
Gross motor development
• Motor development progress in an orderly
sequence to ultimate attainment of
locomotion & more complex motor tasks
thereafter. In an infant it is assessed &
observed as follows:-
52. Cont
…
52
Age Milestone
3m Neck holding
5m Rolls over
6m Sits with own support
8m Sitting without support
9m Standing holding on (with support)
12m Creep well, stand without support
15m Walks alone creeps upstairs
18m Runs
2 yr Walks up and down stairs
3 yr Rides tricycle,
4yr Hops on one foot, alternate feet going downstairs.
Key gross motor development milestones
53. Fine motor skill development
• Fine motor development upon neural tract
maturation. Fine motor development promotes
adaptive actives with fine sensorimotor
adjustments and include eye coordination, hand
eye coordination, hand to mouth coordination,
hand skill as finger thumb apposition, grasping,
dressing ect.
53
54. Age Milestone
4m reaching out for the objects with both hands
6m Reaching out for the objects with one hand
9m Immature pincer graps
12m Pincer graps mature
15m Imitates scribbling, tower of 2 blocks
18m Scribbles, tower of 3 blocks
2yr Tower of 6 blocks, vertical and circular stroke
3 yr Tower of 9 blocks, copies circle
4yr Copies cross, bridge with blocks
5yr Copies triangle, gate with blocks 54
Key fine motor development milestone
55. 55
Personal & social development
• Personal and social development includes personal
reactions to his own social and cultural situations
with neuromotor maturity and environment
stimulation. It is related to interpersonal and social
skill as social smile, recognition of mother, use of
toys.
56. 56
Age Milestone
2m Social smile
3m Recognizes mother
6m Recognizes strangers, stranger anxiety
9m Waves “bye bye”
12m Comes when called, plays simple ball game
15m Jargon
18m Copies parents in tasks
2yr Asks for food, drink, toilet
3yr Shares toys, knows full name and gender
4yr Plays cooperatively in a group, goes to toilet alone.
5yr Helps in household tasks, dressing and undressing
Key social and adaptive milestones
57. Language development
Age Milestone
1m Alerts to sound
3m Coos ( musical vowel sounds)
4m Laugh loud
6m Monosyllables (ba, da, pa) sound
9m Bisyllables ( mama, baba, dada) sound
12m 1-2 words with meaning
18 m 8 -10 words vocabulary
2yr 2-3 word sentences, uses pronouns “I”, “Me”, “you”
3 yr Ask question
4yr Says songs or poem, tell stories
5yr Asks meaning of words 57
58. 58
Assessment of Development
• Healthy development, in all forms, particularly
social/emotional, communication, and behavior,
should be monitored by parents and physicians
through screenings at each well visit.
59. 59
Cont
…
• The Denver Developmental screening test
• Denver articulation screening examination
(DASE)
• Baroda screening test
• Trivandrum development screening test
• Other test
– Woodside DST
– Cognitive adaptive test
– Early language milestone etc.
60. 60
The Denver Developmental
screening test
• Developmental originally by Franken – burg and
dodds(1967), this simple, economic and useful test
screens for developmental delays during infancy and
the preschool period.
• On the test, the age division are monthly unit 2 years
of age , and half yearly from 2 to 6 years of age.
61. 61
Baroda Screening test
• It was developed by Dr. Promila phatak with 25
test items primarily for psychological aspects. The
test is relevant for age 0 to 30 months. Gross
motor, fine motor and cognitive aspects are
evaluated in 10 mints mainly by the psychologist
62. 62
Trivandrum development screening test
• It is simplified version of Baroda DST that can be
used by the health worker, nurses and
pediatricians/ physicians. It has17 test items
relevant for 0 to 2 years of age. The children are
evaluated in three domains( gross motor, fine
motor and cognitive for 5 minutes only.