basic discussion on the growth and development of children focussing on under 5

1. GROWTH AND
DEVELOPMENT

2. DEFINITION
• GROWTH
• The term growth denotes a net increase in the
size, or mass of the tissue.
• It is a quantitative change in the child’s body.
• It is largely attributed to multiplication of cells
and increase in the intracellular substance.
• It can be measured in Kg, pounds, meters, inches, ….. etc

3. DEVELOPMENT
• Development specify maturation of functions.
It is related to the maturation and myelination
of the nervous system and indicates
acquisition of a variety of skills for optimal
functioning of the individual
• It is a qualitative change in the child’s
functioning.
• It can be measured through observation.

4. Growth Pattern

5. 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.

6. PRINCIPLES OF DEVELOPMENT
• Development is a
continous process
from conception
to maturity

7. • Development depends on the maturation and
myelination of nervous system.
• The sequence of the development is the same
for all children, but the rate of development
varies from child to child

8. • Development
follows a
direction and
uniform
pattern

9. • Development proceeds from general to
specific responses

10. DEVELOPMENTAL AGE PERIODS
• Infancy
– Neonate
• Birth to 1 month
– Infancy
• 1 month to 1 year
• Early Childhood
– Preschool
• 1-4 years

11. • Middle Childhood
– School age
– 5 to 12 years
• Late Childhood
• Adolescent
– 13 years to approximately 19 years

12. FACTORS AFFECTING GROWTH AND
DEVELOPMENT
FETAL STAGE
Genetic potential
Sex
Fetal hormones
Fetal growth factors
Placental factors
Maternal factors

13. POST NATAL PERIOD
• Sex
• IUGR
• Genetic factors
• Hormonal influences
• Nutrition
• Infections
• Chemical agents
• Trauma

14. SOCIAL FACTORS:
• Socioeconomic level
• Poverty
• Natural resources
• Climate
• Emotional factors
• Cultural factors
• Parental education

15. Physical Growth

16. Weight
Calculating infant’s Weight
Infants from 3 to 12 months
Weight = Age in months + 9
2
Wt of 7 months old infant = 7+9 = 16 = 8 kg
2 2

17. Formula to calculate normal weight of
children over 1 year of age is
Age in years X 2+8 = ….. kg.
e.g., The weight of a child aging 4
years
= 4 X 2 + 8 = 16 kg

18. Height
• 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

19. After 1 yrs of age
• During 1–2 years, the child's height
increases by 1cm/month.
The toddler's height increases about 10 to
12.5cm/year.
Formula to calculate normal height
Age in years X 5 + 80 = cm.
e.g., the length of 2 years old child
= 2 X 5 + 80 = 90cm

20. Head circumference
• It increases about 2 cm /month during the 1st 3
months,
• Then, ½ cm/month during the 2nd 9 months of
age.
• Posterior fontanel closes by 6-8 w of age.
• Anterior fontanel closes by 12-18 months of age.
• The head increases 10 cm only from the age of 1
year to adult age.

21. Chest circumference
By the end of the 1st year, it will be equal to head
circumference.
• During preschool years, chest circumference
continues to increase in size and exceeds head
circumference.

23. ERRUPTION OF TEETH

25. PERMANENT TEETH
Molar
6 to 7 years
Central and lateral incisors 6 to 8 years
Canines and premolars 9 to 12 years
Second molars 12 years
Third molars 18 years or later

26. DEVELOPMENT

27. GROSS MOTOR DEVELOPMENT

28. • 6 WEEKS – DEVELOP
HEAD CONTROL
• 20 WEEKS – COMPLETE
NECK CONTROL

29. • 6 MONTHS – CHILD CAN
BEAR ALMOST ALL HIS
WEIGHT
• 9 MONTHS- _ begins to
stand holding on the
furniture
• 10 – 11 months – start
cruising around the
furniture
• 12- 13 months _ stands
independently.

30. Pre-school
At 15 months, the toddler can:
• Walk alone.
• Creep upstairs.
• Assume standing position without falling.
• Hold a cup with all fingers grasped around it.
At 18 months:
• Hold cup with both hands.
• Transfer objects hand-to hand at will.

31. Continuous
At 24 months:
• Go up and down stairs alone with
two feet on each step.
• Hold a cup with one hand.
• Remove most of own clothes.
• Drink well from a small glass held in
one hand.

32. At 30 months: the toddler can:
•Jump with both feet.
• Jump from chair or step.
•Walk up and downstairs, one foot
on a step.
• Drink without assistance.

33. FINE MOTOR DEVELOPMENT

34. • Hand eye
coordination
• 12-20 weeks – child
observes his own hands
(hand regard)
• 4 months – hand of the
children come together
at midline as he plays

35. Offer a red cube to the child
• 5-6 months : infant reaches and holds the
cube in a crude manner using the ulnar aspect
of his hand
• 6-7 months : transfer objects from one hand
to other
• 8-9 months : child is able to grasp from the
radial side of the hand

36. By offering pellets, finer hand skills are
assessed
• 9-10 months : child approaches the pellet by
an index finger and lifts it using – thumb
opposition

37. HAND TO MOUTH COORDINATION
• 6 months : child can
take a biscuit to his
mouth and chew
• 1 year : tries to feed
self from a cup but
spills some of the
content

38. DRESSING
• 1 year : child
starts to pull
off mittens,
caps and socks

39. Pre-school
• 1 year old: transfer objects from hand to hand
• 2 year old: can hold a crayon and color vertical
strokes
• Turn the page of a book
• Build a tower of six blocks
• 3 year old: copy a circle and a cross – build
using small blocks
• 4 year old: use scissors, color within the
borders

40. Social development

41. • 1 month _ child
intently watches
his mother
when she talks
to him

42. •6-8 weeks
: social
smile

43. • 3 months : enjoys
looking around and
recognizes the
mother
• 6 months : vocalizes
and smiles at his
mirror image and
imitates acts such as
cough or tongue
protrusion

44. • 6-7 months : stranger
anxiety
• 9 months : waves ‘bye-bye’.
Repeats any
performance that
evokes an appreciative
response from the
observers

45. 1 year : he can
understand simple
questions like ‘ where is
your papa?’

46. Social development: Preschooler
• The is very social being but still egocentric.
• He imitates parents.
• Notice sex differences and know own sex.
• As he grows old
• Tolerates short separation
• Less dependant on parents

47. The school–age child
Continues to be egocentric.
• Wants other children to play with him.
• Insists on being first in every thing
• Becomes peer oriented.
• Improves relationship with siblings.
• Has greater self–control, confident, sincere.
• Respects parents and their role.
• Joints group (formal and informal).
• Engage in tasks in the real world.

48. LANGUAGE
• 1 month – alerts to sound
• 3 month – coos ( musical vowel sounds)
• 4 months – laugh aloud
• 6 months – monosyllables (ba- pa –da), ah-goo
sounds
• 9 months – bisyllables (mama, baba, dada)
• 12 months – 1-2 words words with meaning

49. • 18-20 months: 20 to 30
words – 50% understood
by strangers
• 22-24 months: two word
sentences, >50 words,
75% understood by
strangers
• 30-36 months: almost all
speech understood by
strangers

50. VISION
• 1 month – baby can fixate on his
• mother as she talks to him
• 3-4 months : child can fixate intently on an object
shown to him (grasping with eye)
• 6 weeks : binocular vision begins and is well
established by 4 months
• 6 months : child adjusts his position to follow
object of interest
• 1 year : follow rapidly moving objects

51. HEARING
• 3-4 months : child turns his
• head towards the source of sound
• 5-6 months : child turns the head to one side
and then downward if a sound is made sound
below the level of ears.
• 10 months : child directly looks at the source
of diagonally