Growth And Development

G r ow t h a n d D e vel o pm e n t Prepared by: Ms. Shenell A. Delfin, RN

GROWTH AND DEVELOPMENT DEFINITION A. GROWTH – denotes increase in body size; focus is on child's height and weight. It occurs as cells divide and synthesize new proteins; change in body structure B. DEVELOPMENT – gradual growth and change from a lower to a more advance state of complexity. progressive increase in skill and capacity to function it involves expansion of the child capacities through growth, maturation, and progressive gains in function ability; change in body function. C. MATURATIONS – “Readiness” states that learning takes place quickly and effortlessly when the child is ready

PRINCIPLES OF GROWTH AND DEVELOPMENT Growth and development occurs in regular directions reflecting definite and predictable patterns or trends A. Directional Trends – occur in regular direction reflecting the development of neuromuscular functions: these apply to physical mental, social and emotional development and includes: Cephalo-caudal – occurring along body’s long axis in which control overhead, mouth and eye movements precedes control over upper body, torso and legs Proximo-distal – progressing from the center of the body to the extremity, in which the child develops arm movements before fine motor finger ability *is symmetrical – each side develops in the same direction at the same rate as the other Mass –specific –sometimes referred to as “differentiation” in which the child masters simple operations before complex functions and moves from broad general patterns of behavior to more refined patterns

B. Sequential Trend – involves a predictable sequence of growth and development stage through which a child normally passes these is true of motor skills – LOCOMOTION – child crawls before creeping, creeps before standing; and stand before walking; behaviors such as language and social skill (child plays alone, then with others in increase numbers and in progressively complex activities) C. Secular – refers to worldwide trends in the rate and age of maturation. In general, children are maturing earlier and growing larger at each age as compared to preceding generations 2. Principle of Asynchronous growth – not all parts of the body grow at once and at the same time at same rate 3 . Growth and development is continuous process beginning from conceptions and ends in death (womb to tomb); there are periods of rapid rate (fetal, infancy- the most rapid, adolescence) of alternating rapid and slow (Toddler and Pre-school) and slow (School period) 4. Behavior is most sensitive and comprehensive indicator of developmental status 5. Play is central to the life of a child – is the universal language of a child 6. A great deal of skill and behavior is learned by practice

7. All aspects of development are interrelated Aspects of Development – Denver Developmental Screening Test – used to evaluate once development Fine Motor Adaptive Gross Motor Personal –Social Language 8. Each child is unique (Genetic influence, sex, environment and national as well as Racial characteristics. Factors: Heredity – refers to those characteristics acquired through one's genetic make-up by inheritance, physical characteristics, and disease. Ex. skin color, eye color, body build, DM, HPN Environment – the total of external and internal auditions affecting existence, growth and welfare of the person. Child, family, society – culture has big influence.

GENERAL CHARACTERISTICS Some- SMILE Vain- VOCALIZES Hands- HEAD CONTROL Have- HANDS GRASP Received- ROLL OVER Sylvia's- SITS WITH SUPPORT Card- CRAWLS From Paul- PREHENSION But Paul- PULLS UP Won't- WALKS WITH SUPPORT Say- STANDS ALONE When- WALKS ALONE

INFANCY Birth to 1 year old Milestones 1 – 2 months, smile 2 months –lifts head from prone position and briefly holds it erect 3 months –vocalize in response to voices 4 months –head control 4 months – purposely grasps objects 4 – 5 months – rolls from abdomen to back 6 – 7 months sits 6 – 7 months anything grasps goes into mouth 9 months crawls rapidly, keeping belly off floor 9 months – moves from crawling to sitting position 9 months – pulls up 9 months – pincer grasp rather than palmer grasp 10 months – walks with support 11 months stands alone 12 months walks alone

Milestones - 12 to 15 month walks - 15 mo. - climb stairs - 18 mo. - climbs - 2 years – runs - 3 years – walks backward and hops on 1 foot - 3 years – throws a large ball - 3 years – puts simple clothes - 3 years – achieves fairly good bowel and bladder control BOWEL TRAINING 18-24 MONTHS Immune system matures at age 2

TODDLER 1 – 3 years old- SLOW GROWTH PERIOD - “TERRIBLE TWO'S; TRUSTING THREES'S” - Characteristics protruding abdomen results from underdeveloped abdominal muscles (POUCHY BELLY) - Bow-legged since legs bear the weight of the relatively large trunk; LORDOSIS - Anterior fontanel closes between 12 to 18 months - Fine motor skills include: Undressing Drawing simple lines Building simple things IMITATES A VERTICAL STROKE AT 18 MONTHS IMITATES A CIRCULAR STROKE AT 2 YEARS

PRESCHOOLER 3 – 6 years old- SLOWER GROWTH RATE CONTINUES - “FRUSTRATING FOUR'S; FASCINATING FIVE'S” - Coordination and muscle strength increase rapidly - handedness clearly established by 4 years - Trunk grows more rapidly than the other tissue - Appears taller and thinner - Gender specific behavior evident by 5 y.o. - grows 2.5 – 3 inches/year -Gains 5lb/yr.

-BUILDS TOWER BLOCK OF 9 – 10 CUBES BY 5 YEARS OLD -TIES SHOE LACE BY 5 YEARS OLD -IMMITATES A CIRCLE AT 3; CROSS AT 4; DRAWS A MAN WITH THREE PARTS AT 4 ½; COPY SQUARE AT 5; DIAMOND TRIANGLE AT 5; DRAWS A COMPLETE PERSON WITH CLOTHING AT 6 AND CAN WRITE FAIRLY WELL. -can use scissors successfully and tie shoelaces. 20 teeth present By 5 years may begin to lose deciduous teeth By 5 years have first permanent teeth

SCHOOL – AGE 6 – 12 years old -Girls often grow faster than boys -period of strong individual friendships and group relations - ”SAUCY SIXES; SWEET SEVENS; AGGRESSIVE EIGHT, NIFTY NINES” LEARNING PHYSICAL SKILLS BUILDING WHOLESOME ATTITUDES TOWARD ONESELF LEARNING TO GET ALONG WITH AGE MATES LEARNING AN APPROPRIATE SEX ROLE DEVELOPING FUNDAMENTAL SKILLS IN READING, WRITING AND CALCULATING DEVELOPING ATTITUDES TOWARD SOCIAL GROUPS AND INSTITUTIONS

-Appears thinner and more graceful than preschoolers - Musculoskeletal growth leads to greater coordination and strength - Lungs and alveoli fully mature, so less chance of respiratory infections -Eustachian tube move downward, so less chance of otitis media -All 20 deciduous teeth lost and replaced by 28 of 32 permanent teeth. -puberty begins/FEMALES TALLER THAN MALES 1. Sex education a must 2. responsible sexuality and dangers, such as AIDS, pregnancy, STD's

ADOLESCENCE 11 -21 years old -RAPID RATE OF PHYSICAL GROWTH; PERIOD OF STRESS AND STORM (Stanley Hall) -”MATURITY” - ”TERRIBLE TEENS” -Encompasses puberty -Hormonal changes _most girls reach reproductive maturity 2 – 5 years after onset of menstruation -ultimately, height, weight and body fluid influenced by diet, exercise and heredity. - “PUBERTAS”- AGE OF MANHOOD = PHYSICAL CHANGES – SEXUAL MATURATION; CAPABLE OF PRODUCING OFFSPRING OVERLAPPING PERIOD -”PUBESCENT”

PREPUBESCENT , one who is no longer a child but only yet as adolescent; secondary organs are not fully developed. PUBESCENT, criteria of sexual maturity appear = menarche, nocturnal emission. POSTPUBESCENT, secondary sex characteristics become well developed; sex organs function in a mature manner. - An important period, transitional period, period of change= heightened emotionality problem period; search for identity.

MUST KNOWS FOR DEVELOPMENTAL TASK INFANCY -WEIGHT 2x AT 6 months, 3x @ 1 year -THUMBSUCKING; FEEDING -SLEEPS MOST OF THE TIME -posterior fontanel closes @ 2-3 months - Primitive reflexes (Moro, tonic neck , protective-gag, cough, blink, pupillary; grasp, rooting, Babinski) -ROOTING, TONIC NECK, PALMAR GRASP, MORO, STEPPING REFLEXES GONE AT 4 MONTHS

- Vision fully developed @ 6 years -responds to own name @ 7 months -vocalizes 4 words @ 1 year -rice cereal @ 6 months -fruits/vegetables @ 6-8 months -meats @ 8-10 months -1 new food at a time waiting at least 3 days to introduced another -deciduous teeth by 5-6 months (lateral incisors) -juices @ 1:1 dilution @ 6 months

TODDLER - weight, 4 x 2½ -GAINS 5-10 LBS/YR -WIDE GAITED; POT BELLIED LOOK -EYE-HAND COORDINATION IS GOOD BUT JUDGEMENT OF DISTANCE IS FAULTY LEADING TO BUMPS AND FALLS -walks without help by 15 months -jumps in place by 18 months -goes up stairs and runs fairly well by 24 months -copies a circle by 3 years -knows own name by 12 months -able to speak 300 words by 2 years

-OBJECT PERMANENCE -RITUALISM -Deciduous teeth approx. 20 are present by 2 ½ years – 3 years - TOILET TRAINING: 3 YEARS OLD -18 MONTHS, BOWEL CONTROL -2 – 3 YEARS OLD, DAYTIME BLADDER CONTROL -VOCABULARY INCREASES TO 10-20 WORDS TO OVER 100 WORDS BY 3 YEARS -MY, MINE (18 MONTHS); I, ME, YOU (3 YEARS OLD) - MOVERS FROM HOARDING AND POSSESSIVENESS AT 18 MONTHS TO SHARING WITH PEERS 3 YEARS OLD

PRESCHOOLER -skips and hops on one foot by 4 years -stands on one foot by 3 years old; jumps on one step by 3 years old - walks down the stairs using alternate feet by 4 years old -skips and hops in alternate foot by 5 years old - throws and catches ball by 5 years old -jumps rope by 5 years old - rides tricycle by 3 years -throws and catches ball well by 5 years - knows 2,100 words by 5 years -conscience is developed -4 – 6 LBS/YR -INCREASE IN HT . INCREASE IN WT -2 ½ INCHES PER YEAR IN HEIGHT -GREATER AMOUNT OF SKELETAL GROWTH = FEET AND LEGS - “SLIM, TALL FIGURE”

- HANDLESS SCISSOR, 5 Y.O. -HAND DOMINANCE BY 5 - Dressing, want to choose -SLEEP, problem = refusal to sleep and night walking; may need a night light - BATHING, should not be left unsupervised -NIGHT GRINDING, (BRUXISM), a way of letting go; anxiety related -DISCIPLINE = TIME OUT - COMMON BEHAVIORAL PROBLEMS: A.TELLING TALL TALES B.IMAGINARY FRIENDS C. DIFFICULTY IN SHARING (expose child to 3 categories = mine, yours, ours) D.REGRESSION E.SIBLING RIVALRY

SCHOOL – AGE - Vision 20/20 by 6-7 years - “ Junk foods” - age 12 has all permanent teeth - “LOOKS LANKY” - REFINEMENT IN COORDINATION, BALANCE AND CONTROL -READINESS FOR LEARNING ACQUIRIES USE OF REASONING; UNDERSTANDING OF THE RULES -1.5 – 3 KG/YR WEIGHT GAIN - 2.5 – 5 CM/YR GROWTH RATE - PREPUBERTAL GROWTH SPURT; 10 – 12 YEARS – GIRLS TALLER THAN THE BOYS -DEFINITION: 6 YEARS FIRST PERMANENT TOOTH ERUPTS; 12 YEARS HAS 28 PERMANENT TEETH -PR = 70 – 110 BPM - RR = 16 – 22 CPM - loses primary teeth at age 6 - 12 years old, permanent teeth complete except or 3rd molars

ADOLESCENCE - 95% OF MATURE HEIGHT ACHIEVE BY ONSET OF MENARCHE OR SKELETAL AGE OF 13 YEARS - HEIGHT GAIN 10 – 30 CMS - “WHO AM I?” - 4 areas in order to achieve a sense of identity 1.accepting their changed body image 2.establishing a value system or what kind of person they want to be 3.making a career decision 4.becoming emancipated from their parents Characteristics o an emotionally mature person: 1.able to meet responsibilities 2.good judgment 3.able to face and accept reality 4.able to select a mate] 5.accepts dependency of others

COMMON PROBLEMS OF THE NEWBORN: Seborrheic dermatitis (cradle cap) Moliaria (Sudamina), Prickly heat Spitting up,regurgitation Colic Constipation- bottle-fed infant Occasional cross eyes Diaper rash WHEN THE MOTHER FEELS WARM KEEP THE BABY COOL, WHEN THE MOTHER FEELS COLD KEEP THE BABY WARM

Theories of personality development: Sigmund Freud - psychosexual theory the libidual energy and its relationship to the development of personality. Erick Erikson -Eight ages of man of developmental tasks.

Harry Stack Sullivan- Interpersonal theory - Relationship between infant and the mothering one as the fundamental to personality development. Jean Piaget – Cognitive theory -stage of cognitive development according to a specific age level.

PLAY Purpose of play: 1. To practice motor skills 2. To gain coordination 3. To relate objects and to people 4. Child’s work- learn by play INFANTS - Solitary- Love to play with their own bodies AGE-appropriate toys: Mobiles Squeeze toys Rattles Teething rings Musical box Textured balls Large cuddly toys Toddlers- Parallel- Play next to playmate Toys: Push-pull toys Balls Puzzle with large pieces Crayons (thick) Blocks Musical / talking toys

PRESCHOOLERS-Associative/ Cooperative Toys: Housekeeping toys Playground equipment Water colors, finger-paints, clay Picture coloring books Materials for cutting, and pasting Simple jigsaw puzzle SCHOOL-AGE Child-Competitive Toys: Dolls Trains and model kits Games; jigsaw puzzle, magic tricks Books; table games TV, video, records Bicycles, skateboards Collect objects

Growth And Development

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Growth And Development