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Questions and Answers
What percentage of patients with Attention Deficit Hyperactivity Disorder (ADHD) still exhibit symptoms in adulthood?
What percentage of patients with Attention Deficit Hyperactivity Disorder (ADHD) still exhibit symptoms in adulthood?
At what age can most children control urination?
At what age can most children control urination?
What is the prevalence of Autism Spectrum Disorder in America?
What is the prevalence of Autism Spectrum Disorder in America?
What is the name of the triad of symptoms associated with Autism Spectrum Disorder?
What is the name of the triad of symptoms associated with Autism Spectrum Disorder?
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What is the term for enuresis that occurs in children who previously had bladder control?
What is the term for enuresis that occurs in children who previously had bladder control?
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At what age does the first permanent molar tooth typically emerge?
At what age does the first permanent molar tooth typically emerge?
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What is the typical number of milk teeth in a child?
What is the typical number of milk teeth in a child?
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At what age does the nerve myelin form?
At what age does the nerve myelin form?
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What is the typical location of the inferior spinal cord in a 4-year-old?
What is the typical location of the inferior spinal cord in a 4-year-old?
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What is the typical age range for the disappearance of physiological reflexes?
What is the typical age range for the disappearance of physiological reflexes?
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At what age can a newborn see objects at a distance of 15-20cm?
At what age can a newborn see objects at a distance of 15-20cm?
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What is the common measuring position for subcutaneous fat?
What is the common measuring position for subcutaneous fat?
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What is the ratio of head to body in an adult?
What is the ratio of head to body in an adult?
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What is the term for the rapid growth period in adolescence?
What is the term for the rapid growth period in adolescence?
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What is the average height growth rate for boys per year during adolescence?
What is the average height growth rate for boys per year during adolescence?
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What is the method used to evaluate growth and development using mean and standard deviation?
What is the method used to evaluate growth and development using mean and standard deviation?
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At what age does the anterior fontanel commonly close in?
At what age does the anterior fontanel commonly close in?
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At what age can an infant's eyes move with a moving object up and down?
At what age can an infant's eyes move with a moving object up and down?
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What is the term for the curvature of the spine in the lumbar region?
What is the term for the curvature of the spine in the lumbar region?
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When is an infant's auditory development complete?
When is an infant's auditory development complete?
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What is the method used to evaluate bone age?
What is the method used to evaluate bone age?
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At what age can an infant distinguish between different shapes?
At what age can an infant distinguish between different shapes?
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When is an infant's sense of taste most sensitive?
When is an infant's sense of taste most sensitive?
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At what age can an infant react to perfume?
At what age can an infant react to perfume?
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When is an infant's sense of pain complete?
When is an infant's sense of pain complete?
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At what age does a child's gross motor development typically involve rolling?
At what age does a child's gross motor development typically involve rolling?
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What is the primary type of memory in infants and toddlers?
What is the primary type of memory in infants and toddlers?
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At what age can a child typically draw a line?
At what age can a child typically draw a line?
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When does a child's imagination typically begin to develop?
When does a child's imagination typically begin to develop?
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What is the typical age range for a child to say several words?
What is the typical age range for a child to say several words?
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At what age can a child typically build with blocks?
At what age can a child typically build with blocks?
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When does a child's thinking typically begin to involve abstract thinking?
When does a child's thinking typically begin to involve abstract thinking?
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What is the typical age range for a child to be afraid of strangers?
What is the typical age range for a child to be afraid of strangers?
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What is the characteristic of emotional expression in infants?
What is the characteristic of emotional expression in infants?
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What is personality development influenced by?
What is personality development influenced by?
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What is the purpose of the Denver Development Screening Test (DDST)?
What is the purpose of the Denver Development Screening Test (DDST)?
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What is the age range for the Bayley Scales of Infant Development?
What is the age range for the Bayley Scales of Infant Development?
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What is enuresis an example of?
What is enuresis an example of?
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What is the name of the test used to evaluate social life ability in infants and middle school children?
What is the name of the test used to evaluate social life ability in infants and middle school children?
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What is an example of a personality behavior problem?
What is an example of a personality behavior problem?
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What is the name of the test used to evaluate intelligence in children from 4-6.5 years old?
What is the name of the test used to evaluate intelligence in children from 4-6.5 years old?
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Study Notes
Growth and Development
- Growth and development is a continuous process, but not constant.
- Individual differences are present in growth and development.
- Development of different systems is not balanced.
Regularity of Growth and Development
- Growth and development proceed from top to bottom, near to far, rough to fine, low to high, and from simplicity to complexity.
- Development is influenced by genetics, nutrition, mother's disease, environment, and socioeconomic factors.
DOHaD (Developmental Origins of Health and Disease) Doctrine
- Fetal intrauterine environment affects fetal development.
- The effects of fetal development continue into adulthood through fetal programming and epigenetics.
- Resulting in adult diseases, particularly metabolic diseases.
Physical Growth Index
- Weight: the sum of all systems and organs in the body, and the most important indicator of physical growth and nutrition.
- Height or length: measured in decubitus position for children under 3 years old, and in standing height for children over 3 years old.
- Head circumference: represents the development of the brain.
- Chest circumference: represents the development of the lung and thorax.
- Biceps circumference: represents the development of muscle, bone, subcutaneous fat, and skin.
- Subcutaneous fat: measured in the abdominal region, and can also be measured in the back.
Weight
- Average birth weight is approximately 3.3 kg.
- Physiological weight loss: 3-9% loss in the first week after birth, regained by the 10th to 14th day.
Height or Length
- Average birth length is approximately 50 cm.
- Length increases by 11-13 cm by the end of the third month after birth.
- Maximum growth in stature occurs in the first year of life, with an increase of approximately 25 cm.
- Formula for height estimation: height (cm) = age (year) * 7 + 75.
Sitting Height or Crown-Rump Length
- Measured from the top of the head to the ischial tuberosity.
- Represents the growth of the long bone of the upper extremity.
Head Size (Circumference)
- Represents the development of the brain.
- Average head circumference: 33-34 cm in newborns, 42-44 cm in six-month-olds, 46 cm in one-year-olds, and 50 cm in five-year-olds.
Chest Circumference
- Represents the development of the lung and thorax.
- The head circumference is 1-2 cm larger than the chest circumference in newborns.
- The head circumference is usually equal to the chest circumference at the end of the first year of life.
Biceps Circumference
- Represents the development of muscle, bone, subcutaneous fat, and skin.
- Measured in the midpoint of the connecting line from the shoulder peak to the eagle beak.
Body Proportion
- Umbilicus and pubic symphysis are used as markers.
- Head accounts for one-fourth of the body in infants and one-eighth of the body in adults.
- Body type symmetry: weight for height, chest circumference for weight, height for weight, and body mass index (BMI).
Adolescence Growth
- The second rapid growth period.
- Rapid pubertal growth.
- Mental development is gradually maturing.
- There is an obvious sexual difference in this period.
- Rapid growth of boys is 2 years later than that of girls, and the growth rate of boys is faster than that of girls every year.
Evaluation Methodology for Growth and Development
- Mean deviation method: mean ± SD.
- Percentile standards method: P3, P50, P97, etc.
- Standard deviation method: Z score.
Growth Curve
- A graph that shows the growth of a child over time.
Other Index Related to Growth and Development
- Skeleton: cranium, vertebrae, and long bone.
- Cranium: posterior fontanel closes in 6-8 weeks, cranial suture closes in 3-4 months, and anterior fontanel closes in 12-18 months.
- Vertebrae: almost straight in newborns, with the first curve forming in 3 months, the second curve forming in 6 months, and the third curve forming in 12 months.
- Long bone: growth mainly consists of cartilage, ossification of the metaphysis, and an increase in ossification centers with age.
- Bone age: determined by X-ray examination, which can be standardized.
Mental and Psychological Development
- Temper tantrums and breath-holding spells: common in 1-4 year old children.
- Learning disability: a common psychological abnormality.
- Chronic rubbing tight syndrome: a common psychological abnormality.
- Attention deficit hyperactivity disorder (ADHD): a common behavior disorder syndrome.
- Autism spectrum disorder: a group of heterogeneous diseases represented by autism.
Attention Deficit Hyperactivity Disorder (ADHD)
- Most common behavior disorder syndrome.
- Morbidity: 6-9% worldwide, 4.31-5.81% in China.
- Chronic disease: symptoms can persist into adolescence (60-80% of patients) or adulthood (30% of patients).
- Symptoms: distraction, attention span shrinkage, hyperactivity, emotional impulse, learning difficulty, and cognitive disorder.
Enuresis
- Most 2-3 year old children can control urination.
- The 20% of children still do not control urination at 4 years old.
- Enuresis: inability to control urination after 5 years old, mostly occurring at night.
- Primary enuresis: most common, with a family history, and no organic disease.
- Secondary enuresis: induced by a systemic or urinary disease.
Autism Spectrum Disorder
- A group of heterogeneous diseases represented by autism.
- Morbidity: 1% in America.
- Etiology: uncertain, related to genetic, nerve, and psychological factors.
- Three main symptoms: communication barriers, language barriers, and stereotyped behavior.
- Other abnormalities: sensing abnormalities, fear of certain sounds, and fear of certain visual patterns.
Subcutaneous Fat Measurement
- Common measuring position: abdominal subcutaneous fat
- Method: finger placed 2cm from umbilicus, then two fingers 3cm apart, and pinch the skin to measure skinfold thickness
- Measuring back subcutaneous fat is also acceptable
Body Proportion
- Umbilicus and pubic symphysis are markers
- Head accounts for one-fourth of body in infants
- Head accounts for one-eighth of body in adults
Body Type Symmetry
- Weight for height
- Chest circumference for weight
- Height for weight
- Body mass index (BMI)
Other Measurements
- Finger span for height: finger span is slightly bigger than height
- If finger span is 1-2cm greater than height, the patient may suffer from Marfan's syndrome (arachnodactyly)
Adolescence Growth
- Second rapid growth period
- Rapid pubertal growth
- Mental development gradually matures
- Obvious sexual differences during this period
- Rapid growth of boys is 2 years later than that of girls, and growth rate of boys is faster than girls every year
- Second rapid growth: 9-11 years old for girls, 11-13 years old for boys
- Average height of girls grows by 8-9cm per year
- Average height of boys grows by 9-10cm per year
Evaluation Methodology for Growth and Development
- Mean deviation method: mean±SD
- Percentile standards method: P3, P50, P97, etc.
- Standard deviation method: Z score
Growth Curve
- Not explained
Grade Evaluation
- Three divided method (trichotomy)
- Five divided method
- Grades: low, middle, high, abnormal
Other Index Related to Growth and Development
- Skeleton
- Craniums (skull): posterior fontanel closes in 6-8 weeks, cranial suture closes in 3-4 months, anterior fontanel commonly closes in 12-18 months
- Vertebrae (backbone): almost straight in newborn, first curve (cervical lordosis) in 3 months, second curve (thoracic kyphosis) in 6 months, third curve (lumbar lordosis) in 12 months
- Long bone: growth mainly consists of cartilage, ossification of the metaphysis, and ossification center increases with age
- Bone age: evaluated by X-ray examination, the time, quantity, and form of the ossification center with different age can be known and standardized
- The left wrist is evaluated, with zero center at birth, 10 centers in 10 years, and wrist center number = age+1 (for 1-9 years)
- Teeth
- First tooth comes out during 4-10 months
- Teeth are all out usually at 2-2.5 years
- 20 milk teeth, 32 permanent teeth
- Milk teeth number = months-(4~6) (for less than 2 years old baby)
- Teeth-out delay: no tooth at 12 months
- First permanent molar tooth comes out at 6 years, and then permanent tooth will gradually replace milk tooth during 6-12 years old
- The third permanent molar is out at 17-18 years
Mental and Behavior Development
- Depends on the development of the nervous system
- Nerve myelin forms at 4 years
- Electrical conduction is slower and excitement easily generalizes
- Because the development of the spinal cord is earlier than vertebrae, extremital inferior spinal cord is at the lower of the second lumbar vertebrae in fetus and at the lower of the fourth lumbar vertebrae in 4 years
Mental and Behavior Development (continued)
- Physiological reflex: disappearing at 3-4 months
- Rooting reflex (觅食反射)
- Sucking reflex (吸允反射)
- Moro reflex (拥抱反射)
- Grasping reflex (握持反射)
Sensory Perception Development
- Vision
- Newborn: light sensation, can see something in 15-20cm
- 1 month: watches light
- 2 months: eyes can follow objects
- 4 months: head and eyes can coordinate better, likes to look at his head
- 6 months: eyes can move with the moving thing up and down
- 18 months: distinguishes objects' shape
- 2 years: distinguishes straight line and transverse line
- 5 years: distinguishes all kinds of colors
- Auditory Sense
- Birth: poor hearing, because tympanic no gas
- 3-7 days: good hearing
- 3-4 months: head turns to the sound and smiles if hears music
- 7-9 months: confirms the sound source, understands simple statements
- 4 years: auditory development complete
- Taste and Smell
- Taste: newborn has good taste, 4-5 months is very sensitive
- Smell: newborn has basic maturity, 3-4 months distinguishes the smell of pleasure or unhappiness, 7-8 months reacts to perfume
- Skill Sensation
- Touch feeling is sensitive in newborn, specially sense of eyes, mouth, hand, and foot
- Pain sense of skin is insensitive, so it is easily scaled, and it is complete development in 2 months
- Temperature sensation is sensitive in newborn, specially chilly sense
Motor Development
- Gross Motor
- 2 months: raising
- 4 months: turning
- 6 months: sitting
- 7 months: rolling
- 8 months: climbing
- 1 year: walking
- Fine Motor
- 3 months: playing hand
- 5 months: grasping object
- 7 months: hand to hand
- 9 months: finger to finger
- 1 year: drawing a line
- 2 years: folding paper
- 3 years: building blocks
Language Development
- Pronunciation Period
- Birth: crying
- 4 months: babbling
- 8 months: baba or mama (unconsciousness)
- Understand Period
- 10 months: baba or mama (consciousness)
- 12 months: says 1-2 words
- 18 months: says several words
- Expression Period
- 2 years: speaks some names of people or objects
- 3 years: speaks short poems and songs
- 4 years: tells a simple story
Mental Activity Development
- Early Activity
- 2 months: smile
- 4 months: laugh
- 7 months: afraid of strangers
- 1 year: plays hide
- 2 years: not afraid of strangers
- Attention
- Increases with age (attention culture in toddler)
- Memory
- Mainly be rote (mechanical) memory in infants and toddlers
- Thought
- Thinking begins at 1 year, but only has imaginal thinking before 3 years
- Abstract thinking begins at 3 years
Mental Activity Development (continued)
- Imagination
- No imagination in newborn
- Imagination begins at 1-2 years and develops with age
- Emotion and Feeling
- Emotional characteristic in infant is transient, strong, instability, and real
- Emotion is stable gradually with age
- Personality and Character
- Gradually develop with age
- Temperament is congenital
- Personality is acquired
Evaluation of the Mental and Psychology
- Ability Test
- Screening Test
- Denver Development Screening Test (DDST): used for less than 6 years old children
- Peabody Picture Vocabulary Test (PPVT): used for 4-9 years old children
- Drawing-a-Person Test: used for 5-9.5 years old children
- Diagnosis Test
- Bayley Scales of Infant Development: used for 2-30 months infants
- Gesell Developmental Scale: used for 4 weeks-3 years infants
- Wechsler Preschool and Primary School Scale of Intelligence: used for 4-6.5 years children
- Wechsler Intelligence Scale for Children-Revised: used for 6-16 years children
- Stanford-Binet Scale of Intelligence: used for 2-18 years old children, and the result is an IQ
- Screening Test
Evaluation of the Mental and Psychology (continued)
- Adaptive Behavior Test
- Infant-middle school children social life ability scale: used for 6 months to 15 years old children, and this scale is from Japan
Behavior and Psychological Abnormality
- Biofunction Behavior
- Enuresis
- Sleep disorder (parasomnias, nightmare, such as night terror and sleepwalking; dyssomnia, such as problems going to sleep and nighttime awakenings, etc.)
- Bad appetite, etc.
- Social Behavior
- Breaking, stealing, lying, attacking, etc.
- Personality Behavior
- Panic disorder, depression, social withdrawn, disobey, uncontrollable temper,
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Description
This quiz covers the basics of human growth and development, including the process, individual differences, and factors that influence development.