Growth and Development (Bel-1) PDF

INTRODUCTION TO HUMAN GROWTH AND DEVELOPMENT DUODU BELINDA TEL. +233 246 154 202 EMAIL: [email protected]  Objectives By the end of this lecture, the student will be able to:  Define growth and development.  Identify the importance of g...

INTRODUCTION TO HUMAN GROWTH AND DEVELOPMENT DUODU BELINDA TEL. +233 246 154 202 EMAIL: [email protected]  Objectives By the end of this lecture, the student will be able to:  Define growth and development.  Identify the importance of growth and development.  Mention the principles of growth and development.  Mention types of growth and development.  List factors affecting growth and development.  Introduction  Growth and development is defined as a dynamic ongoing process consisting of the sum of the many physiological and psycho- emotional changes that takes place throughout the lifespan  These ongoing processes are interrelated and interdependent and have specific genetic, endocrine, environmental, constitutional, and nutritional influence  Definition of Terms (Cont.) Growth  Growth is the physical increase in size and appearance of the body caused by increasing number of new cells  Growth is the change in size, in proportion, disappearance of old features and acquisition of new ones (Hurlock, 1959)  It is simply a quantitative change in the child’s body.  It can be measured in Kg, pounds, meters, inches, Growth cont’d Growth can be measured in terms of :  Nutritional anthropometry (wt, ht, head & chest circumference)  Assessment of tissue growth (muscle mass, skin fold thickness  Bone age (radiological assessment of epiphysis)  Dental age (counting the number of erupted teeth)  Histologic means  Definition of Terms (Cont.) Development  Development refers to a progressive increase in the skills or ability to function.  An increase in function and complexity that occurs through growth, maturation, and learning  E.g. The process of language acquisition. This becomes increasingly complex as the child matures  It is a qualitative change in the child’s functioning, more challenging to measure objectively.  It can be measured through observation.  Definition of Terms (Cont.)  Includes acquisition of gross and fine motor skills, personality, and mental development - Developmental milestones Developmental milestones  Age dependent milestones  Cues can be picked from the way an infant interacts with surroundings, moves around, gestures Smiling, waving, bubbling and how infant plays with toys can be termed as developmental milestones READ ON THE DEVELOPMENTAL MILESTONES Types of growth and development Types of growth: - Physical growth (Wt, Ht, head & chest circumference - Physiological growth (vital signs) Types of development: - Motor development - Cognitive development - Emotional development - Social development - Moral and spiritual development Factors affecting growth and development  Growth and development depend upon multiple factors or determinants  They influence directly or indirectly by promoting or hindering the process  They include:  Genetic factors  Prenatal factors  Postnatal factors Genetic factors  Genetic predisposition is the important factor which influence the growth and development of children  Sex  Race Prenatal factors  Intrauterine environment is an important factor of growth and development  Various condition influence fetal growth in utero  Maternal malnutrition  Maternal infection  Maternal substance abuse  Maternal illness  Hormones etc. Postnatal factors  Nutrition  Socio- economic status  Childhood illnesses  Number of siblings in the family  Physical environment  Play and exercise  Psychological environment  Intelligence  Cultural influence  Hormonal influence  Family structure Growth and Development – What is the Difference?  Difference GROWTH btw Growth DEVELOPMENT & Development Qualitative 1. Quantitative 2. Comprises Height, Weight, Size, Cognitive, social & emotional changes Shape of body organs 3. It is due to cell divisions It is due to motor & adjustment in mental processes and their interplay. 4. It is for limited period (stop at It takes place till death maturation) 5. It can be measured It can be observed by matured behaviour 6.Individual differences exist Children differs in the level of development 7. Not affected by learning Learning and experiences affect 8. It is purely physical attributes It implies improved adapatation & functioning.  Importance of Growth and Development for Nurses It helps in  knowing what to expect of a particular child at any given age, in terms of behaviour.  gaining a better understanding of the reasons behind illnesses.  the formulation of the plan of care of children across the various stages.  parents’ education in order to achieve optimal growth & development at each stage.  Importance of Growth and Development for Parents  By understanding what to expect during each stage of development, parents can easily capture the teachable moments in everyday life to enhance their child's language development, intellectual growth, social development and motor skills.  Enhances anticipatory guidance and child safety  Helps parents to know the difference between normal and abnormal G & D  Relieves parents of unnecessary worries/concerns  Principles of Growth & Development 1. G & D are directional and follow predictable patterns/Sequence  Cephalo-caudal(head down to toes)  Proximodistal (center of the body to the peripheral)  General to specific  Simple to complex 2. The rate of growth (GR) is not constant as the child matures, i.e., don’t progress at the same rate ↑ periods of GR in early childhood and adolescents & ↓ periods of GR in middle childhood  Principles of Growth & Development  Growth spurts are short periods of time when your child experiences quick physical growth in height and weight.  They occur at different stages of childhood until physical maturity is reached.  Physical growth is very fast during infancy and then levels to a more gradual and steady rate during early childhood up until puberty. Puberty brings another sudden spurting growth as well as developmental maturation.  Principles of Growth & Development  Spurts are frequently seen as the child prepares to master a significant developmental task, such as walking.  An increase in growth around a child’s first birthday may promote neuromuscular maturation needed for taking the first steps  Principles of Growth & Development 3. Not all body parts grow at the same rate at the same time. 4. Individual differences affect development. Each child grows in his/her own unique way. 5. Mastery of developmental tasks is not static or permanent. A child may master developmental tasks only to regress to earlier levels when ill or stressed  Principles of Growth & Development 6. Developmental stages do not always correlate with chronological age. 7. Speed of development of all individuals is different. Children progress through develop- mental stages at varying rates within normal limits. 8. Each stage of G&D is affected by the preceding types of development. 9. Development depends on heredity and environment.  Directional Patterns of Growth & Development Cephalocaudal (head to foot)  Head leads in development (this is why head is large)  Examples  Head initially grows fastest (fetus), then trunk (infant), then legs (child)  Infants can raise the head before sitting and can sit before standing  Directional Patterns of Growth & Development Proximodistal (near to far)  From trunk outwards  Examples  Body- arms- hands- fingers  Inthe respiratory system, the trachea which is the central structure develops first in the embryo, followed by branching and growth outward of the bronchi, bronchioles, and alveoli in the foetus and infant  Motor control of the arms comes before control of the hands, and hand control comes before finger control Growth Pattern  Directional Patterns of Growth & Development General To Specific  As a child matures, activities become less generalized and more focused  For example A newborn’s response to pain is usually a whole-body response, with flexing of the arms and legs, even if the pain is in the abdomen.  As the child matures, the pain response becomes more localized to the stimulus. An older child with abdominal pain guards the abdomen  Directional Patterns of Growth & Development Simple to Complex  Being fed- eating with fingers- using spoon  Easily observed in language development A toddler’s first sentences are formed simply, using only a noun and a verb  By age 5 years, the child constructs detailed stories using many complex modifiers.  Developmental Age Periods  Prenatal period – conception to birth  Germinal – conception to 2 weeks  Embryonic – 2 to 8 weeks  Foetal – 8 to 40 weeks  Infancy period – birth to 1 year  Neonatal – birth to 28 days  Infancy – 1 to approx. 1 year  Early childhood – 1 to 6 years  Toddler – 1 to 3 years  Preschool – 3 to 6 years  Developmental Age Periods (Cont.)  Middle childhood – 6 to 11 or 12 years  Frequently referred to as school age  Late childhood – 11 to 18 years  Prepubertal – 10 to 12 years  Adolescents – 13 to approx. 18 years  Types of Growth and Development Children mature, grow, and develop in several different ways:  Physical/physiological  Cognitive/intellectual  Emotional and Social (psychosocial)  Speech and language Types Of Growth and Development A. Physical Growth  Growth in bone, muscle and fat  Rate of growth is high during the first 2 years of life tapering later in childhood  Types Of Growth and Development  Children grow physically, with increases in sensory acuity, gross and fine motor skills.  Physical development provides children with the abilities they need to explore and interact with the world around them.  A young child's physical growth first begins as muscles gain strength and children gradually develop coordination.  The development of muscular control is the first step in this process.  Types Of Growth and Development Physical development is often broken into two distinct sections: i. Gross motor development  Gross motor skills are movements that utilize the large muscles of the body and requires less precision.  Gross motor development or skills, control bigger actions like throwing and kicking balls, as well as crawling, walking, running, hopping, and jumping.  The development of gross motor skills starts as soon as a child is born.  As children age, their gross motor abilities continue to develop and improve. Types Of Growth &Development ii. Fine motor development  Fine motor skills develop after gross motor skills  Fine motor skills are achieved when children learn to use their smaller muscles, specifically muscles in the hands, fingers, and wrists to pick up small objects, hold a spoon or use a pencil to draw.  Children use their fine motor skills when writing, holding small items, buttoning clothing, turning pages, eating, cutting with scissors, and using computer keyboards.  Mastery of fine motor skills requires precision and coordination. Types Of Growth & Development  Physical growth/maturation is accompanied by physiological changes.  Physiological changes associated with growth is evident in normal changes in vital signs, specifically pulse, respiration, blood pressure  Normal vital signs for children vary according to age  The older the child, the lower the heart and respiratory rates and higher the BP  Growth and Development Monitoring  Parameters For Assessing Growth Physical Growth  Height  Weight  Head circumference  Chest circumference  Teething/dentition Weight  Weight gain is one of the best criteria for assessing growth and a good indicator of health and nutritional status of a child  Babies delivered at term weigh approx. 2.5kg to 3.5kg  Most babies experience a slight weight loss (about 10% of their birth weight) within the first week of life and regains it by 10 days of age  Then, weight gain is about 25- 30g per day for the 1st 3 months and 400g/month till one year of age  Infants weight double their birth weight by 4- 6 months of age and triples their birth weight by one year, 4 times by 2yrs, 5 times by 3yrs, 6 times by 5yrs, 7 times by 7yrs and 10 times by 10yrs  Weight increases rapidly during puberty followed by weight increase to adult size Length and height  Increase in height indicates skeletal growth. Yearly increments in height gradually diminishes from birth to maturity  Average length of a newborn is 50cm  It increases to 60cm at 3 months, 70cm at 9 months  Length increases by 50% i.e. 75cm during the first year of life  In 2nd year there is 12cm increase, 3rd year, 9cm, 4th year, 7cm, 5th year, 6cm Head circumference  It is related to brain growth and development of intracranial volume  Average head circumference is about 35cm at birth  At 3 months it is about 40cm, 6 months – 43cm, 1 year – 45cm, 2 years – 48cm, 7 years – 50cm, and 12 years – 52cm almost same as an adult  If head circumference increases more than 1cm in 2 weeks during the first 3 months of age then hydrocephalus should be suspected  Head circumference is measured by using a tape measure placing it over the occipital protuberance at the back, above the ear on the side and just over the supraorbital ridges Fontanelle closure  At birth, anterior and posterior fontanelles are usually present  Posterior fontanelle closes first between 6 to 8 weeks of age  Anterior fontanelle normally closes by 18months of age  Early closure of fontanelle indicates craniostenosis due to premature closure of skull sutures Chest circumference  It is an important parameter of assessment of growth and nutritional status  At birth it is 2 – 3cm less than head circumference. At 6 – 12months of age both becomes equal  At first year of age, chest circumference is greater than head circumference by 2.5cm and by the age of 5, it is about 5cm larger than head circumference  Chest circumference is measured by placing the tape measure around the chest at the level of the nipple, in between inspiration and expiration Body mass index (BMI)  An important criteria which helps to assess normal growth or any deviations from normal- i.e. malnutrition or obesity  BMI = Weight in kg (height in m)² Underweight =