Growth and Development PDF

Growth and Development Prepared by: Mary Jane T. Itugot, RM, RN, LPT, MAN  Growth and development in children encompass Growth and a range of physical, cognitive, emotional, and social changes that occur from infancy through Development adolescence....

Growth and Development Prepared by: Mary Jane T. Itugot, RM, RN, LPT, MAN  Growth and development in children encompass Growth and a range of physical, cognitive, emotional, and social changes that occur from infancy through Development adolescence. Growth typically refers to measurable physical changes, such as height and weight, while development involves the progression of skills, behaviors, and emotional maturity. Both are critical in shaping a child’s overall health, abilities, and well-being. Theoretical Approaches to the Growth and Development of Children  Erik Erikson’s Psychosocial Theory This is a comprehensive model of development that identifies eight key stages throughout an individual's life, from infancy to adulthood. Each stage is marked by a specific psychosocial challenge or “crisis” that a person must resolve to develop healthily.  Erik Erikson’s Psychosocial Theory Erikson's theory emphasizes the influence of social relationships, experiences, and cultural factors on personality and identity. Successful resolution of each crisis leads to the development of virtues, such as hope, will, and wisdom, which support overall psychological well-being. Stages in Erikson's Psychosocial Theory Stages in Erikson's Psychosocial Theory  Jean Piaget’s Cognitive Development Theory Piaget’s theory focuses on the development of children’s thinking processes. He proposed that children go through four stages: sensorimotor, preoperational, concrete operational, and formal operational.  Jean Piaget’s Cognitive Development Theory Each stage marks a shift in cognitive abilities, from reflex-based interactions in infancy to abstract reasoning in adolescence. Piaget emphasized that children actively construct knowledge by interacting with their environment, suggesting that cognitive growth is a dynamic process of assimilation and accommodation.  Jean Piaget’s Cognitive Development Theory Assimilation: Assimilation is the ability to incorporate new ideas, objects, and experiences into the framework of one’s thoughts. The growing child will perceive and give meaning to new information according to what is already known and understood  Jean Piaget’s Cognitive Development Theory Accomodation: Accommodation is the ability to change a schema (individual’s cognitive structure or framework of thought) to introduce new ideas, objects, or experiences. Accommodation changes the mental structure so that new experiences can be added.  Stages of Cognitive Development 1. Sensorimotor Stage (Birth to 2 years) In this stage, infants explore the world through their senses and actions. Their understanding is limited to direct sensory experiences and motor activities.  Milestones in the Sensorimotor Stage 1. Object Permanence (around 8–12 months): The understanding that objects continue to exist even when they are not visible. Example: A child who develops object permanence will start to search for a toy hidden under a blanket, realizing the toy still exists even if it is not visible.  Milestones in the Sensorimotor Stage 2. Goal-Directed Behavior (around 8–12 months): Performing actions with specific goals in mind. This behavior demonstrates that infants are not merely reacting to stimuli but are capable of planning simple actions to achieve desired outcomes. Example: An infant may intentionally knock over a cup to reach the food it holds, showing an understanding of cause- and-effect relationships. reactions.  Milestones in the Sensorimotor Stage 3. Deferred Imitation (around 18–24 months) The ability to observe an action and then imitate it at a later time. It indicates the beginning of symbolic thought and memory, as it suggests the child can retain information and recall it later. Example: If a child sees a sibling wave and then waves back later without the sibling being present, they’re demonstrating deferred imitation.  Milestones in the Sensorimotor Stage 4. Trial and Error Learning: Experimenting with various actions to achieve desired outcomes. This type of learning shows the child’s willingness to explore different methods and adapt based on the results. Example: An infant may repeatedly drop a toy from their highchair to see if a caregiver will pick it up, learning about gravity and social reactions.  Stages of Cognitive Development 2. Preoperational Stage (2 to 7 years) At this stage, children start using symbols to represent objects (such as words or images) but lack logical reasoning. Thinking is dominated by intuition and egocentrism (difficulty seeing things from perspectives other than their own).  Stages of Cognitive Development 2. Preoperational Stage (2 to 7 years) Example: A 4-year-old child is playing "restaurant" with her toys. She uses a small block to represent a slice of pizza, a crayon as a spoon, and an empty cup as a glass of water. She “serves” her stuffed animals by arranging these objects in front of them, pretending that they’re having a meal.  Stages of Cognitive Development 3. Concrete Operational Stage (7 to 11 years) During this stage, children begin to think logically about concrete events and understand the concepts of conservation, classification, and seriation (ordering things in a sequence). Their thinking becomes less egocentric as they start to consider others’ perspectives. Example: A child realizes that reshaping a ball of clay into a flat pancake doesn’t change the amount of clay.  Stages of Cognitive Development 4. Formal Operational Stage (11 years to adulthood) In this final stage, individuals develop the ability to think abstractly, reason logically, and consider hypothetical situations. They can engage in systematic problem-solving and think about concepts such as justice and ethics. Example: A teenager can think about different possible outcomes of a scenario, such as imagining what would happen if certain laws were changed.  Lawrence Kohlberg: Moral Development Theory Moral Development Theory explores how individuals develop a sense of right and wrong, along with the reasoning that guides moral decisions. One of the most influential theorists in this area was Lawrence Kohlberg, who expanded on the work of Jean Piaget to outline stages of moral reasoning that individuals typically progress through as they grow.  Lawrence Kohlberg: Moral Development Theory Kohlberg proposed that moral development occurs in three levels, each containing two stages, for a total of six stages. Lawrence Kohlberg: Moral Development Theory  Sigmund Freud: Psychosexual Theory Sigmund Freud’s Psychosexual Theory is a framework describing how personality develops through a series of childhood stages. According to Freud, each stage centers on a different erogenous zone, which he believed was the primary source of pleasure and psychological focus during that stage.  Sigmund Freud: Psychosexual Theory Components of the Theory Levels of awareness Agencies of the mind (id, ego, superego) Concept of anxiety and defense mechanism Psychosexual stages of development  Psychosexual Theory: Level of Awareness 1. Unconscious Level of Awareness The unconscious is not logical and is governed by the Pleasure Principle, which refers to seeking immediate tension reduction. Memories, feelings, thoughts, or wishes are repressed and are not available to the conscious mind. These repressed memories, thoughts, or feelings, if made prematurely conscious, can cause anxiety  Psychosexual Theory: Level of Awareness 2. Preconscious Level of Awareness The preconscious is called the subconscious. The preconscious includes experiences, thoughts, feelings, or desires that might not be in immediate awareness but can be recalled to consciousness. The subconscious can help repress unpleasant thoughts or feelings and can examine and censor certain wishes and thinking.  Psychosexual Theory: Level of Awareness 3. Conscious Level of Awareness The conscious mind is logical and is regulated by the Reality Principle. Consciousness includes all experiences that are within an individual’s awareness and that the individual is able to control and includes all information that is remembered easily and is immediately available to an individual. Psychosexual Theory: Three Systems Personality Psychosexual Theory: Three Systems Personality  Psychosexual Theory: Anxiety and Defense Mechanism The ego develops defenses or defense mechanisms to fight off anxiety. Defense mechanisms operate on an unconscious level, except for suppression, so the individual is not aware of their operation. Defense mechanisms deny, falsify, or distort reality to make it less threatening.  Psychosexual Theory: Anxiety and Defense Mechanism An individual cannot survive without defense mechanisms; however, if the individual becomes too extreme in distorting reality, interference with healthy adjustment and personal growth may occur. Psychosexual Theory: Psychosexual stages of Development Psychosexual Theory: Psychosexual stages of Development Growth and Development Growth and Development  Principles of Growth and Development Growth and development are continuous processes. Development follows a sequence. Growth and development proceed in specific directions: ❖ Cephalocaudal Development: from the head down to the toes ❖ Proximodistal Development: from the center of the body outward Growth and development progress from general to specific responses (broad to more refine).  Principles of Growth and Development Growth and Development occur at different rates for each individual. All aspects of development (physical, cognitive, emotional, and social) are interconnected. A change in one area can affect others, as development is a holistic process. Growth and development occur in predictable stages or patterns, such as infancy, childhood, adolescence, and adulthood.  Anthropometrics Anthropometrics refers to the measurement of the human body and its parts, such as height, weight, body circumferences, and skinfold thickness. These measurements provide essential data for assessing growth, nutritional status, health, and physical fitness.  Anthropometrics Measurements 1. Height (Stature)Measures the length or stature of an individual. Used to assess growth in children and determine appropriate weight ranges in adults. At 2 years old,: ½ mature height for boys At 3 years old: 3 feet tall At 4 years old: 2x the birth length At 13 years old: 3x the birth length  Anthropometrics Measurements 2. Weight - Indicates overall body mass. Used to monitor nutritional status, with weight changes providing insights into health, dietary habits, and energy balance. Birth weight is doubled at 4 months Birth weight is tripled at 1 year  Anthropometrics Measurements 3. Body Mass Index (BMI) - A calculated value using weight and height (weight in kilograms divided by height in meters squared). Used to classify individuals into weight categories, such as underweight, normal weight, overweight, and obese, providing an indicator of overall body fatness.  Anthropometrics Measurements 4. Waist Circumference - Measures the circumference around the abdomen at the level of the navel. Used as an indicator of abdominal fat, which is associated with an increased risk of metabolic conditions like cardiovascular disease and type 2 diabetes.  Anthropometrics Measurements 5. Hip Circumference - Measures the circumference around the hips at the widest part. Often used in conjunction with waist circumference to calculate the waist-to-hip ratio (WHR), which assesses fat distribution and health risk.  Anthropometrics Measurements 6. Mid-Upper Arm Circumference (MUAC) - Measures the circumference of the upper arm, typically midway between the shoulder and elbow. Used to assess nutritional status in children and identify malnutrition in clinical settings.  Anthropometrics Measurements 7. Skinfold Thickness - Measures the thickness of skinfolds at specific body sites (like triceps, subscapular, and abdominal regions) using calipers. Used to estimate body fat percentage, as skinfold thickness correlates with overall body fat.  First Year of Life Growth: Objective assessment: weight, length, head circumference Average newborn: 3 kilos or 6 lbs. Babies double their birth weight during the 4th-5th months and triple at 1 year old  Developmental Milestone Developmental milestones are a set of goals or markers that a child is expected to achieve during maturation. They are categorized into 4 domains: ❖ Physical Development ❖ Cognitive Development ❖ Emotional and Social Development ❖ Language Development  Developmental Milestone 1. Physical Development Encompasses physical growth and motor skills. This includes both fine motor skills (like grasping and drawing) and gross motor skills (like walking and jumping). Physical development tracks the child’s body growth, coordination, and physical capabilities.t  Developmental Milestone 2. Cognitive Development Refers to the development of thinking, problem-solving, and understanding. This domain includes skills such as memory, learning, language development, and reasoning abilities. Cognitive development milestones measure a child’s intellectual and mental growth.  Developmental Milestone 3. Emotional and Social Development Focuses on how children understand and manage their own emotions, form relationships, and interact socially. This includes attachment, empathy, self-awareness, and the ability to form friendships. Emotional and social development helps children navigate relationships and cope with emotional experiences.  Developmental Milestone 4. Language Development Refers to the acquisition and use of language, including both verbal and non-verbal communication. Language milestones track a child’s ability to understand and express themselves through sounds, words, sentences, and body language.  Developmental Milestone Delay Child’s development is not as advanced as it should be The rate of development has been slower than what is usually acceptable Developmental Milestone in the First Year of Life 2-3 Months GM: Lifts head when prone FM: Tracks past midline L: Alert (more aware of the surroundings), coos SC: Social smile Developmental Milestone in the First Year of Life 4-5 Months GM: Rolls front to back FM: Grasp rattle L: Laughs and squeals SC: Looks around and laughs Developmental Milestone in the First Year of Life 6 Months GM: Sits with pelvic support FM: Transfer objects L: Babbles (make repetitive, consonant-vowel sounds, "ba-ba," "da-da," or "ma- ma) SC: Stranger anxiety  Developmental Milestone in the First Year of Life 9-10 Months GM: Crawls, cruising FM: Immature pincer grasp L: Mama/dada SC: Waves bye bye, Object permanence Object permanence describes a child's ability to know that objects continue to exist even though they can no longer be seen or heard. Developmental Milestone in the First Year of Life 12 Months GM: Walks alone FM: 2 finger pincer L: 1-3 words, follows 1 step commands SC: Separation anxiety Developmental Milestone in the First Year of Life Gross Motor Skills 10 mos: sits up alone and indefinitely without support with back straight; pulls to stand 12 mos: rises independently; takes several steps 15 mos: walks alone; crawls up stairs 18 mos: runs stiffly; walks upstairs with one hand held Developmental Milestone in the First Year of Life Fine Motor Skills 8 mos: pincer grasp 12 mos: turns pages of book; releases object to another person on request 13 mos: scribbles 15 mos: builds tower of 2-3 cubes; makes a line with crayon 18 mos: imitates vertical line; tower of 4 cubes Developmental Milestone in the First Year of Life Receptive Language 1.5 mos: smiles in response to face & voice 2 mos: smiles on social contact 3 mos: turns head to sound/voice 6 mos: looks to see where dropped toy is Developmental Milestone in the First Year of Life Receptive Language 7 mos: responds to name- calling; inhibits to “no”; follows 1-step command with gesture 10 mos: follows 1-step command w/o gesture 18 mos: points to body parts Developmental Milestone in the First Year of Life Expressive Language 1 mo: throaty gurgling sounds 2 mos: vocalizes, coos 3 mos: says “aah” 4 mos: laughs aloud 5 mos: “ah-goo” Developmental Milestone in the First Year of Life Expressive Language 6 mos: imitates sounds; babbles: “da-da, ba-ba, pa- pa” 10 mos: says “mama”, “dada” 12 mos: speaks first real word; 2-word vocabulary 15 mos: jargon (long strings of sounds that resemble sentences, ex. asking question, telling a story) 18 mos: speaks 10-15 words; names pictures Developmental Milestone at 2-5 years Old 2 Years Old Dry by day (fewer accidents, developing bladder control) Runs Follows 2/3 commands Parallel play Developmental Milestone at 2-5 years Old 3 Years Old Dry by night Rides a tricycle Knows name, age, and sex Draws a circle Developmental Milestone at 2-5 years Old 3 Years Old Dry by night Rides a tricycle Knows name, age, and sex Draws a circle Developmental Milestone at 2-5 years Old 4 Years Old Hops Draws a cross Knows colors Visual acuity is 20/20 Developmental Milestone at 2-5 years Old 5 Years Old Skips Draws a square Knows ABC Can write name 5 Years Old Skips Draws a square Knows ABC Can write name 5 Years Old Skips Draws a square Knows ABC Can write name  Other Developmental Milestones Handedness: 3 years old Bed Wetting: ❖ Up to 4 y/o - Girls ❖ Up to 5 y/o - Boys Ties shoes: 6 years old Language explosion: 2 years old (20-50 words by end of 2nd year) Interest in basic sexuality: 4-5 years old Other Developmental Milestones  Newborn Reflexes Newborn reflexes, also known as baby reflexes or infant reflexes, are normal and are crucial for a baby's survival. They are the baby's muscle reactions, involuntary movements or neurological responses to stimulation or triggers which may include sound, light, sudden movement and being stroked or touched.  Moro Reflex Moro reflex is elicited by supporting the infant in a semi-erect position and then allowing the infant’s head to fall backwards onto the examiner’s hand  Moro Reflex Moro reflex is elicited by supporting the infant in a semi-erect position and then allowing the infant’s head to fall backwards onto the examiner’s hand  Moro Reflex Normal = symmetric extension and abduction of the fingers and upper extremities, followed by flexion of the upper extremities and an audible cry Asymmetric response = fractured clavicle, brachial plexus injury, or hemiparesis No response = significant CNS dysfunction  Palmar Grasp Reflex It is elicited by placing a finger in the open palm of each hand At 37 wk of gestation, it is strong enough that the examiner can lift the infant from the bed with gentle traction  Tonic Neck Reflex It is produced by manually rotating the infant’s head to 1 side and observing for the characteristic fencing posture  Parachute Reflex Slightly older infants evoked by holding the infant’s trunk and then suddenly lowering the infant as if he or she were falling The arms will spontaneously extend to break the infant’s fall o this reflex a prerequisite to walking  Landau Reflex When the infant is suspended by the examiner’s hand in the prone position, the head will extend above the plane of the trunk. The trunk is straight and the legs are extended so the baby is opposing gravity.  Landau Reflex When the examiner pushes the head into flexion, the legs drop into flexion. When the head is released, the head and legs will return to the extended position.  Stepping Reflex This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with their feet touching a solid surface.  Plantar Reflex The plantar reflex is a reflex elicited when the sole of the foot is stimulated with a blunt instrument. The normal plantar reflex consists of flexion of the great toe or no response. Plantar Reflex  Babinski Reflex Babinski sign occurs when stimulation of the lateral plantar aspect of the foot leads to extension (dorsiflexion or upward movement) of the big toe There may be fanning of the other toes. Babinski sign should disappear after 24 months  Rooting Reflex This reflex starts when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking.  REFLEX AGE OF APPEARANCE AGE OF DISAPPEARANCE Rooting 32 weeks AOG 1 month Palmar 28 weeks AOG 2-3 months Placing/Stepping 37 weeks AOG 4-5 months Moro 28-32 weeks AOG 5-6 months Tonic Neck 35 weeks AOG 6-7 months Plantar 11 weeks AOG 7-9 months Covered up by voluntary Landau 3 months action Covered up by voluntary Parachute 4-9 months action Health Promotion and Disease Prevention in Different Stages of Growth and Development Health Promotion and Disease Prevention in Different Stages of Growth and Development Thank You!