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Growth and Development Updated Dr Yemane- August 2024

Pediatric and child health lecture

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Growth and Development Updated Dr Yemane- August 2024

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  1. Growth and Development Yemane G/mariam ( MD, Pediatrician and child health advocate) Adigrat University School of Medicine Department of PCH

  2. Lecture objectives • After completing this lecture, students will be able to: • Explain the difference between growth and development • Describe each of the basic principles of child growth and development • Explain different developmental and behavioral theories • Identify the stages of development. • Learn to estimate age in their respective attachments • Describe red flags of growth and development G&D,Yemane Ped

  3. Growth • Growth refers to an increase in physical size of the whole body or any of its parts. • It is simply a quantitative change in the child’s body. • It can be measured in Kg, pounds, meters, inches, ….. etc G&D,Yemane Ped

  4. Child Growth (Image: WHO) G&D,Yemane Ped

  5. Development • Development refers to a progressive increase in skill and capacity of function. • It is a qualitative change in the child’s functioning. • It can be measured through observation. G&D,Yemane Ped

  6. Cont… • Growth is an orderly process, occurring in systematic fashion. • Rates and patterns of growth are specific to certain parts of the body. • Wide individual differences exist in growth rates. • Development proceeds from the simple to the complex and from the general to the specific. • There are critical periods for growth and development. • Development continues throughout the individual's life span. G&D,Yemane Ped

  7. 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. G&D,Yemane Ped

  8. Principles of Child Development • Principle 1 – Developmental Sequence is Similar for All • Children develop in relatively the same ways. • There is a typical sequence of development that occurs as a child grows. • While the sequence is similar, and the behaviors or skills emerge in the same order, children can take more or less time with each behavior or skill. G&D,Yemane Ped

  9. Principle 2 – Development Proceeds from General to Specific • Development progresses from a beginning point moving in a forward direction. • Just as growth of an infant proceeds from the top down and from the center of the body to the limbs, development of behaviors and skills moves from general to specific. • Development continues in the smaller muscles in the fingers and toes, and results in the ability of the fingers to grasp objects and the toes to help with balance when standing and walking. G&D,Yemane Ped

  10. Principle 3 – Development is Continuous • In children who develop typically, behaviors and skills they have already acquired become the basis for new behaviors and skills. • Children continue to add new behaviors and skills as they perfect their abilities to walk, to write or draw, and to speak. • The continuation of development can easily be seen in children as they mature from age two to age twelve. G&D,Yemane Ped

  11. Principle 4 – Development Proceeds at Different Rates • Each child is different and the rates at which individual children develop are different. • Although the sequences for development are usually the same for all children, the rates at which individual children reach each stage will be different. • Development is never uniform, but it is constant. G&D,Yemane Ped

  12. Developmental and Behavioral Theories Biopsychosocial Model and Ecobiodevelopmental Framework : Models of Development • Medical model • Focuses on diagnosis and treating disease of the body. • It neglect psychological aspects of person. G&D,Yemane Ped

  13. B. Biopsychosocial models • Societal and community systems are simultaneously considered along with more proximal systems that make up the person and the person's environment • A patient’s symptoms are examined and explained in the context of the patient’s existence. • Can be used to understand health and both acute and chronic disease. G&D,Yemane Ped

  14. Fig: Continuum and hierarchy of natural systems in the biopsychosocial model G&D,Yemane Ped

  15. C. Ecobiodevelopmental framework model • More accurate model has emerged • Emphasizes how the ecology of childhood interacts with biological process to determine outcomes & life trajectories. G&D,Yemane Ped

  16. Fig: An ecobiodevelopmental framework for early childhood policies and programs G&D,Yemane Ped

  17. Developmental Domains and Theories of Emotion and Cognition • Child development can also be tracked by the child's developmental progress in particular domains, • Motor skills (Gross motor, Fine motor,) • Social and emotional, • Language , and • Cognition G&D,Yemane Ped

  18. 1.Psychoanalytic theoriesof Sigmund Freud and Erik Erikson and the cognitive theory of Jean Piaget share the idea of stages as qualitatively different periods in the development of emotion and cognition. Cognitive development is best understood through the work of Piaget. 2. Behavioral theory • Relies less on qualitative changes and more on the gradual modification of behavior or accumulation of knowledge. • Lack of concern with a child’s inner experience. G&D,Yemane Ped

  19. Classic Developmental stage Theories G&D,Yemane Ped

  20. G&D,Yemane Ped

  21. Factors affecting Growth & Dev’t • Genetics-hereditary (biological factors) • Nutrition • MedicalIllnessese.g. Congenital anomaly, chronic infection • Endocrines e. g. Thyroid Stimulating hormone and Growth hormone • Emotionalfactors e. g. lack of love and security, • Environmental factors etc G&D,Yemane Ped

  22. Why developmental assessment? • Early detection of deviation in child’s pattern of development. • Simple and time efficient mechanism to ensure adequate surveillance of developmental progress. • Domains assessed: cognitive, motor, language, social / behavioral and adaptive. G&D,Yemane Ped

  23. Patterns of development • There are definite and predictable patterns in the growth and development that are continuous, orderly, and progressive. • These patterns are universal and basic to all human beings. • G & D follow predetermined trends in direction, sequence, and pace, but each human being accomplishes these in a manner and time unique to that individual. G&D,Yemane Ped

  24. Growth monitoring • Growth monitoring is one of the basic strategies for child survival. The program is aimed to detect malnutrition at the earliest possible time and take intervention measures. • Growth monitoring charts are useful for three purposes: • Screening of malnutrition, • Education and • Evaluation of nutrition programs G&D,Yemane Ped

  25. Indicators of Nutritional Status • Anthropometric evaluation • Biochemical (laboratory) assessment • Clinical evaluation • Dietary evaluation • A combination of all the parameters of evaluation forms the basis of evaluation. G&D,Yemane Ped

  26. Physical Development • Weight: Birth weight = 3.25kg • Doubles by 4 months • Triples by end of first year • Quadruples by age 2 ½ years • Height: Birth length = 50cm • Doubles by 4 years of age • Triples by about 13 years of age G&D,Yemane Ped

  27. Formulas for Approximate Average Height and Weight of Normal Infant and Children G&D,Yemane Ped

  28. Developmental Assessment • Gross motor development - Gross muscular activity and neuro-development including posture, independent mobilities and progress from head control to running • Fine motor development - The ability to reach for, grasp and manipulate objects • Cognition and Social skill - Social smile, watching a mirror, waving goodbye, general alertness and curiosity about the surrounding. • Language G&D,Yemane Ped

  29. Stages of Growth and Development • Infancy • Neonate • Birth to 1 month • Infancy • 1 month to 1 year • Early Childhood • Toddler • 1-3 years • Preschool • 3-6 years • Middle Childhood • School age • 6 to 12 years • Late Childhood • Adolescent • 13 years to approximately 18 years G&D,Yemane Ped

  30. Somatic Development Prenatal period • Conception to birth (Embryonic=conception to 8 weeks: Fetal=8 to 40 weeks or birth). - Rapid growth rate - Total dependence (on the mother) - The most crucial period in the developmental process - Maternal conditions directly affect it G&D,Yemane Ped

  31. Table; Milestones of Prenatal Development G&D,Yemane Ped

  32. Infancy period • Is one of the rapid motor, cognitive, and social development • Through mutuality with the caregiver (mother) the infant establishes a basic trust in the world and the foundation for future interpersonal relationships • Total brain volume doubles and increases by an additional 15% over the 2nd yr. • 36% of adult volume at age 1 mo, 72% by 1 yr, 83 by 2 yr) G&D,Yemane Ped

  33. Table; Developmental Milestones in 1st 2 Yrs of Life G&D,Yemane Ped

  34. G&D,Yemane Ped

  35. Table; Emerging Patterns of Behavior During the 1stYr of Life G&D,Yemane Ped

  36. G&D,Yemane Ped

  37. TableEmerging Patterns of Behavior from 1-5Yr of Age G&D,Yemane Ped

  38. G&D,Yemane Ped

  39. Developmental milestones • First 1 yr • By the 1st Birthday, Birth weight has tripled, length has increased by 50%, and head circumference has increased by 10 cm. G&D,Yemane Ped

  40. 6-12 mo old infants show advances in cognitiveunderstanding and communication. • New tensions arise in regard to attachment and separation. • Crawling and pulling to stand around 8 mos. • Some walks by 1 yr. • A major milestone is the achievement by 9 mo of object permanence(constancy). G&D,Yemane Ped

  41. Con.. G&D,Yemane Ped

  42. Infants at 7 mo of age are: • Adopt at nonverbal communication • Expressing a range of emotions and • Responding to vocal tone and facial expressions. G&D,Yemane Ped

  43. Estimate the age? G&D,Yemane Ped

  44. 2nd year • Rapid growth of development in socio-emotional and cognitive skills. • A s well as motor development. • 85% of adults HC achieved by age 2yrs. @15 mo • points to major body parts and uses 4-6 words spontaneously and correctly. • Toddlers also enjoy polysyllabic jargoning G&D,Yemane Ped

  45. Linguistic Development • The most dramatic developments in this period are linguistic. • 10-15 words at 18 mo to between 50 and 100 at 2 yr • Toddlers understand 2-step commands , such as “Give me the ball and then get your shoes. G&D,Yemane Ped

  46. Toddlerhood G&D,Yemane Ped

  47. The Preschool Years (2- 5 yrs) • 2 kg in weight and 7-8 cm in height per year are expected • Birth weight quadruples by 2.5 yr of age • Handedness is usually established by the 3rd yr. • Bowel and bladder control emerge during this period • Bed-wetting is common up to age 5 yr G&D,Yemane Ped

  48. Pre-School G&D,Yemane Ped

  49. con.. • Motor Devt • 2 & half yr walk upstairs alternating feet, • 3 yr ride tricycles & copy circle • 4 hop on one foot, throw ball over head & copy cross • 4 & half yr copy square; at 5 yr skip & copy triangle. G&D,Yemane Ped

  50. Linguistic Development • language develop most rapidly between 2-5 yr, vocabulary increases from 50-100 to about 2000 words • Number of words in a sentence equals age in yrs. • Preschool lang. lays the foundation for later success in school. G&D,Yemane Ped

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