Growth and Development Introduction Developmental pediatrics is concerned with the processes of children’s learning and competent adaptation to the environment from birth to adulthood. So by monitoring children we can assess the procedure of growth and development such as the formation of tissues; the enlargement of head, trunk, and limbs; the progressive increases in strength and ability to control large and small muscles; the development of social relatedness, thought, and language; and the emergence of personality. The context for observing a child’s development is the family, school and community. Family, educational, social, cultural, spiritual, economic, environmental and political forces act favorably or unfavorably, but always significantly, on the health and functioning of children. Childhood marks the change from the entirely dependent baby into the mature independent adult. During this period the child: •builds up a store of knowledge about the environment; •learns motor skills to survive; •learns a language with which to communicate and think; develops a sense of self, self-regulation of emotions and behavior and the coping strategies for successful interpersonal relationships. Definitions: n Growth: increase in the size or dimensions; as weight, height, skull circumference. is the increase in size and number of cells in certain tissues. n Development: Functional maturation of organs i.e. to acquire skill, learn and to adapt to stress. the normal process of maturation of functions. Stages Growth and Development Intrauterine: Embryonic period F !st trimester (organogenesis) u Fetal period: u 2nd u n trimester (more in length) 3rd trimester (more in weight) u u n Infancy: u Early Neonate: Birth to 1 week u Neonate: Birth to 1 month Infancy : Birth to 1 year u u n Toddler : 1-3 years Preschool: 3-6 years Middle Childhood u Extratrauterine: n Early Childhood School age 6 to 12 years Late Childhood u u Adolescent 13 -18 years approximately Factors affecting Stages of Growth and Development n n n n n n n n Genetic factors: racial & genetic. Nutritional factors: adequate nutrition: Socio-economic factors: poverty & ignorance. Environmental factors: general hygiene. Endocrinal factors. Sex differences. Chronic diseases. Emotional factors. Growth Patterns: 4 8 12 16 years Assessment of Growth Weight: there is 5-10% loss of weight in the first 3-4 days, regained back by 10 days. -At birth 2.5-3.5 kg -Triple Weight at 1 year Later on: Wt is approximately calculated: Weight = Age in years x 2 + 8 (kg) -Length: at birth 50 cm - at 1year 75 cm - at 2 year 100 cm Later on: Wt is approximately calculated: Height = Age in years x 5 + 80 (cm) Growth Curves Wt in Kg 95 75 50 25 Age in years 5 Principles of Growth and Development n n n n 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. Growth and development are influences by a multiple factors. Principles Continued n n n n Development proceeds from the simple to the complex and from the general to the specific. There are critical periods for growth and development. Rates in development vary. Development continues throughout the individual's life span. Growth Patterns n n The child’s pattern of growth is in a head-to-toe direction, or cephalocaudal, and In an inward to outward pattern called proximodistal. Purposes of developmental assessment? n n Early detection of deviation in child’s pattern of development Domains assessed: cognitive, motor, language, social / behavioral and adaptive •to promote optimal physical and mental health and development for all children, ] •applying principles of prevention of impairment, wherever possible, and to reduce disability and handicap. •to ensure early diagnosis and effective treatment of impairments of body, mind and personality; •to discover the cause and means of preventing such impairments. Method of studying growth n 1- Cross - sectional: 2- Longitudinal: - Measurements used in normal growth : 1- Linear ; a-height b-length c-sitting height d-span 2-Weight 3-Circumference a-head circumference b-chest circumference c-lower limbs 4-Skin & subcutaneous fat