Growth and Development
Definitions of
Growth and Development

Growth


Increase in physical size of a whole or any
of its parts, or an increase in number and
size of cells: Growth can be measured
Development

A continuous, orderly series of conditions
that leads to activities, new motives for
activities, and patterns of behavior
PRINCIPLES
OF
GROWTH AND DEVELOPMENT
Principles of G&D
Occurs in an orderly sequence
 Development is Directional
 Individualized – each child is unique
 Development is interrelated
 Development becomes increasingly
differentiated.
 Development becomes increasingly
integrated and complex

Patterns of Growth and
Development
Cephalocaudal Pattern (head to toe)
Proximodistal Pattern (from center outward)
Periods of greatest growth
A rapid pace from birth to 2 years
 A slower pace from 2 years to puberty
 A rapid pace from puberty to
approximately 15 years
 A sharp decline from 16 years to
approximately 24 years when full adult
size is reached

Factors that Influence Growth
and Development

Genetics

Environment

Culture

Nutrition

Health status

Family

Parental attitudes

Child-rearing philosophies
Genetic influences on growth
and development

pattern, rate, rhythm and extent:


governed by genes interplaying with environment
intrauterine life extremely important in growth and
healthy development of the child
Environmental influences
family composition
 family position in society
 family socioeconomic status
 knowledge of the family
 availability of healthy diets
 housing
 diseases present in family and child

Cultural influences
Must be considered when assessing
growth and development
 Customs vs. work demands from
different cultures

Nutritional influences
Begins during the prenatal period
 LBW/preterm can result from poor
prenatal nutrition
 Socio-economics may impact growth

Health status of the child
Certain diseases may affect g & d
 Endocrine and cardiac status included
here

Family / Parental Attitudes / Child-rearing
Philosophy
Critical in growth and development,
esp. emotional growth
 Intellectual growth must be included
here as well
 Chronic illness can be combated with a
loving environment and close family
relationships

Theories of Growth and Development
 Theorists

Piaget
 Freud
 Erickson
Just review these theorists and their theories – focus
mainly on Erickson
Methods to Evaluate Growth
charts: compare to norms
 compare to self over time
 xrays
 teeth
 height, weight, head circumference
 size of head and legs: length of bones

Methods to Evaluate Development

Denver Development Test – II

Play
Denver Development Test II




Screening test – not a measurement of intelligence
Used to - identify children whose development
deviates significantly from that of other children
warranting further investigation to determine if there
exists a problem requiring treatment.
Test covers - four general functions: personal social
(such as smiling), fine motor adaptive (such as
grasping and drawing), language (such as combining
words), and gross motor (such as walking).
Ages covered by the tests range from birth to six
years.
Denver Development Test II

Nursing Implications
Before beginning – inform parents purpose
of test. Be sure to stress it is not an IQ test.
 Administer test in a comfortable
environment that contains only items
needed for testing
 After testing, share information with the
parent.

Importance of Play

Allows child the learn about themselves
and relate to others….it is work for the
child
Classification of Play



Functional or Practice play
 Involves repetitive muscle movements
 Infant plays with objects making use of their
properties to produce pleasurable effects
Symbolic play
 Child incorporates some object, uses a theme, and
then play the role that each player will have
Games
 Includes rules and usually played
by more than one person
 Mainly used by school-age child and helps to learn
boundaries, teamwork, taking turns, and
competition
Social Aspects of Play
Solitary play
 Parallel Play
 Associative play
 Cooperative Play
 Onlooker Play

Solitary Play

Independent play

Child plays alone with toys that are very different
from those chosen by other children in the area.

Begins in infancy and goes through toddler age
Parallel Play
Two children are displaying typical parallel play
since they enjoy playing near other children, but
are NOT engaging in social interactions with
each other. Which cognitive and motor skills are
these children developing?
Usually Toddler
Associative Play
Group play without group goals
 Even though playing with same toys,
there is lack of formal organization


Mostly seen in
toddler - preschooler
Cooperative Play
Preschoolers have well-developed language, motor,
and social skills, and they can work cooperatively
together on an art project, as this group is doing.
Onlooker Play

Child observes others playing.

Although the child may ask questions of
the players, the child does not attempt
to join the play
Types of Play
Dramatic
Play – act out roles and
experiences that happened to them
Familiarization
Play
Allows children to handle materials in nonthreatening way. Helpful in preparing child for
procedures.
Functions of Play
Physical Development
 Cognitive Development
 Emotional Development
 Social Development
 Moral Development

Nutritional Assessment

A nutritional assessment is an essential
component of the health examination of
infants and children.
Key Dietary
Recommendations

Consume whole grains

Children 2-8 should consume 2 cups
of low-fat milk or equivalent milk products and
children 9 years and older should consume 3 cups
 Limit juices, eat fruit and vegetables each day
 Watch fat intake. Polyunsaturated and
monounsaturated fatty acids such as fish, nuts, and
vegetable oils should be the primary source
My Pyramid
Eat Right.
Exercise
Have Fun
Nutrition and Activity

Due to increase in childhood obesity,
parents should encourage their children
to increase daily physical activity.

Plan regular periods of exercise

Make exercise a fun and habitual
activity.
Growth and Development
Milestones
INFANT
BIRTH TO 12 MONTHS
Physical Growth and Development Milestones During Infancy
Birth to 1 month
Infancy 2-4 months
Infancy – 4-6 months
Infancy - 6-8 months
Infancy - 10-12 months
Summary of key points - Infant

Nursing Interventions
 Encourage parents to hold and stay with infant.
 Provide opportunities for sucking.
 Provide infant with toys that give comfort or
stimulate interest

Developmental milestones
 Rolls over; Sits up; Stands.
 Able to say one to two words.
 Uses pincer grasp well.
Milestones in Infant Communication

1-3 months
Reflex smile that becomes more
voluntary and reciprocal

3-4 months
Babbling, crying more differentiated

4-6 months
Squealing, playing with sound,
identifying parent’s voice

6-8 months
Single-consonant babbling, increasing
interest in sound

8-9 months
Stringing of vowels and consonants,
use of some words

9-12 months
Vocabulary of two to three words, use
of gestures
TODDLER
1-3 years
Developmental milestones for Toddler
Summary of Key points - toddler


Nursing Interventions
 Maintain toilet-training procedures.
 Encourage appropriate independent behavior.
 Give short explanations.
 Provide rewards for appropriate behaviors.
Developmental milestones
 Walks up and down stairs; Kicks a ball.
 Undresses self.
 Scribbles on paper.
 Has a vocabulary of 1000 words and uses short
sentences.
Pre-schooler
4-5 years of age
Milestones for the Preschooler
Summary of Key points - preschooler

Nursing Interventions
 Encourage parents to be involved in care of child.
 Provide safe versions of medical equipment for
playtime.
 Give clear explanations about procedures and
illnesses.

Milestones
 Uses scissors.
 Rides bicycle with training wheels.
 Throws a ball.
 Writes a few letters.
 All parts of speech well-developed.
School-age Child
6-12 years old
Developmental Milestones – School-age
Summary of Key points – School-age


Nursing Interventions
 Provide for privacy and modesty.
 Explain treatments and procedures clearly.
 Encourage continuation of school work.
Milestones
 Possesses reading ability.
 Rides a two-wheeled bike.
 Jumps rope.
 Plays organized sports.
 Mature use of language.
Adolescent age
12-21 years
Adolescent


Psychosocial development
 Independence
 Identity
 Peers
 Language use
 Exploration and rebellion
 Need for privacy
 Sexuality
Cognitive development
 Formal operations
 Abstract thinking
Summary of Key points – Adolescent

Nursing Interventions





Provide privacy.
Interview and examine adolescent without parents present, if
possible.
Encourage adolescent participation in treatment and decision
making.
Encourage visitation of peers.
Milestones
 Fine motor skills well-developed.
 Gross motor skills improve due to growth spurts.
 Able to apply abstract thought and analysis.