GROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENT

Dr.Khalid Hama salih,

Pediatrics specialist M.B.Ch.; D. C.H

F.I.B.M.S.ped

Introduction:Introduction: Is the essence of childhood Is the essence of childhood G &DG &D

Why Growth & developmental Why Growth & developmental assessmentassessment??

To know normal growth& developmentTo know normal growth& development To improve the early identification of childrenTo improve the early identification of children with growth and developmental problem.with growth and developmental problem.

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growthgrowthgrowthgrowth: :

is a an anatomical process involving increase in is a an anatomical process involving increase in the physical size of an organ, tissue& body, by the physical size of an organ, tissue& body, by

multiplication or enlargement of cellmultiplication or enlargement of cell. . It can be measure by anthropematric measureIt can be measure by anthropematric measure..

Accurate measurement of growth is a vital Accurate measurement of growth is a vital part of the assessment of childrenpart of the assessment of children

DevelopmentDevelopment::

Development: Development: physiological or functional maturation of physiological or functional maturation of various organ or system, acquisitionvarious organ or system, acquisition of neweror of neweror skill & adaptation to environment ,skill & adaptation to environment ,is differentiation is differentiation in function.in function.

G&DG&DAlthough they are presented separately, they Although they are presented separately, they are closely correlated entities.are closely correlated entities.

Stages of Growth and DevelopmentStages of Growth and Development

InfancyInfancy NeonateNeonate

Birth to 1 monthBirth to 1 month InfancyInfancy

1 month to 1 year1 month to 1 year

Early ChildhoodEarly Childhood ToddlerToddler

1-3 years1-3 years PreschoolPreschool

3-6 years3-6 years

Middle ChildhoodMiddle Childhood School ageSchool age 6 to 12 years6 to 12 years

Late ChildhoodLate Childhood AdolescentAdolescent 13 years to approximately 13 years to approximately

18 years18 years

Growth& developmentGrowth& development

geneticgenetic

Growth &development socioeconomicGrowth &development socioeconomic

IufIuf&& prenatal prenatal

c chronic c chronic diseasedisease emotional emotional

nutritionalnutritional

Env.&seasonalEnv.&seasonal Growth potentialGrowth potential

l hormonal factorl hormonal factor

Principles of growth & developmentPrinciples of growth & development

11..Growth& development is continuous &orderlyGrowth& development is continuous &orderly

processprocess..

22..Pattern of growth is different in different body Pattern of growth is different in different body tissuetissue

33..Pace of growth is unique for every childPace of growth is unique for every child

44..Growth and development are influences by a Growth and development are influences by a multiple factorsmultiple factors

ContCont.……….………..

5.The child’s pattern of growth is in a head-to-5.The child’s pattern of growth is in a head-to-toe direction, or toe direction, or cephalocaudalcephalocaudal, and in an , and in an inward to outward pattern called inward to outward pattern called proximodistalproximodistal..

6.The acquisition of gross motor skill precedes 6.The acquisition of gross motor skill precedes the development of fine motor skills.the development of fine motor skills.

Growth PatternGrowth Pattern

ANTI-GRAVITY ANTI-GRAVITY MOVEMENTSMOVEMENTS

HEADHEAD

TRUNKTRUNK

LOWER EXTREMITY

LOWER EXTREMITY

Growth assessment is a 4 step Growth assessment is a 4 step a.recording of appropriate parametera.recording of appropriate parameter

b. comparing this value with reference b. comparing this value with reference

c.serial recording &put on chart to assess c.serial recording &put on chart to assess growth velocitygrowth velocity

d. interpretation & convey the information to d. interpretation & convey the information to parent as well as suitable remedial actioparent as well as suitable remedial actionn

::Anthropometric measuresAnthropometric measuresweightweightheightheight

head circumferencehead circumference

GrowthGrowth

LengthLength

•• The child should be measuredThe child should be measured

lying down until 2 years of agelying down until 2 years of age

•• Measuring the length of infantsMeasuring the length of infants

requires skillrequires skill

•• Use proper equipment and twoUse proper equipment and two

people to hold the childpeople to hold the child

GrowthGrowthHeightHeight

•• Use a properly calibratedUse a properly calibrated

standing framestanding frame

•• The child should be measuredThe child should be measured

barefoot with knees straightbarefoot with knees straight

and feet flat on the floorand feet flat on the floor

•• Stretch the child gently andStretch the child gently and

read the measurementread the measurement

GrowthGrowth

WeightWeight Scales must be calibratedScales must be calibrated

accuratelyaccurately Babies should be weighed nakedBabies should be weighed naked

(no nappy!)(no nappy!) Older children should be weighedOlder children should be weighed

in underwear onlyin underwear only

GrowthGrowth Height or Length, Gains length in 1 year:Height or Length, Gains length in 1 year: 0__3m: 4cm/m0__3m: 4cm/m 3__6m:2cm/m3__6m:2cm/m 6___12m:1cm/m6___12m:1cm/m average length at birth 50 cmaverage length at birth 50 cm

at 1 year 75 cm.at 1 year 75 cm.

2 2 –– 12 years age (in years) x 6 + 77 12 years age (in years) x 6 + 77 Average annual height increase; is 6 cm/yr between 4 yr and Average annual height increase; is 6 cm/yr between 4 yr and

pubertypuberty Parental ht is an important determinant of their childrens height ,ht of Parental ht is an important determinant of their childrens height ,ht of

aboye at 2 year & girls at 2.5 is nearly half of the adult height +-5aboye at 2 year & girls at 2.5 is nearly half of the adult height +-5

GrowthGrowth

WeightWeight :Weight loss in the first few days of life; 5-10% of :Weight loss in the first few days of life; 5-10% of birth weightbirth weight..

This will return to birth weight by 7-10 daysThis will return to birth weight by 7-10 days

average weight at birth 3.250Kg.average weight at birth 3.250Kg.

3 -12 months of age 3 -12 months of age age (in months)+9age (in months)+9

22

1 - 6 years age (in years) x 2 + 81 - 6 years age (in years) x 2 + 8

7 7 –– 12 years 12 years age (in years) x 7 -5age (in years) x 7 -5

22

GrowthGrowth

Head circumferenceHead circumference Use flexible non-stretchableUse flexible non-stretchable

tapetape Obtain three successiveObtain three successive

measurements and take themeasurements and take the

largest to be the occipitolargest to be the occipito

frontal circumference (OFCfrontal circumference (OFC

GrowthGrowth Head circumference in 1Head circumference in 1stst year of life year of life 11stst 3m of age each m 2cm 3m of age each m 2cm 2nd 3m of age each m 1cm2nd 3m of age each m 1cm Last 6m of age each m 0.5cmLast 6m of age each m 0.5cm average OFC at birth 35 cm.average OFC at birth 35 cm. at 3 months 41 cm.at 3 months 41 cm. at 6 months 44 cm.at 6 months 44 cm. at 1 year 47 cm.at 1 year 47 cm. at 2 year 49 cm.at 2 year 49 cm. at 3 year 50.5 cm.at 3 year 50.5 cm.

When we examine the child’s growth we usually measure his When we examine the child’s growth we usually measure his Height, weight, and head circumference, then we plot them Height, weight, and head circumference, then we plot them on the corresponding growth charts according to the child’s on the corresponding growth charts according to the child’s

age and sexage and sex

e.g Rand is a 2 year old boy having a health supervision e.g Rand is a 2 year old boy having a health supervision visit,he is perfectly healthy during the exam, his height isvisit,he is perfectly healthy during the exam, his height is

90 cm, his weight is 12.5 kg, his head circumference is 48 cm.90 cm, his weight is 12.5 kg, his head circumference is 48 cm.

SummerySummery::

Growth is: continuous& quantitative change.Growth is: continuous& quantitative change.

Development:= = = = =&Qualitative change.Development:= = = = =&Qualitative change.

Factors affect growth & developmentFactors affect growth & development

Principles of growth & developmentPrinciples of growth & development

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