GROWTH AND DEVELOPMENT.ppt 93.ppt

8/10/2019 GROWTH AND DEVELOPMENT.ppt 93.ppt

1/38

GROWTH AND DEVELOPMENT

Dr.P.Natarajan


2/38

Percentile

Data is arranged in ascending order from 0 to 100 to show

which percentage of the distribution is above and below the

item


3/38

Standard deviation

The Standard Deviation is a measure of how

far away a particular value is from the normal

Its symbol is (the Greek letter sigma)

It is the square root of the Variance.


4/38

S.D

1 SD=About 68%

2 SD=About 95%

3 SD= bout 99.7%

Gaussian distribution


5/38

Z score The standard normal distribution is sometimes called

the z distribution.

A z score reflects the number of standard deviations

above or below the mean a particular score is.

For instance, if a person scored a 70 on a test with amean of 50 and a standard deviation of 10, then they

scored 2 standard deviations above the mean.

Converting the test scores to z scores, an X of 70

would be:


6/38

DEFINITION

Growth:

1.It is physical maturation. It is the increase in size of the

bodyin height, weight and other measurable areas.

quantitative2.Rates vary during different stages of growth ; The growth

rate is rapid during the prenatal, neonatal, infancy and

adolescent stages and slows during childhood;

3.GROWTH SPURTS


7/38


8/38


9/38


10/38

Development

1. Qualitative

2. Development is physiological, social and

psychological maturation.

3. It is the gaining of behaviour and skills in all

aspects of the childs life.


11/38

Definitions

Developmental milestonesare a set of

functional skills or age-specific tasks that most

children can do at a certain age range.


12/38

Domains1. Gross motor: sit, stand, walk, run, etc.,

2. Fine motor: using hands to be able to eat, draw, erc

3. Language: speaking, using body language and gestures,

communicating, and understanding what others say & writing

4. Cognitive: Thinking skills: including learning, understanding,

problem-solving, reasoning, and remembering.

5. Social: Interacting with others, having relationships with family,

friends etc

6. Adaptive: life sustaining skills

7. Sexual development

8. Bone and dental development


13/38

RULES OF G&D

1. Definite and predictable pattern,

2. Continuous & orderly

3. Normal G&D is determined by physiological

maturity and functional integrity of CNS.

4. progressive through the same stages.

1. Child starts crawling before walking- Crawl

CreepWalk

2. Speech: BabblesWordsSentences;

ScribbleWriting

3. Social: First child plays alone, then with others.


14/38

1. There is a directional Pattern in G&D:

1. Cephalocaudal Pattern ( Head to Tail)

2. Proximal to Distal (Midline to peripheral)

3. Mass to specific (Differentiation)

2. Brain takes over spine:

1. Primitive reflexes are replaced by voluntary acts.

Grasp reflex is replaced by voluntary grasp

2. Mass activity replaced by activity. Looking at abright object infant moves all limbs excitedly but

older child is less excited and approaches the

object with one hand


15/38

Cephalocaudal growth


16/38

Ulnar grasp pincer grasp


17/38

Fetal Development

1. 0-8 weeks: Embryonic period: 3 layers; Paired heart tubes,

vulnerable for teratogenic and hypoxic insults

2. Fetal period: 9 weeks to birth: organogenesis

1. 10 weeks: face recognizable; rotation of gut

2. 12 weeks: gender of genitals becomes visible; budding of

bronchi and bronchioles

3. 20-24: primitive alveoli and surfactants begin to form

4. 26 weeks: eye opening

5. III trimester: respond to external stimuli by body movements

and heart rate changes; habituation with repetitive stimuli


18/38

New-born

1. Wt: 2.8 to 3.4 kg; boys heavier;

2. Length: 50 cm (20)

3. HC: 35 cm (14 )

4. Eye: Focal length: 8-12; nearsighted from breast to mothers

face; preference for faces

5. Hearing: developed well; preferential turn toward female voice

6. Gaze back at mother

7. Autonomic instability: flushing, mottling, perioral pallor,

hiccupping, vomiting, uncontrolled limb movements and

inconsolable crying


19/38

Behavioural states

byPrechtl and Beintema1. Quiet sleep: not arousable by heel stick

2. Active sleep: arousable but gets habituated by

repeated heel stick

3. Drowsy: repeated heel stick pushes the infant to fussyor crying state

4. Alert: fixate on object or face and follow horizontally

and vertically; turn toward a novel sound5. Fussy

6. Crying


20/38

0-2 months: Physical1. Weight:

1. Wt loss by 10% of birth weight in first week; regains it in 2 week2. Gains 30 gm /day in first month (fastest growth in life)

2. Uncontrolled writhing and purposeless closing and opening of

hands

3. Active Moro response; tonic neck posture

4. Involuntary smiling

5. 6 behavioural states; sleep and wakefulness evenly distributed and

later sleep period more in nights6. Eye gaze, head turning, sucking under some control

7. Visual preference to human face

8. Turns towards mother voice indicating some recognition memory


21/38

21


22/38


23/38


24/38

Cognitive:

Recognizes facial expression like smile

Habituates to repeated stimuli

Increase attention to changing stimulus

Discriminates rhythmic patterns in language

Emotional:

Crying in response to wet diaper

Cries while hungry and relief after feeding


25/38

2-6 months

Physical:

1. Weight gain is 20 gm/day in 3-4 months and birth weight is

doubled at the end of 4 months

2. Disappearance of asymmetric tonic neck reflex and hands are

brought to midline to examine objects

3. Grasp reflex disappear to hold and release objects voluntarily

4. Gains control over trunk muscles that helps in intentional

rolling over

5. Holds heads with bopping 3 mo, steadily at 4-5 mo whilesitting and start taking spoon feeding

6. Can gaze across at things

7. Achieves greater degree of regular sleep-wake cycle;


26/38

Cognitive:

1. Starts shifting attention from breast feeding

mother to other things around

2. Starts exploring his own body by hands

Emotional development and communication:

1. Shows anger, fear and joy for appropriate stimuli

2. Says inga - 3 mo

3. Loughs aloud - 4 mo4. Excited at sight of food- 4 mo

5. Shows facial imitation and hand games

6. Show sadness when parents are unavailable


27/38

6-12 months

Physical:

1. At 1 year the birth weight triples; length increase

by 50%; HC increases by 10 cm

2. Sits supported 6-7 mo; without support 10 mo;

pivots while sitting 9-10 mo; examines several

objects at a time

3. Crawl and pulling to stand 8 mo

4. Thumb finger grasp 8-9 mo; pincer grasp by 12 mo;

5. Walks by 1 yr

6. Mandibular central incisors erupt


28/38

Cognitive:

1. Objects are passed from hand to hand

2. Looks down for a ball that has been dropped

3. At 9 mo, search for objects if hidden - object permanence

4. Plays peek-a-boo; pat-a-cake and waves bye bye -10 mo

Emotional:

1. Look anxiously at stranger, clings to motherstranger anxiety

2. Cry to call mother in next room

3. Tantrums appear as a drive for autonomy and mastery

Communication:

1. Understands and responds to vocal and facial expressions-7 mo

2. Shows toy to parents to share the joy - 9 mo

3. Utter syllables like ma, da, pababbling 8-10 mo

4. Responds to name

5. Uses a first true word for the object permanence or a person

6. Says mama, dada-12 mo

h d


29/38

The second year: 12-18 mo Physical:

1. Growth rate slows and appetite declines2. Relatively short legs and long torsos with exaggerated

lumbar lordosis and protruding abdomen

3. Brain growth and myelinisation increase head

circumference by 2 cm

4. Walks independently with genu varus (bow leg) and gets

corrected over few months

5. Stops, pivots and stoops without toppling over

6. Increasing dexterity ( reaching, grasping and releasing) and

mobility

7. Casting: throwing away objects onto floor


30/38

Cognitive:

1. Stacks blocks

2. Uses things for intended purposes: combs for hair, cups for drinking

3. Symbolic play: pretends to drink from an empty cup

4. Imitates parent or older children

Emotional:

1. Orbit around parents- going away and return to parents now and then

2. Exhibit temper tantrums reflecting their inability to verbally

communicate their emotional states

Linguistic:

1. Receptive language precedes expressive language

2. Unintelligible jargon

3. Responds appropriately by words like no, bye-bye, give-me etc -12 mo

4. Names body parts and uses 4-6 words correctly- 15 mo


31/38

Second year: 18-24 mo

Physical:

1. Gains 5 and 5 lb

2. At 24 mo they their adult height

3. 90% head circumference achieved in 2 yr

4. Casting disappears by 18 mo

Cognitive:

1. Uses a stick to get a toy out of reach18 mo

2. Can wind a mechanical toy

3. Symbolic play: Feeds a toy from empty plate


32/38

Emotional:

1. Shows separation anxiety when parents are missing

2. Uses a toy or blanket (transitional object) while sleepingto represent absent parent

3. Looks at the mirror and remove an unusual thing from his

nose

4. Hand over a broken toy to parents to fix

5. Says himself no, no when touches a forbidden object

Linguistic:

1. 15-20 words at 18 mo and 50-100 words at 2 years

2. Combine two words

3. Understands 2step commands like give the ball and take

the shoes


33/38

Age 3 years: (Preschool)

1. In 3-year-olds, growth is still slow compared to the first year.

2. Most children have become slimmer and lost the roundedtummy of a toddler.

3. Weight: average gain of about 2 kg per year

4. Height: average growth of about 7 cm per year

5. All 20 primary teeth have erupted by 3 yr.

6. The preschooler has genu valgum (knock-knees)

7. Mild pes planus (flatfoot). The torso slims as the legs lengthen.

8. Somatic and brain growth slows

9. Decreases in nutritional requirements and appetite, and the

emergence of picky eating habits


34/38

Gross motor

1. Walk with a mature gait

2. Runs steadily and jumps easily

3. Walks up stairs unassisted

4. Rides a tricycle

5. Washes and dries hands

6. Throws and kicks a ball

7. Dances to tunes

8. Stacks 10 blocks9. Handedness is usually established

Fi t


35/38

Fine motor:

1. Easily draws straight lines and copies a circle

2. Can stand on tip-toes

3. Uses spoon well and feeds self

4. Dresses and undresses self except for buttons and

laces

5. Holds a pencil in writing position

6. Screws and unscrews jar lids, nuts, and bolts

7. Turns rotating handles

8. Can concentrate on tasks for 8 or 9 minutes

9. Develop handedness


36/38

Adaptive

1. Has all 20 primary ("baby") teeth

2. Vision is nearing 20/203. Bladder and bowel control are usually established; uses potty

chair or toilet

4. May sleep 11 to 13 hours total, may still take a short afternoon

nap5. Understands size differences (i.e., big and little)

6. Understands past tense (yesterday)

7. Understands long sentences

8. Understands prepositions (on, under, behind)

9. Uses pronouns correctly (I, you, he, me, etc.)

10. Asks "why" constantly

11. Counts up to four objects by 4 years old

Speech


37/38

Speech

1. Should be able to say about 500 to 900 words

2. Speech can be understood by others

3. Speaks in three word sentences

4. Can remember simple rhymes or lyrics

5. Uses "please" and "thank you"

6. Uses pronouns (I, you, me, we, they) and some plurals (cars,

dogs, cats)

7. Refers to self by using own name8. Names colors

9. Says full name and age

10. More thoughts less words leave to physiological stuttering

Social:


38/38

Social:

1. Understands concept of "mine" and "his/hers

2. Begins to share and likes to play with other children

3. Can take turns

4. Role-play activity, as in playing house & increasingly governed

by rules

5. Imitates adults and playmates

6. Spontaneously shows affection for familiar playmates

7. Begins to show feelings in socially acceptable ways

8. Tantrums normally appear toward the end of the 1st yr of life

and peak in prevalence between 2 and 4 yr of age.

Documents

GROWTH AND DEVELOPMENT.ppt 93.ppt