Stages of growth and development Stages of growth

Stages of growth and development

Stages of growth and development I- Prenatal period: Ovum (0 – 14 days after conception) Embryo - (14 days - 8 weeks of gestational phase) Fetus(8 weeks of gestational phase - birth) II- Postnatal period. Infancy: from birth to 12 months Neonate (newborn) (from birth to four weeks of life) Infancy (1 month - 12 months) Early childhood (1 - 6 years) -Toddler(1 - 3 years) - preschool (3 – 6 years)

Stages of growth and development Middle childhood/ school age (6 - 12 years) Later childhood: from 11 to 19 years from puberty to adulthood Early adolescent / late childhood (12 - 14 years) Middle adolescent (14 - 16 years) Late adolescent (16 – 19 years)

Assessment of growth: Measurement of physical growth in children is a key element in evaluating their status. Physical growth parameter include weigh, height (length), skin fold thickness, arm circumference, and head circumference. Values for this growth parameter are plotted on percentile charts and the child's measurements in percentiles are compared with those of the general population.

Assessment of development: Denver Developmental Screening Test (Engel, 2006): A test for evaluating development in children from 1 month to 6 years of age. 4 Main Rated Categories of DDST- Denver development screening test Language communication Personal social-interaction Fine motor adapting- prehensile ability to use hand movement Gross motor skills- large body movement

Normal Infant Infancy period starts at the end of the first month up to the first year of age. Infant's growth and development during this period are characterized by being rapid. Physical Growth. a. Weight: the infant gains: - Birth to 4 months -----¾ kg/month. - 5 to 8 months -------½ kg/month. -9 to 12 months ---- ¼ kg/month.

The infant will double his birth weight by 5 -6 months and triple it by 12 months of age. Another way of calculating the weight for infant age 3 to 12 months Weight = Age in Month + 9 -------------2 For example, The weight of 7 month old infant = 7+9 16 ------ = 8 kg 2 2

b. Height Length increases about 3 cm I month during the first 3 months of age, then it increases 2 cm/ month at age of 4 -6 months, then at 7 to 12 months it increases 1 1/2 cm I month. c. Head Circumference - It increases about 2 cm I month during the first 3 months, then 1/2 cm I month during the second 9 months of age. - Posterior fontanel closes by 6 to 8 weeks of age. - Anterior fontanel closes by 12 - 18 months of age. Chest Circumference By the end of the first year, it will be equal to head circumference.

Physiological Growth Pulse: 110 - 150 beats I minute. Respiration: 35+ 10 c/minute. Breathe though nose. Blood Pressure: 80/50 + 20/10 mm. Hg. Dentition Eruption of teeth starts by 5 to 6 months of age. It is called "Milky teeth" or "Deciduous teeth "or "temporary teeth" or primary teeth Average for teeth Eruption

Motor development: Gross motor: - Hold head erect steady by 3 -4 months. - Sit with support at 4 -5 months. - Sit without support at 7 -8 months. - Crawls at 9 month. - Creeps well at 10 month. - Walks with-help at 12 month, --

Fine motor: - Holds a rattle briefly when placed in his hand at 2 month. - Grasps objects with both hand. - Carry objects to mouth by 4 month. - Holds own bottle by 6 month. - Drink from cup with assistance at 8 month. - Picks small objects up with index finger and thumbs (i. e. pincer grasp) at 10 months. - Drinks from a cup and eats from a spoon, but still requires some help at 12 months.

Language Development 2 nd month: Coos and responds to caregiver's voice "ah, " "eh, " "uh. " 3 rd month: Laugh loudly. 6 th month: Vocalizes several well-defined syllables. 7 thmonth: Vocalizes da, ma, and ba. 9 th month: Associates words with persons or objects, says "ma ma, ''''da da. " 10 th month: May speak one word "no" or "hi. " 12 th month: May speak two or more words beside "ma ma", "da da", "baba".

Cognitive Development The infant's behavior in this stage progresses from biologic reflex activity through simple repetitive acts to imitative activity during late infancy period (and early toddler period). Infant learns through sensation and movement. He learns that objects continue to exist even when they are out of sight. Infant develops a primitive grasp of cause - effect relationship, but does not learn to think which is beyond his sensorimotor experience.

Emotional Development - The infant expresses his emotions through crying, laughter, and body movements. changes from crying to laughter. - His affection for or love of family members appears. - By 10 months, he expresses several beginning recognizable emotions, such as anger, sadness, pleasure, jealousy, anxiety, . and affection. By 12 months of age, these emotions are clearly' distinguishable.

Social development By 2 month: –Distinguishes mother as primary care giver from others-Leans that crying brings attention. By 3 to 4 months: - Smiles in response to smile of others. -Shows interest in other family members. By 7 to 8 months: -Show fear of stranger (stranger anxiety) -Responds socially to his own name. By 9 to 10 months: -Play simple games with adult, e. g. "bye-bye" by 9 months and social games with adults e. g. " peek -a -boo" by 10 months. -Imitates facial expression at 10 months.

Eye -to -eye contact, smiling, and vocalization are the evidences of attachment between the infant and his parent, especially his mother. -According to Erikson, through the infant interaction with caregiver (mainly the mother), especially during feeding, he learns to trust others through the relief of basic needs, i. e. to trust those who give pleasant sensations, sense of trust win result also from being held, talked. To, cuddled, warmed, and so. . on. If this sense of trust in others is not learned, the reverse, a sense of mistrust is acquired.

Needs of an Infant 1 - Infants need for feeding; during feeding the infant receives comfort and warmth from his mother or care giver. 2 - Infants need for sucking pleasure, he uses sucking to relive his tension and induce comfort and peace 3 - Infants need for warmth and comfort, he enjoys warmth and comfort of the mother's body, he also enjoys rhythmic rocking and gentle movement by his mother 4 - Infants need for sensory stimulation 5 - Infants need for love and security, he needs love as being cuddled, played during the daily activity.

Problems of infants I- Psychological problems Anxiety due to: 1 - Frustration in feeding 2 - Frustration in sucking 3 - Lack of parental love and frustration 4 - Stranger anxiety and loss of mother (maternal deprivation) 5 - Child abuse 6 - Malnutrition due to disturbed mother child relation

II- Health problems 1 - Malnutrition 2 - Infection Infant care 1 - Carrying the infant and cuddle him 2 - Bathing for cleanliness 3 - Exercise 4 - Observation of infant's body and skin 5 - Clothing for comfort, it should be suitable for his age and sex, weather and activity 6 - Expose infant to fresh air and sunshine

7 - Sleep: The amount of sleep depend on the infants need, perfect position for sleep is either prone position with head to one side or lying on one side. At the 3 rd month of age infant sleep about 15 -16 hours/ day and one or two naps. 8 - Safety measures should be followed for each procedure, bathing, clothing, selection of toys and furniture (his crib, mattress, pillows, cloths. ) 9 - Feeding and weaning 10 - Immunization

Normal Toddler stage is between 1 to 3 years of age. During this period, growth slows considerably. Physical Growth Weight: - Average weight gain is 1. 8 to 2. 7 kg/year. - Formula to calculate normal weight of children over 1 year Of age= Age in years x 2 + 8 =. . Kg

Height: - It increases about 10 to 12. 5 cm l year. 12 years increases 1 cm 1 month. - Formula to calculate normal height of children over 1 year of age= Age in years x 5 + 80 =. . Kg. Head and Chest Circumferences: - 1 year to adult head increases 1 0 cm only. - During toddler years, chest circumference continues to increase in size and exceeds head circumference. - Anterior fontanel closes between 12 - 18 months of age.

Motor development: Gross: - Walks alone at 15 month. - Runs well at 24 month. - Jump with both feet at 30 month. Fine: . . - Holds cup with both hands at 18 months. - Eats with spoon at 18 month. - Removes most of own clothes at 24 month. - Drinks without assistance at 30 month.

Language Development: 15 th months: Says 4 to 6 words (mainly names). 18 th months: Says 10 words or more. 24 th months: vocabulary of almost 300 words. 30 th months: -Talks constantly. - Uses plurals. - Gives first and last name Cognitive development: Up to 2 years, the toddler uses his senses and motor development to differentiate self from objects. Toddler from 2 to 3 years will be in the pre-conceptual phase of cognitive development (2 -4 years) where he is still egocentric and cannot take the point view of other people. His thinking is based on concrete perceptions and on actions in his immediate environment.

Emotional Development: The toddler is; - Less fear of strangers, but he develops separation anxiety (anxiety develop ·when 'he is separated from "the caregiversmother). - Temper - tantrums as means of anger expression. - Afraid from falling, loss of support, loud voices and strange places and people.

Social Development: -Toddler is very social beings but still egocentric ﺍﻧﺎﻧﻰ - Imitates parents, e. g. in clothes, in cleaning the house. - Notice sex differences and know own sex. - Develop "sense of autonomy“ ﺍﻻﺳﻘﻼﻝ i. e. "I can do it my self. " The development of autonomy during this period is centered on toddlers' increasing abilities to control their bodies, themselves, and their environment. They want to do things for themselves, using their newly acquired motor skills, e. g. walking climbing. . etc. , their mental power of selection and decision-making. If they feel small and /or when they are forced to be dependent on others, they will develop a sense of doubt and shame.

Behavioral characteristics of the toddler 1 - Negativism 2 - Ritualistic behavior 3 - Slowness in carrying out requests 4 - Temper tantrums 5 - Strong expression of emotions

Needs of toddler child 1 - Love and security 2 - Independence in self care 3 -Toilet training ( Bowel control at 18 months, bladder control in day time 2 -3 years, bladder control at night 3 -4 years) Care of the toddler child I- Physical care: - this will include bathing, dental care to prevent teeth decay, clothing and freedom to play. II- Sleep: - Toddler child sleep on the average 12 -14 hours out of 24 hours, including a day time nap of one to two hours.

Ill- Safety measures: - The common sources of accidents among toddlers are: 1 - burns 2 - falls 3 - poisoning 4 - motor vehicle accidents 5 -suffocation 6 - drowning. IV- Health supervisions- Physical checkup, immunization and dental care.

IV- Nutrition: The toddler age group needs 1200 calories per day. The toddler child needs 1. 2 gm/kg of protein to meet demands for muscle tissue growth and high activity level, the need for minerals such as iron. calcium, and phosphorus is still high, The mother should be: 1 - Serve food in small amounts. 2 - Chop or cut food in to small pieces. 3 - Serve food which includes all groups as milk, meat, fruits, vegetables Cereals, fat and carbohydrates. 4 - Serve nutritious snacks between meals. 5 - Give vitamins and iron supplement

Preschool Stage It is the stage where child is 3 to 6 years of age. The preschoolers grow relatively slow during this period. Physical Growth Weight: The preschooler gains approximately 1. 8 kg/year. Height: He doubles birth length by 4 -5 years of age. N. B. : Formula to calculate weight and height are the same as toddlers Physiological Growth: Pulse: 80 -120 beat I min (average 100 beat I min). Respiration: 20 -30 cycle minutes. Blood pressure: 100167 + 24125.

Motor development: Gross: - Rides tricycle using pedals at 3 years. -Climbs from greater height at 4 years. Fine: - Can undress him self at 3 years. _ Bath himself at 4 -5 years. _ Able to lace shoes at 5 years.

Language Development 3 rd year: -Vocabulary of 800 - 1000 words. - Uses 4 words sentences. - Ask why. 4 th year: Uses "I" in his speech◦ Vocabulary of 1500 words◦ Uses 3 to 7 words sentences. 5 th year - Repeats sentence of 12 or more syllables - Asks for the meaning of words - Vocabulary, of 21 00 word

Cognitive Development: Preschooler up to 4 years of age is in the preconceptual phase (refer to toddler's cognitive development). While, preschooler from 4 to 6 years, is in the intuitive phase (4 -7 years of age), where he begins to be able to give reasons for his belief and actions, but not a true cause- effect relationships. e. g. he may say : "It is not morning because I didn't eat breakfast" He has concept of time and uses symbols in his play, e. g. a piece of wood may represent a car. Emotional Development: The preschooler: - F ears the dark. - Tends to be impatient and selfish. ﺍﻧﺎﻧﻰ - Expresses aggression through physical and verbal behaviors. - Shows signs of jealousy ﺍﻟﻐﻴﺮﺓ of siblings (it is called sibling rivalry )ﺍﻟﺘﻨﺎﻓﺲ ,

Social Development: The preschooler: - Egocentric ﺍﻧﺎﻧﻰ in his thought and behavior, unable to see others' viewpoints. - Tolerates short separation from parents by 3 years and separates easily by 5 years of age. - Less dependent on parents but needs their reassurance and help. - May have dreams and nightmares. - Demonstrates strong attachment for parent of opposite sex. More cooperative in play. ◦ The preschooler is in the stage where he develops a sense of initiative; where he wants to learn what to do for himself, learn about the world and other people. If he fails to achieve this sense of initiative, he will develop a sense of guilt, where he will appear anxious and frightened in his contact with

Needs of the preschool child : 1 - Learning language. 2 - Religious education 3 - Sex information. 4 - Love and security. 5 - Guidance Problems of the preschool child: Thumb sucking. Enuresis and encopresis Selfishness. Bad language. Destructiveness Aggressiveness. Masturbation. Food likes and dislike.

Care of the preschool child 1 - Nutrition: Similar to those for toddler, daily caloric requirement 13001800 calories and fluid requirement may decrease slightly to about 90 ml/kg/day. Parents sometimes worry about the quantity of food but the quality is much more important than the quantity 2 - Sleep and activity: - Average sleeping hours about 12 hours a night and infrequently takes day time naps. Activities continue to be in high levels.

3 - Dental care: -Dental care is essential habits, he still require assistance and supervision with brushing by parents. 4 - Injury prevention: - Poisoning is still a danger, motor vehicle injuries increase from activities such as playing in street, riding tricycles or forgetting safety regulations when crossing streets.

Normal School-Age Child School- age child is between the ages of 6 to 12 years. He is characterized by gradual growth Physical Growth: Weight: School-age child gains about 3. 8 kg/year. Boys tend to gain slightly more weight through 12 years. Formula for 7 to 12 years = (age in years x 7) - 5 -----------2 Height: -Gains about 5 cm/ year. - Body proportion during this period: both boys and girls are long-legged. Formula is the same preschoolers

Dentition: During school -age period, permanent teeth erupt, starting from 6 years, usually in the same order in which primary teeth are lost). Acquires permanent molars, medial and lateral incisors Physiological Growth: - Pulse: 90 + 15 beats /min (75 to 105). - Respiration: 21 + 3 beats l min (18 - 240). - Blood pressure: 100/60 + 16110. - School-age child get tired easily. Immune system reaches normal adult level - Nervous system is mature by 10 years of age

Motor development: Gross: * Rides bicycle using pedals at 6 -8 years. * Enjoy all physical activities at 10 -12 years. Fine : * Can com hair at 6 -8 years. * Uses spoon, fork, knife skillfully at 8 -10 years.

Language Development: - Vocabulary expands by 20. 000 to 30. 000 words. - Sentence structure and use of grammar continue to improve. - Speech proceeds from egocentric to social. Cognitive Development - The 6 years old is still in pre-operational stage, where he is able to understand think (see the preschooler cognitive development). - 7 to 11 tears old child now in the concrete operational stage of cognitive development. He is able to function on a higher level in his mental ability.

The school age child will be able to: i- Think and give reasons as he develops concept of cause-effect relationship and can manipulate symbols, therefore can solve problems. ii- Classify objects to classes and subclasses as they can see the differences more than the similarities of objects. iii- Ordering, i. e. arrange. things according to their sizes and relationship to other things. iv- Tell time; know date, month and season. Emotional Development: _ Fears injury to body, and fear of dark. _ Jealous of siblings (especially 6 -8 years old child). -curious about every thing - By 10 years of age, he has short bursts of anger, but able to control anger by 12 years.

Social Development: 6 -8 years: - Continues to be egocentric. - Wants other children to play with him. - Insists on being first in everything. 8 - 10 years: - Becomes peer oriented. - Considers peers' opinions more important than parents. - Begins hero worth ship. - Relationships with siblings improve.

10 -12 years: - Confident, sincere, has their role. - Respects parents and their role. - Joints groups (formal and informal). School-age child begins development of sense of industry, i. e. child desires to engage in tasks in the real world (as he enjoys doing socially useful tasks for others). Mastery of social interaction facilitates development of the sense of industry and child's feeling of competence, which leads to positive sense of self. If the child fails to achieve the sense of industry, and I or child's feeling of competence, which leads to positive sense of self, he will develop a sense of inferiority.

Care of the school- age child: 1 - Bathing. dressing and toileting 2 - Sleep and rest 3 - Safety measures include accidents prevention and sex education. 4 - Nutrition during the school age caloric requirements per unit of body weight continue to decrease. but the nutritional requirements remain relatively greater than in a mature person. 5 - Play and work 6 - Health: preschool health examination and school health program. exercise and activity , television, sports

Health problems during school age 1 - Exposure to communicable disease 2 - Handicapped children: meeting the need of them on entrance the school 3 - Physical changes they will experience at puberty 4 - Smoking and drug abuse 5 - Dental problem 6 - Infectious disease

7 - Behavioral disorders in school age children - Attention deficit disorder - Specific learning disability - School phobia - Enuresis and Encopresis - Recurrent abdominal pain - Conversion reaction (Hysteria) - Childhood schizophrenia

The Normal Adolescent is a period of transition from childhood to adulthood. It is based on childhood experiences and accomplishments. It begins with the appearance of secondary sex characteristics and ends when somatic growth is completed and the individual is psychologically mature, capable of becoming a contributing member of society: .

Physical Growth: Weight: - Growth begins earlier in girls (10 - 14 years, while 12 - 16 in boys). - Males will gain 7 to 30 kg, while female will gain 7 to 25 kg. Height: - Birth length triples by about age of 13. - Males will gain 10 to 30 em in height. - Females will gain less height than males as they gain 5 to 20 cm. - Growth in height ceases at 16 or 17 years in females and 18 to 20 in males. Physiological Growth: Pulse: reach adult value 60 -80 beats/ min respiration: 16 -20 cycle I min. - The sebaceous glands of face, neck, and chest become more active. When their secretion accumulates under the skin in face, acne will appear.

Secondary sex characteristics: In boys: • increase in size of genitalia Swelling of the breast. Growth of pubic, axillary, facial and chest hair. Change in voice. Rapid growth of shoulder breadth. Production of spermatozoa. (Which IS sign of puberty)? In girls: Increases in transverse diameter of the pelvis. Development of the breasts. Change in the vagina~ secretions. Growth of pubic and axillary hair. Menstruation (first menstruation is called menarche, which occurs between the age of 12 to 13 years old).

Cognitive Development: Adolescent can deal with a problem that does not have a basis in "here and now" as he can think beyond the present. In solving a problem, he can make use of assumptions; formulating hypotheses while thinking. he can' have in mind many ideas about a problem simultaneously and can predict a variety of possible solutions

Emotional Development: Rapid physical changes occur in this period are accompanied by changes in emotional control. Adolescent exhibits alternating and recurrent episodes of disturbed behavior with period of quite one. There is increase in moods and sentiments. He may become hostile or ready to fight, complain, or resist everything. Little things can cause emotional upheaval as the tension is relieved, emotion is brought under-control and he retreats in an attempt to master his anger and to grow his ability to control his emotions and gain from the new experience.

Social Development: Throughout childhood, the child has been going through the process of identification, (with parents, teachers, and significant people) as the child concentrates on various parts of the body at specific times. In adolescence, he comes to see himself as a distinct individual, who is somewhat unique and separate from every other individual. He needs to know "who is he" in relation to family and society i. e. to develop a sense of identity. If the adolescent is unable to formulate a satisfactory identify from the multi-identifications, a sense of selfdiffusion will be developed. - Egocentrism disappear at this age. - Adolescent shows interest in other sex. - He looks for close friendships.

Care during adolescent stage: -Personal care: Including hygienic care. adequate sleep and rest. -Vision : Regular vision testing is an important part of health care and supervision during adolescent. -Education for prevention of smoking. - Nutrition : The calorie and protein requirements during these years are higher than any other time of life.

Posture : Rapid skeletal growth is associated with lag in muscular growth leads to weakness easy fatigability. These characteristics predispose youngest to slumping and make them less include to stand or sit correctly. -Dental health. -Accidents prevention: Motor vehicle accidents or sports injuries. -Sex education and guidance. -

Health problems of adolescent: - Delayed growth and /or maturation. - Acne is a common problem during a adolescence. - Infections, Mono nucleasis. - Systemic hypertension. - Disorders of the reproductive system:

Disorders of the reproductive system: In female • Amenorrhea In male • Infection: • Dysfunction"uterine • Hematuria bleeding'' • Voiding dysfunction • Dysmenorrhea • Penile problems • Vaginitis vulvitis, and • Disorders of the scrotum and testes