HUMAN GROWTH AND DEVELOPMENT
GROWTH
Growth refers to an
increase in physical size of the whole body or any of its parts.
It is simply a quantitative change in the
child’s body.
DEVELOPMENT
Development refers to a
progressive increase in skill and capacity of function.
It is a qualitative change
in the child’s functioning.
It can be measured through
observation.
MATURATION
•
Increase in
child’s competence and adaptability.
•
It is
describing the qualitative change in a structure.
•
The level of
maturation depends on child’s heredity.
IMPORTANCE OF GROWTH & DEVELOPMENT
By understanding what to
expect during each stage of development, parents can easily capture the teachable moments in
everyday life to enhance their child's language development, intellectual
growth, social development and motor skills.
•
Gaining better
understanding of the reasons behind abnormality
•
Helping in
formulating the plan of care.
•
Helping in
parents’ education in order to achieve optimal growth & development at each
stage.
PRINCIPLES OF GROWTH & DEVELOPMENT
•
Continuous
process
•
Predictable
Sequence
•
Do not
progress at the same rate (↑ periods of GR in early childhood and adolescents
& ↓ periods of GR in middle childhood)
•
Not all body
parts grow in the same rate at the same time.
•
Each child
grows in his/her own unique way.
•
Each stage of
G&D is affected by the preceding types of development.
•
G & D
proceed in regular related directions :
- Cephalo-caudal
(head down to toes)
- Proximodistal
(center of the body to the
peripheral)
- General to specific
GROWTH PATTERN
The child’s pattern of
growth is in a head-to-toe direction, or cephalocaudal, and in an inward to
outward pattern called proximodistal.
PRE-NATAL STAGE
•
A model for
the development of all subsequent periods
•
Understand how
the developing organism can be affected by mother-to-be’s health, habits, and
lifestyle
Prenatal Periods
•
Germinal
Period
•
Embryonic
Period
•
Fetal Period
1. Germinal period
(single-cell zygote Ã
morula Ã
blastocyst)
•
Conception to
attachment (8-10 days later)
2. Embryonic period (embryo)
–
Attachment to
end of 8th week (when all major organs have taken primitive shape)
3. Fetal period (fetus)
–
9th
week (with first hardening of the bones) until birth
GERMINAL STAGE
•
Cleavage:
Mitotic division of zygote into multiple cells
•
Heterochrony:
Different parts of the organism develop at different rates
•
Heterogeneity: Variability in levels of development of
different parts of the organism at a given time
•
Epigenetic Hypothesis:
Interactions between the cells and their environment generate the new cell
forms and emergence of body organs
EMBRYONIC STAGE
•
Begins with
implantation and lasts for about 6 weeks
–
Basic organs
formed; sexual differentiation occurs
–
Organism
begins to respond to direct stimulation (e.g., will turn its head in response
to a light touch around the mouth)
•
Developmental
patterns
–
Cephalocaudal: Proceeds from head down
–
Proximodistal: From middle of organism out to the periphery
FOETAL STAGE
•
Begins with
skeletal ossification
•
From week 8/9
until birth
•
From 1¼ Ã 20 inches
•
From 8 Ã 3250 grams
Foetal Development
•
10th
week: Intestines in place; breathing and jaw-opening movements
•
12th
week: Sexual characteristics; well-defined neck; sucking and swallowing
movements
•
16th
week: Head erect and lower limbs well-developed
•
5th
month: As many nerve cells as it will ever have
•
7th
month: Eyes open and lungs capable of breathing
•
8th
month: Many folds of the brain present
•
9th
month: Brain more convoluted
•
Fetus doubles
in weight in final weeks before birth
Prenatal Development
•
Sensory
Capacities
•
Fetal Learning
•
Maternal
Conditions
•
Teratogens
Brain Development
Fetal Sensory Capacities
•
Sensing motion
–
Sense of
balance at 5 months
•
Vision
–
Responds to
light (i.e., heart rate changes, increased movement) at 26 weeks
•
Sound
–
Responds at 5-6
months
–
Can
discriminate outside sounds, but hears mother’s voice best (i.e., changes in
heart rate)
Fetal Learning
•
Mothers read
the Story “The Cat in a Hat” 2x/day for last 1½ months of pregnancy
•
Method: Changes in rate of sucking turned on or off a tape
recorder of mother reading (half read that story, the other half another story)
•
Finding: Infants modified their rates of sucking in the direction that produced
the familiar story
Maternal Conditions: Attitudes &
Stress
l Presence of a sympathetic mate and other supportive
family members, adequate housing, and steady employment – factors that give a
woman a basic sense of security – appear to enhance the prospects for a
healthy baby (Thompson, 1990)
l Czech
study: At birth, unwanted
children weighed less and needed more medical help than children in the
control group
l Psychological
stress during pregnancy is
associated with premature delivery and low birth weight (Hedegaard, 1993)
Teratogens: Smoking
•
Increase in
rate of spontaneous abortion, stillbirth, and neonatal death
•
Nicotine
results in abnormal growth of the placenta
•
Similar
effects from cigarette smoke of others
Teratogens: Alcohol
•
Fetal Alcohol Syndrome
•
Abnormally
small head, underdeveloped brain, eye abnormalities, congenital heart disease,
joint anomalies, malformations of the face
•
Most serious
damage from alcohol caused in first weeks of pregnancy
Teratogens: Drugs
Prescription: Thalidomide (nausea), Valium (tranquilizer),
Accutane (acne), streptomycin & tetracycline (antibiotics), artificial
hormones
Caffeine: Increased rate of spontaneous
abortion and low birth weight
Marijuana: Low birth weight, premature delivery; infants
startle more readily, have tremors, and experience sleep cycle problems
Cocaine: More likely to be stillborn or premature, have low
birth weights, have strokes, have birth defects; infants more irritable,
uncoordinated, slow learners
Methadone & Heroin: Born addicted; likely to be premature,
underweight, vulnerable to respiratory illness, tremors, irritable; infants
have difficulty attending, poor motor control
Teratogens: Infections
Rubella: Can cause a syndrome of congenital heart disease,
cataracts, deafness, and mental retardation in more than half of all babies
born to mothers who suffer from the disease during the first 12 weeks of
pregnancy
AIDS: Approximately 30% of the babies born to mothers who test positive for
the AIDS virus acquire this disease
Also Rh incompatibility,
radiation, etc
BIRTH
NEWBORN
Newborn stage is the first
4 weeks or first month of life.
It is a transitional
period from intrauterine life to extra uterine environment
Normal Newborn
Physical growth
- Weight = 2.700 – 4 kg
- Wt loss 5% -10% by 3-4 days after birth
- Wt gain by 10th days of life
- Gain ¾ kg by the end of the 1st
month
They
loose 5 % to 10 % of weight by 3-4 days
after birth as result of :
• Withdrawal of hormones from mother.
• Loss of excessive extra cellular fluid.
• Passage of meconium (feces) and urine.
• Limited food intake.
•
Boys average
Ht = 50 cm
•
Girls average
Ht = 49 cm
•
Normal range
for both (47.5- 53.75 cm)
Head circumference
33-35 cm
Head is ¼ total body
length
Skull has 2 fontanels
(anterior & posterior)
Anterior fontanel
• Diamond in shape
• The junction of the sagittal, corneal and frontal
sutures forms it
• Between 2 frontal & 2 parietal bones
• 3-4 cm in length and 2-3 cm width
• It closes at 12-18 months of age
Newborn Senses
Touch
•
It is the most
highly developed sense.
•
It is mostly
at lips, tongue, ears, and forehead.
•
The newborn is
usually comfortable with touch.
Vision
•
Pupils react
to light
•
Bright lights
appear to be unpleasant to newborn infant.
•
Follow objects
in line of vision
Hearing
•
The newborn
infant usually makes some response to sound from birth.
•
Ordinary
sounds are heard well before 10 days of life.
•
The newborn
infant responds to sounds with either cry or eye movement, cessation of
activity and / or startle reaction.
Taste
Well developed as bitter
and sour fluids are resisted while sweet fluids are accepted.
Smell
Only evidence in newborn
infant’s search for the nipple, as he smell breast milk.
Gross Motor Development
The newborn's movement are
random, diffuse and uncoordinated. Reflexes carry out bodily functions and
responses to external stimuli.
Reflexes
•
Swallowing
•
Gagging
•
Sucking
•
Grasp
•
Tonic-neck
Cognitive Development
The cognitive development
of newborn infant is difficult to understand or observe it.
Socio-Emotional Development
The newborn infant
expresses his emotion just through cry for hunger, pain or discomfort sensation
INFANCY
It is the period which
starts at the end of the first month up to the end of the first year of age.
Infant's growth and development during this period are rapid
Physical Growth
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 wt by 4-5 months and triple it by 10-12 months of age
•
Length
increases about 3 cm /month during the 1st 3 months of age,
•
then it
increases 2 cm /month at age of 4-6 months,
•
Then, at 7 –
12 months, it increases 1 ½ cm per month
Eruption of teeth
Eruption of teeth starts
by 5–6 months of age. It is called "Milky teeth" or "Deciduous
teeth" or "Temporary teeth".
Motor Development
•
At 2 months
•
Hold head
erects in mid-position.
•
Turn from side
back.
•
At 3 months, the infant can
•
Hold head
erects and steady.
•
Open or close
hand loosely.
•
Hold object
put in hand
At 4 months, the infant can
•
Sit with
adequate support.
•
Roll over from
front to back.
•
Hold head
erect and steady while in sitting position.
•
Bring hands
together in midline and plays with fingers.
•
Grasp objects
with both hands.
At 9 months, the infant can
•
Rise to
sitting position alone.
•
Crawl (i.e.,
pull body while in prone position).
•
Hold one
bottle with good hand-mouth coordination
At 11 months, the infant can
•
Walk holding
on furniture.
•
Stand erect
with minimal support
Emotional Development
•
His emotions
are instable, where it is rapidly changes from crying to laughter.
•
His affection
for or love 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.
•
He learns that
crying brings attention.
•
The infant
smiles in response to smile of others.
•
The infant
shows fear of stranger (stranger anxiety).
•
He responds
socially to his name.
•
According to
Erikson, the infant develops sense of trust.
•
Through the
infant's interaction with caregiver (mainly the mother), especially during
feeding, he learns to trust others through the relief of basic needs.
Speech Milestone
•
1-2 months:
coos
•
2-6 months:
laughs and squeals
•
8-9 months
babbles: mama/dada as sounds
•
10-12 months:
“mama/dada specific
•
18-20 months:
20 to 30 words – 50% understood by strangers
•
22-24 months:
two word sentences, >50 words, 75% understood by strangers
•
30-36 months:
almost all speech understood by strangers
TODDLERHOOD
Toddler stage is between 1
to 3 years of age. During this period, growth slows considerably.
Physical Development
Weight:
The toddler's average
weight gain is 1.8 to 2.7 kg/year.
Formula to calculate
normal weight of children over 1 year of age is
Age in years X 2+8 = ….. kg.
e.g., The weight of a
child aging 4 years
= 4 X 2 + 8 = 16 kg
Gross Motor
At 15 months, the toddler can
•
Walk alone
•
Creep
upstairs.
•
Assume
standing position without falling.
•
Hold a cup
with all fingers grasped around it.
At 18 months:
•
Hold cup with
both hands.
•
Transfer
objects hand-to hand at will.
At 24 months:
•
Go up and down
stairs alone with two feet on each step.
•
Hold a cup
with one hand.
•
Remove most of
own clothes.
•
Drink well
from a small glass held in one hand.
Emotional Development
•
Stranger
anxiety – should dissipate by age 2 ½ to 3 years
•
Temper
tantrums: occur weekly in 50 to 80% of children – peak incidence 18 months –
most disappear by age 3
Socio-emotional Development
•
Sibling
rivalry: aggressive behavior towards new infant: peak between 1 to 2 years but
may be prolonged indefinitely
•
Thumb sucking
•
Toilet
Training
Social Development
•
The toddler is
very social being but still egocentric.
•
He imitates
parents.
•
Notice sex
differences and know own sex.
•
According to
Erikson the development of autonomy during this period is centered around
toddlers increasing abilities to control their bodies, themselves and their
environment i.e., "I can do it myself".
Cognitive Development
•
Up to 2 years,
the toddler uses his senses and motor development to different self from
objects.
•
The 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 can not take the point of view of
other people.
EARLY
CHILDHOOD
•
It is the
stage where child is 3 to 6 -7 years of age. The growth during this period is
relatively slow.
Physical growth
Weight: The preschooler gains approximately 1.8kg/year.
Height: He doubles birth length by 4–5 years of age.
Fine Motor
•
3 year old:
copy a circle and a cross – build using small blocks
•
4 year old:
use scissors, color within the borders
•
5 year old:
write some letters and draw a person with body parts
Cognitive Development
Preschooler up to 4 years
of age is in the pre-conceptual phase. He begins to be able to give
reasons for his belief and actions, but not true cause-effect relationship.
•
Fears the dark
•
Tends to be
impatient and selfish
•
Expresses
aggression through physical and verbal behaviours.
•
Shows signs of
jealousy of siblings
Social Development
•
Egocentric
•
Tolerates
short separation
•
Less dependant
on parents
•
May have
dreams & night-mares
•
Attachment to
opposite sex parent
•
More
cooperative in play
•
According to
Erikson theory the preschooler is in the stage where he develops a sense of
initiative.
•
He wants to
learn what to do for himself, learn about the world And other people.
Set Backs
•
Inability to
perform self-care tasks, hand washing simple dressing, daytime toileting
•
Lack of
socialization
•
Unable to play
with other children
•
Unable to
follow directions during exam
Middle & Late Childhood (School Age)
Physical Growth
Height:
•
The child
gains about 5cm/year.
•
Body
proportion during this period: Both boys and girls are long-legged.
Fine Motor
•
Writing skills
improve
•
Fine motor is
refined
•
Fine motor
with more focus
o Building:
models – logos
o Sewing
o Musical instrument
o Painting
o Typing skills
o Technology: computers
At 6–8 years, the
school–age child:
•
Rides a
bicycle.
•
Runs Jumps,
climbs and hops.
•
Has improved
eye-hand coordination.
•
Prints word
and learn cursive writing.
•
Can brush and
comb hair.
At 8–10 years, the school–age child:
•
Throws balls
skillfully.
•
Uses to
participate in organized sports.
•
Uses both
hands independently.
•
Handles eating
utensils (spoon, fork, knife) skillfully.
At 10–12 years, the school–age child:
•
Enjoy all
physical activities.
•
Continues to
improve his motor coordination.
School Performance
•
Ask about
favorite subject
•
How they are
doing in school
•
Do they like
school
•
By parent
report: any learning difficulties, attention problems, homework
•
Parental
expectations
Cognitive Development
At 7-11 years, the child
now is in the concrete operational stage of cognitive development.
He is able to function on
a higher level in his mental ability.
Greater ability to
concentrate and participate in self-initiating quiet activities that challenge
cognitive skills, such as reading, playing computer and board games.
Emotional Development
The school–age child:
•
Fears injury
to body and fear of dark.
•
Jealous of siblings
(especially 6–8 years old child).
•
Curious about
everything.
•
Has short
bursts of anger by age of 10 years but able to control anger by 12 years.
Social Development
The school–age child is :
•
Continues to
be egocentric.
•
Wants other
children to play with him.
•
Insists on
being first in every thing
•
Becomes peer
oriented.
•
Improves
relationship with siblings.
•
Has greater
self–control, confident, sincere.
•
Respects
parents and their role.
•
Joints group
(formal and informal).
•
Engage in
tasks in the real world.
Set Backs
•
School failure
•
Lack of
friends
•
Social
isolation
•
Aggressive
behavior: fights, fire setting, animal abuse
ADOLESCENCE
Adolescence is a
transition period from childhood to adulthood.
Its 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 psychological mature.
Physical Growth
Weight:
•
Growth spurt
begins earlier in girls (10–14 years, while it is 12–16 in boys).
•
Males gains 7
to 30kg, while female gains 7 to 25kg.
Height:
•
By the age of
13, the adolescent triples his birth length.
•
Males gains 10
to 30cm in height.
•
Females gains
less height than males as they gain 5 to 20cm.
•
Growth in
height ceases at 16 or 17 years in females and 18 to 20in males
SECONDARY SEX CHARACTERISTICS OF GIRLS
•
Increase in
transverse diameter of the pelvis.
•
Development of
the breasts.
•
Change in the
vaginal secretions.
•
Growth of
pubic and axillary hair.
•
Menstruation
(first menstruation is called menarche, which occurs between 12 to 13 years).
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).
Cognitive Development
Through formal operational
thinking, adolescent can deal with a problem.
Emotional Development
This period is accompanied
usually by changes in emotional control.
Adolescent exhibits
alternating and recurrent episodes of disturbed behavior with periods of quite
one.
He may become hostile or
ready to fight, complain or resist every thing.
Adolescence Teaching
•
Relationships
•
Sexuality –
STD’s / AIDS
•
Substance use
and abuse
•
Gang activity
•
Driving
•
Access to
weapons
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