Growth and development
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Growth and development are closely related processes that are assessed simultaneously to evaluate health. Growth is a quantitative increase in size through cell growth and division, while development is qualitative maturation of organ systems and skills. Diseases have more severe impacts during periods of rapid growth and development. Growth is measured through weight, height, head circumference, and dentition, while development is assessed based on gross motor, fine motor, vision, hearing, speech, and social skills appropriate for age. Serial measurements plotted on growth charts best indicate overall health and nutrition.
Growth and development
- 2. GrowthGrowth && DevelopmentDevelopment ByBy Dr Muhammad Saleem LaghariDr Muhammad Saleem Laghari MBBS(KEMU), MCPS,FCPS (paeds)MBBS(KEMU), MCPS,FCPS (paeds) Gold Medalist FCPS-IGold Medalist FCPS-I Assistant ProfessorAssistant Professor SZMC,RYKSZMC,RYK 22
- 4. GROWTHGROWTH Change in size resulting from increase in number or size of cells of the body. Quantitative increase in size of body. Can be measured in terms of cm & kg etc.
- 5. DEVELOPMENTDEVELOPMENT Qualitative and functional maturation of organ system. Assessed in terms of acquisition of skills and ability to adopt to new situation.
- 6. GROWTH & DEVELOPMENTGROWTH & DEVELOPMENT Growth and development are assessedGrowth and development are assessed simultaneously as they are verysimultaneously as they are very closelyclosely relatedrelated to each otherto each other.. They provide the best and most practicalThey provide the best and most practical means ofmeans of evaluation of healthevaluation of health of anof an individual.individual. Diseases tend to haveDiseases tend to have more impairmentmore impairment when they occur during period ofwhen they occur during period of rapid growth & development.growth & development.
- 8. GROWTH: WeightWeight, Length/HeightLength/Height, OFCOFC , MUACMUAC & DentitionDentition. DEVELOPMENTDEVELOPMENT 1. Gross motor 2. Fine motor and vision. 3. Hearing and speech. 4. Social behavior. ASSESMENT OF GROWTH &ASSESMENT OF GROWTH & DEVELOPMENTDEVELOPMENT
- 10. GROWTHGROWTH • Rate of growth is more important than actual size. • Serial measurements of growth plotted on standard growth chart are best indicator of health.
- 11. WEIGHTWEIGHT • The best index of nutrition & growth. • Changes in weight occur before changes in other aspects of growth. • Average weight at birth is 3.2 kg. (7lb)
- 12. • The increase in weight is 30 gm/ day or 200 gm/week during first three months. • Birth weight is doubled at 6-months, tripled at 1-year and four times at 2-years age. • Then annual increase of 5-lb/year. • At 7-years it becomes 7-time of birth weight. • During puberty, there is growth spurt.
- 13. HEIGHT (LENGTH)HEIGHT (LENGTH) • Average length at birth is 50 cm. • It increases by 25 cm in first year. • It is 85 cm at 2-years, 95 cm at 3 years, 100 cm at 4 years. • Then it increases by 5-cm/year until puberty. • The pubertal growth spurt leads to increase 10- cm/year for 2 -- 3 years. • Adult height is twice the height at 2 years age. • Only Chronic illness affects length.
- 14. HEAD CIRCUMFERENCEHEAD CIRCUMFERENCE Age Birth 3 months 6 months 9 months 1 year 2 years 3 years 5 years Head Circumference (cm) 35 41 44 46 47 49 50 51
- 15. DENTITIONDENTITION • First MILK tooth erupts at 6-months age • Eruption of milk teeth completes by 2.5 years (20-teeth) • Shedding of milk teeth at 6-years and is complete by 12-years of age. • PERMANENT Teething is complete by 12-years of age except wisdom teeth which appear at 22-years (32 - teeth).
- 16. DEVELOPMENTDEVELOPMENT • It takes place in cephalocaudal direction. • It is influenced by, child’s maturity, illness, hunger or thirst and alertness or drowsiness.
- 18. Development is assessed under four headings: 1. Gross motor 2. Fine motor and vision. 3. Hearing and speech. 4. Social behavior.
- 19. NEONATENEONATE Gross Motor • In prone position turns head to one side, limbs flexed under the body. • In supine position tonic neck reflex is present. • Pulled to sit Marked head lag • Ventral suspension Head & limbs are flexed, limbs hang downward
- 20. NEONATENEONATE • Fine motor and vision • Pupils react to light. • Optical closure from sudden bright light. • Doll’s eye reflex present. Hearing & Speech • Startle response to sudden loud noise. • Cries vigorously. Social Behaviour • Sleeps most of the time. • Moro, rooting & sucking reflexes present. • Social smile comes at 4-6 weeks.
- 21. 3 MONTHS AGE3 MONTHS AGE Gross Motor • Pulled to sit Neck holding present. • Prone position Lifts head and chest above couch using forearm as support. • Held sitting Straight back • Held Standing Sags at knees • Ventral suspension Head held well above the body, Hips extended
- 22. 3 MONTHS AGE3 MONTHS AGE Fine Motor & Vision • Grasps rattle for few moments ( Palmer Grasp ). • Regards mother’s face. • Follows dangling ball/ light through an arc of 180 degree
- 23. 3 MONTHS AGE3 MONTHS AGE Hearing and speech. • Quietens to sound of rattle and spoon in cup • Vocalizes & Delighted when spoken to • Turns to nearby voice. • Social Behaviour • Happy response to mother’s face. • Laughs at pleasurable social contact. • Active Grasp present.
- 24. 6 MONTHS AGE6 MONTHS AGE Gross Motor • Supine Lifts head from pillow, Lifts legs to vertical, Grasps feet & takes to mouth. • Prone Lifts head and chest well up supporting weight on extended arms while in prone position. • Sitting with support present • Held standing Bears weight on legs
- 25. 6 MONTHS AGE6 MONTHS AGE Fine Motor & Vision • Transfers objects from one hand to others. • Both eyes move in union. • Follows dangling ball in all directions.
- 26. 6 MONTHS AGE6 MONTHS AGE • HEARING AND SPEACH • Responds to hearing tests at 1 foot on ear level. • Vocalizes in single or double e.g.. Goo, ah-ah etc. • Shouts to attract attention. Social Behaviour • Mouthing present • Imitates bye-bye. • Fear of strangers present from 7-months age onwards
- 27. 12 MONTH AGE12 MONTH AGE Gross Motor • Crawling (10-m) • Walks like a bear. • Can build a tower of three tubes
- 28. 12 MONTH AGE12 MONTH AGE Fine Motor & Vision • Pincer grasp present (10 months) • Imitates hand clapping. • Drinks from a cup • Looks for hidden and fallen toys. Hearing & Speech • Knows and turns to own name. • Speaks 2-3 words (papa, mama)
- 29. 12 MONTHS AGE12 MONTHS AGE Social Behaviour • Drinks from cup • Waves bye-bye. • Points to desired objects. • Gives toys on request.
- 30. 2 YEARS AGE2 YEARS AGE Gross Motor • Runs well, stops and starts safely. • Climbs on furniture. • Walks up and downstairs one hand held, two feet per step.
- 31. 2 YEARS AGE2 YEARS AGE Fine Motor & Vision • Picks up pins, thread. • Turns pages singly. • Builds tower of six cubes. • Holds pencil and scribbles
- 32. 2 YEARS AGE2 YEARS AGE HEARING & SPEACH • Joins 2-3 words to form sentences. • Refers to self by name • Constantly asking names of objects and people.
- 33. 2 YEARS AGE2 YEARS AGE Social Behavior • Verbalizes toilet needs • Usually dry by day. • Enjoy picture books and stories. • Lifts and replaces cup safely. • Handle spoon well.
- 35. 3 YEARS AGE3 YEARS AGE GROSS MOTOR • Rides tricycle using pedals. • Can walk on tiptoe • Walks upstairs with alternating feet. • Can stand momentarily on one foot.
- 36. 3 YEARS AGE3 YEARS AGE FINE MOTOR AND VISION • Copies a circle • Builds tower of 9-10 cubes.
- 37. 3 YEARS AGE3 YEARS AGE HEARING AND SPEECH • Gives full name and knows age and sex. • Counts up to 10 or more. • Knows several nursery rhythms. SOCIAL • Dry by night (toilet trained) • Washes and dries hand under supervision. • Can pull pants down and up but unable to button.
- 38. 4 YEARS AGE4 YEARS AGE GROSS MOTOR • Stands on one foot 3-5 seconds. • Runs on tiptoe. • Climbs well. FINE MOTOR AND VISION • Can copy a cross. • Draws a man with head, leg, and trunk. • Builds three steps with six cubes.
- 39. 4 YEARS AGE4 YEARS AGE HEARING AND SPEECH • Gives full name and address • Speaks grammatically correct and intelligible SOCIAL • Washes and dries hand • Brushes the teeth. • Can dress and undress except shoe laces. • Tells a story. • Understands taking turns as well as sharing.
- 41. 5 YEARS AGE5 YEARS AGE GROSS MOTOR • Walks on a straight line. • Hops and skips on one foot. • Runs up and downstairs. • Stands on one foot with folded arms. FINE MOTOR & VISION • Can catch a ball. • Copies square and triangle • Thread large needle and sew stitches.
- 42. 5 YEARS AGE5 YEARS AGE HEARING & SPEECH • Gives full name, age and birthday. • Name four colors. SOCIAL • Washes and dries hands and face. • Dress and undress alone. • Affectionate and helpful to younger sibs. • Knows right and left. • Goes to school unattended.
- 44. THANKS