1. child growth & development
TRANSCRIPT
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GROWTH &GROWTH &
DEVELOPMENT INDEVELOPMENT IN
CHILDRENCHILDREN
Martira MaddeppungengMartira Maddeppungeng
DEPARTMENT OF CHILD HEALTH,DEPARTMENT OF CHILD HEALTH,HASANUDDIN UNIVERSITYHASANUDDIN UNIVERSITY
DR. AHIDIN SUDIROHUSODO HOSPITALDR. AHIDIN SUDIROHUSODO HOSPITAL
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ChildrenChildrenHa!e a t"pi#a$ #%ara#teri&ti#Ha!e a t"pi#a$ #%ara#teri&ti# ' a$(a"&' a$(a"&
gr)(t% * de!e$)p+ent ' dierent r)+ t%egr)(t% * de!e$)p+ent ' dierent r)+ t%e
adu$tadu$t..C%i$drenC%i$dren i& n)t a +iniature ) t%e adu$ti& n)t a +iniature ) t%e adu$t T%e $a( pr)te#ti)n ) #%i$dT%e $a( pr)te#ti)n ) #%i$dN). -N). - "ear"ear -//--//- SSe#ti)n 0 r)+ t%e $a( pr)te#ti)n ) #%i$d 1e#ti)n 0 r)+ t%e $a( pr)te#ti)n ) #%i$d 1
e!er" #%i$d i& entit$ed t) 2e a2$e t) $i!e,e!er" #%i$d i& entit$ed t) 2e a2$e t) $i!e,gr)(t%, de!e$)p and parti#ipating t) t%egr)(t%, de!e$)p and parti#ipating t) t%e+anner 2)rn+anner 2)rn
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Child :Child : conception 18 yearsconception 18 years(Convention of Child(Convention of Child
Right /CRC and Indonesian Child ProtectionRight /CRC and Indonesian Child Protection
Right)Right)
Based on :Based on :
anatomical groth (epipyphise clossing! reprod"ctiveanatomical groth (epipyphise clossing! reprod"ctive
system mat"ration etc# )system mat"ration etc# ) Psychosocial development (adolescentPsychosocial development (adolescent ad"lthood)ad"lthood)
C%i$d n)t a +iniature ) adu$tC%i$d n)t a +iniature ) adu$t$$$$
Spe#ii# a&pe#t&Spe#ii# a&pe#t&11 gr)(t% and de!e$)p+entgr)(t% and de!e$)p+ent
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CHILDRENCHILDREN%ope%ope&he parents&he parents
&he nation&he nation
&he orld&he orld
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ROWTH-DEVELOPMENT
ROWTH-DEVELOPMENT
IN CHILDRENN CHILDREN
3ROTH3ROTH t%e #%ange ) $arge, a+)unt,t%e #%ange ) $arge, a+)unt,+ea&ure& )r di+en&i)n ) t%e #e$$ &tage,+ea&ure& )r di+en&i)n ) t%e #e$$ &tage,
)rgan and indi!idua$)rgan and indi!idua$ 44 2)d" (eig%t, 2)d" $engt%2)d" (eig%t, 2)d" $engt%,, 2)ne age2)ne age,,
#ir#u+eren#e %ead#ir#u+eren#e %ead,, #ir#u+eren#e ) t%e ar+#ir#u+eren#e ) t%e ar+
DEVELOPMENTDEVELOPMENT in#rea&ing ) t%e &5i$$ inin#rea&ing ) t%e &5i$$ in&truture and 2)d" un#ti)n (%i#% +)re&truture and 2)d" un#ti)n (%i#% +)re#)+p$e6, regu$ar pattern, #an 2e )re#a&ted,#)+p$e6, regu$ar pattern, #an 2e )re#a&ted,t%e re&u$t ) pr)#e&& +aturati)nt%e re&u$t ) pr)#e&& +aturati)n
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Stages of growth-
tages of growth-
deveo!"e#t
eveo!"e#t
I.I.The periods ofThe periods ofprpreenatal (intra uterin)natal (intra uterin) is divided 2 :is divided 2 :
a.a. T%e peri)d& ) e+2r")T%e peri)d& ) e+2r") #)n#epti)n#)n#epti)n77 age )age )
eig%t (ee5&eig%t (ee5&
2.2. T%e peri)d& )T%e peri)d& ) ))etu&etu& age ) nine (ee5&age ) nine (ee5&77
t%e 2irt%t%e 2irt%
44 Ear$"Ear$" FF))etu&etu&8989 (ee5&(ee5&7 tri+e&ter -:7 tri+e&ter -:
acceleration groth! forming of physic! 'odyacceleration groth! forming of physic! 'ody
appliance have 'een formed start toappliance have 'een formed start to
f"nctionf"nction 44 Ad!an#ed )etu&Ad!an#ed )etu& final trimester of grothfinal trimester of groth
tae place fastly e*istence of groth oftae place fastly e*istence of groth of
f"nctions of Ig + transfer! the acc"m"lationf"nctions of Ig + transfer! the acc"m"lation
of fat of esensial (,mega - and ,mega .)of fat of esensial (,mega - and ,mega .)
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Stages of growth-
tages of growth-
deveo!"e#teveo!"e#t
II .II .The periods ofThe periods ofpostnatal (postnatal (after birthafter birth))
;.;. T%e peri)d& )T%e peri)d& )ne)nata$ne)nata$ 8/4-
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..T%e peri)d& ) pre%))$T%e peri)d& ) pre%))$ 8-4=8-4= "r"r:: &ta2$e )&ta2$e )t%e gr)(t%t%e gr)(t%, #)rp)rea$ a#ti!it" in#rea&e * t%e, #)rp)rea$ a#ti!it" in#rea&e * t%e
in#rea&ing ) &5i$$ed * pr)#e&& ) t%in5ingin#rea&ing ) &5i$$ed * pr)#e&& ) t%in5ing
0.0. T%e peri)d& ) %))$T%e peri)d& ) %))$ 88 =4;/=4;/ "r"r,, . T%e peri)d& ) ad)$eentT%e peri)d& ) ad)$eent 88;/4;
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T%e #%ara#teri&ti# ) gr)(t%T%e #%ara#teri&ti# ) gr)(t%
1#1# Change of meas"reChange of meas"re physicalphysical
increasing of the 'ody organincreasing of the 'ody organ
improvement of re0"irement of 'odyimprovement of re0"irement of 'ody
increasedincreased
## Change of proportionChange of proportion head of thehead of the
ne'orn 'a'y relative have the 'iggerne'orn 'a'y relative have the 'igger
proportion than age f"rproportion than age f"rtthermore#hermore#
Center 'ody in "m'ilic"s! ad"lt asCenter 'ody in "m'ilic"s! ad"lt as
high as p"'is symphisishigh as p"'is symphisis
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T%e #%ara#teri&ti# ) gr)(t%T%e #%ara#teri&ti# ) gr)(t%-#-# &he vanish of old maring&he vanish of old maring grothgroth
processprocess disappearing of the thym"sdisappearing of the thym"s
gland! fall o"t of the milteeth! thegland! fall o"t of the milteeth! thevanish of primitive reflectsvanish of primitive reflects
2#2# 3ppear of the ne maring3ppear of the ne maring thethe
mat"ration effect of organ f"nctionmat"ration effect of organ f"nction permanet toothpermanet tooth!! the maring ofthe maring of
secondary se*secondary se*
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Pro!ort$o# of %od he$ght
ro!ort$o# of %od he$ght
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-//
;
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Curve growth patternCurve growth pattern
Pattern groth of generalPattern groth of general
Pattern groth of organ limfoidPattern groth of organ limfoid
Pattern groth of 'rain headPattern groth of 'rain head
PPattern groth of organ reprod"ceattern groth of organ reprod"ce
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Patter# growth of ge#eraPatter# growth of ge#era
CharacteristicCharacteristic'ody length'ody length
4ast "ntil age yr4ast "ntil age yrsta'ilsta'ilee((infl"ence ofinfl"ence ofgroth hormone)groth hormone)
P"'ertP"'ertyy effecteffect hormonhormone of se*e of se*
the groth go on 0"iclythe groth go on 0"icly
stoppingstopping
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3a+2ar ;. @ur!a $au 5enai5an tinggi 2adan ana5 $a5i4$a5i
de M)nt2ei$$ard
Men#
ap
ait i n
ggi,#+
per t
a%un
--
-/
;. Fe+a$e pu2i# %air de!e$)p+ent. e!ual "aturit# ratin$ % (&R %) : Prepu2erta$B n) pu2i# %air.
SMR - 1 Straig%t %air i& e6tending a$)ng t%e $a2ia and, 2et(een rating& - and , 2egin& )n t%e
pu2i&. SMR 1 Pu2i# %air %a& in#rea&ed in uantit", i& dar5er, and i& pre&ent in t%e t"pi#a$ e+a$e
triang$e 2ut in &+a$$er uantit". &R ': Pu2i# %air %a& in#rea&ed in uantit", i& dar5er, and i& +)re
den&e, #ur$ed, and adu$t in di&tri2uti)n 2ut $e&& a2undant. &R :A2undant, adu$t4t"pe patternB
%air +a" e6tend )nt) t%e +edia$ a&pe#t ) t%e t%ig%&. 8Fr)+ Danie$ A, Pau$&%)#5 ?G. Ap%"&i#ian& guide t) &e6ua$ +aturit" rating. atient Care Ma" /,;99, (it% per+i&&i)n. I$$u&trati)n
2 Pau$ Sin %4R)
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Fig ;. Ma$e genita$ and pu2i# %air de!e$)p+ent. Rating& )r pu2i# %air and )r genita$ de!e$)p+ent #andier in a t"pi#a$ 2)" at an" gi!en ti+e, 2e#au&e pu2i# %air and genita$ia d) n)t ne#e&&ari$"de!e$)p at t%e &a+e rate. e!ual "aturit# ratin$ % (&R %): Prepu2erta$B n) pu2i# %air. 3enita$iaun#%anged r)+ ear$" #%i$d%))d. &R 2: Lig%t, d)(n" %air de!e$)p& $atera$$" and $ater 2e#)+e&dar5. Peni& and te&te& +a" 2e &$ig%t$" $argerB r)tu+ 2e#)+& +)re te6tured. &R * : Pu2i# %air%a& e6tended a#r)&& t%e pu2i&. Te&te& and r)tu+ are urt%er en$argedB peni& i& $arger, e&pe#ia$$"in $engt%. &R ' : M)re a2undant pu2i# %air (it% #ur$ing. 3enita$ia re&e+2$e t%)&e ) an adu$tBg$an& %a& 2e#)+e $arger and 2r)ader, r)tu+ i& dar5er. &R : Adu$t uantit" and patter+ )
pu2i# %air, (it% %air pre&ent a$)ng t%e inner 2)rder& ) t%e t%ig%&. T%e te&te& and t%e r)tu+ areadu$t in &ie. . 8Fr)+ Danie$ A, Pau$&%)#5 ?G. A p%"&i#ian& guide t) &e6ua$ +aturit" rating.4
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Fig ;9. Se6 +aturit" rating& ) 2rea&t #%ange& in ad)$eent gir$&. 8C)urte&" )
M Tanner, M.D., In&titute ) C%i$d Hea$t%, Depart+ent ) 3r)(t% and
De!e$)p+ent, Uni!er&it" ) L)nd)n, L)nd)n, Eng$and:
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Fig -/. A.Seuen#e ) pu2erta$ e!ent& in +a$e&. ?.Seuen#e ) pu2erta$
e!et& in e+a$e&. 8Fr)+ R))t A. End)#rin)$)g" ) pu2ert". +
ediatr ;9B
3ENITAL >
PU?IC HAIR 0
PU?IC HAIR
PU?IC HAIR -
3ENITAL
3ENITAL -
3ENITAL 0
PHV
?REAST >
MENARCHE
PU?IC HAIR >
?REAST 0
PU?IC HAIR 0
?REAST
?REAST -
PU?IC HAIR -
PHV
PU?IC HAIR
A ?
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Ch$d rowth
h$d rowth
Increases ofIncreases of physical sizesphysical sizes
1.1. heightheight2.2. weightweight3.3. head circumferencehead circumference4.4. etcetcIncreases of cells, matrixes, connective tissues,Increases of cells, matrixes, connective tissues,
bones, muscles, organ systems etc.bones, muscles, organ systems etc.
eterminant factors of growtheterminant factors of growth internal !internal !
geneticgenetic! father, mother, grandpa,! father, mother, grandpa,grandmagrandma
intrauterine processintrauterine process! nutrition, disease,! nutrition, disease,drug, polution, toxin ,drug, polution, toxin ,
externalexternal!!nutrition, disease, polution,nutrition, disease, polution,
exercise, emotional supportexercise, emotional support
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3ddition of 'ody length3ddition of 'ody length
&rimester I&rimester I : !8 2!2 cm /: !8 2!2 cm / monthsmonths
&imester II&imester II : 1!7 !. cm /: 1!7 !. cm / monthsmonths&rimester III&rimester III : 1!- 1!. cm /: 1!- 1!. cm / monthsmonths
&rimester I&rimester I : 1! 1!- cm /: 1! 1!- cm /monthsmonths
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I#f'e#(e of ge#et$( to
#f'e#(e of ge#et$( to
%od he$ght
od he$ght
Range of predictional final height at 18 years oldRange of predictional final height at 18 years old
Boys = (Boys = (Father + mother height + 13 cmFather + mother height + 13 cm )) ++ 8,5 cm8,5 cm22
Girls = (Girls = (Father + mother height 13 cm)Father + mother height 13 cm) ++8,5 cm8,5 cm
22
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Body weightBody weight
Infl"enced 'yInfl"enced 'y::
+eneti+eneticc((clanclan))
Intae n"tritionIntae n"trition((eateat!! drindrin!! ssnnacac))
3'sor'tion of intestine3'sor'tion of intestine escretionescretion
Physical activityPhysical activity
?eta'olism of the 'ody?eta'olism of the 'ody! hormon! hormonee
Chronic diseaseChronic disease((heart! "rinary tract infection!heart! "rinary tract infection!
t"'erc"losist"'erc"losis))
content ater and 'ody fatcontent ater and 'ody fat
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Additi)n ) 2)d"Additi)n ) 2)d"(eig%t(eig%t
&rimester I : =55 1555 gram/&rimester I : =55 1555 gram/monthmonth
&imester II : ;55 .55 gram/&imester II : ;55 .55 gram/
monthmonth
&rimester III : -;5 2;5 gram/&rimester III : -;5 2;5 gram/monthmonth
&imester I : ;5 -;5 gram/&imester I : ;5 -;5 gram/monthmonth
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Cir#u+eren#eCir#u+eren#e %ead%ead
Re$ating t) gr)(t% ) 2rain !)$u+eRe$ating t) gr)(t% ) 2rain !)$u+e
Cir#u+eren#e %ead +)re 2iggerCir#u+eren#e %ead +)re 2igger8+a8+a##r)r)##eep%a$"p%a$"::
J +i$d +enta$ retardati)n+i$d +enta$ retardati)n J J &e!ere +enta$&e!ere +enta$ retardaretardati)nti)n 88Lober 0Lober 0
riestl#riestl#, ;9
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Age 2rain20 weak ~ 100 g
Born ~ 400 g
18 month ~ 800 g
3 year ~ 1100 g
Adult ~ 1400 g
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.I
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. E@ ell no"rished ell no"rished
L 9 E@ "ntil - E@ mild9moderateL 9 E@ "ntil - E@ mild9moderate
maln"tritionmaln"trition
L 9 - E@ severe maln"tritionL 9 - E@ severe maln"trition
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Head C$r('"ferre#(e
ead C$r('"ferre#(e
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Head C$r('"ferre#(e
ead C$r('"ferre#(e
C'rves
'rves
Boys +irls
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/ead )ircumferrence
)) #acrocephal %follow up2F ys'!
-- normal IJ,) mild mental retardation, severe mental retardation%Dober riestly, 1-1'
#icrocephal !mentally retarded
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&&&% "e#elo$mental +creening
1#@
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1% "*N:* &&+ross motor4ine motor! vis"alEpeech! lang"age! hearing!
comm"nicationEocial! emotional! 'ehavio"r
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5$#ter!retas$+6
#ter!retas$+6
DormalDormal
9 delay (9)! ma* 1 C9 delay (9)! ma* 1 C
E"specE"spec
9 or more C and or 1 or more @9 or more C and or 1 or more @
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2 -*"&AT&) +.6-T'6+ )/*)7(&+T
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2% -*"&AT&) +.6-T'6+ )/*)7(&+T6ur$hy ! =ellineck 145
;or ages: 2 1' yearsContents :6$ items of child behaviour" answer by parent"$ minutes
never score +,sometimes score 1,often always score *,
Interpretation: score> *8 should be reffered
Good sensitivity & e@cellent specifity Glascoe" 1##',
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IV7 8a"$ ed'(at$o#
V7 8a"$ ed'(at$o#
+roth and development+roth and development
D"trition! imm"nisation! play! stim"lation!D"trition! imm"nisation! play! stim"lation!ed"cationed"cation
Protection from riss of :Protection from riss of : Bio9physics haFardBio9physics haFard:: infection! pol"tion!infection! pol"tion!
accident! addictionaccident! addiction Psychosocial haFardPsychosocial haFard:: a'"se! neglect!a'"se! neglect!
e*ploitatione*ploitation!!
Child Right ConventionChild Right Convention
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DISORDER
ISORDER
ROWTH-
ROWTH-
DEVELOP
EVELOP
@elay speech/lang"age@elay speech/lang"age
PalsyPalsy Cere'ralCere'ral
@on@onsindromesindrome Ehort stat"reEhort stat"re
a"tisa"tistic spectr"m disordertic spectr"m disorder
?ental retardation?ental retardation
3ttention defisit disorder hyperactifity (3@@%)3ttention defisit disorder hyperactifity (3@@%)
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