Chapter 3Chapter 3Normal Growth and Normal Growth and

DevelopmentDevelopment

Dr. Areefa AlbahriDr. Areefa Albahri

Growth and development are complex processes Growth and development are complex processes involving all the child’s body, mind, and involving all the child’s body, mind, and personality develop simultaneously, although not personality develop simultaneously, although not independently, and emerge at varying rates and independently, and emerge at varying rates and sequences. sequences.

All children are basically alike. They follow the All children are basically alike. They follow the same pattern of development and maturation, same pattern of development and maturation, while at the same time, their hereditary, while at the same time, their hereditary, cultural, and experiential backgrounds make cultural, and experiential backgrounds make each child distinct from every other child. each child distinct from every other child.

What is GrowthWhat is Growth

An increase in weight and size of An increase in weight and size of an individual caused by cell an individual caused by cell division and synthesis of new division and synthesis of new protein. protein.

It is It is quantitativequantitative change and can change and can be measured in cm. or kg. be measured in cm. or kg.

What is GrowthWhat is Growth DevelopmentDevelopment A gradual change from a simple to a A gradual change from a simple to a

complex functioning or capacity through complex functioning or capacity through growth, maturation, and learning. growth, maturation, and learning.

It is qualitative change that cannot be It is qualitative change that cannot be weighed or measured in cm, or kg. weighed or measured in cm, or kg.

It can be observedIt can be observed . . Development is a continuous process from Development is a continuous process from

conception to conception to maturity, Examples are: maturity, Examples are: Child sits before standing. Child sits before standing. Stand before walking. Stand before walking. Learn alphabet before wards. Learn alphabet before wards.

In Principles of growth and developmentIn Principles of growth and development : :

Development proceeds from the large to Development proceeds from the large to the small. the small.

Development proceeds from the center Development proceeds from the center of the body out. of the body out.

Development proceeds from head to Development proceeds from head to toe. Upper body muscles, neck, toe. Upper body muscles, neck, chest,arms, develop before lower body chest,arms, develop before lower body muscles. muscles.

Development is orderly.Development is orderly. Development occurs in stages. Development occurs in stages.

Growth chartGrowth chart A growth chart is used to measure and A growth chart is used to measure and

compare a child's growth with what is compare a child's growth with what is considered normal for that child's age and considered normal for that child's age and gender. gender.

The Growth chart measurements are compared The Growth chart measurements are compared with the standard (normal) range for children with the standard (normal) range for children of the same gender and age. of the same gender and age.

The measurements are important because they The measurements are important because they may provide an early warning that the child may provide an early warning that the child has a medical problem. has a medical problem.

For instance, during the first 18 months of life For instance, during the first 18 months of life and particularly during early infancy, abnormal and particularly during early infancy, abnormal growth of the head can alert to a problem. growth of the head can alert to a problem.

Head circumference growth that is too Head circumference growth that is too rapid may be a sign of hydrocephalus rapid may be a sign of hydrocephalus (water around the brain), a brain tumor, (water around the brain), a brain tumor, or other conditions that cause or other conditions that cause macrocephaly (abnormally large head). macrocephaly (abnormally large head). Growth that is too slow may be a sign of Growth that is too slow may be a sign of problems in brain development, early problems in brain development, early fusion of sutures (the bones of the skull), fusion of sutures (the bones of the skull), or other problems. Insufficient gain in or other problems. Insufficient gain in weight, height, or a combination may weight, height, or a combination may indicate failure-to thrive, chronic illness, indicate failure-to thrive, chronic illness, neglect, or other problems. neglect, or other problems.

Failure-to-thrive: Failure-to-thrive: The most common definition is The most common definition is

weight less than the third to weight less than the third to fifth percentile for age on more fifth percentile for age on more than one occasion or weight than one occasion or weight measurements that fall 2 major measurements that fall 2 major percentile lines using the percentile lines using the standard growth charts. standard growth charts.

curve on this chart represents what curve on this chart represents what children are of the same height and children are of the same height and weight. The 50th percentile represents weight. The 50th percentile represents the median height and weight for each the median height and weight for each age group, so that 50% of children will age group, so that 50% of children will be above this point and 50% will be be above this point and 50% will be below it. below it.

If a two year old boy weighed at the If a two year old boy weighed at the 10th percentile for his weight at this 10th percentile for his weight at this age. This means that 90% of two year age. This means that 90% of two year old boys weigh more than him, but it old boys weigh more than him, but it also means that he weighs more than also means that he weighs more than 10% of children of this same age. 10% of children of this same age.

Developmental Age Developmental Age PeriodPeriod -; -;

1. 1. Prenatal period Prenatal period - From - From conception to birth, divided into:- conception to birth, divided into:-

a.a. Germinal Germinal - conception to - conception to approximately 2-3 weeks . approximately 2-3 weeks .

b. b. EmbryonicEmbryonic - From 3 - 8 weeks. - From 3 - 8 weeks. c. c. FetalFetal - From 8 - 40 weeks (birth). - From 8 - 40 weeks (birth). 2. Infancy period2. Infancy period:- From birth to :- From birth to

12 12 oror 18 month:- 18 month:- a. a. neonatalneonatal:- From birth to 28 days. :- From birth to 28 days. bb. infancy. infancy:- From 1 to 12 months. :- From 1 to 12 months.

3. Early childhood: 1 to 6 years 3. Early childhood: 1 to 6 years divided into:- divided into:-

a. Toddler 1 to 3 years. a. Toddler 1 to 3 years. b. Preschooler 3 to 6 years. b. Preschooler 3 to 6 years. 4. Middle childhood: 6 to 11 or 12 4. Middle childhood: 6 to 11 or 12

years. (School age). years. (School age). 5. Later childhood: 11 to 19 years. 5. Later childhood: 11 to 19 years. a. Prepupertal period 11 to 13 years. a. Prepupertal period 11 to 13 years. b. Adolescence: From13 to b. Adolescence: From13 to

approximately 18 years. approximately 18 years.

Growth and development are Growth and development are affected by a variety of conditions affected by a variety of conditions and circumstances including: and circumstances including:

Genetic makeup Genetic makeup Sex of the child. Sex of the child. Environment: physical Environment: physical

environment/climate, nutrition and environment/climate, nutrition and exposure to infection exposure to infection

Interpersonal relationships/ Interpersonal relationships/ Socioeconomic level Socioeconomic level

Height/ LengthHeight/ Length

Height: Height: is the crown-heel measurement in is the crown-heel measurement in standing position. ―After 5 years of life‖ standing position. ―After 5 years of life‖

LengthLength: : is the crown-heel measurement in is the crown-heel measurement in recumbent position. ―From birth to 5 recumbent position. ―From birth to 5 years of life‖ years of life‖

Birth length average is 50 cm, at 1 year is 75 Birth length average is 50 cm, at 1 year is 75 cm, is doubled at 4 years of age and tripled by cm, is doubled at 4 years of age and tripled by age of 13 years. age of 13 years.

Formula: length (cm) after the Formula: length (cm) after the 4th year 4th year =age((y) x5 +80=age((y) x5 +80

Weight: Weight: It is the best index of nutrition and growth. It is the best index of nutrition and growth. Average birth weight is 2.5- 4 Kg. At birth baby Average birth weight is 2.5- 4 Kg. At birth baby

loses up to 10% of birth weight in the first 3-4 loses up to 10% of birth weight in the first 3-4 days of life due to loses of meconium, urine, days of life due to loses of meconium, urine, edema fluid and less intake. Regains his birth edema fluid and less intake. Regains his birth weight by 10-14 days of age. If loss was more weight by 10-14 days of age. If loss was more than 10%, or last more than 14 days, it is than 10%, or last more than 14 days, it is considered pathological. considered pathological.

Infant gains 680 gm each month in the first 6 Infant gains 680 gm each month in the first 6 month. Birth weight doubles by 4-7 months, and month. Birth weight doubles by 4-7 months, and triples by the end of the first year. triples by the end of the first year.

Formula: Weight (2-7 years) = age(y) x 2 + 8 Formula: Weight (2-7 years) = age(y) x 2 + 8 Weight (8-12 years) = age (y) x 3 Weight (8-12 years) = age (y) x 3

Neonatal Reflexes (Primitive Neonatal Reflexes (Primitive Reflexes)Reflexes)

Most of the newborn’s physical behavior Most of the newborn’s physical behavior appears to be reflexive in nature, as the appears to be reflexive in nature, as the newborn’s nervous system matures these newborn’s nervous system matures these reflexes disappear and are replaced by more reflexes disappear and are replaced by more voluntary, coordinated movements. voluntary, coordinated movements.

Moro reflex Moro reflex Present at birth and disappears by 3-6 Present at birth and disappears by 3-6

months of age. months of age. Absent reflex in brain-damaged babies, Absent reflex in brain-damaged babies,

depressed babies due to narcotics at birth. depressed babies due to narcotics at birth. Persistent reflex in cerebral palsy (C.P.). Persistent reflex in cerebral palsy (C.P.).

Stepping reflex Stepping reflex Appears at birth and disappear by 6 Appears at birth and disappear by 6

months of age. months of age. Suckling reflex: elicited by stroking Suckling reflex: elicited by stroking

of lips. Present at birth and persist 9 of lips. Present at birth and persist 9 months months

Rooting reflex Rooting reflex Hand Opening: Hand Opening: Grasp reflex Grasp reflex Babinski’s sign Babinski’s sign

Thank You AllThank You All

Any Question ??????Any Question ??????