GROWTH AND DEVELOPMENT Dr.Khalid Hama salih, Pediatrics specialist M.B.Ch.; D. C.H F.I.B.M.S.ped
Why Growth & developmental assessment? • To know normal growth& development • To improve the early identification of children with growth and developmental problem. ?
growth growth : is a an anatomical process involving increase in the physical size of an organ, tissue& body, by multiplication or enlargement of cell . It can be measure by anthropematric measure. Accurate measurement of growth is a vital part of the assessment of children
Development: Development: physiological or functional maturation of various organ or system, acquisitionof neweror skill & adaptation to environment ,is differentiation in function. G&D Although they are presented separately, they are closely correlated entities.
Infancy Neonate Birth to 1 month Infancy 1 month to 1 year Early Childhood Toddler 1-3 years Preschool 3-6 years Middle Childhood School age 6 to 12 years Late Childhood Adolescent 13 years to approximately 18 years Stages of Growth and Development
Growth& development genetic Growth &development socioeconomic Iuf& prenatal c chronic disease emotional nutritional Env.&seasonal Growth potential l hormonal factor
Principles of growth & development 1.Growth& development is continuous &orderly process. 2.Pattern of growth is different in different body tissue 3.Pace of growth is unique for every child 4.Growth and development are influences by a multiple factors
Cont……….. 5.The child’s pattern of growth is in a head-to-toe direction, or cephalocaudal, and in an inward to outward pattern called proximodistal. 6.The acquisition of gross motor skill precedes the development of fine motor skills.
ANTI-GRAVITY MOVEMENTS HEAD TRUNK LOWER EXTREMITY
Growth assessment is a 4 step a.recording of appropriate parameterb. comparing this value with reference c.serial recording &put on chart to assess growth velocityd. interpretation & convey the information to parent as well as suitable remedial action
Growth Length • The child should be measured lying down until 2 years of age • Measuring the length of infants requires skill • Use proper equipment and two people to hold the child
Growth Height • Use a properly calibrated standing frame • The child should be measured barefoot with knees straight and feet flat on the floor • Stretch the child gently and read the measurement
Growth • Weight • Scales must be calibrated accurately • Babies should be weighed naked (no nappy!) • Older children should be weighed in underwear only
Growth • Height or Length, Gains length in 1 year: • 0__3m: 4cm/m • 3__6m:2cm/m • 6___12m:1cm/m • average length at birth 50 cm at 1 year 75 cm. 2 – 12 years age (in years) x 6 + 77 • Average annual height increase; is 6 cm/yr between 4 yr and puberty • Parental ht is an important determinant of their childrens height ,ht of aboye at 2 year & girls at 2.5 is nearly half of the adult height +-5
Growth • Weight:Weight loss in the first few days of life; 5-10% of birth weight. • This will return to birth weight by 7-10 days average weight at birth 3.250Kg. 3 -12 months of age age (in months)+9 2 1 - 6 years age (in years) x 2 + 8 7 – 12 years age (in years) x 7 -5 2
Growth • Head circumference • Use flexible non-stretchable tape • Obtain three successive measurements and take the largest to be the occipito frontal circumference (OFC
Growth • Head circumference in 1st year of life 1st 3m of age each m 2cm 2nd 3m of age each m 1cm Last 6m of age each m 0.5cm average OFC at birth 35 cm. at 3 months 41 cm. at 6 months 44 cm. at 1 year 47 cm. at 2 year 49 cm. at 3 year 50.5 cm.
When we examine the child’s growth we usually measure his Height, weight, and head circumference, then we plot them on the corresponding growth charts according to the child’s age and sex e.g Rand is a 2 year old boy having a health supervision visit,he is perfectly healthy during the exam, his height is 90 cm, his weight is 12.5 kg, his head circumference is 48 cm.
Summery: • Growth is: continuous& quantitative change. Development:= = = = =&Qualitative change. Factors affect growth & development Principles of growth & development ?