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GROWTH &
DEVELOPMENT
Growth                 Development
It is change in size/weight      A gradual change in
resulting from an increase in    advancement/function from
number or size of cells.         lower to higher stage

It is Quantitative               It is Qualitative



It is measured in terms of       It is assessed in terms of
centimeters or Kgs               acquisition of skills and ability


                        Maturation
          • It is increase in competence and adaptability
FACTORS AFFECTING GROWTH AND
                    DEVELOPMENT


Prenatal            Neonatal             Postnatal

Genetic potential                               Sex

                           LBW           Hormonal Influence
   Genetic
 abnormalities
                                             Nutritional
      Sex
                                              Infection
 Fetal / growth
  hormones                                    Trauma
                     Neonatal Seizures

Placental Factors                         Socioeconomical
                                             Influences
ASSESSMENT OF GROWTH OF
             CHILD
  Anthropometry:
It is most common method used it includes:
      Weight
      Height/Length

      Head Circumference

      Mid-Arm Circumference

      Chest Circumference
WEIGHT:

  It is total of all organ, tissue and fluids.
   Method :
          Nude/ Minimal light clothing:
          Lever or electronic type of weighing scale
                       ~ or less than         Double the    TRIPLE THE   FOUR TIMES
3 kg                   3kg                                  WEIGHT       THE WEIGHT
                                              Weight
  • BIRTH                  • 3 -10 DAY           • 4          • 12         • 2 YEAR
    WEIGHT                                         MONTHS       MONTHS




           AGE               FORMULATIONS FOR CALCULATIONS

           3-12              Age (m) +9/2
           Months
           1-6 Years         Age (y) x 2 +8

           7-12 Years        Age x 7 - 5
HEIGHT/LENGTH:
    Height : ( >2 years)

        • Vertical distance between head and heel of foot
        • Measured in erect standing posture by stadiometer
        • Formula: Age (y) x 6 +77

    Length: (<2 years)
        • Measured in lying down position.
                           Upper – Head-Pubis
        • Total Length     Lower – Pubis - Toe
                           U/L – 1:7 -birth
                                 1:1 -7year
                                                                 Until
 At                1st              2-3           4th
Birth             year             year          year           puberty
        50 cm            75cm             90cm          100cm
                                                                     5cm/year
HEAD CIRCUMFERENCE

    It is an estimate of brain growth
    Most useful in 2 years of life
    Method:
               Use a non-stretchable tape on occipital protuberance to the
                supra-orbital ridges on forehead
    Clinical corelate:
               Microcephaly
               Macrocephaly
               Cranisynostosis
     At                     2nd                6th               9th
    Birth                  month             month              month
            35 cm                   41 cm             44 cm             46 cm


                              1st               2nd
                             year              year
                                     47 cm             49 cm
CHEST CIRCUMFERENCE
   It is clinically important in the 5th year of life.

   Method:
        Measure at the level of nipples midway between
         expiration and inspiration by Cross-tape method.


                                                  later it
    At Birth CC            At 1st year
                                                exceeds i.e
       < HC                 HC=CC
                                                 CC>HC
MILESTONES

Gross motor    Fine motor
Development   Development




 Social and       Key
  Adaptive     Language
 Milestone     Milestone
THROUGH AGE OF 1 MONTH – 9 MONTH
AGE           GROSS MOTOR             FINE MOTOR
              DEVELOPMENT             DEVELOPMENT
1-2 Month     Moves extremity
              equally

3 Month       Neck Holding            “Hand regard”
                                      Observes his own hand very
                                      intensely

4 Month       Sit with support        “Bidextrous Reach”


5 Month       Roll over


6 -7 Month    Sit in tripod fashion   Transfer object
                                      from Hand to hand

8 Month       Sit without support


9 Month       Stands holding with Probes with Finger               No Sitting without
              support                                              support
THROUGH AGE OF 12 MONTH – 5 YEARS
AGE           GROSS MOTOR           FINE MOTOR
              DEVELOPMENT           DEVELOPMENT

12 Month         Stand without      Mature Pinser Grasp
                    Support

15 Month      “ Toddler can Walk”   Imitates Scribbling,    Not Standing
                                     Tower of 2 blocks         Alone
18 Month            Runs             Makes Tower of 3       Not Walking
                                         blocks               Alone
2 years       Walks Up and Down     Vertical and Circular
                    Stairs                 strokes
3 years         Ride Tricycles       Makes Cirlce and
                                     Tower of 9 Blocks

4 years        Hops on One Foot       Makes A Cross


5 years         Skip, dress and      Copies a Triangle
                    undress
THROUGH AGE OF 1 MONTH – 9 MONTH
AGE         SOCIAL AND                  KEY LANGUAGE
            ADAPTIVE                    MILESTONES
            MILESTONES
1Month      Regards face and            Alert in Sound
            follow moving object
            with eyes
2 Month     Social Smile (after being                        No Visual
            talked to)                                       fixation
3 Month     Recognize Mother            Musical Sound
                                        and coos
4 Month                                 Laugh Loud

5 Month                                 Orient to voice

6-7 Month   Recognize Stranger          Monosyllable         No vocalization
            “Stranger Anxiety”          Babbles (Ma, Pa)
8 Month

9 Month     Waves “Bye- Bye”            Bisyllable Babbles
                                        (Mama, Baba)
THROUGH AGE OF 12 MONTH – 5 YEARS
AGE         SOCIAL AND             KEY LANGUAGE
            ADAPTIVE               MILESTONES

12 Month    Comes when Called      1-2 words with
            to.                    meaning and
                                   understand “No”
15 Month    Jargon

18 Month    “ Copies Parent”       8-10 word
                                   vocabulary
2 years     Ask for food, drink and Use a 2-3 word
            toilet                  sentence
3 years     Group Play , know      Ask Questions     Lack of
            Full name and gender                     imaginative Play

4 years     Plays Cooperatively    Sing songs or
                                   poem
5 years     Helps in house hold    Ask meaning of
            task                   words

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Child's Normal Growth & Development

  • 2. Growth Development It is change in size/weight A gradual change in resulting from an increase in advancement/function from number or size of cells. lower to higher stage It is Quantitative It is Qualitative It is measured in terms of It is assessed in terms of centimeters or Kgs acquisition of skills and ability Maturation • It is increase in competence and adaptability
  • 3. FACTORS AFFECTING GROWTH AND DEVELOPMENT Prenatal Neonatal Postnatal Genetic potential Sex LBW Hormonal Influence Genetic abnormalities Nutritional Sex Infection Fetal / growth hormones Trauma Neonatal Seizures Placental Factors Socioeconomical Influences
  • 4. ASSESSMENT OF GROWTH OF CHILD  Anthropometry: It is most common method used it includes:  Weight  Height/Length  Head Circumference  Mid-Arm Circumference  Chest Circumference
  • 5. WEIGHT: It is total of all organ, tissue and fluids.  Method :  Nude/ Minimal light clothing:  Lever or electronic type of weighing scale ~ or less than Double the TRIPLE THE FOUR TIMES 3 kg 3kg WEIGHT THE WEIGHT Weight • BIRTH • 3 -10 DAY • 4 • 12 • 2 YEAR WEIGHT MONTHS MONTHS AGE FORMULATIONS FOR CALCULATIONS 3-12 Age (m) +9/2 Months 1-6 Years Age (y) x 2 +8 7-12 Years Age x 7 - 5
  • 6. HEIGHT/LENGTH: Height : ( >2 years) • Vertical distance between head and heel of foot • Measured in erect standing posture by stadiometer • Formula: Age (y) x 6 +77 Length: (<2 years) • Measured in lying down position. Upper – Head-Pubis • Total Length Lower – Pubis - Toe U/L – 1:7 -birth 1:1 -7year Until At 1st 2-3 4th Birth year year year puberty 50 cm 75cm 90cm 100cm 5cm/year
  • 7. HEAD CIRCUMFERENCE  It is an estimate of brain growth  Most useful in 2 years of life  Method:  Use a non-stretchable tape on occipital protuberance to the supra-orbital ridges on forehead  Clinical corelate:  Microcephaly  Macrocephaly  Cranisynostosis At 2nd 6th 9th Birth month month month 35 cm 41 cm 44 cm 46 cm 1st 2nd year year 47 cm 49 cm
  • 8. CHEST CIRCUMFERENCE  It is clinically important in the 5th year of life.  Method:  Measure at the level of nipples midway between expiration and inspiration by Cross-tape method. later it At Birth CC At 1st year exceeds i.e < HC HC=CC CC>HC
  • 9.
  • 10. MILESTONES Gross motor Fine motor Development Development Social and Key Adaptive Language Milestone Milestone
  • 11. THROUGH AGE OF 1 MONTH – 9 MONTH AGE GROSS MOTOR FINE MOTOR DEVELOPMENT DEVELOPMENT 1-2 Month Moves extremity equally 3 Month Neck Holding “Hand regard” Observes his own hand very intensely 4 Month Sit with support “Bidextrous Reach” 5 Month Roll over 6 -7 Month Sit in tripod fashion Transfer object from Hand to hand 8 Month Sit without support 9 Month Stands holding with Probes with Finger No Sitting without support support
  • 12. THROUGH AGE OF 12 MONTH – 5 YEARS AGE GROSS MOTOR FINE MOTOR DEVELOPMENT DEVELOPMENT 12 Month Stand without Mature Pinser Grasp Support 15 Month “ Toddler can Walk” Imitates Scribbling, Not Standing Tower of 2 blocks Alone 18 Month Runs Makes Tower of 3 Not Walking blocks Alone 2 years Walks Up and Down Vertical and Circular Stairs strokes 3 years Ride Tricycles Makes Cirlce and Tower of 9 Blocks 4 years Hops on One Foot Makes A Cross 5 years Skip, dress and Copies a Triangle undress
  • 13. THROUGH AGE OF 1 MONTH – 9 MONTH AGE SOCIAL AND KEY LANGUAGE ADAPTIVE MILESTONES MILESTONES 1Month Regards face and Alert in Sound follow moving object with eyes 2 Month Social Smile (after being No Visual talked to) fixation 3 Month Recognize Mother Musical Sound and coos 4 Month Laugh Loud 5 Month Orient to voice 6-7 Month Recognize Stranger Monosyllable No vocalization “Stranger Anxiety” Babbles (Ma, Pa) 8 Month 9 Month Waves “Bye- Bye” Bisyllable Babbles (Mama, Baba)
  • 14. THROUGH AGE OF 12 MONTH – 5 YEARS AGE SOCIAL AND KEY LANGUAGE ADAPTIVE MILESTONES 12 Month Comes when Called 1-2 words with to. meaning and understand “No” 15 Month Jargon 18 Month “ Copies Parent” 8-10 word vocabulary 2 years Ask for food, drink and Use a 2-3 word toilet sentence 3 years Group Play , know Ask Questions Lack of Full name and gender imaginative Play 4 years Plays Cooperatively Sing songs or poem 5 years Helps in house hold Ask meaning of task words