Chapter 3 Normal Growth and Development Dr. Areefa Albahri

Growth and development are complex processes involving all the child’s body, mind, and personality develop simultaneously, although not independently, and emerge at varying rates and sequences. Growth and development are complex processes involving all the child’s body, mind, and personality develop simultaneously, although not independently, and emerge at varying rates and sequences. All children are basically alike. They follow the same pattern of development and maturation, while at the same time, their hereditary, cultural, and experiential backgrounds make each child distinct from every other child. All children are basically alike. They follow the same pattern of development and maturation, while at the same time, their hereditary, cultural, and experiential backgrounds make each child distinct from every other child.

What is Growth What is Growth An increase in weight and size of an individual caused by cell division and synthesis of new protein. An increase in weight and size of an individual caused by cell division and synthesis of new protein. It is quantitative change and can be measured in cm. or kg. It is quantitative change and can be measured in cm. or kg.

What is Growth Development A gradual change from a simple to a complex functioning or capacity through growth, maturation, and learning. A gradual change from a simple to a complex functioning or capacity through growth, maturation, and learning. It is qualitative change that cannot be weighed or measured in cm, or kg. It is qualitative change that cannot be weighed or measured in cm, or kg. It can be observed. It can be observed. Development is a continuous process from conception to maturity, Examples are: Development is a continuous process from conception to 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 development : In Principles of growth and development : Development proceeds from the large to the small. Development proceeds from the large to the small. Development proceeds from the center of the body out. Development proceeds from the center of the body out. Development proceeds from head to toe. Upper body muscles, neck, chest,arms, develop before lower body muscles. Development proceeds from head to toe. Upper body muscles, neck, chest,arms, develop before lower body muscles. Development is orderly. Development is orderly. Development occurs in stages. Development occurs in stages.

Growth chart A growth chart is used to measure and compare a child's growth with what is considered normal for that child's age and gender. A growth chart is used to measure and compare a child's growth with what is considered normal for that child's age and gender. The Growth chart measurements are compared with the standard (normal) range for children of the same gender and age. The Growth chart measurements are compared with the standard (normal) range for children of the same gender and age. The measurements are important because they may provide an early warning that the child has a medical problem. The measurements are important because they may provide an early warning that the child has a medical problem. For instance, during the first 18 months of life and particularly during early infancy, abnormal growth of the head can alert to a problem. For instance, during the first 18 months of life and particularly during early infancy, abnormal growth of the head can alert to a problem.

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

Failure-to-thrive: Failure-to-thrive: The most common definition is weight less than the third to fifth percentile for age on more than one occasion or weight measurements that fall 2 major percentile lines using the standard growth charts. The most common definition is weight less than the third to fifth percentile for age on more than one occasion or weight measurements that fall 2 major percentile lines using the standard growth charts.

curve on this chart represents what children are of the same height and weight. The 50th percentile represents the median height and weight for each age group, so that 50% of children will be above this point and 50% will be below it. curve on this chart represents what children are of the same height and weight. The 50th percentile represents the median height and weight for each age group, so that 50% of children will be above this point and 50% will be below it. If a two year old boy weighed at the 10th percentile for his weight at this age. This means that 90% of two year old boys weigh more than him, but it also means that he weighs more than 10% of children of this same age. If a two year old boy weighed at the 10th percentile for his weight at this age. This means that 90% of two year old boys weigh more than him, but it also means that he weighs more than 10% of children of this same age.

Developmental Age Period;- 1. Prenatal period - From conception to birth, divided into:- 1. Prenatal period - From conception to birth, divided into:- a. Germinal - conception to approximately 2-3 weeks. a. Germinal - conception to approximately 2-3 weeks. b. Embryonic - From weeks. b. Embryonic - From weeks. c. Fetal - From weeks (birth). c. Fetal - From weeks (birth). 2. Infancy period:- From birth to 12 or 18 month:- 2. Infancy period:- From birth to 12 or 18 month:- a. neonatal:- From birth to 28 days. a. neonatal:- From birth to 28 days. b. infancy:- From 1 to 12 months. b. infancy:- From 1 to 12 months.

3. Early childhood: 1 to 6 years divided into:- 3. Early childhood: 1 to 6 years 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 years. (School age). 4. Middle childhood: 6 to 11 or 12 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 approximately 18 years. b. Adolescence: From13 to approximately 18 years.

Growth and development are affected by a variety of conditions and circumstances including: Growth and development are affected by a variety of conditions and circumstances including: Genetic makeup Genetic makeup Sex of the child. Sex of the child. Environment: physical environment/climate, nutrition and exposure to infection Environment: physical environment/climate, nutrition and exposure to infection Interpersonal relationships/ Socioeconomic level Interpersonal relationships/ Socioeconomic level

Height/ Length Height: is the crown-heel measurement in standing position. ―After 5 years of life ‖ Height: is the crown-heel measurement in standing position. ―After 5 years of life ‖ Length: is the crown-heel measurement in recumbent position. ―From birth to 5 years of life ‖ Length: is the crown-heel measurement in recumbent position. ―From birth to 5 years of life ‖ Birth length average is 50 cm, at 1 year is 75 cm, is doubled at 4 years of age and tripled by age of 13 years. Birth length average is 50 cm, at 1 year is 75 cm, is doubled at 4 years of age and tripled by age of 13 years. Formula: length (cm) after the 4th year =age((y) x5 +80 Formula: length (cm) after the 4th year =age((y) x5 +80

Weight:  It is the best index of nutrition and growth.  It is the best index of nutrition and growth.  Average birth weight is Kg. At birth baby loses up to 10% of birth weight in the first 3-4 days of life due to loses of meconium, urine, edema fluid and less intake. Regains his birth weight by days of age. If loss was more than 10%, or last more than 14 days, it is considered pathological.  Average birth weight is Kg. At birth baby loses up to 10% of birth weight in the first 3-4 days of life due to loses of meconium, urine, edema fluid and less intake. Regains his birth weight by days of age. If loss was more than 10%, or last more than 14 days, it is considered pathological.  Infant gains 680 gm each month in the first 6 month. Birth weight doubles by 4-7 months, and triples by the end of the first year.  Infant gains 680 gm each month in the first 6 month. Birth weight doubles by 4-7 months, and triples by the end of the first year.  Formula: Weight (2-7 years) = age(y) x  Formula: Weight (2-7 years) = age(y) x Weight (8-12 years) = age (y) x 3 Weight (8-12 years) = age (y) x 3

Neonatal Reflexes (Primitive Reflexes) Most of the newborn’s physical behavior appears to be reflexive in nature, as the newborn’s nervous system matures these reflexes disappear and are replaced by more voluntary, coordinated movements. Most of the newborn’s physical behavior appears to be reflexive in nature, as the newborn’s nervous system matures these reflexes disappear and are replaced by more voluntary, coordinated movements. Moro reflex Moro reflex  Present at birth and disappears by 3-6 months of age.  Present at birth and disappears by 3-6 months of age.  Absent reflex in brain-damaged babies, depressed babies due to narcotics at birth.  Absent reflex in brain-damaged babies, 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 months of age. Appears at birth and disappear by 6 months of age. Suckling reflex: elicited by stroking of lips. Present at birth and persist 9 months Suckling reflex: elicited by stroking of lips. Present at birth and persist 9 months Rooting reflex Rooting reflex Hand Opening: Hand Opening: Grasp reflex Grasp reflex Babinski’s sign Babinski’s sign

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