1. بسم الله الرحمن الرحيم

2. Growth &Development

3. Fetal Growth & Devloment
Pregnancy is actually 280 days, or 40 weeks measured from the first day of the last menstrual period,, divided into three trimesters.
The fetus develops over many months’ time, but the first few months are the most critical.
All baby’s major organs begin forming in the early weeks of pregnancy, some even before realizing pregnancy.
Therefore, mother's health, nutrition, and avoidance of harmful substances are important even before pregnancy begins.
Anything mothers eat, drink, breathe, or touch can affect baby’s development, especially in the very sensitive period beginning at conception.

4. Growth & Development
-They are two terms refer to continuous dynamic processes occurring from conception to maturity and follow certain dynamic sequences.
-They are parallel to each other in normal child
-They are consistent, predictable and sequential

5. Growth
It is an increase of physical size of the whole body or organ of different parts of the body.
It is an increase of the number and the size of each individual cell
The measuring scales are related to:
weight which is measured by Kg., gm or pound, Ounce.
Height Which is measured by Cm, Feet.

6. Normal Growth of young children
Regular measurements of child's height, weight and head circumference and plotting them on a growth chart are a good way to see if the child is growing normally.
Although many parents are preoccupied by where their child is on the growth charts and often worry if their child is small or near the bottom of the growth chart, it is child's rate of growth that is the most important factor to consider when evaluating if child is growing and developing normally.
If child is following his growth curve, then he is likely growing normally

7. Growth charts

9. Also keep in mind that some children can normally move up or down on their growth curves when they are 6-18 months old.
As long as they are not actually losing weight, and they have no other symptoms, such as persistent diarrhea, vomiting, poor appetite or having frequent infections, then it may be normal to move down on your growth percentiles.
Older children should stick to their growth curves fairly closely though.

10. General guidlines
for younger child
growth rates

11. The majority of babies born full-term ,
i.e. 40 weeks (280 days), weight from just over 2.6 to 3.8 kilos , and they are between
cm long, head circumference is between 34 – 40 cm.
Infants born before the completion of 37 weeks of gestation are called premature.

12. continue.
Weight
2 weeks regains birth weight and then gains about 1 1/2 - 2 pounds a month
3 months - gains about 1 pound a month
5 months - doubles birth weight
1 year triples birth weight and then gains about 1/2 pound a month
2 years quadruples birth weight and then gains about 4-5 pounds a year
9-10 years - increased weight gain as puberty approaches, often about 10 pounds a year

13. 0-12 months - grows about 10 inches (25 cm).
Height
0-12 months - grows about 10 inches (25 cm).
1-2 years - grows about 5 inches (13 cm).
2-3 years - grows about 2 1/2 inches( 8 cm) a year.
Most children will double their birth height by 3-4
years of age.
3 years to puberty - grows about 2 inches (5cm) a
year

14. Head Circumference 0→3 Months - ↑ 2 centimeters a month
6→12 Months -↑ 1/2 centimeter a month
1→ 2 Years ↑ 2 centimeters a year

15. Remember
that these are general guidelines though that the child may grow a little more or a little less than this each year.

16. Factors Affecting Growth
Mother‘s health during pregnancy.
Period of pregnancy.
Multiplication of labor.
Gender.
Nutritional factors.
Health status of the baby.

17. Development
It is a progressive increase in skill and capacity of function.
i.e increase of functional activity, indicates development
of millstones. (The ability to achieve specific function
at certain age)
It is measured by specific scales that determines the different
age to achieve certain function.
e.g.:
Test form with 105 items for
The Denver Development Screening Test,
Test of Motor Proficiency for
Bruininks – Oseretesky. Form for eight subtests.

18. The Denver Development Screening Test (DDST)
It includes 4 areas of development :
1.Personal – social : the child ability to get along with people and to take care of himself .
2. Fine – motor adaptive : the child ability to see and use his hands to pick up objects and to draw .

19. 3. Language : the child ability to hear , to follow directions and to speak .
4. Gross – motor : the child ability to sit , walk and jump .
It was performed on children from birth to 6 years .
It has 105 items and the scoring is as follow : P = pass , F = failure , R = refusal , N.O. = no opportunity .

20. Bruininks – Oseretesky Test of Motor Proficiency (BOT)
It is designed to assess gross and fine motor functions in children from 4.5 – 14.5 years . It included 8 subtests comprised of 46 separate items .

21. The subtests are running speed & agility , balance , bilateral co-ordination , strength (gross – motor skills) , limb co-ordination (gross and fine motor skills ) , response speed , visual motor control , upper limb speed and dexterity ( fine motor skills) .

22. Development depends on the maturation of the C.N.S.
Mylination of C.N.S. Is complete by the end of the first year of age.
Mylination without skills→→ Retardation
Skills without mylination →→no function

23. Patterns of growth and development
1st pattern of development
A cephalocaudal direction
or from head to tail. The head of the fetus initially forms more completely than the body and limbs. Then the trunk and limbs of the fetus develop. In following this pattern after birth, the infant develops beginning head control before learning to control the trunk or limbs functionally. Development moves downward with the child learning to control the upper trunk before the lower and using the eyes to engage the environment before learning the skills to use the hands to grasp and manipulate.

24. 2nd pattern of development.
From the center outward,
or proximal to distal.
The fetus develops the spinal cord and trunk , as limb buds are barely formed. As the fetus develops, the limb buds continue to grow into fully formed limbs and the peripheral nerves form to provide sensory data to the central nervous system, the brain.
The infant follows the same patter of proximal to distal development, with the brain growth fastest in the first few years of life when the development of more fine control of limbs is still emerging. As the child grows, the movements of the limbs become more refined and the child develops specific skills, such as throwing, writing. And dancing

25. 3rd Pattern of development
From general to the specific,
or from simple to more complex.
As the fetus grows, undifferentiated cells migrate to specific location in the fetus and take on specific roles (brain cells, skin, blood). In the developing child, this pattern is also strong. The child learns general skills first; for example, the child will cry to communicate. General communication strategies are refined to specific language over time. Limb movements start out as gross patterns that are directed by reflexes, and mature into skilled movements that are functional for life and safety such as running, jumping and climbing.

26. Stages of growth and develpment

27. Stages of growth and develpment
Prenatal Stage:
About 40 weeks (280 days), from conception to
birth . Infants born before the completion of 37
weeks of gestation are called premature infants.
Fetal Stage : After 8 weeks of gestation to birth.
Postnatal Stage
Neonatal Stage : From birth to 4 weeks of age.
Infant Stage : 4 weeks through 12 months of age
Toddler : 13th months through 2 years of age
Early childhood : From 2 years Through 6 years of age
Middle childhood : From 6 years Through 12 years of age
Adolescence : From 12 years of age up to 18 years.

28. Parameters of development
Biological development is related to enzyme systems that stimulate complex metabolic changes.
Psychological development refers to cognitive and effective ( emotional)
Social development provides child to live in community.
All the parameters of development affect one another.

29. Normal new born baby Characters of full term baby:
Should be delivered at or near term (after 40 weeks of pregnancy)
Free from any congenital defects or obstetrical changes.
Healthy pink color.
His or her heart rate is beats / min.
Breaths spontaneously and cries lustily
Position in prone lying, with head turned one side and arms, legs are flexed. (Flexion attitude).

30. 7. On ventral suspension, no head control (head lag)
8. Has a skeletal muscle tone.
↑muscle tone in both upper and lower extremities due to unmylination of the pyramidal tract.
9. The fist of the hands are clenched and the thumb inside the palm