1. Postnatal Growth & Maturation

2. Growth & Maturation GROWTH MATURATION
Increase in size of tissue or organ
Hypertrophy
Auxetic – increased cell size
Accretionary – increased extracellular constituents
Hyperplasia
Multiplicative – increased cell number
MATURATION
Change in structure or function of the tissue or organ moving it closer towards the mature state

3. Methods of Studying Growth
Longitudinal Study
one or more individuals are monitored over several years
time consuming, costly, attrition of sample
only way to study the dynamics of growth
Cross-Sectional Study
sample many different children at same time
good for norms and bench marks

4. Count Philibert de Montbeillard
Measured son every 6 months from birth to 18 years
( )

5. Standards for Growth Assessment
What are the appropriate criteria for choice?
Cross-sectional / longitudinal
Local / National / International
Special populations
What is available?

6. NCHS/CDC Growth Charts
The most commonly used norms in North America are cross-sectional norms produced in 1977 by the National Center for Health Statistics.
These were recently updated and are now presented by the Center for Disease Control (2000)
CDC Growth Charts

7. Height for Age & Weight for Age

8. Weight for Height

9. BMI for Age

10. Longitudinal vs Crossectional
Comparison of early and a late maturers who attain similar height at age 17yrs
Longitudinal vs Crossectional
EARLY
LATE

11. CDC Growth Charts All Racial and Ethnic Groups Combined
Environmental influences appear to contribute to variations in growth more than genetic influences
Inadequate sample data for racial- and ethnic-specific charts
The effect of race and ethnicity on BMI-for- age is unclear
CDC promotes one set of growth charts for all racial and ethnic groups. Racial- and ethnic-specific charts are not recommended because studies support the premise that differences in growth among various racial and ethnic groups are the result of environmental rather than genetic influences.
Also, the reference population lacked sufficient numbers of specific racial/ethnic groups to consider separate charts.
Although some studies using BMI-for-age to evaluate at risk of overweight and overweight have found differences by ethnic and racial groups, factors that affect differences in growth among racial and ethnic groups, if they truly exist, remain unclear and more research is needed to clarify the issue.

13. Anthropometric Assessment of Special Populations
A Special Population is one that can not be assessed by orthodox methodology
Growth & Nutritional Status assessments

14. Treatment and Rehabilitation of Children with cerebral palsy, brain injuries and other neuromotor problems

15. S.H.A.P.E.S.

16. SELECTED MEASUREMENTS & EQUIPMENT

17. S.H.A.P.E.S. custom software
serial plotting (up to 100 measurement occasions)
anthropometric profile

18. Height Distance & Velocity Curves
Adolescent growth spurt
growth most rapid in first two years

19. Height Velocity Curves
Indicator of maturity
Needs longitudinal data
Other “systems” have similar curves

22. Shifting of age axis values to coincident age of PHV before averaging velocity curves

23. Means of PHV Parameters
Age at takeoff
♀: yrs ♂: yrs
Age at PHV
♀: yrs ♂: yrs
PHV (cm/yr)
♀: yrs ♂: yrs

24. Intrauterine growth velocity is greater than during any postnatal period.
Timing of birth affects growth velocities

27. Predicting Adult Size Predictions of adult stature can be made from:
heights at earlier age
parental stature
skeletal maturation

28. Four Curves of Growth

29. Differential Growth Birth to Maturity
30-40 times
Muscle, Genital Organs
20-25 times
Body, Skeleton, Respiratory System
15-20 times
heart, Liver
< 5 times
Nervous System

31. Head Circumference for Age

32. Shape Changes with Age

33. Changes in Proportions

34. Somatotype Sheldon vs Heath-Carter Shape vs Size
Mainly used as photographic record of child

36. Adult Size not well correlated with Birth Size

37. Differential Growth
Adult proportions are a result of complex genetic and environmental influences

38. Mean Ages (yrs) at Peak Velocity
Girls (n=10)
Boys (n=12)
Leg Length
11.3
13.4
Stature
11.8
14.1
Sitting Height
12.4
14.6
Humerus Width
11.9
Tibia Width
11.1
13.6

39. Saskatchewan Longitudinal Growth Study (1964 – 1973)

43. Adult Sexual Dimorphism
No difference in proportional weight
Male-Female difference greatest in:
Triceps, Biceps, Front Thigh and Medial Calf Skinfolds
Secondary sexual adiposity

44. Adult Sexual Dimorphism

45. Estimates of Muscularity
Skinfold-Adjusted Arm Girth – Muscularity Indicator
Ga = G - (3.14xS) S G G Ga
S = Skinfold Thickness
G = Girth
Ga = Skinfold adjusted Girth

46. Girth adjusted for Skinfold at that site
s.a. Girth (cm) = Girth (cm) - (Π x Skinfold (mm) / 10)
Girth
Skinfold
s.a. Arm girth
Relaxed Arm Girth
Triceps
s.a. Chest girth
Chest
Subscapular
s.a. Thigh girth
Thigh
Front Thigh
s.a. Calf girth
Calf
Medial Calf
s.a. Forearm girth
Maximum Forearm
Forearm

47. Adult Sexual Dimorphism
s.a. Girths are Muscularity indicators
Greatest differences between the sexes in the upper body
Greatest potential for hypertrophy in the upper body
Muscularity profile is very sensitive to the specific activity of the individual

48. Adult Sexual Dimorphism
Proportionally larger sitting height in females
Males tend to have proportionally longer limbs.
Biggest difference in distal segments

49. Adult Sexual Dimorphism
Humerus to Femur Width differences reflects muscularity differences
Males have broader and deeper chests proportionally.
Classic hip-shoulder dimorphism:
Males proportionally wider shoulders
Females have proportionally wider hips

50. Shoulder-Hip Dimorphism
Sex N
Mean
Std. Deviation
Biacromial/Biiliocristal Breadth
Male 69
1.44
0.12
Female
115
1.31

51. (2nd digit length to 4th digit length ratio)
2D:4D Ratio
(2nd digit length to 4th digit length ratio)
Sex N
Mean
Std. Deviation
Male
136
0.947
0.029
Female
137
0.965
0.026
a Allison A. Bailey, Peter L. Hurda, Department of Psychology, University of Alberta. 2004 2D 4D

52. 2D:4D Ratio Ratio determined in utero Larger ratio in females
2D:4D is negatively correlated with prenatal testosterone and positively correlated with prenatal estrogen
Larger ratio in females
Married women had higher 2D:4D ratios than unmarried women
Significant negative associations were found between 2D:4D in men and reproductive success and significant positive relationships between 2D:4D in women and reproductive success
Found to be related to:
Aggression, Competitive success, Sexual orientation

54. Gradient vs Indicator Maturity Gradients Maturity Indicators
assessment of the relative rates of development of parts or structures of the body
Maturity Indicators
Some characteristic of the body that has distinct stages of development that all normally developing children will pass through

55. Maturity Gradient

56. Upper Arm Maturity Gradient

57. Three 13 year old Girls

58. Three 14 year old Boys

59. Bigness vs Maturity Do not confuse size with maturation
Obesity often associated with advanced maturation skeletally but not in muscular development

60. Maturity Indicators Age of Peak Height Velocity Skeletal Age
Dental Age
Menarche
Secondary Sexual Characteristics
Ratings of Pubic Hair, Penis & Testicular development, Breast development

61. Skeletal Age

62. Closer relationship of Age at Menarche with Skeletal Age (SA) than Chronological Age (CA)

63. Stages of Penis Development

64. Stages of Pubic Hair Development (Girls)

65. Synchrony of Pubertal Events

66. ORCHIDOMETER Word Origin and History for orchid n.
1845, introduced by John Lindley in "School Botanty," from Modern Latin Orchideæ (Linnaeus), the plant's family name, from Latin orchis, a kind of orchid, from Greek orkhis (genitive orkheos) "orchid," literally "testicle," from PIE *orghi-, the standard root for "testicle" (cf. Avestan erezi "testicles," Armenian orjik, Middle Irish uirgge, Irish uirge "testicle," Lithuanian erzilas "stallion"). The plant so called because of the shape of its root. Earlier in English in Latin form, orchis (1560s), and in Middle English it was ballockwort (c.1300; see ballocks ). Marred by extraneous -d- in an attempt to extract the Latin stem.
orchid. (n.d.). Online Etymology Dictionary. Retrieved October 07, 2015, from Dictionary.com website:
ORCHIDOMETER
Source

67. Synchrony of Pubertal Events

68. Correlations between several Maturity Indicators PHV = Age at Peak Height Velocity, B2 = Age at attaining Breast Stage 2, PH2 = Age at attaining Pubic Hair Stage 2, M = Age at attaining Menarche, G2 = Age at attaining Gonadal Stage 2

69. Tanner Breast Stages Tanner I
no glandular tissue: areola follows the skin contours of the chest (prepubertal) (typically age 10 and younger)
Tanner II
breast bud forms, with small area of surrounding glandular tissue; areola begins to widen (10–11.5)
Tanner III
breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast (11.5–13)
Tanner IV
increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast (13–15)
Tanner V
breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla. (15+)
Source:
Prosecution of child pornographers have been based upon the contention that unidentified females with stage 4 nipple development are under the age of 18. However recent studies have concluded that it is not uncommon for females over the age of 18 to have stage 4 breast development.