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International Islamic University


 Patterns of growth

 Infancy

 Early childhood

 Middle & late childhood

 Puberty

 Early adulthood

 Middle adulthood

 Late adulthood
There are two patterns of growth:
The cephalocaudal pattern is the sequence in which the greatest growth always
occurs at the top (the head) with physical growth in size, weight, and feature
differentiation gradually working its way down from top to bottom e.g. neck,
shoulders, trunk, etc.
This same pattern occurs in the head area, because the top parts of the head (the
eyes and brain) grow faster than the lower parts.
An extraordinary proportion of the total body is occupied by the head during
prenatal development and early infancy.
Sensory and motor development proceeds according to the cephalocaudal
principle e.g. Head is controlled before hands
The proximodistal pattern of development is where growth starts at the centre of the
body and moves towards the extremities. An example of such a pattern is that head,
trunk and arm control develops before control of hands.

A newborn's skin is oftentimes grayish to
dusky blue in color. As soon as the newborn
begins to breathe, usually within a minute or
two of birth, the skin's color returns to normal tones. Newborns are wet, covered in
streaks of blood, and coated with a white substance known as vernix caseosa, which is
believed to act as an antibacterial barrier. The newborn may also have Mongolian spots,
various other birthmarks, or peeling skin, particularly at the wrists, hands, ankles, and
A newborn's shoulders and hips are narrow, the abdomen protrudes slightly, and the arms
and legs are relatively short. The average weight of a full-term newborn is approximately
7 ½ pounds (3.2kg), but can be anywhere from 5.5–10 pounds (2.7–4.6kg). The average
total body length is 14–20 inches (35.6–50.8cm), although premature newborns may be
much smaller.
A newborn's head is very large in proportion to the rest of the body, and the cranium is
enormous relative to his or her face. While the adult human skull is about 1/8 of the total
body length, the newborn's is twice that. At birth, many regions of the newborn's skull
have not yet been converted to bone. These "soft spots" are known as fontanels; the two
largest are the diamond-shaped anterior
fontanel, located at the top front portion of the
head, and the smaller triangular-shaped
posterior fontanel, which lies at the back of
the head.
The average newborn is 20 inches long.
Ninety-five percent of full-term newborns
are 18-22 inches long. Infants grow about
1 inch per month during the first year,
reaching approximately 1½ times their
birth length by their first birthday. Infants’
rate of growth is considerably slower in
the second year of life than first year. At
age 2, the average infant is 32-35 inches
long. By the end of the first year an infant's
height is increased by 50% and by the age
of 2 the baby will have grown 75% greater.
The average baby weighs 7½ pounds.
Ninety-five percent of full-term newborns
weigh between 5½ and 10 pounds. In the
first several days of life, most newborns
lose 5-7 percent of their body weight before
they adjust to neonatal feeding. Infants gain 5-6 ounces per week during the first month.
They have doubled their birth weight by the age of 5 months. They have nearly tripled
their birth weight by their first birthday.
Brain grows from 12 oz to 2.5 pounds in first year.

As the preschool child grows older, the
percentage of increase in height and weight
decreases with each additional year. Girls are
only slightly smaller and lighter than
boys during these years. Both boys and
girls slim down as the trunks of their
bodies lengthen. Although their heads are
still somewhat large for their bodies, by the
end of preschool years most children have
lost their top heavy look. Body fats also
show a slow, steady decline during the
preschool years. Girls have more fatty tissue
then boys; boys have more muscle tissues.
Growth pattern vary individually: some are
taller, some are shorter, some are fatter,
some are thinner, some are stronger, some
are weaker. Much of the variation is due to
heredity, but environmental experiences are
also involved. Urban, middle-socioeconomic-
status, and first born children were taller then
rural, lower- socioeconomic-status, and later-
born children.
Growth hormone deficiency is the absence or
deficiency of growth hormone produced by
pituitary glands to stimulate the body to grow.
Growth hormone deficiency may occur during
infancy or later in childhood.
Children who are chronically sick are shorter then
their counterparts who are rarely sick. Children who
have been physically abused or neglected may not
secrete adequate growth hormone, which can restrict
their physical growth. Children of addict parents have
inappropriate growth then children of healthy parents.


This period involves slow and consistent growth.
During the elementary school years, children
grow an average of 2 to 3 inches a years. At the
age of 8 the average boy and the average girl are 4
feet and 2 inches tall. During middle and late
childhood years, children gain about 5 to 7
pounds a year. The average 8 years old boy and
the average 8 years old girl weigh 56 pounds.
The weight increase is due mainly to increase in
the size of the skeletal and muscular system, as
well as the size of some body organs. Muscle
mass and strength gradually increase as “baby fat”
decreases in middle and late childhood.
The loose movement and knock-knees of early
childhood give way to improved muscle tone in
middle and late childhood. The increase in
muscular strength is due to heredity and to
exercise. Children also double their strength
capabilities during these years. Because of their greater number of muscle cells, boys
tend to be stronger then girls. Head circumference, waist circumference, and leg length
decrease in relation to body height.

Puberty refers to the physiological changes
involved in the sexual maturation of a child,
as well as other body changes that may occur
during this period of time. Adolescence refers
to the stage from puberty to adulthood, and
includes the psychological experiences of the
child during this period. Adolescence is
described as being the teenage years from
thirteen to eighteen years of age; however,
puberty decides the onset of adolescence.
Therefore, adolescence occurs in some children as early as nine years of age. During this
period of time the child has a great deal of concern over his/her body image. Puberty is
the time when a person's reproductive organs begin the process of becoming mature and
functional. The brain is the organ that starts the whole process of puberty. At the base of
the brain is a center called the hypothalamus. The hypothalamus sends signals to the
pituitary gland which in turn releases hormones into the bloodstream. These hormones
(special chemical substances) travel to an individual's "sex glands" or "reproductive
organs" which are called gonads. There are two kinds of gonads: ovaries which are found
in the female body and testicles which are found in the male body.
The female body, much like the male body, experiences a variety of changes during
adolescence as a result of puberty. Puberty in a young woman's body is the time when her
reproductive organs, ovaries, begin producing increased amounts of a hormone called
estrogen, and estrogen is the special chemical substance that causes the changes to occur.
Usually the first change that takes place will be in the female's breasts. They begin to get
larger so that some day she will be able to breastfeed a newborn baby. The young
woman's hips begin to get broader, and she will also begin to grow taller. Hair will begin
to grow under her arms, around her sex organs (pubic region). Her voice may deepen
much like a male's does, and she may start having some skin problems due to the increase
of oil in the pores of her skin, especially on her face.
The first menstrual bleeding is referred to as menarche. The average age of menarche is
about 12.7 years, usually about 2 years after thelarche. Menses (menstrual periods) are
not always regular and monthly in the first 2 years after menarche. Ovulation is necessary
for fertility, and may or may not accompany the earliest menses. By 2 years after
menarche, most girls are ovulating at least several times a year. Over 90% of girls who
experience menarche before age 13 years are experiencing very regular, predictable
menses accompanied by ovulation within 2 years, and a higher proportion of those with
later menarche may not establish regular ovulation for 4 years or more. However,
initiation of ovulation after menarche is not inevitable, and a high proportion of girls with
continued irregularity several years from menarche will continue to have prolonged
irregularity and anovulation, and are at higher risk for reduced fertility.

The estrogen-induced pubertal growth spurt in girls begins at the same time the earliest
breast changes begin, or even a few months before, making it one of the earliest
manifestations of puberty in girls. Growth of the legs and feet accelerates first, so that
many girls have longer legs in proportion to their torso in the first year of puberty. The
rate of growth tends to reach a peak velocity (as much as 7.5-10 cm or 3-4 inches per
year) midway between thelarche and menarche and is already declining by the time
menarche occurs. In the 2 years following menarche most girls grow about 5 cm (2
inches) before growth ceases at maximal adult height. This last growth primarily involves
the spine rather than the limbs.
Spermarche is when sperms are produced first time. At puberty, testosterone starts
being produced by the testicles, and when this takes place, the journey to sexual maturity
begins. Some of the first changes are as follows: clothes begin fitting tighter; arms and
legs grow rapidly; muscles become heavier and stronger; and sex organs (penis and
testicles) grow. This hormone can also cause some rather unusual and perhaps
embarrassing things to happen. Sometimes young men have what are called nocturnal
emissions or "wet dreams". These are times when seminal fluid - a liquid which contains
sperm cells - is released from the penis when the individual is sleeping. This is a natural
way for the male body to get rid of excessive seminal fluid.
Testosterone also causes hair to grow on the young man's face, chest, legs, under his
arms, and around his pubic region - the area where his external sex organs are located.
The adolescent male’s vocal cords begin to change, so his voice may "crack" as the pitch
begins to lower. They may begin having some skin problems due to an increase of oil in
the pores of their skin.

Young adults do not grow significantly taller in
their 20’s; they typically grow stronger and
healthier as their bodies reach adult size.
In terms of overall health, as well as peak
physical condition, early adulthood is the
prime of life. With each year from 20 to 40,
signs of senescence-the state of physical
decline, in which the body gradually becomes
less strong and efficient with age-become more
apparent. All the body systems gradually become
less efficient (though at different rates) and
homeostasis takes increasingly longer to reach.

During this stage changes are gradual. Rate of aging vary from person to person.
Many people are concerned with changes in their body shape as they age. Although some
changes inevitably occur with aging, your lifestyle choices may slow or accelerate these
changes.People may become shorter. The tendency to become shorter occurs among all
races and both sexes. Height loss is related to aging changes in the bones, muscles, and
joints.People typically lose about 1 cm (0.4 inches) every 10 years after age 40. Height
loss is even greater after 70 years old. In total, you may lose 1 to 3 inches in height as you
age.This varies, however. Physical activity, a proper diet, and treating osteoporosis can
help reduce height loss.
Men often gain weight until about age 55, then begin to lose weight. This may be related
to a drop in the male sex hormone testosterone. Women usually gain weight until age 65,
then begin to lose weight. Weight loss is, in part, caused by a loss of muscle tissue.

Of course, weight loss or gain varies from person to person, too. Diet and exercise play a
large role in these changes.

Hair color change is probably one of the most obvious signs of aging. Hair color is
caused by a pigment (melanin) produced by hair follicles. With aging, the follicle
produces less melanin.Graying often begins in the 30s, although this varies widely.
Graying usually begins at the temples and extends to the top of the scalp. Hair becomes
progressively lighter, eventually turning white.Many people have some gray scalp hair by
the time they are in their 40s. Body and facial hair also turn gray, but usually later than
scalp hair. The hair in the armpit, chest, and pubic area may gray less or not at
all.Graying is genetically determined. Gray hair tends to occur earlier in Caucasians and
later in Asian races. Nutritional supplements, vitamins, and other products will not stop
or decrease the rate of graying.

The immune system loses it's ability to fight off infections as people grow older. This
increases risk for geting sick, and may make immunizations less effective. Flu shots or
other immunizations may not work as well, and protection may not last as long as
expected. The immune system's ability to detect and correct cell defects also declines,
which results in an increase in cancers associated with aging.Later in life, the immune
system also seems to become less tolerant of the body's own cells. Sometimes an
autoimmune disorder develops -- normal tissue is mistaken for non-self tissue, and
immune cells attack certain organs or tissues.

With aging, the outer skin layer (epidermis) thins even though the number of cell layers
remains unchanged.The number of pigment-containing cells (melanocytes) decreases, but
the remaining melanocytes increase in size. Aging skin thus appears thinner, more pale,
and translucent. Large pigmented spots (called age spots, liver spots, or lentigos) may
appear in sun-exposed areas.


The human body is made up of fat, lean tissue
(muscles and organs), bones, watesssr, and other
substances. As we age, the amount and
distribution of these materials will change.
Fat tissue may become increasingly deposited
toward the center of the body, including
around the abdominal organs. The proportion
of body fat may increase by as much as 30%.
As fat increases, lean body mass decreases.
Your muscles, liver, kidney, and other organs may
lose some of their cells. This process is called
atrophy. Bones may lose some of their minerals and become less dense (a condition
called osteopenia, or at its later stage, osteoporosis). Tissue loss reduces the amount of
water in your body.
Some decline occurs in the body's ability to gather and distribute oxygen, and to the
circulatory system's ability to carry oxygen-enriched blood from the heart to the rest of
the body. These declines are really only visible when the individual is engage in
exercise, not when we're at rest. Beginnings at age 40, people are likely to experience a
1% decrease per year in respiration. With regard to individual’s heart, between ages 25-
65, there will be a decline of 30-40%. Again, these declines are only visible during
exercise, not rest, and maintaining aerobic fitness in old age will decrease the likelihood
of decline. Finally, systolic blood pressure increases until age 70-80, when it may
decrease. This is caused by the lack of elasticity in the circulatory system that occurs as
age increases.


Women's ability to reproduce is influenced much earlier. Hormonal changes produce

menopause somewhere around 49-51 on average. Menopause means that women stop
menstruating, they no longer release eggs and reproduction ceases. Menopause is
accompanied by changes in the breasts (tissue is subsequently less dense and firm) and
the genitals: ovaries and uterus become smaller, vagina shorter and smaller in diameter
(walls thinner and less elastic). As a result of less estrogen in their systems, women
produce less lubrication. Fifty to 75% of women experience hot flashes (a quick rise in
body temperature, skin flushes and sweating occurs) which may last from a year (85% of
those who experience hot flashes) to 5 or more years. These hot flashes may make
women feel awkward, and more seriously, if they occur too frequently, they may interfere
with sleep patterns and produce exhaustion. But most men does not loss the ability to sex.

Late adulthood brings an increased risk of physical disability.
For most people aging is a process of growing shorter and (at least initially) heavier.
Expect to lose 1-2 inches of height over the course of your life starting around age 40 as
your disks (and later the vertebrae) begin to shrink. Most people gain weight in their
30's, and continue to do so until sometime in their 50's when they are likely to begin
losing weight.
Changes in vision begin at an early age. The cornea
becomes thicker and less curved. The anterior chamber decreases in size and volume.
The lens becomes hicker and more opaque, and also
increases rigidity and loses elasticity. The ciliary
muscles atrophy and the pupil constricts. There is
also a reduction of rods and nerve cells of the retina.
You will probably begin to wrinkle noticeably around
age 40-50 (wrinkles are more pronounced on those individuals who spend a lot of time in
the sun). Why? - fat gets redistributed, collagen reduces elasticity, sweat & oil glands
aren't as effective, so skin is more likely to dry out, crack,. Hair loss and graying of hair
is extremely variable. However, most all adults will experience some of both (including
hair loss in women who have experienced menopause).
Just as tissue in the eye will begin to harden, so too does tissue in the ear, producing
(along with other types of decay) some hearing loss over time - presbycusis. The little
hair cells in the cochlea are particularly sensitive to this hardening, and become less
sensitive. Hearing loss begins much earlier, and most of you are already beginning to
lose your hearing, but it is not so severe as to require intervention. Hearing loss is more
common among men than women. Hearing loss associated with presbycusis is
particularly likely to occur at higher frequencies. In addition, the elderly are likely to
have difficulty perceiving speech when there is noise in the background.
Sensitivity to odors and taste decline with age. The sense of smell begins to degenerate
with the loss of olfactory sensory neurons and loss of cells from the olfactory bulb. The
decline in taste sensation is more gradual than that of smell. The elderly have trouble
differentiating between flavors. The number of fungiform papillae of the tongue decline
by 50% by the age of 50. Taste could also be affected by the loss of salivary gland
secretions, notably amylase. This loss of taste and smell can have a significant effect on
an elder's health. With the reduced ability to taste and smell, it is difficult to adjust food
intake as they can no longer rely on their taste receptors to tell them if something is too
salty, or too sweet. This can also cause the problem in that they might not be able to
detect if something is spoiled, making them at a higher risk for food poisoning.
A serious loss of strength (around 20%)
begins in late adulthood (as early as age
50 or as late as 70). It is not simply that
we do less as we age and our muscles
decay as a result (even muscles in the
bladder, diaphragm, and chest, all of
which are constantly in use get weaker).
Muscles will respond positively to weight
training in old age, but aerobic activity
does not ward off the effects.
As age increases, a number of changes occur in bones
as well. 1. People begin to lose bone
marrow (the part of body that produces blood cells) in extremities and it becomes more
concentrated in the bones of trunk. 2. Osteoporosis - bones become more brittle and
porous because of losing calcium. This begins in the thirties and is more serious for
women, particularly after menopause. 3. Osteoarthritis - the joints can become worn,
and this produces pain.


Climateric - the loss in reproductive ability (men & women). Reproductive capability
can continue on into the 80s for men. Beginning around age 40, there is a decline in
sperm produced, and around age 60 seminal fluid decreases in volume. There is also
thought to be a small decline in the amount of testosterone produced. Impotency (the
inability to achieve or maintain an erection, which may or may not be related to physical
factors) shows a significant increase as men age. Risk factors for impotency include:
heart disease, alcohol consumption, heart & high blood pressure medication, and

The heart loses about 1% of its reserve plumbing capacity every year after we
turn 30. Change in blood vessels that serve brain tissue reduce nourishment to
the brain, resulting in the malfunction and death of brain cells. By the time we
turn 80, cerebral blood flow is 20% less, and renal blood flow is 50% less than
when we were age 30. As we age our heart goes through certain structural
changes: the walls of the heart thicken and the heart becomes heavier, heart
valves stiffen and are more likely to calcify, and the aorta, the major vessel
carrying blood out of the heart, becomes larger.

The digestive system is very sensitive to emotions. An older person may experience an
upset stomach or lack of appetite when lonely, depressed, or worried. Regular contact
with friends and relatives, through visits and telephone calls, can help prevent these
problems.It is fairly common for older people to have less frequent bowel movements
and to suffer from constipation. This is due to changes in tissue and muscles and reduced
thirst. Regular exercise, such as a daily walk, can prevent constipation. A well-balanced
diet that includes adequate fiber and fluid intake also encourages normal bowel function
and minimizes the need for laxatives.