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INTRODUCTION

Growth is the progressive increase in the size of a child or parts of a child.

Development is progressive acquisition of various skills (abilities) such as head
support, speaking, learning, expressing the feelings and relating with other
people. Growth and development go together but at different rates. The
assessment of growth and development is very helpful in finding out the state of
health and nutrition of a child. Continuous normal growth and development
indicate a good state of health and nutrition of a child. Abnormal growth or growth
failure is a symptom of disease. Hence, measurement of growth is an essential
component of the physical examination.

This study focuses on a 4-year-old child, whom we can call “Rhenzo”.

Rhenzo, is a preschooler. He lives with his parents, Riezel Cadungog and Justin
Padilla at Bajada, Davao City. He was born on April 21, 2015, at Well Family
Lying-in Clinic located in Bajada, Davao City. He is the only child of Riezel and
Justin, up to date. He is currently studying as a preschooler at San Roque
Central Elementary School.

This study indicates personal information, health history, and other

relevant data that are used to trace the milestones of Rhenzo since birth up to
date. Also, it talks about the physical, emotional, cognitive, psychosocial,
psychosexual growth and development of Rhenzo. The data gathered from the
interviewer’s observation and Rhenzo’s parents and relatives, will then be
compared and differentiated in relation to the different theories discussed about
physical, emotional, cognitive, psychosocial, psychosexual growth and
development of a preschooler.

This study was conducted to know whether Rhenzo is growing and

developing normally for a child in his age. Or, if his growth and development is
slow for a child in his age or fast. This is also to know if there are any
abnormalities in Rhenzo’s growth and development as a preschooler. This study
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will shed light to Rhenzo’s pattern of growth and development, needs and
problems, differences and similarities. This will also give further knowledge to the
parents on preparing their child for the next stages of development, and
improving their parenting roles in the development of their child. For the students
and instructors of the institution, this study can be a guide in determining the
growth deviation of a particular individual, in order to make accurate description
of growth observations, corresponding precise information about the normal state
must be available. This study will also influence the society through its culture
and values to the development of children.
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Personal Information

Name :Rhenzo

Age :4 years old

Birthdate :April 21, 2015

Birthplace :Well Family, Bajada, Davao City

Address :35-2, Fatima Village, Barangay 19B, Bajada, Davao City

Mother’s Name :Riezel Cadungog

Age :27 years old

Father’s Name :Edric Justin Padilla

Age :26 years old

Health History

Rhenzo has experienced cough and colds for three days when he was 2
years old and was not given any medication. His mother just let him drink lots of
water. He also experienced fever many times, and was given Paracetamol
(Biogesic) syrup for kids, 1 teaspoon every four hours. Rhenzo has also suffered
from passage of loose watery stools when he was aged two and three, he was
given an anti-diarrheal oral solution, his mother cannot recall the drug name and
dosage. Other than that, Rhenzo has never experienced any diseases up to
date. Also, he has not been hospitalized due to illness and diseases since birth.
He is allergic to dried fish. His lips swell whenever he eats one. He was given
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medication, Cetirizine Hydrochloride 5mg/5ml oral solution. Aside from that, he

has no known allergies as of today.

Family History

Birth History

According to the mother, she did not know that she was pregnant until her
eighth week of gestation. She had morning sickness and had taken Paracetamol
(quantify) that time. The mother also experienced pica and had cravings for
singkamas and vinegar. All in all, she had 6 prenatal visits. One on the first
trimester, two on the second trimester, and three on the third trimester. She was
given two doses of tetanus toxoid. She also had taken the ferrous and folic acid
vitamins, and calcium supplementation given to her from the health center. She
said, on the fifth month, she felt her baby’s hiccups inside her womb. And
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described it as twitch-like movement, somewhat similar to a muscle spasm. After

that, she also felt her child kick and jab inside the womb, about around six
months.

(OB Score)TPAL score is 1-0-0-1. Rhenzo, weighed 2.7 kg upon birth.

Rhenzo was born normally through vaginal delivery. There were no abnormalities
found after delivery, according to his mother. His body was covered with vernix
caseosa, said his mother. Lanugo was also observed around his back and
shoulders. Also, mila was present around the nose and cheek area. According to
his mother, his hair has also grown a lot by the time he was born. He was also
able to eliminate during the first hour of birth. Hours after birth, he was able to
suck and started breastfeeding. At age one, Rhenzo was fully immunized with
BCG, OPV, IPV, and MMR.

Psychosocial History

Rhenzo, is the first child of Riezel and Justin. His parents are not married,
they are just living together. He was baptized as a Roman Catholic at age one.
His father is a sales associate, and has a salary of 12,000 monthly. His mother is
a pharmacy assistant, and gains 7,500 monthly. Also, they gain extra income
from their loading station and by selling milk bar and pinipig.

They live together with his grandmothers in one roof and is only separated
in one room. In their compound, there lived his father’s aunts and uncles and
their families. Their house is made of heavy materials. They have water and
electrical connection. They own a ref, aircondition, flat screen TV with cable, a
motorcycle, a tablet and four mobile phones. They eat variety of food, but mostly
meat and fruits. When his parents are at work, his grandmother (age) is the one
who takes care of him, feed him, bathe him, fetches him to school, and teaches
him how to read and write. He do his assignment together with his mother at
night. His mother is strict, she would not let him play his toys or watch YouTube
videos whenever he cannot learn to count, read, and write.
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Rhenzo plays with his father’s pets. He also enjoys singing and dancing
around. He is also sociable and friendly. He likes to catch people’s attention
(make “papansin”), whenever there are new people around him.

Physical Growth and Development

HC : 48 cm

CC : 55 cm

MUAC : 15 cm

Weight : 18.5 kg

Height : 95.2 cm

Face: The face is symmetrical. There are no wounds, scars, and abnormalities in
the face.

Hair and Scalp: His hair is short and thick. Hair strand is also thick. Hair color is
black. There are no lesions or wounds in the head and scalp. There are no
dandruff and lice.

Eyes: The conjunctiva is pink, moist, and intact. The sclera is white and intact.
He does not wear eyeglasses. He has never experienced any eye surgery and
treatments. There were no known vision defects and problems. The pupils are
equal, round, reactive to light, and accommodation.

Ears: The skin behind the ears are intact. There were no earwax or other
discharges in the ear canal. He can hear loud and soft noises. He does not wear
any hearing aid or hearing devices.
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Nose: There were no lesions or wounds around the nose. He has nasal
congestion. There were mucus discharges in the nose.

Mouth: His lips are symmetrical, pink in color, and moist. Oral mucosa is pinkish.
There were no bumps, lesions, and patches around the mouth. Teeth are not
complete, Teeth are intact. One lower and one upper primary teeth were
extracted. Teeth are light yellow in color.

Neck: He can look left, right, up, and down in full range of motion.

Skin: His skin is moist and intact. His skin feels warm. He has fair skin.

Nails: His nails are white. His nails are rounded and clean.

Gross Motor:

3 months: He can raise head when pulled in sitting position

5 months: He can roll from back to side. Can roll from back to front.
7 months: He can bear weight on one hand.
9 moths: He can already crawl. He can already reach for things when sitting.
1 year: He can already pull a standing position. He can also cruise around chairs
and tables.
1 year 3 months: He can already walk alone. He can walk up and down steps
holding hand.
1 year 7 months: He can run already, but falls easily.
2 years 2 months: He can walk and run pretty well. He can already jump.
2 years 6 months: He can already climb upstairs without support. He can already
kick and throw a ball.
3 years old: He can run around with things in both hands. He can already catch a
ball.
4 years old: He can already play jump rope. He can jump, climb, and run well. He
can already shoot ball in short baskets. He can already ride a bicycle.

Fine motor:
1 month: He can already grasp objects.
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6 months: He can already reach objects. He can pick up things.

1 year old: Can build small tower out of lego toys.
2 years old: He can already bring spoon and fork in his mouth. He can roll,
squeeze and pull clay.
3 years old: He can self feed with minimal assistance. He can already hold
crayons and pencil. Commonly, he uses his one hand in most activities.
4 years old: He can already imitate circles, straight lines, and cross. He can
already imitate writing letters. He can color a coloring book in round strokes.

According to the Biophysical Theory, coined by Arnold Gesell, each child

has his own timetable. Wherein each development in a child’s life, is maturational
and is directed by genetics, which he said, upon conception, a child’s
development was already endowed in his/her parent’s genes. Which is also
supported by the physical traits being measured and observed, during the entire
course of interview. Take for example, the time when he was able to sit, crawl
and stand on his own, and all the other movement he can do on his own, is only
observed upon reaching a certain age, and changes upon the course of time,
supported by the book Kozier and Erb’s Fundamentals of Nursing (p,356-358).
These characteristics only appear in time for the child’s growth and development.

Also, his milestone shows the timetable Gesell was referring to. And these
milestones observed, are the indicators of how developed he is physically.
Compared to other children in this age, he is just on the right timing and his
physical growth and development is neither slow nor advance.
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Cognitive Development

Rhenzo is a child who asks questions from time to time, like “unsa na
ma?”, “ngano nagfly and dragon ma?”, “asa adto ang pagkaon ma?”. He is
talkative. He can count from 1-20. He can recite the alphabet. He can read 3-4
letter words. He can match animals with the noises they make. He can already
identify common colors. He likes to practice writing the letter “R” again and again.
He is also imaginative, and likes to fly his car toys. He also likes to sing nursery
rhymes such as The Wheels on The Bus, Humpty Dumpty, and I’m a Little
Teapot. He is also self-centered, and uses simple reasoning to prove he’s right.
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According to Piaget, preschoolers belong to the Preoperational Stage (2-7

years old). During this stage, they can think about things symbolically. At this
stage also, they are still egocentric. They have a difficulty in taking others
viewpoints. Rhenzo, as evidence is a self-centered and egocentric child, where
he believes that he is always right. Children’s thinking is sometimes described as
“magical” during these early years. Reasoning tends to center around the self,
and there is a lot of fantasy play. This is normal and healthy. He can mix and
match animals with the noises they make, means that he already learned the
schema of these animals, and can assimilate and accommodate new schema of
these animals through trial and error with mix and matching animals face and the
noises they make.
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Social Development

Psychosexual Development

At this age, Rhezo still sucks his thumb. He was toilet trained. He directly
goes to the bathroom whenever he feels urinating. When we wants to eliminate
bowel, he immediately calls his mother or grandmother to accompany him in the
toilet. Rhenzo, like to play with his genitals, he would touch it before, during, and
after he takes a bath.

According to Freud, toilet training is another milestone at this age. It’s

generally best to wait until a child is able to stay dry for several hours at a time
and remain dry after a nap before teaching him to use a potty. Training may take
until age three and a half or later, and once a child has learned to use a toilet
during the day, he may still wet the bed at night for another six months or so.
Remember that bed-wetting accidents are normal in young children.
Preschoolers, are now in their Phallic Stage of Psychosexual Development. In
this stage, they seek pleasure through their genitals.  Interest in the genitals and
masturbation, which is universal among children, will often become increasingly
apparent during this stage of development. As seen on Rhenzo, he likes to play
with his genitals, and he like to call it “putoytoy”. Oedipus Complex has not been
observed to Rhenzo.
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Psychosocial Development

Rhenzo likes to play along with his little uncle, Ember, and other kids from
the nighborhood. He would initiate making games. He rarely share his toys, and
always want to borrow toys from others. He sometimes tend to become moody,
from being excited to play games to being lousy. He likes to roleplay, acting out
scenes from Ang Probisyano and acting like Coco Martin, and sometimes acting
like a dinosaur or a horse. He can follow simple rules in games, but he would
always want to win. He is bossy and manipulative, and still egocentric. He wants
to do things independently without being told to.

According to Bandura’s Theory, where children imitate what the adults did
to the bobo doll, Rhenzo showed that he likes to imitate and act out scenes from
teleseryes or movies or videos he had watched before.

According to Erik Erikson’s Theory, a preschooler belongs to the Initiative

vs Guilt stage of development. There are capable of initiating activities and
asserting control over their world through social interaction. Though Rhenzo is
still somewhat egocentric, but little by little according to his mother he would
share his toys now with other kids. Concurrently, children will be developing a
moral sense that helps in adapting to an expanding social world. A three-year-old
may have a hard time understanding what it means to share, but by age four or
five she will be taking turns at the playground. Children this age will also begin to
comprehend 

According to Havighurst, child at the age of four should be able to

accomplish developmental tasks such as, learning to walk, run, climb up stair,
talk, read, write, and forming concepts. Obviously, from previous information
given, Rhenzo has successfully acquired these developmental tasks, and still
trying to acquire some of the developmental tasks enlisted by Havighurst.
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Emotional Development

As said above, Rhenzo is a very cheerful kid. He can get along easily with
other children, and even adults. He gets happy easily whenever you give him
things that are not familiar in his eyes. He mostly gets excited when watching his
favorite cars the movie. He is also a very jealous child. Whenever his mother or
father would hold other children he would cry and throw tantrums. But, he would
easily calm down when his parents would hold him up. He also gets jealous
whenever his playmate has a new toy, and would sometimes throw the toy. He is
closer to his grandmother (his father’s aunt).

According to Chess and Thomas’ Temperament Theory, temperament is

multidimensional leading to the development of a child’s personality traits. As for
Rhenzo’s activity level, he is very active. On the approach, he is always on the
go and jumps right into activities. On his mood, he is cheerful, and sometimes
moody especially in the morning after waking up, and when he is sleepy. Despite
your best efforts, children will have times when they lose emotional control.
Temper tantrums, which may begin toward the end of a child’s first year, tend to
peak between the ages of two and four. Children use tantrums in part to maintain
a sense of control and to test their parents’ limits. Tantrums can also occur when
children are overly tired or fearful, or if an ailment is causing discomfort. They
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may become entrenched if parents give in to them,

(www.healthcommunities.com). 

Spiritual Development

Rhenzo, can already pray a memorized prayed. He can also imitate

prayers from Sunday school. He bows his head when praying, and does the sign
of the cross. According to Fowler, children at this age are at the intuitive
projective stage of spiritual development. Faith is primarily a result of teaching
from parents and teachers. They can also imitate religious behavior at this stage,
just like Rhenzo when he bows his head and do the sign of the cross, even
though he does not know its significance.

Nutrition and Feeding

Rhenzo was breastfeed until one year and six months of age. He was
supplementarily fed after then. He was given Cerelac, mashed squash, mashed
potato, and mashed rice with soup. When he can already take in solid food, he
would preferrably eat meat such as hotdog, tocino, lumpia, and barbecue. When
we has 1 month to two years old, he was given Tiki Tiki vitamins (syrup for kids),
1 tsp every day. After, he was given Ceelin Vitamins syrup, one tbsp. every day.
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(24 hour diet recall was not done, due to the interview was done prior the
guideline was given)

Language and Communication

Rhenzo’s first word was “papa” when he was 6 months old. He can speak
in Cebuano and in tagalog. He can read short sentences slowly. He can read 3-4
letter words correctly. When he wants something he would tell it directly to his
mother and would say please. When he’s angry we would cry and would throw
things around. These years are marked by dramatic strides in communication
skills. From the ages of two to four, youngsters progress from knowing roughly
100 words to up to 1,000, and they pepper their conversations with endless
questions about their surroundings. Language acquisition emerges as an
important gauge of intellectual and emotional progress.  Language can also be an
important emotional outlet for children. Encourage your child to express his
feelings, rather than acting them out, by teaching him the meaning of words like
“afraid” or “angry.”

Play

(PARALLEL PLAY) Rhenzo likes to play with his toy cars. He likes to fly
his toy cars. He also likes to play with dinosaurs. He likes to pet their lizards,
rabbits and mice. He likes to play with his little uncle Ember, and their neighbors.
He likes to watch Cars the movie, and other animated videos and movies. He
likes to dance and sing along with nursery rhymes.
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Child Rearing Practices

Rhenzo likes to feed himself and his parents let him practice this since he
was three. He wants to be bathe with his favorite shampoo with is citrus in scent.
His mother strictly taught him how to write, count, and read. She would not let
him play and watch if he cannot read, write, and count. Rhenzo likes to sleep
with his favorite blanket. His mother would put him to sleep covered with his
favorite blanket. (Rituals)

Recommendations

1. Let your children learn on their own, just be there to guide and support
them
2. Let them make friends with other kids their age and let them socialize, for
them to develop their interpersonal relation skills.
3. The mother should not be that strict to Rhenzo when learning to count,
read, and write, he might grow up resentful.
4. The parents should observe Rhenzo’s temperament, and adjust the
environment for him to express himself more.
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5. The parents should teach Rhenzo to share his things to others, for him to
not be egocentric.
6. They should give Rhenzo more nutritious food, such as fruits and
vegetables.
7. The parents should observe if Rhenzo excessively plays with his genitals
and explain to him what he should do.
8. The parents should encourage Rhenzo to play regular, vigorous physical
avtivities.
9. The parents should praise Rhenzo more, to uphold his confidence.
10. The parents should provide adequate space and a variety of activities.