Growth and Development

Definitions of
Growth and Development
● Growth
● Increase in physical size of a whole or any of its
parts, or an increase in number and size of cells:
Growth can be measured quantitatively
● Development
● A continuous, orderly series of conditions that
leads to activities, new motives for activities,
and patterns of behavior; happen qualitatively
 PRINCIPLES
OF
GROWTH AND DEVELOPMENT
PRINCIPLES OF
GROWTH AND DEVELOPMENT
● Growth is an orderly process, occurring in systematic
fashion.
● Rates and patterns of growth are specific to certain
parts of the body.
● Individualized; Wide individual differences exist in
growth rates; each individual is unique
● Growth and development are influences by are
influences by a multiple factors.
PRINCIPLES continued….
● Development proceeds from the simple to the complex
and from the general to the specific; an orderly process
● Development becomes increasingly integrated and
complex
● Development occurs in a cephalocaudal and a
proximodistal progression ; directional
● There are critical periods for growth and development.
● Rates in development vary.
● Development continues throughout the individual's life
span.
Patterns of Growth and
Development
Cephalocaudal Pattern (head to toe)

Proximodistal Pattern (from center outward)

 Growth Pattern

Head to
Toe
Inward to Cephaloca
Outward udal
Proximodist
al
Growth Patterns
● The child’s pattern of growth is in a
head-to-toe direction, or cephalocaudal,
and in an inward to outward pattern called
proximodistal.
Periods of greatest growth
● A rapid pace from birth to 2 years
● A slower pace from 2 years to puberty
● A rapid pace from puberty to
approximately 15 years
● A sharp decline from 16 years to
approximately 24 years when full adult size
is reached
Factors that Influence Growth
and Development
● Genetics
● Environment
● Culture
● Nutrition
● Health status
● Family
● Parental attitudes
● Child-rearing philosophies
Genetic influences on growth
and development
● pattern, rate, rhythm and extent:
● governed by genes interplaying with environment
● intrauterine life extremely important in growth and
healthy development of the child
 Environmental influences
● family composition
● family position in society
● family socioeconomic status
● knowledge of the family
● availability of healthy diets
● housing
● diseases present in family and child
Cultural influences
● Must be considered when assessing growth
and development
● Customs vs. work demands from different
cultures
Nutritional influences
● Begins during the prenatal period
● LBW/preterm can result from poor prenatal
nutrition (Low Birth Weight)
● Socio-economics may impact growth
Health status of the child

● Certain diseases may affect g & d

● Endocrine and cardiac status included here
(related to hormone and heart)
Family / Parental Attitudes / Child-rearing
Philosophy

● Critical in growth and development, esp.

emotional growth
● Intellectual growth must be included here as
well
● Chronic illness can be combated with a
loving environment and close family
relationships
Theories of Growth and Development

● Theorists
● Piaget
● Freud

● Erickson

Just review these theorists and their theories – focus

mainly on Erickson
Methods to Evaluate Growth
● charts: compare to norms
● compare to self over time
● xrays
● teeth
● height, weight, head circumference
● size of head and legs: length of bones
Growth and Development
Milestones

Chapter 34
Stages of Growth and Development

● Infancy ● Middle Childhood

● Neonate ● School age
● Birth to 1 month
● 6 to 12 years
● Infancy
● 1 month to 1 year ● Late Childhood
● Early Childhood ● Adolescent
● Toddler ● 13 years to
● 1-3 years approximately 18 years
● Preschool
● 3-6 years
 INFANT

BIRTH TO 12 MONTHS
Physical Growth and Development Milestones During Infancy

Birth to 1 month
Infancy 2-4 months
Infancy – 4-6 months
Infancy - 6-8 months
Infancy - 10-12 months
 Summary of key points - Infant
● Nursing Interventions
● Encourage parents to hold and stay with infant.
● Provide opportunities for sucking.
● Provide infant with toys that give comfort or stimulate
interest

● Developmental milestones
● Rolls over; Sits up; Stands.
● Able to say one to two words.
● Uses pincer grasp well.
Milestones in Infant Communication
● 1-3 months Reflex smile that becomes more
voluntary and reciprocal

● 3-4 months Babbling, crying more differentiated

● 4-6 months Squealing, playing with sound,

identifying parent’s voice

● 6-8 months Single-consonant babbling, increasing

interest in sound

● 8-9 months Stringing of vowels and consonants, use of

some words

● 9-12 months Vocabulary of two to three words, use

of gestures
TODDLER

1-3 years
Developmental milestones for Toddler
 Summary of Key points - toddler

● Nursing Interventions
● Maintain toilet-training procedures.
● Encourage appropriate independent behavior.
● Give short explanations.
● Provide rewards for appropriate behaviors.
● Developmental milestones
● Walks up and down stairs; Kicks a ball.
● Undresses self.
● Scribbles on paper.
● Has a vocabulary of 1000 words and uses short
sentences.
Pre-schooler

4-5 years of age

Milestones for the Preschooler
 Summary of Key points - preschooler
● Nursing Interventions
● Encourage parents to be involved in care of child.
● Provide safe versions of medical equipment for playtime.
● Give clear explanations about procedures and illnesses.

● Milestones
● Uses scissors.
● Rides bicycle with training wheels.
● Throws a ball.
● Writes a few letters.
● All parts of speech well-developed.
School-age Child

6-12 years old

Developmental Milestones – School-age
Summary of Key points – School-age

● Nursing Interventions
● Provide for privacy and modesty.
● Explain treatments and procedures clearly.
● Encourage continuation of school work.
● Milestones
● Possesses reading ability.
● Rides a two-wheeled bike.
● Jumps rope.
● Plays organized sports.
● Mature use of language.
Adolescent age

12-21 years
Adolescent
● Psychosocial development
● Independence
● Identity
● Peers
● Language use
● Exploration and rebellion
● Need for privacy
● Sexuality
● Cognitive development
● Formal operations
● Abstract thinking
 Summary of Key points – Adolescent

● Nursing Interventions
● Provide privacy.
● Interview and examine adolescent without parents present, if
possible.
● Encourage adolescent participation in treatment and decision
making.
● Encourage visitation of peers.

● Milestones
● Fine motor skills well-developed.
● Gross motor skills improve due to growth spurts.
● Able to apply abstract thought and analysis.