GROWTH AND DEVELOPMENT

LEARNINGOUTCOMES

After completing this class, you will be able to:

 Differentiate between the terms growth and development.

 Describe essential principles related to growth and development.
 List factors that influence growth and development

Introduction

Continual change is the essence of life. The rapid changes in size that we call
growth, and the rapid changes in form, function and behaviour that we call
development, are the core of pediatrics.

Growth is a form of motion. Growth means the increase in the size of the various
parts and organs of the body by multiplication of cells and intercellular
components during the period commencing from fertilization to physical
maturity. Child development refers to the sequence of physical, language,
thought and emotional changes that occur in a child from birth to the beginning
of adulthood. During the process a child progresses from dependency on their
parents/guardians to increasing independence.

Growth

- It is the process of physical maturation resulting an increase in size of the

body and various organs. It occurs by multiplication of cells and an
increase in intracellular substance. It is quantitative changes of the body.

Development

- It is the process of functional and physiological maturation of the

individual or it is progressive increase in skill and capacity to function and
it is related to maturation and myelination of the nervous system which
includes psychological, emotional and social changes. It is a qualitative
aspect.

Principles of Growth and Development

1. Cephalocaudal

- This principle describes the direction of

growth and development.

- The head region starts growth at first,

following by which other organs starts
developing.

- The child gains control of the head first, then the arms and then the legs.
- Infants develop control of the head and face movements at first two
months. In next few months they are able to lift themselves up by using
their arms. Next gain control over leg and able to crawl, stand, walk, run,
jump, climb, day by day.

2. Proxidistmal
- The directional sequence of
development during both prenatal and
postnatal stages may either be (i)
from head to foot, or (ii) from the
central axis to the extremities of the
body.

- The spinal cord develops before outer

parts of the body.

- The child's arms develop before the

hands, the hands and feet develop before the fingers and toes.

- Fingers and toe muscles are the last to develop in physical development.

3. Continuous process
- Growth and Development is a
continuous process from conception of
death.

- In the early years of life, development

consists of changes that lead the child
to maturity not only of body size and
functioning, but also of behaviour.

- Even after maturity has been attained,

development does not end. Changes continue which lead to the period of
life known as senescence or old age.

- These changes continue until death ends the life cycle.

4. Orderly or Sequential process

- Every species, whether animal or human,
follows a pattern
- of development peculiar to it. This
pattern in general is the same for all
individuals.

- Social and behavioural scientists

increasingly have come to see
development as a relationship between
organism and environment in a transaction or collaboration.
 - All children follow a development pattern with one stage leading to the
next.

- Ex - Infants stand Before they walk; draw circles before they make
squares

7. Simple to Complex

- Children use their cognitive and

language skills to reason and solve
problems.
-
- Children at first are able hold the
big things by using both arms, In
the next part able to hold things in
a single hand,
- then only able to pick small objects
like peas, cereals etc.
-
- Children when able to hold pencil, first starts draw circles then squares
then only letters after that the words.
10. Coordination between increase in
size and maturation

- Maturation refers to the sequential

characteristic of biological growth
and development.

- The biological changes occur in

sequential order and give children
new abilities.

- Changes in the brain and nervous system account largely for maturation.
And help children to improve in thinking and motor skills.

- Children must mature to a, certain point before they can progress to new
skills.

Major Factors Influencing G & D

 Genetic factors – Sex, Race and Nationality

 Prenatal factors – Environment, Malnutrition, Maternal Infections,
Maternal Illness, Hormones
 Postnatal factors – Growth Potential, Nutrition, Childhood Illness, Physical
Environment, Psychological Environment, Cultural Influences, Socio-
economic Status, Climate and Season, Play and Exercise, Birth order of
the child, Intelligence, Hormonal Influence, Learning and Reinforcement

Growth and Developmental Age Periods

10 Life Stages

Prenatal Period: The stage before

taking birth

Infancy: Birth to one (1) year

Baby Hood

Early childhood: 1-6 years

Late childhood: 6-12 years

Puberty or Adolescence

Adolescence: 12-18 years

Early Adulthood: 19-40 years

Middle Adulthood: 40-65 years

Old age: After 65 years

Growth and Development Monitoring

Assessment of Growth

 Assessment of physical growth can be done by anthropometric

measurement and the study of velocity of physical growth.
 Measurement of different growth parameters is the importance nursing
responsibility in child care.

Weight

Weight is one of the best criteria for assessment of growth and a good indicator
of health and nutritional status of child.

Among Indian children, weight of the full terms neonate at birth is approximately
2.5 kg to 3.5kg.

There is about 10% loss of weight first week of life, which regains by 10 days of
age.

Then, weight gain is about 25-30 gm per day for 1st 3 month and 400gm/
month till one year of age.

The infants double weight gains their birth weight by 5month of age, trebled by
one year, fourth time by two years, five times by three year, six times by five
year, seven times by seven year and ten times by ten years.

Then weight increases rapidly during puberty followed by weight increase to

adult size.

Length and Height

Increase in height indicates skeletal growth. Yearly increments in height

gradually diminished from birth to maturity.

At birth average length of a healthy Indian newborn baby is 50cm.

It Increase to 60cm at 3 months, 70cm of 9 month and 75cm at one year of age.

In second year, there is 12cm increase, third year it is 9cm, fourth year it is 7cm
and in fifth year it is 6cm.

So, the child doubles the birth by 4 to 4.5 years of age afterwards there is about
5cm increase in every year till onset of puberty.

Body mass index (BMI)

It is an important criterion which helps to assess the normal growth or its

deviations i.e. malnutrition or obesity.

BMI = Weight in Kg/ (Height in meter) 2

BMI remains content up to the age of 5 years. If the BMI is more than 30 kg/m²,
it indicates obesity and if it is less then 15Kg/m², it indicates malnutrition.
BMI categories

Underweight = <18.5

Normal weight = 18.5 - 24.9

Overweight = 25-29.9

Obesity = BMI of 30 or greater

Head Circumference

It is related to brain growth and development of intracranial volume. Average

head circumference measured about 35 cm at birth.

At 3 months it is about 40 cm, at 6-month 43 cm, at one-year 45cm, at 2 years

48 cm, at 7 years 50 cm and at 12 years of age it is about 52 cm, almost same
an adult.

If head circumference increases more than 1cm in two weeks during the first 3
months of age the hydrocephalus should be suspected.

Head circumference is measured by ordinal tap, placing it over the occipital

protuberance at the back, above the ear on the side and just over the
supraorbital ridges in front measuring the point of head circumference.