Growth & Development

Dr. Rismarini, SpA

 Child and adult is different Child does not a little neither mini adult Specific characteristic of child are

Growing and developing

Growth and development are different proces, but dont stand alone and connected each other

Growth
Growth is an increase in number and size of the cell and intercellular tissue increase in size of the body Quantitative countable, measurable In length unit, or weight unit Indicator : - Body weight - Body length / body height - Head circumference - Upper arm circumference

Development
Maturity of the body structure and function developing the skill and knowledge Qualitative uncountable Difficult to measurement milestone Indicator : - Gross and fine motor - Language and speech - Socioemotional - Vision and hearing

General Objective of learning GD

Growth and development process

Birth potensial

Useful Adult

To help all children achieve their maximum developmental potential

Specific objective
To understand the process of growth and development since conception to adult To monitor chlidrens progress To identify delays or abnormalities in development early diagnosis early intervention Know the cause of GD impairment counsel the parent to avoid the abnormalities

The principles of growth

1. Changes of the size increasing in body weight, body height

2. Canges of the proportion of the body head proportion, central point of the body

The principles of growth

3. Loosing the old characteristic thymus gland, decidual teeth, primitive reflexes 4. Appearing of the new characteristic permanent teeth, external genital signs

Phenomenon of growth
Growth rapid is irregular, with fluctuation in growth rapid

Every organ has their own growth pola

4 growth curve pola

1. 2. 3. 4. General growth curve Head and brain growth curve Lymphoid tissue growth curve Reproductive organ curve

General growth
Growth keep continuing regularly since conception to adolescence, with fluctuation in growth rapid Maximum rapid start from fetus, then keep in decreasing while passing the infant period Preschools growth is slow Adolescences growth is fast and end after adolescence period is finish

Head and brain growth

Newborn is 25 % of adult brain weight 50 % of brains development occur in the first year 20 % of brains development occur in the second year At 5-6 yr of age, their brain is 90 % of adult brain weight

Lymphoid tissue growth

Grow rapidly in infants and kids Lymphoid tissue in 10 12 yr old child is 2x bigger than adults Will decrease in puberty, and involute to adults

Reproduction organ growth

Grow slowly in the first year

Growth rapidly in adolescence period secondary genital signs

Grow very fast after bodys growth end

The principles of development

1. Development is a continuous process from conception to maturity. Before any milestone is reached a child has to go through many preceding stages of development

2. Development depends on the maturation and myelinitation of the nervous system 3. The sequence of development is the same for all children, but the rate of development varies from child to child

The principles of development (cont.) 4. Certain primitive reflexes anticipate corresponding voluntary movement and have to be lost before the voluntary movement develops 5. The direction of development is cephalocaudal and proximodistal 6. Generalised mass activity gives way to spesific indiviual responses

General factors affecting the course of GD

GD is a result of many factors interaction, that can be divided into :
Internal factors

External factors

Internal factors
Genetics Race, ethnic, nation Age Gender Family history Chromosomal abnormalities

External (environment) factors

1. Prenatal factors : - Maternal nutrition - Placental problem (maternal hypertension, toxaemia, bleeding, fetal intra-uterine growth retardation) - Infection and drugs in pregnancy - Immunologic distubances - Endocrine problem (DM, hypothyroidism) - Radiation, Toxic, chemical substances - Mothers psychology

2. Perinatal factors :

* Birth complication * Head trauma * Asphyxia

3. Postnatal factors - Illness - Cultural practices - Chronic Infection - Health surveilance - Nutrition - Drugs - Endocrine problems (GH, insulin, thyroid,sexH) - Socioeconomic factors - Management of handicap - Parental health & attitudes - Education & opportunities in life (stimulation) - Physical and chemical environment

Basic Needs of Childrens GD

For optimal GD, the evironment has to meet the childd needs Physico-biomedical needs ( ASUH ) Psychological needs
Love and emotional needs ( ASIH ) Stimulation needs ( ASAH )

Physico-biomecial needs (ASUH)

Nutrition (enough and balance) Basic health care (immunization, early detection, early treatment) Clothing (proper, comfortable, clean) Hygiene and sanitation Parents health and social-economy Sports and recreation Health, prosperous, and education facilities

Love and emotional needs (ASIH)

Parents care Safety Self esteem Successful needs Independence Support Experience opportunity Respect

Stimulation needs (ASAH)

As early as possible Playing, training, education Motoric, language, speech, sosioemotional, cognition aspects Informal, formal, nonformal situation