THE HEALTHY CHILD

GROWTH AND DEVELOPMENT OF A

HEALTHY CHILD
 INTRODUCTION
• The process of growth and development starts before the baby
is born, i.e. from the conception in the mother’s womb. The
period extends throughout the lifecycle. But the principal
changes occurs from the conception to the end of adolescence.
• Growth and development are closely inter-related. Each child
has individualized pattern of growth and development.
• Promotion of child health and care of children depend upon
understanding of growth and development.
 IMPORTANCE OF LEARNING
GROWTH AND DEVELOPMENT
• Knowing what to expect of a particular child at any given age.
• Gaining better understanding of the reasons behind illnesses.
• Helping in formulating the plan of care.
• Helping in parents’ education in order to achieve optimal
growth & development at each stage.
• To develop a rapport with the child to enhance the provision of
health care and to help to build healthy lifestyle for optimum
health for the future.
 GROWTH
• Growth refers to an increase in
physical size of the whole body
or any of its parts.
• It is simply a quantitative change
in the child’s body.
• It can be measured in Kg,
pounds, meters, inches, Etc.
 DEVELOPMENT
• Development refers to a
progressive increase in skill and
capacity of function.
• It is a qualitative change in the
child’s functioning.
• It can be measured through
observation.
 MATURATION
• Increase in child’s competence
and adaptability.
• It is describing the qualitative
change in a structure.
• The level of maturation depends
on child’s heredity.
 PRINCIPLES OF GROWTH AND
DEVELOPMENT
1) Continuity
2) Sequentiality
3) Generality to Specificity
4) Differentiality
5) Development proceeds from the head downward
6) Development proceeds from the centre of the body outward
7) Development depends on maturation and learning
 PRINCIPLES OF GROWTH AND
DEVELOPMENT
8) Development proceeds from the simple to more complex
9) Growth is a personal matter
10) Growth comes from within
11) Growth has certain characteristics common at particular
stages
12) Growth is gradual and orderly but uneven
CONTINUITY
• Growth and Development is a continues process from conception to
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.
SEQUENTIALITY
• 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 behavioral scientists increasingly have come to see development as a
relationship between organism and environment in a transaction or collaboration.
• Individuals work with and affect their environment, and in turn the environment
works with and affects them.
• 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
GENERALITY TO SPECIFICITY
• Development proceeds from general to specific. In all areas of
development, general activities always precedes specific activity.
For example;
• The fetus moves its whole body but incapable of making specific
responses
• Infants wave their arms randomly. They can make such specific
responses as reaching out for an object near them.
DIFFERENTIALITY
• The tempo of development is not even. Individuals differ in the rate of
growth and development.
• Boys and girls have different development rates. Each part of the body has
its own particular rate of growth. Development does not occur at an even
pace.
• There are periods of great intensity and equilibrium and there are periods of
imbalance.
• Development achieves a plateau and this may occur at any level or between
levels.
DEVELOPMENT PROCEEDS FROM THE
HEAD DOWNWARD (CEPHALO-CAUDAL)
• 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.
DEVELOPMENT PROCEEDS FROM THE CENTRE
OF THE BODY OUTWARD (PROXIMODISTAL)

• 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 develops before the hands, the hands and feet develops
before the fingers and toes.
• Fingers and toe muscles are the last to develop in physical development.
The directional sequence of development stages may either be (A) from
head to foot, or (B) from the central axis to the extremities of the body.
DEVELOPMENT DEPENDS ON
MATURATION AND LEARNING
• 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.
 DEVELOPMENT PROCEEDS FROM
THE SIMPLE TO MORE 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.
GROWTH IS A PERSONAL MATTER
• Each child grows in his own
personal manner. He/she should be
permitted to grow at his/her own
rate.
• If we expects too much, he/she may
does even less than he/she is able to
do.
GROWTH COMES FROM WITHIN
• One or surrounding environment can
encourage or can hinder the energy of
a child, but the drive force that pushes
a child to grow is carried inside him.
• Parent or teacher job is to clear the
track, guide the child with loving
acceptance and then relax and enjoy.
 FACTORS AFFECTING GROWTH AND
DEVELOPMENT
• Hereditary
• Environmental factors
• Prenatal environment (1. Factors related to
mothers during pregnancy, 2. Factors
related to fetus)
• Post natal environment (1. External
environment, 2. Internal environment)
 HEREDITARY
• The heredity of a man and women
determined that of a children.
• Some children's are small not because of
endocrine and nutritional disturbances but
because of their genetic constitution.
• Health history of parents is studied to
determine the hereditary traits likely to
exist in the children .
Sex:
• After Birth The Male Infant Is Both Longer And Heavier
Than The Female Infant.
• Boys Maintain These Superiority Until About 11 Years
Of Age.
• Girls Mature Earlier , Reach The Period Of Accelerated
Growth Earlier Than Boys And Are Taller On The
Average , Bone Development Is More Advanced In Girls
During Prepubertal Spurt Of Growth And Development.
• Earlier Eruption Of The Permanent Teeth In Girls.
RACE AND NATIONALITY:
• Race : Distinguishing
Characteristics Called Racial Or
Subracial Development In
Prehistoric Humans As Too
Height , Tall And Short.
• Nationality : We Think Of
Physical Characteristics Of
National Groups Because The
Inhabitants Of Various Nations
 ENVIRONMENT
Pre-natal environment
1-Factors related to mothers during pregnancy:
- Nutritional deficiencies
- Diabetic mother
- Exposure to radiation
- Infection with German measles
- Smoking
- Use of drugs
2-Factors related to fetus
Mal-position in uterus
Faulty placental implantation
Post-Natal Environment
I. External environment:
Socio-economic status of the family
Child’s nutrition
Climate and season
Child’s ordinal position in the family
Number of siblings in the family
Family structure (single parent or extended
family
II. Internal environment
Child’s intelligence
Hormonal influences
PRENATAL ENVIRONMENT
• Intrauterine environment is an important predominant factor of growth and development.
Various conditions influence the fetal growth in utero.
• Maternal Malnutrition.
• Maternal Infections.
• Maternal Substance abuse.
• Maternal Illness.
• Hormones. Like thyroxin and insulin influence the fetal growth.
• Miscellaneous:- Various parental conditions, which may also influence fetal growth include
uterine malformations mal-positions of the fetus oligohydramnios, faulty placental implantation
or malfunction, maternal emotion during pregnancy, inadequate prenatal care, etc.
POSTNATAL ENVIRONMENT
I. EXTERNAL ENVIRONMENT
• Growth Potential:- is indicated by child’s size at birth. The smaller the child at birth
the smaller she / he is likely to be in subsequent years.
• Nutrition:- balanced amount of essential nutrients have great significant role in
growth and development. Both quantitative and qualitative supply of nutrition are
necessary for promotion of G & D.
• Childhood Illness:- both acute and chronic illnesses of childhood affect the child’s G
& D adversely.
• Physical Environment: Housing, living conditions, safety and fresh air, hygiene,
safe water supply, etc.
Cont…
• Psychological Environment:- Healthy family, good parent child relationship and healthy
interaction with other family members, neighbors, friends. Lack of love affection and security
leads to emotional disturbance which hinders emotional maturity and personality development.
Broken family, sibling jealousy and inappropriate school environment has poor effect on
psychological development.
• Cultural Influences.
• Socioeconomic Status.
• Climate and Season:- Climatic variation and seasonal changes influence the child health.
• Play and exercise:- play and exercise promote physiological activity and stimulates muscular
development.
• Birth order of the child:- the first born is usually intelligent achievement oriented.
II. INTERNAL ENVIRONMENT

• Intelligence:- Intelligence of the child influences mental and social

development.
• Hormonal Influence:- Hormones are the important aspects of internal
environment which have vital role in growth and development of the
children. All hormones in the body affect growth in some manner.
ASPECTS OF GROWTH AND
DEVELOPMENT
GROWTH AND DEVLOPMENT HAVE THE
FOLLOWING ASPECT:
A: Growth B: Development
a. Biological growth a. Intellectual
b. Sensory growth b. Moral
c. Motor growth c. Emotional
d. Sexual
e. Social
f. language
A. GROWTH
• Biological Growth: Changes in body result from growth of different parts of body. The parameters
for assessing growth in children.
• Length or height
• Weight
• Head circumstance
• Chest circumstance
• Motor growth: Motor development depends on maturation of muscular, skeletal and nervous
system.
• Gross motor
• Fine motor
• Sensory growth: Although sensory system is functional at birth, the child gradually learns the
process of associating meaning with a perceived stimulus.
B. DEVELOPMENT
• Intellectual: Mental development is demonstrated in problem solving and
general understanding of what to do in a given situation.
• Moral: the complicated process by which values are formed, how they affect
behavior and how they are changed through experience
• Emotional: Psychosocial development or emotional and personality
development is a continuous process.
• Sexual:
• Social
• language
STAGES OF GROWTH AND
DEVELOPMENT
• Prenatal • Middle Childhood
- Embryonic (conception- 8 w) - School age
- Fetal stage (8-40 or 42 w) - 6 to 12 years
• Infancy • Late Childhood
- Neonate: Birth to end of 1
month - Adolescent
- Infant: 1 month to end of 1 year - 13 years to 18 years
• Early Childhood
- Toddler: 1-3 years
- Preschool: 3-6 years
GROWTH AND DEVELOPMENT FROM
BIRTH TO ADOLESCENCE
 NEWBORN STAGE

Newborn stage is the first 4 weeks or first month of

life. It is a transitional period from intrauterine life to
extra uterine environment.
NORMAL NEWBORN INFANT
PHYSICAL GROWTH
Weight

- Weight = 2.700 – 4 kg
- Wt. loss 5% -10% by 3-4 days after birth
- Wt. gain by 10th days of life
- Gain ¾ kg by the end of the 1st month
Weight cont……
They loose 5 % to 10 % of weight by 3-4 days after birth as
result of :
 Withdrawal of hormones from mother.
 Loss of excessive extra cellular fluid.
 Passage of meconium (feces) and urine.
 Limited food intake.
Height

• Boys average Ht = 50 cm
• Girls average Ht = 49 cm
• Normal range for both (47.5-
53.75 cm)
Head circumference

Normal HC of newborn baby is 33-35 cm

Head is ¼ total body length
Skull has 2 fontanels (anterior & posterior)

Chest circumference
It is 30.5 to 33cm (usually 2–3cm less than
head circumference).
fontanel
Anterior fontanel Posterior fontanel
• Diamond in shape, also called • Triangular in shape, also called
Bergma lambda
• The junction of the sagittal, corneal • Located between occipital & 2
and frontal sutures forms it parietal bones
• Between 2 frontal & 2 parietal • Closes by the end of the 1st
bones
month of age
• 3-4 cm in length and 2-3 cm width
• It closes at 12-18 months of age
 PHYSIOLOGICAL GROWTH

Vital signs
• Temperature (36.3
to37.2C ).
• Pulse ( 120 to 160 b/min ).
• Respiration ( 35 to 50C/min) .
 NORMAL NEWBORN INFANT
SENSORY GROWTH
Senses:
- Touch
- Vision
- Hearing
- Taste
- Smell
Touch
• It is the most highly developed
sense.
• It is mostly at lips, tongue, ears,
and forehead.
• The newborn is usually
comfortable with touch.
Vision
• Pupils react to light
• Bright lights appear to be
unpleasant to newborn infant.
• Follow objects in line of vision
Hearing
• The newborn infant usually makes some
response to sound from birth.
• Ordinary sounds are heard well before 10
days of life.
• The newborn infant responds to sounds
with either cry or eye movement,
cessation of activity and / or startle
reaction.
Taste
• Well developed as bitter and
sour fluids are resisted while
sweet fluids are accepted.
Smell
• Only evidence in newborn
infant’s search for the
nipple, as he smell breast
milk.
NORMAL NEWBORN INFANT
MOTOR GROWTH
Gross Motor Development

• The newborn's movement are

random, diffuse and
uncoordinated. Reflexes carry
out bodily functions and
responses to external stimuli.
Fine Motor Development

• Holds hand in fist

• When crying, he draws
arms and legs to body
NORMAL NEWBORN INFANT
REFLEXES
Reflexes
• Swallowing Sucking and
swallowing
reflexes
• Gagging
• Sucking
• Grasp
• Tonic-neck
• Step reflex
• Crawl reflex
 DEVELOPMENT
• COGNITIVE DEVELOPMENT: The cognitive development of
newborn infant is difficult to understand or observe it.
• EMOTIONAL DEVELOPMENT: The newborn infant
expresses his emotion just through cry for hunger, pain or
discomfort sensation
• SOCIAL DEVELOPMENT: The newborn infant recognize
his/her mother or care taker only.
 INFANT
1 MONTH TO END OF 1 YEAR
 NORMAL INFANT

• It is the period which starts at

the end of the first month up to
the end of the first year of age.
Infant's growth and development
during this period are rapid.
 NORMAL INFANT
PHYSICAL GROWTH
Weight
The infant gains :
- Birth to 4 months → ¾ kg /month
- 5 to 8 months → ½ kg / month
- 9 to 12 months → ¼ kg /month

The infant will double his birth wt by 4-5 months and triple it by 10-12
months of age
Weight cont….
Calculating infant’s weight:
Infants from 3 to 12 months

Weight = Age in months + 9

2
Weight of 7 months old infant = 7+9 = 16 = 8 kg
2 2
Height

• Length increases about 3 cm /month during the 1 st 3

months of age,
• Then it increases 2 cm /month at age of 4-6 months,
• Then, at 7 – 12 months, it increases 1 ½ cm per month
Head circumference
• It increases about 2 cm /month during the 1st 3 months,
• Then, ½ cm/month during the 2nd 9 months of age.
• Posterior fontanel closes by 6-8 w of age.
• Anterior fontanel closes by 12-18 months of age.

Chest circumference
• By the end of the 1st year, it will be equal to head circumference.
Physiological growth of infants:-

• Pulse 110-150 b/min

• Resp 35 ± 10 c/min
• Breath through nose.
• Blood pressure 80/50 ± 20/10 mmHg
Dentition:
• Eruption of teeth starts by 5–6 months of age. It is called "Milky teeth" or
"Deciduous teeth" or "Temporary teeth".
• Average age for teeth eruption:
NORMAL INFANT
MOTOR GROWTH
 MOTOR DEVELOPMENT
At 2 months
• Hold head erects in mid-position.
• Turn from side back.
At 3 months, the infant can
• Hold head erects and steady.
• Open or close hand loosely.
• Hold object put in hand
At 4 months
• Sit with adequate support.
• Roll over from front to back.
• Hold head erect and steady while
in sitting position.
• Bring hands together in midline
and plays with fingers.
• Grasp objects with both hands.
 MOTOR DEVELOPMENT
At 5 months At 6 months

• Balance head well when sitting. • Sit alone briefly.

• Sit with slight support. • Turn completely over ( abdomen to
abdomen ).
• Pull feet up to mouth when supine.
• Lift chest and upper abdomen
• Grasp objects with whole hand (Rt. when prone.
or Lt.).
• Hold own bottle.
• Hold one object while looking at
another
 MOTOR DEVELOPMENT
At 7 months At 9 months
• Sit alone. • Rise to sitting position alone.
• Hold cup. • Crawl (i.e., pull body while in
• Imitate simple acts of others. prone position).
• At 8 months • Hold one bottle with good hand-
• Site alone steadily. mouth coordination
• Drink from cup with assistance.
• Eat finger food that can be held in one
hand.
 MOTOR DEVELOPMENT
At 10 months
• Creep well (use hands and legs).
• Walk but with help.
• Bring the hands together.
At 11 months , the infant can
• Walk holding on furniture.
• Stand erect with minimal support
At 12 months
• Stand-alone for variable length of time.
• Site down from standing position
alone.
• Walk in few steps with help or alone
(hands held at shoulder height for
balance).
• Pick up small bits of food and transfers
them to his mouth
 EMOTIONAL DEVELOPMENT
• His emotions are instable, where it is rapidly changes from crying to
laughter.
• His affection for or love family members appears.
• By 10 months, he expresses several beginning recognizable emotions, such
as anger, sadness, pleasure, jealousy, anxiety and affection.

• By 12 months of age, these emotions are clearly distinguishable.

 SOCIAL DEVELOPMENT
• He learns that crying brings attention.
• The infant smiles in response to smile of others.
• The infant shows fear of stranger (stranger anxiety).
• He responds socially to his name.
• According to Erikson, the infant develops sense of trust. Through the
infant's interaction with caregiver (mainly the mother), especially during
feeding, he learns to trust others through the relief of basic needs.
 VISION DEVELOPMENT
• As an infant's vision develops, he or she may seem preoccupied with
watching surrounding objects and people
 SPEECH DEVELOPMENT
• 1-2 months: coos
• 2-6 months: laughs and squeals
• 8-9 months babbles: mama/dada as sounds
• 10-12 months: “mama/dada specific
• 18-20 months: 20 to 30 words – 50% understood by strangers
• 22-24 months: two word sentences, >50 words, 75% understood by
strangers
• 30-36 months: almost all speech understood by strangers
EARLY CHILDHOOD
TODDLER: 1-3 YEARS
 NORMAL TODDLER

• Toddler stage is between 1

to 3 years of age. During
this period, growth slows
considerably.
 NORMAL TODDLER
PHYSICAL GROWTH
Weight

The toddler's average weight gain is 1.8 to 2.7 kg/year.

Formula to calculate normal weight of children over 1 year of age is

Age in years X 2+8 = ….. kg.

e.g., The weight of a child aging 4 years
= 4 X 2 + 8 = 16 kg
Height
• During 1–2 years, the child's height increases by 1cm/month.
• The toddler's height increases about 10 to 12.5cm/year.
Formula to calculate normal height
• Age in years X 5 + 80 = cm.
e.g., the length of 2 years old child
= 2 X 5 + 80 = 90cm
Head and chest circumference

• The head increases 10 cm only from the age of 1 year

to adult age.
• During toddler years, chest circumference continues to
increase in size and exceeds head circumference.
Teething

• By 2 years of age, the toddler has 16 temporary teeth.

• By the age of 30 months (2.5 years), the toddler has 20
teeth
Physiological growth

Pulse: 80–130 beats/min (average 110/min).

Respiration: 20–30C/min.
Bowel and bladder control:
Daytime control of bladder and bowel control by 24–30
months.
NORMAL TODDLER
MOTOR GROWTH
Fine motor
• 1 year old: transfer objects from hand to hand
• 2 year old: can hold a crayon and color vertical strokes
• Turn the page of a book
• Build a tower of six blocks
• 3 year old: copy a circle and a cross – build using small
blocks
Gross motor
At 15 months, the toddler can: At 24 months:
• Walk alone. • Go up and down stairs alone with
• Creep upstairs. two feet on each step.
• Assume standing position without • Hold a cup with one hand.
falling.
• Hold a cup with all fingers grasped • Remove most of own clothes.
around it. • Drink well from a small glass held
At 18 months: in one hand.
• Hold cup with both hands.
• Transfer objects hand-to hand at will.
Gross motor
At 30 months: the toddler can:
• Jump with both feet.
• Jump from chair or step.
• Walk up and downstairs, one foot on a step.
• Drink without assistance.
 EMOTIONAL DEVELOPMENT
• Stranger anxiety – should dissipate by age 2 ½ to 3 years
• Temper tantrums: occur weekly in 50 to 80% of children – peak incidence
18 months – most disappear by age 3
• Sibling rivalry: aggressive behavior towards new infant: peak between 1
to 2 years but may be prolonged indefinitely
• Thumb sucking
• Toilet Training
 COGNITIVE DEVELOPMENT
• Up to 2 years, the toddler uses his senses and motor development to
different self from objects.
• The toddler from 2 to 3 years will be in the pre-conceptual
phase of cognitive development (2-4 years), where he is still
egocentric and can not take the point of view of other people.
 SOCIAL DEVELOPMENT
• The toddler is very social being but still egocentric.
• He imitates parents.
• Notice sex differences and know own sex.
• According to Erikson,
• The development of autonomy during this period is centered around
toddlers increasing abilities to control their bodies, themselves and their
environment i.e., "I can do it myself".
PRE-SCHOOL
 PRESCHOOL STAGE

Definition:-
It is the stage where child is 3 to 6
years of age. The growth during this
period is relatively slow.
 PHYSICAL GROWTH

Weight: The preschooler gains approximately

1.8kg/year.
Height: He doubles birth length by 4–5 years of
age.
PHYSIOLOGICAL GROWTH

• Pulse: 80–120 beat/min. (average 100/min).

• Respiration: 20–30C/min.
• Blood Pressure: 100/67+24/25.
FINE MOTOR – OLDER TODDLER

• 3 year old: copy a circle and a cross – build using

small blocks
• 4 year old: use scissors, color within the borders
• 5 year old: write some letters and draw a person
with body parts
 FINE MOTOR – OLDER TODDLER
• Buttoning clothing
• Holding a pencil
• Building with small blocks
• Using scissors
• Playing a board game
• Have child draw picture of himself
 COGNITIVE DEVELOPMENT

Preschooler up to 4 years of age is in the

pre-conceptual phase. He begins to be
able to give reasons for his belief and
actions, but not true cause-effect
relationship.
 EMOTIONAL DEVELOPMENT
• Fears the dark
• Tends to be impatient and selfish
• Expresses agression through physical and verbal
behaviours.
• Shows signs of jealousy of siblings.
 SOCIAL DEVELOPMENT
• Egocentric
• Tolerates short separation
• Less dependant on parents
• May have dreams & night-mares
• Attachment to opposite sex parent
• More cooperative in play
 SOCIAL DEVELOPMENT

According to Erikson theory:

• The preschooler is in the stage where he
develops a sense of initiative, Where he
wants to learn what to do for himself, learn
about the world And other people.
SCHOOL-AGE
 NORMAL SCHOOL-AGE
CHILD
School-age period is between the age of 6
to 12 years. The child's growth and
development is characterized by gradual
growth.
PHYSICAL GROWTH
Weight:
•School–age child gains about 3.8kg/year.
•Boys tend to gain slightly more weight through 12
years.
•Weight Formula for 7 - 12 yrs
= (age in yrs x 7 )– 5
2
PHYSICAL GROWTH
Height :
•The child gains about 5cm/year.
•Body proportion during this period: Both boys and
girls are long-legged
PHYSICAL GROWTH
Dentition:
•Permanent teeth erupt during school-age period,
starting from 6 years, usually in the same order in
which primary teeth are lost.
•The child acquires permanent molars, medial and
lateral incisors.
PHYSIOLOGICAL GROWTH:
•Pulse: 90+15 beats/min
(75 to 105).
•Respiration: 21+3C/min
(18–24).
•Blood Pressure: 100/60+16/10.
FINE MOTOR
•Writing skills improve
•Fine motor is refined
•Fine motor with more focus
•Building: models – logos
•Sewing
•Musical instrument
•Painting
•Typing skills
•Technology: computers
MOTOR DEVELOPMENT
At 6–8 years, the school–age child:
•Rides a bicycle.
•Runs Jumps, climbs and hops.
•Has improved eye-hand
coordination.
•Prints word and learn cursive
writing.
•Can brush and comb hair.
At 8–10 years, the school–age child:
•Throws balls skillfully.
•Uses to participate in organized sports.
•Uses both hands independently.
•Handles eating utensils (spoon, fork,
knife) skillfully.
At 10–12 years, the school–age child:
•Enjoy all physical activities.
•Continues to improve his motor
coordination.
SCHOOL AGE: GROSS MOTOR
•8 to 10 years: team sports
•Age ten: match sport to the physical and
emotional development
SCHOOL PERFORMANCE
•Ask about favorite subject
•How they are doing in school
•Do they like school
•By parent report: any learning difficulties, attention
problems, homework
•Parental expectations
COGNITIVE DEVELOPMENT
At 7-11 years, the child now is in the concrete
operational stage of cognitive development. He is able to
function on a higher level in his mental ability.
Greater ability to concentrate and participate in self-
initiating quiet activities that challenge cognitive skills, such
as reading, playing computer and board games.
EMOTIONAL DEVELOPMENT
The school–age child:
•Fears injury to body and fear of dark.
•Jealous of siblings (especially 6–8 years old child).
•Curious about everything.
•Has short bursts of anger by age of 10 years but able to
control anger by 12 years.
SOCIAL DEVELOPMENT
The school–age child is :
•Continues to be egocentric.
•Wants other children to play
with him.
•Insists on being first in every
thing
•Becomes peer oriented.
•Improves relationship with
siblings.
•Has greater self–control,
confident, sincere.
•Respects parents and their role.
•Joints group (formal and
informal).
•Engage in tasks in the real world.
DEFINITION OF
ADOLESCENT:
Adolescence is a transition period from
childhood to adulthood. Its is based on
childhood experiences and accomplishments.
It begins with the appearance of secondary sex
characteristics and ends when somatic growth is
completed and the individual is psychological
mature.
PHYSICAL GROWTH
Weight:
•Growth spurt begins earlier in girls (10–14 years, while it is 12–16 in
boys).
•Males gains 7 to 30kg, while female gains 7 to 25kg.
Height:
•By the age of 13, the adolescent triples his birth length.
•Males gains 10 to 30cm in height.
•Females gains less height than males as they gain 5 to 20cm.
•Growth in height ceases at 16 or 17 years in females and 18 to 20in males
PHYSIOLOGICAL
GROWTH:
Pulse:
• Reaches adult value 60–80 beats/min.
Respiration:
•16–20C/minute.
NB:
• The sebaceous glands of face, neck and chest become more
active. When their secretion accumulates under the skin in face,
acne will appear.
APPEARANCE OF
SECONDARY SEX
CHARACTERISTICS
1. Secondary sex characteristics in girls:
•Increase in transverse diameter of the pelvis.
•Development of the breasts.
•Change in the vaginal secretions.
•Growth of pubic and axillary hair.
•Menstruation (first menstruation is called menarche,
which occurs between 12 to 13 years).
BODY IMAGE
2- Secondary sex characteristics in boys:
•Increase in size of genitalia.
•Swelling of the breast.
•Growth of pubic, axillary, facial and chest hair.
•Change in voice.
•Rapid growth of shoulder breadth.
•Production of spermatozoa (which is sign of
puberty).
Cognitive development:
Through formal operational thinking, adolescent can deal with a problem.
Emotional development:
This period is accompanied usually by changes in emotional control. Adolescent
exhibits alternating and recurrent episodes of disturbed behavior with periods of quite
one. He may become hostile or ready to fight, complain or resist every thing.
Social development:
He needs to know "who he is" in relation to family and society, i.e., he develops a
sense of identity. If the adolescent is unable to formulate a satisfactory identity from the
multi-identifications, sense of self-confusion will be developed according to Erikson:-
• Adolescent shows interest in other sex.
• He looks for close friendships.
ADOLESCENT BEHAVIORAL
PROBLEMS
•Anorexia
•Attention deficit
•Anger issues
•Suicide
ADOLESCENT TEACHING
•Relationships
•Sexuality – STD’s / AIDS
•Substance use and abuse
•Gang activity
•Driving
•Access to weapons
THANK YOU