Growth and Development

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Growth and Development

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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
• Development
• A continuous, orderly series of conditions that
  leads to activities, new motives for activities,
  and patterns of behavior

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Principles of Growth and development
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Principles of GD

• Occurs in an orderly sequence
• Development is Directional
• Individualized each child is unique
• Development is interrelated
• Development becomes increasingly differentiated.
• Development becomes increasingly integrated and
  complex

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Patterns of Growth and Development
Cephalocaudal Pattern (head to toe)
Proximodistal Pattern (from center outward)
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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

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Factors that Influence Growth and Development

• Genetics
• Environment
• Culture
• Nutrition
• Health status
• Family
• Parental attitudes
• Child-rearing philosophies

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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

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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

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Cultural influences

• Must be considered when assessing growth and
  development
• Customs vs. work demands from different cultures

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Nutritional influences

• Begins during the prenatal period
• LBW/preterm can result from poor prenatal
  nutrition
• Socio-economics may impact growth

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Health status of the child

• Certain diseases may affect g d
• Endocrine and cardiac status included here

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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

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Theories of Growth and Development

• Theorists
• Piaget
• Freud
• Erickson
• Just review these theorists and their theories
  focus mainly on Erickson

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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

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Methods to Evaluate Development

• Denver Development Test II
• Play

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Denver Development Test II

• Screening test not a measurement of
  intelligence
• Used to - identify children whose development
  deviates significantly from that of other
  children warranting further investigation to
  determine if there exists a problem requiring
  treatment.
• Test covers - four general functions personal
  social (such as smiling), fine motor adaptive
  (such as grasping and drawing), language (such as
  combining words), and gross motor (such as
  walking).
• Ages covered by the tests range from birth to
  six years.

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Denver Development Test II

• Nursing Implications
• Before beginning inform parents purpose of
  test. Be sure to stress it is not an IQ test.
• Administer test in a comfortable environment that
  contains only items needed for testing
• After testing, share information with the parent.
  

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Play Therapy
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Importance of Play

• Allows child the learn about themselves and
  relate to others.it is work for the child

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Classification of Play

• Functional or Practice play
• Involves repetitive muscle movements
• Infant plays with objects making use of their
  properties to produce pleasurable effects
• Symbolic play
• Child incorporates some object, uses a theme, and
  then play the role that each player will have
• Games
• Includes rules and usually played
• by more than one person
• Mainly used by school-age child and helps to
  learn boundaries, teamwork, taking turns, and
  competition

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Social Aspects of Play

• Solitary play
• Parallel Play
• Associative play
• Cooperative Play
• Onlooker Play

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Solitary Play

• Independent play
• Child plays alone with toys that are very
  different from those chosen by other children in
  the area.
• Begins in infancy and goes through toddler age

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Two children are displaying typical parallel play
since they enjoy playing near other children, but
are NOT engaging in social interactions with each
other. Which cognitive and motor skills are these
children developing?
Parallel Play
Usually Toddler
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Associative Play

• Group play without group goals
• Even though playing with same toys, there is lack
  of formal organization
• Mostly seen in
• toddler - preschooler

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Preschoolers have well-developed language, motor,
and social skills, and they can work
cooperatively together on an art project, as
this group is doing.
Cooperative Play
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Onlooker Play

• Child observes others playing.
• Although the child may ask questions of the
  players, the child does not attempt to join the
  play

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Types of Play

• Dramatic Play act out roles and
• experiences that happened to them
• Familiarization Play
• Allows children to handle materials in
  non-threatening way. Helpful in preparing child
  for procedures.

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Functions of Play

• Physical Development
• Cognitive Development
• Emotional Development
• Social Development
• Moral Development

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Nutrition
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Nutritional Assessment

• A nutritional assessment is an essential
  component of the health examination of infants
  and children.

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Key Dietary Recommendations

• Consume whole grains
• Children 2-8 should consume 2 cups
• of low-fat milk or equivalent milk products
  and children 9 years and older should consume 3
  cups
• Limit juices, eat fruit and vegetables each day
• Watch fat intake. Polyunsaturated and
  monounsaturated fatty acids such as fish, nuts,
  and vegetable oils should be the primary source

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My Pyramid

Eat Right.

Exercise
Have
Fun
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Nutrition and Activity

• Due to increase in childhood obesity, parents
  should encourage their children to increase daily
  physical activity.
• Plan regular periods of exercise
• Make exercise a fun and habitual activity.

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Growth and Development Milestones
Chapter 34
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INFANT

• BIRTH TO 12 MONTHS

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Physical Growth and Development Milestones
During InfancyBirth to 1 month
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Infancy 2-4 months
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Infancy 4-6 months
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Infancy - 6-8 months
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Infancy - 10-12 months
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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.

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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
  parents 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

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TODDLER

• 1-3 years

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Developmental milestones for Toddler
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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.

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Pre-schooler

• 4-5 years of age

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Milestones for the Preschooler
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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.

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School-age Child

• 6-12 years old

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Developmental Milestones School-age
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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.

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Adolescent age

• 12-21 years

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Adolescent

• Psychosocial development
• Independence
• Identity
• Peers
• Language use
• Exploration and rebellion
• Need for privacy
• Sexuality
• Cognitive development
• Formal operations
• Abstract thinking

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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.