g and d lecture
TRANSCRIPT
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Pediatrics I
Module on Growth and Development
Dr. Rosalina Q. De Sagun
Dr. Noemi T. Salazar
Dr. Rosalia M. Buzon
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Growth And Development
Growth - refers to physical
development and measured with theweight, height, etc .
Development - refers to maturation,acquisition of competence or changein childs behavior
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Assessment
1. Physical Growth
- weight
- length / height
- head circumference
2. Development
Motor- gross and fine
Language - comprehension
- expression
Personal/Social
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0 - 2 months
Physical development
- newborn weight decreases 10% below BW inthe 1st wk
- regains or exceeds BW by 2 wks
- Wt gain = 30 gm/day during the 1st month
- BW doubled = by 4-5 months
- BW 3x = 1 year- BW 4x = 2nd yr
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0 2 months
Cognitive Development
- Recognizes human face and smiles
- Increased attention when stimulus changesEmotional Development
- Basic trust vs mistrust 1stEricksons
Psychosocial stage- develops as infants learn that their urgent
needs are met regularly
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2 - 6 months
Physical development
- By 3-4 months - rate of growth = 20 gm/day
- Early reflexes disappear
- Voluntary movements appear
Cognitive Development
- More interested socially
- Becomes distracted with stimuli
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6 - 12 months
Physical development- Increased mobility and exploration
- Growth slows wt gain of 15g/d (6-9mos),
12g/d (9-12mos)- Tooth eruption usually starts with themandibular central incisors maxillarycentral incisors mandibular lateral incisors maxillary lateral incisors cuspids 1stmolars 2nd molars- Tooth development partly reflects skeletalmaturation and bone age
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Emotional Development
- Starts to have emotions of fear,
anger, joy
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6 - 12 months
Cognitive Development- Increased cognitive understanding &
communications
- Complex plays- Object constancy starts at 9 months
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6 to 12 months
Emotional Development- Separation anxiety- Tantrums startOthers
- Language development
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12 18 months
Physical development
- Growth rate decreases further in the 2nd year
(8g/d for 1-3 yrs old)
- Appetite decreases
- Baby fat burned up with increased mobility
- Exaggerated lumbar lordosis
- Brain growth & myelination continues
- Motor development
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12 18 months
Cognitive Development
- Mastery of reaching, grasping & releasing
- Imitates elders- Make- believe play centers on his body
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Emotional Development
- Attachment to parents
- Temperament depends on attachment to& comfort given by parents
Others
- Receptive language precedes expressive
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18 - 24 months
Physical development
- Improved balance & agility i.e. running /climbing stairs
- Weight/height increase at a steady rate
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Cognitive Development
- 18 months end of sensorimotordevelopment
- Object permanence firmly established
Emotional Development- Increased awareness of possibility of
separation
Others- Start asking What is this?
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2 - 5 years (Pre-school yrs)
Physical development
Somatic & brain growth slows with decrease
in nutritional requirement & appetite
By 2-5 years, child gains 2 Kg in wt/yr., 7 cmin height/ year
Abdomen flattens-
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2 5 yrs
All 20 primary teeth haveerupted by 3 years
Handedness established by 3
years old; bowel/bladdercontrol established by average3 years.
Bedwetting normal up to 4 yearsin girls ; 5 years in boys
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Cognitive Development
- Pre-school magical thinking
- Egocentricism
- Play complex, imaginative
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2 5 years
Emotional Development
- Acceptance of limits, interacts with
adults & peers
- They learn what behaviors are
acceptable and not
- Learn how to adapt to new rules- Control is a central issue
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Others
-Visual acuity: 20/30 by 3 years
20/20 by 4 years
-Language development:occurs most rapidly 2-5 yrs.
- As a rule, # of words in atypical sentence equals the
childs age(2 by 2 years; 3 by 3years); 4 years old can use pasttense; 5 yrs old can use futuretense
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6 - 12 years (School yrs)
Physical development- Growth averages 3 - 3.5 Kg/yr and 6
cm/year
- Loss of deciduous teeth with eruption of 1stmolar (by 6 years) rate of replacementwith adult teeth approx. 4/yr
- Lymphoid tissues hypertrophy
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CognitiveDevelopment- Learning centers onreading, writing and
math- Apply rules based onobservable phenomena
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6 12 years
Emotional Development
- More and longer separation from home
- Influence of peer group increases- Seeks acceptance from teachers
- Self esteem a central issue with popularity
as its central component
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Formulas for Approximate Average Weight& Height of Normal Infants & Children
Weight :
- at birth: 3.25 Kg
- for 3-12 months: age (mo) + 9 / 2- for 1-6 yrs: age (yr) x 2 + 8
- for 7-12 yrs: age (yr) x 7 5 / 2
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Height :- at birth: 50 cm
- at 1 yr: 75 cm- at 2-12 yrs:
age (yr) x 6 + 77
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All 20 primary teeth haveerupted by 3 years
- Handedness established by 3years old; bowel/bladdercontrol established by average3 years. Bedwetting normal upto 4 years in girls ; 5 years in
boys
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Developmental Milestones
Newborn:
lies in flex attitude, turns head from
side to sidehead lags on pull
can fixate face or light in line with vision
Moro , grasp , stepping reflexes activeVisual preference to a human face
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Developmental Milestone
At 1 month:
Holds head up momentarily
Tonic neck posture predominatesFollows moving object
Reflex smile
Body movements in cadence with voice ofothers in social contact
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Developmental Milestone
At 2 months:
Head sustained on ventral suspension
Tonic neck posture predominates
Follows moving objects past midline- 180degrees
Smiles on social contact (social smile)
Listens to voice and coos
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Developmental Milestone
At 4 months:Symmetric posture
No head lag on pull to sit (good head
control)When held erect, pushes with feet
Reaches & grasps objects and brings themto mouth
Laughs out aloud
Shows displeasure when social contact isbroken
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Developmental Milestone
At 7 months:
Rolls over; crawls or creeps
Sits briefly with supportTransfers objects from hand to hand
Polysyllabic vowel sounds
Prefers mother
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Developmental Milestone
At 10 months:
Sits alone; pulls to stand
Cruises; walks holding on to furniturePincer grasp; looks for hidden toy
Repetitive consonant sounds( mama,
dada)Responds to sound of name
Waves bye-bye; plays peek-a-boo
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Developmental Milestone
At 12 months:
Walks with 1 hand held
Obeys simple commands on requestor gesture
Speaks few words besides mama, dada
Makes postural adjustment to dressing
Plays simple ball game
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Developmental milestones
At 15 months:
Walks alone; crawls up stairs
Makes a line with crayonJargon; follows simple commands
May name a familiar object (ball)
Indicates needs by pointing
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Developmental Milestone
At 18 months:Runs stiffly; walks up stairs with 1 handheld
Imitates scribbling and vertical strokeNames pictures; identifies 1 or more bodyparts
Average of 10 words
Feeds self
Seeks help when in trouble
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Developmental milestones
At 24 months (2 yrs):Runs well; walks up & down stairs onestep at a time; climbs to furniture
Circular scribbling
Puts 3 words together ( subject-verb-object)
Handles spoon well; listens to storieswith pictures
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Developmental Milestone
At 30 months:
Goes upstairs with alternating feet
Imitates circular strokeKnows full name; refers to self as I
Helps put things away; pretends in play
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Developmental Milestones
At 36 months (3 yrs):Rides tricycle
Copies a circle; imitates a cross
Knows age and sex; counts 3 objectscorrectly
Plays simple games with other children;helps in dressing
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Developmental Milestone
At 48 months (4yrs):
Hops on one foot
Copies cross and square; draws a manwith
2 to 4 parts besides the head; names
longer of 2 linesTells a story
Goes to toilet alone.
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Developmental Milestones
At 60 months:
Skips
Copies a triangle; names heavier of 2weights
Names 4 colors
Dresses and undressesAsks questions about meaning of words
Domestic role-playing
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Thank You