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    Growth and Development

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    Overview

    Outline

    I. Growth

    II. Development (motor, psychosocial, cognitive)

    III. Health Promotion

    Infant 1 month1 year

    Toddler 1 year3 years

    Preschooler 3 years6 years

    School Age 6 years12 years

    Adolescence 12 years21 years

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    Infant: Growth

    0-6mos: gain 1lb2 lb per month

    6-12mos: gain 1 lb per month

    Double birth weight by 6mos &

    triple birth weight by 1 year

    0-6mos: increase length 1 inch per month

    6-12mos: increase length by inch per month

    Increase length by 50% by age 1 year

    Head circumference growth rate: 1cm per month

    for the first year

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    Infant: Development

    Ericksons stage: Trust versus Mistrust

    Piagets stage: Sensorimotor

    Parent-Infant attachment critical Cognitive development parallels motor

    development

    Language development is a criticalindicator of normal development over the

    first year of life (and beyond)

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    Infant: Health Promotion

    Immunizations

    Hearing Screen (usually done at birth)

    Feeding

    Sleeping

    Safety (burns, poisoning, falls, asphyxiation)

    Prevention of Lead Exposure

    Age Appropriate Toys

    Do Not Use Walkers

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    Toddler: Growth

    Physical growth slows

    Weight gain: 5 lb per year

    Height: 3 inches per year

    2 years: head circumference is 90% ofadult size

    Overall head growth: 1.5 inches during

    toddler years Immature abdominal musculature and

    exaggerated lumbar curve

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    Toddler: Development

    Ericksons Stage: Autonomy vs. Shame and Doubt

    12-24mos: Piagets Stage: Sensorimotor

    2-4 years: Piagets Stage: Preoperational

    Language accelerates: 300 words by age 2

    Kohlbergs Stage: Punishment-Obedience

    Learning occurs through trial and error, play, and

    exploring freely in a safe environment

    Refine ability to walk, build with blocks, and

    expanding motor skills for exploration

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    Toddler: Health Promotion

    Nutrition (finger foods, physiologic anorexia, usecup and spoon)

    Teeth care

    Consistent limit setting Consistent positive reinforcement

    Toilet training (generally not before age 2)

    Temper tantrum management

    Socialization

    Caregiver support

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    Preschooler: Growth

    Slow and steady growth

    Weight gain = 2.25kg (5lbs) per year

    Height = 5-7.5 cm (2-3 inches) per year

    Appetite decreases Slimmer, more agile appearance

    Vital capacity increases and RR slows

    Cardiovascular maturation allows the child toparticipate in sustained activity

    20 deciduous teeth present by age 3 years

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    Preschooler: Development

    Ericksons Stage: Initiative versus Guilt

    Piagets Stage: Preoperational

    Kohlbergs Stage: Premorality

    Fine and gross motor ability improve Handedness emerges by age 3 years

    By age 4-5 years the child can perform ADLsindependently

    >2100 words by 5 years

    Rhymes and silly words by age 4 years

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    Preschooler: Health Promotion

    Need 10-12 hours of sleep/24 hours

    Nightmares/night terrors

    Magical thinking poses safety issues

    Simple, concrete explanations Gun safety, stranger awareness, learn personal

    information, good touch/bad touch

    Water safety

    School readiness Booster seat in car (car seat up to 40 lbs)

    Appropriate child care

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    School Age: Growth

    Slow, steady growth

    Weight gain: 5.5 lbs per year

    Height: 2 inches per year

    Growth spurt age 10-12 years indicates onset of puberty

    Average age of puberty is 11-12 years

    Girls experience puberty 1.5 years earlier than boys

    Lymphatic tissue reaches adult level by age 10 years

    Frontal sinuses develop age 7 years

    Increased musculoskeletal growth promotes strengthand coordination

    Myelinization of CNS continues to age 10; refinement offine motor skills

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    School Age: Development

    Ericksons Stage: Industry vs. Inferiority

    Piagets Stage: Concrete Operations

    Kohlbergs Stage: Morality of Conventional Role

    Conformity (7-10 years); Law and OrderOrientation (10-12 years)

    Increased mastery of language

    Emergence of logic Self-esteem development

    Friendship skills established

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    2 + 3 = 5

    53 = 2

    Problem Solving

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    School Age: Health Promotion

    20 primary teeth lost; replaced with 28 permanent teeth

    Reading improves language skills

    Helmet use

    Overestimate ability and maturity

    School Refusal Obesity

    Regular sleep

    Supervise activities

    Limit TV viewing/video game playing Media Influence

    Emotional support

    Sex Education

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    Adolescent: Growth

    Rapid Growth Period

    Tanner Stages (pg. 152-153)

    Growth stops in females 2 years after menarche

    Growth acceleration in males later than females(begins 10-16 years; ends 13-17 years)

    Muscle mass increases in males

    Fat deposition increases in females

    Cardiopulmonary capacity matures in lateadolescence and is individually variable

    Bone calcification is completed after puberty

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    Adolescent: Development

    Ericksons Stage: Identity vs. Role Confusion

    Piagets Stage: Formal Operations

    Kohlbergs Stage: Social Contract Orientation

    Cognitive development influences psychosocial

    development

    Establishment of sexual and vocational identity

    Refine social relationships Egocentrism and risk taking behavior

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    Adolescent: Health Promotion

    Address issues related to fatigue Promote physical activity

    Nutrition

    Assess/Discuss risk taking behaviors

    Violence (homicide second leading cause of death age15-19)

    Sun Protection

    Abstinence/Contraception

    STD education

    Psychosocial support/Listening Car Safety

    Consequences of decisions/making good decisions