GROWTH AND DEVELOPMENT

Dr. Celeste Ceniza Cabahug MD, FPPS, RN

Growth refers to an increase in
physical size of the whole or any of its
parts
GROWTH
COMPETENCIES CONTENT
I. Define growth A process by which a living being or any part increases in
size and mass over time either by multiplication or by
enlargement of component cells.

II. Recognize the importance & significance of growth Factors Affecting Growth & Development
a.Biologic - Biology is Destiny
- Nature:Genes
a.Psychologic - Behavioral Patterns
1. Psycho social –Erikson
2. Psycho Sexual – Frued
3. Cognitive – Piaget
4. Moral – Kohlberg
5. Attachment - Bowlby
c. Social - Environment
III. Organogenesis
a.3 Phases of intrauterine development
1. Ovular = 0 – 14 days
2. Embryonic = 14 days – 9 weeks
3. Fetal = 9 weeks – Birth

a.3 Germ layers – Organs

1. Ectoderm
2. Mesoderm
3. Endoderm
GROWTH
COMPETENCIES CONTENT
I. Define growth A process by which a living being or any part increases in
size and mass over time either by multiplication or by
enlargement of component cells.

II. Recognize the importance & significance of growth Factors Affecting Growth & Development
a.Biologic - Biology is Destiny
- Nature:Genes
a.Psychologic - Behavioral Patterns
1. Psycho social –Erikson
2. Psycho Sexual – Frued
3. Cognitive – Piaget
4. Moral – Kohlberg
5. Attachment - Bowlby
c. Social - Environment
GROWTH
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d. Patterns of Growth
Organ specific growth pattern
1. Lymphoid
2. Neural
3. Somatic/General
4. Reproductive/Genital
GROWTH

d. Patterns of Growth
Organ specific growth pattern
1. Lymphoid
2. Neural
3. Somatic/General
4. Reproductive/Genital
GROWTH
COMPETENCIES CONTENT
III. Interpret growth measurments Measurements of the following:

a.Weight
GROWTH
COMPETENCIES CONTENT
III. Interpret growth measurments Measurements of the following:

a. Weight
at 4-5 m0. = 2X Birth Weight
at 1 year = 3X Birth Weight
at 2 years = 4X Birth Weight
at 3 years = 5X Birth Weight
at 5 years = 6X Birth Weight
at 7 years = 7X Birth Weight
at10 years = 10 X Birth Weight

Calculations
Weight (Kg) 3 – 12 mos. = age (mos.) + 9
2

1 – 6 yo = age (yr) X2 +8

7 – 12 yo = age (yr) X7 - 5
b. Height / Length 2

Height (cms) 2 – 12yo age(yr) X6 + 77 Nelson

age(yr) X5 + 80 Del Mundo

PATTERNS of GROWTH

LENGTH
Birth to 3rd month: 9 cm
4th to 6th month: 8 cm
7th to 9th month: 5 cm
10th to 12th month 3 cm

TOTAL GROWTH
25 cm
over the FIRST YEAR
GROWTH
At 1 year old = 1.5XBirth Length
4 years old = 2XBirth Length
13 years old = 3XBirth Length

c. Head circumference
First 4 months = ½ in./mo. = 2 in.
Next 8 months = ¼ in./mo. = 2in.
Second year = = 1 in.
Third to Fifth yr = ½ in. /yr = 1.5 in.
Sixth to Twentieth yr = ½ in. /5 yr = 1.5 in.

d. Chest circumference
e. Weight for length / height
f. Mid – parental height
GROWTH

Child Growth Standard

1. Gomez classification = actual weight x 100

ideal weight

Weight for age Status

91 – 100 Normal
76 – 90 1st degree malnutrition
61 – 75 2nd degree
<60 3rd degree
GROWTH

2.
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COMPETENCIES CONTENT

3.
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COMPETENCIES CONTENT
IV. Utilize other parameters and predictors of growth Other parameters
A.Mid – arm circumference
B.Skin fold thickness
C.Body proportion
i. US/LS ratio – for short stature
ii. Waist/hip ratio - for obesity

D. BMI (Body Mass Index)

E. Mid parental target height

Instructions on obtaining accurate measurements (4.a – 4.c)
and calculating 4.c – 4.d
Interpretation of significance of these measurements
A. Mid – arm circumference
COMPETENCIES CONTENT
IV. Utilize other parameters and predictors of growth Other parameters

E. Mid parental target height

Instructions on obtaining accurate measurements (4.a – 4.c)
and calculating 4.c – 4.d
Interpretation of significance of these measurements

V. Interpret changing values in measures of function of Procedure in obtaining the following

different organ systems A.Blood pressure
B.Cardiac rate
C.Respiratory rates
COMPETENCIES CONTENT
V. Interpret changing values in measures of function of Procedure in obtaining the following
different organ systems
A.Dentition
COMPETENCIES CONTENT

V. Interpret changing values in measures of function of Procedure in obtaining the following

different organ systems
A.Growth rates
COMPETENCIES CONTENT
V. Interpret changing values in measures of function of Procedure in obtaining the following
different organ systems
A.Hematologic (CBC, platelet)
COMPETENCIES CONTENT

V. Interpret changing values in measures of

B. Immunologic (Ig G, A, M, E, D)
function of different organ systems 1. Ig G

2. Ig A

3. Ig M

4. Ig E

5. Ig D

C. Neurologic (CSF)
 DEVELOPMENT

A process of unfolding, expanding, becoming fuller, more complex and more complete.

Encompasses growth, increase in understanding, acquisition of new skills, more

sophisticated responses, and behavior.
DEVELOPMENT
COMPETENCIES CONTENT
I. Define development A complex process of growing and acquiring skills occuring
in an orderly, predictable pattern as a result of maturation
and experience.

Reflects the increase in skill and complexity of function

performed by an individual.

II. Recognize the importance and significance of Statistics on developmental disorders Gov’t programs /
development budget supporting child development
Laws supporting development

A.ECCD – RA 8980
B.DOH AO 2010 – 2015 = Adopting WHO growth charts
C.RA 6972 – Barangay Level Total development and
protection in children

III. Explain the principles that govern development Basic principles:

- Contionous process
- Intimately related to the CNS
- Follows a definite sequence but variable rate
- Follows a cephalo – caudal pattern
- Proceeds from gross undifferentiated skills to precise and
refined individual responses
COMPETENCIES CONTENT

IV. Identify the factors affecting development Modifying factors:

-Biological endowment
- Environmental Influences:

A.Human relations

A.Nurtition

A.Available learning experiences

A.Socio – economic resources

V. Explain behavioral theories and models governing Behavioral Theories and Models
development A.Cognitive Theory (Piaget)

B. Psychosexual Theory (Frued)

C. Psychosocial Theory (Erickson)

D. Neurodevelopmental Theory (Gesell)

E. Moral Development (Kohlberg)

 Theory Infancy Toddlerhood Preschool School Age Adolescenc
(O – 1 (2 – 3 years) (3 – 6 years) (6 – 12 e
year) years) (12 – 20 yrs.)

Freud: Oral Anal Oedipal Latency Adolescence

Psychosexual

Basic Trust Autonomy vs Shame Initiativs vs Guilt Industry vs Identity vs Idenity

Erikson: and Doubt Inferiority diffusion
Psychosocial

Sensorimotor Formal operations

Sensorimotor Preoperational
(Stages V, VI)
(Stages I – IV) Concrete
Piaget: Cognitive operations

Pre Conventional
Premoral: Post conventional:
Pre Conventional
Conventional:
A. Might is right
Kohlberg: Moral 1) Stage of 1.) First stage of true
(1 – 3 Years Old) Naive Instrumental
Gratification 1.)Conformity morality
Hedonism
(0 – 6 Months) (7 – 9 Years Old) (12 – 18 Years Old)
(3- 7 Years Old)

2.) End justifies 2.) Law and Order 2.) True Morality
the means (9 – 12 Years Old) (18 – 21 Years Old)
(6 – 12 Months)
COMPETENCIES CONTENT
VI. Enumerate periods of Prenatal Period:
development Ovular O – 14 days
Embryo 14th day – end of 8th
week
(Concepts on adolescent development Fetal 9th week - birth
are taken up separately; see Module on Postnatal period:
Adolescent Growth and Development) Infancy Birth - 1 year
Toddler 1 - 3 years
Childhood
Early 3 – 5 years
Middle 6 – 8 years
Late 9 – 10 years
Adolescence
Early 10 – 13 years
Middle 14 – 16 years
Late 17 – 19 years
COMPETENCIES CONTENT
VII. Describe the domains and Discuss the different domains and
milestones in the different age groups milestones:

a.Motor (gross, fine)

b.Language (receptive, expressive)
c.Personal/ social
d.Cognitive

According to age groups:

1.Newborn
2.Infancy
3.Toddler
4.Pre – school
5.School age
NEWBORN
NEWBORN

A.Motor

1.) Gross – Generally flexed prone or supine, turns head from side to side, head sags on
ventral suspension, reflexes in the newborn.

2.) Fine – None.

B. Language and Cognitive - Crying

C. Social – Visual preference for human face, bonding - Breastfeeding

D. Cognitive – CNS reflexes of the newborn, doll’s eye movement, head turning and eye
gazing, fixate face on light in line of vision.
INFANCY STAGE

GROSS MOTOR
1st 3 Months Head Lags, legs extended, Tonic Neck reflex

4 Months Head Control

7 Months Sits with support, rolls over, squirms

10 Months Sits alone, creeps, crawls, cruises, pulls up on standing

1 Year Old Walk with support, takes steps

INFANCY STAGE
FINE MOTOR

3 Months Reaches towards and missles objects

4 Months Hands midline, reaches and grasps objects and brings to the mouth

7 Months Reaches and grasps objects using radial palm and transfers from hand to hand
10 Months Assissted pincer grasp, object permanence (uncovers hidden toy)

1 Year Old Unassissted pincer grasp, releases object to other person on request or gesture
Language
2 Months Smiles, coos

3 Months Says “aah, ngaah”

4 Months Laughs out loud

7 Months Forms polysyllabic vowel sounds, babbles

10 Months Repetitive consonant sounds, “mama, dada”

1 Year Old Few words, in short sentences

 Social
1 Month Body movements in candence with other person’s voice

2 Months Smiles, listens to voice and coos

3 Months Sustains social contact, listens to music

4 Months Laughs out loud, displeasure if social contact is broken

7 Months Prefers mother, enjoys mirror, responds to changes in emotional content of social contact

10 Months Responds to sound of name, peek a boo, pat-a-cake, waves bye-bye,

1 Year Old Plays simple ball game, postural adjustment to dressing

Cognitive
1 Month Follows moving object

2 Months Follows moving object at 180 degrees

4 Months Sees pellet, objects and grasps objects brings to the mouth

7 Months Rakes at the pellet, transfers object hand to hand, brings to the mouth

10 Months Object constancy or permanence, assisted pincer grasp

1 Year Old Release of object on gesture or request, unassisted pincer grasp

Toddler and Preschool
A.Motor
1. Gross

15 Months Walks alone, crawls upstairs

Runs stiffly, walks upstairs with one hand held,

18 Months explores drawers and waste basket

Runs well, walks up and down stairs 1 step at a

2 Years Old time, opens door, climbs furniture, jumps

2 and a Half Years old (30 Months) Goes upstairs alternating one foot

3 Years Old (36 Months) Rides tricycle, stands on one foot

4 Years Old (48 Months) Hops, uses scissors, climbs well

5 Years Old Skips

Fine
15 Months Makes a line, makes a tower of 3 cubes

18 Months Makes a tower of 4 cubes, imitates scribbling and vertical stroke

24 Months Makes a tower of 7 cubes, scribbles in circular pattern, imitates horizontal stroke, imitates to
fold paper once

30 Months Makes a tower of 9 cubes, makes vertical and horizontal strokes, imitates circular strokes

36 Months Makes a tower of 10 cubes, copies a circle

48 Months Copies cross and square, draws man with two to four parts besides the head, identifies
longer of two lines

60 Months Draws a triangle, names heavier of 2 objects

72 Months Draws a diamond

 Cognitive & Language

15 Months Jargon, follows simple commands, names familiar objects, responds to his/her name

18 Months Names pictures, knows 10 words, identifies parts of the body

24 Months Put 3 words together at least 50 – 100 words

30 Months Knows full name, refers to self “I”

36 Months Knows age and sex, counts 3 objects, repeats 3 numbers, sentence of 6 syllables,
intelligible speech to strangers

48 Months Tells story, counts up to 4

60 Months Names 4 colors, counts up to 10, sentence of 10 syllables

C. Social
15 Months Indicates some desires or needs by pointing, hugs
parents

18 Months Feeds self, seeks help when in trouble, kisses

parents, complains when wet

24 Months Handles spoon well, tells immediate experiences,

helps to undress, listens to stories especially when
shown pictures
30 Months Helps put things, pretends in play

36 Months Plays simple games with other kids, helps in

dressing, put on shoes and buttons clothing, washes
hands
48 Months Role-playing, goes toilet alone

60 Months Dress and undresses, questions about words and

things, engage in domestic role playing
 School Age
Gross Motor 5-6
Hops on one foot.
Walks on heels/ toes.
Pencil grasp secure.
Fine Motor Capital letters formation.
Colors neatly with crayons.
Receptive Language Understands when, where, why
Expressive Language Present tense.
Cause – effect sequence.
Cognitive Remembers 4 digits or objects in
sequence.
Knows alphabet, days of week.
Counts more than 20, compares
length sizes, simple concrete
problem solving, turns to adults for
answers.
Social Cooperative group play.
Simple games.
Limited verbal interaction.
7- 9
Secure balance on gait.
Complex motor tasks.
Sports.
Improved Pencil control.
Prints capital letters.
Uses tools awkwardly.
Understands passive verb forms.
Past and future tenses.
Narrative with proper sequence,
development and resolution.
Remembers 5 digits or objects in
sequence.
Counts backwards, tells days of the
week backward, tells time, begins to
reason and compares volumes,
attempts simple simple conceptual
problems, right and wrong defined
terms for punishment, interest in
rules of complex games
Plays in same sex pairs.
Uses social conventions.
10 – 12
Increases sports.
Good eye – hand coordination.
Increased Strength.
Cursive writing.
Works well with tools.
Mechanical or art projects.
Understands multiple meaning
of words.
Figurative language.
Change style of language to fit
several context.
Abstract reasoning skills.
Developing, attempt caried
problem solving strategies.
Understands rule of complex
games and anticipates action.
Group activities focus on areas
of competence or common
social interest.
Plays in groups of same sex.
COMPETENCIES CONTENT
VIII. Differentiate methods of Developmental Differentiate between surveillance methods:
Surveillance - Screening
- Monitoring
- Assessment
Indications for recent and commonly - used tools
screening / monitoring development
+ PEDS
+ Denver II
+ Gesell Scales
+ Cattell – Clinical Linguistic and Auditory Milestones

IX. Recognize the indicators of developmental delay Limit ages

Patterns of development
- Normal
- Dissociated
- Deviant
- Delayed

X. Discuss the more common developmental Discuss the following disorders according to
disorders hallmarks , prominent symptoms/ signs, patterns of
development.

A.Mental retardation (Down Syndrome)

B.Cerebral palsy
C.Autism
D.ADHD (Attention Defecit Hyperactivity Disorder)
E.Hearing Impairment
THANK YOU!