Growth and Development

Overview

Outline I. Growth II. Development (motor, psychosocial, cognitive) III. Health Promotion

Infant Toddler Preschooler School Age Adolescence

1 month 1 year 1 year 3 years 3 years 6 years 6 years 12 years 12 years 21 years

Infant: Growth
0-6mos: gain 1lb 2 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

Infant: Development
Ericksons stage: Trust versus Mistrust Piagets stage: Sensorimotor Parent-Infant attachment critical Cognitive development parallels motor development Language development is a critical indicator of normal development over the first year of life (and beyond)

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

Toddler: Growth
Physical growth slows Weight gain: 5 lb per year Height: 3 inches per year 2 years: head circumference is 90% of adult size Overall head growth: 1.5 inches during toddler years Immature abdominal musculature and exaggerated lumbar curve

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

Toddler: Health Promotion

Nutrition (finger foods, physiologic anorexia, use cup and spoon) Teeth care Consistent limit setting Consistent positive reinforcement Toilet training (generally not before age 2) Temper tantrum management Socialization Caregiver support

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 to participate in sustained activity 20 deciduous teeth present by age 3 years

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 ADLs independently >2100 words by 5 years Rhymes and silly words by age 4 years

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

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 strength and coordination Myelinization of CNS continues to age 10; refinement of fine motor skills

School Age: Development

Ericksons Stage: Industry vs. Inferiority Piagets Stage: Concrete Operations Kohlbergs Stage: Morality of Conventional Role Conformity (7-10 years); Law and Order Orientation (10-12 years) Increased mastery of language Emergence of logic Self-esteem development Friendship skills established

2+3=5

53=2
Problem Solving

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

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 late adolescence and is individually variable Bone calcification is completed after puberty

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

Adolescent: Health Promotion

Address issues related to fatigue Promote physical activity Nutrition Assess/Discuss risk taking behaviors Violence (homicide second leading cause of death age 15-19) Sun Protection Abstinence/Contraception STD education Psychosocial support/Listening Car Safety Consequences of decisions/making good decisions