PHYSICAL DEVELOPMENT IN CHILDHOOD AND PUBERTY

PHYSICAL DEVELOPMENT IN EARLY CHILHOOD

Puberty
Height and The Weight Brain Handedness

PUBERTY AND ADOLESCENCE

Stereotyping Adolescents Sexuality and Todays Youth Some Adolescent Problem and Disorders

Motor Development

PHYSICAL DEVELOPMENT IN MIDDLE AND LATE CHILDHOOD

Skeletal and Muscular Systems

HEALTH NUTRITION AND EXERCISE

Sports

Motor Skills

A Developmental Perspective on Childrens Health

Poverty Illness and Health in the Worlds Children

Exercise

Nutrition and Obesity

TWO PRINCIPLES OF PHYSICAL DEVELOPMENT

Cephalocaudal principle
Fig 1

Principle that development proceeds in a headto - tail direction : the upper body parts develop before the lower parts Proximodistal principle Principle that development proceeds in a nearto-far manner : the parts of body near its center (spinal cord) develop before the extremities

Fig 1. The laws of developmental direction

PHYSICAL PROPORTION

Changes in the proportions of the human body during growth

The most striking changes is that the head become smaller in proportion to the rest of the body
The increasing leg proportion is almost exactly the reverse of decreasing head proportion (Fig.2)

1/2

1/3

1/4

1/5

1/6

1/7

1/8

2 mo (fetal) 5 mo

Newborn

2 yr

6 yr

12 yr

25 yr

Fig 2. Changes in body proportions from the 2nd fetal mo to adulthood. (From Robbins WJ, Brody S, Hogan AG, et al: Growth New Haven, Yale University Press, 1928)

INCREMENTS Percent Adult / five weeks

10

7.5

2.5

20 WEEKS

40
BIRTH

12
MONTHS

18

24

Fig 3. Velocity curves of the various components of human brain growth. Solid line with two peaks = DNA; dashed line = brain weight; single peak solid line = cholesterol. (From Brasel JA, Gruen RK. In; Falkner F, Tanner JM (eds) : Human Growth: A Comprehensive Treatise. New York, Plenum Press, 1986, pp 78 -95 ).

Fig 4. Pertumbuhan Otak Anak (Dikutip dari Morley, 1986)

Ukuran pertumbuhan otak Jaringan sel otak (tiap sel menjadi 14000 sel otak)

Cepat 3 bulan dalam kandungan Pada saat lahir

1 tahun

Lambat

Sangat Lambat

2 tahun 5 tahun Lahir 2 tahun

Head Circumference (HC) 1. Average HC : 35 cm at birth (13.5 inches) 2. HC increases : 1 cm / mo for first yr (2 cm / mo for first 3 mo, then slower); 10 cm for rest of life

Fig 5. Head Circumference of girl (Nellhaus)

Fig 6. Head Circumference of boy (Nellhaus)

HEIGHT Average length : 20 inches at birth, 30 inches at 1 yr

1. At age 3 yr, the average child is 3 ft tall

2. At age 4 yr, the average child is 40 inches tall (double birth length) 3. Average annual height increase : 2-3 inches between age 4 yr and puberty

APPROXIMATE AVERAGE ADULT HEIGHT BASED ON FATHER AND MOTHER HEIGHT (GENETIC POTENTIAL)
Girl : (Father height - 13cm) + Mother height +/- 8.5 cm 2

Boy : (Father height + 13cm) + Mother height +/- 8.5 cm 2

RULES OF THUMB FOR HEIGHT

1 - year 4 - year 6 - year 13 - year Adult : 1.5 : 2 : 1.5 : 3 : 3.5 x x x x x birth length birth length height at 1 year birth length height at 2 year

RULES OF THUMB FOR WEIGHT

Weight loss in first days : 5 - 10%
Return to birthweight: 7 - 10 days Double : 4 - 5 mo Triple : 1 year Quadruple : 2 yr Average : 3.5 kg at birth 10 kg at 1 yr 20 kg at 5 yr 30 kg at 10 yr

Table 1. Formulas for Approximate Average Height and Weight of Normal Infants and Children
WEIGHT (a) At birth (b) 3 12 mo (c) 1 6 yr (d) 7 12 yr HEIGHT (e) At birth (f) At 1 yr (g) 2 12 yr KILOGRAMS 3.25 age (mo) + 9 2 age (yr) x 2 + 8 age (yr) x 7 - 5 2 CENTIMETERS 50 75 age (yr) x 6 + 77 (POUNDS) (7) (age [mo] + 11) (age [yr] x 5 + 17) (age) [yr] x 7 + 5) (INCHES) (20) (30) (age [yr] x 2 + 30)

*Adapted from Tanner JM: Growth at Adolescence, 2nd ed. Oxford, Blackwell

Scientific Publications, 1962

22 20 18 16

14
12 10 8 5 4 0 2 4 6 8 10 12 14 16 18

UMUR, TAHUN

Fig 7. Height velocity of boy (Philibert de Montbeillard)

200 180 160 140 120 100 80

60
0 2 4 6 8 10 12 14 16 18

UMUR, TAHUN

Fig 8. Distance curve of height in boy (Philibert de Montbeillard)

24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

Height gain, cm / yr

Girls

Boys

9 10 11 12 13 14 15 16 17 18 19

Age, years
Fig 9. Growth velocity, in centimeters per year, at different ages of the boy and girl whose statures are shown in figure 1. (Reproduced from Tanner et al., 1966)

190 180 170 160 150 140 130

Boys Girls

Height, cm

120
110 100 90 60 70 60 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Age, years
Fig 10. Height at different ages of a hypothetical boy and girl of mean birth length, who grew at the mean rate and experienced the adolescent growth spurt at the mean age for their sex. Each finally reached the mean adult stature. (Reproduced from Tanner et al., 1966)

Table 2. Chronology of Tooth Eruption

ERUPTION

Maxillary
Primary (month 1 SD)
Central incisor Lateral incisor Canine First molar Second molar 10 (8-12) 11 (9-13) 19 (16-22) 16 (13-19 boys) (14-19 girls) 29 (25-33)

Mandible
8 (6-10) 13 (10-16) 20 (17-23) 16 (14-18)

27 (23-31 boys) (24-30 girls)

NORMAL DISTRIBUTION CURVE

10

25

50

75

90 97

- 30

- 20

- 10
MEAN

+ 10

+ 20

+ 30

PERCENTILES STANDARD DEVIATION

Fig 20. Normal (gaussian) distribution curve. This curve represents the theoretical distribution of values for many biologic measurements. The percentiles indicate certain positions within this distribution, as do the standard deviations from the mean

Growth Chart
Height (cm)
95 50 5

95 50 5

4 Age (years)

Height (cm) Percentile

89 94.9 102.0 5 50 95

Frequency Distribution for 3-Year-Olds

Fig 21. Relationship between percentile lines on the growth curve and frequency distributions of height at different ages