growth and development

• Growth

  Increase in physical size, results in increase in size and weight of the whole or any of its parts, predictable and symmetrical pattern, measurable, continues for approximately 20 years
• Development

  Represents an increase in skills needed to function, usually results in achievement of increasingly complex tasks, happens in a predictable pattern, continues though the life span
• Growth and Development

  • Cephalocaudal - head to tail
  • Proximal to distal
  • Development is variable & is about averages
  • Every child is different
  • Know your milestones - they are sequential
• Infant Growth Trends

  • In the first 6 months: 1 1/2 lbs./month, 1 inch/month
  • In the last 6 months: 3/4 lb/month, 1/2 inch/month
  • Double birthweight at 6 months
  • Triple birthweight at 1 year
• Infant Development - Fontanels

  • Posterior - small - occipital closes by two months
  • Anterior - diamond shape - large - frontal. Closes by 12-18 months
  • Measure head circumference under 2 years of age
• Infant Gross Motor Milestones

  • 5 mo - head lag gone, rolls abdomen to back
  • 6 mo - sits with support, rolls back to abdomen
  • 7 mo - sits alone, leaning forward on hands
  • 8 mo - sits without support
  • 9 mo - crawls
  • 10 mo - maneuver from prone to sitting
• Infant Psychosocial Development - Trust vs Mistrust


  Relationship with primary caregiver, meet basic needs, need for non-nutritive sucking, positive resolution achieved through consistency of care from caregivers
• Temperament

  General Behavioral Style - the how of behavior, nature versus nurture, "easy, slow-to-warm-up, difficult", accept it, cultivate its strengths, appreciate its differences
• Infant Cognitive Development - Sensorimotor


  Moves from being primarily reflexive to voluntary response, beginning recognition of cause and effect as repetitive actions produce consistent response, distinguishes parent as separate from self, stranger anxiety around 6 months, object permanence 9-10 months
• Implications of Growth and Development (0-6 months)

  • Basic needs, after 6 months consistent caregivers are helpful (stranger anxiety), promote self-regulating behaviors - self comforting, support parental role and involve in care - observe caretaking abilities, auscultate first if quiet, speak softly, move slowly, determine if finger/thumb sucker, anticipate parental concerns/needs
• Toddler Growth

  • Birth weight quadruples by 2 1/2 years, by age 2 height is approximately 50% of eventual adult height
• Toddler Psychosocial Development - Autonomy vs Shame and Doubt


  I am a separate being from you, characteristics: negativistic, ritualistic, socially - parallel play, does not like strangers or sharing, motor - runs - clumsy, language - multi word sentences, positive resolution - self control without loss of self-esteem, ability to cooperate develops
• Toddler Cognitive Development - Sensorimotor (12-18)/Pre-Operations (18-36)


  Transductive reasoning, irreversibility of actions, animism - giving lifelike qualities to inanimate objects
• Implications of Toddler Growth and Development

  • Consistent caregivers, involve parents in care - try not to separate, keep parent close during procedures, implement child's rituals into cares - don't deviate, fear of separation & bodily harm, violently resistive - protect self, approach slowly & at their level, let them handle equipment you plan to use, use distraction & play to allow approach, attention span is small
• Preschool Growth

  • Weight - yearly gain around 2-3 kg (4 1/2 - 6 1/2 lbs), Height - yearly gain of 5-7.5 cm (2-3")
• Preschool Psychosocial Development - Initiative vs Guilt


  Need to achieve, don't make them feel bad when they don't reach the mark, very social - don't know a stranger, positive resolution - learning the degree to which assertiveness & purpose influence the environment, developing conscience, proficient language - but literal, talk incessantly regardless of anyone listening, ask why - information seeking, curious - no subject is sacred, rapid growing vocab & attempt to use may result in stutter
• Preschool Cognitive Development - Preoperational


  Pre-logical, animism, imaginary friends, can't separate fact and fantasy, limited body boundaries
• Implications of Preschool Growth and Development

  • They want to be cooperative but can't always get it done, emphasize success - do not make them feel bad, benefit greatly from preparation for procedures - medical play, distraction, comfort positions, needle phobia, lack of body boundaries, pre-logical - don't try and reason, the kings & queens of procrastination, some separation concerns if stressed, fear of bodily harm, feelings of guilt, allow them to help/make choices when possible
• School Age Growth

  • Weight - Yearly gain 2-3 kg (4 1/2 -6 1/2 lbs), Height - Yearly gain of 5 cm (2")
• School Age Psychosocial Development - Industry vs Inferiority


  Well coordinated, succeeding in school a priority - self esteem, competent & competitive, social, peers increasing importance - parents still important, positive resolution - develops a sense of competence and perseverance
• School Age Cognitive Development - Concrete Operations


  Logical, can think things through, deal best with something they have had previous experience with, thought processes less self-centered...can consider another's point of view, want to participate in their own care
• Implications of School Age Growth and Development

  • Involve in their care - expect an appropriate level of self care, explain all procedures and what you expect of them, access to phone, logical - understands reason, fears loss of control, school issues - be aware and make arrangements to maintain progress when needed, wants to know what is going on - keep informed
• Adolescent Growth

  • Pubertal Growth Spurt: Females 10-14 yrs - Mean weight gain of 17.5 kg (38 1/4 lbs), Height 2-10", approximately 95% of mature height is achieved by onset of menarche (app. Age 13), Males 11-16 yrs - Mean gain 33.5 kg (15 1/4 lbs), Height gain of 4-12", 95% of mature height by 16 yrs
• Adolescent Psychosocial Development - Identity vs Role Confusion


  Consider the adolescent in 3 sub stages - early (13-14), middle (15-16) & late (17-18), growth - pubertal changes, peers become priority, positive resolution - coherent sense of self & the ability to actualize one's abilities
• Adolescent Cognitive Development - Formal Operations


  Ability to abstract, can consider situations with which they have never had experience, idealistic...difficult time with injustice
• Implications of Adolescent Growth and Development

  • The 3 P's - Phones, Peers, Privacy, body image is everything, involve them in their care, recognize that anger, belligerence etc. may actually be fear, ability to abstract & reason, stress, nature of the problem, fears loss of control, take opportunities to teach - they think you may know something