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Overview of Development

Dr. Samer Khader Alnawajha

Definition of human growth and development

Growth

refers to quantitative increase in size and structure.

 

It implies a physical change,

 

usually resulting from either an increase in cell number

or cell size.

 

Body and its part become larger, heavier and longer.

 

The

process

of

growth

starts

from

the

time

of

conception of the fertilized ovum and continues until the child grows into a fully mature adult.

Development

refers to qualitative and quantitative changes.

A change or modification in a person’s capacity to function; the enhancement of a skill.

a progressive series of orderly, coherent changes.

Progressive signifies that the changes are directional, that

they lead forward rather than backward.

Orderly and coherent suggest that there is a definite relationship between the changes taking place and those

that preceded or will follow them.

The differences between growth and

development

Growth

Development

Refers to increase in size, height, weight etc.

Refers to improvement in the functioning of the body process

Easily measured and observed

Cannot be measured easily

It is limited. Starts with birth to

A continuous unending process

reach the maximum at maturity

all through life

Limited to specific areas

Concerned with various aspects and parts of body and behavior as a whole

Quantitative change

Qualitative

and

Quantitative

change

Overview of physical growth

Growth in young people occurs in the following pattern:

Relatively rapid growth during infancy with a gradual

deceleration until about the fourth year of life

A slow but uniform period of growth until puberty

A prominent adolescent growth spurt

A relatively gradual decrease in the rate of growth until completion of maturity, usually after age 20.

Differences in the size of adults between

populations depends on differences in the gene pools of those populations as well as differences in environmental factors

Factors which affect growth:

1. Genetic factors

2. Maternal illnesses during pregnancy.

Examples:

Diabetes,

endocrine diseases,

diseases which affect placental sufficiency

Factors which affect growth:

3. Maternal and family socio-economic

disadvantages during and after pregnancy.

Examples:

Poor nutrition,

lack of access to prenatal care,

poor education,

inadequate treatment of maternal illnesses can

affect maternal health.

Factors which affect growth:

4.

Maternal

and

family

social/emotional

problems during childhood.

Examples environmental or emotional deprivation.

Overview of development

Brain Growth and Development

Nearly one-half of the brain’s postnatal growth is

achieved by the end of the first year, as witnessed by the impressive increase in head circumference.

The

enormous

increase

in

head

size

is

primarily

accounted for by growth of the cerebral cortex.

New cortical cells are added (neurons as well as

dendritic cells), more connecting links are created,

and cells become larger.

Myelination of brain cells (development of a

sheath around each brain cell) is an important

reason for the increase in head size as well.

As different parts of the nervous system undergo myelination, the infant/toddler is capable of increasingly complex motor, verbal, and cognitive functions.

The

pattern

of

myelination

results

in

a

very

predictable pattern of motor development:

1. Cephalad to caudal (head to tail)

2. Proximal to distal (from thorax to periphery)

Development is divided into four major areas:

1.

Motor

2.

Speech/language

3.

Cognitive

1. Motor development

Motor development occurs in a cephalo-caudal, proximo-

distal pattern.

This means that the infant first achieves postural control of

the head through control of the neck muscles, and is able

to lift her head.

Subsequently, the infant develops control of the shoulders, upper back, lower back, hips, etc.

Arm and hand, and upper leg/lower leg motor control then also develops, subsequently extending to fingers and

toes.

The major accomplishments of the first year of life are the ability to stand, and the capacity for a pincer grasp.

2. Speech and language development

Infant communication: proto-conversations, in which

parent and infant take turns responding through facial gestures.

Cooing: the infant makes vowel sounds

Babbling: the infant makes consonant sounds. Arises prior

to six months

Jargon: speech-like sounds which include vowels,

consonants, and prosody (the music of language) without actually using words. Arises prior to one year.

Single words. Usually arise by age one.

Two and three word sentences. Usually arise by age two.

Depending on the degree of stimulation, the

development of speech and language skills is potentially limitless.

The capacity of the brain to respond to this

environmental stimulation does have limits,

3. Cognitive development: the work of Piaget

Piaget was the first child psychologist to map

out child cognitive development.

His “map” of child development is still useful

when attempting to understand various aspects of cognitive development.

Piaget divided child development into four stages:

a. Sensorimotor stage (ages 0 to 2) In the sensorimotor stage, infants learn:

About their own body movements

That the movements of their body can have an

effect on their environment

To

coordinate

two

or

more

movements

or

activities to reach a goal

 

The concept of object permanence

 

Object permanence

is the understanding that objects continue to

exist even when they cannot be observed (seen,

heard, touched, smelled or sensed in any way).

b.The Preoperational stage: age 2 to 4 or 5

Cause and effect relationships between two events

through their proximity in space or time.

Any two events close in time or space are related

causally.

In a preschooler’s mind, a child can catch any and all illnesses by being close to someone with an illness.

The egocentricity of preschoolers.

Preschoolers cannot understand that someone seeing an object from an angle different from

themselves see the object differently from

themselves.

Preschoolers

cannot

concept at a time.

apprehend

more

than

one

e.g. width and length, simultaneously.

C. The concrete operational stage: ages 5 to 11 or 12

The child learns operations such as:

Addition,

Subtraction,

Multiplication,

Division,

Serial ordering

The child learns to conserve volume.

Piaget considered this to be the major achievement of this age group.

Conservation of number, substance, weight, and volume occur at different ages but in a specific order.

There is a decline of egocentrism. Children at this stage are now able to imagine how others would perceive

various situations.

The child is unable to understand hypothetical

situations.

They are not able to answer a question based on

a hypothetical proposition.

For example, if you asked a child at a concrete

operational stage of thinking: "If all dogs were pink, what color your dog would be?" they would

not be able to answer the question. They might

answer: "Dogs aren't pink."

D. The stage of formal operations: Adolescence and beyond

The adolescent must start to think about imaginary things and possible occurrences.

Adolescents learn how to

1.

Use strategies for solving problems.

 

2.

Accept

a

proposition

that

may

be

completely

ridiculous and make arguments or conclusions from this proposition.

3.

Understand abstractions (justice, liberty, etc.).

4.

Think about their own thinking.

 

4. Social / emotional development

Social-emotional development includes

the

child’s

experience,

expression,

management of emotions

and

the ability to establish positive and rewarding relationships with others.

It encompasses both intra- and interpersonal

processes.

4. Social / emotional development

The core features of emotional development include

a.

accurately read and comprehend emotional states

in others,

b.

to manage strong emotions and their expression in a constructive manner,

c.

to regulate one’s own behavior,

d.

to develop empathy for others, and

e.

to establish and maintain relationships.

Infants

experience,

express,

and

perceive

emotions before they fully understand them.

Healthy social-emotional development for infants and toddlers unfolds in an

interpersonal context, namely that of positive

ongoing relationships with familiar, nurturing

adults.

PRINCIPLES OF GROWTH AND DEVELOPMENT

1. There

are

development

individual

differences

in

we

cannot

expect

the

same

behavior

from

all

children of the same age

 

e.g. Some children may grow up to 180 cm tall, while

others might stop at 150 cm or in between.

2. Different areas develop at different rates

e.g. the heart, liver and digestive organs grow slowly in

childhood, but rapidly during the early years of adolescence.

Each child is different and the rates at which individual children grow is different.

the rates at which individual children reach developmental stages will be different.

Some children will walk at 10 months while others walk a few

months older at 18 months of age.

Some children are more active while others are more

passive.

This does not mean

that the passive child

will

be less

intelligent as an adult.

There is no validity to comparing one child’s progress with

or against another child.

Rates of development also are not uniform within an individual child. For example, a child’s intellectual

development may progress faster than his emotional or

social development.

3. Development is continuous

Development is a continuous process from the time

of conception to death.

It may slow down or speed up at certain times, but

it never stops completely at any time. e.g. physical development is rapid during infancy and adolescent period but slows down during childhood period.

4.Development is sequential

Development follows an orderly sequence, which in general

is the same for most children.

Each stage of development leads to the next.

There are two basic sequences:

First, development proceeds from head to toe (Cephalo-

caudal) e.g. a child first controls his head, then his trunk

(turns) and later his legs (stands).

This order of development never changes.

Secondly, development proceeds from center of the body towards outside (proximo-distal) eg. Child catches a ball first

with both his arms, then with palms and later with his fingers.

5. Development proceeds from general to specific responses

The early responses of the infant are very

nature as age increases they

general

in

become more specific.

e.g. in early stages of language development,

the child uses the word 'toy' before he learns

to call each toy by name.

6. Development is influenced by both heredity

and environment

Heredity

plays

an

important

part

in

a

child’s

development.

 

color of eyes, facial features

 

Environmental factors such as nutrition, motivation, good role model etc. play an important role

A child who is not given opportunities to interact with others, generally turns out to be shy and introvert.

7. Development is due to maturation

No development can take place unless the

child’s body is strong and able to support the concerned muscles. E.g. A child can hold his head only after neck muscles are strong enough to hold it.

8. Development is predictable

eg. Children of tall parents are generally tall.

9. Many forms of so- called ‘problem behavior’ are normal

behavior of the age in which they occur

E.g. Bed wetting during the first year of life is normal

but it can become a problem behavior during early childhood.

10. Development involves changes

Change in size: Each year as child grows his/her height

and weight changes.

Change in proportion: As the child grows in size changes

in proportion also occur.

e.g. at birth head occupies ¼ of the body length. This

proportion changes and in adulthood the head occupies 1/8 of the body length.

Disappearance of old features: Old features

disappear or get modified as the child grows. E.g: Disappearance of baby hair and baby teeth

Acquisition of new features:

permanent teeth,

appearance characteristics

of

primary

and

secondary

sex

FACTORS AFFECTING GROWTH AND DEVELOPMENT

1. Heredity and Environment

It greatly influences the different aspects of growth

and development,

i.e. height, weight and structure of the body, color of

hair and eye, intelligence and aptitude.

The genes in the chromosomes of the mature sperm cell and the mature ovum carries potential for

physical and mental traits.

Environment

Individual’s environment consists of the sum total of

the stimulations (physical and psychological) which he receives from his conception onwards.

The different types of environment are physical, social and psychological environment.

Physical environment consists of all outer factors

such as food, clothing, shelter, weather and climate.

Social environment is constituted by the society-

individuals and institutions, social laws, customs by which human behavior is regulated.

Psychological environment is rooted in the

individual’s reaction with an object. One’s love, affection and fellow feeling attitude will strengthen human bonds.

Environment affects a child’s personality in many

ways.

 

A

child

absorbs

a

lot

from

his

parents,

home,

surroundings, school, friends and the neighborhood.

Many

traits

which

are

important

to

personal

adjustments

environment.

may

be

changed

by

variations

in

The color of a child’s hair and eyes, his physique and

strength are inherited

but these are also influenced by climate, diet and disease.

Every human being is born with certain muscular and

skeletal structures- it is shaped and molded by learning

and experiences.

Many activities, like writing, throwing a ball, spelling

a word etc. are influenced by heredity and environment.

Genetic factors have been found more important

than environmental factors in determining the age at which first menstruation occurs.

2. Sex

There is difference in growth and development of

boys and girls.

Boys are generally taller and courageous than girls.

Girls show rapid physical growth during adolescence

3. Nutrition

Insufficient diet during the growing period causes

growth retardation.

This condition cannot be rectified with quality diet

in later period of life.

food habit and nutrition.

4. Glands of internal secretion

Thyroxin produced by the thyroid gland is essential

for the physical and mental development.

 

Deficiency

during

the

growing

years

results

in

stunted growth (cretinism).

5. Position in the family

The second, third or fourth child within a family

generally develops more quickly than the first born, because of the fact that the younger children learn

from imitating their elder brothers and sisters.

6. Maturation and learning

Development is a result of maturation and learning.

Maturation is the natural unfolding of traits present at

the time of birth.

Learning comes from experiences. Learning helps the child in his physical, mental, emotional, intellectual, and

language development.

Knowledge and skills, habits, and attitudes of a person help to deal with people.

7. Physical defect

The achievements of physically defective persons are far below when compared to normal children.

Physical

defects

like

visual,

auditory

defects

and

orthopedic disabilities affect the normal development of

children.

e.g. blind children are slower in walking, feeding or

dressing themselves than children with normal vision.

8. Emotional factors

broken homes and orphanages do not grow

and develop to an optimum level.

Emotional

disturbances, insecurity, sibling

rivalry, jealousy, loss of parents, inadequate schooling etc. have a negative effect on

growth and development.

9. Hereditary disorders

9. Hereditary disorders

1. Haemophilia

Haemophilia is a condition in which blood does not clot normally.

This results in severe bleeding from minor wounds.

It is always associated with a defective gene.

This disease only affects boys, rarely occurs in women

but is transmitted to their sons.

A female can be a carrier.

2. Muscular Dystrophy

Muscular dystrophy (MD) is a group of more than 30 inherited diseases.

They all cause muscle weakness and muscle loss.

Some forms of muscular dystrophy appear in infancy or childhood.

Others may not appear until middle age or later. Most people with muscular dystrophy eventually

lose the ability to walk.

3. Down's Syndrome

An

inherited

disorder

resulting

from

an

extra

chromosomal material on pair number twenty one.

Causes

mental

retardation

and

distinct

physical

features.

Physical

features are almond shape of the eye,

flattened facial features, poor muscle tone, broad

hands, with unusual crease of the palm.

4. Phenyl-Ketonuria [PKU]

Phenyl-ketonuria is a metabolic disorder, in which phenylalanine an amino acid in milk and high protein

foods such as meat cannot be metabolized normally

by the liver.

As

nervous

system becomes deprived of enough nutrients and

metabolic

result,

phenylalanine

in

and

other

a

products

accumulate

the

blood;

the

severe mental retardation occurs.

5. Gout

Gout is caused by a build-up of uric acid in the blood.

The uric acid cause the formation of tiny crystals in and

around joints.

They accumulate in the joints or surrounding tissue

and cause pain, inflammation and swelling.

Purines can be found naturally in human body, as well as in food, such as fish, caffeine, organ meats, beef, fried foods, soda, rich sauces, shell fish and fruit juice.

6. Sickle Cell Anaemia

Sickle shaped cells cannot transport oxygen to various parts.

They live only for a short duration than normal blood cells( RBC) more over bone marrow cannot replace them.

When the sickle shaped cells block small blood vessels it leads to anemia, jaundice, low resistance to infection

and susceptibility to severe pain, and damage to

various organs.

7. Myopia or Short-Sightedness

Myopia is a very common eye condition that causes

close objects

distant

seen clearly.

object

appearing blurred, while

It is a refractive error of eye, a condition where the light that comes in does not directly focus on the retina but in

front of it.

NORMAL GROWTH RATES

Different tissues and different regions of the body

mature at different rates

The velocity or rate of growth reflects the child’s

state at any particular time

The velocity of growth decreases from birth

onward (and actually from as early as the fourth month of fetal life), but this decrease is

interrupted shortly before the end of the growth

period.

in boys from

about 13 to

15 years adolescent

growth spurt.

From birth until age 4 or 5, rate of growth in height

declines rapidly

A slight increase in velocity occur b/w 6 and 8 years.

The peak velocity of length is reached at about four

months after the mother’s last menstruation.

Weight peak velocity is reached at approximately 34

weeks after the mother’s last menstrual period.

From 34 to 36 weeks onward, the rate of growth of

the fetus slows down because of the influence of the

maternal uterus, whose available space is by then becoming fully occupied.

There are rate differences between the sexes and

various tissues

Obvious examples are the fact that girls of 13 or 14

years are often the same or even greater height than their male peers

The lymphoid structures of a child grow so rapidly

that within 6 or 7 years they achieve status far exceeding 100% of adult size and are in fact receding

during adolescence when the body as a whole

(skeletal, muscle mass, and blood volume) is increasing in the rate of growth.

Thus a second grader's tonsils may be very large and

yet not be enlarged; a young child's spleen may become palpable during any infection.

Mesenteric

adenopathy

is

ever

present

in

the

differential diagnosis of appendicitis in children.

During infancy by 1st year of life the child increases

in weight 3 fold and by 50% in length

And increase in head circumference by 10 cm.

The growth rate slows in the 2nd year of life

head circumference increases by 2 cm over the year and by 24 months

The human head grows so fast that it reaches near

adult size in only 6 years.

This rapid head growth necessitates birth for

humans, unlike other mammalian species, at a time

long before walking is possible.

At birth the child is growing

at the rate

of

9

to

10

kg/yr.

by the end of the first year, growth is proceeding at a

much slower pace of 2 to 2.5 kg/yr.

 

This marked reduction of rate can be regarded as the

physiologic marker of the end of infancy.

90% of brain growth in three years

major psychomotor and mental development takes place during the same time.

The

gut

is

anatomically

mature

by

24

weeks

of

gestation

 

Nutritional requirements are high during periods of

rapid growth and hence deficiency states are most

likely in their wake.

 

clinical scurvy, rickets, and iron deficiency anemia

arise during the latter half of the first year.

Awareness

of

these

growth

phases

and

their

attendant psychodynamic implications enables the

nurse to

1.

anticipate patient behavior

 

2.

facilitates establishment of effective rapport

 

NUTRITION AND GROWTH

Nutrition needed for organ maturation

Major organ maturation takes place in the brain, GI system, kidneys and metabolic activity as the child

grows.

Neurological maturation

Brain utilizes glucose as its fuel

Thus

complementary feeding is required for this process

to continue uninterrupted.

appropriate

timing

and

progression

of

Gastrointestinal maturation

Milk feeding especially human milk due to presence of epidermal growth factor and lactoferrin in the

colostrum.

Early

hormones including cholecystokinin

feeding

also

stimulates

the

release

of

gut

Pancreatic

fat

digestion

is

relatively

immature

at

birth

breast milk lipase helps to absorb breast milk lipids

effectively.

 

Breast

feeding

also

prevents

gut

infection

by

providing specific secretory IgA,

Renal maturation

At birth both GFR and renal tubular concentrating capacity is reduced.

High

proteins

form

urea

excreted by kidneys.

Thus

proteins

in

kidneys mature.

diet

are

that

may

gradually

not

be

well

increased

as

Nutritional requirements at different life stages

Infants

Breast milk contains all the nutrients required during

infancy period.

Exclusive breast feeding should be encouraged till 6

months of age with introduction of weaning diet after

that.

Weaning food should meet the requirement of iron, proteins, thiamine, niacin, vitamin B6 & B12, magnesium, zinc, sodium and chloride.

1-3 years of age

greater energy requirement.

There is increased need for all vitamins and minerals

except Vitamin D & zinc.

Lesser amounts of calcium, phosphorus and iron are needed as compared to earlier.

Fiber (non starch polysaccharide) should also be added

to meet the satiety needs.

Protein requirements do not increase much.

4-6 years of age

Energy requirements continue to increase

proteins, vitamins except C & D)

all minerals (except iron).

7-10 years

Energy,

increase.

protein,

vitamin

and

mineral

requirements

Requirement for thiamine, vitamin C & D remain same.

11-14 years

Protein requirement increases by 50%.

Energy requirement continues to increase.

Boys require increased vitamins and minerals

In girls, iron requirement is very high and there is no

change in requirement of thiamine, niacin & vitamin

B6.

15-18 years

Energy, protein, vitamin and mineral requirement

vitamin B12, folate, vitamin C, magnesium, sodium, potassium, chloride and copper.

Calcium and iron requirement markedly increases.

Energy requirement till 18 years old

Age

Energy Requirement

Energy Requirement

Males (Kcal)

Females (Kcal)

0.3 month

545

515

4-6 month

690

645

7-9 month

825

765

10-12 month

920

865

1-3 years

1230

1165

4-6 years

1715

1545

7-10 years

1970

1740

11-14 years

2220

1845

15-18 years

2755

2110

THEORIES OF GROWTH AND

DEVELOPMENT

1. Erik Erikson (USA 1902-1993)

Erikson theory believed that children go through

stages of personality development.

8 stages/crises of man:

Infancy Trust vs. Mistrust

Toddler Autonomy vs. Shame and Doubt

Play Age Initiative vs. Guilt

School Age Industry vs. Inferiority

Adolescence Identity vs. Identity Confusion

Young Adult Intimacy vs. Isolation

Mature Adult Generativity vs. Stagnation

1. Erik Erikson (USA 1902-1993)

Erikson theory believed that children go through

stages of personality development.

Each stage has its own crisis, or struggle between

positive and negative outcomes, which must be worked through successfully 8 stages

Each stage builds on the successful completion of

earlier stages

Upon successful completion of each stage a virtue or strength emerges

The challenges of stages not successfully completed may be expected to reappear as problems in the future

Erikson’s Stages of Psychosocial Development

Infancy (Birth-12 months)

Psychosocial Crisis: Trust vs. Mistrust

 

Main question asked: “Is my world predictable and supportive?”

Central focus: Receiving care

 

Positive

outcome:

Trust

in

people

and

the

environment

Virtue: Hope

Developmental

tasks:

Attachment,

maturation

of

sensory, perceptual, and motor functions

Toddler (1-3 years)

Toddler (1-3 years) • Psychological Crisis: Autonomy vs. Shame and Doubt • Main question

Psychological

Crisis:

Autonomy

vs.

Shame

and

Doubt

Main question asked: “Can I do it by myself? Or will I

always need help?”

 

Central focus: Imitation

Positive outcome: Pride in self, assertion of will

 

Virtue: Will

Developmental

tasks:

Locomotion,

language

development, self-control, egocentrism

Play Age (3-5 years)

Psychosocial crisis: Initiative vs. Guilt

Main question asked: “Am I good or bad?”

Central focus: Identification

Positive outcome: Able to initiate activities and enjoy learning

Virtue: Purpose

Developmental tasks: Sex-role identification, fantasy play, early moral development, self-esteem, group play

Purpose • Developmental tasks : Sex-role identification, fantasy play, early moral development, self-esteem, group play

School Age (5-11 years)

Psychosocial crisis: Industry vs. Inferiority

 

Main question asked: “Am I successful at what I do or am I worthless?” How a child does at school

becomes important in development

 

Central focus: Education

 

Positive

outcome:

Acquire

skills

for

and

develop

competence in work; enjoy achievement

 

Virtue: Competence

 

Developmental tasks: Friendship, skill learning, self-

evaluation, team play

Adolescence (11-18 years)

Psychosocial crisis: Identity vs. Identity Confusion

Main question asked: “Who am I? Where am I going in life?”

Central focus: Peer group

Positive outcome: A strong identity that is predictable, reliable and consistent; ready to plan for the future

Virtue: Loyalty

Developmental tasks: Physical maturation, emotional development, membership in peer group

Young Adult (18-35 years)

Young Adult (18-35 years) • Psychosocial crisis: Intimacy vs. Isolation   • Main question asked :

Psychosocial crisis: Intimacy vs. Isolation

 

Main question asked: “Will I be able to share my

identity with a significant other?” Central focus: Care giving

 

Positive outcome: Form close relationships and share

with others

Virtue: Love

Developmental rearing and work

tasks:

stable

relationships,

child

Mature Adult (35-65 years)

Psychosocial crisis: Generativity vs. Stagnation

Main question asked: “Will I produce something of value with my life?”

Central focus: Creativity

Positive outcome: Nurturing children or helping the

next generation in other ways

Virtue: Care

Developmental tasks: Nurture close relationships, management of career and household, parenting

Old Age (65 and older)

Old Age (65 and older) • Psychosocial crisis: Integrity vs. Despair • Main question asked :

Psychosocial crisis: Integrity vs. Despair

Main question asked: “Have I gained a sense of wisdom

and am I satisfied with the way my life has gone?”

Central focus: Introspection

Positive outcome: A sense of fulfillment about life; A

sense of unity with self and others

Virtue: Wisdom

Developmental tasks: Promote intellectual vigor,

redirect energy to new roles and activities, develop a

point of view about death

2. Jean Piaget (Cognitive theory)

His

theories

of

development

of

intelligence

are

widely studied

 

Spent nearly 50 years studying children of all ages to

discover how intelligence develops (also studied and

observed his own children)

Defined

four

major

developmental

growth of intelligence

periods

in

the

Defined four major developmental growth of intelligence periods in the

Believed

that

intelligence

begins

at

birth

and

develops

through

baby’s

interaction

with

the

environment, as:

 

1.

The

infant

is

active

and

seeks

stimulation

and

contact with the environment

as:   1. The infant is active and seeks stimulation and contact with the environment

2. The quality of the environment is very important to

the development of the intelligence

3. Child is an active learner at all stages; development

is orderly and sequential

the development of the intelligence 3. Child is an active learner at all stages; development is

4. The rate of development is affected by the

experiences made available to the child

5. Ideally parents and caregivers should provide a

stimulating, rich environment

Children move from reflexes and concern with its own body to deliberate action, coordinating behavior, experimenting, symbolic thoughts, language, and logical thinking

Stages of Piaget cognitive development

1. Sensori-motor (birth-2 years)

Five Senses (Taste, Touch, Smell, See and Hear)

Movement (Locomotion, Seemingly random and Reflexes)

No Formal Language, communicates verbally and nonverbally

• Movement (Locomotion, Seemingly random and Reflexes) • No Formal Language, communicates verbally and nonverbally

2. Pre-operational (2-7 years)

Beginning to learn formal language

No logical thought

Slow process of “organizing” mind

Language increases/thinking ability increases

Egocentric

Trial and Error

Fantasy and Reality

mind – Language increases/thinking ability increases – Egocentric – Trial and Error – Fantasy and Reality

Thought processes

Animism- nonliving things are real

Artificialism- artificial explanations

Dreams- real and others can see them

Rules- come from higher power and unchangeable

3. Concrete Operations (7-12 years)

3. Concrete Operations (7-12 years)

3. Concrete Operations (7-12 years)

2 nd and 3 rd grade through 7 th , 8 th and 9 th grade

Huge vocabulary

Categories, classify objects by shape, color, size

Cause and effect

Right and wrong

Morality based on laws not judgment

Personal experiences guide judgment

4. Formal Operations (12 yearsadulthood)

4. Formal Operations (12 years — adulthood)

4. Formal Operations (12 yearsadulthood)

Abstract thinking

Quality of thought

Conceptual thought

Hypothetical thought

Logical deductions based on imagined conditions

Higher moral judgment

Can discuss abstract ideas

Good vs. Evil

Justice

Love

Can make predictions

• Can discuss abstract ideas  Good vs. Evil  Justice  Love • Can make

3. Sigmund Freud (Psychoanalytic theory 1856- 1939 Vienna, Austria)

Believed

that

all

behavior

is

motivated;

either

consciously or unconsciously

Believed

that

psychological

principles

could

be

applied to raising children

 

Believed that the personality changes and develops, especially during periods of infancy, childhood and

adolescence

3. Sigmund Freud (Psychoanalytic theory 1856- 1939 Vienna, Austria)

1.

Child gains control over actions

 

2.

Perception, memory and thinking develop

 

3.

Person

functions

in

a

smother

manner

as

they

develop

4.

Matures

Divided man’s “mind” into id, ego, superego, each

with function and impact on others

Believed that children move from stage to stage of

psycho-sexual development: oral, anal, phallic, latency, genital

4. Lawrence Kohlberg (Moral development theory 1927-1987 New York)

Children go through 6 stages of moral development

1. Early pre-moral stage : infant is totally egocentric

New York) Children go through 6 stages of moral development 1. Early pre-moral stage : infant

4. Lawrence Kohlberg (Moral development theory 1927-1987 New York)

2.

punishment

Pre-moral

stage

:

“hedonism”

with

fear

of

Kohlberg (Moral development theory 1927-1987 New York) 2. punishment Pre-moral stage : “hedonism” with fear of

4. Lawrence Kohlberg (Moral development theory 1927-1987 New York)

3. Early conventional morality: upholds rules out of desire to please others (mother, father, teachers)

New York) 3. Early conventional morality : upholds rules out of desire to please others (mother,

4. Conventional morality : upholds rules, knows

general rules of behavior, compares individual rules to the rules of society

morality : upholds rules, knows general rules of behavior, compares individual rules to the rules of

5. Post-conventional morality : abstract moral

philosophy; ideas of right and wrong; follows moral code; obeys laws; concerned with legality

morality : abstract moral philosophy; ideas of right and wrong; follows moral code; obeys laws; concerned

6. Individual Conscience : self-directed moral choice

based on the betterment of society

Conscience : self-directed moral choice based on the betterment of society Not all individuals reach this

Not all individuals reach this stage !!

Believed that most people function on a daily basis

at around level five

AREAS OF DEVELOPMENT

1. Physical development

changes in height and weight and associated changes in size and shape of the body.

Physical development influences child’s behavior directly and indirectly

Development is how children gain control over their physical actions to do complicated and difficult activities

more skillfully and easily.

Physical skills depends on the size of the child and their muscular strength.

There are factors that can affect this sequence, such as a disability.

of the child and their muscular strength. • There are factors that can affect this sequence,

2. Motor development

Motor

development

means

the

development

of

control over bodily movements through

a.

the co-ordinated activity of the nerve centers,

b.

the nerves and the muscles.

 

Motor

development

is

partially

responsible

for

overcoming the helplessness of newborn infants.

a. Fine motor skills

a. Fine motor skills
a. Fine motor skills

a. Fine motor skills

Control of smaller muscles of the hands, fingers and feet

so that a child can do more delicate tasks e.g. drawing, fastening buttons and threading beads.

fingers and feet • so that a child can do more delicate tasks e.g. drawing, fastening

Children use a variety of grips until they master the mature

pincer grip at about 4 years of age.

Children learn to co-ordinate inwards to outwards.

They learn to control their arms , then their hands and then

their fingers.

learn to co-ordinate inwards to outwards. • They learn to control their arms , then their
learn to co-ordinate inwards to outwards. • They learn to control their arms , then their

Fine motor sequence

3 Months : Fingers and hand play

Fine motor sequence 3 Months : Fingers and hand play
Fine motor sequence 3 Months : Fingers and hand play

Fine motor sequence

6 Months : Whole hand palmar grasp

Fine motor sequence 6 Months : Whole hand palmar grasp
Fine motor sequence 6 Months : Whole hand palmar grasp

Fine motor sequence

9 Months : Primitive pincer grasp

Fine motor sequence 9 Months : Primitive pincer grasp

Fine motor sequence

12 Months : Primitive tripod grasp

The thumb and index finger form a circle

The pencil is held between the index and third fingers with

the tips of the thumb and index finger on the pencil. The pencil rests against the side of the third finger near its end.

the tips of the thumb and index finger on the pencil. The pencil rests against the

Fine motor sequence

15 Months : Palmar grasp

Fine motor sequence 15 Months : Palmar grasp
Fine motor sequence 15 Months : Palmar grasp
Fine motor sequence 15 Months : Palmar grasp

Fine motor sequence

18 Months : Refined pincer grasp and tripod grasp

Fine motor sequence 18 Months : Refined pincer grasp and tripod grasp

Fine motor sequence

2 years: Preferred hand

Fine motor sequence 2 years: Preferred hand

Fine motor sequence

2.5 years: Improved tripod grasp

Fine motor sequence 2.5 years: Improved tripod grasp

Fine motor sequence

4 years: Mature pincer grasp

Fine motor sequence 4 years: Mature pincer grasp

B. Gross motor skills

B. Gross motor skills

B. Gross motor skills

is the development and control of the whole body and the larger muscles.

Children need this control to be able to balance, walk

and climb.

Newborn babies have very little control over their

bodies, the actions they make are involuntary

reflexes.

As they get older they develop more control over

these actions.

A child may learn the control to walk at a different

rate to another, on may learn to walk at 9 months of age another at 12 months another at 18 months.

These are a development stage at which a skill is mastered and is linked to a wide age range.

Children learn to control their muscles from their

head hen their shoulders then their arms and then their legs.

Gross motor sequence

Gross motor sequence

3. Language and speech development

The thoughts and feelings can be communicated in any form of language (gestures, emotional expressions, speech

or written language).

emotional expressions, speech or written language). • Speech is a motor-mental skill. • Speech development

Speech is a motor-mental skill.

Speech development is:

the ability to use meaningful words

and to understand the meaning of words used by others.

4. Emotional development

Is the ability to express, control, understand and

accept one's emotions.

It has an influence on children’s personal and social adjustments.

Adults are able to use words to express their feelings

and explain how they are feeling.

Children cannot do this as easily as they may not

have the words to describe how they are feeling.

Children express their feelings by:

Hitting out when angry

Crying, kicking and screaming when they are refused

Shriek with happiness

by:  Hitting out when angry  Crying, kicking and screaming when they are refused 
by:  Hitting out when angry  Crying, kicking and screaming when they are refused 

Positive emotions such as happiness need to be

encouraged by praising. Negative emotions such as anger and anxiety need

to dealt with carefully and in a positive way, cuddles,

being calm, distraction and patience.

anger and anxiety need to dealt with carefully and in a positive way, cuddles, • being

Learning to control feelings and behavior is part of a

child’s emotional development.

A baby develops an emotional bond with their main

carers over the first 18months of their life.

it gives the baby stability and security to develop well.

5. Social development

Is the ability to behave in accordance with social

expectations.

The change of children into social, nonsocial or

antisocial person depends mainly on learning, not on heredity.

Emotional development is about an individual’s

relationships with people in different environments

and situations.

From the time a baby is born, is aware of people and

spend a lot of time watching and copying them.

Feeding,

dressing,

washing

and

toileting are

important social skills

watching and copying them . • Feeding, dressing, washing and toileting are important social skills
watching and copying them . • Feeding, dressing, washing and toileting are important social skills

A child will learn to:

Consider other people’s opinions, views and feelings

Communicate with others

Become independent

Develop friendships

Activities that encourage social development:

Meeting

people

environments e.g. visits

other

in

different

situations

and

Meeting people of all ages e.g. grandparents

Mixing with their peers e.g. playgroup

Contact with other cultures e.g. holidays

Opportunities to play

Importance of play

it is a way that children learn how to get on with other children.

The stages of play

Solitary play playing alone 0-2 years

The stages of play • Solitary play – playing alone – 0-2 years

The stages of play

Parallel play playing alongside 2 years old

The stages of play • Parallel play – playing alongside – 2 years old

The stages of play

Looking on play watching other children play and

copying them - from 3 years old

The stages of play • Looking on play – watching other children play and copying them

The stages of play

Co-operative play children play together and share

activities - from 3 years old

The stages of play • Co-operative play – children play together and share activities - from

Factors that might affect social development

Problems with language development

Problems with physical development

Lack of opportunities to meet others

Weak bond with parents

Learning difficulties

Cultural difficulties

Poor role models

Lack of opportunity to play with other children

Stress

when

feeding,

dressing,

washing

and

toileting

6. Cognitive or intellectual development

Is

the

sum

total

of

sensation,

perception

and

cognition.

 

Sensation

means sensing something through sense

organs.

 

Perception gives additional meaning to sensing.

 

Cognition is the process of thinking and knowing.

The intellectual or cognitive development helps a

person to memorize, imagine, communicate, perceive and to solve problems.

EVALUATION OF HUMAN GROWTH

AND DEVELOPMENT

EVALUATION OF HUMAN GROWTH AND DEVELOPMENT

There are various measurements that are used to

measure growth. These are:

a.

Anthropometric measurement

 

b.

Assessment of Fontanels

c.

Cognitive

and

behavioral

assessment

(Denver

Developmental Screening Test “DDST” )

a. Anthropometric measurement

1.

Weight

2.

Height

3.

Head circumference

4.

Mid upper arm circumference (MUAC)

5.

Chest circumference

6.

Body mass index

In general, boys are heavier and taller than girls when growth

is complete because:

a. boys have a longer prepubertal growth period,

b. Boys

have

increased

peak

velocity

during

growth spurt, and

the

pubertal

c. a longer adolescent growth spurt.

Weight assessment indicators

Weight-for-age z-score (birth 5) years: BOYS

Weight assessment indicators Weight-for-age z-score (birth – 5) years: BOYS

Weight-for-age z-score (birth 5) years: GIRLS

Weight-for-age z-score (birth – 5) years: GIRLS

2. Height / Length

In general, length in normal-term infants

increases about 30% by 5 month

and > 50% by 12 month;

infants grow 25 cm during the 1st year;

height at 5 year is about double birth length.

2. Height / Length

In most boys, half the adult height is attained by

about age 2

in most girls, height at 19 month is about half the

adult height.

Before 12 month, height velocity varies and is

due in part to perinatal factors (e.g, prematurity).

After

genetically

determined, and height velocity stays nearly

constant until puberty;

12

month,

height

is

mostly

2. Height / Length

a child’s height relative to peers tends to remain the

same.

Some small-for-gestational-age infants tend to be shorter throughout life than infants whose size is appropriate for their gestational age.

Extremities grow faster than the trunk, leading to a

gradual change in relative proportions

trunk, leading to a gradual change in relative proportions The crown-to-pubis/pubis-to-heel ratio is: • 1.7 at

The crown-to-pubis/pubis-to-heel ratio is:

1.7 at birth,

1.5 at 12 month,

1.2 at 5 year, and

1.0 after 7 year.

Height indicators

Length/height-for-age

BOYS

z-score

(birth

5)

years:

Height indicators • Length/height-for-age BOYS z-score (birth – 5) years:

Length / Height-for-age z-score (birth 5) years: GIRLS

Length / Height-for-age z-score (birth – 5) years: GIRLS

3. Body mass index (BMI)

BMI is a person's weight in kilograms divided by the

square of height in meters.

A high BMI can be an indicator of high body fatness

BMI does not measure body fat directly, but it gives direct measures of body fat, such as skinfold thickness measurements, bioelectrical impedance,

densitometry (underwater weighing)

Classification of BMI: adopted from Centers for

Disease Control and Prevention (CDC, 2015)

BMI kg/m 2

Classification

Below 18.5

Underweight

18.5

24.9

Normal

25.0

29.9

Overweight

30.0

and above

Obese

BMI-for-age z-score (5 19) years: BOYS

BMI-for-age z-score (5 – 19) years: BOYS

BMI-for-age z-score (5 19) years: GIRLS

BMI-for-age z-score (5 – 19) years: GIRLS

Growth indicators

Z-score

Length/height for- age

Weight-for age

BMI-for-age

Above 3

See note 1

Obese

Above 2

Above 3 See note 1 Obese Above 2 Above 1 Over weight Possible risk of overweight

Above 1

Over weight

Possible risk of

overweight

(See note 3)

See note 2

0 (median)

risk of overweight (See note 3) See note 2 0 (median) Below -1 Below -2 Stunted

Below -1

Below -2

Stunted

(See note 4)

Underweight

Wasted

Below -3

Severely stunted

(See note 4)

Severely underweight

Severely wasted

Notes

1. A child in this range is