Developmental Influences on Child Health Promotion

1
Developmental Influences on Child Health Promotion

• Part 1 Physical Development
• Ricci, chapters 25-29

2
Introduction

• A traditional definition of growth is limited to
  physical maturation
• A more appropriate definition includes functional
  maturation or development of skills
• Need to look at both growth and development

3
Definitions

• Growth An increase in number and size of cells
  that results in increased physical size
• Percentiles of growth a statistical
  representation of 100 children and each ones
  placement within the 100 members

4
Definitions

• Development sequential gaining of functions and
  skills influenced by heredity and environment.
• Maturation refinement of functions and skills,
  making them increasingly useful.

5
Major Trends

• Directional cephalocaudal, proximodistal, mass
  to specific
• Sequential definite predictable sequence
• Pace each child follows a pattern of
  acceleration and deceleration, but each at
  his/her own pace
• Sensitive periods child is more susceptible to
  positive and negative influences opportune time
  when a skill is best learned

6
Developmental Age Periods

• Neonatal first 28 days
• Infancy 1 up to 12 months
• Toddlerhood 1 up to 3 years
• Preschool 3 to up 6 years
• School-age 6 up to 12 years
• Adolescence 12 to up 18 years (pre-pubertal 10
  to 13 years)

7
General Biologic Growth and Maturation

• Skeletal Height is the most widely used
  however, bone age is the most accurate way to
  measure age and development
• Teeth lower central incisors 6 mo 20 teeth by
  2 ½ years permanent start about age 6 years
• Lymphs adult size by 6 years 2x by 12 years,
  returns to adult size by 18 years
• Neuro most growth in utero 90 by 6 years
• Language infants 1-2 word sentences toddlers
  2-3 preschool 3-4 school-age 5-7 or more

8
General contd

• Metabolic temp stabilizes by 12 years
  fluctuates with environmental temp, activity,
  crying
• Cardio/resp VS gradually slow as child ages
• GI immature at birth gradually adds hormones,
  enzymes mature by age 3 years
• Genitourinary physically able to toilet train
  at 18 months, but not ready until later
• Sleep newborns most of time 2 year olds, 2
  naps 3 year olds, 1 nap 5 years, 0 naps

9
Infant Physical Growth and Gross Motor Skills

• BW 7.5 lbs doubles 6 mos triples 1 yr
• Primitive reflexes to protective reflexes
• Growth is cephalocaudal proximodistal

• Head control 4 mo
• Sitting crawling 7 mo
• Standing with help 8 mo
• Cruising 9-11 mo
• Standing alone 12 mo
• Walking alone 13 mo

10
Infant Fine Motor Skills and Language

• Hand grasp 4-5 mos
• Pincer grasp 10 mos.
• Puts objects in/out of container 11 mos.
• Builds 2 block tower 12 mos.

• Differentiated cry 1 mo
• Laugh 3 mos
• Babble 6 mos
• Imitates sounds 9-10 mos
• First word with meaning 12 mos.

11
Toddler Physical Growth and Gross Motor Skills

• 5.5 lbs 4.75 inches
• Lordosis
• Pot belly
• Short, bowed legs

• Runs 18 mo
• Walks up down stairs jumps 2 yr
• Throws retrieves
• 20 primary teeth
• 2 ½ yr

12
Toddler Fine Motor Skills and Language

• Holds pencil handles small objects with control
  15 mo
• Scribbles can draw straight lines 2 yr

• Vocabulary grows from 1-2 words to over 200.
• Understands everything, but cant say everything.
• Telegraphic speech (noun verb)

13
Preschool Physical Growth and Gross Motor Skills

• 4.5 lb 2.75 inches
• Slimmer more muscle, less fat
• Longer legs, more graceful
• Physiologic systems are mature
• Muscle cartilage grow rapidly

• Hops on 1 foot 4 yrs
• Skip 5 yrs
• Walks forward and backward
• Jumps

14
Preschool Fine Motor Skills and Language

• Draws circle 3 yr
• Uses scissors 4 yr
• Strings beads
• Copies shapes letters
• Hand preference 5 yr
• Uses fingers independently

• 3-4 word sentences 3-4 yr
• 6-8 word sentences 5-6 yr
• Tells stories
• Asks many questions
• 2100 word vocab by 5 yr

15
Middle Childhood Physical Growth

• 6.5 lb 2 inches
• Agile, graceful more coordinated stronger
• Boys heavier taller than girls until 10 yrs.
• Growth spurt 12 yrs.
• Black children larger Asian smaller

• Facial bones grow faster than head
• Bones ossify replace cartilage
• Loses primary teeth begins permanent

16
Middle Childhood Fine and Gross Motor Skills

• Does well with fine motor skills such as drawing,
  writing, needlework, model building, playing
  instruments

• Does well with gross motor skills such as
  running, throwing, jumping, biking, swimming

17
Preadolescence

• Girls 9-12 yrs
• Rapid growth of ht wt
• Breast development
• Pubic hair
• Axillary hair
• Menstruation between 9 and 15 yrs

• Boys 10-14 yrs
• Rapid growth of ht wt
• Genital growth
• Pubic hair
• Axillary hair
• Erections
• Nocturnal emissions

18
Adolescence (12-20)

• Completion of secondary sex characteristics
• Maturation of sex organs
• Gains 15-65 lb grows 6-12 inches
• Girls stop growing about age 16 boys about 20.
• Physical health good
• Know Tanners Stages (chapter 32)

19
Factors Influencing G D

• Heredityphysical characteristics, personality,
  and temperament
• Neuroendocrinegrowth hormone, thyroid hormone,
  sex hormones
• Nutritionmost important influence
• Diseasechronic illness, skeletal disorders,
  chromosomal abnormalities
• Environmental hazardscigarette smoke, chemicals,
  lead, asbestos, unsafe neighborhoods

20
Factors contd

• Prenatal influencesbirth weight reflects
  intrauterine environment moms health
  (nutrition, drugs, illness)
• Socioeconomic statusupper and middle class
  children are taller, have better nutrition, and
  do not usually live in unsafe neighborhoods
• Interpersonal relationshipshaving physical and
  emotional needs met
• Stressneed security to develop coping skills and
  problem-solving skills
• Mass mediaTV and internet have most impact can
  be good or badparents must monitor