1. GROWTH AND DEVELOPMENT Dr.Khalid Hama salih, Pediatrics specialist M.B.Ch.; D. C.H F.I.B.M.S.ped

2. Introduction: Is the essence of childhood G &D

3. Why Growth & developmental assessment? To know normal growth& development To know normal growth& development To improve the early identification of children To improve the early identification of children with growth and developmental problem. with growth and developmental problem.?

5. growth growth : is a an anatomical process involving increase in the physical size of an organ, tissue& body, by multiplication or enlargement of cell. is a an anatomical process involving increase in the physical size of an organ, tissue& body, by multiplication or enlargement of cell. It can be measure by anthropematric measure. It can be measure by anthropematric measure. Accurate measurement of growth is a vital part of the assessment of children Accurate measurement of growth is a vital part of the assessment of children

7. Development: Development: physiological or functional maturation of various organ or system, acquisition of neweror skill & adaptation to environment,is differentiation in function. physiological or functional maturation of various organ or system, acquisition of neweror skill & adaptation to environment,is differentiation in function.G&D Although they are presented separately, they are closely correlated entities.

8. Stages of Growth and Development Infancy Infancy Neonate Neonate Birth to 1 month Birth to 1 month Infancy Infancy 1 month to 1 year 1 month to 1 year Early Childhood Early Childhood Toddler Toddler 1-3 years 1-3 years Preschool Preschool 3-6 years 3-6 years Middle Childhood Middle Childhood School age 6 to 12 years Late Childhood Late Childhood Adolescent 13 years to approximately 18 years

9. Growth& development genetic Growth &development socioeconomic Growth &development socioeconomic Iuf& prenatal c chronic disease c chronic disease emotional nutritional emotional nutritional Env.&seasonal Env.&seasonal Growth potential Growth potential l hormonal factor

10. Principles of growth & development 1.Growth& development is continuous &orderly process. process. 2.Pattern of growth is different in different body tissue 3.Pace of growth is unique for every child 3.Pace of growth is unique for every child 4.Growth and development are influences by a multiple factors

11. Cont……….. 5.The child’s pattern of growth is in a head-to- toe direction, or cephalocaudal, and in an inward to outward pattern called proximodistal. 6.The acquisition of gross motor skill precedes the development of fine motor skills.

12. Growth Pattern

13. ANTI-GRAVITY MOVEMENTS HEAD TRUNK LOWER EXTREMITY

14. Growth assessment is a 4 step a.recording of appropriate parameter b. comparing this value with reference c.serial recording &put on chart to assess growth velocity d. interpretation & convey the information to parent as well as suitable remedial actio n

15. :Anthropometric measures weight height head circumference

16. Growth Length The child should be measured The child should be measured lying down until 2 years of age Measuring the length of infants Measuring the length of infants requires skill Use proper equipment and two Use proper equipment and two people to hold the child

17. Growth Height Use a properly calibrated Use a properly calibrated standing frame The child should be measured The child should be measured barefoot with knees straight and feet flat on the floor Stretch the child gently and Stretch the child gently and read the measurement

18. Growth Weight Weight Scales must be calibrated Scales must be calibratedaccurately Babies should be weighed naked Babies should be weighed naked (no nappy!) Older children should be weighed Older children should be weighed in underwear only

19. Growth Height or Length, Gains length in 1 year: Height or Length, Gains length in 1 year: 0__3m: 4cm/m 0__3m: 4cm/m 3__6m:2cm/m 3__6m:2cm/m 6___12m:1cm/m 6___12m:1cm/m average length at birth 50 cm average length at birth 50 cm at 1 year 75 cm. at 1 year 75 cm. 2 – 12 years age (in years) x 6 + 77 2 – 12 years age (in years) x 6 + 77 Average annual height increase; is 6 cm/yr between 4 yr and puberty Average annual height increase; is 6 cm/yr between 4 yr and puberty Parental ht is an important determinant of their childrens height,ht of aboye at 2 year & girls at 2.5 is nearly half of the adult height +-5 Parental ht is an important determinant of their childrens height,ht of aboye at 2 year & girls at 2.5 is nearly half of the adult height +-5

20. Growth Weight :Weight loss in the first few days of life; 5-10% of birth weight. Weight :Weight loss in the first few days of life; 5-10% of birth weight. This will return to birth weight by 7-10 days This will return to birth weight by 7-10 days average weight at birth 3.250Kg. average weight at birth 3.250Kg. 3 -12 months of age age (in months)+9 3 -12 months of age age (in months)+9 2 1 - 6 years age (in years) x 2 + 8 1 - 6 years age (in years) x 2 + 8 7 – 12 years age (in years) x 7 -5 7 – 12 years age (in years) x 7 -5 2

21. Growth Head circumference Head circumference Use flexible non-stretchable Use flexible non-stretchabletape Obtain three successive Obtain three successive measurements and take the largest to be the occipito frontal circumference (OFC

22. Growth Head circumference in 1 st year of life Head circumference in 1 st year of life 1 st 3m of age each m 2cm 1 st 3m of age each m 2cm 2nd 3m of age each m 1cm 2nd 3m of age each m 1cm Last 6m of age each m 0.5cm Last 6m of age each m 0.5cm average OFC at birth 35 cm. average OFC at birth 35 cm. at 3 months 41 cm. at 3 months 41 cm. at 6 months 44 cm. at 6 months 44 cm. at 1 year 47 cm. at 1 year 47 cm. at 2 year 49 cm. at 2 year 49 cm. at 3 year 50.5 cm. at 3 year 50.5 cm.

23. When we examine the child’s growth we usually measure his Height, weight, and head circumference, then we plot them on the corresponding growth charts according to the child’s age and sex e.g Rand is a 2 year old boy having a health supervision visit,he is perfectly healthy during the exam, his height is e.g Rand is a 2 year old boy having a health supervision visit,he is perfectly healthy during the exam, his height is 90 cm, his weight is 12.5 kg, his head circumference is 48 cm.

27. Summery: Growth is: continuous& quantitative change. Growth is: continuous& quantitative change. Development:= = = = =&Qualitative change. Factors affect growth & development Principles of growth & development ?