1. Growth and Development

2. Principles of Growth & Development n occur in an orderly sequence n occur continuously but rates vary- growth spurts n highly individualized rate from child to child n vary @ different ages for specific structures n process involving the whole child

3. Growth patterns n n Cephalocaudal n n Proximo-distal n n Prehensile

4. Periods of greatest growth n fetus n birth n infancy n puberty

5. Factors that Influence Growth and Development n Genetics n Environment n Culture n Nutrition n Health Status n Family

6. Genetic influences on growth and development n pattern, rate, rhythm and extent: n governed by genes interplaying with environment n intrauterine life extremely important in growth and healthy development of the child

7. Understanding the genetic link n n Genes defined n n Chromosome n n Autosomes n n Sex Chromosomes n n In 2000: Genome project : one of the most imp single findings of mankind

8. Genetic screening n Done during the 1st trimester of pregnancy n Methods: n blood studies from parents check carrier status n measure level of alphafetoprotein (AFP) in mother’s blood for incomplete development of brain or spinal cord: suggestive of neural tube defect (spina bifida)

9. genetic screening, cont. n later in pregnancy: n amniocentesis: @ l2-l6 weeks n chorionic villa sampling: @ l0-11 weeks n role of the genetic counselor

10. Examples of environmental influences on a child n family composition n family position in society n family socioeconomic status n knowledge of the family n availability of healthy diets n housing n diseases present in family and child

11. Cultural influences n Must be considered when assessing growth and development n Customs vs. work demands from different cultures

12. Nutritional influences n Begins during the prenatal period n LBW/preterm can result from poor prenatal nutrition n Socio-economics may impact growth

13. Health status of the child n Certain diseases may affect g & d n Endocrine and cardiac status included here

14. Family relationships and the impact on child growth and development n Critical in growth and development, esp. emotional growth n Intellectual growth must be included here as well n Chronic illness can be combated with a loving environment and close family relationships

15. Growth and development:measures n n Charts n n Baseline over time n n Xrays n n Teeth n n Height, wt, FOC n n Length of bones

16. Intellectual Development n review material on Piaget n Assimilation n Accommodation n Reflect on the process of habituation and its possible role as a predictor of intelligence

17. Growth of Emotions n Emotion defined n All emotions contain: n feelings n impulses n physiological responses n reactions (internal and external) n Subjective data: n Objective data:

18. Emotions, cont. n Love: n includes persons who help them meet their needs, share their pleasure and achievements n when the child receives love, he can give love

19. Emotions, cont. n Fear: n exhibited by crying, running, or hiding n fear can diminish; do not laugh-give love and help them feel safe

20. Anger, cont. n Ways in which anger may be displayed: n shouting n screaming n acts of disobedience n temper tantrums n act out when…. n act better when….

21. Jealousy n A combination of anger, fear, and love n A child 1st loves something, counts it as his own and 2nd perceives that it has been taken away or interfered with n The loss may be real or perceived, ie., sibling rivalry

22. Emotions, summarized n Emotions will come out one way or another n How can the nurse help the child respond constructively to these feelings?

23. Types of play n n Solitary n n Parallel n n Associative n n Cooperative n n Onlooker

24. Stages of play n Practice play n Symbolic play n Games

25. Functions of Play n Physical Development n Cognitive Development n Emotional Development n Social Development n Moral Development

26. Dental needs of the child n n Deciduous teeth (primary teeth) begin to be lost around age 6 n n Early childhood caries (ECC) n n By age 2, full set of teeth

27. Discipline styles that work in the healthcare setting n CLEAR n C: n L: n E: n A: n R: