1. HOW DOES YOUR GARDEN GROW? ASSESSING PHYSICAL GROWTH IN CHILDREN

2. GROWTH MEASUREMENTS §WEIGHT §HEIGHT §SKIN FOLD THICKNESS §ARM CIRCUMFERENCE §HEAD CIRCUMFERENCE

3. LENGTH §REFERS TO MEASUREMENT WHEN SUPINE (RECUMBENT LENGTH) §USED UNTIL 24 MONTHS OF AGE AND AS LONG AS THE 36 MONTH CHART IS USED §HEAD MIDLINE AND LEGS FULLY EXTENDED §USED MEASURING BOARD OR PENCIL §MOST INCORRECTLY DONE

4. EXPECTED GROWTH RATES AT VARIOUS AGES §1-6 MONTHS18-22 CM/YR §6-12 MONTHS14-18 CM/YR §2ND YEAR11 CM/YR §3RD YEAR8 CM/YR §4TH YEAR7 CM/YR §5TH-10TH YEARS5-6 CM/YR

5. HEIGHT §REFERS TO MEASUREMENT TAKEN WHEN STANDING UPRIGHT (STATURE) §SHOES OFF AND MINIMAL CLOTHING §FEET FLAT AND HEAD MIDLINE §HEELS, BUTTOCKS, BACK, AND SHOULDERS TOUCHING WALL §LINE OF VISION PARALELL TO FLOOR §DECREASE STATURE IN THE AFTERNOON §STADIOMETER MOST ACCURRATE

7. WEIGHT §BEAM BALANCE SCALES OF APPROPRIATE SIZES (MANUAL OR ELECTRIC) §CALIBRATED BEFORE USES §INFANT SCALES MORE ACCURATE THAN ADULT SCALES §WARM ROOM §MINIMAL CLOTHING §ADUST FOR SPECIAL DEVICES (ARM BOARD) §USE INFANT PLATFORM SCALE WHENEVER RECUMBENT LENGTH IS USED

10. SKINFOLD THICKNESS AND ARM CIRCUMFERENCE §TO DISTINGUISH BETWEEN ADIPOSE TISSUE AND MUSCLE §SKINFOLD THICKNESS MEASURED WITH CALIPERS (TRICEPS, SUBSCAPULA, SUPRAILIAC, ABDOMEN, & UPPER THIGH) §ONLY RELIABLE IF DONE CORRECTLY §ARM CIRCUMFERENCE NOT WIDELY USED DUE TO UNESTABLISHED NORMS §HIGH VALUES OFTEN CORRELATE WITH INCREASED BMI

12. HEAD CIRCUMFERENCE §MEASURE IN CHILDREN UPT TO THREE YEARS OF AGE §USE PAPER OR PLASTIC TAPE MEASURE §HEAD AND CHEST EQUAL FROM 1- 2 YEARS OF AGE §AFTER 2 YO CHEST USUALLY 2-3 INCHES LARGER

15. NATIONAL CENTER FOR HEALTH STATISTICS (NCHS) GROWTH CHARTS §USED ACROSS RACIAL AND ETHNIC GROUPS AS A REFERENCE GUIDE §INCLUDE BODY MASS INDEX FOR AGE (BMI FOR AGE) CHARTS §3RD TO 97% CURVES AVAILABLE §THREE AVAILABLE VERSIONS §AVAILABLE AT WWW.CDC.GOV/GROWTHCHARTS §BMI USED TO IDENTIFY CHIDREN WHO ARE OVERWEIGHT OR AT RISK FOR OVERWEIGHT

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47. USE & INTERPRETATION OF CDC GROWTH CHARTS

48. STEP ONE OBTAIN ACCURATE WEIGHTS & MEASURES

49. STEP TWO SELECT THE APPROPRIATE GROWTH CHART BASED ON AGE AND GENDER ENTER CHILD’S NAME AND RECORD NUMBER

50. STEP THREE §ENTER MOTHER & FATHER’S HEIGHT §ENTER GESTATIONAL AGE §ENTER DATE OF BIRTH §ENTER BIRTH WEIGHT, LENGTH, & HEAD CIRCUMFERENCE §ADD NOTABLE COMMENTS (BREASTFEEDING) §ENTER TODAY’S DATE §ENTER CHILD’S AGE (CALCULATED) §ENTER WEIGHT, STATURE, & HEAD CIRCUMFERENCE §AD COMMENTS (NOT COOPERATIVE)

51. STEP FOUR CALCULATE BMI

52. STEP FIVE §FIND CHILD’S AGE ON THE HORIZONTAL AXIS & DRAW A VERTICAL LINE UP FROM THAT POINT §FIND THE APPROPRIATE MEASUREMENT (WEIGHT, LENGTH, STATURE, HEAD CIRCUMFERENCE, OR BMI) ON THE VERTICAL AXIS & DRAW A HORIZONTAL LINE UNTIL IT INTERSECTS WITH THE VERTICAL LINE §MAKE A SMALL DOT WHERE THE TWOLINES INTERSECT

53. STEP SIX §INTERPET THE PLOTTED MEASUREMENTS §DETERMINE THE PERCENTILE RANK §DETERMINE IF THE VALUE IS INDICATIVE OF NUTRITIONAL RISK §COMPARE TODAY’S RANK WITH PREVIOUS VISITS

54. GROWTH CHART “RED FLAGS” §WIDELY DISPARATE WEIGHT & HEIGHT §FAILURE TO SHOW EXPECTED GROWTH RATES §SUDDEN INCREASE OR DECREASE IN A PREVIOUSLY STEADY GROWTH PATTERN (EXCEPT DURING PUBERTY) §MOST RELIABLE WHEN COMPARED OVER TIME §CONSIDER GENETICS AND FAMILIAL PATTERNS

55. WELL? WHATCHA THINK?

56. OK135S072

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70. OK135S072