GROWTH & DEVELOPMENT Normal Parameters & Abnormality

Growth Development

It is change in size/weight resulting from an increase in number or size of cells.

A gradual change in advancement/function from lower to higher stage

It is Quantitative It is Qualitative

It is measured in terms of centimeters or Kgs

It is assessed in terms of acquisition of skills and ability

Maturation

• It is increase in competence and adaptability

FACTORS AFFECTING GROWTH AND DEVELOPMENT

Prenatal

Genetic potential

Genetic abnormalities

Sex

Fetal / growth hormones

Placental Factors

Neonatal

LBW

Neonatal Seizures

Postnatal

Sex

Hormonal Influence

Nutritional

Infection

Trauma

Socioeconomical Influences

ASSESSMENT OF GROWTH OF CHILD

Anthropometry:It is most common method used it includes:

Weight Height/Length Head Circumference Mid-Arm Circumference Chest Circumference

It is total of all organ, tissue and fluids. Method :

Nude/ Minimal light clothing: Lever or electronic type of weighing scale

WEIGHT:

3 kg

• BIRTH WEIGHT

~ or less than

3kg

• 3 -10 DAY

Double the Weight

• 4 MONTHS

AGE FORMULATIONS FOR CALCULATIONS

3-12 Months

Age (m) +9/2

1-6 Years Age (y) x 2 +8

7-12 Years

Age x 7 - 5

HEIGHT/LENGTH:

Height : ( >2 years)

• Vertical distance between head and heel of foot• Measured in erect standing posture by stadiometer• Formula: Age (y) x 6 +77

Length: (<2 years)

• Measured in lying down position.• Total Length

Upper – Head-PubisLower – Pubis - ToeU/L – 1:7 -birth 1:1 -7year

50 cm

At Birth

75cm

1st year

90cm

2-3 year

100cm

4th year

5cm/year

Untilpuberty

HEAD CIRCUMFERENCE

It is an estimate of brain growth Most useful in 2 years of life Method:

Use a non-stretchable tape on occipital protuberance to the supra-orbital ridges on forehead

Clinical corelate: Microcephaly Macrocephaly Cranisynostosis

35 cm

At Birth

41 cm

2nd mont

h

44 cm

6th month

46 cm

9th month

47 cm

1st year

49 cm

2nd year

It is clinically important in the 5th year of life.

Method: Measure at the level of nipples midway between

expiration and inspiration by Cross-tape method.

CHEST CIRCUMFERENCE

At Birth CC < HC

At 1st year

HC=CC

later it exceeds

i.e CC>HC

MILESTONES

Gross motor Development

Fine motor Development

Social and Adaptive Milestone

Key Language Milestone

THROUGH AGE OF 1 MONTH – 9 MONTHAGE GROSS MOTOR

DEVELOPMENTFINE MOTORDEVELOPMENT RED FLAGS

1-2 Month Moves extremity equally

3 Month Neck Holding “Hand regard” Observes his own hand very intensely

4 Month Sit with support “Bidextrous Reach”

5 Month Roll over

6 -7 Month Sit in tripod fashion

Transfer object from Hand to hand

8 Month Sit without support

9 Month Stands holding with support

Probes with Finger

No Sitting without support

AGE GROSS MOTOR DEVELOPMENT

FINE MOTORDEVELOPMENT

RED FLAGS

12 Month Stand without Support

Mature Pinser Grasp

15 Month “ Toddler can Walk”

Imitates Scribbling,

Tower of 2 blocks

Not Standing

Alone

18 Month Runs Makes Tower of 3 blocks

Not Walking Alone

2 years Walks Up and Down Stairs

Vertical and Circular strokes

3 years Ride Tricycles Makes Cirlce and Tower of 9 Blocks

4 years Hops on One Foot Makes A Cross

5 years Skip, dress and undress

Copies a Triangle

THROUGH AGE OF 12 MONTH – 5 YEARS

AGE SOCIAL AND ADAPTIVE MILESTONES

KEY LANGUAGE MILESTONES

RED FLAGS

1Month Regards face and follow moving object with eyes

Alert in Sound

2 Month Social Smile (after being talked to)

No Visual fixation

3 Month Recognize Mother Musical Sound and coos

4 Month Laugh Loud

5 Month Orient to voice

6-7 Month Recognize Stranger “Stranger Anxiety”

Monosyllable Babbles (Ma, Pa)

No vocalization

8 Month

9 Month Waves “Bye- Bye” Bisyllable Babbles (Mama, Baba)

THROUGH AGE OF 1 MONTH – 9 MONTH

AGE SOCIAL AND ADAPTIVE

KEY LANGUAGE MILESTONES

RED FLAGS

12 Month Comes when Called to.

1-2 words with meaning and understand “No”

15 Month Jargon

18 Month “ Copies Parent” 8-10 word vocabulary

2 years Ask for food, drink and toilet

Use a 2-3 word sentence

3 years Group Play , know Full name and gender

Ask Questions Lack of imaginative Play

4 years Plays Cooperatively Sing songs or poem

5 years Helps in house hold task

Ask meaning of words

THROUGH AGE OF 12 MONTH – 5 YEARS