Growth and DevelopmentGrowth and Development

Principles of Growth & Principles of Growth & DevelopmentDevelopment occur in an orderly sequenceoccur in an orderly sequence occur continuously but rates vary- growth occur continuously but rates vary- growth

spurtsspurts highly individualized rate from child to highly individualized rate from child to

childchild vary @ different ages for specific vary @ different ages for specific

structuresstructures process involving the process involving the whole childwhole child

Growth patterns

Cephalocaudal Proximo-distal Prehensile

Periods of greatest growthPeriods of greatest growth

fetusfetus birthbirth infancyinfancy pubertypuberty

Factors that Influence Growth Factors that Influence Growth and Developmentand Development GeneticsGenetics EnvironmentEnvironment CultureCulture NutritionNutrition Health StatusHealth Status FamilyFamily

Genetic influences on growth Genetic influences on growth and developmentand development pattern, rate, rhythm and extent:pattern, rate, rhythm and extent:

governed by genes interplaying with environmentgoverned by genes interplaying with environment intrauterine life extremely important in growth and intrauterine life extremely important in growth and

healthy development of the childhealthy development of the child

Understanding the genetic link

Genes defined Chromosome Autosomes Sex Chromosomes In 2000: Genome project : one of the

most imp single findings of mankind

Genetic screeningGenetic screening

Done during the 1st trimester of pregnancyDone during the 1st trimester of pregnancy Methods:Methods:

blood studies from parents check carrier statusblood studies from parents check carrier status measure level of alphafetoprotein (AFP) in mother’s blood measure level of alphafetoprotein (AFP) in mother’s blood

for incomplete development of brain or spinal cord: for incomplete development of brain or spinal cord: suggestive of neural tube defect (spina bifida)suggestive of neural tube defect (spina bifida)

genetic screening, cont.genetic screening, cont.

later in pregnancy:later in pregnancy: amniocentesis: @ l2-l6 weeksamniocentesis: @ l2-l6 weeks chorionic villa sampling: @ l0-11 weekschorionic villa sampling: @ l0-11 weeks

role of the genetic counselorrole of the genetic counselor

Examples of environmental Examples of environmental influences on a childinfluences on a child family compositionfamily composition family position in societyfamily position in society family socioeconomic statusfamily socioeconomic status knowledge of the familyknowledge of the family availability of healthy diets availability of healthy diets housinghousing diseases present in family and childdiseases present in family and child

Cultural influencesCultural influences

Must be considered when assessing growth and Must be considered when assessing growth and developmentdevelopment

Customs vs. work demands from different culturesCustoms vs. work demands from different cultures

Nutritional influencesNutritional influences

Begins during the prenatal periodBegins during the prenatal period LBW/preterm can result from poor LBW/preterm can result from poor

prenatal nutritionprenatal nutrition Socio-economics may impact growthSocio-economics may impact growth

Health status of the childHealth status of the child

Certain diseases may affect g & dCertain diseases may affect g & d Endocrine and cardiac status included Endocrine and cardiac status included

herehere

Family relationships and the impact on Family relationships and the impact on child growth and developmentchild growth and development

Critical in growth and development, esp. Critical in growth and development, esp. emotional growthemotional growth

Intellectual growth must be included Intellectual growth must be included here as wellhere as well

Chronic illness can be combated with a Chronic illness can be combated with a loving environment and close family loving environment and close family relationshipsrelationships

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

Intellectual DevelopmentIntellectual Development

review material on Piagetreview material on Piaget AssimilationAssimilation AccommodationAccommodation Reflect on the process of habituation Reflect on the process of habituation

and its possible role as a predictor of and its possible role as a predictor of intelligenceintelligence

Growth of EmotionsGrowth of Emotions

Emotion definedEmotion defined All emotions contain:All emotions contain:

feelingsfeelings impulsesimpulses physiological responsesphysiological responses reactions (internal and external)reactions (internal and external)

Subjective data:Subjective data: Objective data:Objective data:

Emotions, cont.Emotions, cont.

Love:Love: includes persons who help them meet their includes persons who help them meet their

needs, share their pleasure and needs, share their pleasure and achievementsachievements

when the child when the child receives lovereceives love, he can , he can give give lovelove

Emotions, cont.Emotions, cont.

Fear:Fear: exhibited by crying, running, or hidingexhibited by crying, running, or hiding fear can diminish; do not laugh-give love fear can diminish; do not laugh-give love

and help them feel safeand help them feel safe

Anger, cont.Anger, cont.

Ways in which anger may be displayed:Ways in which anger may be displayed: shoutingshouting screamingscreaming acts of disobedienceacts of disobedience temper tantrumstemper tantrums act out when….act out when…. act better when….act better when….

JealousyJealousy

A combination of anger, fear, and loveA combination of anger, fear, and love A child A child 1st1st loves something, counts it as loves something, counts it as

his own and his own and 2nd2nd perceives that it has perceives that it has been taken away or interfered withbeen taken away or interfered with

The loss may be real or perceived, ie., The loss may be real or perceived, ie., sibling rivalrysibling rivalry

Emotions, summarizedEmotions, summarized

Emotions will come out one way or Emotions will come out one way or anotheranother

How can the nurse help the child How can the nurse help the child respond constructively to these respond constructively to these feelings?feelings?

Types of play

Solitary Parallel Associative Cooperative Onlooker

Stages of playStages of play

Practice playPractice play Symbolic playSymbolic play GamesGames

Functions of PlayFunctions of Play

Physical DevelopmentPhysical Development Cognitive Development Cognitive Development Emotional DevelopmentEmotional Development Social DevelopmentSocial Development Moral DevelopmentMoral Development

Dental needs of the child

Deciduous teeth (primary teeth) begin to be lost around age 6

Early childhood caries (ECC) By age 2, full set of teeth

Discipline styles that work in the Discipline styles that work in the healthcare settinghealthcare setting CLEARCLEAR

C: C: L:L: E:E: A:A: R:R: