Growth and Development II

8/4/2019 Growth and Development II

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Growth and Development II

Victoria Craig-Cherry MSN, APN


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Developmental Tasks fromBirth through Adolescence

Neonates and infants (birth to1 year)

Adjustment to environment outside the uterus

Toddlers (1 to 3 years) Progress from no control to walking andspeaking

Control elimination

Acquire information about environment


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Preschoolers (4 and 5 years)

Physical growth slows

Control of body and coordination greatly increases

World enlarges with relatives, friends, etc.

School-age children (6 to 12 years)

Deciduous teeth are shed

Includes preadolescence (or prepuberty)

Period ends with onset of puberty

Skills learned are important for later life


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Adolescents (12 to 18 years)

Physically and psychologically mature

Acquire personal identity

Ready to enter adulthood


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Physical Development:Neonates and Infants

Weight

Doubles by 5 mo

Triples by 12 mo

Length

Gains 13.75 cm (5.5 in.) by6 mo

Additional 7.5 cm (3 in.) by12 mo.

Head and ChestCircumference

Head > chest at birth

Head = chest 9-10 mo.

Head < chest after 1 yr.


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Anterior fontanel closes between 9 and 18 mo.

Posterior fontanel closes between 2 and 3 mo.

Vision

Birth - blinks in response to bright light 1 mo - focus on objects

4 mo - almost complete color vision, follows object in180 arc

5 mo - reaches for objects 6-10 mo - focus on object and follow in all directions

12 mo - depth perception developed


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Hearing Intact at birth

Moro reflex to loud noises

2-3 mo - vocalize to sounds and voices 3-6 mo - looks for sounds, pause to listen,

responds to angry/happy voices

6-9 mo - may look at named objects/people

9-12 mo - understands some words, usesgestures, say one or two words

12 mo - responds to simple commands


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Smell and Taste Intact at birth

Touch Well developed at birth

Poor temperature regulation

Diffuse response to pain

Reflexes Reflexes present at birth

Disappear to permit voluntary movement


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Motor Development: Neonatesand Infants

Uncoordinated at birth

1 mo - lifts head when prone, head lag present

4 mo - minimal head lag

6 mo - sits without support

9 mo - reach, grasp, transfer object from

hand to hand

12 mo - fine motor skills begin todevelop


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Physical Development: Toddlers

Lose the baby look by age 2

Gain 35 kg (710 lb) between ages 1

and 3

Height spurts between ages 1 and 2, then

slows

By 24 mo., head circumference 80% adult

size

Vision continues to mature; 20/40 at age 2

Hearing, taste, smell, and touch increasinglydeveloped

Fine and gross motor skills improve


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Physical Development:Preschoolers

Body appears out of proportion as extremitiesgrow more quickly

Weight gain generally slow

Doubles birth length by age 5

20/30 normal vision at age 5

Hearing at optimal levels

Shows taste preferences Motor abilities strengthen as child begins to

master physical activities


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Physical Development: School-age Children

Major weight gain at age 912 (girls) and 1012(boys)

Growth spurt at age 1012 (girls) and 1214

(boys) 20/20 vision established between ages 911

Well-developed senses of hearing and touch

Increased perspiration and other prepubertalchanges

Motor abilities well developed during this period


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Physical Development:Adolescents

Body parts reach adult size, beginningwith head, hands, and feet

Rapid growth in height and weight forboys, slower in girls

Glandular changes cause increased sweatand acne

Primary and secondary sexualcharacteristics develop


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Psychosocial Development(Erikson)

Neonates and Infants Trust versus mistrust

Toddlers

Autonomy versus shame Preschoolers

Initiative versus guilt

School-age Children

Industry versus inferiority

Adolescents Identity versus role confusion


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Cognitive Development(Piaget): Neonates and Infants

Sensorimotor Phase

Perceptual recognition(48 mo.)

Responds to newstimuli, remembersobjects, looks for them(6 mo.)

Concept of both spaceand time develops (12mo.)


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Cognitive Development(Piaget): Toddlers

Completes SensorimotorPhase

Trial-and-error problem

solving Solving problems mentally

Preconceptual Phase (2 yr)

Learn sequence of time

Develop some symbolicthought


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Cognitive Development(Piaget): Preschoolers

Intuitive Thought Phase

Still egocentric, but subsiding

Learn through trial and error

Think of one idea at a time

Do not understand relationships

5 yr count pennies, reading skills develop


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Cognitive Development(Piaget): School-age Children

Concrete OperationsPhase

Cooperative

interactions Intuitive reasoning

Cause-and-effect

Concepts of money

and time learned Reading skills well

developed


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Cognitive Development(Piaget): Adolescents

Formal Operations Phase

Thinking beyond the present

Idealistic thinking

Abstract thinking


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Moral Development(Kohlberg)

Neonates and infants

No related stage

Pleasure/pain

Parent tone of voice, facial expressions

Toddlers

Preconventional level

Stage 1: Punishment and reward


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Preschoolers

Prosocial behavior

Modeling moral behavior

School-age children Preconventional level

Stage 1: Punishment and reward

Stage 2: Instrumental-relativist

Conventional level Stage 3: Good boy-nice girl

Stage 4: Law and order


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Adolescents

Conventional Level(Young Adolescent)

Postconventional orPrincipled Level


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Spiritual Development(Fowler)

Toddlers

Undifferentiated

Preschoolers

Intuitive-projective

School-age children

Mythic-literal

Adolescents

Synthetic-conventional


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Assessment: Neonates andInfants

Apgar scoring

Denver Developmental Screening Test (DDST-II)

Physical development Growth in normal range

Appropriately size fontanels Vital signs in normal range

Ability to habituate to stimuli and clam self

Motor development Gross and fine skills in normal range

Appropriate reflexes

Symmetrical movements

No hyper- or hypotonia


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Assessment: Neonates andInfants

Sensory development Follows moving objects Responds to sound Coos, babbles, laughs

Imitate sounds Psychosocial development

Interacts with parents through movement andvocalizations

Development in activities of daily living (ADL) Eats, drinks appropriate amounts Exhibits elimination patterns normal for age Exhibits normal rest and sleep patterns


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Assessment: Toddlers

Physical development

Physical growth in normal range

Vital signs in normal range

Vision, hearing within normal range

Motor development

Achieves gross and fine motor milestones

Psychosocial development

Achieves milestones


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Assessment: Toddlers

Development in ADL

Feeds self

Eats variety of foods

Begins to develop bowel and bladder control

Rest and sleep patterns appropriate for age


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Assessment: Preschoolers


Physical growth within normal range



Motor development

Achieves gross and fine motor milestone


Achieves milestones


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Assessment: Preschoolers

Development in ADL

Control of bowel and bladder functions

Performs simple hygiene activities

Dresses and undresses self

Engages in bedtime rituals

Demonstrates ability to put self to sleep


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Assessment: School-ageChildren





Demonstrate male or female prepubertalchanges

Motor development Possesses coordinated motor skills for age


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Assessment: School-ageChildren

Psychosocial Development

Achieves milestones

Development in ADL

Concern for personal cleanliness andappearance

Expresses need for privacy


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Assessment: Adolescents



Demonstrates male or female sexual

development within standards

Vital signs within normal range for gender

Hearing, vision within normal range


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Interacts well with parents and others

Likes self

Has plans for future Choose lifestyle and interests that fit own identity

Determines own beliefs and values

Begins to establish a sense of identity in family

Seeks help from appropriate people as needed


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Development in ADL

Knowledge of physical development,menstruation, reproduction, and birth control

Exhibits healthy lifestyle practice

Demonstrates concern for personalcleanliness and appearance


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Health Promotion Guidelines:Neonates and Infants

Health examinations Birth, 2 weeks, 2, 4, 5, and 12 mo

Protective measures Immunizations Fluoride supplementation as needed Screening for TB and PKU Prompt attention to illness Appropriate hygiene

Infant safety Importance of supervision

Home environmental safety Feeding measures Appropriate toys


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Health Promotion Guidelines:Neonates and Infants

Nutrition

Breast and formulafeeding

Solid foods Iron supplementation

Elimination

Characteristics

Frequency

Diarrhea

Rest/Sleep

Patterns

Sensory stimulation

Touch stimulation Visually stimulating

toys

Hearing loss screening

and intervention


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Health Promotion Guidelines:Toddlers

Health examinations

15, 18 months and then

as recommended by physician

Protective measures Immunizations

Screening for TB, lead poisoning

Fluoride supplementation as

needed


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Safety

Supervision

Teaching

Home environmentsafety

Outdoor safety

Appropriate toys

Nutrition

Nutritious meals andsnacks

Mealtime manners Dental care


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Elimination

Toilet training

Rest/Sleep

Sleep disturbances

Play

Adequate space

Toys for acting on behavior

Motor and sensory stimulation


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Health Promotion Guidelines

Additional safety and health concerns fortoddlers

Injuries Visual problems

Respiratory and ear infections Dental caries


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Health Promotion Guidelines:Preschoolers

Health Examinations

Every 1-2 years

Protective measures

Immunizations Screening for TB,

vision, hearing, dental

Fluoride treatment

Preschooler safety

Education

Play safety

Prevention ofpoisoning


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Health Promotion Guidelines:Preschoolers

Nutrition

Nutritious meals andsnacks

Elimination Proper hygiene

Rest/Sleep

Sleep disturbances

Play

Group play activities Teach simple

cooperative andinteractive games

Toys for dress-up


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Additional safety and health concerns forpreschoolers

Injuries Visual problems Dental caries Respiratory tract and ear infections

Communicable disease Congenital abnormalities correction

H l h P i G id li


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Health Promotion Guidelines:School-age Children

Physical development As recommended

Protective measures

Immunizations Screening for TB

Periodic vision, speech, hearing, dentalscreening

Fluoride treatment

Sexual education

H l h P i G id li


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Health Promotion Guidelines:School-age Children

Safety

Sports safety

Education

Nutrition No skipped meals

Balanced diet

Obesity

Play and SocialInteraction

Organized group

activities Parental expectations

Parentalresponsibilities


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Additional safety and health concerns forschool-age children

Communicable Diseases

Dental Cavities

Injuries

Obesity

H l h P i G id li


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Health Promotion Guidelines:Adolescents

Health Examinations

As recommended

Protective measures

Immunizations

Periodic screenings for TB, vision, hearing,dental screening

Accurate sexual information

H lth P ti G id li


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Safety Issues

Motor vehicle safety

Sports safety

Substance abuse

Emotional disturbances

Nutrition and exercise

Health snacks

Appropriate food intake and exercise

H lth P ti G id li


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Social Interaction

Positive relationships

Peer group activities

Home environment Family responsibilities

and participation


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Additional safety and health concerns foradolescents

Consequences of Risky Behavior

Injury Sexually transmitted disease Teen pregnancy

Psychological and Emotional Challenges

Addiction Schizophrenia may appear Suicide

Infectious Diseases

Growth and Development II

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