Growth and Development

Definitions of
Growth and Development

Growth

Increase in physical size of a whole or

any of its parts, or an increase in number
and size of cells: Growth can be
measured

Development

A continuous, orderly series of conditions

that leads to activities, new motives for
activities, and patterns of behavior

PRINCIPLES
OF
GROWTH AND DEVELOPMENT

Principles of G&D
Occurs in an orderly sequence
Development is Directional
Individualized each child is unique
Development is interrelated
Development becomes increasingly
differentiated.
Development becomes increasingly
integrated and complex

Patterns of Growth and

Development
Cephalocaudal Pattern (head to toe)

Proximodistal Pattern (from center outward)

Periods of greatest growth

A rapid pace from birth to 2 years
A slower pace from 2 years to
puberty
A rapid pace from puberty to
approximately 15 years
A sharp decline from 16 years to
approximately 24 years when full
adult size is reached

Factors that Influence Growth

and Development

Genetics

Environment

Culture

Nutrition

Health status

Family

Parental attitudes

Child-rearing philosophies

Genetic influences on growth

and development

pattern, rate, rhythm and extent:

governed by genes interplaying with

environment
intrauterine life extremely important in
growth and healthy development of the child

Environmental influences
family composition
family position in society
family socioeconomic status
knowledge of the family
availability of healthy diets
housing
diseases present in family and child

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

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

Health status of the child

Certain diseases may affect g & d

Endocrine and cardiac status
included here

Family / Parental Attitudes / Child-rearing

Philosophy
Critical in growth and development,
esp. emotional growth
Intellectual growth must be
included here as well
Chronic illness can be combated
with a loving environment and
close family relationships

Theories of Growth and Development

Theorists

Piaget
Freud
Erickson

Just review these theorists and their theories

focus mainly on Erickson

Methods to Evaluate Growth

charts: compare to norms
compare to self over time
xrays
teeth
height, weight, head circumference
size of head and legs: length of
bones

Methods to Evaluate Development

Denver Development Test II

Play

Denver Development Test II

Screening test not a measurement of intelligence

Used to - identify children whose development
deviates significantly from that of other children
warranting further investigation to determine if there
exists a problem requiring treatment.
Test covers - four general functions: personal social
(such as smiling), fine motor adaptive (such as
grasping and drawing), language (such as combining
words), and gross motor (such as walking).
Ages covered by the tests range from birth to six
years.

Denver Development Test II

Nursing Implications
Before beginning inform parents
purpose of test. Be sure to stress it is
not an IQ test.
Administer test in a comfortable
environment that contains only items
needed for testing
After testing, share information with the
parent.

Importance of Play

Allows child the learn about

themselves and relate to
others.it is work for the child

Classification of Play

Functional or Practice play

Involves repetitive muscle movements
Infant plays with objects making use of their properties to
produce pleasurable effects
Symbolic play
Child incorporates some object, uses a theme, and then
play the role that each player will have
Games
Includes rules and usually played
by more than one person
Mainly used by school-age child and helps to learn
boundaries, teamwork, taking turns, and competition

Social Aspects of Play

Solitary play
Parallel Play
Associative play
Cooperative Play
Onlooker Play

Solitary Play

Independent play

Child plays alone with toys that are very

different from those chosen by other children
in the area.

Begins in infancy and goes through toddler

age

Parallel Play
Two children are displaying typical parallel play
since they enjoy playing near other children, but
are NOT engaging in social interactions with
each other. Which cognitive and motor skills are
these children developing?

Usually Toddler

Associative Play
Group play without group goals
Even though playing with same
toys, there is lack of formal
organization

Mostly seen in
toddler - preschooler

Cooperative Play
Preschoolers have well-developed language, motor,
and social skills, and they can work cooperatively
together on an art project, as this group is doing.

Onlooker Play

Child observes others playing.

Although the child may ask

questions of the players, the child
does not attempt to join the play

Types of Play
Dramatic

Play act out roles and

experiences that happened to them
Familiarization

Play
Allows children to handle materials in
non-threatening way. Helpful in
preparing child for procedures.

Functions of Play
Physical Development
Cognitive Development
Emotional Development
Social Development
Moral Development

Nutritional Assessment

A nutritional assessment is an
essential component of the health
examination of infants and
children.

Key Dietary
Recommendations

Consume whole grains

Children 2-8 should consume 2 cups

of low-fat milk or equivalent milk products and
children 9 years and older should consume 3 cups

Limit juices, eat fruit and vegetables each day

Watch fat intake. Polyunsaturated and
monounsaturated fatty acids such as fish, nuts, and
vegetable oils should be the primary source

My Pyramid
Eat Right.
Exercise
Have Fun

Nutrition and Activity

Due to increase in childhood obesity,

parents should encourage their children
to increase daily physical activity.

Plan regular periods of exercise

Make exercise a fun and habitual

activity.

Growth and Development

Milestones

INFANT

BIRTH TO 12 MONTHS

Physical Growth and Development Milestones During Infancy

Birth to 1 month

Infancy 2-4 months

Infancy 4-6 months

Infancy - 6-8 months

Infancy - 10-12 months

Summary of key points - Infant

Nursing Interventions
Encourage parents to hold and stay with infant.
Provide opportunities for sucking.
Provide infant with toys that give comfort or
stimulate interest

Developmental milestones
Rolls over; Sits up; Stands.
Able to say one to two words.
Uses pincer grasp well.

Milestones in Infant Communication

1-3 months

Reflex smile that becomes more

voluntary and reciprocal

3-4 months

Babbling, crying more differentiated

4-6 months

Squealing, playing with sound,

identifying parents voice

6-8 months

Single-consonant babbling, increasing

interest in sound

8-9 months
words

Stringing of vowels and consonants,

9-12 months Vocabulary of two to three words, use

of gestures

use of some

TODDLER
1-3 years

Developmental milestones for Toddler

Summary of Key points - toddler

Nursing Interventions
Maintain toilet-training procedures.
Encourage appropriate independent behavior.
Give short explanations.
Provide rewards for appropriate behaviors.
Developmental milestones
Walks up and down stairs; Kicks a ball.
Undresses self.
Scribbles on paper.
Has a vocabulary of 1000 words and uses short
sentences.

Pre-schooler

4-5 years of age

Milestones for the Preschooler

Summary of Key points - preschooler

Nursing Interventions
Encourage parents to be involved in care of child.
Provide safe versions of medical equipment for playtime.
Give clear explanations about procedures and illnesses.

Milestones
Uses scissors.
Rides bicycle with training wheels.
Throws a ball.
Writes a few letters.
All parts of speech well-developed.

School-age Child

6-12 years old

Developmental Milestones School-age

Summary of Key points School-age

Nursing Interventions
Provide for privacy and modesty.
Explain treatments and procedures clearly.
Encourage continuation of school work.
Milestones
Possesses reading ability.
Rides a two-wheeled bike.
Jumps rope.
Plays organized sports.
Mature use of language.

Adolescent age

12-21 years

Adolescent

Psychosocial development
Independence
Identity
Peers
Language use
Exploration and rebellion
Need for privacy
Sexuality
Cognitive development
Formal operations
Abstract thinking

Summary of Key points Adolescent

Nursing Interventions

Provide privacy.
Interview and examine adolescent without parents present, if
possible.
Encourage adolescent participation in treatment and decision
making.
Encourage visitation of peers.

Milestones
Fine motor skills well-developed.
Gross motor skills improve due to growth spurts.
Able to apply abstract thought and analysis.