GROWTH AND

DEVELOPMENT
Mentor:dr. Pulung M. Silalahi,
Sp.A
Written by :Trianggi Putri Husni
Lubis

Introduction
Growth and development is a continuous
process that occurred since conception and
continues into adulthood. In this process of
becoming an adult, a child must go through
various stages of growth and development.

Growth and Development

1 Growth is a quantitative change, the
increasing number, size, and dimensions at
the level of cells, organs, and individuals
2 The development is the qualitative change.
development is the increasing skill in the
structure and function of the body, which is
more complex in a regular pattern and can
be predicted as a result of the maturation
process

Factors that affect Growing and

development
1. Genetic Factors
2. Environmental Factors
a. prenatal factors
b. postnatal factors

biological environment
physical factors
psychosocial factors
Family factors and customs

Childs Basic Needs

ASUH (biomedical Needs)
Regarding child nutrition during pregnancy and thereafter, the
need for shelter, proper clothing and safety, health care such as
immunizations and early detection and early intervention would
be the onset of symptoms.

ASIH (emotional needs)

It is important creates a feeling of safety (emotional security)
with physical and psychic contact with the mother as early as
possible. Children's needs affection, attention and appreciated,
a new experience, praise, responsibility for independence is
essential for granted. Not prioritize sentence with anger, but
more give examples of affectionate .

 ASAH (The need for early mental stimulation)

early learning, education, and training provided as early as
possible and as appropriate. Especially in the first 4-5 years
of age (golden year) so it will be realized ethics, personality
steady, wise, with intelligence, independence, skills and
good productivity.

Stages of Growth
1. The period of prenatal (prenatal period)
a. Zygote period: conception - 2 weeks
b. Embryonic period: 2 weeks - 8/12 Week
c. Fetal / fetus: 9/12 weeks born
. Early fetal period: 9 weeks-2nd trimester
. Further fetal period: the last trimester of pregnancy
2. Infancy (infancy): 0-1 years
a. Neonatal period: age 0-28 days
. Early neonatal period: 0-7 days
. Further neonatal period: 8-28 days
b. Post-neonatal period: 29 days - 12/15 months
3. Early Childhood / (toddlerhood): age 1-3 years
4. The period of pre-school (preschool / early childhood): age 3-6 years
5. The school year: 6 - 18/20 years
a. Pre-teens (middle adolescence): age 6-11 years
b. Adolescence (adolescence):
. Early Adolescence (early adolescence): 11-13
. Adolescence middle (middle adolescence): 14-17 years
. Further Adolescence (late adolescence): 17-20 years

Characteristics of Growth
1.
2.
3.
4.

Changes in sizes
Changes in the proportions
The loss of the old traits
The emergence of new traits

Growth and Calorie Needs

Antrophometry
There are several ways to assess the
nutritional status of the community.
One of them is the measurement of
the human body, known as
anthropometry.
In use for the assessment of
nutritional status, anthropometric
index are presented in the form
associated with other variables.

Anthropometry variable

Age
Weight
Height
Head circumference

Example:
A boy
Age
: 12 months
Weight : 11 kg
Height : 80 cm

Interpretation of nutritional status

based on Waterlows theory
Based on weight for heights formula

Normal
90-110%
Mild Malnutrition
80-90%
Moderate Malnutrition 70-80%
Severe Malnutrition
<70%

Interpretation of nutritional status

based on Jelliffes theory
Based on Weight for ages formula
Over Nourished
: >110%
Normal
: 90-110%
Mild Malnutrition
: 80-90%
Moderate Malnutrition : 60-80%
Severe Malnutrition
: <60%

Interpretation of nutritional status

based on CDC/WHO
Based on Height for ages formula
Normal
Stunted

: 90%
: <90%

 Conclusion:
WFA = 107%
Normal

HFA = 106%
Normal

WFH = 96%
Normal

Good Nourished

Head circumference
Head circumference counting is commonly used
method to determined the growth and brain
development of children.
Usually the size of the skull growth following the
development of the brain, so that when there are
obstacles to the growth of the skull the brain
development of children is also inhibited.
Measurements were taken at occipitofrontal
diameter by taking the average of 3 times
measurements as standard. Rapid growth rate in the
first 6 month of the baby, 35 cm to 43 cm at birth at
the age of 6 month.

 Growth rate then decreases, only 46,5 cm

at age 1 and 49 cm at the age of 2 years.
Furthermore drastically reduced to only
grow 1cm to 3 years of age and increased
again about 5 cm to
adolescence/adulthood.
Therefore the benefits of the
measurements head circle limited to age 3
years, except when required as in the
case of hydrochepalus.

Child development
In toddler years, the development of
language skills, creativity, social awareness,
emotional intelligence, runs very fast and is
the foundation for the next development.
Moral development as well as the basics of
personality is also formed in this period.
So that any abnormalities / slightest
deviation is detected especially if not
handled properly, will lessen the quality of
human resources in the future days.

Developmental phase
Assessment of child development in
the early phase is generally divided
into four functional capabilities:
gross motor and fine motor,
Vision and Hearing,
Language and speech,
Emotional behavior and social behavior.

0 6 MONTHS

6 12 MONTHS

12 18 MONTHS

18 24 MONTHS

2 3 YEARS

4 5 YEARS

Developmental screening
A brief assessment procedure
designed to identify children who
should receive more intensive
diagnosis or assessment

 Goal:
To determine abnormalities child
development and other issues that are
the risk of developmental abnormalities
Knowing various developmental
problems that require treatment or
genetic counseling
Knowing when a child should be referred
to a higher service center

Screening instrument

STANFORD-BINET test
For age 2 adult
Mostly verbal
To score IQ and mental age
Wechsler intelligence scale for children test
For pre school age 4-6 years
Verbal and performance test
To score IQ
Take a long time to finish, but it could score children who has learning
problem or mental retardation
Gesell infant scale
For 4 weeks 6 years age
To score motor, adaptive, language, and social behavior
BAYLEY infant scale of development
For 2 30 months
To score mental, and motor development, and behavior record
Denver II screening test
For birth to 6 years old
To score developmental level, screen children without symptom

DENVER II SCREENING TEST

Frakenburg, et al (1981) through the DDST (Denver
Developmental Screening Test) suggested four parameters
used in assessing the developmental progress for toddler are:
Personal social (personality / social behavior)
Aspects related to the ability of independent, socialize and interact
with its environment
Fine Motor adaptive (fine motor movement)
Aspects related to the child's ability to observe something, do
movements that certain body parts only and do small muscles,
but requires careful coordination For example, the ability to draw,
holding some object, etc.
Language
Ability to respond to sound, follow orders and speak spontaneously
Gross Motor (gross motor development)
Aspects related to movement and posture

Denver screening
Only use the corrected age

 Scoring:
P (Pass)
F (Failure)
NO (No Opportunity)
R (Refusal)

 Advanced
Normal
:
<75%
Caution
Delayed

: Pass <25%
Pass 25%-90%, Failure, Refuse
: Failure, Refuse 75%-90%
: Failure, Refuse >90%

Advanced : Pass <25%

Normal: Pass 25 % - 90%

Failure, Refuse <75%

Caution : Failure, Refuse 75%-90%

Delayed

: Failure, Refuse
>90%

Interpretation
Normal
Without (F) or at least 1 (C)
Retest on the next control

Suspect
2 or more (C) / 1 or more (F)
Retest in 1-2 weeks to eliminate the momentary factor (fear,
illness/pain, drowsy, or tiredness)

Abnormal
2 or more (F)
Refer for evaluation diagnostic

Cannot be tested
If the patient refuse on 1 or more items on the left of the age line /
refuse on more than 1 item on 75%-90% area
Retest in 1-2 weeks

Normal

Normal
Without (F) or at least 1
(C)
Retest on the next
control

Abnormal

Abnormal
2 or more (F)
Refer for evaluation diagnostic

Abnormal

Suspect

Suspect
2 or more (C) / 1 or
more (F)
Retest in 1-2 weeks to
eliminate the
momentary factor (fear,
illness/pain, drowsy, or
tiredness)

Growth and developmental problem

Physical Growth Disorders

Impaired motor development
Impaired language development
Emotional and Behavioral Disorders

WARNING SIGN IN DEVELOPMENT

Children 0-6 months
physical development
a. At 2 months of age the child is not able to hold his
head when you picked it up.
b. At the age of 3 or 4 months the child can not hold his
head very well.
c. At 6 months of age a child can not sit even if you have
been helped.

language development
a. At the age of 4 months, the child can not imitate your
voice.
b. At 6 months of age the child does not want to laugh
or cry

 2. Children 6-12 months

physical development
a. At the age of 7 months, the child can not control his head well
when the child is placed in a sitting position, do not want to reach
something around it, and can not put something in his mouth.
b. At the age of 8 month child can not sit alone.
c. At the age of 12 months, your child is not able to crawl and could
not stand although in cling to.

language development
a. at the age of 9 months, the child can not give voice to seek
attention.
b. At the age of 10 months, the child did not respond when on call
c. At the age of 12 months, the child is not trying to communicate
to you even if he needed help, the child also can not be waved
wishful nod or shake his head.

Problems of growth and development of

children

Disorders of speech and language.

Cerebral Palsy
Down Syndrome
Short stature
Disorders autism
Mental Retardation
Attention deficit disorder

 THANK YOU