Growth and Development from Infant to adolesent.pptx

Growth and Development from Infant to adolesent

1. UNIT – III GROWTH AND DEVELOPMENT IN CHILDREN AND ADOLESCENTS Mrs. D. Melba Sahaya Sweety RN,RM PhD Nursing , MSc Nursing (Pediatric Nursing), BSc Nursing Associate Professor Department of Pediatric Nursing Enam Nursing College, Savar , Bangladesh. 1

2. INTRODUCTION Continual change is the essence of life. The rapid changes in size that we call  growth , and the rapid changes in form, function and behaviour that we call  development , are the core of paediatrics.  Growth is a form of motion. Growth means the increase in the size of the various parts and organs of the body by multiplication of cells and intercellular components during the period commencing from fertilization to physical maturity Child development refers to the sequence of physical, language, thought and emotional changes that occur in a child from birth to the beginning of adulthood. During this process a child progresses from dependency on their parents/guardians to increasing independence 2

3. DEFINITION Growth It is the process of physical maturation resulting an increase in size of the body and various organs. It occurs by multiplication of cells and an increase in intracellular substance. It is quantitative changes of the body. Development It is the process of functional and physiological maturation of the individual or It is progressive increase in skill and capacity to function and It is related to maturation and myelination of the nervous system which includes psychological, emotional and social changes. It is a qualitative aspects. 3

4. DIFFERENCE BETWEEN GROWTH AND DEVELOPMENT 4 GROWTH DEVELOPMENT Growth refers to physiological changes Development refers to overall changes in the individual. It involves changes in an orderly and coherent type towards the goal of maturity. Changes in the quantitative respect is termed as growth. The changes produced by growth are subjects of measurements. They may be quantified and observable in nature Development changes in the quality along with quantitative aspect and it brings qualitative changes which are difficult to measure directly. They are assessed through keen observation of behaviour in different situations. Growth does not continue throughout life and its stops after maturation Development continues throughout life

5. 5 GROWTH DEVELOPMENT Growth is cellular it occurs due to the multiplication of cells Development is organizational which occur due to both maturation and interaction with the environment Growth is one of the part of the developmental process Development is a wider and comprehensive term Growth may be referred to describe the changes in particular aspects of the body and behaviour of the organism Development describes the changes in the organism as a whole Growth is structural and external process Development is considered as functional and an internal process Growth is influenced by the development Development is independent it does not depend upon growth Growth changes the physical changes of a person On the other hand, development changes the character of a person. DIFFERENCE BETWEEN GROWTH AND DEVELOPMENT

6. PRINCIPLES OF GROWTH AND DEVELOPMENT Growth and Development proceeds from the head down to the tail or cephalocaudal direction Growth and Development proceeds from the centre of the body towards peripheral or Proximodistal direction Growth and development proceed from the general to specific. Growth and development is a continuous process. Development depends on maturation and learning. Development proceeds from the simple (concrete) to the more complex Early Development is more critical than later Development There are individual rates of growth and development. 6

7. PRINCIPLES OF GROWTH AND DEVELOPMENT Development is sequential . Development is Predictable The child development as a unified whole Each Development takes place in stages Each Developmental stage has certain characteristic trait There are period of accelerated growth and decelerated growth Development is influenced by Heredity and Environment Development proceeds at different rates or different behaviour 7

8. FACTORS AFFECTING GROWTH AND DEVELOPMENT 8

9. 9 FACTORS AFFECTING GROWTH AND DEVELOPMENT Prenatal Factors

10. 10 FACTORS AFFECTING GROWTH AND DEVELOPMENT Postnatal Factors

11. STAGES OF GROWTH AND DEVELOPMENT 3 PRE NATAL OVUM ( 0 to 14 days of conception) EMBRYO ( 14 days to 8 Weeks) FETUS ( 8 Weeks to birth) POST NATAL NEONATES ( from birth to 28 days) INFANCY ( first year of life) TODDLER ( 1 to 3 year of life) PRESCHOOLER ( 3 to 5 year of life) SCHOOL-GOING (6 to12 year of life) ADOLESCENCE ( 12 to 21 year of life) 11

12. GROWTH AND DEVELOPMENT OF INFANT

13. The word infant is derived from the Latin word, ‘ infans ’ which means  ‘unable to speak’ . During the infancy stage, babies cannot speak. Infants can be considered children anywhere from  birth to 1 year old . At this stage, the infant is still very dependent on its mother, but it can now breathe independently, and cry when it feels hungry, cold, hot, or generally uncomfortable. INTRODUCTION 2

14. NEEDS OF INFANT 14

15. WEIGHT : Formula For calculating weight is Age in months +9 2 1-6 months – 30 gm/day 7-12 months- 15 gm/day The infant will double his birth weight by 4-5 months and triple it by 10-12 months of age LENGTH : <6 months- 2.5 cm/month 7-12 months- 1.5 cm/month Height at 1 year -75 cm PHYSICAL OR BIOLOGICAL DEVELOPMENT OF INFANT 15

16. HEAD CIRCUMFERENCE : Increase 1.5 cm per month during first 6 months 0.5 cm in next 6 months CHEST CIRCUMFERENCE : Usually 1-2 cm lesser than HC HC and CC will be equal by 1 year PULSE : 100- 150 be/mt RESPIRATION : 35 + or – 10 be/mt BLOOD PRESSURE : 80/50 + or – 20/10 PHYSICAL OR BIOLOGICAL DEVELOPMENT OF INFANT 16

17. Posterior fontanel closed at 6 to 8 weeks of age Drools between 3 and 4 months of age indicating increased production of saliva .Unable to swallow it, therefore, it runs from mouth. Ultimate color of iris is established at 7 month PHYSICAL OR BIOLOGICAL DEVELOPMENT OF INFANT 17 TEETING : Age Teeth Development 6 (+ or – 2 ) Month Two lower central incisors erupt Begins to bite and chew 7(+ or – 2 ) month Upper central incisors erupt 9 (+ or – 2 ) month Upper lateral incisors erupt 12 (+ or – 2 ) month Has 6 to 8 deciduous teeth

18. Age in Month Gross motor Development 1 month old Turns head when prone, Back completely rounded when sitting, head forward 2 month old Hold chest up when prone 3 month old Head partly lags when child pull to sitting 4 months old Begins to roll front to back, head steady in sitting, Lifts up on elbows 5 months old “Swims” in prone position, Lifts up on hands, No head lag when pulled to sitting from supine, Roll back to front, sit with pelvic support 7 months old Sits independently, rolls over, rocks on hands and knees, free head lift in prone position 8 months old Get in to sitting position when supine, Supports weight standing, bounces when held 9 months old Sits alone well, may crawl, pulls to stand 10 months old Cruises, pivots while seated, walk with two hand support 11 month old Stand alone , walk with one hand support 12 months old Walks without support, stands alone momentarily GROSS MOTOR DEVELOPMENT OF INFANT 18

19. Age in Month Fine motor Development 1 month old Holds Hands in tight Fists 2 month old Hold hands unfisted half the time 3 month old Bats at object; sustain grasp if an object is placed on palm 4 months old Reaches for objects when supine, Brings hands together in midline Plays with fingers, Thumb apposition in grasping occurs between third and fourth months 5 months old Tries to obtain object beyond the reach, Ulnar-palmar grasp, transfer object from hand to mouth to hand 6 months old Radial-palmar grasp, transfer object from hand to hand; immature rake 7 months old Radial-digital grasp, Holds cup, Transfers a toy from one hand to the other, usually successfully 8 months old Bangs cubes on table, Release objects from hand voluntarily , Eat finger foods, such as crackers, that can be held in one hand 9 months old Shows inferior pincer grasp, uncover hidden objects, Bangs two objects together 10- 11 month old points with index finger, Brings the hand together, Beginning to hold a crayon and make a mark on paper 12 months old Picks up pellet with pincer grasp, attempt 2 block tower FINE MOTOR DEVELOPMENT OF INFANT 19

20. Age in Month Sensory Development 1 month old Startled by sound and Visual acuity approaches 20/100 3 month old Binocular coordination (Vertical and Horizontal vision ) when an object is moved from right to left and up and down in front of face 4 months old Beginning Hand - eye coordination 4-5 months old Can fixate object more than 3 feet away Visual acuity 20/200 6-7 months old Localizes sounds made above the ear, Moves in order to see an object 7-8 months old Has preferences in taste for food 7-9 months old Recognizes familiar words and sounds 9-10 months old Able to follow objects through transition from one place to another 12 months old Visual acuity; 20/100 to 20/50 SENSORY DEVELOPMENT OF INFANT 20

21. Age in Month Psychosocial Development 1- 3 month old Complete dependence on care giver, Establishes Eye Contact Smiles Briefly 5- 6 months old Recognizes parents , Recognizes strangers (5 th and 6 month ) as different from family members. 7-8 months old Actively clings to a familiar person when distressed, Affection for or love of family members 9- 10 months old Expresses several beginning recognizable emotions such as anger, sadness, jealousy, anxiety, pleasure, excitement, and affection, Play social games with adults such as “pat-a-cake” and “peek-a-boo” 11-12 months old Shows emotions, such as jealousy, affection (may hug or kiss on request) PSYCHOSOCIAL DEVELOPMENT OF INFANT 21 SENSE OF TRUST VS MISTRUST

22. PSYCHOSEXUAL DEVELOPMENT OF INFANT 22 ORAL STAGE Oral – dependent or oral-passive ; need for sucking pleasure SPIRITUAL DEVELOPMENT OF INFANT UNDIFFERENTIATED MORAL DEVELOPMENT OF INFANT PRECONVENTIONAL MORALITY Stage 0 (0 to 2 Yrs ) The Good is what I like and want

23. 23 Age in Month Intellectual Development 1 to 4 months old Primary Circular Reaction : Hand to mouth movement permits sucking, an infant might repeat the motion of passing their hand before their face 4 to 7 months old Sensorimotor stage : Secondary Circular Reaction Repeats actions that affect an object to get a response (Shaking a Rattle ) 8- 12 months old Sensorimotor Stage : Secondary circular reaction and coordination of secondary schemas Coordination of vision and touch—hand-eye coordination , Trying to find the object INTELLECTUAL DEVELOPMENT OF INFANT

24. LANGUAGE DEVELOPMENT OF INFANT 24 Age in Month Receptive Language Expressive Language 1 to 3 months old Attends to voice, turns head or eyes Startles to loud sounds ,Quiets in response to voice Smiles Undifferentiated but strong cry Coos and gurgles Single-syllable repetition g, k, h, and ng appear 3 to 6 months old Actively seeks sound source May look in response to name Responses may vary to angry or happy voice Respond to changes in the tone of caregiver’s voice. Pay more attention to music and, perhaps, coo along with the music. Imitate familiar sounds and actions. Begin to babble with repetitive syllables, starting with vowel sounds (“oh” and “ah”) and moving on to new sounds and combinations with “p,” “m,” “b,” and “d” in them.

25. LANGUAGE DEVELOPMENT OF INFANT 25 Age in Month Receptive Language Expressive Language 6 to 9 months May look at family member when named Inhibits to “no” Begins interest in pictures when named Individual words begin to take on meaning Try to communicate using actions or gestures Babbles tunefully Increased sound combinations Uses m, n, b, d, t Initiates sounds, such as click or kiss Uses nonspecific “mama” and “dada” Use their voices to express pleasure and displeasure 9 to 12 months Follow simple instructions, especially if vocal or physical cues are given, such as “drink your milk,” and simple commands, such as “no.” Recognize their name when called. Understand the names of familiar objects or people Responds with gestures to “bye-bye” Try to mimic familiar sounds, such as car and animal noises. Focus on the speaker’s mouth and try to imitate words and practice inflection. Say a few two-syllable words, such as “dada,” “mama,” and “uh-oh.” Accompanies vocalizations with gestures Jargon increases

26. PLAY STIMULATION OF INFANT 26 Age in Month Play Stimulation 1 month Hold, Touch, Rock infant gently Talk and sings softly to infant at close range 2 month Offer a rattle Hold or Dangle toy in front of infant to encourage eye movement. 3 month Hold bright toys in front of infant to encourage reaching Provide greater variety of toys as baby shows interest in play things. 4-5 month Light tickling stimulates laughter. Shake rattle placed in infant hand Encourage splashing in bath water Provide variety of small multi textured (fuzzy, smooth) and colored objects that infant can hold but not swallow.

27. PLAY STIMULATION OF INFANT 27 Age in Month Play Stimulation 5- 6 month Provide sound making toys. Provide more complex soft cuddly toys Encourage infant to look in a mirror; repeat names of parts of face, such as mouth, nose, and eyes. Place infant in a sitting position and encourage leaning away from the wall that improve balance 7-8 month Help infant learn to stand. Encourage banging of toys and clapping hands Provide a larger environment in which the infant can move safely; crawling, creeping Place toys under blanket and encourage infant to find it

28. GROWTH AND DEVELOPMENT OF TODDLER

29. INTRODUCTION The word is derived from “to toddle”, which means to walk unsteadily, like a child of this age. The toddler period extends from age 1 year to approximately 3 years of age. The toddler who learned to trust the parents during infancy now can use this trust in exploration and investigation of a world beyond the parent’s arms. The toddler years are a time of great cognitive, emotional and social development. 29

30. CHARACTERISTICS OF TOODLER 30

31. CHARACTERISTIC BEHAVIOURS OF TOODLER Recognize themselves in pictures or a mirror; Imitate the behavior of others, especially adults and older children. Beginning of reading and writing. Short attention span. Negativistic attitude and Independence. Ritualistic behavior. Temper tantrums. Regression Egocentric Dawdling Ambivalence 31 Curious and more energetic. Babbling; beginning to develop language. Judgment based on perception, rather than logic. Recognizes parents and special people, attaches to special toys, objects. Expresses feelings through crying, facial expressions, body language, sounds. Understands words; communicates via sounds, gesture. Show greater independence; begin to show defiant behavior;

32. NEEDS OF TODDLERS 32

33. WEIGHT : Formula For calculating weight is Age in year X 2 + 8 2 years-12kgs 2.5 years- 4 times to birth weight HEIGHT : Formula For calculating Height is Age in years X 6 +77 2 years -85cm PULSE : 90- 130 be/mt PHYSICAL OR BIOLOGICAL DEVELOPMENT OF TODDLER 33 RESPIRATION : 26 + or – 5 be/mt BLOOD PRESSURE : 100/60 + or – 20/20 ANTERIOR FONTANEL CLOSED BETWEEN 12 – 18 MONTHS DENTITION 2 years-16 teeth 2.5 yrs - 20 teeth ( Primary teeth Completes)

34. PHYSICAL OR BIOLOGICAL DEVELOPMENT OF TODDLER Body System Developmental Changes Gastrointestinal By 2 years, the salivary glands reach adult size. During the second year, the liver matures and becomes more efficient in vitamin storage, glycogenesis, amino acid changes, and ketone body formation. The lower edge of the liver may still be palpable. Stools are more like those of adults. Renal A 2-year-old may excrete as much as 500 to 600 mL of urine a day. 34

35. GROSS MOTOR DEVELOPMENT OF TODDLER Age Gross motor Development 12 – 13 month Pulls self to stand Stands alone for 3 to 5 seconds Walks holding on to furniture , Creeps up stairs Lowers self from standing to sitting without falling Rolls a ball 15 months Stands alone well Walks forward and backward Stoops and recovers Climbs up stairs without alternating feet Pulls a pull toy 18 months Throws while aiming Walks well independently Pushes and pulls toys , Seat self in small chair Climbs on furniture Pulls toy while walking backward 35

36. GROSS MOTOR DEVELOPMENT OF TODDLER Age Gross motor Development 24 month Throws overhand Runs well Climbs up on furniture Kicks large ball Walks up and down stairs both feet on one step at a time, holding onto a railing or the wall, Can Walk with heel-to gait Runs , Jumps up 30 months Jumps with both feet Climbs stairs alternating feet Stands on one foot for 1 second Walks on tiptoes Stands on one foot alone momentarily 36

37. FINE MOTOR DEVELOPMENT OF TODDLER Age Fine motor Development 12 – 13 month Uses pincer grasp Stacks two blocks Clasps hands together Scribbles spontaneously 15 months Puts blocks in a cup Stacks two blocks Scribbles spontaneously Pats pictures in books and begins to turn pages 18 months Stacks three - four blocks Turn pages in a book two or three at a time Imitates a vertical stroke with crayon Puts block in to hole 37

38. FINE MOTOR DEVELOPMENT OF TODDLER Age Fine motor Development 24 month Builds tower of seven cubes Circular scribbling Imitates folding paper once Turns doorknob Turns pages one at a time 30 months Builds tower of nine cubes Draws vertical and horizontal lines Imitates circle Hold crayon with finger instead of entire hand Adds chimney to train of cubes 38

39. SELF CARE DEVELOPMENT OF TODDLER Age Feeding Skills Dressing skills Toileting and Grooming Skills 15 month Enjoys finger feeding Hold a cup with all fingers grasped about it. Removes socks Sticks out arm and leg to help in dressing Indicates when diaper is wet or soiled 18 months Holds cup with both hands. Eats with spoon ; turn spoon in mouth. Spills frequently Removes Simple garments ( mittens, shoes) and unzips garments May complain When wet or soiled or give indication of need to toilet 39

40. SELF CARE DEVELOPMENT OF TODDLER Age Feeding Skills Dressing skills Toileting and Grooming Skills 24 month Drinks well from a small glass held in one hand Plays with food Imitates eating habits of other Pulls on Own, simple garments- coat, elastic pant, shoes(laces untied) Removes most of on clothing (hat, pant) Usually urinates when taken to toilet, May brush teeth with help Verbalizes toilet needs 30 Month Pour from pitcher; often spills Uses fork, but is held in fist Put arm through large armhole Buttons one large front button and unbuttons large front button Usually has mastered daytime bladder control , Beginning of night time bladder control May go to toilet by self (for bowel movement 26 months, for urination 30 months) and needs assistance with wiping 40

41. SENSORY DEVELOPMENT OF TODDLER Age Sensory Development 15 months Binocular vision fully developed 18 months Identifies various shapes Can see better, thus has intense interest in picture 24 months Visual acuity 20/40 30 Months Visual Acuity 20/30 Recall Visual Images 41

42. PSYCHOSOCIAL DEVELOPMENT OF TODDLER Age Psychosocial motor Development 15 month Egocentric, Separation anxiety, Hugs and kisses parents 18 months Begins to have temper tantrums if things go wrong Imitates parent’s domestic activities (sweeping, Dusting) Beginning awareness of ownership (“my toy”) 24 months Has great sense of “mine”, little of “yours”; Possessive Violent temper tantrum decreasing Negativism and dawdling , would like to make friends but does not know how 30 months Separates more easily from parent Begins to notice gender differences; knows own gender Emotions expand to include pride, shame, guilt, embarrassment Negativism and dawdling continue 42 SENSE OF AUTONOMY VS DOUBT AND SHAME

43. PSYCHOSEXUAL DEVELOPMENT OF TODDLER PRECONVENTIONAL MORALITY (1 to 3 Years) Stage 1: Child if punished is wrong, if not punished it is right 43 ANAL STAGE (1 to 3 Years) Obtain pleasure from feeling of a distended bladder from masses of feces in the rectum and from the release contents from those organs SPIRITUAL DEVELOPMENT OF TODDLER INTUTITE PROJECTIVE (1 to 3 Years) Imitates religious behaviors such as bowing the head in prayer, but does not understand the meaning MORAL DEVELOPMENT OF TODDLER

44. INTELLECTUAL DEVELOPMENT OF TODDLER 44 Age in Month Intellectual Development 15 months old Sensorimotor stage : ( Tertiary circular reaction) Children become captivated with object properties and start to solve problems using trial and error methods. An example of tertiary circular reaction is dropping food on the floor to see what happens 18 months old Sensorimotor stage : Substage IV ( Invention of new mean through Mental combination) From 18 months to 2 years, the child begins to use insight and creativity An example of beginnings of thought would be a child playing with an imaginary friend. 24 & 30 months old Preoperational stage : Preconceptual phase (2 to 4 Yrs ) Young children are able to think about things symbolically. Their language use becomes more mature. They also develop memory and imagination, which allows them to understand the difference between past and future, and engage in make-believe.

45. LANGUAGE DEVELOPMENT OF TODDLER 45 Age in Month Receptive Language Expressive Language 12 to 18 months Follows one-step commands Each week understands new words Increased interest in naming pictures Differentiates environmental sounds Points to familiar objects and body parts when named Understands simple questions Begins to distinguish “you” from “me” Uses all vowels, many consonants Increased use of real words Jargon is sentence-like Likes to use negatives (i.e., says “no” often) Names a few pictures By 18 months old, articulates 15 to 20 words and understands 50 Imitates non-speech sounds (e.g., cough, tongue click) Names some body parts

46. LANGUAGE DEVELOPMENT OF TODDLER 46 Age in Month Receptive Language Expressive Language 18 to 24 months Follows two-step commands Vocabulary increases rapidly Enjoys simple stories and songs Recognizes pronouns Imitates two-word combinations Dramatic increase in vocabulary Speech combines jargon and words Names self Answers some questions Begins to combine words Begins to use pronouns 24 to 30 months Understands prepositions in and on Seems to understand most of what is said Understands more reasoning (“when you are finished, then …”) Identifies object when given function (wear on feet, cook on) Babbles less Two-to three-word sentences Repeats two numbers Increased use of pronouns Asks simple questions Joins in songs and nursery rhymes Can repeat simple phrases and sentences

47. PLAY STIMULATION OF TODDLER 47 Age in Month Play stimulations 15 months old Provide Balls, Stuffed animals, Dolls, Musical toys, Picture books, Stacking discs or blocks 18 months old Wooden blocks, pull toys, clay, large crayons, stuffed toys, sand toys, Enjoy Solitary play, Imitates parental action Enjoy playing with balls 24 months old Pulls wagon Enjoys hearing stories Manipulates play materials such as clay Brush paint, Large crayons Large crayons 30 months old Motor Play :- Provide Large Cars, trucks, pushes and pull toys Creative Play:- Provide clay, finger paint, large wooden puzzles, large crayons. Dramatic Play:- Provide Baby doll and doll equipment's, play telephone, Toys for house keeping (Small broom, dust cloth etc... PARALLEL PLAY

48. GROWTH AND DEVELOPMENT OF PRESCHOOLER

49. INTRODUCTION The preschool period is the period between 3 and 5 years of age. The pre- school years is also known as “ the years before formal schooling begins . This is a time of continued growth and development. Physical growth continues much more slowly compared to earlier years however the child achieves several milestones in life which also serve as basic foundation of learning and development.   Preschoolers have more control in there body, since they have their center of gravity at a lower level, right about near the belly button. This gives them more ability to be stable and balanced than the toddler. The preschooler moves from the unsteady stance of toddlerhood to a more steady bearing. They no longer “toddle”, that wobbly way that toddlers walk. This also allows the preschooler to move more “successfully” than the toddler. 49

50. CHARACTERISTICS OF PRESCHOOLERS 50

51. NEEDS OF PRESCHOOLERS 51

52. DEVELOPMENTAL & HEALTH PROBLEMS OF PRESCHOOLERS 52

53. PHYSICAL OR BIOLOGICAL DEVELOPMENT OF PRESCHOOLERS 53 WEIGHT : Formula For calculating weight is Age in year X 2 + 8 HEIGHT : Formula For calculating Height is Age in years X 6 +77 3 years- 90.5-101.5 cm 4 years- 95-109 cm 5 years- 103-115 cm PULSE : 90 - 110 be/mt RESPIRATION : 26 + or – 5 be/mt BLOOD PRESSURE : 95/55 + or – 20/10

54. PHYSICAL DEVELOPMENT OF PRESCHOOLERS 54 Body System Developmental Changes Neurologic Continued myelinization and cortical development occurs. Fine motor movements are more detailed and sustained. Gross motor skills are smoother and more coordinated. Sensory function is more mature Cardiovascular By the fifth year, the heart has quadrupled in size since birth. By 5 years, the heart rate is typically 70 to 110 bpm. The hematologic system should produce only adult hemoglobin by the fifth year. The hemoglobin level stabilizes at 12 to 15g/dL. Pulmonary Abdominal respiratory movements continue until the end of the fifth or sixth year. Respiratory rate slows to about 30 breaths per minute.

55. PHYSICAL DEVELOPMENT OF PRESCHOOLERS 55 Body System Developmental Changes Gastrointestinal The stomach becomes more bowed and increases its capacity to about 500 mL. Many children still require a nutritious snack between meals because of small stomach size Renal A 4-to 5-year-old excretes between 600 and 750 mL daily Endocrine Quiescent time for sexual growth, with few physical or hormonal changes. Growth hormone stimulates body growth.

56. GROSS AND FINE MOTOR DEVELOPMENT OF PRESCHOOLERS Age Gross Motor Development Fine Motor Development 3 years Climbs ladders May pedal tricycle Balances on one foot 2 to 3 seconds Kicks ball with direction Catches a ball Walks on tip toes May try to dance, but balance may not be adequate Build a tower of 9 – 10 blocks Copies a circle Shows preference for handedness Can help with simple house hold tasks (dusting, etc..) Puts beads on string 4 years Tries to skip using alternate feet Catches a bouncing ball Runs around corners lightly on toes and stops voluntarily Stands on one foot for 5 seconds Uses scissors successfully to cut out picture following outline In drawing, copies square, traces cross and diamond 56

57. GROSS AND FINE MOTOR DEVELOPMENT OF PRESCHOOLERS Age Gross Motor Development Fine Motor Development Walks down stairs alternating feet Throws ball underhand Jumps from greater height 5 years Catches bounced ball most of the time Stands on one foot for 7 to 8 seconds Gallops (combination of skipping and running) Does a somersault Hops Skips successfully Imitates dance steps if taught Copies a triangle Cross vertical lines Copies letters; May be able to print own name Draws a three part man 57

58. SELF CARE DEVELOPMENT OF PRESCHOOLERS 58 Age Feeding Skills Dressing skills Toileting and Grooming Skills 3 years Can put an coat without assistance Can undress self in most instance Can pull pants up and down Can go to toilet alone Brushes teeth with help 4 Years Manage spoon with little spilling Eat with fork held in fingers Buttons side buttons, small buttons Can put on socks with help Knows back from front of clothes Put on shoes (not lace) without help May bath self with assistance Wash and dries hands without supervision 5 Years Selects fork over spoon when appropriate May be able to lace shoes Manages Zippers in back Wipes self independently Flushes toilet after each use Bath self and combs hair with help Can blow nose when asked

59. SENSORY DEVELOPMENT OF PRESCHOOLERS PSYCHOSOCIAL DEVELOPMENT OF PRESCHOOLERS 59 Visual acuity 20/20 Age Psychosocial development 3 years May have fears, especially of dark and going to bed Knows own gender and gender of others Egocentric in thought and behavior Less dependent on parents but needs reassurance and help Sense of Initiative Vs Guilt

60. PSYCHOSOCIAL DEVELOPMENT OF PRESCHOOLERS 60 Age Psychosocial development 4 Years Very independent Tends to be selfish and impatient Aggressive physically as well as verbally Takes pride in accomplishments Has mood swings 5 Years Continues to be egocentric Separates easily from parents Has fantasies and day dreaming Independent and trust worthy Eager to do things right and to please; tries to “live by the rules” Has better manners Sense of Initiative Vs Guilt

61. PSYCHOSEXUAL DEVELOPMENT OF PRESCHOOLERS 61 PHALLIC STAGE ( Demonstrates strong attachment for parents of opposite sex) SPIRITUAL DEVELOPMENT OF PRESCHOOLERS INTUITIVE – PROJECTIVE FAITH MORAL DEVELOPMENT OF PRESCHOOLERS PRE CONVENTIONAL MORALITY Stage 2 :-You do it for me ; I will do it for you

62. INTELLECTUAL DEVELOPMENT OF PRESCHOOLERS 62 AGE INTELLECTUAL DEVELOPMENT 3 years Is egocentric in thought and behavior Has beginning understanding of time; uses many time-oriented expressions, talks about past and future as much as about present, pretends to tell time Has improved concept of space, as demonstrated by understanding of prepositions and ability to follow directional command Has beginning ability to view concepts from another perspective 4 years Judges everything according to one dimension, such as height, width, or order Obeys because parents have set limits, not because of understanding of right or wrong Is beginning to develop less egocentrism and more social awareness 5 years Begins to question what parents think by comparing them with age-mates and other adults May begin to show understanding of conservation of numbers through counting objects regardless of arrangement Uses time-oriented words with increased understanding

63. LANGUAGE DEVELOPMENT OF PRESCHOOLERS AGE RECEPTIVE EXPRESSIVE 3 years Can obey two prepositional commands (on, under) Has vocabulary of about 900 words Uses primarily “telegraphic” speech Uses complete sentences of three or four words Asks many questions 4 years Understands directives (On, Under, Inback , Infront) Has vocabulary of 1500 words or more Uses sentences of four or five words Questioning is at peak Tells exaggerated stories Knows simple songs Use ‘’I’’ and Counts to 5 5 years Carries out instruction with three suggested task to wash, dry, sit down Names Primary colors. Ask meaning of words Count 1 to 10 Has a vocabulary of 2100 words Knows names of days of week, months, and other time-associated words 63

64. AGE PLAY STIMULATION 3 Years Crayons , paints Play telephone, Busy-box, Music record players Single puzzles, toy dishes, soap bubbles 4 Years Play cooperatively with others Provide Hand puppets, doll house, doll nurse or doctor kit Provide Blackboard, chalk, paper , paste, scissors, clay , finger paints to stimulate creativity Sliding boards, swing, blocks of all sizes , Tinker toys to encourage motor activity 5 Years Play Competitive games Love to transport things in trucks, Cars, Wagons Construction toys, paper dolls, opportunities for collecting nature specimens for creativity activity See – Saw, jungle gym , Slides , jump rope and skates for motor activity Color sets, books and puzzles for quiet play 64 PLAY STIMULATION OF PRESCHOOLERS

65. GROWTH AND DEVELOPMENT OF SCHOOL GOING 65

66. Introduction School-age children are those 6 to 12 years of age. This is a stage of continuing growth and development for young child. They will go through many changes in physical, mental, and social development. While all children may grow at a different rate,  and they have different interests, abilities, and personalities. School- age children become increasingly capable of self care. They follow the values, belief and habits of the parents. So Parents are still responsible for information giving and explaining physiologic changes that occur during school age. 66

67. Subphases of School going 67

68. 68 Needs for School Going

69. Physical or biological development 69 WEIGHT : Formula For calculating weight is 1 – 6 years - Age in year X 2 + 8 7 - 12 years - (7 x Age in years – 5) 2 12 years - 40kg (Increases 2-3 kg/year) PULSE : 75 - 95 be/mt RESPIRATION : 18 - 24 be/mt BLOOD PRESSURE : 100/60 + or – 16/10 DENTITION 6 years - Central mandibular incisors erupt Loses first tooth 7 years- Maxillary central incisors and lateral mandibular incisors erupt, Jaw begins to expand to accommodate permanent teeth 8 - 9 years - Lateral incisors (maxillary) and mandibular cuspids erupt 10 – 12 years - Remainder of teeth will erupt and tend toward full development (except wisdom teeth) HEIGHT : Formula For calculating Height is Age in years X 6 +77 6 yrs. - 116 cm 12 yrs-150 cm (Increase of 5cm per year)

70. Body System Developmental Change Skin and lymph At about 6 years old, tonsils and adenoids reach their largest size. Prepubescence is characterized by more active sebaceous glands and vasomotor instability that can lead to uncontrolled blushing. Head, eyes, ears, nose, and mouth Head size becomes smaller in proportion to body size. Undeveloped sinus cavities contribute to increased susceptibility to upper respiratory infections, sinus irritation, and sinus headaches. By 6 to 7 years old, the retina is fully developed, and visual acuity is 20/20. By middle childhood, the Eustachian tube grows longer, narrower, and more slanted. By 5 to 6 years old, first primary teeth are shed, and the first permanent teeth erupt, usually the central incisors. Each year after 6 years old, approximately four teeth are replaced—one set in the upper jaw, and one set in the lower jaw. 70 Physical or biological development

71. Body System Developmental Change Pulmonary Through childhood, the lungs gradually descend into the thoracic cavity. By 8 years old, alveolar development is complete. During middle childhood, tidal volume increases; normal adult respiratory rate is achieved (18 to 30 breaths per minute). Increased maturation of the macro phagocytic activity of mucus and ciliary function in lungs makes the child more resistant to respiratory infections Cardio vascular By 7 years old, the left ventricle thickens; it is two to three times greater in size than right; blood pressure increases to 90 to 108/60; cardiac volume increases; heart rate declines to 60 to 100 bpm. 71 Physical or biological development

72. Body System Developmental Change Gastro intestinal By middle childhood, the GI system is of adult size and function. Genito urinary By 6 years old, elimination patterns are established; greater than 90% of children are toilet trained. Bladder capacity continues to expand. Between 10 and 14 years old, puberty begins but can be normal in any child after 8 years old for females and 9 years old for males. Delayed puberty is diagnosed if no secondary sex changes (e.g., breast budding; penis or testicle growth) are noted at 13 years old in girls and 14 years old in boys. Musculoskeletal Long bones grow, leading to the taller, thinner school-age child. Spine becomes straighter; legs become straighter. Facial bones are actively changing as nasal accessory sinuses grow. Immune system Rapid maturation of the immune system during middle childhood. Allergic conditions may appear. 72 Physical or biological development

73. Gross And Fine Motor development Age in Years Gross Motor Development Fine Motor Development 6- 8 years Rides tricycle without training wheels Runs, Jump, Climb, Hops and Constantly in motion Clumsy and awkward Coordination improving Knows right from left hand Draw a person with 12-16 parts Has improved eye-hand coordination Print words; learns cursive writing 8-10 years Performs tricks on bicycles; and races Begins to participate in organized sports , like base ball , soccer Throws a ball skillfully, over hand and underhand Use both hands independently Draws a person with 18-20 parts and print fluently , cursive writing improved 10 - 12 years Enjoy all physical activities Coordination continues to improve 73

74. Self Care Age in Years Feeding Skills Grooming and dressing skills 6-7 years At 6 years, likes to eat with fingers, stuff food into mouth, talkative while eating At 7 years, improved table manners, less talking may bolt food. Self- care managed ; has a tendency to dawdle in bath tub Can brush and comb hair May need some help with dressing Leave clothes where they are removed 8-10 years Handles eating utensils skillfully Dressing self completely; enjoys selecting own clothes Unaware of dirty clothes and Need to be reminded to brush teeth 11- 12 years Cooks or sews in small ways Washes and dries own hair; is responsible for a thorough job of cleaning hair but may need reminding to do May wear some clothes continually 74

75. Sensory development Age in Years Psychosocial Development 6-8 years Continue to be egocentric, Bossy Has a “ Know it all ” Attitude Insists on being first in everything , Jealous of siblings Return of temper tantrums may use Verbal, Physical attack 8- 10 years Concerned about relationships with others Begins hero worship Relationship with siblings improved Aware of appropriate sexual role 75 Visual Acuity 20/20 Psycho Social development Sense of Industry vs Inferiority

76. Age in Years Psychosocial Development 10- 12 years Congenial, Sincere, Confident Respects parents and their role Has short bursts of anger (10 yrs ) Able to control anger (12 yrs ) Hero worship of adult continues Still fears the dark 76 Psycho Social development Psycho Sexual development Latency Stage (6 – 12 yrs ) The superego or conscious is internalized. Energy is put into acquiring cultural and social skills. Guidelines established by the family are followed

77. 77 Spiritual Development Mythical literal faith (6 – 12 years) In this stage, information is organized into stories and together with moral rules are concretely understood by the child. Moral Development Pre Conventional Morality Stage 2 (4-7Yrs)   Instrumental purpose orientation Behavior is determined again by consequences. The individual focuses on receiving rewards or satisfying personal needs. Conventional Morality Stage 3 (7-9Yrs) Developing Good Interpersonal Relationships : Behavior is determined by social approval. The individual wants to maintain or win the affection and approval of others by being a "good boy-good girl“ Conventional Morality Stage 4 (10-12Yrs) Maintaining Social Order

78. 78 Intellectual Development Age in Years Intellectual Development 6-7 years Pre operational thought Sub stage II (4-7Yrs) Can tell time , Can describe objects in picture, knows their use Can see difference more than similarities performs mental operation of conservation of liquid vs solid amount Age in Years Intellectual Development 8- 10 years Concrete Operational Stage Memory span increasing, Time – usually punctual Ashamed of failure, Learn to understand and use abstract symbols and caries out mental operations 11- 12 years Formal Operational Thought Develops abstract and deductive reasoning, Uses problem solving method, Short interest span , Preoccupied with right and wrong 78

79. Language development Age in Years Receptive Language Expressive Language 6- 8 years Follows series of 3 commands, response dependent on mood Responds to praise and recognition Can repeat sentences of 10 to 12 words. Has a vocabulary of 2500 words. Knows number combinations up to 10 Develops a sense of humor; enjoys telling jokes 8-10 years Follows suggestion better than commands Begins to use shorter and more compact sentence Is gregarious 10 - 12 years Follows suggestions better than request Is obedient Oral vocabulary of 7200 words and reading vocabulary of 50,000 Enjoy riddles Uses parts of speech correctly Uses numbers beyond 100 with meaning 79

80. 80 Play Stimulation Provide Table games, board games for competitive and team play. Loves active play, prefers group play Provide Bicycles, Jump ropes, Punching bags, roller skates, bat/balls, gymnastic equipment for motor activity Provide Puppets, dolls, paints, crayons, drawing materials ,clay, magic tricks, dance lessons, musical instruments for creative activity Provide Books, puzzles records, tapes “ Collectibles” for quiet play. For 8 -10 years Provide Bicycles, Jump ropes, Punching bags, roller skates, bat/balls, gymnastic equipment for motor activity For 10- 12 years Enjoy Athletic sports and Talking on telephone Reading mystery and love stories

81. GROWTH AND DEVELOPMENT OF ADOLESCENCE 81

82. INTRODUCTION Adolescence is a period of psychosocial and emotional transition between childhood and adulthood—a time of rapid physical, cognitive, social, and emotional maturation. Adolescence, which literally means “to grow into maturity,” is generally regarded as the psychological, social, and maturational process initiated by the pubertal changes Several terms are used to refer to this stage of growth and development. Puberty refers to the maturational, hormonal, and growth process that occurs when the reproductive organs begin to function and the secondary sex characteristics develop. This process is sometimes divided into three stages: prepubescence , the period of about 2 years immediately before puberty when the child is developing preliminary physical changes that herald sexual maturity; puberty , the point at which sexual maturity is achieved, marked by the first menstrual flow in girls but by less obvious indications in boys; and postpubescence , a 1- to 2-year period after puberty during which skeletal growth is completed and reproductive functions become fairly well established. 82

83. SUBPHASES OF ADOLESCENCE 83

84. NEEDS OF ADOLESCENCE 84

85. PHYSICAL OR BIOLOGICAL OF ADOLESCENCE 85 WEIGHT : 12 - 14 years Male :- Approximately 38 – 60 Kg Female :- Approximately 40 – 60 kg 14 - 16 years Intensified appetite related to accelerated growth Male :- Approximately 50 – 60 kg Female :- Approximately 42 – 64 kg 17 - 21 years Male :- Approximately 56 – 80 kg Female :- Approximately 48 – 72 kg HEIGHT : 12 - 14 years Male :- Approximately 154 – 174 cm Female :- Approximately 153 – 167 cm 14 - 16 years Male :- Approximately 164 – 180 cm Female :- Approximately 155 – 169 cm 17 - 21 years Male :- Approximately 163 – 182 cm Female :- Approximately 156 – 170 cm

86. PHYSICAL OR BIOLOGICAL OF ADOLESCENCE 86 PULSE : 60 - 80 be/ mt RESPIRATION : 14 - 20 be/ mt BLOOD PRESSURE : 100/70 to 120/80 mmHg 12 – 14 years -Secondary sex characteristics appear 15-17 years - Secondary sex characteristics well advanced 18 – 21 years - Structure and reproductive growth almost complete

87. CHARACTERISTICS PHYSICAL DEVELOPMENT OF ADOLESCENCE SEXUAL MATURATION 87 Tanner’s Stages Female Male Tanner’s Stages Breast Development Pubic Hair Breast Development Pubic Hair Stage 1 Prepubertal: Papilla Elevation Only Prepubertal: No pubic hair Prepubertal: Papilla Elevation Only Prepubertal: No pubic hair Stage 2 Pubertal: Breast bud stage- Small area of elevation around papilla; enlargement of areolar diameter Spare long, slightly pigmented hair on labia majora Pubertal: Breast bud stage- Small area of elevation around papilla; enlargement of areolar diameter Initial enlargement of Scrotum and testes, Spare growth of long, straight, downy, slightly pigmented hair at the base of penis. 87

88. CHARACTERISTICS PHYSICAL DEVELOPMENT OF ADOLESCENCE SEXUAL MATURATION 88 Tanner’s Stages Female Male Tanner’s Stages Breast Development Pubic Hair Breast Development Pubic Hair Stage 3 Further enlargement of areolar with no separation of their contours Dark, coarse, curled hair, spreads sparsely over entire pubis (mons) Further enlargement of areolar with no separation of their contours Initial Enlargement of penis mainly in length, testes and scrotum further enlarge, Dark, coarse, curled hair, spreads sparsely over entire pubis Stage 4 Projection of areola and papilla to to form a secondary Pubic hair denser, curled, adult type hair Projection of areola and papilla to to form a secondary Increased size of penis with growth in diameter and development of 88

89. CHARACTERISTICS PHYSICAL DEVELOPMENT OF ADOLESCENCE SEXUAL MATURATION 89 Tanner’s Stages Female Male Tanner’s Stages Breast Development Pubic Hair Breast Development Pubic Hair mound (may not occur in all girls) limed to pubis mound (may not occur in all girls) glans, glans larger and broader, scrotum darker, pubic hair more abundant with curled, adult type hair limed to pubis Stage 5 Projection of papilla only caused by recession areola into general contour Adult type hair, distribution to the medial thigh. Projection of papilla only caused by recession areola into general contour Testis, penis and Scrotum adult in size and shape; Adult type hair, distribution to the medial thigh. 89

90. MOTOR AND SELF CARE 90 Age in Years Motor and Self Care 12 – 21 years Eye – hand Coordination at adult level Possesses manual dexterity Clumsiness occurs due to rapid physical growth(12- 14 Years) Motor Function comparable to adult Visual Acuity 20/20 SENSORY DEVELOPMENT

91. PSYCHOSOCIAL DEVELOPMENT 91 12 – 14 years Sense of Identity Vs Self diffusion or Role confusion Preoccupation with body changes and image; self-conscious about appearance High expectations of self yet this alternates with lack of confidence Peer group becoming more influential; less affection shown for parents Searching for new people to love High levels of physical activity Many mood swings and impulsive Increased ability to think in a complex manner (for example, abstractly) and sense of right and wrong More able to express feelings verbally, but often expresses feelings by action Most interest is in present and near future Tests rules and limits

92. PSYCHOSOCIAL DEVELOPMENT 92 15 – 17 years Sense of Identity Vs Self diffusion or Role confusion Greater desire for independence Self-conscious Peer group dominates social life; efforts to make new friends and select role models Less conflict with parents, but sadness due to realizing psychological “loss” of parents Increased ability to care and share so can develop more intimate relationships Risk behaviors more prevalent Sexuality is of great interest Improved work habits and sense of right and wrong (conscience) More concern about future plans and intellectual interests Unrealistically high expectations of self alternate with poor self-concept

93. PSYCHOSOCIAL DEVELOPMENT 93 18 – 21 years Sense of identity vs role confusion (12 – 18 yrs) and intimacy vs isoation (19 – 40yrs) Identity more firm, including sense of humour , interests, emotional stability Able to compromise and develop useful insight Adult appearance, clear sexual identity More capable of orienting activities toward the future (setting goals and following through), of mutual caring (for example, verbally expressing feelings) and of internal control (for example, delayed gratification, thinking ideas through, making decisions, self-reliance, self-esteem) Uncertainties about sexuality, future relationships and work possibilities Pride in own work Accepts social institutions and cultural traditions

94. 94 PSYCHOSEXUAL DEVELOPMENT GENITAL STAGE The individual develops a strong sexual interest in the opposite sex. This stage begins during puberty but last throughout the rest of a person's life . SPIRITUAL DEVELOPMENT Synthetic – Conventional Faith (12 – 17 years) This stage is characterized by the identification of the adolescent/adult with a religious institution, belief system, or authority, and the growth of a personal religious or spiritual identity.   INDIVIDUATING REFLECTING FAITH (18 – 22 Years) Adolescence starts to question their own assumptions around the faith tradition. Along with questioning their own assumptions about their faith, they start to question the authority structures of their faith.

95. 95 INTELLECTUAL DEVELOPMENT Formal Operational Thoughts Early Adolescence: Explores newfound ability for limited abstract thought, Clumsy groping for new values and energies and Comparison of “normality” with peers of same sex Middle Adolescence : Developing capacity for abstract thinking, Enjoys intellectual powers, often in idealistic terms, Concern with philosophic, political, and social problems Late Adolescence: Established abstract thought, Can perceive and act on long-range options, Able to view problems comprehensively, Intellectual and functional identity established

96. 96 MORAL DEVELOPMENT Post conventional stage Stage V Social contract Orientation: The rules or law established for mutual good, mutual cooperation, and mutual development Stage VI Universal Ethical Principle: Oriented towards decision of conscience and universal principles , The principles apply to everyone. E.g., human rights, justice, and equality. Seriously asking question regarding the existing moral values.

97. 97 LANGUAGE DEVELOPMENT Uses slang within and outside peer group Uses distinct meanings for words Continue to learn new words and concepts PLAY STIMULATION 12 – 14 years Chooses activities according to individual interests. Interest in world affairs Expressive arts, hobbies, crafts. 15 – 17 Years Engages in organized competitive sports 18 – 21 years Chooses more passive spectator sports

98. 98 THANK U