HNW CHP # 6. HEALTH FITTNESS AND WELLNESS ISSUES DURING CHILDHOOD AND.pptx

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1. HEALTH FITTNESS AND WELLNESS ISSUES DURING CHILDHOOD AND ADOLESCENCE Chapter # 6

2. The Dynamic process of growth and development Neonates, infants, children and adolescents face unique changes as they dynamically grow and develop into adults. Many people contribute to this dynamic process involving families, communities, educators and health care professionals. So health care professionals should be aware of physical and psychosocial transformations taking place early in life. Genetics and environment both play an important role in a child's physical and psychosocial development.

3. The Dynamic process of growth and development Childhood / Juvenile  ( Childbirth ) (0 – 19years) Infant  (baby) (0 month - 12 months) Toddler  (1 – 3 years) Play age  (3 – 5 years) Primary school  age ( middle childhood  also called  prepubescence ) (6 - 11) Preadolescence   (9 – 11 years) Adolescence  (12 – 19 years) Adulthood  (20+ years) Young adulthood  (20 – 39 years) Middle adulthood  (40 – 60 years) Elder / Senior citizen  (60+ years) Death  (unpredictable)

4. Early childhood screening APGAR test A------ infants activity or (muscle tone) 0 Limp; no movement 1 Some flexion of arms and legs 2 Active motion P------ pulse or heart rate 0 No heart rate 1 Fewer than 100 beats per minute 2 At least 100 beats per minute G----- grimace/infantile reflex tone) 0 No response to airways being suctioned 1 Grimace during suctioning 2 Grimace and pull away, cough, or sneeze during suctioning

5. APGAR test A----- appearance(in term of normal skin color) 0 The baby's whole body is completely bluish-gray or pale 1 Good color in body with bluish hands or feet 2 Good color all over R----- Respiration (breathing ) 0 Not breathing 1 Weak cry; may sound like whimpering, slow or irregular breathing 2 Good, strong cry; normal rate and effort of breathing This test provide a quick screening of the newborn’s body function at 1 minute and 5 minute after birth Used by obstetricians Each point score 2 Score analysis 7-10 normal 4-6 require some immediate medical assistance Below 4 require immediate medical attention and are at risk for problems

6. Denver II Developmental Screening Test A screening test for children from birth to age 6 Includes Personal social skills Fine motor adaptive skills Language skills Gross motor skills

7. Factors influencing growth and development in early children Two main factors are Genetics Environmental factors During first 6 month body undergoes dramatic changes to accommodate the dynamic physical changes of an infants On average babies grow 10 inches in height while tripling birth weight upto 1year After age 1: growth in length slows By age 2 : growth in height becomes steady about 2.5 inches per year Prepubescent growth spurts begins at age 8 in girls and at 10 in boys Then development of secondary sex characteristics , age 18 youth has reached physical maturity.

8. Lack of physical activity 12 to 21 years of age Lack of vigorous activity Leads to:- Obesity Type 2 diabetes mellitus Problem with musculoskeletal and cardiopulmonary system Fertility problems Psychosocials consequences in the form of a negative self image, Emotional and behavioral problems Depression

9. Common health problems of infants and young children Excessive crying (under 3 months of age) colic, acute abdominal pain. 2. Sleep disorders In school going children. 9 hrs of sleep for elementary school children is recommended. Less sleep may be due to sleep disorders, that are acute but if not addressed then become chronic. 3. Fevers Common in children, not always necessitate a doctor visit unless and until Feverish child is under the age of 3 months Fever + localized pain(headache, chest, throat, abdominal) Fever more than 4 days, duration unexplained & other illness No above conditions but child’s parents are very concerned.

10. 4. Otitis media inflammation behind the eardrum affects 70% children before age of 2 years, child may cry, irritable, reduced appetite, difficulty sleeping. Chronic otitis media may lead to hearing loss. Pain refer to TM joint also indicate otitis media in older child. 5. Urinary tract infection(UTI) Age 0 -23 months Accompanied with fever Also include vomiting, diarrhea, irritability, and poor feeding Urine smell foul

11. 6. Skin pathologies 1. Dermatitis , also known as  eczema , is a group of diseases that results in  inflammation  of the  skin .  These diseases are characterized by  itchiness ,  red skin , and a rash. In cases of short duration there may be small  blisters  while in long-term cases the skin may become  thickened . The area of skin involved can vary from small to the entire body 2::: Hemangiomas a benign tumor of blood vessels, often forming a red birthmark

12. . 3. Warts (yellowish or brownish usually on hands) A wart is a  skin  growth caused by some types of the virus called the  human papillomavirus (HPV) . HPV infects the top layer of skin, usually entering the body in an area of broken skin. The virus causes the top layer of skin to grow rapidly, forming a wart. Most warts go away on their own within months or years. Warts can grow anywhere on the body 4.Tinea capitis (a scalp fungal infection, round or irregular patches of broken hair)

13. 7. Trauma accidental Fall, burn, fracture, drowning, motor vehicle injuries etc 8. Allergies seasonal allergies present with nasal congestion, sneezing, rhinorrhea - Food allergies: cow’s milk protein, egg white, wheat, soybean, peanuts, sea food, citrus fruit and chocolate. Symptoms: red itchy mouth and throat then rashes , abdominal pain, vomiting, diarrhea, Rx: antihistamine

14. 9. Asthma 10. Chronic pain Teething pain Growing pains: age--- 3—10 years, area __ legs, evening pain awaken the child from sleep Abdominal pains Headaches: intracranial disease, migraine, exposure to sun rays, nuts, caffiene 11. Enuresis and constipation Nocturnal enuresis(urinary incontinence) Encopresis (involuntary defecation) 12. Seizures With fever, last for less than 5 minutes Longer------ consult physician

15. 13. Developmental delays Emotional disturbance, learning disabilities, health impairments, visual impairments, traumatic brain injuries, mental retardation, speech or language impairments etc. 14. Attention deficit/hyperactivity disorder 15. Other behavioral problems Poor appetite, shyness, aggression and spoiled behavior 16. Obesity in childhood Healthy diet habits, low calorie diet, increase physical activity, reduce sedentary life style especially television viewing 17. Anorexia and bulimia Anorexia: a disordered self image of being over weight when they may be grossly under weight Bulimia: people engage in binge eating followed by self induced vomiting.

16. Risk behavior during preadolescents and adolescents years Limited physical activity Poor nutrition Poor stress management Exposure to infective agents Sun exposure Substance abuse Sports injuries obesity Riding with a driver who had been drinking alcohol Watching TV more than 3 hours a day Under age alcohol use Cocaine use Cigarette use Desire to commit Even for those who engage in physical activity, increased risk of injuries if not wearing the appropriate protective gear

17. Exercise for children and youth Purpose Controlling weight Reducing blood pressure Raising HDL cholesterol Reducing the risk of diabetes and some kind of cancer Improving in many areas of psychological wellbeing, including gaining more self confidence and higher self esteem.

18. Recommendation Engage in regular, moderately intense physical activity for at least 30 min. a day Vigorous physical activity: 3 or more days per week for at least 30 min, develops and maintain cardiorespiratory fitness Learn and use self management skills(goal setting, monitoring, barrier minimization) to maintain active life styles Know the amount and types of physical activity associated with the benefits(social, emotional, health, physical) and participate in these. Increase physical activity by reducing the time spent in watching TV, playing video games etc Develop skills and learn how to participate in developmentally appropriate physical activities

19. Suggested physical activities For age 2 to 3 Running Jumping Walking in a yard or play ground Swimming or slid in child sized playground set. Water play etc. Children can not understand the concept of performing in a team, so plan exercise in their playtime. All physical activities should be closely supervised and provided on soft play surface

20. Age 4 to 6( school going age) Capable of higher level of balance and coordination activities Capable of sharing toys Engage in social activities with other children Jumping rope Playing catch with ball Riding a tricycle Dancing etc. Age 7 to 10 team sports including Baseball, gymnastic, soccer, swimming, tennis etc

21. Age 10 and older Cycling Aerobic exercises Strength training Hiking Organizing team sports Running Track and field events Precautions Avoid risk of over use injuries Risk to damage to epiphyseal growth plates of bones Careful in forceful external rotation of ankle and foot as this can cause the rotational injuries of the distal tibial growth plate Higher risk of anterior cruciat ligament of knee Forearm fracture So use protective athletic gear

22. Exercise prescription According to FITTE principle Frequency: strength training twice per week, but participate in various forms of physical activity for fitness and enjoyment daily. Intensity: overstressing must be avoided, resistance training not on maximum weights or to the point of muscle fatigue. achieve frequency rather intensity Time and duration: initially perform slowly,1 to 2 sets(with 8 to 12 repetitions per set) of 8 to 10 exercise Type: variety of exercise that work on different major muscle group Enjoyment: encourage to participate in physical in activities for the sake of enjoyment rather competition

23. Other considerations Provide instruction show the child proper breath and exercise techniques to ensure safe execution of the desired movement Supervise for safety and good techniques Warm up cool down: 5 to 10 min of warm up activity as walking, jogging, jumping etc. 5 to 10 min of cool down activity Thinking light weight, controlled repetitions 12 to 20 repetition with lighter weight Rest between workout: rest periods at least a day b/t strength training workouts. 2 to 3 session per week are adequate Track progress Add weight gradually Keep it fun