Slide 1

Growth and Development

Slide 2

Concepts of growth and development n Psychosocial development: Erikson n Cognitive development: Piaget n Moral development: Kohlberg n Sexual development: Freud

Slide 3

Improving child health by having knowledge of definitions n health maintenance n preventive health

Slide 4

Definitions n Mortality: the # of deaths/100,000 n Morbidity: used to express the ratio of sick to well in a community n Infant mortality: # of children per l000 live births who die before 1st birthday.

Slide 5

Major causes of death during infancy and childhood (these represent death rates for the ages of l-l4 yrs per l00,000) n Accidents n Congenital abnormalities n Cancer n Homicide n Heart disease n Pneumonia & influenza n Suicide n Human immunodeficiency disease

Slide 6

Principles of Growth & Development n occur in an orderly sequence n occur continuously but rates vary- growth spurts n highly individualized rate from child to child n vary @ different ages for specific structures n process involving the whole child

Slide 7

Assessments of development n DDST (Denver II) DOES NOT MEASURE IQ n Classic screening tool to assess development n Personal, fine motor skills, language, gross motor n Basic assessment includes the following nursing assessments: hx taking, developmental screening, growth measurements, parent teaching

Slide 8

Functions of Play on Growth & Development n Physical Development n Cognitive Development n Emotional Development n Social Development n Moral Development

Slide 9

Periods of greatest growth n fetus n birth n infancy n puberty

Slide 10

Factors that Influence Growth and Development n Genetics n Environment n Culture n Nutrition n Health Status n Family

Slide 11

Genetic influences on growth and development n pattern, rate, rhythm and extent: n governed by genes interplaying with environment n intrauterine life extremely important in growth and healthy development of the child

Slide 12

Understanding the genetic link n Genes defined n Chromosomes n autosomes n sex chromosomes n the genomes discovered in 2000! This was a project funded by the U.S. Genome project and one of the most important single finding in mankind

Slide 13

Genetic screening n Done during the 1st trimester of pregnancy n Methods: n blood studies from parents check carrier status n measure level of alphafetoprotein (AFP) in mothers blood for incomplete development of brain or spinal cord: suggestive of neural tube defect (spina bifida)

Slide 14

genetic screening, cont. n later in pregnancy: n amniocentesis: @ l2-l6 weeks n chorionic villa sampling: @ l0-11 weeks n role of the genetic counselor

Slide 15

Examples of environmental influences on a child n family composition n family position in society n family socioeconomic status n knowledge of the family n availability of healthy diets n housing n diseases present in family and child

Slide 16

Family relationships (environmental) and the impact on child growth and development n Critical in growth and development, esp. emotional growth n Intellectual growth must be included here as well n Chronic illness can be combated with a loving environment and close family relationships

Slide 17

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

Slide 18

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

Slide 19

Comparison of nutritional needs InfancyToddler Pre- schooler SchoolAgeAdolescence Breast, formula PhysiologAnorexia Diet similar to toddler Resp. for prep calories Avoid Certain foods Variety Meals are social event Good time to teach re nutrition Fast foods Intro of solids Alarm of parents Enjoy helping Visual learners Peer groups imp. Egg yolk last food Intake sufficient Food jags Hands-on Social event

Slide 20

Dental needs of the child from infancy to adolescence n Caries in infancy due to nurse for long periods of time n See text for the sequence of eruption of teeth n Braces may be indicated at the time of puberty n See p. 1115 oral care and dental care

Slide 21

Health status of the child n Certain diseases may affect g & d n Endocrine and cardiac status included here

Slide 22

Growth and development, cont. n Methods to evaluate growth: n charts: compare to norms n compare to self over time n xrays n teeth n height, weight, head circumference n size of head and legs: length of bones

Slide 23

physical growth, cont. n Intervals @ which birth weight changes: n doubles by end of fifth month of age n triples by end of 1st year n cephalocaudal n proximo-distal n prehensile behavior

Slide 24

Intellectual Development n review material on Piaget n intelligence n habituation n Reflect on the process of habituation and its possible role as a predictor of intelligence

Slide 25

Importance of Play n Allows child the learn about themselves and relate to others.it is work for the child

Slide 26

Stages of play n Practice play n Symbolic play n Games

Slide 27

Types of play n Solitary play n Parallel Play n Associative play n Cooperative Play n Onlooker Play

Slide 28

Growth of Emotions n Emotion defined n All emotions contain: n feelings n impulses n physiological responses n reactions (internal and external) n Subjective data: n Objective data:

Slide 29

Emotions, cont. n Love: n includes persons who help them meet their needs, share their pleasure and achievements n when the child receives love, he can give love

Slide 30

Emotions, cont. n Fear: n exhibited by crying, running, or hiding n fear can diminish; do not laugh-give love and help them feel safe

Slide 31

Anger, cont. n Ways in which anger may be displayed: n shouting n screaming n acts of disobedience n temper tantrums n act out when. n act better when.

Slide 32

emotions, cont. n Anger: do infants have anger? n expected responses that indicate anger:

Slide 33

Jealousy n A combination of anger, fear, and love n A child 1st loves something, counts it as his own and 2nd perceives that it has been taken away or interfered with n The loss may be real or perceived, ie., sibling rivalry

Slide 34

Emotions, summarized n Emotions will come out one way or another n How can the nurse help the child respond constructively to these feelings?

Slide 35

Parenting: rule #l n PARENTS MUST BE CONSISTENT AND PARENT IN A STYLE APPROPRIATE TO THE CHILD

Slide 36

Discipline n Techniques: n The model is to teach by example! n Listening skills n passive n acknowledgement n door openers n active listening

Slide 37

discipline, cont. n Techniques, cont. n reality principle n distractions or substitutions n time out n positive practices n point systems with rewards for good behavior n promotes self esteem in children

Slide 38

discipline, cont. n CLEAR n C: n L: n E: n A: n R:

Slide 39

The End!