Key Chapter Questions

How do changes in growth and development support physical, cognitive, and social skills during early childhood?

How can children be provided with a good foundation for lifelong health?

How can parents and caregivers keep children safe?

How do common illnesses affect development?

Physical Growth and DevelopmentGrowth and Size

Rate of growth slows between ages 2 and 6

Average gain of 5 pounds per year

Average height gain of 2.5 to 3 inches per year

Transition to a longer, leaner torso and flatter-bellied preschooler

Gains include better agility and straighter posture

Growth Rates of Three Systems Compared with Overall Growth

Dendritic Spreading Brain undergoes dramatic

anatomical changes between ages of 3 and 15 Some areas almost

double in size, purge of unneeded cells follows (up to age 4)

Frontal lobe growth (3–6 years of age)

Temporal and parietal lobes (6–puberty)

Brain Development

Brain changes occur in size and structure, reaching 90% of its adult volume by age 6.

Many sensitive periods of development occur in early childhood.

Areas of brain become more differentiated (more distinct and specialized).

Areas become more integrated as complex networks increase.

Sensitive Periods in Early Brain Development

Self-Regulation and Executive Function

Self-regulation: The capacity to alter behavior to adjust to social and situational demands

Executive function: Refers to a broad array of processes that regulate and coordinate goal-directed behavior (memory, attention, shifting focus, ability to inhibit an emotional impulse)

Brain Areas That Support Self-Regulation and Executive Function

Self-Regulation: Sleep and Toileting

Both involve neurological and physiological maturation.

Children between ages 2 and 5 spend 10 to 12 hours each day sleeping.

Common problems include bedtime resistance, trouble falling asleep, awakening in night, demanding attention, and nightmares.

Self-Regulation: Toileting

Physiological and behavioral readiness occurs between 18 and 24 months.1. Longer periods of dryness during day2. Sufficient muscle tone to control urinary/anal sphincters3. Can pull up their pants4. Ability to understand instructions, name/point to body

parts5. Motivated toward independence

Self-Regulation: ToiletingCommon Approaches

Child-oriented approach: Parents cue children about toileting.

Structured behavioral training: Parents place child on toilet at regular intervals and reward performance.

Most children are fully trained at about age 3.

Stress and Developing Brain

Positive stress: short-lived; may be caused by frustration, disappointment, discomfort; no lasting effects on the brain

Tolerable stress: death, divorce, serious illness; may affect brain structure

Toxic stress: prolonged stress response; allostatic load; result of persistent abuse, neglect, poverty, interpersonal conflict; enduring adverse effects on brain

Toxic Stress and Brain Architecture

The Developing Brain

Plasticity of brain

Some neural circuitry can recover to some degree under certain circumstances.

It is “better to get it right the first time” rather than to fix problems later.

Reducing the impact of poverty, neglect, and abuse is a better investment than remediation later.

Vision Problems

Visual problemsFunctional

amblyopia: “lazy eye”Imbalance, one eye does all of the work

Strabismus: misalignment of eyesOne type: “crossed eyes”

Motor Development

Gross motor: involves large muscle groups (torso, arms, legs)

Examples include: walking, running, throwing, catching, jumping

Proximodistal development: muscle control from torso outward to arms and legs

Differentiation: physical structures more specialized over time

Motor Development

Fine motor: involves hands and fingers

More difficult to master than gross motor skills

Examples include: grooming, brushing teeth, combing hair, using tools, using utensils, writing, drawing, and painting.

Gross and Fine Motor Development Milestones

Writing, Drawing, and Painting

18 months–3 years: Scribbling

2–4 years: Early figures and copying

4–6 years: Realistic drawings and symbols

Handedness

Handedness, the Brain, and LanguageApproximately 95% of right-handed

individuals process speech primarily in left hemisphere

Left-handed individuals Show more variation in processingMore likely to have reading

problems

HandednessLeft-handers more common

among MathematiciansMusiciansArchitectsArtists

20% of top-scoring SAT group were left handed

Sleep and Sleep Problems

Most young children sleep through night and have daytime nap Transitional objects (bedtime

companions) Link between sleep and behavioral

problemsNightmares: frightening dreamsNight terrors: sudden arousal, intenseSomnambulism: sleep walking; most

outgrow

Foundations of Health: Health Promotion

“Children’s health is a nation’s wealth.”

Goal is promotion of health and prevention of injury, illness, and disease.

Healthy People 2020: Promotes access to health care and good nutrition for all children

Nutrition, Food Allergies, and Malnutrition

Ages 2–3: 1000-1400 calories per day

Ages 4–8: 1400-1600 calories per day

Variety of foods is KEY

Grains, fruits, and vegetables, dairy, meat/protein

Child > 2: low-fat milk

Limit sweets and sodium

Children Get Too Much Fat and Sugar

Malnutrition

Overnutrition: obesity; more calories consumed than needed

Overweight: body mass index for age and gender above the 85th percentile

Obesity: body mass index above the 95th percentile

Children 2–5 years: 1 in 5 overweight

10–14% obese

Eating Habits

Avoid power struggles

Establish routines to help promote positive feelings

Set reasonable expectations

Don’t use food as rewards, or withhold as punishment

Food Insecurity and Food Deserts

Food insecurity: not enough food, resulting in hunger or food of poor nutritional quality

Food desert: an area where people have limited access to a variety of fresh food

14.6% of U.S. households experience food insecurity.

Immunizations and Vaccines

Vaccines: protection from life-threatening communicable diseases

Only 68% of young children, ages 19-35 months, received the full vaccine series in 2008.

Promoting Dental Health

At age 3, most children have their first set of teeth.

By age 5 or 6, permanent teeth develop.

Dental Health and Fluoride

Dental carries: the single most common disease of childhood

Risk factors include a diet high in sugary and starchy foods, infrequent/inadequate brushing

Prevention includes a healthy diet, avoidance of sugary food, regularly brushing, flossing, and checkups

Fluoridated water reduces dental carries in young children by 50–60%, but the practice is controversial

Safety at Home and in the Community

Unintentional injuries are the leading cause of death between ages 1 and 5.

Motor vehicle accidents are 1, followed by drowning.

Unintentional injuries account for 30% of young children’s visits to the emergency room.

Accidents are the leading cause of death in infancy (in the USA) due to modern immunizations•Aspiration of foreign objects•Suffocation•Falls•Poisoning•Burns•Motor vehicle accidents

Leading Causes of Death,Ages 1–5

Leading Causes of Death from Unintentional Injury, Ages 1–5

Common Disruptions in Health

After dental carries, asthma is the most common chronic disease of childhood in the United States.

Asthma is caused by interactions among genetics and environmental exposures.

Common triggers: Dust mites, cock roach droppings, mouse droppings, mold, pollen, irritants, viruses

Common Disruptions in Health

Ear infections: Otitis Media

80% of children have had at least one infection.

7% of children experience recurrent ear infections.

Permanent hearing loss is a concern.