HUMAN GROWTH & DEVELOPMENT

1. HUMAN GROWTH & DEVELOPMENT INFANCY TO ADOLESCENCE

2. BIRTH TO ONE YEAR • PHYSICAL ASSESSMENT:AP= 100-180, R=50-80, Many relfexes present: Moro (startle), grasping, rooting and sucking, swallowing, gag • Immature nervous system • Posterior fontanel closes2-3 mos.; Anterior begins to close at 9-10 mos. • Senses: infant sees, hears, smells, tastes & is sensitive to touch & light • Freudian stage: Oral • Eriksonian stage: Trust VS. Mistrust

3. Birth to One Yr. (cont.) • 1-4mos. Baby develops hand to mouth capacity, ear to eye coordination, responds to people & objects • 5 mos = baby should have doubled it’s birth weight, sit alone • 4-8mos. Baby recognizes and even initiates new experiences: reaching, holding, listening, laughing, sitting up, crawling Memory is laid down as baby anticipates familiar events and persons • 8-12mos.Baby performs clear acts of intelligence (such as searching for and retrieving objects)realization of his own separateness causes separation anxiety (Taylor table p 140) • COMMON HEALTH PROBLEMS: Skin disorders such as cradle cap, prickly heat,thrush. Failure to Thrive. Colic. Aspiration, suffocation. Surgeries =Pyloric stenosis, congenital heart problems.

4. The ToddlerOne to Three Years • Physical Assessment: AP=90-100, R=24-26, Anterior fontanel is solid by 18 mos., after 1 yr. all brain cells are present • Bones begin to ossify, muscular development is ongoing, about age 1 yr. child begins to walk • Toilet training can begin about age 2 yrs. • Sleeps 12 hrs./noc, takes 1-2 naps

5. The Toddler (cont.) • By 3 yrs: child can use a spoon, drink from a cup, run, jump, kick, ride a tricycle • Freudian stage: Anal • Eriksonian stage: Autonomy VS. Shame & Doubt • Toddler: masters good eating habits, toilet training, gives affection, communicates effectively to get his/her needs met • Religious Development: Pre-religious stage(mimics others to get praise & attention • (Taylor table p 143) • COMMON HEALTH PROBLEMS: Accidents: poisoning, burns, drowning Upper respiratory infections (URIs),ear infections Surgeries= cleft lip & palate repair, hernias, some heart defects,

6. The PreschoolerAges 3 through 5 yrs. • Assessment: Ap=90-95, R=22-24, BP 100/60. • All senses fully functioning, • Has complete bowel & bladder control • Has 20 deciduous teeth, may begin to loose baby teeth, food habits become more adult-like • Protruding “potbelly” of the toddler disappears by the end of this stage

7. The Preschooler (cont.) • Can throw and catch a ball, skip, copy figures on paper, should be able to print his own name by end of this stage • Sleeps 10-12 hrs./noc, still naps • Religious Development: Does not think abstractly enough to understand religion, but follows the rituals of his parents because they are all powerful/all knowing. He is trusting and literal in interpretation (Taylor table p 148) COMMON HEALTH PROBLEMS: Communicable diseases, URIs, accidents, speech disorders require treatment now, Surgeries: hernias, some heart problems, hypospadias,undescended testicle

8. The Scholchild Ages 6 – 12 Years • Assessment: AP =85-100 at 6 yrs, 60-80 by 12 yrs; R=18-20; BP 100/60 at age 6 yrs, 110/70 by 12 yrs. • Fine motor skills become well coordinated, by the end of this period the child can print & write in cursive, easily manipulate instruments such as scissors, can cut his own meat at mealtime

9. Schoolchild (cont.) • Growth of bones may be faster than muscles causing “growing pains” • GI tract is fully mature, diet is adult-like, able to go without the many daily snacks required for the toddler/preschooler • Some children enter puberty late in this period; the urinary system is mature now, boys are taller & heavier than girls from ages 6-10, but the reverse occurs between 10-12 years. • 6 yr old needs 10-12 hrs of sleep/noc, 12 yr. old needs 10 hrs sleep/noc

10. Schoolchild (cont.) • Fruedian stage:Phallic then Latency period • Eriksonian stage:Initiative VS. Guilt, then Industry VS. Inferiority • At age 6 yrs. The head is adult size, and the weight should be double what it was at 1 yr. • Religious Development: Moves from the fairy-tale idea of God as a giant in the sky into the concrete stage of God being like a human figure. By age 6; understands God as his Creator, expects all his prayers to be answered. By age 12; realizes his prayers aren’t always answered as he expected, and that no magic is involved. May drop religion at this point or continue to accept the family preference. (Taylor table p 148) • COMMON HEALTH PROBLEMS: Accidents, Communicable diseases (Head lice, scabies, ringworm, impetigo) Drug & Alcohol abuse

11. The AdolescentAge 13-18 Years • Assessment: Vital Signs are the same as adult normals • The CNS is mature • After a rapid growth spurt in this stage the musculoskeletal system matures; however the adolescent may pass through a period of clumsiness as this occurs. By age 17 yrs., a boy’s muscle mass is twice that of a girl’s. • The reproductive system is mature by the end of this stage; girls broaden at the hips, boys at the shoulders. As secondary sexual development takes place menstruation begins in girls, spermatogenesis in boys. • The adolescent has all his permanent teeth, caloric requirements are high during this period and appetite increases

12. The Adolescent (cont.) • Sleep requirements are excessively high for adolescents. The kid who fought taking a nap now begs to sleep late. • Freudian stage: Genital • Eriksonian stage: Intimacy VS. Isolation • Religious Development: The adolescent measures his parents’ moral & religious verbal standards against their actual practice to decide if they are worth incorporating into his own philosophy of life. He now comprehends religious abstractions. He may have a religious/scientific crisis. He must answer questions about life & the meaning of the universe for himself. The more strictly an adolescent was raised, the more likely he is to rebel during this stage. • Taylor tables pp 150 & 153 • COMMON HEALTH PROBLEMS: Accidents, Acne, Substance Abuse, Suicide, Teen age pregnancy, STDs, Eating Disorders