First Lecture

1. First Lecture Foundation of Growth and Development Suhaila Halasa RN, PhD, CIMI

2. Objectives • By the end of this discussion you will be able to: • Differentiate between growth development, differentiation, and maturation • Discuss the stages of growth and development

3. Explain the patterns of growth and development • Discuss the principles of growth and development • Identify factors that affect growth and development

4. Suhaila Halasa RN, PhD, CIMI

5. Growth & Development • The terms Growth & Development both refer to: • dynamic processes., used interchangeably • usually referred to as a unit, expresses the sum of the numerous changes that take place during the lifetime of an individual.

6. Activity # 1 • Work in groups (4-5) • Discuss the concept of: - Growth, - Development, - Maturation, - and Differentiation • Present your work in class Suhaila Halasa RN, PhD, CIMI

7. https://www.google.jo/search?biw=1600&bih=794&tbm=isch&sa=1&q=smile+&oq=smile+&gs_l=psyab.3..0i67k1j0j0i67k1j0.28916.30145.0.34420.4.4.0.0.0.0.117.437.0j4.4.0....0...1.1.64.psy-ab..0.4.437....0.zbDmFTlBlSs#imgrc=_https://www.google.jo/search?biw=1600&bih=794&tbm=isch&sa=1&q=smile+&oq=smile+&gs_l=psyab.3..0i67k1j0j0i67k1j0.28916.30145.0.34420.4.4.0.0.0.0.117.437.0j4.4.0....0...1.1.64.psy-ab..0.4.437....0.zbDmFTlBlSs#imgrc=_

8. Growth • is physical change & an increase in number and size of cells as they divide and synthesize new proteins • results of increase in size & weight of the whole or any of the body parts. • Growth rate is rapid during the prenatal, neonatal , infancy & adolescent stages & slows during childhood • Physical growth is minimal during adulthood

9. Development • a gradual change and expansion; advancement from lower to more advanced stages of complexity; the emerging and expanding of the individual's capacities through growth, maturation, and learning • Development is the behavioral aspect of growth e.g. a person develops the ability to walk, talk & run

10. Growth generally takes place during the first 20 years of life; development takes place during that time & also continues after that point

11. Maturation • An increase in competence adaptability, complexity of a structure that makes it possible for that structure to begin functioning; to function at a higher level.

12. Differentiation • A processes by which early cells and structures are systematically modified and altered to achieve specific & characteristic physical and chemical properties • It used sometimes to describe the trend of mass to specific; development from simple to more complex activities & functions

13. Differentiation • These processes are interrelated, simultaneous & ongoing • The processes depend on a sequence of endocrine, genetic, constitutional, environmental & nutritional influences • Growth can be viewed as a quantitative change, & Development; as a qualitative change

14. Stages of growth and development Activity # 2 Work with Group Discuss the Stages of growth and development Post your answer on the sheet Discuss the result with your Peers

15. Stages of growth and development • A developmental task: • Is a set of skills and competencies peculiar to each developmental stage that children must accomplish or master in order to deal effectively with their environment. • It is significant for nurses to know that there are characteristic health problems peculiar to each major phase of development.

16. Developmental Age Periods: • Prenatal period :conception to birth. - Germinal: conception to approximately 2 weeks • Embryonic: 2-8 gestational weeks • Fetal: 8- 42 gestational weeks (birth) • A rapid growth rate & total dependency make this one of the most crucial periods in the development process ( the importance of adequate prenatal care )

17. Stages of growth and development • Infancy period : birth to 12 months • Neonatal: birth -27or 28 days • Infancy: 1-12 months • It is one of rapid motor, cognitive & social development, infant establishes a basic trust in the world & the foundation for future interpersonal relationships

18. Stages of growth and development • The critical first month of life, although part of the infancy period is differentiated from the remainder because of the major physical adjustments of extra-uterine existence & psychological adjustment of the parent

19. Stages of growth and development Early childhood:1-6 years. Toddler: 1-3 years. Preschool: 3-6 years. This period, which extends from the time the children attain upright locomotion until they enter school, characterized by intense activity & discovery

20. Stages of growth anddevelopment • Middle childhood: 6-11 or 12 years Referred as school age ,there is a steady advancement in physical , mental & social development . This is a critical period in the development of self-concept

21. Stages of growth and development • Later childhood:11-19 years • Prepubertal :10-13 years • Adolescence: 13- approximately18 years. • The tumultuous period of rapid maturation & change known as adolescence is considered to be a transitional period that begins at the onset of puberty & extends to the point of entry into the adult world

22. Stages of growth and development • In the late adolescent period the young person begins to internalize all previously learned values & focus on an individual rather than a group, identity

23. Stages of growth and development • Young adulthood (20-40 years) • Middle adulthood (40-65 years) • Older adulthood: • Young-old (65-74 years) • Middle old (75-84 years) • Old-old (85 and over )

24. Activity #3 Work with Group Discuss the Pattern, Principles of Growth and Development/ and Factors affect Growth and Development Post your answer on the sheet Discuss the result with your Peers Suhaila Halasa RN, PhD, CIMI

25. Patterns of Growth and Development • There are definite & predictable patterns in growth & development that are continuous,orderly & progressive. These patterns, or trends are universal and basics to all human beings, but each human being accomplishes these in a manner & time unique to that individual

26. Patterns of Growth and Development • Directional Trends: • Growth and development proceed in regular, related directions or gradients and reflect the physical development and maturation of neuromuscular functions

27. Patterns of Growth and Development 1. The first pattern is the cephalocaudal, or head-to-tail, direction. • The head end of the organism develops first and is very large and complex, whereas the lower end is small and simple and takes shape at a later period. • The physical evidence of this trend is most apparent during the period before birth, but it also applies to postnatal behavior development.

28. Patterns of Growth and Development • Infants achieve structural control of the head before they have control of the trunk and extremities, hold their back erect before they stand, use their eyes before their hands, and gain control of their hands before they have control of their feet.

29. Patterns of Growth and Development 2. The Proximodorsal: near to far, from the center of the body outward trend applies to the midline to peripheral concept; early embryonic development of limb buds followed by rudimentary fingers & toes • E.g. infants can roll over before they can grasp an object with the thumb and second finger

30. Directional trends in growth https://www.google.jo/search?q=3+directional+trends+in+growth+and+development&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjAvI2lvM_WAhVoCMAKHUOsCZ8Q_AUICigB&biw=1600&bih=794#imgrc=nLsr-SYmgQERZM:

31. Patterns of Growth and Development • The third trend, differentiation, describes development from simple operations to more complex activities and functions. • From very broad, global patterns of behavior, more specific, refined patterns emerge. • All areas of development (physical, mental, social, and emotional) proceed in this direction

32. Patterns of Growth and Development • Through the process of development and differentiation, early embryonal cells with vague, undifferentiated functions progress to an immensely (very) complex organism composed of highly specialized and diversified cells, tissues, and organs. • Generalized development precedes specific or specialized development; gross, random muscle movements take place before fine muscle control

33. Patterns of Growth and Development • Sequential trends: :In all dimensions of G & D there is predictable sequence with each child normally passing through every stage. • e.g. children crawl before they creep, & creep before they stand

34. Patterns of Growth and Development • Developmental pace (SPEED OR RATE): Although there is a fixed, precise order to development, it does not progress at same rate or pace. • Periods of accelerated and decelerated growth both total body and subsystems. e.g. rapid growth before and after birth and slow at middle childhood

35. Sensitive Periods of Growth • Periods termed critical, sensitive, vulnerable, and optimal are those times in the lifetime of an organism when it is more susceptible to positive or negative influences. • The quality of interactions during these sensitive periods determines whether the effects on the organism will be beneficial or harmful.

36. Sensitive Periods of Growth • For example, physiologic maturation of the central nervous system is influenced by adequacy and timing of contributions from the environment such as stimulation and nutrition. • The first 3 months of prenatal life are sensitive periods for physical growth of the fetus

37. Sensitive Periods of Growth • Psychological development also appears to have sensitive periods when an environmental event has maximal influence on the developing personality. • For example, primary socialization occurs during the first year when the infant makes the initial social attachments and establishes a basic trust in the world.

38. Individual Differences • Each child grows in his or her own unique and personal way. • Great individual variation exists in the age at which developmental milestones are reached. • The sequence is predictable; the exact timing is not. • Rates of growth vary, and measurements are defined in terms of ranges to allow for individual differences.

39. Individual Differences • Some children are fast growers, others are moderate, and some are slower to reach maturity • Periods of fast growth, such as the pubescent growth spurt, may begin earlier or later in some children than in others • Children may grow fast or slowly during the spurt and may finish sooner or later than other children • Gender is an influential factor because girls seem to be more advanced in physiologic growth at all ages

40. Principles of Growth and Development • All humans follow the same pattern of growth and development • Each development stage has its own characteristic • Learning can either help or hinder the maturation process ,depending on what is learned.

41. Principles of Growth and Development • The pace of growth & development is uneven • It is known that growth is greater during infancy than childhood

42. Biologic growth and development • As children grow, their external dimensions change which is accompanied by alteration in structure and function of internal organs and tissues. • Each part has its own rate of growth which may be related to the size of the child (e.g., the heart rate). • Growth rates for the body as a whole and three types of tissues

43. Biologic growth and development • Lymphoid type: thymus, lymph nodes, and intestinal lymph masses • Neural type: brain, dura, spinal cord, optic apparatus, and head dimensions • General type: body as a whole; external dimension; and respiratory, digestive, renal, circulatory, and musculoskeletal systems

44. External proportions • Variations in the growth rate of different tissues and organ systems produce significant changes in body proportions during childhood • The cephalocaudal trend of development is most evident in total body growth as indicated by these changes.

45. External proportions • During fetal development the head is the fastest growing body part, and at 2 months of gestation the head constitutes 50% of total body length. • During infancy growth of the trunk predominates; the legs are the most rapidly growing part during childhood; in adolescence, the trunk once again elongates.

46. External proportions • In the newborn infant the lower limbs are one third the total body length but only 15% of the total body weight • in the adult the lower limbs constitute one half of the total body height and 30% or more of the total body weight.

47. External proportions

48. Biologic determinants of G& D The most prominent feature of childhood and adolescence is physical growth. Throughout development various tissues in the body undergo changes in growth, composition, and structure. In some tissues the changes are continuous (e.g., bone growth and dentition); in others, significant alterations occur at specific stages (e.g., appearance of secondary sex characteristics).

49. Biologic determinants of G& D • Physical measurements: • Linear growth or height: maximum growth in length occur before birth. - Double the child's height at the age of 2 years to estimate how tall he or she may be as an adult.

50. Biologic determinants of G& D • Weight: is more variable than height and is, to a greater extent, a reflection of the intrauterine environment average newborn 3400 g. • Doubles weight at 4-7 month of age. • Triples by the end of first year of age. • Quadruples by 2 - 2.5 years of age