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GROWTH &DEVELOPMENT

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Growth DevelopmentIt is change in size/weight A gradual change inresulting from an increase in advancement/function fromnumber or size of cells. lower to higher stageIt is Quantitative It is QualitativeIt is measured in terms of It is assessed in terms ofcentimeters or Kgs acquisition of skills and ability Maturation • It is increase in competence and adaptability

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FACTORS AFFECTING GROWTH AND DEVELOPMENTPrenatal Neonatal PostnatalGenetic potential Sex LBW Hormonal Influence Genetic abnormalities Nutritional Sex Infection Fetal / growth hormones Trauma Neonatal SeizuresPlacental Factors Socioeconomical Influences

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ASSESSMENT OF GROWTH OF CHILD Anthropometry:It is most common method used it includes:  Weight  Height/Length  Head Circumference  Mid-Arm Circumference  Chest Circumference

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WEIGHT: It is total of all organ, tissue and fluids.  Method :  Nude/ Minimal light clothing:  Lever or electronic type of weighing scale ~ or less than Double the TRIPLE THE FOUR TIMES3 kg 3kg WEIGHT THE WEIGHT Weight • BIRTH • 3 -10 DAY • 4 • 12 • 2 YEAR WEIGHT MONTHS MONTHS AGE FORMULATIONS FOR CALCULATIONS 3-12 Age (m) +9/2 Months 1-6 Years Age (y) x 2 +8 7-12 Years Age x 7 - 5

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HEIGHT/LENGTH: Height : ( >2 years) • Vertical distance between head and heel of foot • Measured in erect standing posture by stadiometer • Formula: Age (y) x 6 +77 Length: (<2 years) • Measured in lying down position. Upper – Head-Pubis • Total Length Lower – Pubis - Toe U/L – 1:7 -birth 1:1 -7year Until At 1st 2-3 4thBirth year year year puberty 50 cm 75cm 90cm 100cm 5cm/year

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HEAD CIRCUMFERENCE It is an estimate of brain growth Most useful in 2 years of life Method:  Use a non-stretchable tape on occipital protuberance to the supra-orbital ridges on forehead Clinical corelate:  Microcephaly  Macrocephaly  Cranisynostosis At 2nd 6th 9th Birth month month month 35 cm 41 cm 44 cm 46 cm 1st 2nd year year 47 cm 49 cm

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CHEST CIRCUMFERENCE It is clinically important in the 5th year of life. Method:  Measure at the level of nipples midway between expiration and inspiration by Cross-tape method. later it At Birth CC At 1st year exceeds i.e < HC HC=CC CC>HC

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MILESTONESGross motor Fine motorDevelopment Development Social and Key Adaptive Language Milestone Milestone

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THROUGH AGE OF 1 MONTH – 9 MONTHAGE GROSS MOTOR FINE MOTOR DEVELOPMENT DEVELOPMENT1-2 Month Moves extremity equally3 Month Neck Holding “Hand regard” Observes his own hand very intensely4 Month Sit with support “Bidextrous Reach”5 Month Roll over6 -7 Month Sit in tripod fashion Transfer object from Hand to hand8 Month Sit without support9 Month Stands holding with Probes with Finger No Sitting without support support

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THROUGH AGE OF 12 MONTH – 5 YEARSAGE GROSS MOTOR FINE MOTOR DEVELOPMENT DEVELOPMENT12 Month Stand without Mature Pinser Grasp Support15 Month “ Toddler can Walk” Imitates Scribbling, Not Standing Tower of 2 blocks Alone18 Month Runs Makes Tower of 3 Not Walking blocks Alone2 years Walks Up and Down Vertical and Circular Stairs strokes3 years Ride Tricycles Makes Cirlce and Tower of 9 Blocks4 years Hops on One Foot Makes A Cross5 years Skip, dress and Copies a Triangle undress

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THROUGH AGE OF 1 MONTH – 9 MONTHAGE SOCIAL AND KEY LANGUAGE ADAPTIVE MILESTONES MILESTONES1Month Regards face and Alert in Sound follow moving object with eyes2 Month Social Smile (after being No Visual talked to) fixation3 Month Recognize Mother Musical Sound and coos4 Month Laugh Loud5 Month Orient to voice6-7 Month Recognize Stranger Monosyllable No vocalization “Stranger Anxiety” Babbles (Ma, Pa)8 Month9 Month Waves “Bye- Bye” Bisyllable Babbles (Mama, Baba)

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THROUGH AGE OF 12 MONTH – 5 YEARSAGE SOCIAL AND KEY LANGUAGE ADAPTIVE MILESTONES12 Month Comes when Called 1-2 words with to. meaning and understand “No”15 Month Jargon18 Month “ Copies Parent” 8-10 word vocabulary2 years Ask for food, drink and Use a 2-3 word toilet sentence3 years Group Play , know Ask Questions Lack of Full name and gender imaginative Play4 years Plays Cooperatively Sing songs or poem5 years Helps in house hold Ask meaning of task words