GROWTH AND DEVELOPMENTINDICATIONS OF PROBLEM

Community health care

Sara Abdelwahhab And Alaa Fayyad

Outline: Growth and Development Definition Milestone Definition (2 months, 4 months, 6 months, 9 months and 12 months

milestone) Toddler 1-3 years old milestone Preschooler 3-6 years old milestone School 6-12 years old milestone Adolescent 12- 18 years old milestone Developmental Delay Video about Delay speech as an example Conclusion Article

References

Objectives:

At the end of this discussion we will be able to:

Identify Growth and development definition.

Learn about Milestone to each age group.

Learn about Developmental delay. Recognize speech delay to a 4 year old

child.

Growth and development

Child development refers to how a child becomes able to do more complex things as they get older. Development is different than growth. Growth only refers to the child getting bigger in size.

When we talk about normal development, we are talking about developing skills like:

Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions.

Fine motor: using hands to be able to eat, draw, dress, play, write, and do many other things.

Language: speaking, using body language and gestures, communicating, and understanding what others say.

Cognitive: Thinking skills: including learning, understanding, problem-solving, reasoning, and remembering.

Social: Interacting with others, having relationships with family, friends, and teachers, cooperating, and responding to the feelings of others

Developmental milestones are a set of functional skills or age-specific tasks that most children can do at a certain age range. Your pediatrician uses milestones to help check how your child is developing. Although each milestone has an age level, the actual age when a normally developing child reaches that milestone can very quite a bit. Every child is unique!

2 month Physical and motor-skill markers:

Closing of soft spot at the back of the head (posterior fontanelle)

Several newborn reflexes, such as the stepping reflex (baby appears to dance or step when placed upright on solid surface) and grasp reflex (grasping a finger), disappear

Less head lag (head is less wobbly on the neck) When on stomach, able to lift head almost 45

degrees Less flexing of the arms and legs while lying on

the stomach

Sensory and cognitive markers:

Beginning to look at close objectsCoosDifferent cries means different things

Head turns from side to side with sound at the level of the ear

SmilesResponds to familiar voices

Play recommendations:

Expose your baby to sounds outside those of the home

Take your baby for rides in the car or walks in the neighborhood

The room should be bright with pictures and mirrors

Toys and objects should be bright colors Read to your baby Talk to your baby about objects and

people in his or her environment

4 month PHYSICAL AND MOTOR SKILLs

The typical 4-month-old baby should: Slow in weight gain to about 20 grams per day Double the birth weight Have almost no head droop while in a sitting

position Be able to sit straight if propped up Raise head 90 degrees when placed on stomach Be able to roll from front to back Hold and let go of an object Play with rattle when it's placed in the hands,

but won't be able to pick it up if dropped Be able to grasp rattle with both hands Be able to place objects in mouth Sleep 9 to 10 hours at night with two naps (total of

14 - 16 hours per day)

SENSORY AND COGNITIVE SKILLS

A 4-month-old baby is expected to: Have well-established close vision Increase eye contact with parents and others Have beginning hand-eye coordination Be able to coo Be able to laugh out loud Anticipate feeding when able to see a bottle

(if bottle-fed) Begin to show memory Demand attention by fussing Recognize parent voice or touch

PLAY

You can encourage development through play:

Place the baby in front of a mirror Provide bright-colored toys to hold Repeat sounds the infant makes Help the infant roll over Use an infant swing at the park if the

baby has head control Play on the stomach (tummy time)

 6 month Physical and motor skill markers:

Able to hold almost all weight when supported in a standing position

Able to transfer objects from one hand to the other Able to lift chest and head while on stomach, holding

the weight on hands (often occurs by 4 months) Able to pick up a dropped object Able to roll from back to stomach Able to sit in a high chair with a straight back Able to sit on the floor with lower back support Beginning of teething Increased drooling Should be able to sleep 6 - 8 hour stretches at night Should have doubled birth weight (birth weight often

doubles by 4 months, and it would be cause for concern if this hasn't happened by 6 months)

Sensory and cognitive markers:

Begins to fear strangers Begins to imitate actions Begins to realize that if an object is dropped, it is

still there and just needs to be picked up Can locate sounds not made directly at the ear level Enjoys hearing own voice Makes sounds (vocalizes) to mirror and toys Makes sounds resembling one-syllable words

(example: da-da, ba-ba) Prefers more complex sounds Recognizes parents Starts to imitate sounds Vision is between 20/60 and 20/40

Play recommendations:

Read, sing, and talk to your child Imitate words such as "mama" to help baby learn

language Play peek-a-boo Provide an unbreakable mirror Provide large, bright-colored toys that make noise

or have moving parts (avoid toys with small parts) Provide paper to tear Speak clearly Start naming parts of the body and the environment Use body movements and actions to teach language Use the word "no" infrequently

9 month PHYSICAL CHARACTERISTICS AND MOTOR SKILLS

A 9 month old has usually reached the following milestones:

Gains weight at a slower rate -- about 15 grams per day, 1 pound per month

Increases in length by 1.5 centimeters per month Bowel and bladder become more regular Puts hands forward when the head is pointed to

the ground (parachute reflex) to protect self from falling

Is able to crawl Sits for long periods Pulls self to standing position Reaches for objects while sitting

Bangs objects together Can grasp objects between the tip of

the thumb and index finger Feeds self with fingers Throws or shakes objects

SENSORY AND COGNITIVE SKILLS

The 9 month old typically: Babbles Has separation anxiety and may cling to parents Is developing depth perception Understands that objects continue to exist, even

when they are not seen (object constancy) Responds to simple commands Responds to name Understands the meaning of "no" Imitates speech sounds May be afraid of being left alone Plays interactive games, such as peek-a-boo and pat-

a-cake Waves bye

PLAY

To help the development of the 9 month old: Provide picture books Provide different stimuli:

Go to the mall (people) Go to the zoo (animals)

Build vocabulary by reading and naming people and objects in the environment

Teach hot and cold through play Provide large toys that can be pushed to

encourage walking Sing songs together Avoid television time until age 2 A transition object may help decrease separation

anxiety

12 month

PHYSICAL AND MOTOR SKILLS A 12-month-old child is expected to: Be 3 times the birth weight Grow to a height of 50% over birth

length Have a head circumference equal to

that of the chest Have one to eight teeth

Stands by his or herself Walk alone or when holding one

hand Sit down without help Bang two blocks together Turn through the pages of a book by

flipping many pages at a time Picks up a small object using the tip

of the thumb and index finger Sleep 8 - 10 hours a night and take

one to two naps

SENSORY AND COGNITIVE DEVELOPMENT

The typical 12-month-old: Begins pretend play (such as pretending

to drink from a cup) Follows a fast moving object Responds to his or her name Can say momma, papa, and at least one

or two other words Understands simple commands Tries to imitate animal sounds Connects names with objects

Understands that objects continue to exist, even when they are not seen (object constancy)

Participated in getting dressed (raises arms)

Plays simple back and forth games (ball game)

Points to objects with index finger Waves bye May develop attachment to a toy or object Experiences separation anxiety and may

cling to parents May make brief journeys away from

parents to explore in familiar settings

PLAY

You can help your 12-month-old develop skills through play:

Provide picture books Provide different stimuli, such as going to the mall or zoo Play ball Build vocabulary by reading and naming people and

objects in the environment Teach hot and cold through play Provide large toys that can be pushed to encourage

walking Sing songs Have a play date with a child of a similar age Avoid television time until age 2 A transitional object may help with separation anxiety

Toddler -- 1 to 3 years

Able to feed self neatly, with minimal spilling Able to draw a line (when shown one) Able to run, pivot, and walk backwards Able to say first and last name Able to walk up and down stairs Begins pedaling tricycle Can name pictures of common objects and

point to body parts Dresses self with only a little bit of help Imitates speech of others, "echoes" word

back

Learns to share toys (without adult direction)

Learns to take turns (if directed) while playing with other children

Masters walking Recognizes and labels colors appropriately Recognizes differences between males and

females Uses more words and understands simple

commands Uses spoon to feed self

Preschooler -- 3 to 6 years

Able to draw a circle and square Able to draw stick figures with two to three

features for people Able to skip Balances better, may begin to ride a bicycle Begins to recognize written words --

reading skills start Catches a bounced ball Enjoys doing most things independently,

without help Enjoys rhymes and word play

Hops on one foot Rides tricycle well Starts school Understands size concepts Understands time concepts

School-age child -- 6 to 12 years

Begins gaining skills for team sports (soccer, T-ball, etc.)

Begins to lose "baby" teeth and get permanent teeth

Girls begin to show growth of armpit and pubic hair, breast development

Menarche (first menstrual period) may occur in girls

Peer recognition begins to become important Reading skills develop further Routines important for daytime activities Understands and is able to follow several

directions in a row

Adolescent -- 12 to 18 years

Adult height, weight, sexual maturity Boys show growth of armpit, chest, and

pubic hair; voice changes; and testicles/penis enlarge

Girls show growth of armpit and pubic hair; breasts develop; menstrual periods start

Peer acceptance and recognition is of vital importance

Understands abstract concepts

Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing major or minor delay in the process of development. If your child is temporarily lagging behind, that is not called developmental delay. Delay can occur in one or many areas—for example, gross or fine motor, language, social, or thinking skills .

Developmental Delay is most often a diagnosis made by a doctor based on strict guidelines. Usually, though, the parent is the first to notice that their child is not progressing at the same rate as other children the same age. If you think your child may be “slow,” or “seems behind,” talk with your child's doctor about it. In some cases, your pediatrician might pick up a delay during an office visit. It will probably take several visits and possibly a referral to a that the delay is not just a temporary lag. Your child's doctor may use a set of screening tools during regular well-child visitsdevelopmental specialist to be sure

Video!!

Conclusion

In each stage of child’s age there are certain things must be considered to acknowledge child’s growth and development, early diagnosis is always preferable and be treated as soon as possible will reduce or control many problems, and also dont be afraid to ask or do regular growth and development check ups for children…they really need it!

Article: Consanguinity in Gaza and its possible role in

developmental delay and chronic illnesses

Abstract: Aim: to access the rate of consanguinity in a selected

population in Gaza and its possible role in the etiology of developmental delay or neurometabolic disorder.

Setting: the study was conducted at the Jordanian field hospital, Gaza during the period from February 2010 to May 2010.

Patients and Methods: Analysis of the information of the families of 546 patients attending the pediatric clinic was carried out. A simple random sampling was used in the selection of patients. Information was collected as to patients basic information, presenting illness, parents consanguinity status, presence of chronic illnesses, developmental delay, neurologic or neurometabolic disease in the family or relatives.

 

Results: The data of families of 546 patients was analysed; consanguinity was present in 46% of families, 1st cousins marriages constituted 33.5% of the families whereas 5% were 2nd cousins and 7.5% were far relatives, where as 54% were not related. 32/251 of consanguineous families had a family member who had a chronic illness in the form of developmental delay, proved or suspected metabolic or neurometabolic disorder.

  Conclusion: consanguineous marriages are

common in Gaza, and they are an important contributing factor in the etiology of developmental delay and suspected metabolic disorders.

Reference:

http://www.med.umich.edu/yourchild/topics/devdel.htm

http://www.nlm.nih.gov/medlineplus/ency/article/002002.htm

http://www.youtube.com/watch?v=V0L9bl8Ebj0

http://www.youtube.com/watch?v=bxFqtWkTy3g

THANK YOU!