LIFESPANPHYSICAL DEVELOPMENT

FELDMAN: MODULE 3 -1

NORMAL GROWTH

Growth occurs in a cephalocaudal (head to tail) patternThe head takes up one-fourth of total body length at birth, but only one-fifth at age 2.

Growth occurs in a proximodistal (near to far) pattern.The head, chest and trunk precede the limbs and extremities.

BODY GROWTH IN INFANCYAverage North American newborn weight 7 ½ pounds

and is 20 inches long.

Birth weight triples in one year and quadruples by the end of two years.

By the second year, the child is at 1/5 of its adult weight (30 lbs.) and ½ its adult height (30 + inches).

Muscle tissue increases very slowly.

2-3 inches per year

5 pounds per year

Baby fat declines

Posture and balance improve due to lower center of gravity.

2-3 inches per year

5 pounds per year

Bones harden (skeletal age), lengthen and broaden

ligaments are not yet firmly attached.

Improved strength and muscle tone.

Primary teeth are replaced with permanent teeth

FACTS ABOUT PHYSICAL GROWTHEARLY CHILDHOOD MIDDLE CHILDHOOD

BODY GROWTH AND GENDERGirls are shorter and lighter and have a higher ratio of body fat to muscle than boys.

Children differ in the rate of physical growth.

Skeletal age is the best way to estimate the child’s physical maturity.

African Americans mature faster than Caucasians and girls mature faster than boys.

.Gross motor development involves large muscle groups and activities that generally have to do with locomotion

Fine motor development involves smaller muscle groups and activities such as reaching and grasping

MOTOR DEVELOPMENT

PERSPECTIVES ON MOTOR DEVELOPMENT Nature-focused view: Developmental maturation

Nurture-focused view: Dynamic systems theory: the child develops new motor skills by

adapting and adding to old ones to meet his/her goals

DYNAMIC SYSTEMS THEORY OF MOTOR DEVELOPMENT

Mastery of motor skills involves acquiring increasingly complex systems of action.

Each new skill is a joint product of: 1) Central nervous system development 2) movement capacities of the body 3) goals of the child 4) environmental supports for the skill

NEWBORN REFLEXES

blinking Babinskigrasping Mororooting steppingsucking swimming

Gross motor development follows a generally universal sequence.

Cephalocaudal and proximodistal trends are evident.

There is no fixed maturational timetable.

GROSS MOTOR DEVELOPMENT

AGE NORMS (IN MONTHS) FOR GROSS MOTOR SKILLS*

Iranian orphans are not encouraged to move

Indians in Southern Mexico are discouraged from walking

Kipsigi parents in Kenya encourage motor skills and children walk early

CULTURAL VARIATIONS IN MOTOR DEVELOPMENT

GROSS MOTOR - PRESCHOOLAge 3 – hop, jump, run for the fun of

it

Ages 4 and 5 – more adventurous, climb

USING COMMON SENSE

For adequate motor development, preschoolers need places and opportunities to play

There is no evidence that formal lessons facilitate development

Pushing the child may undermine self confidence

GROSS MOTOR – SCHOOL CHILDREN

Skipping rope, swimming, bike-riding, skating

10-11 year olds can learn from sports

Gain greater control over muscles

Boys outperform girls

Need opportunities for physical play

ORGANIZED SPORTS IN CHILDHOOD - POSITIVES

Opportunities for exercise

Learning to compete

Opportunities for peer, friendship relationships

Reduces tendency for obesity

ORGANIZED SPORTS IN CHILDHOOD - NEGATIVES

NegativesToo much pressure to perform Physical injuries Distraction from academic work Unrealistic expectations as an athlete Wrong values Possible exploitation

GROSS MOTOR - ADULTHOODGross motor skills improve in

adolescence

They peak in the 20’s

They decline through the remainder of adulthood

FINE MOTOR SKILLS

Newborns pre-reach (drops out about 7 weeks)

Voluntary reaching appears at about 3 months

By 4-6 months an infant can grasp an object in a darkened room.

By 7 months they can use one arm

INFANCY - SEQUENCE OF REACHING BEHAVIOR

Newborn grasping reflex

palmar grasp – can be varied

4-5 months, transfer objects from hand to hand1 year – pincer grasp

(Trying to push infants beyond their readiness may backfire.)

SEQUENCE OF GRASPING BEHAVIOR

Reaching affects cognitive development because it opens up new ways of exploring the environment.

Infants use proprioceptive cues to reach as early as 4 months

FINE MOTOR SKILLS - INFANCY

REACHING & GRASPING IN INFANCY

Perceptual-motor coupling is usedsense of touchsense of vision by 8 months

Experience plays a role in development

Pincer grasp goes with crawling & children pick up things from floor.

FINE MOTOR – EARLY CHILDHOOD

Fine motor progress is apparent in

Children’s care of their own bodiesDrawing and painting

SELF-HELP SKILLS2-3 yearszips, puts on clothes3-4 yearsbutton (large buttons)5-6 years ties shoes

2-3 yearsuses spoon3-4 yearsserves self food4-5 yearsuses fork5-6 yearsuses knife

DRAWING AND PAINTING3-4 yearscopies vertical line/circleDraws a “tadpole” person

4-5 yearsCuts with scissorsCopies triangle, cross, some letters

5-6 yearsDraws person with 6 partsCopies some numbers, simple words

FINE MOTOR – MIDDLE CHILDHOOD

Increased myelination of CNS6-year-olds can hammer, paste, tie shoes,

fasten clothes7 years – use pencil & print smaller8-10 years – write cursive & use hands

independently12 years – approach adult skill levelsGirls outperform boys

FINE MOTOR – OLDER ADULTHOOD

Slower motor behavior

Neural noise – irregular neural activity in the CNS

Strategy – may have to slow to perform accurately

Can learn new motor tasks, but more practice required

INFLUENCES ON PHYSICAL GROWTH & HEALTH

GeneticsInfectious diseaseChildhood injuriesHormonesEmotional well-beingNutrition

CHILDREN’S HEALTH - PREVENTIONImmunization Meningitis, measles, rubella, mumps, chicken pox, polio

Accidents Poisonings, falls, drowning, choking

Poverty Good medical care, nutrition, living conditions

INFLUENCES ON PHYSICAL GROWTH & HEALTH - IMMUNIZATIONImmunization has caused a dramatic

decline in childhood diseases in the industrialized world

24% of American preschoolers lack essential immunizations (40% in poverty)

Availability of careMisconceptions (MMR & autism)

INFLUENCES ON PHYSICAL GROWTH & HEALTH – PITUITARY GROWTH HORMONES

Growth hormone (GH) needed for development of all body tissues except CNS & genitals

Thyroid-stimulating hormone (TSH) causes the thyroid gland to release thyroxin, needed for normal nerve cell development and for GH to have a full impact on body size

INFLUENCES ON PHYSICAL GROWTH & HEALTH – EMOTIONAL WELL BEING

Psychosocial dwarfismCaused by extreme emotional deprivationAppears between 2 & 15 years of ageCan interfere with the production of GHVery short stature Immature skeletal ageSevere adjustment problemsCan be treated

ADOLESCENCE

DEFINITION OF ADOLESCENCE

Transition between childhood and adulthood

Physically begins with puberty

Culturally defined; ends gradually with assumption of adult responsibilities.

Lasts nearly a decade (or more) in the U.S.; culturally exaggerated due to education

THE GROWTH SPURT OF PUBERTY

Most rapid growth since infancy

Average of age 9 for girls; 11 for boys

Girls grow 3.5 inches/year; boys 4 inches

50% of body weight gained in adolescence

Also changes in leg length and facial structure

WHY DOES PUBERTY HAPPEN EARLIER THAN IT USED TO?

Nutrition ? – Better than in earlier times

Hormones ? – Found in food supply

Stress ?Fat ?

STRESS THEORY OF EARLY PUBERTY

Hypothalamus pituitary sex glands produce gonadotrophinsAndrogens (testosterone)Estrogens (estradiol)

Pituitary thyroid gland produces growth hormone

Cortisol (stress hormone) may trigger early onset (pituitary activity)

FAT THEORY OF EARLY PUBERTY

Weight affects the timing of menarche (106 +/- 3 pounds)

Athletes and anorexics become amenorrheic

Fat and leptin may also be influential

ADULTHOOD

NORMAL PHYSICAL DEVELOPMENT:EARLY & MIDDLE ADULTHOOD

Early Adulthood, peak muscle tone & joint function

Senescence

Middle Adulthood – gradual changes,lose height, gain weight, in 40s & 50s skin sags, wrinkles, age spots, hair thins, thicker finger- and toenails, yellow teeth

CHANGES IN MIDDLE ADULTHOOD (CONT’D)

Sarcopenia – age-related loss of muscle mass & strength

Lose 1-2% per year starting at age 50

Exercise can help to reduce this loss

Also lose bone from the late 30’s; this accelerates in the 50’s

CHANGES IN MIDDLE ADULTHOODCholesterol increasesLDL – leads to atherosclerosis

Blood Pressure increases; sharply for women at menopause

Metabolic disorder – hypertension, obesity, insulin resistance, high cholesterol, low HDL, weight gain (Part of normal aging?); weight loss & exercise help

Lungs become less elastic

ADULT HEALTH - REPRODUCTIVE SYSTEMThe 20’s are ideal for reproduction. Risks

of miscarriage and chromosomal disorders are reduced.

First births to women in their 30’s have increased in the past two decades

Dramatic rise in fertility problems in the mid-thirties (14 to 26%)

CHANGES IN MIDDLE ADULTHOOD - SEXUALITY

Climacteric – loss of fertility

Menopause – ceasing of menstrual cycles (average age 52)

Drop in estrogen, hot flashes, nausea, fatigue, rapid heartbeat

Gradual decline for men (no andropause)

ADULT HEALTH IMMUNE SYSTEMCapacity declines after age 20,

partially due to thymus and inability to produce mature T cells

Stress and depression can also weaken the immune system

ADULT HEALTH - STATES OF MINDWestern stereotype: deterioration is

inevitable In one study, people with positive self-perceptions of aging live 7 ½ years longer

More optimistic elders are about capacity to cope with physical challenge, better they are at overcoming threats to health

Low SES elders are less likely to believe they can control their health, to seek medical treatment, or to follow doctors’ orders.

BIOLOGICAL THEORIES OF AGINGCellular clock (Hayflick) 70-80 cell divisions, based on telomeres 120-year lifespan

Free-radical Calorie restriction antioxidants

Mitochondrial Cellular energy producers Linked to free radical theory

Hormonal Stress hypothalamic-pituitary-adrenal axis Stress & decline in immune function

FELDMAN: MODULES 4-1 & 4-2

Injury and Illness through the Lifespan

CHILDREN’S HEALTH - PREVENTIONImmunizationMeningitis, measles, rubella, mumps, chicken pox, polio

AccidentsPoisonings, falls, drowning, choking

PovertyGood medical care, nutrition, living conditions

INFLUENCES ON PHYSICAL GROWTH & HEALTH - IMMUNIZATIONImmunization has caused a dramatic decline in childhood diseases in

the industrialized world24% of American preschoolers lack essential immunizations (40% in

poverty) Availability of care Misconceptions (MMR & autism)

INFLUENCES ON PHYSICAL GROWTH & HEALTH – INFECTIOUS DISEASES

70% of deaths in children under age 5 are due to infectious diseases

99% are in developing countries and are related to malnutrition

Most death due to diarrhea can be prevented by oral rehydration therapy (ORH)

INFLUENCES ON PHYSICAL GROWTH & HEALTH – OTITIS MEDIA

70+% of American children have had at least one bout by age 3

Xylitol may be a preventativeTubes remain controversialChild-care settings should control infectionMay cause problems in language

development due to hearing problems

HEALTH - MIDDLE TO LATE CHILDHOODThis is generally a healthy time

Otitis media becomes less prevalent.

19% of N.A. children have chronic diseases and conditions

Asthma accounts for 1/3 of chronic illness and is the most common reason fro school absence

Incidence has increased dramatically, 8% of U.S. children—boys, low SES, parents smoke, born underweight most at risk

INJURIES IN EARLY CHILDHOODLeading cause of childhood mortality in

industrialized countries.

Motor vehicle collisions are the most frequent source of injury at all ages & the leading cause of death among children over 1 year old

Auto accidents, drownings and burns are the most common accidents of early childhood

INJURIES IN MIDDLES TO LATE CHILDHOODThe rate of injury fatalities increases into

adolescence with rates for boys rising considerably above those for girls.

MV accidents are still the leading cause of death, with bicycle accidents next.

Parents often overestimate children’s safety knowledge and behavior

OBESITY: U. S. & WESTERN NATIONS

There has been a marked rise in obesity in the U.S. and other Western nations. Percentage doubled since 1980; quadrupled since 1965

U.S. may have 2nd highest rate15% of U.S. children 6-11 overweight

CAUSES OF OBESITYGeneticsSES (diet); high fat, low-cost foodsFamily stress (comfort food)Pastimes (TV, videogames) and

lack of exerciseFast-food and busy schedulesLearned food preferences (school

cafeterias)

NUTRITION – OBESITY IN ADULTHOOD

Adult obesity correlated with increased risk of hypertension, diabetes, & cardiovascular disease

May be a genetic propensity for obesity. It tends to run in families. (May also be learned eating patterns.)

MIDDLE ADULTHOOD: ILLNESS & DISABILITYCancer & cardiovascular disease are

the leading causes of death. Cancer alone among women.

Motor vehicle collisions decline, falls resulting in fractures & death nearly double.

Personality traits that magnify stress, especially hostility and anger, are serious threats to health.

CARDIOVASCULAR DISEASEFirst detected factors may be high

blood pressure, high cholesterol, and atherosclerosis (a buildup of plaque in the coronary arteries).

Heart attack: blockage of blood supply to an area of the heart (50% die before reaching the hospital, 15% during treatment)

Other conditions include arrhythmias and angina pectoris

CANCER – MIDDLE ADULTHOODThe death rate multiplies tenfold from

early to middle adulthood.Lung cancer has dropped in men (fewer

smoke) and increased in women.Cancer occurs when a cell‘s genetic

program is disrupted, leading to uncontrolled growth.

Damage to the p53 gene is involved in 60% of cancers. This gene stops defective DNA from multiplying.

Having the BRCA1 or BRCA2 tumor-suppressing gene is protection against breast cancer.

CANCER

40% of people with cancer are cured.Breast cancer is most prevalent for

women, prostate cancer for men.Lung cancer is next, followed by

colon/rectal cancer.

ADULT-ONSET DIABETESCauses abnormally high levels of blood

glucoseIncidence doubles from middle to late

adulthoodEffects 10% of the elderlyInactivity and abdominal fat deposits

greatly increase risksTreated with controlled diet, exercise,

and weight loss

ARTHRITISEffects 45% of American men and 52% of

women over 65. Rises to 70% in women at age 85.

Osteoarthritis: most common and involves deteriorating cartilage on the ends of bones of frequently used joints

Rheumatoid arthritis: an autoimmune response leading to inflammation of connective tissue, especially the membranes that line the joints

HEALTH & DISEASE IN OLDER ADULTHOOD

Generally a continuation and intensification of problems that began in middle adulthood.

PHYSICAL DISABILITIES

Cardiovascular illness and cancer increase dramatically and remain the leading causes of death

Respiratory diseases also rise sharplyEmphysema, mostly from smokingPneumonia, 50 typesStroke is the 4th most common killerHemorrhage or blockage of blood flow in the brain

CHRONIC CONDITIONS - OLDER ADULT

ArthritisHypertensionHearing and vision impairmentHeart diseaseDiabetesAsthmaOsteoporosis

OSTEOPOROSISMajor age-related bone loss12 to 20 % of patients die within a year of a

major break such as a hipPatients are advised to:Take calcium and vitamin DEngage in weight-bearing exerciseTake HRT/ERTTake bone-strengthening medications

UNINTENTIONAL INJURY

At age 65 and older, the death rate from unintentional injuries is at an all-time high

Due to MV accidents and fallsOlder adults have higher rates of traffic

violations, accidents, and fatalities per mile driven than any other age group

30% of people over 65 and 40% of those over 80 have experienced a fall in the last year

Declines in vision, hearing and mobility make it harder to avoid hazards and keep one‘s balance