Growth and Development Pedatrics

Infant physical growth HEIGHT

• 50% increase in 1 year

• 1 inch per month for the first 6 months

• 50% growth by 12 months

Infant physical growth WEIGHT

• Doubles by 6 months

• Triples by 12 months

Infant physical growth HEAD CIRCUMFERENCE

• 2 cm/month in 1st 3 months

• 1 cm/month at 4-6 months

• ½ cm/month until 1 year

Infant growth motor skills CRAWLING

• Head:

  • 1 month: head lag

  • 2 months: prone position holds head up

  • 4 months: holds head up unsupported when held

• Posture

  • 4 months: pushes up to prone position

  • 5-6 months: rolls from front to back

• Sitting

  • 7-8 months: leans forward supports with both hands

  • 9 months: without assistance

• Rolling

  • 5-6 months: front to back

• Crawling

  • 9-10 months: hands and knee crawling

Infant growth motor skills WALKING

• 11-12 months: cruises and walks holding hand

• 12 months: pulls up to standing and walks along holding onto furniture

• 15 months: take first steps

• 18 months: walking alone

Infant fine motor

• Grasping (First 6 months)

  • 1 month: grasp reflex, closed fist

  • 2 months - grasp reflex fading, brief opening hands

  • 4 months - holds object/toy when placed in hand, picks up objects in both hands and attempts to put into mouth

• Grasping (second 6 months)

  • 7 months - object transfer from hand to hand, develop raking grasp

  • 8 months - develops pincer grasp

  • 11 months - neat pincer grasp present

• Feeding

  • 6 months - holds bottle independently

  • 8-11 months - pincer grasp allows child to pick up dry cereal

  • 12-15 months - uses cup independently

Infant Language

• 2 months: makes sounds other than crying, reacts to loud sounds

• 4 months: makes cooing noises, makes sounds back when you talk to them, turns head toward sound of your voice

• 6 months: takes turns making sounds with you, blows “rasberries,” makes squealing noises

• 9 months: “mama mama” “babababa” understands “mo,” “mama” “dada”

• 12 months: waves “bye bye”

Infant psychosocial

• 2 months: demonstrates early social engagement by looking at faces

• 4 months: smiles intentionally

• 6 months: enjoys looking at themselves in mirror

• 9 months: develops facial expressions

• 12 months: inceraes interaction paty cake demonstrating reciprocal play

infant socialization

• 4-8 months: separation anxiety

• 6 months: fears strangers

• 12 months: increase social bonding

Infant sleep

• 3-4 months: nocturnal patter, sleep 14-15 hours/day

• 9 months: episodes of night wakening

• 12 months: sleeps through the night, 1-2 naps/day

Infant Nutrition

• Don’t prop bottles up during feeding —→ aspiration, otitis media

• Don’t put to bed with bottle, hold them

Toddler physical growth patterns HEIGHT

• 1-2 years - fast grpwtj

• plotted on growth charts

• up to 3 inch per year

Toddler physical growth patterns WEIGHT

• 4-6 lbs per year

• plotted on growth charts

• BMI begin measuring at 2 years old

Toddler physical growth patterns HEAD

• measured until 2 years and as needed from 2 years on

• plotted on growth chart

Toddler gross motor

• 15 months - takes few steps on their own

• 18 months - walks independelty, climbs on and off furniture

• 24 months - kicks ball, runs, walk upstairs

• 30 months - jumps off the ground with both feet

• 36 monts - rides a tricycle

Toddler fine motor and cognitive (15, 18, 24, 30 months)

• 15 months -

  • stacks at least 2 small objects

  • claps when excited

  • continues to use fingers to feed themselves

• 18 months -

  • scribbles

  • drinks from an open cup with or without spilling

  • attempts to use utensils

• 24 months -

  • holds something in one hand while using the other hand

  • uses gestures appropritaley (blowing kiss, nodding)

• 20 months -

  • uses one or both hands to twist things

  • takes clothes off independently

  • turns book pages one at a time

Toddler launguage

• 15 months: attempts more workds, ask for things through pointing

• 18 months: 3 or more different words, follows one step directions

• 2 years: uses gestures, 2-3 word sentences

• 36 months: 50+ word vocabulary, 2 or more words and verb sentences

Toddler tantrums

• educate carefiver that this is normal

Toddler sleep patterns

• require 11-14 hours of sleep per day

• sleep is calculated over 24 hour period including naps

• concerns: daytime sleeping, insomnia, snoring, nightitime waking, breathing problems, nightmares

Preschooler physical growth pattern (3-5 years)

• slower, consistent growth in preschool in an upright posture

• 3 years: 32lb, 37.5in

• 4 years: 36.5 lbs, 40.5in

• 5 years: 41lbs, 43.5in

Preschool Gross motor

• 3 years: stands on one foot for a few seconds, jumps off bottom step, rides a tricycle

• 4 years: catches a large ball, rides bicycle with training wheels

• 5 years: hops, skips on one foot, throw ball overhead

Preschool fine motor

• strings 2+ items together

• drawing and coloring become more refined

• holding crayons (first) then to pincer grasp between thumb and fingers

• draws shapes - circles to squares, to triangles, to diamonds

• 4 years of age draws a person with 3 separate body parts then 6 body parts by 5 years of age

Preschooler socialization

• illness or hospitalization = major fears like mutilation, body harm, left alone

• MAGICAL THINKING

• 3 years - capable of sharing, plays with others

• 4 years- enjoys playing in groups

• 5 years - emergence of friendships

Preschooler langauge skills

• 3-4 years - 3-4 word sentences

• 4-5years - 4-5 word sentences

• talks incessantly, take things literally

• “Why?” (want to understand the world)

Preschooler psychosocial

• desire to explore world

• Why?

• increased interaction with ppl and environments

• personality development

Denver Developmental screening test (DDST)

• know the child’s exact age and compares their development (language, gross/fine motor skills, social skills) to others the same age

• 1 month - 6 years

School age height and weight

• height - 2 in/year

• weight - 6 lbs/year

Physical maturation/puberty

• females - 9-10 years

• males - 12 years

School aged gross and fine motor

Age 6 - has acheived all development tasks

School aged language skills

• structured and mature

• full sentences with meaning

• 10-12 years reads independelty

• 12 years - can carry out adult convo

School age socialization

• Friendships are super important

• Bullying in middle school

• mental health and behavioral concerns

Adolescent physical growth

• height - increase 4-6 in

  • female growth stops 2-2.5 years after menarche

  • male growth stops 18-20 years

• weight - doubles prepuberty

• Tanner staging - body hair development, chest tissue. stages maturation and delopment