83. Age, morphological and physiological peculiarities among children and adolescents.

what are the stages of child development?

1. Germinative (12-60 days)

2. Embryonic (8-12 weeks) and

3. Fetus (12-40 weeks)

4. First year

5. Preschool years (3-6)

   • elaborate

6. Early school years-7-12

   • elaborate

Preschool years

(3-6)

• gain in weight and height are steady (2kg and 6-8cm per year)

• Neurodevelopment

• Language development

  • influenced by laguages spoken at home

• psychosocial development

  • Play evolves:

    • Parallel play: Children play alongside each other

    • Interactive play: Children begin to play together, share, and cooperate

Early school years

• (7-12)

• Steady growth ends in preadolescent growth spurt

• Weight gain: 3–3.5 kg/year

• Height gain: ~6 cm/year

• Head circumference: 51–54 cm (almost adult brain size)

• Skeleton & body:

  • Facial bones grow → bigger nasal and accessory sinuses

  • Spine straighter, body more supple

  • Motor skills more specialized, vigorous activities common

• Health: Respiratory infections are more frequent

• 
  Psychosocial development

• greater independence (more time away from home )

• Look for other family members for goals, values and standards of behaviour

• sense of duty, responsibility, and realistic accomplishment are developed

stages of adolesnce

13-18 years

early

middle

late

Adolescence- defined

• Definition: Puberty is described in stages (e.g., Tanner stages) because children progress through these physical changes in a consistent order, even if the chronologic age varies.

• Sex differences in body changes:

  • Females: Each successive stage → increase in body fat (especially hips, thighs, breasts)

  • Males: Each successive stage → increase in muscle mass and strength

Key idea: Pubertal stages track physical development, not exact age.

Early adolescence

Early adolescence (puberty onset):

• Boys: 10.5–14 years

• Girls: 10–13 years

Physical development:

• Females:

  • FSH stimulates ovaries to produce estrogen

  • Breast buds form

  • Vaginal mucosa thickens

  • Increased pigmentation and blood flow in genital area

  • Labia majora become more sensitive

  • Slight enlargement of clitoris and uterus

• Males:

  • Testes enlarge due to growth of seminiferous tubules and Leydig/Sertoli cells

  • Increased testosterone causes growth of epididymis, seminal vesicles, prostate

  • Scrotum thins and becomes more vascular

  • Penis enlarges shortly after testicular growth begins

  • Ejaculation starts about 1 year after testicular enlargement, coinciding with pubic hair growth

Both sexes:

• Adrenal androgens cause pubic and axillary hair growth

• Sebaceous glands increase in size and secretion

Cognitive development:

• Rapid cognitive growth phase

• Mostly concrete thinking

• Impulsive behavior is common

• Abstract reasoning still limited

• Difficulty understanding nutrition-health links

• Poor problem-solving skills for behavior change

• Limited ability to foresee long-term health consequences of current behavior

Middle adolescence

• Age range

  • Males: 12.5–15 years

  • Females: 12–14 years

• Growth

  • Period of rapid vertical (height) growth

  • Females: ~8 cm/year at age 12

  • Males: ~10 cm/year at age 14

  • Growth begins in distal limbs (hands, feet), then progresses proximally

  • Trunk elongates

  • arms and legs lengthen

  • Chest expands (anteroposterior diameter increases) later in the growth spurt

• Physical development

  • Onset of mensuration is a major event

    • (occurs in ~60% of girls during this stage)

  • Timing is influenced by genetic, nutritional, and environmental factors

• Cognitive development

  • Increased emotional independence

  • separation from family

  • Conflicts over autonomy, including food choices

  • Most physical growth is completed

  • Body image issues may persist:

    • Males who mature later may feel insecure

    • Females may struggle with sudden changes in body shape and size

Late adolescence

Age

• Males: 14–16 years

• Females: 14–17 years

Physical Development

• Body size and proportions resemble those of a young adult

• Minimal height gain after the mid-adolescence growth spurt

• Secondary sexual characteristics continue to mature

  • e.g. deepening of the male voice

Physical Development

• Body size and proportions resemble those of a young adult

• Minimal height gain after the mid-adolescence growth spurt

• Secondary sexual characteristics continue to mature

  • e.g. deepening of the male voice

Disorder of pubertal development

• considered abnormal when:

  • Girls: signs of puberty before age 8

  • Boys: signs of puberty before age 9

Types:

1. Precocious Puberty Without Pathologic Findings

   • Girls: breast development appears first, followed by pubic hair

   • Boys: early enlargement of penis and testes, appearance of pubic hair, acne, and erections

   • Growth parameters (height, weight, bone age) are advanced

   • Treatment: can slow or reverse secondary sexual traits, normalize growth and bone maturation

2. Precocious Puberty Due to Organic Brain Lesions

   • Seen in 40% of boys and 10% of girls with true precocious puberty

   • It may be caused by brain tumours or neurological conditions

   • Often associated with endocrine or neurological symptoms

why is moitoring growth and development needed?

Monitoring growth and development is essential for early detection and prevention of chronic conditions like:

• Obesity

• diabetes mellitus

• hypertension

• allergies.