Peds Chapter 28

What is growth?

an increase in the number and size of cells as they divide and synthesize new proteins

•Results in increased size and weight 

Can be viewed as a quantitative change change or something we can measure

What is development?

a gradual change and expansion, advancement from lower to more advanced stages of complexity

•Increased capacity through growth, maturation, and learning

A qualitative change, can be hard to measure, it in continuous, we are always progressing, it has a beginning, it is individualized

Growth and development include

Physical and functional maturation

What is a developmental task?

set of skills/competencies specific to each developmental stage that children must accomplish/master to function within their environment.

Patterns of growth and development are

´Definite predictable patterns that are

•Continuous, orderly, progressive (crawl-creep-stand-walk)

•Periods of accelerated/decelerated growth

•Unique to each individual!!!

Directional trends: Cephalocaudal

direction is the way we progress, from the head to the feet. Top extremities develop before bottom.

First thing babies do, happens at about 6 weeks

hold their head up

Directional trends: Proximodistal

midline of body develops before digits (arms and extremities)

Biologic growth and development: Infancy, children, adolescence

Has the most rapid growth, especially in trunk

Children legs elongate

Adolescence trunk elongates, especially until puberty

Birth weight should —— at 6 months

double

Birth weight should —— at 1 year

Triple

At 2 years old a child is half

their adult height

Neurologic maturation mostly happens before

birth, at 15-20 weeks and 30 weeks

•Increasing communication with other cells, advancing peripherally to keep up with expanding body

Lymphoid tissue in children

Lymph nodes swollen or larger can indicate infection

Kids lymph tissue expects to fight infection, they have so much lymph tissue to fight stuff off. We do not need so much lymph tissue when we are older because our body remembers old sickness we have had and can fight it.

Metabolism and basal metabolic rate

•Decreases with maturity, varies with growth

•determines caloric, water needs

The younger we are the higher our BMR is which is why vitals are all higher.

Adolescents will need a higher nutrition while growing, same for small babies and in that first

Physiologic changes are measured by

Vital signs

Temperature (a reflection of metabolism)

•Thermoregulation immaturity in infants

•Infants produce more body heat

Sleep and rest

•Allows for repair/recovery of tissues after activity

Nutrition

•Single most important influence on growth

•Fluctuations in appetite as response to fluctuations in growth

Erikson’s Stages of Psychosocial Development Stage 1 (kids have to progress in each of these stages to interact with others)

Trust versus mistrust

Erikson’s Stages of Psychosocial Development Stage 2

Autonomy versus shame and doubt

Erikson’s Stages of Psychosocial Development Stage 3

Initiative versus guilt

Erikson’s Stages of Psychosocial Development Stage 4

Industry versus inferiority

Erikson’s Stages of Psychosocial Development Stage 5

Identity versus role confusion

Piaget’s Cognitive Development (logical thinking) phase 1

Sensorimotor

(object permanence) At about 10 months or less, they do not have object permanence, they don’t realize if its gone it doesn’t mean forever.

Piaget’s Cognitive Development Phase 2

Preoperational

Egocentric, everything is in relation to them

Piaget’s Cognitive Development phase 3

Concrete operations

Conservation: when they really start understanding mass and weight and how it all works in relation to one another. That’s why we cant use number pain scale till about 8.

Piaget’s Cognitive Development Phase 4

Can consider multiple variables, abstract thinking

Comprehension exceeds vocabulary

They can hear and understand but they have limited language ability or the fine motor control to control their words. They can gesture and do like hand gestures before they can control tiny motor movements with their tongue.

Toddler (13 months- 3 years) language:

Incomplete but understandable (2-3 words)

How many words should you use for talking to age 1

1 word

Language in school age (4-6):

Structurally complete sentences 5-7 years

Play enhances

everything! All of their growing! Its so important that they play.

What type of play is toddler play

Parallel play is considered toddler play. They will not interact they do their own thing. Playing the same thing but side by side.

School age or preschool age lay is

more associative play.

School age kids can do

Cooperative play that is like games that have rules.

If it can fit through a toilet paper tube,

a kid can choke on it

A diagnostic test is

diagnosing something

A developmental screening

is aware of something we are looking for something

ASQ-Ages and Stages Questionnaire

Developmental age screening, is what the child doing and working on developmentally appropriate for their age