Growth and Development Peds Exam 1

Factors influencing growth & development

socioeconomic level

parent-child relationship

family position

health/genetics

nutrition

genetics

temperament

chronological age is not equal to

developmental age

Cephalocaudal

head to lower extremities

Proximodistal

starts in the center and proceeds to the periphery

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example: movement and control of the trunk, then the arms, and later fine movements of the fingers

Differentiation

simple to complex progression of achievement of developmental milestones

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example: the child learns to crawl before learning to walk

infant

birth to 1 year

toddler

1 to 3 years

preschool

3 to 6 years

school-age

6 to 12 years

adolescence

12 to 18 years

2-3 months fine motor skills

__**grasp toys, open and close hands**__

eyes follow object

blow bubbles

2-3 months gross motor skills

__**raises head and chest when lying on stomach**__

supports upper body with arms when lying on the stomach

stretches legs out and kicks when lying on stomach or back

6-8 months fine motor skills

bangs objects on the table

can transfer objects from hand to hand

start of __**pincer grasp**__

6-8 months gross motor skills

can __**roll**__ from side to side

can sit unsupported by 7 or 8 months

__**supports whole weight on legs**__

1 year fine motor skills

__**can hold crayons**__, may mark on paper

begins to use objects correctly

1 year gross motor skills

pulls self up to stand

walks holding on to furniture

__**may walk two or three steps independently**__

2-3 years fine motor skills

learning to dress self

__**can draw a simple shape (e.g circle)**__

2-3 years gross motor skills

__**jumps, kicks ball, learning to pedal tricycle**__

4-5 years fine motor skills

dresses independently

use scissors

__**learning to tie shoes**__

brushes teeth

4-5 years gross motor skills

goes up and down stairs independently

throws a ball overhand

__**hops on one foot**__

weight for birth to 1 year

* doubles by 6 months
* triples by 1 year

height for birth to 1 year

* Increase by 1 foot by 1 year of age

teeth for birth to 1 year

* Erupt by 6 months
* has 6-8 teeth by 1 year of age

weight for toddler 1-3 years

* gains 8oz or more a month from 1-2 years
* gains 3-5 lbs a year from 2-3 year

height for toddler 1-3 years

* from 1-2 yr--grows 3-5 inches
* from 2-3 yr--grows 2-2.5 inches per year

teeth for toddler 1-3 years

* by 3 years, has 20 teeth

weight for preschool & school-age (3-12)

* gains 3-5lb a year

height for preschool & school-age (3-12)

* grows 1.5-2.5 inches a year

weight for adolescence 12-18 years

* girls: 15-55 lbs
* boys: 15-65 lbs

height for adolescence 12-18 years

* girls: 2-8 inches
* boys: 4.5-12 inches

first stage of Piaget’s five stages of cognitive development

sensorimotor stage (birth-2 years)

stage 1 of sensorimotor stage

birth to 2 months = reflexes

stage 2 of sensorimotor stage

1-4 months = primary circular reactions

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i.e sucking thumb

stage 3 of sensorimotor stage

4-8 months = secondary circular reactions

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i.e repeat actions that will trigger a response (child puts a toy rattle in the month)

stage 4 of sensorimotor stage

8-12 months = coordination of secondary schemata

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i.e to achieve the desired effect, the child will repeat the action

stage 5 of sensorimotor stage

12-18 months = tertiary circular reactions

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i.e making a sound to get the attention from the caregiver

stage 6 of sensorimotor stage

18-24 months = inventions of new means

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i.e child learns that objects and symbols represent events

characteristics of sensorimotor stage

During this stage, the child progresses from reflex activity to simple repetitive behaviors

by the end of the stage these should be mastered→

object permanence

understanding of cause and effect

second stage of Piaget’s five stages of cognitive development

pre-operational stage (2-4 years)

third stage of Piaget’s five stages of cognitive development

intuitive thought phase (4-7 years)

fourth stage of Piaget’s five stages of cognitive development

concrete operation stage (7-11 years)

five stage of Piaget’s five stages of cognitive development

formal operational stage (11 years to adulthood)

characteristics of pre-operational stage

* egocentric
* magical thinking
* increase in language development
* associates words with objects/symbols

characteristics of intuitive thought

* thinks of others
* can think of one idea at a time
* words used to express thoughts

characteristics of formal operational stage

* adaptable and flexible
* Use of rational thinking
* thinks abstractly

freud’s stage of psychosocial development for __**infancy**__

oral stage: comforted through the mouth

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i.e biting, chewing, sucking

freud’s stage of psychosocial development for __**toddler**__

anal stage: derives gratification from the control of bodily excretions

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i.e gratification from voluntarily pooping:)

freud’s stage of psychosocial development for __**preschool**__

phallic stage: becomes aware of self as a sexual being

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i.e girls may experience penis envy, and wish they had one, and boys suffer from fear of losing the penis.

oedipal complex

attachment of a boy to his mother

electra complex

attachment of a girl to her father

freud’s stage of psychosocial development for __**school age**__

latency stage: focuses on peer relationships, emphasis on privacy and understanding the body

freud’s stage of psychosocial development for __**adolescent**__

genital stage: focus on genital function and relationships

erikson’s __**infancy**__ stage of psychosocial developmental

trust vs mistrust

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“the child learns to trust as needs are met by caregiver”

erikson’s __**toddler**__ stage of psychosocial developmental

autonomy vs. shame/doubt

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“I am a big kid now”

erikson’s __**preschool**__ stage of psychosocial developmental

initiative versus guilt

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learning right from wrong

erikson’s __**school-age**__ stage of psychosocial developmental

industry vs inferiority

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rule-following behavior

erikson’s __**adolescent**__ stage of psychosocial developmental

identity vs role confusion

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preoccupied with appearance and what other think of them

kohlberg’s __**first stage**__ of moral developmental

pre-conventional level (2-7 years)

stages and characteristics of pre-conventional level

1: Obedience and punishment orientation

2: individualism and exchange

\-follow rules that are set by authority

\-adjusts behavior according to right/wrong

kohlberg’s __**second stage**__ of moral developmental

conventional level (7-12 years)

stages and characteristics of conventional level

3: Good interpersonal relationships

4: Maintaining the social order

\-seeks conformity and loyalty

\-follow rules

\-Maintain social order

kohlberg’s __**third stage**__ of moral developmental

post-conventional autonomous level (12 years and older)

stages and characteristics of post-conventional autonomous level

5: social contract and individual rights

6: universal principles

\-constructs a personal value system independent of authority figures

Neonatal period (Birth to 1 month)

head is 1/4 of body length

weight 6-8 lbs

length 48-50 cm

head circumference 33-35 cm about 1-2cm greater than chest circumference

how would you measure a neonate head circumference

measure above the eyebrows and around the largest part of the occiput

neonates play:

unoccupied play, mirrors, mobiles that turn and play music

posterior fontanel

closes by 2-3 months a

anterior fontanel

closes by 12-18 months

moro

abduction and extension of arms and legs

disappears by 4-6 months

tonic neck

neonate assumes fencing position with arms and legs extended in the direction in which the head is turned

disappears by 4-6 months

when does grasp reflex disappear?

by 3 months

when does rooting reflex disappear?

by 4 months

babinski

hyperextension and fanning toes

disappears by 1 year

what age do infants roll back to side?

4 months (at risk for falls)

what age do infants sit alone without support?

7-8 months

what age do infants crawl with abdomen on floor?

10 months

what age do infants walk well with one hand held?

12 months

2-3 month fine motor development

brings hands to midline

4-6 month fine motor development

holds bottle, grasps objects

6-8 month fine motor development

transfers hand to hand

8-10 month fine motor development

pincer grasp well developed

10-12 month fine motor development

places objects into containers

infancy nutrition:

NO SOLIDs before 6 months

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Solid #1 iron-fortified rice, cereal 4-6 mon

Solid #2 veggies and fruits 6-8 mon

After 6 months--100% fruit juice limited

\*citrus fruits, meat and eggs not until after 6 month

cooked chopped table food by 9 months

no tylenol or ibuprofen before

6 months

object permanence

the process by which infants learn that an object still exists when it is out of view (9-10 months)

seperation

infants learn to separate themselves from other objects in their environment

what is an infants first form of communication?

crying

you will hear an infant pronounce single-syllable words when?

near 12 months

stranger fear?

6-8 months--when infants have te ability to discriminate between familiar and unfamiliar people

safety precaution for infants

cribs must have mattresses down and rails up with slats no more than 2 3/8 in apart

nothing in crib!!!

car seats: rear facing

infancy play:

rattles, teething toys, nesting toys, pat-a-cake, __**solitary play**__

infancy pain:

increase BP and HR and decrease in o2 stat

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FLAC scale or IMPASS scale for pain scale

toddler (1-3 years)

anterior fontanel closed by 18 months

weight at 30 months time = 4 x birth weight

height= 3in per year

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toddlers cognitive:

memories of events can relate

domestic mimicry

can imitate seen activities t

toddlers language:

1 year: 5 words

2 year: 2-3 word sentences

3 years: combines words to simple sentences

toddles motor skills

walks alone by 15 months

18 months run clumsily

2 years walk up and down stairs, run and jump

ritualism for toddlers is used to

maintain sameness and reliability, provides sense of comfort

nutrition for toddlers:

no bottle to bed!

picky eaters

feeds self completely by 3 years

hot water heater no more than ______ for safety precautions

120 degrees

toddler play:

Parallel play--playing side by side but not with each other

imitate adults in play

blocks, thick crayons, tossing balls, finger paints