Child growth and development


 * We describe physical development (height, proportionality, maturity of the system...) and neurological development (gross motor, fine motor, cognitive development, speech).

Length/height

 * up to two years we talk about length, from two years about height
 * from 3 years to puberty, the child should grow 5-7 cm per year

Mass

 * average birth weight (PH): 3500 g (then 10% weight loss); doubling of PH – in the 4th-5th months; tripling of PH – in 1 year (approx. 10.5 kg);
 * toddlers, preschoolers and school children should have 2kg annual gain.

Proportionality of growth

 * Head/trunk ratio: newborn 1/4, adult 1/8.
 * proportion of muscle mass: 22% at 3 months, 35% at 3 years, 40% adult male
 * Power consumption:
 * infant: 40% energy for growth (110 kcal/kg per day);
 * toddler: 3% energy for growth (60-90 kcal/kg per day).

Periodization of child growth

 * The human growth pattern is referred to as„sandwich“ pattern, because between the period of rapid postnatal growth and the pubertal spurt there is a period of quiet growth (childhood; 2 to 11 years of life), unlike in other biological species.
 * ICP growth model according to Karlberg:
 * component I (infancy), infantile component of growth - from the 2nd half of intrauterine development to the 3rd to 4th year of life; mainly IGF-I is applied;
 * component C (childhood), the children's component of growth - begins before the end of the 1st year of life and lasts until the end of physical growth; dominant influence of growth hormone and persistent action of IGF-I;
 * component P (puberty), pubertal component of growth – phase of additional growth induced by puberty; it accelerates until the age of the highest growth rate, it slows down until the end of growth; influence of sex hormones.
 * Humans grow relatively slowly (compared to other mammals) – in most mammals, a period of rapid postnatal growth is followed by a pubertal spurt and sexual maturity. In addition, a person has a period of quiet growth between these periods - childhood (specificity of a person).

Brain development

 * Replication of neuronsis completed before birth, but their organization continues long after birth.
 * White brain matter and synapses increase.
 * Gray matter develops relatively late – it grows from the 30th week of gestation and ends in the 1st year, therefore it is relatively sensitive to damage in late gestation and perinatally.
 * Myelination begins in the 4th month of gestation in the spinal cord, in the last trimester and in the brain;
 * at birth, myelination of autonomic nerves, cranial nerves (except optic and olfactory) is complete
 * the cortex and connections to the thalamus and BG are incompletely myelinated (here, myelination ends within 2 years).

Speech development

 * the first stage is nonverbal
 * from 2 months, communication begins to be vocalized – mutual vocal play;
 * 6-10 months - the child begins to better control the oral muscles, begins to babble and repeat syllables without a specific meaning;
 * at 12 months begins to have a need to use specific words to refer to objects and activities;
 * at 18 months can speak about 20-50 words;
 * attention – speech development can be delayed by frequent otitis media with conductive hearing impairment;
 * understanding develops faster than expressive ability;
 * the child understands the first words already at 9 months;
 * can understand 20-100 words at 13 months;
 * at the end of the 2nd year, the child begins to put words into sentences.

Assessment of body growth

 * The basic tool for assessment is the percentile chart of body height;
 * the basis for compiling percentile graphs is national reference studies;
 * we thus evaluate the degree of difference from the norm;
 * 94% of the population lies between the 3rd and 97th percentiles;
 * medium height – between 25-75 percentile (50% of the population);
 * great height – above 75th percentile;
 * very high height – over 97th percentile..
 * The assessment includesan assessment of the child's genetic growth potential ; dítěte;
 * we draw on the right edge of the percentile graph;
 * for boys – the body height of the father (point O), the body height of the mother increased by 13 cm (point M);
 * for girls – mother's body height (point M), father's height minus 13 cm (point O);
 * the middle between these values ​​is the average expected adult height, with a range of 8.5 cm;
 * With repeated measurements, we can calculate the growth rate in cm/year;
 * it changes depending on age and gender - we evaluate it from the percentile chart.
 * children from the age of two are correctly measure with a stadiometrattached to the wall - on the stadiometer scale there is a moving head that touches the vertex of the head (or have a giraffe there);
 * children under two years old are measured using the so-called body meter („trough“) – we determine length.

Development of teeth

 * Milk teeth
 * eeruption – on the mandible 5–7 month, on the maxilla 6–8 Moon;
 * exfoliation – mandible 6.–7. year, maxilla 7–8 year;
 * eruption of all milk teeth should be within 3 years of life;
 * we indicate a dental examination when not a single tooth has erupted within 13 months.
 * Permenant dentition
 * lower incisor – 6.–7. year (mandibula), 7.–8. year (maxilla);
 * second molar – 12.–13. year (mandibula).

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