Growth and Development Flashcards
Infancy-Birth to 12 months-weight gain per week
5-7 ounces
Infancy-Double birth weight by age
6 months
Infancy-Triple birth weight by age
1 year
Infancy-Height increases by 1 inch per month for:
6 months
Infancy-Growth–Birth to 12 months
“spurts” rather than gradual pattern
Infancy-Posterior fontanel
fuses by 6-8 weeks
Infancy-Anterior fontanel closes
12-18 months
Infancy-Systems maturing -Respiratory
rate slows, and becomes more regular
Infancy-Systems maturing-Immunologic system-
immature
Infancy-Systems maturing-Cardiovascular
HR slows
Infancy-Systems maturing- Hemopoietic changes-
fetal hgb decrease, maternal iron stores until 5 months
Infancy-Systems maturing-Digestive processes-
immature
Infancy-Systems maturing-Thermoregulation
becomes more efficient
Infancy-Systems maturing-Sensory
binocularity occurs by 6 months.
Infancy-Four Areas of Development
Fine Motor
Gross Motor
Language
Social
Infancy-Fine Motor Development -Grasping object
age 2-3 months – hold a rattle but will not reach for it-4 months will grasp objects voluntarily
Infancy-Fine Motor Development-Transfer object between hands
age 7 months
Infancy-Fine Motor Development-Pincer grasp age
9 months
Infancy-Fine Motor Development-Remove objects from container
age 11 months
Infancy-Fine Motor Development-Build tower of two blocks
age 12 months
Infancy-Gross Motor Development-Head Control
has almost no head lag when pulled to sitting position
Infancy-Gross Motor Development-Rolling
4 months – Rolls from back to side
6 months – Rolls from back to abdomen, abdomen to back
Infancy-Gross Motor Development-sitting
4 months – balances head well in sitting position
6 months – Will sit in high chair with straight back
7 months – Leans on hands
8 months – Sits steadily unsupported
Infancy-Gross Motor Development-Locomotion-Moves from prone to sitting position
10 months
Infancy-Gross Motor Development-Locomotion-Crawling
6 -7 months
Infancy-Gross Motor Development-Locomotion-Creeping on hands and knees
9 months
Infancy-Gross Motor Development-Locomotion-Pull to standing and holds on to furniture
9 months
Infancy-Gross Motor Development-Locomotion-Cruising/Walking with assistance
11 months
Infancy-Gross Motor Development-Locomotion-Walks alone
12 months
Infancy-Social Development-
Infancy-Social Development-Attachment!
Babies become very attached to their primary caregiver – anyone who is meeting their daily needs
Infancy-Social Development-Social smile
2 months
Infancy-Social Development-Enjoys interaction, begins to show memory
4 months
Infancy-Social Development-Stranger Anxiety
6 months
Infancy-Social Development-Separation Anxiety
8- 9 months
Infancy-Social Development-understands “NO”
9 months
Infancy-Social Development-Object permanence
begins at 6 months, well established by 10 months
Infancy-Language Development-Crying is first verbal communication
relays needs and messages to caretakers
Infancy-Language Development-relays needs and messages to caretakers
2 months
Infancy-Language Development-Makes consonant sounds, LAUGHS
4 months
Infancy-Language Development-Imitates sounds, Babbling resembles one syllable utterances
6 months
Infancy-Language Development-understands social language – talks when others are talking
7 months
Infancy-Language Development-May say one word
10 months
Language Development-3-5 words with meaning
12 months-
Infancy-Teething-Begins
Begins around 4 months and continues until 2 year old molars erupt between the ages of 18 mo and 3 yo.
Infancy-Teething-First sign of teething around 4 months
drooling
Infancy-Teething-Pain
inflammation;
Pulling at ears
Infancy-Teething-eruptions may begin with two lower central incisors
6 months
Infancy-Nutrition during infancy-Nutrition
breast milk is first choice for first 6 months of life
Infancy-Nutrition during infancy-Formula
needs accurate dilution
Infancy-Nutrition during infancy-Introduction of solid foods
4-6 months
Infancy-Nutrition during infancy-Introduce foods at intervals
4-7 days to allow for identification of food allergies – old recommendation;
May vary depending on situation – new recommendations
Weaning from breast or bottle
Infancy-Nutrition during infancy-Whole milk
after 12 months – AAP recommendations until 2yo, then low fat milk
Infancy-Walking – Infant shoes
Inexpensive, well-constructed athletic shoes or soft leather moccasin-type shoes
Hard inflexible shoes (high tops, etc.) may delay walking
Barefoot is best!
Infant-Immunizations
Recommendations provided by:
Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control (CDC)
Infancy-To report any adverse reactions after administration of any vaccine
“VAERS” Vaccine Adverse Event Reporting System
Infancy-Information statements that must be given to parents before administration of given vaccines
Vaccine Information Statements (VIS)
Provide updated information for parent/guardian of child being vaccinated
Infancy-Injury Prevention -Infant
Latex balloons
Crib bedding
Stuffed animals
Plastic bags
Cords (drapery and window blinds)
traditional definition of growth
limited to PHYSICAL maturation
A more appropriate definition includes FUNCTIONAL maturation
An increase in number and size of cells as they divide and synthesize new proteins
Results in increased size and weight of the whole or any of its parts
Growth
Percentile of growth is a statistical representation of 100 children and placement within the 100 members of comparison group
Percentiles of growth
A gradual change and expansion
Advancement from a lower to a more advanced stage of complexity
Increased capacity through growth, maturation, and learning
Development
“head to tail”
Cephalocaudal
“center to periphery”
Proximodistal
Periods of Growth-Infancy
Most rapid
Periods of Growth-Preschool to puberty
Rate of growth slows
Periods of Growth-Puberty
Postpuberty
Decline in rate of growth
Until death
Factors Influencing Growth
Heredity
Nutrition
Gender
Disease
Environment:
Hazards
Socioeconomic influences
Season, climate, and oxygen concentration
Physical growth potential—height, weight, body shape, features
HEREDITY
NUTRITION
Largest single influence on growth
positively correlates with diminished height, weight, and IQ in later life
Severe malnutrition during critical periods of development (e.g., 0-6 months)
Influences are different; different growth charts; onset of puberty; full adult size attained earlier in girls
GENDER
Skeletal disorders—dwarfism, chromosome anomalies, disorders of metabolism and poor absorption of nutrients
Chronic disease leading to chronic (even subacute) hypoxia—small, short stature, poor growth patterns
Examples: Cystic fibrosis, respiratory diseases, cardiac lesions
DISEASE
Carcinogens (e.g., Love Canal, Chernobyl), chemicals, radiation
Unsafe environment»_space; Injuries
Passive inhalation of tobacco smoke
Polluted water, air, food
ENVIRONMENTAL
Higher socioeconomic status (SES) = healthier overall
Availability of good nutrition, especially protein sources
Hazardous environments (e.g., unsafe neighborhoods)
Education—difficult to quantify but affects outcome at some level
SOCIOECONOMIC INFLUENCES:
Children appear to grow in HEIGHT faster in spring and summer; gain weight in fall and winter
Hormonal? Or activity related?
Sunny climate—ultraviolet damage to skin and eyes
Chronic hypoxia—also children in high altitudes generally smaller than those at lower altitudes
SEASON, CLIMATE, OXYGEN:
Heredity and environment
Gender differences vs. cultural expectations
Disease
Prenatal influences
Socioeconomic status
Interpersonal relationships
Stress
Television and mass media
Factors Influencing Development
Heredity and environment BOTH affect
development,
Aggressive play in boys; verbal aggression in girls—even at VERY young ages and in solo play
Imitation and modeling vs. inherent developmental-behavioral differences
For preschoolers playing with dolls, nurturing no different among genders; at ages 6-10 girls become more nurturing
Gender behaviors in children
Disease effect on development
regressive behavior
chronic inner stress
Prolonged state of disequilibrium
Passive smoke, alcohol exposure, other substances such as RXs, illicit drugs, and poor maternal nutrition»_space; poor pregnancy weight gain»_space; IUGR
Prematurity as major influence on neonatal and infant development
PRENATAL INFLUENCES
Influences on development may be perceived as “judgmental” but are historically evident
When children with same disease or disorder are compared, higher SES will have higher developmental outcome
SES
Parents, siblings, extended family members
Need for love and affection—SAFETY and security needs
Discipline and authority
Dependence-independence
Emotional deprivation
INTERPERSONAL RELATIONSHIPS
Stress of hospitalization
Fears of childhood
STRESS in childhood
Identification with behaviors and/or characters indicative of immaturity and possibly mimicking behaviors
Repeated exposure in media»_space; alters view of “normal” behavior and human interaction
TV and Internet»_space; physical inactivity»_space; childhood obesity, childhood depression
TV and mass media
Developmental Theorists-psychosexual
Freud
Developmental Theorists-psychosocial
Erikson
Developmental Theorists-cognitive development
Piaget
the unconscious mind—“pleasure and gratification”
Id
conscious mind—“the reality principle”
Ego
conscience or moral arbitrator—“the ideal”
Superego
Erikson-Trust vs. mistrust
birth–1 year
Erikson-Autonomy vs. shame and doubt
1–3 years
Erikson-Initiative vs. guilt
3–6 years
Erikson-Industry vs. inferiority
6–12 years
Erikson-Identity vs. role confusion
12–18 years
Intuitive
Concrete operational
Formal operational
Piaget’s Stages of Cognitive Development
Piaget-Sensorimotor
birth–2 years
Piaget-Preoperational
2–7 years
Piaget-Concrete operations
7–11 years
Piaget-Formal operations
11–15 years
Body image
Self-esteem
Development of Self-Concept
Denver II is most widely used as
Developmental Screening tool
Purpose: quickly and reliably identify at-risk children for further investigation
“The TERRIBLE Two’s”
Age 12-36 months
Intense period of exploration
Temper tantrums/obstinacy occur frequently/rapid mood swings
Health Promotion of the Toddler and Family-Respiratory
Lymphoid tissue of the tonsils, and adenoids continue to be large
Health Promotion of the Toddler and Family-Ear infections
Internal structures of Eustachian tube are short and straight
Health Promotion of the Toddler and Family-Biologic Development-Weight
Weight gain slows to 4-6 lbs/year
Health Promotion of the Toddler and Family-Biologic Development-Birth weight should be quadrupled
by 2½
Health Promotion of the Toddler and Family-Biologic Development-Height
3” per year
Health Promotion of the Toddler and Family-Biologic Development-Growth
is “step like” rather than “linear”
Health Promotion of the Toddler and Family-Sensory Changes-Visual acuity
20/40 acceptable
Health Promotion of the Toddler and Family-Hearing, smell, taste, and touch
increase in development
Health Promotion of the Toddler and Family-All senses are used to:
explore environment
Health Promotion of the Toddler and Family-Maturation of Systems
Most physiologic systems relatively mature by the end of toddlerhood
Health Promotion of the Toddler and Family-Maturation of Systems-Upper respiratory infections, otitis media, and tonsillitis
are common among toddlers
Health Promotion of the Toddler and Family-
Health Promotion of the Toddler and Family-Voluntary control of elimination
Sphincter control—age 18-24 months
Health Promotion of the Toddler and Family-Gross and Fine Motor Development-Improved coordination
between age 2-3
Health Promotion of the Toddler and Family-Fine motor development-dexterity
Improved manual dexterity age— 12-15 months
Health Promotion of the Toddler and Family-Throw a ball
by age 18 months
Health Promotion of the Toddler and Family-Psychosocial Development-Erikson:
“Autonomy” vs. “shame and doubt”
“Negativism”
Health Promotion of the Toddler and Family-Freud
Id, ego, superego/conscience
Health Promotion of the Toddler and Family-“Ritualization”
provides sense of comfort
Health Promotion of the Toddler and Family-Invention of New Means Through Mental Combinations
Imitation of behaviors
Domestic mimicry
Concept of time still embryonic
Health Promotion of the Toddler and Family-Development of Body Image-Refer to body parts
by name
Health Promotion of the Toddler and Family-Development of Body Image-avoid in toddlers negative labels about:
about physical appearance
Health Promotion of the Toddler and Family-Recognize sexual differences by:
age 2
Health Promotion of the Toddler and Family-Language-Increasing level of
comprehension
Health Promotion of the Toddler and Family-Language-Increasing ability
to understand
Health Promotion of the Toddler and Family-Personal Social Behavior-Toddlers develop skills of:
independence
Health Promotion of the Toddler and Family-Skills for independence may result in:
tyrannical, strong-willed, volatile behaviors
Health Promotion of the Toddler and Family-Skills include :
feeding, playing, dressing, and undressing self
Health Promotion of the Toddler and Family-Coping with Concerns Related to Normal Growth and Development:
Toilet training
Sibling rivalry
Temper tantrums
Negativism
Regressive behavior
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Voluntary sphincter control:
age 2 years
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: to stay dry for
2 hrs
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Willingness to please parents
motivates child to toilet train
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Curiosity
about adults’ or sibling’s toilet habits
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Impatient
with wet or soiled diapers
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Bowel control is usually accomplished
before bladder control
Health Promotion of the Toddler and Family-Assessing Readiness for Toilet Training: Nighttime bladder control may take
months to years after daytime control
Health Promotion of the Toddler and Family-Temper tantrums
Objecting to discipline-lying on floor, kicking feet, screaming
Health Promotion of the Toddler and Family-Temper tantrums- what to do?
Ignore the behavior while assuring the child remains safe
Health Promotion of the Toddler and Family-“NO responses
Reduce the opportunity for NO answers
Give choice answers is known as?–
Negativism
Health Promotion of the Toddler and Family-Retreat from one’s present pattern of functioning
Often brought on by stress
Best approach is to ignore the behavior while praising existing patterns of appropriate behavior
Regressive behavior
Health Promotion of the Toddler and Family-Promoting Optimum Health During Toddlerhood-Nutrition-phenomenon of: “physiologic anorexia”, or “toddler eating slump”
Nutrition
Health Promotion of the Toddler and Family-Nutrition-“physiologic anorexia”, or “toddler eating slump”
Allow for nutritious snacks and meals
Health Promotion of the Toddler and Family-Sleep
activity-total sleep decreases
Health Promotion of the Toddler and Family-Dental health
Regular dental exams (> 6 months)
Removal of plaque (parents to brush at this age)
Fluoride
Low-cariogenic diet
Health Promotion of the Toddler and Family-Leading cause of death
Unintentional Injuries
Health Promotion of the Toddler and Family-Injury Prevention
Motor vehicle injuries: car seat safety
Drowning
Burns
Poisoning
Aspiration and suffocation-foreign body aspiration most common during the second year of life
Bodily damage-accidents
Health Promotion of the Preschooler and Family-age period
age 3-5 years
Health Promotion of the Preschooler and Family-Preparation for most significant lifestyle change
going to school
Experience brief and prolonged separation
Health Promotion of the Preschooler and Family-attention span and memory
Increased
Health Promotion of the Preschooler and Family-Biologic Development-Physical growth
slows and stabilizes
Health Promotion of the Preschooler and Family-Average weight gain remains about
5 lbs/year
Health Promotion of the Preschooler and Family-Average height increases
2½” to 3”/year
Health Promotion of the Preschooler and Family-Body systems
mature and stabilize; can adjust to moderate stress and change
Health Promotion of the Preschooler and Family-Gross and Fine Motor Behavior
walking, running, climbing, and jumping well established
Health Promotion of the Preschooler and Family-Freud
Development of superego (conscience)
Learning right from wrong/moral development
Health Promotion of the Preschooler and Family-Refinement in eye-hand and muscle coordination
Drawing, art work, skillful manipulation
Health Promotion of the Preschooler and Family-Guilt
Feelings of guilt, anxiety, and fear may result from thoughts that differ from expected behavior
Health Promotion of the Preschooler and Family-Psychosocial Development: Erikson
developing sense of initiative
Health Promotion of the Preschooler and Family-Chief psychosocial task of preschool period
developing sense of initiative
Health Promotion of the Preschooler and Family-Cognitive Development
Readiness for school
Readiness for scholastic learning
Typically age 5-6 years
Health Promotion of the Preschooler and Family- Time orientation-is not completely_______
Incompletely understood
I went to the store last year could mean yesterday
When talking to children of this age, try to place event with a daily occurrence
For example: if a child needs to take his medicine at 2pm, the nurse may say…”you will take your medicine after lunch.”
Health Promotion of the Preschooler and Family-Cognitive Development (cont’d)
Language continues to develop
Concept of causality beginning to develop
Concept of time incompletely understood
Utilize “magical thinking” frequently
Health Promotion of the Preschooler and Family-Development of Body Image- increasing comprehension of
“desirable” appearances
Health Promotion of the Preschooler and Family-Development of Body Image-increased awareness of:
Aware of racial identity, differences in appearances, and biases
Health Promotion of the Preschooler and Family-Social Development-Individuation
separation process is completed
Health Promotion of the Preschooler and Family- Still need
parental security and guidance
Security from familiar objects
Health Promotion of the Preschooler and Family-Overcome
Overcome stranger anxiety and fear of separation from parents
Health Promotion of the Preschooler and Family-
Health Promotion of the Preschooler and Family-Play therapy
beneficial for working through fears, anxieties, and fantasies
Health Promotion of the Preschooler and Family-Vocabulary increases dramatically between
age 2-5
Health Promotion of the Preschooler and Family-Language
Major mode of communication and social interaction
Health Promotion of the Preschooler and Family-Complexity of language use increases between age
2-5
Health Promotion of the Preschooler and Family-Personal-Social Behavior-
Self-dressing
Willing to please
Have internalized values and standards of family and culture
May begin to challenge parental values
Health Promotion of the Preschooler and Family-Sex Education
Find out what children know and think
Be honest
Avoid “over-answering” the question
Health Promotion of the Preschooler and Family-Fears
Dark
Being left alone
Animals (snakes, large dogs, etc.)
Ghosts
Objects or persons associated with pain
Technique of desensitization to overcome fears
Night lights helpful
Health Promotion of the Preschooler and Family- Sexual exploration/sexual curiosity
curiosity-do not become overly concerned. Do not punish or condone
Health Promotion of the Preschooler and Family-Stress-Minimum amounts of stress
can be beneficial to help develop coping skills
Health Promotion of the Preschooler and Family- Parental awareness
of signs of stress in child’s life
Health Promotion of the Preschooler and Family-Prevention of
extreme stress
Health Promotion of the Preschooler and Family-Schedule
adequate rest
Health Promotion of the Preschooler and Family-Aggression
gender, frustration, modeling, and reinforcement
Health Promotion of the Preschooler and Family- Speech Problems
Stuttering-normal
Stammering-normal
Dyslalia: articulation problems
Health Promotion of the Preschooler and Family-Nutrition-Caloric requirements approximately
90 kcal/kg
Health Promotion of the Preschooler and Family-Fluid requirements approximately
100 mL/kg depending on activity and climate
Health Promotion of the Preschooler and Family-Food fads
strong tastes common
Health Promotion of the Preschooler and Family-sleep
12 hrs sleep per night, infrequently naps
Health Promotion of the Preschooler and Family-Free play
encouraged
Health Promotion of the Preschooler and Family-Free play-Emphasis on
fun and safety
Health Promotion of the Preschooler and Family-Sleep Problems
Thorough assessment of sleep problems
Nightmares-can remember dream
Health Promotion of the Preschooler and Family-Sleep terrors
Not fully awake
Don’t remember event
Excessive crying and difficulty to console during the event
Health Promotion of the Preschooler and Family-consistent bedtime routine
Encourage
Health Promotion of the Preschooler and Family-Dental Health-Eruption
of deciduous teeth is complete
Health Promotion of the Preschooler and Family-Dental Health
Professional care and prophylaxis
Health Promotion of the Preschooler and Family-Dental Health
Fluoride supplements
Health Promotion of the Preschooler and Family-Injury Prevention
Safety education
Development of long-term safety behaviors
Bike helmets
Health Promotion of the Preschooler and Family
Childcare focus shifts from protection to education
Children begin questioning previous teachings of parents
Children begin to prefer companionship of peers
Health Promotion of the School-Age Child and Family-Biologic Development-Height increases by
2 inches per year
Health Promotion of the School-Age Child and Family-Weight increases
by 2 to 3 kilograms per year
Health Promotion of the School-Age Child and Family-Promoting Optimum-growth and Development-School age is
generally defined as age 6 to 12 years
Gradual growth and development
Progress with physical and emotional maturity
Males and females differ little in size
Health Promotion of the School-Age Child and Family-Maturation of Systems-Bladder
capacity increases
Health Promotion of the School-Age Child and Family-Maturation of Systems-Heart
smaller in relation to the rest of the body
Health Promotion of the School-Age Child and Family-Maturation of Systems-Immune system
is increasingly effective
Health Promotion of the School-Age Child and Family-Maturation of Systems-Bones
increase in ossification
Health Promotion of the School-Age Child and Family
Health Promotion of the School-Age Child and Family-Maturation of Systems-Physical maturity
Physical maturity is not necessarily correlated with emotional and social maturity
Health Promotion of the School-Age Child and Family-Prepubescence
Defined as the 2 years preceding puberty
Typically occurs during preadolescence
Health Promotion of the School-Age Child and Family-Prepubescence
Varying ages from 9 to 12 years (in girls, it occurs about 2 years earlier than in boys)
Health Promotion of the School-Age Child and Family-AVG age puberty
Average age of puberty is 12 years in girls and 14 years in boys
Health Promotion of the School-Age Child and Family
Health Promotion of the School-Age Child and Family-Psychosocial Development
Relationships center around same-sex peers
Health Promotion of the School-Age Child and Family-Freud-
Freud described it as the latency period of psychosexual development
Health Promotion of the School-Age Child and Family-Erikson: Developing a Sense of Industry
Eager to develop skills and participate in meaningful and socially useful work
Acquires a sense of personal and interpersonal competence
Growing sense of independence
Peer approval is a strong motivator
Health Promotion of the School-Age Child and Family-Piaget: Cognitive Development
Concrete operations
Use thought processes to experience events and actions
Develop an understanding of relationships between things and ideas
Able to make judgments based on reason (conceptual thinking)
Health Promotion of the School-Age Child and Family-Social Development
Importance of the peer group
Identification with peers is a strong influence in a child gaining independence from parents
Sex roles are strongly influenced by peer relationships
Health Promotion of the School-Age Child and Family-Relationships with Families-primary influence in shaping a child’s personality, behavior, and value system
Parents are the
Health Promotion of the School-Age Child and Family-Increasing independence
from parents is the primary goal of middle childhood
Health Promotion of the School-Age Child and Family-Children are not ready
to abandon parental control
Health Promotion of the School-Age Child and Family-Play -involves
Involves physical skill, intellectual ability, and fantasy
Health Promotion of the School-Age Child and Family-at this age they form
groups, cliques, clubs, secret societies
Rules and rituals
See the need for rules in games they play
Health Promotion of the School-Age Child and Family-types of play
Team play
Quiet games and activities
Ego mastery
Health Promotion of the School-Age Child and Family-Sex Education
Sex play as part of normal curiosity during preadolescence
Health Promotion of the School-Age Child and Family-Middle childhood is the ideal time for
formal sex education
Life span approach
Information on sexual maturity and the process of reproduction
Effective communication with parents
Health Promotion of the School-Age Child and Family-Developing a Self-Concept-definition
Definition: A conscious awareness of a variety of self-perceptions (e.g., abilities, values, appearances)
Importance of significant adults in shaping a child’s self-concept
Health Promotion of the School-Age Child and Family-Positive self-concept leads
to feelings of self-respect, self-confidence, and happiness
Health Promotion of the School-Age Child and Family-Developing a Body Image-Generally, children
like their physical selves less as they grow older
Body image is influenced by significant others
Increased awareness of “differences” may influence feelings of inferiority
Health Promotion of the School-Age Child and Family-Promoting Optimum Health During the School Years-Nutrition-Importance of
balanced diet to promote growth
Quality of the diet related to the family’s pattern of eating
Quality of dietary choices in the school cafeteria
“Fast food” concerns
Health Promotion of the School-Age Child and Family-Sleep and Rest-avg amount of sleep
sleep a night is 9½ hours in school-age children, but this is highly individualized
Health Promotion of the School-Age Child and Family-Sleep- they may
resist going to bed at age 8 to 11 years
Children of 12 years and older are generally less resistant to bedtimes
Health Promotion of the School-Age Child and Family-Exercise and Activity-Sports concerns
Sports
Controversy regarding early participation in competitive sports
Concerns with physical and emotional maturity in competitive environment
Health Promotion of the School-Age Child and Family-Activity-
Acquisition of skills
Generally like competition
Health Promotion of the School-Age Child and Family-Dental Health
Stage begins with the shedding of the first deciduous teeth
Eruption of permanent teeth
Good dental hygiene
Prevention of dental caries
Malocclusion
Dental injury
Dental avulsion (replacement or reattachment)
Health Promotion of the School-Age Child and Family-Injury Prevention-most common cause of severe injury and death
motor vehicle crashes, pedestrian and passenger
Bicycle injuries; benefits of bike helmets
Appropriate safety equipment for all sports
Health Promotion of the Adolescent and Family-Promoting Optimum Growth and Development-transition between
between childhood and adulthood
Health Promotion of the Adolescent and Family-physical, cognitive, social, and emotional maturation is
Rapid
Health Promotion of the Adolescent and Family-Generally defined as beginning with the
puberty and ending with the cessation of body growth at 18 to 20 years
Health Promotion of the Adolescent and Family-Prepubescence:
About 2 years before puberty, heralding physical changes
Health Promotion of the Adolescent and Family-Puberty
Sexual maturity is achieved
Health Promotion of the Adolescent and Family-Postpubescence:
1 to 2 years after puberty; skeletal growth is complete and reproductive functions become established
Health Promotion of the Adolescent and Family-Adolescence:
Time of growing into psychological, social, and physical maturation
Health Promotion of the Adolescent and Family-Biologic Development-Primary sex characteristics
External and internal organs necessary for reproduction
Health Promotion of the Adolescent and Family-Neuroendocrine Events of Puberty-role of
Role of anterior pituitary and hypothalamus
Health Promotion of the Adolescent and Family-Secondary sex characteristics
Result of hormonal changes: Voice change, hair growth, breast enlargement, fat deposits
Play no direct role in reproduction
Health Promotion of the Adolescent and Family-
Health Promotion of the Adolescent and Family-
Health Promotion of the Adolescent and Family-Neuroendocrine Events of Puberty-hormones
stimulate gonads
Health Promotion of the Adolescent and Family-Gonads produce and release
gametes
Health Promotion of the Adolescent and Family-Gonads secrete
appropriate hormones
Health Promotion of the Adolescent and Family- Sex Hormones-secreted by
by ovaries, testes, and adrenal glands
Health Promotion of the Adolescent and Family-
Produced in varying amounts by both sexes throughout the life span
Health Promotion of the Adolescent and Family-Maturation of gonads produces
biologic changes of puberty
Health Promotion of the Adolescent and Family-
Health Promotion of the Adolescent and Family-Estrogen
In females, levels increase until about 3 years after menarche; estrogen then remains at this maximum level throughout reproductive life
Health Promotion of the Adolescent and Family-Adrenal cortex causes
secretion before puberty
Health Promotion of the Adolescent and Family-“Feminizing hormone”
Estrogen
Low production during childhood
In males, there is gradual production throughout maturation
Health Promotion of the Adolescent and Family-“Masculinizing hormones”
androgens
Secreted in small and gradually increasing amounts up to 7 to 9 years; then rapid increase in both sexes until 15 years
Responsible for rapid growth of the early teenager
Health Promotion of the Adolescent and Family- Testes secrete
Testes secrete testosterone; levels increase to a maximum level at maturity
Boys have a more rapid increase of androgen until about age 15 years.
Health Promotion of the Adolescent and Family-Adrenarche
(8 to 13 years): Pubic hair growth
Health Promotion of the Adolescent and Family-
Health Promotion of the Adolescent and Family-Sexual Maturation for Females-Thelarche
Thelarche (8 to 13 years): Breast buds
Health Promotion of the Adolescent and Family-Sexual Maturation-Tanner stages
Tanner stages of sexual maturity
Stages of development of secondary sex characteristics and genital development
Defined as a guide for estimating sexual maturity
Health Promotion of the Adolescent and Family-Menarche:
About 2 years after thelarche, menstruation begins
Health Promotion of the Adolescent and Family-Puberty “delay”:
No thelarche by age 13 years
Health Promotion of the Adolescent and Family-Sexual Maturation for Males-stage 1
(9½ to 14 years): Testicular enlargement and sparse pubic hair
Health Promotion of the Adolescent and Family-Physical Growth-Adolescent growth spurt
Dramatic increase in growth accompanies sexual maturation
Adolescent growth spurt
20% to 25% of total height is achieved during puberty
Usually occurs within a 24- to 36-month period
Characteristic sequence of changes
Health Promotion of the Adolescent and Family-Stage 3
Penile enlargement, voice changes, early facial hair; gynecomastia (temporary breast enlargement) occurs in 1/3 of males in midpuberty
Health Promotion of the Adolescent and Family-Stage 5:
Penile growth, first ejaculation, axillary, groin, and facial hair, final voice change
Health Promotion of the Adolescent and Family-Sex Differences in General Growth Patterns
Appear to be the result of hormonal effects during puberty
Skeletal growth
Voice changes
Lean body mass
Non–lean body mass
Skin, glands, and hair
Health Promotion of the Adolescent and Family-Physiologic Changes
Health Promotion of the Adolescent and Family-
Size and strength of heart, blood volume, and systolic blood pressure increase
Pulse rate and basal heat production decrease
Adult values for all formed elements of blood
Respiratory volume and vital capacity increase
Increased performance capabilities
Health Promotion of the Adolescent and Family-Psychosocial Development-Erikson
Sense of identity
Early adolescent: Group identity versus alienation
Development of personal identity versus role diffusion
Sex role identity
Emotionality
Health Promotion of the Adolescent and Family-Piaget: Cognitive Development
Formal operations period
Abstract thinking
Think beyond present
Mental manipulation of multiple variables
Concerned about others’ thoughts and needs
Health Promotion of the Adolescent and Family-Social Development-goal is to
Goal is to define one’s identity independently from parental authority
Much ambivalence
Intense sociability; intense loneliness
Acceptance by peers
Health Promotion of the Adolescent and Family- Relationships with Parents
Roles change from “protection–dependency” to “mutual affection and equality”
Process involves turmoil and ambiguity
Struggle of privileges and responsibility
Emancipation from parents may begin with the rejection of parents by the teenager
Health Promotion of the Adolescent and Family-Relationships with Peers
Peers assume an increasingly significant role in adolescence (“best friend”)
Peers provide a sense of belonging and a feeling of strength and power
Peers form a transitional world between dependence and autonomy
Role of social media and advanced technology
Health Promotion of the Adolescent and Family-Adolescent Sexuality
Dating
Sexual orientation
Sexual experimentation (wide range)
Reasons for sexual experimentation
Curiosity
Pleasure
Conquest
Peer pressure to conform
Health Promotion of the Adolescent and Family-Development of Self-Concept and Body Image
Feelings of confusion in early adolescence
Acute awareness of appearance, comparison of appearance with others
Blemishes and defects are magnified out of proportion
Matures to self-concept based on uniqueness and individuality
Health Promotion of the Adolescent and Family-Responses to Puberty
Responses differ depending on the stage of development
Curiosity in early adolescence
Concerns with “Am I normal?”
Concerns for late-maturing teens
Concept of “perfect body” achievement
Health Promotion of the Adolescent and Family-Promoting Optimum Health During Adolescence
Assumption of responsibility for health
Assess for risk factors (GAPS)
Immunizations
Nutrition
Eating habits and behaviors
Healthy lifestyle habits
Health Promotion of the Adolescent and Family-Promoting Optimum Health During Adolescence
Sleep and rest
Exercise and activity
Dental health
Personal care
Vision, hearing
Posture
Body art (piercing and tattooing)
Suntanning, ultraviolet damage
Health Promotion of the Adolescent and Family-Promoting Optimum Health During Adolescence
Stress reduction
Sexuality education and guidance
Media influences
Knowledge from peers, TV, movies, magazines
Need factual information, presentation based on developmental maturity and ability to ask questions
Role modeling
Health Promotion of the Adolescent and Family-Injury Prevention
Motor vehicle crashes are the single greatest cause of serious and fatal injuries in teens
Other vehicles
Firearms and other weapons
Sports injuries
Water safety
Poisoning, tobacco, alcohol, and other drugs