Growth and developmentinfant – Toddler – preschooler – school-age – adolescent Flashcards
Exam 1
Growth
Increase in physical size
How is growth plotted on a graph?
Plotted on standardized growth charts to assess adequate growth for age and gender
How are children typically seen on growth charts?
Children typically remain in same percentiles over time. Major deviations warrant investigation
What kinds of growth charts exist?
Specialized growth charts for children with specific diagnoses (i.e. Downs Syndrome) and breastfeeding infants
Development
Sequential process by which infants and children gain various skills and functions
What is used to assess development?
Utilize screening tools to assess (i.e. Denver II, Ages and Stages, etc.)
Maturation
Increase in functionality of various body systems or developmental skills
When are the two greatest growth changes in pediatrics?
Adolescence and first year of life are two greatest growth changes in pediatrics.
For newborn and infants, how do you measure physical growth?
Weight
Height
Head circumference
Average weight of a newborn
Average is 7.5lbs
How does weight of newborn change in 4-6 months?
Doubles by 4-6 months
How does weight of newborn change in 1 year?
Triples by 1 year
Average height of newborn baby?
20 inches
By 1 year, how much does the average length increase?
By 1 year, length increases by 50%
What is the average head circumference of a newborn?
Average is 14 inches
How much does head circumference grow in a year?
4 inch gain by 1 year
List of reflexes of a newborn (hint: there are 9)
- Moro,
- Root,
- Suck,
- Asymmetric Tonic Neck,
- Plantar Grasp
- Palmar Grasp,
- Step,
- Babinski.
- Grasp
What happens to baby reflexes?
Diminish over first few months (except Babinski which takes 1 year)
What does newborn reflexes give way to?
Gives way to protective reflexes (righting and parachute reactions)
During the first few months of life, reflexive behavior is replaced by what?
Purposeful action
Respiratory rate of newborns
30 -60 in newborn
How much is respiratory rate of a 12 month old?
20-30 breaths
Why is respiratory rate higher in infants than adults?
Babies have high metabolic demand so respiratory rate is faster
When does respiratory system reach full maturity?
Respiratory system do not reach full maturity until about 7 years old
How does nasal passages of newborns compare to adults?
Nasal passages are narrower
How does trachea and chest wall of newborns compare to adults?
Trachea and chest wall are more compliant
How does bronchi and bronchioles of newborns compare to adults?
Bronchi and bronchioles are shorter and narrower
How does alveoli of newborns compare to adults?
Significantly fewer alveoli
What happens to the heart size in the first year of life?
Heart doubles in size in the first year
What happens to the average pulse rate of a newborn? and 1 year old?
Average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1 year old
What happens to blood pressure of newborn?
Blood pressure steadily increases, from an average of 60/40 in the newborn to 100/50 in the 12 month old
How are the peripheral capillaries in newborns?
Peripheral capillaries are closer to the surface of the skin, making the newborn and young infant more susceptible to heat loss
What becomes more effective in newborns as they grow?
Thermoregulation becomes more effective
GI system: Tongue of new born; why is it this way?
Tongue is larger relative to oral cavity size; it must be able to latch onto the nipple for the infant to feed
GI: Stomach of newborn
Stomach capacity increases as the infant grows
When does first primary teeth erupt? What teeth are they? How do teeth emerge?
First primary teeth erupt between the ages of 6 and 8 months
(incisors).
Teeth emerge in a predictable pattern
How is the stool of infants in the first year of life? Why?
Consistency and frequency of stools change over the first year of life based on intake (breast or bottle) and age (i.e. meconium)
Genitourinary and Integumentary Systems: Infants are more susceptible to what?
Infants more susceptible to dehydration
Genitourinary and Integumentary Systems: How is urine of newborn and infant?
Frequent urination with low specific gravity (not concentrated until glomeruli mature)
Genitourinary and Integumentary Systems: What is seen on newborns usually?
Lanugo and vernix may be seen in the newborns
Genitourinary and Integumentary Systems: How is the skin color of newborns?
Acrocyanosis is normal in the newborn and decreases over the first few days of life
Genitourinary and Integumentary Systems: How is the skin of newborns?
Skin is relatively thinner than that of adults with peripheral capillaries more superficial
Hematopoietic and Immunologic Systems: What happens to iron stores during pregnancy?
Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy.
Hematopoietic and Immunologic Systems: What happens to premature infants iron stores?
Therefore, premature infants miss this transfer and are at increased risk of iron deficiency anemia.
Hematopoietic and Immunologic Systems: How do newborns receive immunity?
Newborns receive immunity through the placenta and
utilize those antigens for first 3-6 months of life until they synthesize their own IgG, reaching adult levels by 9 months.
When do infants reach adult levels of IgE?
reaching adult levels by 9 months.
Three Developmental Theorists:
- Erikson
- Piaget
- Freud
Erikson Developmental Theory INFANT stage:
Trust v Mistrust (birth to 1 year)
Trust v Mistrust
Caregivers respond to infant’s basic needs, this creates a sense of trust in the infant.
Infants realized they are separate from their caregivers. They learn to tolerate small amounts of frustration and trust that although gratification is delayed, it will eventually be provided
Piaget Developmental Theories INFANT STAGE:
Sensorimotor
Sensorimotor
Infant uses senses and motor skills to learn about the world
Freud Developmental Theories Infant stage:
Oral stage: birth to 1 year
Oral stage
Pleasure is focused on oral activities; feeding and sucking
Newborn and Infant sensory development: Sight
View objects 8-15 inches away, prefer human face
Newborn and Infant sensory development: Sight- when does binocularity occur?
Binocularity – ability to fuse 2 ocular images into 1, begins at 6 weeks and established by 4 months. Color vision, distance, tracking by 7 months.
Newborn and Infant sensory development: Hearing
Intact at birth
Newborn and Infant sensory development: Smell and Taste:
Newborns can smell and prefer sweet tastes
Newborn and Infant sensory development: Touch:
Touch: Most important
Newborn and infant motor skill development: How do Gross motor skills develop?
*GROSS MOTOR Skills develop CEPHALOCAUDAL –> HEAD TO TOE
*slide 13
Newborn and infant motor skill development: How do FINE motor skills develop?
*FINE MOTOR Skills develop PROXIMODISTAL –> CENTER TO PERIPHERY
*Slide 14
Newborn and Infant: Communication and language development
What are infants mode of communication?
First several months, crying is only form of communication
Newborn and Infant: Communication and language development (1-2 months)
cooing
Newborn and Infant: Communication and language development (4-5 months)
vowel sounds, laughs, responds to voices, responds to name
Newborn and Infant: Communication and language development (6 months)
squealing and yelling
Newborn and Infant: Communication and language development (7 -10 months)
babbling, saying mamma dada without meaning
Newborn and Infant: Communication and language development (9-12 months)
attach meaning to words, recognizes objects by name, imitates words
Newborn and Infant: Communication and language development (12 months)
babbles with inflection
Newborn and Infant Social and Emotional Development: Stranger anxiety
Indicates infant recognizes self as separate from others
Newborn and Infant Social and Emotional Development: Separation anxiety
Infant becomes distressed when parent leaves
Newborn and Infant Social and Emotional Development: Temperament
Ranges from low to moderately active, regular, and predictable, to highly active, more intense, and less adaptable
What must assessments for growth and development include?
Assessments of growth and development must include adjustments for prematurity
What do you use to determine expected outcome of newborns and infants growth and development?
Use the infant’s adjusted age to determine expected outcomes
How to determine newborn and infant adjusted age?
Subtract the number of weeks that the infant was premature from the infant’s chronological age
Plot growth parameters and assess developmental milestones based on adjusted age
Newborn and Infant: Promoting healthy growth and development-
Safety
Nutrition
Newborn and Infant: Promoting healthy growth and development-Safety includes: list 4
Correct positioning and securing children in car seats
Positioning infants “back to sleep” to decrease risk of SIDS
Use of current recommendations for infant furniture
Safety on the changing table and use of mobility devices for infants
Newborn and Infant: Promoting healthy growth and development-Safety includes: list 3
Safety in the home using safety gates, outlet covers
Identify choking hazards (small toys, foods)
Water safety (bathrooms, buckets, and tubs)
Newborn and Infant: Promoting healthy growth and development-Nutrition
What does AAP, NAPNAP, WHO, ACOG, ADA recommend as the natural and preferred method of infant feeding
AAP, NAPNAP, WHO, ACOG, ADA all recommend breastfeeding as the natural and preferred method of infant feeding.
Newborn and Infant: Promoting healthy growth and development-Nutrition
How long does AAP recommend newborns be breastfed, when to introduce solids?
AAP recommends newborns to be breastfed exclusively for the first 6 months of life, then introducing solids with the continuation of breastfeeding until 1 year of age.
Newborn and Infant: Promoting healthy growth and development-Nutrition
Benefits of breastfeeding
Benefits for both mother and baby
Perfectly matched nutrition
Newborn and Infant: Promoting healthy growth and development-Promoting Healthy Eating Habits:
How do infants and newborns feed?
Newborns and young infants feed “on demand”
When can solid food be introduced to diet?
Can start to introduce solids at 4-6 months of age
How many times does infants require exposure to new food before accepting the food?
Infants can require exposure to new foods up to 20 times before accepting the food
How to introduce new food to infants?
Introduce a new food and wait 3 to 4 days before introducing a different food to observe for any allergies
Who decides how much child will eat?
The child will decide how much to eat—the parent provides the food
When should you introduce the cup?
Introduce the cup early (~6 months) to start
How should solid food be given to infants?
Solid food should be soft and mashed until teeth erupt
Newborn and infantcommon developmental concerns
Colic
Spitting up
Thumb sucking, pacifiers, security items
Teething
How long is toddlerhood
1-3 years
How does physical growth of toddler occur?
Height and weight increase steadily in spurts at a slower rate than the infant
By age 2, what is a toddlers height indicative of?
Generally reach half adult height by age 2
Average weight gain of toddler
Average weight gain is 3 to 5 lb per year
Average height gain of toddler per year
Height increases by an average of 3 in per year
When does anterior fontanelle close?
Anterior fontanelle closes by 18 months
By age 3, what happens to head size?
Head size more proportional to body by age 3
Neurologic system of toddler
Brain reaches about 90% of size by age 2.
Increased myelination improves coordination, balance, and sphincter control
Respiratory system of toddler
Alveoli increase in number until age 7;
trachea and airways small compared to adult;
tonsils and adenoids are large relative to size of oral cavity
Cardiovascular system of infants
Heart rate decreases; blood pressure increases
GI system of infants
Stomach increases in size;
small intestine grows in length;
less frequent stools;
stool color may be variable based on diet;
bowel control typically achieved by end of toddler period
Genitourinary system of toddlers
Bladder and kidney reach adult function by 16 to 24 months;
bladder capacity increases;
urethra remains relatively short
Musculoskeletal system of toddler
Bones increase in length; muscle matures;
swayback and pot belly appear due to weak muscles until 3 years old
Erikson Toddler Developmental theories:
Psychosocial theory describes the toddler period as a time of Autonomy vs. Shame and Doubt (1-3 years)
Autonomy vs. Shame and Doubt (1-3 years) in toddlers
Toddler is learning to do for herself what others have been doing for her.
Ambivalence about the move from dependence to autonomy causing emotional lability.
Toddler Developmental theories: Piaget
Cognitive development: Preoperational (2-7 years old)
Toddler Cognitive Development: Preoperational means?
Differentiates self from objects (increased object permanence)
Think before acting, time space causality understanding, make believe, connections with past
Symbolic play – Animism: human feelings attached to objects
Toddler Developmental theory: Freud
Anal stage:
focus on achieving anal sphincter control
Toddler Gross motor skills development
Initial walking with “toddler” gait
Later includes running, climbing, jumping, pushing or pulling a toy, throwing a ball, and pedaling a tricycle
Toddler Fine motor skills development
Progress from holding and pinching to the ability to manage utensils, hold a crayon, string a bead, work a puzzle, and use a touch screen
Toddler Speech development- Receptive language
the ability to understand what is being said or asked
Toddler Speech development- Expressive language
The ability to communicate one’s desires and feelings
Toddler Speech development- How does Receptive Language compare to Expressive language
Receptive far more advanced early on than expressive language development
Toddler Speech development-Bilingual children
Bilingual children: may have simultaneous acquisition of languages, first word may be slightly delayed but still in normal range
Common language occurrences
Echolalia
Telegraphic speech
Echolalia
repetition of words/phrases without understanding
Telegraphic speech:
Want Cookie
2 word sentences
How do infants explore their environments
With all five senses (including taste)
What happens to visual acuity during toddlerhood? Hearing?
Visual acuity continues to improve
Hearing likely to be at adult levels
How is sense of smell in toddlers?
Although not fully developed, toddlers may express preferences for certain smells
How is toddlers sense of touch?
May prefer certain textures (soft vs. scratchy clothes)
In toddlers, emotional development is focused on what?
Separation
Individuation
Egocentrism
Focus on self
Need for control leads to emotional lability
Rely on routines or security items to provide stability and comfort
Emotional and social development in toddlers: Separation
Separation (Seeing oneself as separate from the parent)
Emotional and social development in toddlers: Individuation
Individuation (Forming a sense of self and learning to control one’s environment)
Emotional and social development in toddlers: Egocentricism
Focus on self
Toddler Emotional and Social Development- Typical behaviors
May rely on a security item
Becomes aware of gender differences
May display aggressive behaviors
Consider the role of temperament in developing behaviors
May show fear of loss of parents and of strangers
Becomes more self-aware; does not have clear body boundaries
Separation anxiety may reoccur
May resist invasive procedures
Toddler development: Moral and Spiritual
During toddler years, children may feel comfort by praying;
Don’t understand morality base actions on pleasure or punishment, but older toddlers beginning to understand empathy
Toddler development: Cultural influences
Some parents may “baby” them for a longer period or the opposite;
some discourage crying in boys, “be a man”; ridicule for crying
Toddlerhood: promoting health growth and development. - Wha tis a major socializing medium at this age?
Play is the major socializing medium at this age
Toddlerhood: Promoting Health growth and development- what should parents do
Typically need 30 minutes of structured physical activity and 1 to 3 hours of unstructured physical activity per day
Parents should limit television and encourage creative and physical play instead
Engage in parallel play (playing alongside another child) instead of cooperative play
Toddlerhood: Promoting Health growth and development- How do toddlers play
Toddlers are egocentric and do not like to share
Short attention span of toddlers will make them change toys frequently
Toys that engage multiple senses with creative play need not be expensive!
Toddlerhood: Promoting Safety
Increasing mobility requires increased vigilance
Provide a childproof environment
Use a safe car seat in back seat of the car
Provide a safe home environment
Avoid exposure to tobacco smoke
Prevent injury; water safety
Prevent poisoning
Toddler: Promoting Nutrition- when should weaning from bottle occur? Why?
Weaning from the bottle should occur by 12 to 15 months old, continuation can lead to dental caries
Toddler: Promoting Nutrition- how much mg of Calcium do toddlers require?
Toddler requires 500 mg of calcium per day
Deficiency in what can lead to developmental and psychomotor delays in toddlers?
Iron-deficiency anemia in first 2 years of life can lead to developmental and psychomotor delays
Toddler: Promoting Nutrition- What should NOT be restricted in children younger than 2 years
Fat or cholesterol intake should not be restricted in children younger than 2 years
Toddler: Promoting Nutrition- What is the daily recommended intake of fiber?
Daily recommended fiber intake for 1-3 year old is 19 g
How much juice should a toddler drink? Milk? How should they drink and what about water?
Limit juice to 4-6 oz per day
Milk should be limited to 16-24 oz per day
Juice and milk should be offered along with meals or snacks
Water should be offered in between meals
Toddlers should drink from a cup (no sippy cup with a valve)
Toddlerhood: Promoting Self-feeding
Use a child-sized spoon and fork with dull tines
Ensure the portion size, type, and texture of the food is appropriate for the toddler considering dentition
Seat the toddler in a high chair or at a comfortable height in a secure chair
Include the toddler in family mealtimes; praise attempts at self-feeding
Never leave the toddler unattended while eating
Minimize distractions during mealtime
Toddler: Health Promotion. Healthy Sleep
A typical toddler should sleep through the night and take one daytime nap
Consistent bedtime rituals help the child prepare to sleep
Most children discontinue daytime napping at around 3 years of age; eliminating naptime is highly individualized
Toddler: Health Promotion. Healthy Teeth and Gums
Cleaning teeth with water progressing to small amount of fluoride toothpaste at 2 years old.
Weaning from bottle and no-spill sippy cup by 15 months
Visit dentist by 1 year, discuss fluoride supplementation
Toddlerhood: Promoting Appropriate Discipline
Limit setting
Negotiation
Techniques to assist the toddler to learn problem solving
Offer realistic choices
Keep instructions simple
Reinforce desirable behaviors
Extinction and “Time-outs” for negative behaviors
Toddlerhood: Common Developmental Concerns
Toilet teaching
Negativism
Temper tantrums
Thumb sucking and pacifiers
Sibling rivalry
Aggression and regression
Weaning to cup
Toddlerhood: Toilet teaching
Toilet teaching – myelination of spinal cord at 2 years old achieved, capability of sphincter control develops
Preschooler: Physical Growth- What is the average growth? (weight and height)
Average growth of 2.5 to 3 inch per year
Average weight gain around 4-5 lb per year
How do preschoolers grow?
Loss of baby fat and growth of muscle
Length of skull increases slightly; lower jaw more pronounced; upper jaw widens
How would preschoolers grow on a growth chart?
Expect the child to remain on the same or similar growth curve on the growth chart as from previous visits (large changes in percentiles require additional assessments)
Preschooler organ system maturation
Bladder and Heart
Myelination of the spinal cord allows for bowel and bladder control completion usually around 3 years old
Heart rate decreases, blood pressure increases
Heart murmur and split heart sounds
Stool 1-2 times per day
Short urethra resulting in risk of UTI, still have accidents at 4-5 years old
Preschooler organ system maturation
Lungs, Teeth and Bones
Alveoli increase until 7 years old
Eustachian tubes remain short and straight
20 teeth
Bones increase in length and muscles strengthen however musculoskeletal still not mature and susceptible to injury
Preschooler Developmental Theories (Erikson)
Erikson: (Psychosocial) Initiative versus Guilt (3 to 6 years):
feels pride in accomplishments leading to initiative, however when they extend themselves passed what capable of leads to guilt.
Preschooler Developmental Theories (Piaget)
Piaget: (Cognitive) Preoperational sub-stages:
Preschooler Developmental Theories (Piaget) What are the Preoperational sub-stages?
Preconceptual (2 to 4 years):
Intuitive phases (4 to 7 years): classify and relate objects, knows if something is right or wrong but doesn’t‘ understand why
Preschooler Developmental Theories (Piaget)
Preoperational sub-stages: Preconceptual (2 to 4 years)- What is it?
Preconceptual (2 to 4 years): egocentric, active imagination, learns through observing and imitating
Preschooler Developmental Theories (Piaget)
Preoperational sub-stages:
Intuitive phases (4 to 7 years): What is it?
classify and relate objects, knows if something is right or wrong but doesn’t‘ understand why
Preschooler Developmental Theories: Kohlberg
Kohlberg: punishment–obedience orientation (2 to 7 years): determine good vs bad dependent upon associated punishment
Preschooler Developmental Theories: Freud
Freud: phallic stage (3 to 7 years): jealousy and rivalry toward same-sex parent with love of opposite sex parent
Preschoolermoral and spiritual development
Child’s moral standards are those of their parents or other adults who influence them, not necessarily their own.
Knowing a family’s religious beliefs can be helpful especially when hospitalized.
Slide 45: Expected motor skills development for Preschoolers
Read it cause idk
Preschoolercommunication and language development: 3 years
Speaks in complete sentences
Follows instructions with two or three steps
Can name most familiar things
Vocab of 200 words
Preschoolercommunication and language development: 5 years
Can explain how to use something
Talks about past, present, future and imaginary events
Can answer questions that use why and when
Vocab of 2100 words
Preschooleremotional and social development
Cooperation
Sharing (of things and feelings)
Kindness
Generosity
Affection display
Conversation
Expression of feelings
Helping others
Making friends
Preschooleremotional and social development: Friendships
Preschoolers learn how to make and keep a friend
Preschooleremotional and social development: Temperament
Influenced by parent’s expectation of child’s behavior
Determines child’s task orientation, social flexibility, and reactivity
Preschooleremotional and social development: Fears
Preschoolers exhibit variety of fears
Parents should acknowledge child’s fears
Nightmares versus “night terrors”
Preschoolerpromoting healthy growth and development
Building self-esteem
Maintaining routine and rituals
Setting limits and remaining consistent with them
Early recognition of signs of developmental delay
Supporting development of self-care activities (e.g., dressing, toileting)
Developing social skills within both the family and the larger society
Preschoolernursing concerns
Delayed growth and development
Imbalanced nutrition, less than body requirements
Interrupted family processes
Risk for injury (or falls, poisoning, trauma)
Risk for caregiver role strain
Risk for delayed development
Risk for disproportionate growth
Disturbed sleep patterns
Preschooler signs of developmental delay (3 years)
Falls down often or had trouble with stairs
Drools or unclear speech
Can’t work simple toys
Doesn’t make eye contact
Preschooler signs of developmental delay (5 years)
Doesn’t show a variety of emotions
Extremes of behavior (fear, anger, aggression)
Unusually withdrawn or inactive
Cannot complete self-care activities (toileting, dressing, teeth, brushing)
Preschoolerpromoting healthy growth and development
Promoting growth through play
Promoting early learning
Promoting language development
Promoting social skills for preschool/kindergarten
Promoting safety
Promoting nutrition
Promoting healthy sleep and rest
Promoting appropriate discipline
Preschoolerpromoting nutrition. (Calcium, Iron, Fiber amounts?) and how should they eat?
500 to 800 mg calcium
10 mg iron
19 mg fiber
Regular meals with healthy snacks in between
Diet high in nutrient-rich foods
Preschoolerpromoting nutrition: Amount of fats preschoolers should have
Fat intake no less than 20% and no more than 30% daily calories
Saturated fats less than 10%
Preschoolerspromoting healthy eating habits
Small portions on smaller sized plates and bowls with appropriately sized utensils
Encourage child to serve self
Allow child to decide when to stop eating (don’t force food)
Snacks should be high quality (lean proteins, whole grain, fruits, veggies, dairy)
Family meal times allow parents to model appropriate behaviors at meals and facilitate communication
Preschoolers preventing overweight and obesity- What is overweight defined as?
Overweight is defined as BMI at or above the 85th percentile and below the 95th percentile for age and sex
Preschoolers preventing overweight and obesity- What is obesity defined as?
Obesity is defined as BMI greater than the 95th percentile for age and sex
Consequences of childhood obesity include:
Hypertension
Hyperlipidemia
Insulin resistance
Preschoolersdevelopmental issues
Lying
Sex education
Masturbation
Preschoolersfocus on health care visits
Expected growth and development
Anticipatory guidance
Preparation for school entry
Planning for safety in the child’s environment
School-age childphysiologic growth- How much height and weight gained per year
Grows an average of 2.5 inches per year.
Increases weight by average of 7 pounds per year.
School-age childphysiologic growth- How do girls and boys compare?
Early on, boys and girls are similar in height and weight.
Later, girls may develop faster than boys in height and weight; boys will “catch-up” later.
In school aged children, expectations of behavior should be consistent with what?
Expectations of behavior should be consistent with age, not appearances.
What begins to appear in school aged children?
Secondary sexual characteristics begin to appear.
School-age childorgan system maturation: Neurologic System
brain and skull grow very slowly; cognitive processes mature
School-age childorgan system maturation: Respiratory System
respiratory rates decrease;
respirations are diaphragmatic in nature
School-age childorgan system maturation: Cardiovascular System
blood pressure increases and pulse rate decreases.
School-age childorgan system maturation: Immune System
matures to adult level around 10 years old; fewer infections experienced
School-age childorgan system maturation: GI System
deciduous teeth replaced by permanent teeth;
fewer gastrointestinal upsets;
stomach capacity increases;
caloric needs are lower but appetite may increase.
School-age childorgan system maturation: Genitourinary System
bladder capacity increases (age in years + 2 ounces); prepubescence occurs.
School-age childorgan system maturation: Musculoskeletal System
greater coordination and strength; muscle still immature and can easily be injured.
School-age childmotor skill development: Gross motor skills
Coordination, balance, rhythm improve.
Ride bike, jump rope, dance, sports, skating, swimming
School-age childmotor skill development: Fine motor skills
Hand usage improves.
Eye–hand coordination and balance improve.
Can write, print words, sew, or build models.
Takes pride in activities requiring dexterity and fine motor skills, such as playing musical instruments.
School-age childvision problems: Amblyopia
also called “lazy eye”) is the term to describe the condition when one eye can focus better than the other.
Causes of Amblyopia
Uncorrected refractive errors or other eye defects in one eye (near-sighted, far-sighted or astigmatism)
Malalignment of the eye muscles (strabismus)
Deprivation due to cataract formation in one eye (rare)
Symptoms of Amblyopia
Symptoms: Eye rubbing, squinting, avoiding reading, headaches, problems with depth perception or hand-eye coordination
School-age childdevelopmental theories- Erikson
is psychosocial
Industry vs inferiority
School-age childdevelopmental theories- Piaget
Cognition
Concrete operational thinking
School-age childdevelopmental theories- Kohlberg
Conventional
School-age childdevelopmental theories- Freud
Latency
School-age childcommunication and language development
Vocabulary expands to 8,000 to 14,000 words.
Culturally specific words are used.
Reading efficiency improves language skills.
More complex grammatical forms are used.
Development of metalinguistic awareness occurs (ability to think about language and comment on its properties)
Metaphors are beginning to be understood.
School-age childemotional and social development
Temperament
Self-esteem development
Body image
School-age fears
Peer relationships
Teacher and school influences
Family influences
School-age childpromoting healthy growth and development
Cardiovascular fitness
Weight control
Emotional tension release
Development of leadership and social skills
School-age childpromoting safety
Car safety
Pedestrian safety
Bicycle and sport safety
Fire safety
Water safety
Abuse in children
School-age childpromoting nutrition- how to check for nutrition history
Nutrition history including a 24-hour recall of what was consumed.
School-age childpromoting nutrition
Check height and weight compared to previous measurements; assess BMI for age.
Inquire about family meals and the social aspects of eating including who prepares the meals.
Solicit from both parent and child.
Identify any knowledge gaps relating to nutrition.
School-age childpromoting nutrition- How much water per day? Protein? Calcium?
1,800 to 2,100 mL of water per day (limit sugary beverages and juices)
28 g protein
800–1,000 mg calcium for 4 to 8 year olds, increases to 1,300 mg for 9 to 13 year olds
*skipped slide 70
School-age childdevelopmental concerns
Television and video games (setting limits on both the content and amount of time)
School refusal (school phobia)
Latchkey children and safety
Stealing, lying, cheating, bullying (whether as the perpetrator or the victim)
Fitting in with peer groups
Tobacco and alcohol education
School-age childpromoting sleep and rest: How much sleep is required?
12 hours of sleep required.
School-age childpromoting sleep and rest: how?
Should have predictable bedtime expectations and wake-up times.
Children may need help in winding down to promote sleep.
School-age childpromoting sleep and rest: what may occur? how long?
Night terrors and sleepwalking may occur but should resolve by age 8 to 10 years.
Adolescentgrowth and development- how does growth occur?
Rapid physical growth in body size and proportions second only to growth in infancy
Sexual characteristics and reproductive maturity occur
Adolescentgrowth and development- when does puberty occur?
Puberty begins in girls around 9 to 10
years old and
in boys around 10 to 11 years old
Adolescentgrowth and development – physiologic changes - hormone secretion in girls and boys
Secretion of estrogen in girls and
testosterone in boys stimulates physical sexual changes
Adolescentgrowth and development – physiologic changes - peak height velocity in girls and boys
Peak height velocity occurs at about 12 years of age in girls and 14 years of age in boys
Adolescentgrowth and development – physiologic changes - what increases in girls and boys?
Muscle mass increase in boys and fat deposits increase in girls
Adolescentgrowth and development – physiologic changes common in boys and girls?
Voice deepens (most dramatic in males)
Limbs elongate disproportionately (may look “leggy”)
Growth plates at the end of long bones begin to close
Apocrine glands (sweat glands) activate in axilla and genital areas
Skin changes related to increased sebaceous gland secretions may lead to skin eruptions (acne)
Increase in body hair
Adolescentgrowth and development – physiologic changes differing in boys and girls?
Hips widen in females, shoulders widen in males
Adolescentorgan system maturation: Neurologic system
Neurologic system: growth of myelin sheath enables faster neural processing; cognitive growth increases
Adolescentorgan system maturation: Respiratory system
Increase in diameter and length of the lungs; respiratory volume and vital capacity increase
Adolescentorgan system maturation: Cardiovascular system
size and strength of heart increases; systolic blood pressure increases and heart rate decreases
Adolescentorgan system maturation: GI system
full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge
Adolescentorgan system maturation: Musculoskeletal system
linear growth is not complete until late adolescence in boys and occurs earlier in girls; growth plates (which promote linear growth) begin to close at puberty. Adult height is attained when growth plates have closed in late adolescence
Adolescentorgan system maturation: Integumentary system
skin is thick and tough; sebaceous glands are more active; sweat glands function at adult level
Adolescentdevelopmental theories Erikson
Psychosocial
Identity v role confusion or diffusion
Adolescentdevelopmental theories Piaget
Cognition
Formal operation
Adolescentdevelopmental theories Kohlberg
Moral development
Postconventional level III
Adolescentimprove communication
Allow sufficient time for conversation
Speak respectfully as you would to a colleague
Talk face to face; be aware of body language (yours and the teen’s)
Ask open-ended questions to clarify and promote understanding
Reflect back what you think you heard so that he or she feels heard
Choose words carefully so that message and intent are clear
Be honest; don’t be afraid to say you don’t know
Be liberal with praise; acknowledge effort
Solicit the teen’s input in decision making as often as possible
Clearly state expectations and set limits fairly
Adolescentinfluence of peers- what kind of role do peers play?
Play essential role in identity of the adolescent
Provide opportunities to learn negotiation of differences
Provide recreation, companionship, and someone to share problems with
Create stability in times of stress or transition
Serve as credible sources of information and social reinforcement (behaviors, roles)
Can have positive or negative influences
Adolescentsafety concerns
Unintentional injuries
Internet safety
Motor vehicle safety (as a driver and as a passenger)
Avoiding substance abuse
Firearm safety
Water safety
Adolescentnutrition- what influences food choices?
Peer pressure; growing wish for independence from family in food choices
Low cost/convenience/easy access of fast foods
Family culture relating to food and meal time rituals
Lack of time/opportunities for family meals (busy schedules)
Growing wish for independence in food choices
Others?
