GROWTH AND DEVELOPMENT

生长发育

上海交通大学医学院附属上海儿童医学中心发育行为儿科

(developmental and behavioral pediatrics)

章依文Zhangyiwen@hotmail.com

Normal or Abnormal?

1. 8 month, boy, head circumference 43.1cm ， microcephaly ？

2. 9 month, girl ， no first tooth

3. 15 month, girl ， weight 13.2kg ， obesity ？4. 12 month, boy ， can not sit alone

5. 9 month baby shows no interests and

attention in playing beads. Why?

How Old?

REGULAR PATTERN OF GROWTH AND DEVELOPMENT

• A continuous process

• Different rate of development in various systems

• General pattern

• Individual variance

Different rate of development in various systems

FACTORS OF GROWTH AND DEVELOPMENT

• Genetics

• Gender

• Endocrine

• Pregnant condition

• Nutrition

• Living environment

• Diseases

environment genetics+

PHYSICAL GROWTH

birth weight 3kg≌ W(kg)= birth weight(kg)+month×0.7 (kg)

W(kg)=6 (kg)+month×0.25 （ kg ）

W(kg)=yrs ×2 (kg)+7 or 8 （ kg ）

weight

newborn

1 to 6 mon

7 to 12 mon

2 to 12 yrs

PHYSICAL GROWTH

Height

newborn

0-1yr

2-12yrs

50cm

75cm

H (cm)= yrs×7+70 (cm ）

1-2yr 85cm

PHYSICAL GROWTH

1yr

newborn

5yr

2yr

Head circumference (HC)

34cm

46cm

48cm

50cm

PHYSICAL GROWTH

Chest circumference (CC)

Newborn 32cm

1yr46cm

CC=HC

Anterior fontannel

PHYSICAL GROWTH

Skeleton development

Vertebral column

1~1.5 yr closure

Ossification centerBone age

PHYSICAL GROWTH

First tooth

Deciduous teeth 20

30mon

6-10mon

Teeth development

ASSESSMENT OF GROWTH

Mean (X) ＆ Standard (SD)

Normal distribution XX2SD2SD

±1SD

+2SD

+3SD

68.3%

95.4%

99.7%

ASSESSMENT OF GROWTH

Percentile P3-P97

Growth chart

Multiple indicators

Height for age

Weight for age

Weight for height

Zscore ±2

Growth Curve

NEURO-PSYCHOLOGICAL DEVELOPMENT

Sensation and perception

vision3-4yr

1yr

Newborn

6yr

3mon

20cm

180°level

3m

0.7

1.0

NEURO-PSYCHOLOGICAL DEVELOPMENT

Sensation and perception

hearing

Newborn

3mon

1yr

2yr

4yr

Hearing

Turning head to sound

Knowing his/her name

Following simple direction

Hearing mature

NEURO-PSYCHOLOGICAL DEVELOPMENT

Motor

Gross motor

3mon

6mon

9mon

15mon

Lift head

Sitting

Creep ＆ Standing with support

Walk alone

Lift head Lift head

Sitting Crawing

Standing Walk

Jump Run

NEURO-PSYCHOLOGICAL DEVELOPMENT

Fine motor

3mon

6mon

12mon

10mon

Grasp object

Transfer object

Thumb-finger grasp

Release cubeMotor

NEURO-PSYCHOLOGICAL DEVELOPMENT

Language

age receptive expressive

6m Name Babble

12m Familiar object namePharasesSimple needs

Repeat sound“ba ba” /“ma ma”

15m~18m

Body partFollowing simple direction

Pointing15~20 words

24m People/object

PicturesName/object/pictures

300 words

36m 2~3directionssex identity

SentencesMore words

48m Differenciate colorsFollowing 2~3 directions

Telling storiesDescribing things

NEURO-PSYCHOLOGICAL DEVELOPMENT

ThinkingImaginationWillEmotionPersonalityPersonal-social behavior

ASSESSMENT AND BEHAVIORAL DEVELOPMENT

Intelligence

Abilities of recognizing the world and dealing with the environmental change

Intelligent quotient (IQ)Development quotient (DQ)

ASSESSMENT AND BEHAVIORAL DEVELOPMENT

Psychometry

Visual-space orientationTempory-order

MemorySpeech

language

Single developmental screening tests

ASSESSMENT AND BEHAVIORAL DEVELOPMENT

Denver Developmental Screening Test,DDST

Drawing-a-man testPeabody Picture Vocabulary

Test,PPVT

Abilities tests

Screening tests

Psychometry

ASSESSMENT AND BEHAVIORAL DEVELOPMENT

Psychometry

Bayley Infant Development Test

Gesell Development Test

WPPSI

WISC-R

SM

Abilities test

Diagnostic tests

DIVIATION OF GROWTH

Weight

Height

Head circumference

Overweight >2SD or 97 Percentile

Underweight <2SD or 3 Percentile

Tall status

Stunt

PSYCHOLOGICAL DISORDER

Developmental-behavioral problems

Learning disorders

Speech and language disorders

Mental retardation

Breath holding

Biting thumb Enuresis

Defiance

Lying

Temper tantrums

Sleep disorders

Summary

• Regular pattern of growth and development

• Physical growth and assessment

• Neuor-psychological development and

assessment

Normal or Abnormal?

1. 8 month, boy, head circumference 43.1cm ， microcephaly ？

2. 9 month, girl ， no first tooth

3. 15 month, girl ， weight 13.2kg ， obesity ？4. 12 month, boy ， can not sit alone

5. 9 month baby shows no interests and

attention in playing beads. Why?

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