Physical Assessment of Child Development: A Comprehensive Guide
Physical Assessment of Child Development
Growth and Development
Growth refers to the physical changes in size and structure, while development refers to the emotional and behavioral changes that occur under the influence of the environment and the ability to use your body. The processes of growth and development are parallel.
Physical development can be divided into 6 stages:
- Prenatal: from conception to birth
- Breastfeeding: birth to the end of the 1st year
- Late lactation: 2nd year
- Preschool: 3 to 6 years
- Early school years: from 6 years to puberty
- Adolescence: from puberty to adolescence
Head
At birth, the head is large in proportion to the body. The head circumference is measured to track growth. Cranial growth occurs as a result of the fontanelles (soft tissue areas in the head). The fontanelles close at different ages, with the anterior fontanelle closing around 9 months and the posterior fontanelle closing around 2 years.
Chest and Limbs
At birth, the limbs are short. The lower limbs may have a physiological or sickling deformity of the tibiae that disappears over 2 years.
Muscles
In early childhood, the muscle weight represents 20% of body weight. The muscles of the eyes and respiratory tract mature first, followed by the other major muscle groups. The human body is covered by over 650 voluntary muscles.
Development of the Teeth
The first teeth usually appear around 6-12 months. By age 2 years or 2 ½ years, the full set of 20 baby teeth is complete.
Characteristics of the Newborn
Newborns are characterized by:
- A physiological loss of 10% of body weight in the first 10 days
- A distorted head due to passage through the birth canal
- A sebaceous layer on the skin called vernix caseosa
- A deep red color throughout the body due to excessive red blood cell count
- Mongolian spots, which are blue, gray, or brown patches on the skin
- Short nails and greyish eyes
- A covering of fine hair called lanugo
- A small jaw, rounded and rather flat chest, large abdomen, and short arms and legs
- Large and swollen genitals in both sexes
- Reflexes that disappear within a few weeks
Average Measurements of the Newborn
- Weight: 3-4 kg
- Height: 52 cm
- Head circumference: 35 cm
- Chest circumference: 33 cm
- Breathing rate: 35 to 50 breaths per minute
- Heart rate: 120 to 160 beats per minute
Evolution of the Different Devices and Systems of the Human Body
Gastrointestinal
The stomach of a newborn has a very small capacity, from 20 to 33 cc. The intestinal peristalsis is high, resulting in frequent bowel movements.
Urinary System
The kidneys of a newborn are large and lobed. The bladder has a capacity of 40 to 50 ml, resulting in many voids per day.
Nervous System
Newborns have primitive reflexes that assess neurological status, such as the sucking reflex, the grasp reflex, the tonic neck reflex, and the Moro reflex.
Senses
The hearing of a newborn is not well-developed for fine sounds. The sense of sight is also immature, with newborns only able to distinguish light and dark. The sense of touch is very immature, while the sense of taste is quite developed.
Growth and Physical Development During the First Year
- Cardiorespiratory apparatus: The heart size doubles, blood pressure increases, and pulse rate decreases.
- Nervous system: Brain weight is doubled. Reflexes disappear and motor development begins to be controlled.
- Gastrointestinal: Gastric capacity increases. Intestinal peristalsis decreases.
- Genital tract: In girls, the labia are falling. In boys, the foreskin is retracted, and the testes should have descended.
- Urinary tract: The kidneys triple in weight. The filtering capacity increases.
- Immune system: The immune capacity of the respiratory and gastrointestinal systems is immature.
- Musculoskeletal system: The head and trunk are larger in proportion to the extremities. The head circumference increases to 47 or 48 cm.
- Special Senses: The gaze becomes fixed, and the infant begins to follow the movement of objects and people. The sense of hearing is fully developed at birth. The senses of smell and taste are highly developed at birth.
- Dentition: The lower central incisors appear at 6 months, the 4 upper incisors at 8-12 months, and the two lower lateral incisors at 10-14 months.
- Motor Development: The infant becomes more mobile and has more control over their hands.
- Temperature control: The temperature is normally 37 °C.
Growth and Physical Development During the Second Year
Cardiorespiratory apparatus: triples heart size, blood pressure increases, decreases heart rate. Lung volume increases, decreases respiratory rate of respiration continues, with abdominal.
Nervous system is completed 75% of brain development. Has more control over their movements.
Gastrointestinal: Between 18-24 months receive the voluntary control of fecal elimination.
Urinary and genital tract: In just genital changes. The kidney weight has tripled since the birth and work similarly to those of an adult. Between 18-24 months will be better able to control the urethral sphincter.
Musculoskeletal system: They lengthen the legs. Maintains lordosis (curvature increasing the normally curved lumbar spine) and protruding abdomen. No increase in the development of muscle and adipose tissue (tissue composed of fat) progressively replaced by muscle tissue.
Immune system: The skin functions provide a protective barrier against infectious organisms. It established the production of immunoglobulins (small body that acts as an antibody, ie, in reaction to other substances harmful to health) and specific antibodies).
Dentition: 8 new teeth sprout to a total of 14-16 pieces. At 12-18 months will first 2 upper and lower premolars. At 18-24 months, 2 fangs appear above and 2 below (canines). About 2 years, 2 ½ years will show all the baby teeth, 20 pieces.
Special Senses: Improved visual acuity and depth perception. Structure of the immature ear is very sensitive to infections. It sharpens the taste and smell, about 12-16 months is localized tactile sensation. Locate and know the sounds.
Motor Development: will refine motor skills (gross and fine), due to changes and development of different devices. Increase the size and strength of muscle fibers.
Growth and development in the 3rd year and the beginning of preschool age (from 3 years to 5-6 years).
Device cardio: The heart is 4 times larger than at birth. Decreases heart rate and blood pressure increases. Respiratory tissues continue to develop, the respiratory rate decreases and the lungs continue to increase their volume. The passing from abdominal breathing to chest.
Nervous system is completed 90% of brain growth. The process of myelination, which facilitates development of motor skills. Cerebral dominance is established, dominates the operation of one side of body and hand.
Digestive system: functions similarly to that of an adult.
Dentition: At 3 years have all baby teeth until 6 or 7 years there will be changes.
Urinary and genital tract: No change. At 3 years must have total control of the anal sphincter and bladder.
Musculoskeletal system: The head growth is slower than the trunk and extremities. The face grows more than the skull and jaw grows out of preparing for the permanent teeth. The muscle fibers continue to increase in size and strength. Increase more their size than their weight. Disappears lordosis and protruding abdomen and the fat pockets that erased the natural curve of your feet.