HUMAN GROWTH

AND DEVELOPMENT
Langat Amos
• Throughout your nursing training and career, you will care for patients
and family members of all ages.
• It is important to have an understanding of where they are from both
a developmental and a cognitive perspective.
• This will enhance your interactions and decrease frustration on both
sides.
• Think about the following examples for a moment:
 Administering an immunization to a 1 month old versus a 10 year old

Preparing a 4 year old for an appendectomy versus an 18 year old

Discussing life goals with a 5 year old versus a 20 year old versus a 70
year old
Growth

• Refers to physical increase in some quantity over time.

• It includes changes in terms of height, weight, body proportions and
general physical appearance.
• Involves cell multiplication and body mass.
• A quantitative increase in body size or parts of the body.
Development
• Refers to the qualitative changes in the organism as whole.
• Continuous process through which physical, emotional and
intellectual changes occur.
• Refers to maturation of physical, emotional, intellectual, and social
abilities.
• Involves learning, skills acquisition, and behavioural changes.
Principles of development
1.Development involves change
• The human being is undergoing changes from the moment of
conception to the time of death.

• There are different types of change occur such as, changes in size,
proportions, disappearance of old features and acquisition of new
features etc.
2. Development is a continuous process
• Development continues throughout the life of an individual.
• This process takes place in interaction with the environment in which
a person lives.
• One stage of development is the basic framework for the next stage
of development
3. Development follows a direction and uniform pattern in an orderly
manner

I. proximodistal development
• Development proceeds from the centre of the body outward.
• Growth progresses from central body to extremities.
• Example: Shoulder control develops before hand/finger control.
I. cephalocaudal principle
• proceeds from the head downwards.
• The child gains control of the head first, then the arms and then
the legs.
• Growth and development occur from head to toe.
• Example: Infants control head movements before leg movements.
4. Individual Differences in the Development Process
• Even though the pattern of development is similar for all children but
the rate of development varies among children.
• Each child develops as per his abilities and perception of his
environment.
• Children differ from each other both genetically and environmentally.
5. Development is predictable
Factors influencing growth and
development
• Genetic factors
• Environmental factors
• Social economic status
• Home environment
• Education and training
• Children grow and develop rapidly in their first five years across the
four main areas of development.
 motor (physical)
communication and language
Cognitive
social and emotional
Physical / Motor Development
• Motor development refers to the development of a child’s bones,
muscles and ability to move around and manipulate his or her
environment.

• Typical motor skill development follows a predictable sequence. It

starts from the inner body, including the head, neck, arms and legs,
and then moves to the outer body such as hands, feet, fingers and
toes.
• Motor development can be divided into two sections:
• Gross motor development
• Fine motor development.
• Gross motor development involves the development of the large
muscles in the child’s body.
• Gross motor skills involve motor development of muscles that enable
babies to hold up their heads, sit and crawl, and eventually walk, run,
jump and skip
• Fine motor development involves the small muscles of the body,
especially in the hand.

• Fine motor skills refer to small movements in the hands, wrists,

fingers, feet, toes, lips and tongue.

• Motor development also involves how well children’s muscles work.

This is referred to as muscle tone.
• Children need a balanced muscle tone in order to develop their
muscles and use them with ease when standing, sitting, rolling,
walking, running, swimming and all other postures and actions.
• Motor development also involves the child’s vestibular and
proprioceptive systems. Both of these are part of the child’s sensory
system.
• The vestibular system is located in the inner ear and allows the body
to maintain balance.
• The proprioceptive system involves the inner ear, the muscles, joints
and tendons.
• It allows the body to understand where it’s located. Maintaining
balance and posture and having coordinated movements are only
possible if the proprioceptive system is functioning well.
• The typical development of a child’s motor skills usually follows a
predictable order or sequence.
• As highlighted above, Development occurs from the inner body to the
outer body.
• This means that children usually develop or gain control over their
arms before they develop or gain control over their fingers.
Development also starts from top to bottom. Children need to control
their head first, then they will gain control over their legs and feet.
• Motor development. Most infants follow an orderly pattern of motor
development.
• Although the order in which children progress is similar, there are
large individual differences in the ages at which each ability appears.
It is not unusual for many of the skills to appear 1 or 2 months earlier
than average or several months later (Frankenberg & Dodds, 1967;
Harris & Liebert, 1991).
• Parents should not be alarmed if a child’s behavior differs some from
the average
• Motor development is important throughout a child’s early life,
because physical development is tied to other development areas.
• For example, if a child is able to crawl or walk (gross motor skills),
he/she can more easily explore their physical environment, which
affects cognitive development . Social and emotional development
progresses when a child can speak eat and drink (fine motor skills).
• How well a child’s motor skills are developing will influence how
well they do in other developmental areas:

Motor skills and cognitive development: Children are more likely

to explore their environment if they are able to move easily or
change positions.
They are also more likely to draw and write if they have good
control of their finger muscles.
Motor skills and communication development: Having control over
the oral/motor area allows a child to learn to pronounce letters and
sounds correctly. This is articulation.
Motor skills and social and emotional development: Motor skills are
needed for sitting properly, for speaking, for eating and drinking. How
others react to how well a child does all this may have either a
positive or negative impact on that child’s development.
Motor skills and the development of self-help skills: Solid motor
control helps children learn how to finger-feed and later use utensils
(e.g. forks, spoons, chopsticks), to dress and undress, brush teeth and
wash hands and face, and to learn to use the bathroom.
 Perceptual Development
• Perception refers to children's use of their senses to gather and
understand information and respond to the world around them.
It refers to the development of the five senses: sight, sound, taste,
touch, and smell.
• The use of perceptual information is central to infants' and toddlers'
interactions, exploration, and understanding of their experiences.
• Perceptual and Motor Domain includes fine and gross motor skills,
coordination, integrating motor skills and vision (e.g., eye-hand
coordination), sensory integration, visual memory (e.g., recalling
visual details), and tactile defensiveness (e.g., exploring materials of
different textures, such as play dough and finger-paint).
Hearing
• An infant can hear and react to sound, even before he is born.
• In the uterus, an unborn child hears familiar voices, its mother's
heartbeat, and other internal sounds.
• These familiar sounds often comfort them once they are born. Have
you ever seen a baby become calm at the sound of its mother's voice
or ocean sounds?
• This may be because these sounds are already familiar to them. The
child may startle at sudden, loud noises as well . Sounds like this are
less familiar to the infant. Differentiation between unfamiliar and
familiar sounds will eventually assist with the process of learning
verbal language.
 Sight

• A newborn's vision at birth is about 20/200. He can clearly focus on

objects about 7-18 inches away, and his favourite thing to look at is
the human face.
• This is convenient since 7-18 inches is also about the same distance
as a mother's face while the child is being held or fed.
• A newborn prefers contrasting dark and light colour patterns or
shiny, slow-moving objects. If an object catches the newborn's
attention, he can track its movement in an arc above his head. This
is a far cry from the myth that babies cannot see at birth!
 Smell

• From the time of birth, an infant can distinguish his mother's scent.
He can even tell the difference between his mother's breast milk and
formula or another mother's breast milk.
• In the first week of life, he will learn the differences in smells and start
to prefer pleasant scents to unpleasant ones.
summary
• Gross Motor – Skills are those related to large muscles for walking, running,
jumping, and coordinated movements such as throwing and walking up and down
stairs.

• Fine Motor – These skills require the control and coordination of small muscles in
the arms and hands. Development progresses toward increasingly complicated
tasks that involve precise movements such as cutting with scissors and tracing.

• Perceptual Motor – Skills require the integration of fine motor and perceptual
skills that are needed for tasks such as stacking blocks, copying, manipulating small
objects. The development of skills progresses toward drawing and writing.
Activities focus on motor imitation.
 Social-Emotional
Development Domain
• Social-emotional development is a child’s ability to understand the
feelings of others, control their own feelings and behaviours, and
get along with peers.

• In order for children to attain the basic skills they need such as
cooperation, following directions, demonstrating self-control and
paying attention, they must have social-emotional skills.
• Feelings of trust, confidence, pride, friendship, affection and humour
are all a part of a child’s social-emotional development.
• A child’s positive relationship with trusting and caring adults is the key
to successful social and emotional development.(Erick Erikson theory)
• Social and emotional development involves the acquisition of a set of
skills.
• Key among them are the ability to:
Identify and understand one’s own feelings
Accurately read and comprehend emotional states in others
Manage strong emotions and their expressions in a constructive
manner
Regulate one’s own behaviour
Develop empathy for others
Establish and sustain relationships
• Building a strong social-emotional foundation for a child will help the
child thrive and obtain happiness in life.
• They will be better equipped to handle stress and persevere through
difficult times in their lives as an adult.
 Supporting A Child's Social
Emotional Development:

• parents and educators must learn to read our child’s emotional

cues so that we can help them identify their emotions;
• model the behaviour for our children;
• consistently interact with our child affectionately;
• show consideration for their feelings, desires and needs;
• express interest in their daily activities; respect their viewpoints;
• express genuine pride in their accomplishments with meaningful
comments;
• and provide encouragement and support during times of stress.
Cognitive development
• Involves changes in mental processes including thinking ,learning,
problem solving, memory and reasoning.
• Brain development- rapid neural growth
• Learning and knowledge acquisition-involves understanding concepts
and facts and skills.
• Memory development which includes short-term , long –term and
working memory
• Problem solving and reasoning-ability to analyze , make decision and
think critically
• Attention and executive function-focus ,self-control ,planning and
organization skills.
• Creativity and imagination-ability to generate ideas , engage in
pretend play or innovation.
Communication and language
• Involves the ability to understand and use verbal and nonverbal
communication.
• Receptive language-understanding spoken , written or signed
language.
• Expressive language- using words, sentences or gestures to
communicate
• Nonverbal communication-using gestures, facial expression and body
language
• Literacy- reading and writing skills ,which build on language
foundations.
Stages of development
Infancy and Toddlerhood Stage
• From birth to two years of age.
• The word infant means “without language”.
• Infancy includes development in the areas of cognition, perception,
motor activity, emotion, sociability and language
Physical development
• Infants increase their body weight almost triple and increase in height
by about one-third during the first year alone.
• Also brain size expands rapidly during the first 18 months and brain
weight of the infant reaching more than half of the adult brain due to
rapid growth of dendrites and axons within the brain and glia cells.
• Physical development also includes development in vision, hearing,
perceptual development etc.
• Infants motor development takes place in a sequential order and this
type of development proceeds from head towards the limbs.
• Infant first controls his head and trunk, then lift his chest, sit upright,
crawling, creeping, stand with help, stand along with holding some
objects, walking and so on
Social and emotional
development
• Infants at about two months old demonstrate social smiling in
response to human faces.
• When they are four months old, they show laughter and express
anger, sadness and surprise by six months.
• By 8 or 10 months, they actively seek information about other
people’s feelings.
• They learn to respond when somebody calls them by their names at
about age six to twelve months.
• They also have face to face contact.
• They are afraid of when their parents or care-taker leaves them.
• They start expressing anger if their needs are not met
Cognitive development
• Infants express their intellect by making various sounds like gurgling,
cooing, etc.
• They observe their own hands and feet.
• They gradually learn the relationship between their actions and the
external world.
• They can manipulate various objects to produce effects.
• Infants seem to acquire knowledge about the world only through
motor activities and sensory impressions.
• They try to focus their eyes on various objects and people, put
everything in their mouth.
• Children develop ability to form mental representation during infancy.
• Around the end of the 9th month infants demonstrate object
permanence.
• By babyhood stage they learn to make sounds like mama, papa, they
try to copy various activities as others do.
• By 12 months of age many children are able to say some words which
can be understood by others.
Childhood stage
• This stage includes two sub-stages : early childhood and late
childhood.
• This period covers the period between the age of 3 to 11 years.
• Gain 2 to 3 inches in height and 5 to 6 pounds in weight every year
Physical development
Early childhood stage (3 to 6 years).
• Children begin to develop athletic appearance and they lose their
babyish roundness.
• As abdominal muscles develop, the trunk, arms and legs grow longer.
Their brain and head grow rapidly than any other parts of the body.
late childhood period(6 to 11 years)
• This period is known as pre-adolescence.
• The different parts of the body become stronger during this period.
• Children learn to use their body parts appropriately with speed and
for proper behaviours.
• During late childhood period some of the habits like table manners
interactions with others
Psychosocial development
• In early childhood stage children can say full sentences, express their
feelings and emotions and communicate their needs and feelings and
emotions and communicate their needs and feelings with others.
• During early childhood children have better control of their physical
movement and can have better coordination of their body parts.
• They also learn how to cooperate with other children and conflict
resolution when they are about the age of five or six years they are
independent in various ways.
• There are three important socio-emotional developments, such as;
development of self, gender roles and moral development, take place
during childhood period.
• Through the process of identification the child comes to know who he
is and differentiates from who he wants to be.
• The child is aware of this process through his observation and
imitation of parents and significant others. The child’s personality is
laid down by this identification.
• The child learns the socially appropriate behaviours by observing and
participating in the social events.
• When the children are about the age of 5 to 6 years they can
understand that they belong to a particular gender and also learn to
behave gender roles.
Cognitive development
• Children are curious to know the answers of questions like, “why”,
“Where” and “How” for everything that happens.
• Cognitive abilities include memory, reasoning, perception, problem
solving and thinking abilities which continue to emerge throughout
childhood.
Adolescence
• It includes three sub periods, such as:
• early adolescence (12 -14 years)
• middle adolescence (14 -17 years)
• late adolescence (17- 19 years).
• During this period physical changes that occur are universal, but social
and psychological changes largely depend on the cultural contexts.
Physical development
• Sexuality and identity formation are two major challenges of the
period of adolescence.
• There are changes in the growth rate, sexual characteristics, and
behaviour.
• Adolescent boys and girls develop in their height, weight, strength
and development of bones, muscles, etc
• Puberty and sexual maturity for both boys and girls marks the
beginning of the adolescent period.
• Growth spurts and development of secondary sex characteristics
signal about the onset of adolescence.
• Menstruation is the first sign of puberty for girl whereas appearance
of few whiskers is the sign of puberty for boys.
• Sex hormones like testosterone in males and estrogen in females are
secreted from the sex glands. The secretion of sex hormones help in
pubertal development and also closely associated with emotions
Psycho-social development

• Adolescents become innovative and take interest in learning various

skills with great interest.
• They are argumentative and they have a tendency to find fault with
the authority figures.
• They are not able to differentiate between ideal and real.
• Adolescents suffer from different problems like teenage pregnancy
and juvenile delinquency.
• Positive relationship with parents, peers, siblings and adults play an
important role during adolescence period.
• Peer group influence is very important during adolescence. They want
to do what their friends are doing, Adolescents abuse alcohol and
drugs under peer pressure.
Cognitive development
• During this period adolescents thoughts change from concrete objects
to abstract events.
• They can think flexibly enough about the world.
• They accumulate knowledge through interaction and apply the
learned concepts to new tasks.
• Teenagers develop their reasoning skills and engage in hypothetical
deductive reasoning.
• As adolescents develop their logical thinking, they are becoming
aggressive and argumentative.
• They are able to understand abstract concepts such as congruence
and mass and they think in terms of theoretical concepts.
• They are conscious about others opinion regarding them and curious
enough to know about spirituality, traditions and beliefs
Adulthood stage
• An adult is someone who is responsible, mature, self-supporting and
well integrated into society.
• This adult stage has three sub-stages :
• early adulthood
• middle adulthood
• late adulthood.
Physical development
• Physical growth and development is at its maximum during this
period.
• Physical strength usually is more than previous years due to mature
physical structures. strength, speed, coordination and endurance for
activity is greatest during this period.
• A number of sensory and neural functions are optimal levels during
this period.
• Full brain weight and mature brain wave patterns are observed at this
stage of development.
Psychosocial development
• During early years of adulthood, people face the problem of choosing,
preparing for and entering into careers brings a lot of social changes
in the adult.
• They have cordial relationships with their siblings.
• People are worried about their jobs and pay packages because they
have to meet the daily needs of themselves and of the family.
Cognitive development
• Intellectual ability and cognitive skills are high in early adulthood.
• Middle adulthood people can not learn new skills.
• People utilise their cognitive skills and creativity particularly at the
work place in order to get recognition
Late adulthood /old age
• Categories :
• Young old
• Old old
Physical development
• Types of aging
• (a) Primary ageing- is that in which bodily deterioration occur by
the passage of time or by genetic factors which is gradual and
inevitable.
• (b) Secondary ageing- results from disease, disuse or abuse of
body which is preventable.
• Common physical changes like decrement in sensory abilities of
vision, hearing, taste, smell and other senses, skin becomes inelastic,
decrease in fat and muscle tissue, loss of teeth, deterioration of bone
tissue, decline in height.
Psycho-social development
• Old people remain in a state of inward depression and dissatisfaction.
• These internal feelings are manifested in reaction formations for
which they become over sensitive and demanding. Some old people
depend on their children to a large extent and they feel sad.
Cognitive development
• Intellectual decline is associated with respect to certain functions
such as; speed, perceptual integration ability, memory and inductive
reasoning.