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Thursday, October 20, 2011

Pediatric Notes I

The term “Growth” and “Development” are occasionally used interchangeably but are different.
GROWTH is generally used to denote an increase in physical size or quantitative change.
DEVELOPMENT is used to denote an increase in skills or ability to function.
COGNITIVE DEV’T is the ability to learn or understand from experience, to retain knowledge and to solve problems (Intelligence).


Factors affecting Growth and Development

1. Genetic Influences                          6. Environment
2. Gender                                            7. Nutrition
3. Race and Nationality                      8. Socio-Economic Level
4. Intelligence                                     9. Parent-Child Relationship
5. Health                                             10. Ordinal Position (Family)


Developmental Screening for Newborn – done by Pediatrician

1.Denver II Developmental Screening Test
            - divide streams of Development into gross motor, Fine motor, language and personal-social.

2. Clinical Adaptive Test
            - rates problem solving and visual motor ability.



Criteria for Suitability of Toys

1. Is it safe?   2. Is it Useful?   3. Is it compatible?



Infancy

Solitary
-          stack toys, blocks, pots
-           drums to bang
-           push and pull toys

Toddler

Parallel
      -     rocking horse, swing
-           finger paints, puzzle

Pre-school

Associative
-          Trucks, dollhouse
-           Doctor and nurse kits
-          Sandbox, outdoor gym

Schooler

Cooperative
-          Games and Sports
-           Board games, books and TV



PLAY medium form expression, communication and growth in children



Functions of Play

1.      Educational
2.      Recreational
3.      Physical Dev’t
4.      Social and Emotional Adjustment
5.      Therapeutic


 Growth and Development Throughout Lifespan


Infancy (0-1)

Nutrition
            - Vit. C, D and Iron is not found in milk
            - Solid food introduce at 4 to 6 months
Psychosocial Dev’t
            - mother should not expect too much from infant
Health Maintainace


Toddler (1-3)

-          Autonomy / Independence
-          Recognize that they are separate individual
                        > negativistic
                        > Difficult to manage
Socialization
            - imitates what she/ he sees    
            - differentiate boy from girl
Toilet Training
            - stays dry for 2 hours with regular bowel mov’t
            - Can sit, walk and squat
            - Can verbalize the desire to void or defecate
Negativism
            - undergo extreme negativism, hates to do anything
            - reply to every request is definite NO!

Temper tantrums


Pre-school (4-5)

Oedipus and Electral Complexes
-          aware of sexuality, sexual roles and organs
Phallic Stage
            - Aware of body’s anatomy and sexual identity (Male and Female)
            - Sexual identity is important to preschool in play (Boys-toy guns / Girls-dolls)
            - Penis envy or castration fear
            - Deal with masturbation in non-judgmental manner
Oedipus and Electral Complexes
-          aware of sexuality, sexual roles and organs
Phallic Stage
            - Aware of body’s anatomy and sexual identity (Male and Female)
            - Sexual identity is important to preschool in play (Boys-toy guns / Girls-dolls)
            - Penis envy or castration fear
            - Deal with masturbation in non-judgmental manner


School Age (6-12)


Strives for Achievements of:

            1. Gross motor competency (Sports)
            2. Fine motor dexterity (crafts/arts)
            3. Cognitive proficiency (reading, math)
            4. Social mastery (friends, peer groups)

Psychosocial Development

-          master skills that will help them fxn in the adult world
-          Stealing is a common school-age problem

Ways to assist a school-age child develop psychosocially

  1. Recognizing success and providing praise for achievements.
  2. Guiding children to perform task in w/c they are likely to succeed.
  3. Guiding the child to complete task
  4. Teaching the child to get along with peers
  5. Teaching the child to get along with adut

Play
            - collecting age begins (Cards, posters, marbles etc.)
Cognitive Dev’t
            - develop logical reasoning, cause and effect
Moral and Spiritual Dev’t
            - God is good and always present to help
            - Hygiene and Nutrition

Adolescent (12-18)

-          Period during w/c the person becomes physically and psychologically mature and acquires personal identity.

Puberty – first stage of adolescent in w/c sexual organ begins to grow and mature.
                                    girls – 10 to 14
                                    boys – 12 to 16
Menarche – occurs in girls
Ejaculation - occurs in boys

Physical Dev’t

            - adolescent growth Spurt
            - Glandular changes – sweat, acne

Cognitive Dev’t

            - ability to use scientific thought – plan their future

Psychosocial Dev’t

-          task is to establish identity and self-concept
-          Adolescent are sexually active and may engage in masturbation or heterosexual activity.
      - Dating helps prepare them for marriage by teaching them how to act with members of    opposite sex.

Promoting Healthy Family Functioning

-          It is not easy to be with teenagers, it is equally difficult to be teenagers
-          Teenagers need good adult role models so that they can see that adult roles are not frightening but desirable.

Sex Education

Common Health Problems
            - Obesity
            - Acne
            - Adolescent Pregnancy
            - STD
            - Drug / Alcoholism
            - Suicide
            - Motor Vehicular Accident

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