Growth and

Development Phases
BLOK XIX
Growth & Develoment phases
Prenatal: Conception to the Birth
Infancy: Birth to 12 months
Neonatal period: Birth to 28 days
Early neonatal period: Birth to 7 days
Late neonatal period: 7 days to 28 days
Infancy Period: 29 days to 12 months
Early Childhood: 1 year to 6 years
Toddler Period: 1-3 years
Preschool Period: 3- 6 years
Middle childhood: 6- 12 years
Late Childhood or Adolescent: 12-18 years
Puberty Period:
Male: 12-14 years
Female: 11-13 years

Prenatal Growth & Development
Embryonic period
(1-8 weeks of gestational age)
Week
1. Fertilisation, implantation
2. Endoderm and ectoderm appear
3. Mesoderm appear, somite begin to form
4. Neural fold fuse, folding of embryo into human-like shape, arm and leg
bud appear
5. Lens placodes, primitive mouth, digital rays on hand
6. Primitive nose, philtrum, primary palate
7. Eyelids begin
8. Ovaries and testes distinguishable
End of the period, the rudiments of all major organ systems have developed,
the average weight 9 g, and length of 5 cm


Fetal period (9 weeks to birth)
Week
10 The face is recognizably human
12 External genital distinguishable
13 Breathing and swallowing motions
17. Grasp reflex
20 Primitive alveoli and surfactant production.
28 Eyes open, turns head down
Midgestation, full range of movement
3 rd trimester, respond to external stimuli
38 Aterm, weight 2500-4500 g, length 45-55 cm



The newborn (Neonatal period)
(0-28 days of age)

Birth weight average 3000 g (2500-4500g)
Birth length average 50 cm (45-55 cm)
Birth head cicumference 34 35 cm
Transition from Intrauterine to extrauterin
Soon after birth, alert and ready to interact
After 40 minutes period of alertness, follow by
somnolence, and sleep
Skin-to-skin contact between mother and
infant immediately, increased rate and longer
duration of breast-feeding
Nearsighted, 8 12 inc
Hearing is well developed

The first year
0 - 2 months
2 - 6 months
6 - 12 months
Age 0 - 2 months
1 st wk, weight may decrease (< 10 %)
2 nd wk, regain or exceed birthweight
Grow + 30 g/day during the 1 st mo
Limb movements uncontrolled
Primitive reflexes ex. rooting reflex
Smilling involuntarily
Eye gaze, head turning, sucking are under better
control
Crying in response to stimuli
Recognize facial expression as similar, even on
different faces

Age 2 6 months
Physical development :
3-4 mo, growth solws, + 20 g/day
Primitive reflexes gone
No head lag, rolling
3 mo, asymmetric tonic reflex gone,
manipulate object with 2 hands in the midline
4 mo, graspes rattle, palmar grasp gone,
reaches for object
Cognitive development:
Explore their own body
Vocalizing, blowing bubbles

Social & communication development :
Primary emotions of anger, joy, interest, fear,
disgust and surprise appear in facial
expressions

Age 6 12 months
Physical development :
Growth slows more (15 g/day)
7 mo, sit unsupported
8 mo, crawling
9 mo, pincer grasp
12 mo, walks alone
Cognitive development :
Novel objects are picked up, inspected, passed
hand to hand, banged, dropped, and then
mouthed.
9 mo, object constancy, understanding that
objects continue to exist even when not seen

Emotional development :
Look back and forth between strangers and
parents may cling or cry anxiously
Separation become more difficult
A new demand for autonomy emerges self
feeding, tantrum
Communication :
6 mo, babbling with many syllables (ma, da,
ba)
10 mo, repetitive consonant sounds (mama,
papa, dada)


The second year
12 18 months
18 24months
Age 12 18 months
Physical development :
The growth rate solws further, appetite declines
Walks independently
Cognitive development :
Reaching, grasping, releasing, and greater mobility
gives them access to more and more object,
exploration increases
Imitation of parents and older children is an
important mode of learning
Play centers on the childs own body
( ex. pretending to drink from an empty cup)
Emotional development :
Infant may be irritable
Toddler as intoxicated with their new ability and
the power to control the distance between
themselves and their parents
Communication development :
Receptive language precedes expresive
12 mo, speaks the first word
Respond appropriately to simples statements (no,
bye-bye, give me)
15 mo, points to major body parts
Uses 4 6 words spontaneously and correctly
Age of 18 24 months
Physical develompent :
Height and weight increase at a steady rate
Head growth slows slightly
Motor development is incremental, improvement in
balance and agility, running, stair climbing
Cognitive development :
Object permanence
Cause and effect are better understood
Symbolic transformation in play (ex. feeding the doll
from the empty plate)
Emotional development :
Increased clinginess, separation at bed-time
are often difficult
Many children use transisional object (ex.
special blanket or stufled toys)
Communication :
18 mo, 10 15 words
2 yr, 100 words or more, to make simple
sentences
Understand two-step commands
Preschool years
(2-5 yr of age)
Physical development :
Somatic and brain growth slows
Average child gain + 2 kg/yr, and 7 cm/yr
Nutritional requirement and appettite decreases
3 yr, visual acuity 20/30, all primary teeth have
erupted
Throwing, catching and kicking balls, riding on
bicycles
Handedness
Bowel and bladder control


Communication :
Vocabulary 100 to more than 2.000 words
21/2 yr, using possessives, progressives,
guestions and negatives tenses
4 yr, count to 4, and use the past tense
5 yr, use the future tense
Cognitive development :
Magical thinking
Egocentrism
Thinking that is dominated by perception


Play :
Increasing complexity and imagination
. 2 3 yr, simple scripts (ex. shopping and putting baby to
bed)
. 3 4 yr, more extended scenario (ex. going to the zoo,
going on a trip)
. 4 5 yr, creation of scenario (ex. flying to the moon)
Socialization from minimal social interaction to
cooperative play
. 1 2 yr, solo or parallel play
. 3 4 yr, cooperative play, together, sharing
. 5 yr, recognition the rules
Emotional development :
2 yr, behavioral limits are predominantly
external
5 yr, these controls need to be internalized
Young children cannot control many aspects of
their life temper tantrums
Schoolaged
Physical development :
Growth 3 3,5 kg/yr, and 6 cm/yr
Head grows 2 3 cm
Loss of deciduous teeth, replacement by adult teeth
Lymphoid tissue hypertrophy
Muscular strength, coordination & stamina increase
progressively
Sexual organ physically immature, but interest in
gender differences
Cognitive & language development :
Reading, writing, and basic mathematics skills
Enjoy strategic games and word play

Social & emosional development :
Social & emotional development proceeds in 3
contexts : home, school & neighborhood
Separation from the family and the increasing
importance of teacher & peer relationships.

Adolescence
Rapid changes in body size, shape, physiology,
psychologic, ans social functioning
Hormones set the development agenda
Transition from childhood to adult
Three distinct periods : early, middle, and late
Early adolescence
Biologic development :
Production of androgen development of
underarm odor and genital hair (adrenarche)
GnRH, LH, FSH, androgen and estrogen increases
Somatic & physiologic changes gives rise to the
Sexual Maturity Rating (SMR) or Tanner stages key
stages of breast, pubic hair, and testicle and penile
development
Perkembangan bentuk dan ukuran payudara (Dikutip dari Fig.14-2,
Behrman et al, Nelson textbook of Pediatrics, 2000, hal.54)
Perkembangan rambut pubis (Dikutip dari Fig.14-1, Behrman et al,
Nelson textbook of Pediatrics, 2000, hal.53)
Perkembangan bentuk dan ukuran genitalia (Dikutip dari Fig.18-14,
Vaughan & Litt: Child Adolescent Development: Clinical
Implication, 1990, hal.250)
Girls :
8 13 yr, the first visible sign of puberty is the
appearance of breast bud
9 16 yr, menarche, around the peak in height
velocity
Boys :
91/2 yr, testicular enlargement
Breast hypertrophy occurs in 40 65% of
pubertal boys
Growth acceleration begin in early
adolescence, but peak growth velocities are
not reached until SMR 3 or 4.
Boys typically peak 2-3 yr later than girls, and
continue their linear growth for + 2-3 yr after
girls have stopped
Adrenal adrogens stimulate the sebaceous
glands development of acne.
Sexuality :
Interest in sex increases
Ejaculation (during masturbation, and
spontaneously)
Cognitive development :
Transition from the concrete preoperasional
thinking to formal logical operations
Self-concept :
Self-awareness tends to center on external
characteristics

Relationship with family, peers, and society:
Trend toward separation from family with
increasing involvement in peer activities
Socialize in same-sex peer groups
Relationship to society centers on school
Ready access to pornography on the internet
may increase the risk of premature sexual
activity or exploitation
Middle Adolescence
Biologic development :
Growth accelerates, rate of 6-7 cm/yr
In girls, the growth spurt peaks at 11,5 yr at a
top velocity of 8,3 cm/yr, and then slows to a
stop at 16 yr.
In boys, the growth spurt starts later, peaks at
13,5 yr at 9,5 cm/yr, and then slows to a stop
at 18 yr.
Weight gain parallels linear growth
Muscle mass increases, follow by an increase in
strength
Menarche,
in 30% of girls by SMR3 (+ 12-14 yr), and
in 90% by SMR4 (+ 13-15 yr)
Sexuality :
Dating becomes a normative activity
High testosterone and low religiosity together may
predict which boys become sexually active

Cognitive and moral development :
With the transition to formal operational
thought, they question and analyze
extensively

Self-concept :
Often experiment with different personae,
changing style of dress, groups of friends, and
interests from month to month
Relationship with family, peer & society:
Adolescents may become distance from
parent, redirecting emotional & sexual
energies toward peer relationships
Dating increases, the need to belong to same-
sex groups declines
Often begin thinking seriously about what
want to do as adults
Late Adolescence
Biologic development :
The somatic changes are modest by
comparison
The final stages of breast, penile, and pubic
hair occur by 17-18 yr of age in 95%
adolescents
Psychosocial development :
Sexual experiment decreases as adolescents adopt
more stable sexual identities
Cognition tends to be less self-centered, increasing
thoughts about justice, patriotism and history
Often idealistic, but also may absolutist and
intolerant of opposing views
Dating relationship increasingly involve love and
commitment
Career decision become pressing