Hormonal disorders cause gigantism, dwarfism, or delayed puberty
🟨 10. Gender:
Boys and girls grow at different rates
Girls attain puberty earlier than boys
📚 Golden One-Liners for Revision:
🟢 Growth = increase in size, Development = increase in ability
🟡 Cephalocaudal = head to toe, Proximodistal = center to periphery
🟠 Nutrition is the most important external factor affecting growth
🔴 Development is sequential but individually paced
🟣 Physical and mental growth are interdependent
✅ Top 5 MCQs for Practice:
Q1. Growth refers to: 🅰️ Emotional maturity ✅ 🅱️ Increase in body size and weight 🅲️ Thinking process 🅳️ Language development Answer: ✅ (b)
Q2. Development proceeds from: 🅰️ Complex to simple 🅱️ Foot to head ✅ 🅲️ Head to toe (Cephalocaudal) 🅳️ Outside to center Answer: ✅ (c)
Q3. Which factor most directly influences growth? 🅰️ Playing habits ✅ 🅱️ Nutrition 🅲️ Peer pressure 🅳️ Media exposure Answer: ✅ (b)
Q4. Which principle describes control from shoulder to fingers? 🅰️ Cephalocaudal ✅ 🅱️ Proximodistal 🅲️ Interrelated development 🅳️ Continuous process Answer: ✅ (b)
Q5. Which is a prenatal factor affecting growth? 🅰️ School attendance 🅱️ Emotional bonding ✅ 🅲️ Maternal infection 🅳️ Play therapy Answer: ✅ (c)
📝👶 Techniques of Assessment of Growth and Development
📘 Essential for Pediatric Nursing, Community Health, and Staff Nurse Competitive Exams
🔰 Definition:
Assessment of growth and development refers to the systematic evaluation of a child’s physical, emotional, cognitive, and social progress, using standardized tools and observations, to detect normal or delayed development.
“Assessment is not just measuring height and weight—it’s understanding the child as a whole.”
🧭 Techniques of Growth Assessment:
🟩 1. Anthropometric Measurements:
Used to assess physical growth.
Parameter
Tool Used
Normal Indicators
✅ Weight
Weighing scale
According to WHO Growth Chart
✅ Height/Length
Infantometer/Stadiometer
Based on age and sex
✅ Head Circumference
Non-stretchable tape
Avg. at birth = 33–35 cm
✅ Chest Circumference
Tape
Less than head in infancy
✅ Mid-Upper Arm Circumference (MUAC)
MUAC tape
Detects malnutrition (<12.5 cm)
🟨 2. Growth Monitoring Charts:
WHO Growth Charts (0–5 years)
Indian Academy of Pediatrics (IAP) charts
Used to plot height, weight, head circumference over time
Helps detect growth faltering
🟧 3. BMI (Body Mass Index):
Formula: Weight (kg) / Height (m²)
Assesses nutritional status in children above 2 years
🧠 Techniques of Developmental Assessment:
🟥 4. Developmental Milestone Checklists:
Age-wise expected achievements in: 🔹 Gross motor (sitting, walking) 🔹 Fine motor (grasping, drawing) 🔹 Language (babbling, speaking) 🔹 Social (smiling, playing)
🧾 Used by ANMs, nurses, pediatricians to screen for delays
🟦 5. Denver Developmental Screening Test (DDST-II):
Standardized screening tool (birth to 6 years)
Screens 4 domains: Gross motor, Fine motor-adaptive, Language, Personal-social
Result: Normal, Suspect, or Untestable
🟪 6. Baroda Developmental Screening Test (BDST):
Indian tool used to assess development in rural and urban Indian children
Suitable for use by health workers and nurses
🟫 7. Ages and Stages Questionnaire (ASQ):
Parent-completed questionnaire for age-specific development
Useful in community and home-based settings
⬛ 8. Play Observation & Behavior Analysis:
Observe how child interacts, communicates, solves problems
Reveals emotional, cognitive, and social maturity
🩺 Clinical & Neurological Examinations:
Reflex testing (Moro, Rooting, Babinski in infants)
Muscle tone & coordination
Used in high-risk infants or children with delay
👩⚕️ Nurse’s Role in Growth & Development Assessment:
Record accurate measurements using correct tools
Plot and interpret growth charts
Use milestone checklists during home visits or clinic
Educate parents about expected growth and warning signs
Refer child for early intervention if any delay suspected
Encourage regular follow-up and nutritional support
📚 Golden One-Liners for Revision:
🟩 Head circumference is crucial for brain growth
🟨 MUAC <12.5 cm = moderate to severe malnutrition
🟧 DDST screens 4 developmental domains
🟥 Growth charts help detect growth faltering early
🟦 Play observation is a natural method to assess development
✅ Top 5 MCQs for Practice:
Q1. Which tool is used to assess physical growth in children? 🅰️ IQ test ✅ 🅱️ Growth chart 🅲️ Blood pressure monitor 🅳️ Pulse oximeter Answer: ✅ (b)
Q2. What does DDST stand for? 🅰️ Daily Developmental Stage Test ✅ 🅱️ Denver Developmental Screening Test 🅲️ Development Detection System Test 🅳️ None of the above Answer: ✅ (b)
Q3. Normal head circumference at birth is: 🅰️ 25–28 cm ✅ 🅱️ 33–35 cm 🅲️ 36–40 cm 🅳️ 30–32 cm Answer: ✅ (b)
Q5. What is the best way to assess social development in a 2-year-old? 🅰️ Chest circumference 🅱️ MUAC 🅲️ IQ test ✅ 🅳️ Observation during play Answer: ✅ (d)
📉📏 Plotting of Growth Chart
📘 Essential for Pediatric Nursing, Community Health Nursing, IMNCI & Nutrition Programs
🔰 Definition:
A growth chart is a graphical representation of a child’s physical measurements (such as weight, height, and head circumference) over time compared to standardized reference values to assess nutritional and developmental status.
✅ Growth charts are used to monitor growth patterns and detect early malnutrition, stunting, or obesity.
🧭 Types of Growth Charts Used:
📌 Chart Type
🧒 Age Group
📝 Purpose
🟩 WHO Growth Standards (2006)
0–5 years
International standard used in India
🟨 IAP Growth Charts (India)
5–18 years
For Indian children and adolescents
🟧 Mother and Child Protection Card
0–5 years (community use)
Used by ANMs/ASHAs for growth monitoring
🧠 Key Parameters Monitored:
Weight-for-Age
Height/Length-for-Age
Weight-for-Height (Wasting)
BMI-for-Age
Head Circumference (Infants)
📏 Steps for Plotting Growth Chart:
🟩 1. Accurate Measurement:
Weight: Use calibrated weighing scale
Length (0–2 yrs): Use infantometer
Height (2+ yrs): Use stadiometer
MUAC: Use MUAC tape
Head circumference: Use non-stretchable tape
🟨 2. Identify the Correct Growth Chart:
WHO chart for under-5
IAP chart for school-aged and adolescents
Use gender-specific chart (boys/girls)
🟧 3. Mark the Child’s Age:
Calculate exact age in completed months or years
Mark age on the horizontal (X-axis)
🟥 4. Plot the Measurement:
Mark the measured weight or height on the vertical (Y-axis)
Draw a point at the intersection of age and measurement
🟦 5. Connect Successive Points:
Plot values at each visit (monthly or quarterly)
Join the dots to observe growth trend over time
🟪 6. Interpret the Curve:
Compare with percentile lines (e.g., 3rd, 15th, 50th, 85th, 97th)
Normal growth is between 3rd and 97th percentile
Falling curve = red flag for malnutrition or disease
Sudden jump = obesity, endocrinological issues
🧮 Classification Based on Growth Curve (as per WHO standards):
Zone
Interpretation
🟢 Green Zone
Normal growth (healthy child)
🟡 Yellow Zone
At risk (monitor closely)
🔴 Red Zone
Severe malnutrition (urgent care)
👩⚕️ Nurse’s Role in Growth Chart Use:
Ensure accurate measurement and plotting
Educate parents about child’s nutritional status
Identify children with growth faltering
Refer to nutrition rehabilitation centers if needed
Integrate plotting with IMNCI or RBSK assessments
📚 Golden One-Liners for Revision:
🟢 Growth chart = child’s growth over time vs standard
🟡 WHO chart used for children 0–5 years
🔴 Falling growth curve = possible malnutrition or disease
🟠 Always use gender-specific chart
🟣 MUAC <12.5 cm = moderate to severe undernutrition
✅ Top 5 MCQs for Practice:
Q1. Growth charts help in: 🅰️ Diagnosing cancer ✅ 🅱️ Detecting malnutrition and growth pattern 🅲️ Estimating IQ 🅳️ Counting calories Answer: ✅ (b)
Q2. WHO growth charts are used for children aged: 🅰️ 5–10 years ✅ 🅱️ 0–5 years 🅲️ 10–18 years 🅳️ All ages Answer: ✅ (b)
Q3. What does a falling curve in growth chart indicate? 🅰️ Normal growth 🅱️ Good nutrition ✅ 🅲️ Growth faltering/malnutrition 🅳️ Excess milk Answer: ✅ (c)
Q4. What is plotted on the Y-axis of a growth chart? 🅰️ Age ✅ 🅱️ Weight or height 🅲️ Temperature 🅳️ IQ Answer: ✅ (b)
Q5. The green zone in growth chart represents: 🅰️ Severe malnutrition ✅ 🅱️ Normal growth 🅲️ Moderate malnutrition 🅳️ Obesity Answer: ✅ (b)