GROWTH AND DEVELOPMENT

Introduction of Growth and Development (Introduction of Growth and Development).

The process of growth and development begins before birth, i.e. from the moment of conception in the mother’s uterus, growth and development and pediatrics also begin. Then it starts all life.

Major changes related to growth and development occur between conception and the adolescent age.

Growth and development are closely related to each other, each child has their own unique pattern of growth and development.

Importance of Learning Growth and Development

Knowledge of growth and development is very important for nurses. Through knowledge of growth and development, he can provide effective care to children. The importance of learning growth and development is as follows.

To know about the process of normal growth and normal development of children.

To know what changes can occur in growth and development according to the appropriate age of the child.

To identify early any change in growth and development.

After identification of abnormalities of growth and development to provide appropriate management and treatment early.

To provide the care a child needs at every stage of growth and development.

To explain every aspect of the child’s parents and to participate in the care of the child.

Through a holistic care approach in every aspect of growth and development in every area of ​​the child, he can achieve his full potential.

• Growth (Growth).

Growth is the process of physical maturation. In which maturation (increase) is seen in the size, shape and structure of every organ in the child’s body. This is due to increase in intracellular substances and cell division.

Growth is the quantitative change of the body. It can be easily measured in inches, centimeters, kilograms, pounds etc.

Increase in height, increase in weight etc. in a child shows growth which we can measure in inches or kilograms.

• Development (Development).

Development means the process of physiological maturation of the body and maturation in functional capacity.

That progressive increase in the child’s skill and capacity to do any work is called development.

The main reason for development is the maturation of the nervous system. This is the qualitative aspect of the body.

Measuring development is a bit difficult but it can certainly be measured in a child.
In it, development is measured according to different activities through physiological, psychological, social, intellectual and emotional changes.

A child learns to speak, learn to walk etc. shows development.

• Maturation (Maturation).

Modification of any person’s behavior according to the genetic pattern and continuous increase in functional ability and that person can perform each task at its maximum level according to his capacity is called maturation.

As normal growth of normal height, weight and body structure in the body is called physical maturation.

Research methods for measurement of growth and development. (Research Method for Measurement of Growth and Development).

Different methods are used to measure growth and development. When growth and development are to be measured in children of the same age group, growth and development in children of the same age can be measured and compared by using the cross-section research method.

Longitudinal research method is the measurement of parameters of growth and development of any single child at different ages and comparing them with normal parameters is called longitudinal research method.

Characteristics of Growth and Development. (Characteristic of Growth and Development). Or

Principles of Growth and Development. (Principles of Growth and Development).

Growth and development are closely linked. Growth and development in a child are parallel and continuous.

We use both the terms growth and development interchangeably. But both words are not same. Both have different meanings. Both cannot be used interchangeably We use both terms together for the sake of simplicity.

It is very important to understand the characteristics and principles of growth and development in children, which are given below.

Growth and development is a continuous process. Each child is seen as unique. It also follows patterns of individual differences.

The pattern of growth and development in every child is seen according to its stage. It can be predicted. Stage-wise looks the same for all children but the time to achieve that stage may vary. D. T. Every child learns to sit, learn to speak but the time to achieve this function is different in all children.

In growth, there is an increase in the size and shape of each organ and coordination is seen in it.

Growth and development is observed from Cephalo-caudal i.e. head to tail and Proximo-distal i.e. midline and center to periphery according to these principles.

Growth and development is simple to complex. In the beginning mass movement and activity is seen in a simple pattern. Over time it is observed as specific action and response i.e. complex function.

Development is primarily due to stimulation. As stimulation is given to this child, its development is seen to be better.

Growth and development are interdependent on many factors like heredity and environment.

The influence of society is particularly visible on the growth and development of a child. Development also depends on the cultural aspect.

In growth and development, physical, mental, social, emotional activity is seen in a positive correlation and all those factors are connected with each other.

Growth and development is sometimes fast, sometimes slow and sometimes stable.

• Stages Of Growth and Development (Stages of Growth and Development).

The stages of growth and development are divided into antenatal period and postnatal period as follows.

Antenatal Period (Antenatal Period).

Ovum.
A period of 14 days after conception.
Embryo.
The period from 14 days to eight weeks after conception.
fits.
The period from eight weeks of intrauterine life to the birth of the baby.

Postnatal Period (Postnatal Period).

New Born.
at birth. Or a baby within 24 hours of birth.
Neonate.
Period up to 28 days after the birth of the baby.
Infancy.
A period from one month to one year after birth.
Toddler
Spend one to three years.
Pre school.
A period of three to six years.
School going.
6 to 10 years for girls
Six to 12 years for boys
Adolescent.
The period from puberty to adulthood.
Early Adolescent
Duration from 12 years to 14 years.
Middle Adolescent.
Spend time from 14 years to 16 years.
Late adolescent.
Duration from 16 years to 20 years.

• Factors Affecting Growth and Development

Growth and development depends on many factors. All these factors play an important role in promoting or inhibiting growth directly or indirectly. If all these factors are positively affecting then the growth and development is good and normal. If there are any kind of problems related to these factors then problems are seen in growth and development.

Types of growth and development are as follows.

Biological growth.
It includes height, weight, head circumference, chest circumference etc.

Motor development.
Which includes gross motor and fine motor development.

Sensory Development.
This development is seen due to the sensory stimulation coming from the sensory organs like skin, eye, ear etc.

Factors affecting growth and development mainly include hereditary factors and environmental factors which are described in detail below.

Hereditary factors.

It is also called genetic factor. Which is the main factor affecting growth and development. Different types of characteristics seen in a child such as height, body structure, hair and eye color, skin color, all these factors are seen according to the genetic inheritance received from the parents, that is why children of tall mothers and fathers are usually tall enough. .

Similarly, hereditary or genetic factors, if there is any defective genetic structure in the mother father, it can also produce any type of defect or disease in the children. Genetic diseases like thalassemia, down syndrome, hemophilia etc. are also seen in children from mother father.

Thus, if a normal genetic structure is transmitted from mother to father, the growth and development remains normal, if a defective genetic structure is transmitted, then there is an interruption in its growth and development due to a disease or illness.

A male child or a female child is born due to the sex of the child i.e. caste at the time of conception in the hereditary or genetic structure. Because of this, the characteristics of growth and development are different in both. As a boy child will have more weight at birth and further his body structure growth is more than a female child. Similarly, a female child has lesser growth characteristics than a male child but a female child attains maturity and development earlier than a boy child. This difference is also seen due to hereditary factor.

Due to heredity, different patterns of growth and development are seen in different children according to their nation and race. Like the people of one country are different from the people of another country in terms of height, body structure, skin color, intelligence etc.

Thus, many changes are seen in growth and development due to hereditary factors.

Environmental factors.

These are important factors affecting growth and development. Which includes the following factors.

Antenatal Environmental Factors.

Postnatal Environmental Factors.

Antenatal Environmental Factors.

The period from conception to the birth of the baby, when the fetus is in the mother’s uterus, is called the antenatal period. During this period, many factors related to the mother are responsible for positively and negatively affecting the growth and development of the baby in the uterus. If these factors positively affect the mother, then the growth and development of the child in the womb is better. Similarly, due to the negative effect of this factor, the growth and development of the mother’s child is found to be defective. These factors are as follows.

A. Infectious Conditions and Illnesses of Mother.

Any type of infection or communicable disease or any type of illness in the mother during the antenatal period can adversely affect the growth and development of her micro-organism fetus through the placenta. Due to this infection the baby may be born with congenital anomaly or infection. Which hinders its further growth and development.

B. Maternal mal nutrition.

During the antenatal period, the growth of the child in the uterus is hindered due to the mother not getting enough nutritious diet and due to anemia and nutritional deficiency in the mother. Due to which many problems related to preterm delivery, low birth weight and growth and development are seen in the child.

C. Maternal substance abuse.

During the antenatal period, the mother consumes any type of harmful substance such as tobacco, alcohol, drugs etc. due to long term use, it has a direct side effect on the fetus in the uterus, and its growth and development is disturbed.

Apart from this, the use of any type of medicine without prescription by the mother during this period can also cause congenital problems in the child due to the harmful effects of that medicine, and its growth and development is altered.

D. Hormonal imbalance of mother.

Due to hypo or hyper secretion of any hormone in the mother during the antenatal period, congenital problems can occur in the child. Due to hormonal disturbances in the mother, its side effects are also seen on the intra-uterine growth and development of the children. For example, if a mother has hypothyroidism, her child may have congenital hypothyroidism or growth retardation.

E. Other Maternal Factors.

Other important causes such as reproductive tracks or abnormality such as uterus deformity, placenta’s emotional disturbances, and inadequate. Development found on

All the above factors affect the growth and development of the child during the antenatal period.

Postnatal Environmental Factors.

After the delivery of the mother, the baby arrives in the extra-uterine environment. During this period the following factors affecting the growth and development of the child are seen.

A. Birth condition.

If the weight of the child is normal at the time of birth, the chances of its growth and development being normal later on increases. Apart from this, if the weight of the child is less than normal at the time of birth, then due to many problems related to infection and adjustment, this low weight child is likely to have defective growth and development going forward. So the birth condition in which the child has any congenital anomaly at the time of birth or whether the child has any congenital infection is very important.

B. Nutrition.

After the birth of the child, if the nutritional requirement of the child is fulfilled, the growth and development of the child is seen to be normal. For this the baby should get exclusive breast feeding for six months after birth. A winning diet should then be started and should include adequate amounts of protein, carbohydrates, vitamins and minerals. If a child does not get the nutritional supplements mentioned above, its growth and development is found to be defective. Along with this, many nutritional deficiency disorders can also be seen.

C. Childhood Illness.

If the child has been hospitalized due to any kind of illness or disease during the childhood period, it also affects the growth and development parameters of the child. Apart from this, if there is an acute illness, it does not affect the child much, but if the child has chronic inflammation and frequent hospitalization, then problems in growth and development can be seen.

D. Physical Environment.

The growth and development of the child is affected due to factors such as the condition of the child’s house, the condition around the house, cleanliness, pure water supply, ventilation, safety around the house etc.

E. Psycho – Social and Cultural Factors.

Among the psychological factors, child’s mother-father relationship, love and affection of each family member, healthy and happy family environment etc. affect the positive growth and development of the child. Broken family, unhealthy family member relationship, lack of love, affection and security, stress and inappropriate environment among family members all these factors have a bad effect on the growth and development of the child.

A child’s siblings, society’s neighbors, and the surrounding environment and school environment can also have both positive and negative effects on a child’s growth and development.

The child’s growth and development is also affected due to the culture, habits, traditional beliefs and education, job and economic condition of the family members of the child’s mother and father.

Apart from this, the birth order of the child is also a very important factor. In which the first child gets love and affection very well in the beginning and is given more importance. Then he gets attention for the new child in the family and the first child is neglected. So the birth order of the child is also an important factor for growth and development.

F. Seasonal Change.

In some seasons the growth of the child is seen well and in some seasons the increase in height or length of the child is seen well. The season affects the growth and development of the child.

G. Recreation and Exercise.

Physical activity and exercise in children promotes their growth and development and is very important for healthy growth and development of children.

H. Other Factors.

The intelligence of the child, the balance of hormones in his body, the child’s behavior and his adjustment capacity are also important factors affecting growth and development.

Due to the positive influence of all the above factors, the growth and development of the child is promoted and due to its negative influence, the growth and development of the child is stopped or there is an alteration in it.

• Anthropometric Assessment of Growth and Development.

Anthropometric means scientific measurement of human body. By measuring it, important information about growth can be obtained. By measuring the growth and development process of the child on time, its normal growth and development can be known, and any abnormality can be identified early.

In anthropometric measurement, the physical growth parameters of the child are measured. In which the child’s weight, height or length, head circumference, chest circumference, mid upper arm circumference etc. are measured.

Apart from this, the physical growth of the child can also be assessed due to the closing time of the frontanal in the skull bone, dentition, body mass index etc. to measure the physical growth of the child.

Indications for Measurement of Growth and Development.

To assess normal parameters of child’s normal growth and development.

To identify any abnormality or deviation related to growth and development.

To compare the parameters of growth and development of a child according to age with the parameters of growth and development of another child.

To take immediate treatment measures in case of any abnormality or deviation.

This assessment is also done to prevent complications in the child. For early diagnosis of nutritional deficiency disorders.

Anthropometric Measurement of Growth.

The scientific study of the measurement of physical characteristics of a child to gauge the parameters of its growth is called anthropometric. The following parameters are measured in it.

1. Weight.

Weight is a very important parameter to assess growth in a child. A child’s weight is an important parameter of the child’s overall growth and nutritional status.

The normal birth weight of an Indian baby is 2.5 to 3.8 kg.

In general, all babies lose 10 to 20 percent of their body weight in the first week after birth, and in the following week, i.e. up to two weeks after birth, the baby gains back the same weight as at the time of birth. After this the weight of the child never decreases if there is normal growth.

If the child is growing properly, the child gains approximately 30 to 40 grams of weight per day.

A baby gains double its birth weight during a period of six months. By the age of one year, the weight of the child is three times that of the time of birth.

Apart from this, the weight of the child is four times that of birth at two years, five times that at birth at three years and six times that at birth at five years.

The weight of the child during 7 years is seven times of the time of birth and during ten years the weight of the child is 10 times of the time of birth.

Process of Weight Measurement:

Electronic weight machine as well as adult weight machine or pediatric weight machine are used to measure the weight of the child. In it, the child is weighed keeping in mind the safety of the child with very few necessary clothes and taking precautions of infection prevention.

The weighing fork should be in its normal calibration to weigh the child. Also it should be placed on a flat surface and the weighing fork should be set to zero before weighing.

Record report after weighing the child. Also plotting it in the growth chart and if there is any kind of deviation should be reported to the mother.

2. Height or Length.

A child’s height or length is an important parameter to know the growth of the child’s skeleton. By doing that major one can get information about the child’s growth.

The normal length of a healthy Indian baby at birth is 50 centimeters. It is found to be 60 cm in three months time. 70 centimeters by nine months of age and 75 centimeters by one year.

In two years, the length of the child is found to be 85 centimeters. In three years, the length of the child is found to be 90 to 95 centimeters. During the age of four to five years, the length of the child is almost double that of the time of birth i.e. 100 to 105 centimeters.

After the age of five, a child grows approximately 5 centimeters in length every year until the age of puberty.

Process of height measurement

A tape measure is used to measure the child’s length.

To measure the length of the newborn, the crown heel length is measured after placing him in supine position on a flat surface.

If the child is old enough to stand, he is given a standing height measure. In which the height of the child is measured by standing in front of a stadiometer or vertical height scale.

While measuring the height of the child in standing position, the part of the heel and the part of the buttock and the part of the occiput bone and the solder part of the child should touch the back of the wall or the stadiometer. The child’s gaze should be straight and forward. In this position, the height of the child is measured.

3. Head Circumference.

This is an important indicator for measuring the growth of a child’s brain. In which the head is measured round from the side of the occiput and occiput with a tape measure. So that the growth of the organs inside the cranium cvt can be known.

A normal head circumference of a baby at birth is approximately 33 to 35 centimeters. Which is 40 cm in three months and 43 cm in 6 months. By the age of one year, the baby’s head circumference is found to be 45 centimeters.

Measurement is done with a ringed circle measuring tape from the protuberance of the occipital bone from the upper side of both ears to the front of the supraorbital margin.

If the child’s head circumference is found to be more than normal at the time of birth, the reasons may be hydrocephalus, rickets etc. Babies with this large head circumference are also known as macrocephaly.

Down syndrome, mental retardation, etc. may be the reasons for the head circumference being less than the normal size at the time of birth. Growth Retardation This condition is also known as microcephaly.

Apart from this, the cranium cavity of abnormal shape at birth can also be seen in some conditions.

Craniotabs is also a terminology used for abnormal softness of the bones of the cranium cavity. This condition is also seen as an abnormal birth in the child. This can lead to changes in the normal shape and structure of the cranial cavity.

Fontanelle Of Skull Fontanelle Of Skull..

The depression between the bones of the cranium is called the frontanelle. These are seen in the skull of the child at the time of birth due to the immaturity of the skull bones. The growth of the structure of the skull bone gradually disappears over time. The frontals in the skull are as follows.

Anterior frontanelle.

Located near the junction of the coronal and sagittal sutures in the skull. It is large in size. It is of diamond shape. It takes a year and a half to complete closure. It is also known as second bregma.

Posterior Frontanelle.

This is a depression near the junction of sagittal suture and lambdoidal suture. This is smaller than the anterior. Its shape is triangular. It closes within a period of one and a half to two months after the birth of the child. Its other name is lamb.

The reason for this frontanal closing earlier than normal can be craniostenosis, and the reasons for late closure can be malnutrition, cretinism, etc.

4. Chest Circumference.

Chest circumference is an important parameter for measuring growth. In which the diameter of the chest cavity is measured from the level of the nipple line in a circle with the help of a tape measure.

A normal chest circumference at birth is 2 to 5 centimeters smaller than the head circumference.

Between 6 and 12 months of age, the head and chest circumferences are equal. After one year, the chest circumference continues to increase more than the head circumference.

Normal chest size is symmetrical. Abnormal shape of chest cavity is seen in conditions like rickets, mal nutrition, nutritional deficiency diseases etc.

5. Mid Upper arm Circumference (Mid Upper Arm Circumference).

Mid-upper arm circumference is a very good indicator for assessing the nutritional status of a child. This is an important indicator for identifying growth retardation and nutritional deficiency in children.

Normal mid-upper arm circumference at birth is 11 to 12 centimeters. At the age of one year it is approximately 12 to 16 centimeters. It is found to be 16 to 17 centimeters in a child of 1 to 5 years.

The left hand is always used to measure mid-arm circumference. After hanging the left arm freely, the midpoint is identified by measuring the length between the acromion process of the scapula and the olecranon process of the ulna bone, and from that midpoint, the arm portion is measured in a circle using a tape measure. In this way the measured upper arm circumference can be measured.

For measuring MUAC there is a special tape measure known as Sakir tape.

6. Body Mass Index (Body Mass Index).

It is an important indicator for assessing normal growth of the child, identifying mal-nutrition and obesity.

BMI in children ranges from the 5th percentile to the 85th percentile of normal. A score of less than 5 indicates malnutrition and more than 85 indicates obesity

Normal BMI in adults is found at 18 to 25 kg m square. A BMI less than 18 indicates malnutrition and a BMI greater than 25 indicates obesity.

Classification of malnutrition and obesity is done differently based on BMI.

To calculate BMI.
BMI = weight in kg / height in meter square

7. Dentition.

This is not a major indicator of growth in children. But dentition is also considered as a measure of growth.

Generally, teething occurs at different times in children, but the first central incisor teeth in the lower jaw usually appear in children between 6 and 7 months of age.

The period of tooth eruption may be late in normal children. Even by the age of 15 months, teething action is seen in some children.

The following types of teeth are seen in children.

A. Temporary teeth

These teeth are also called milky teeth or deciduous teeth. Which can be seen in small faces of young children. The teeth first start coming in at 6 to 7 months. After that, an average of one tooth erupts every month in a child.

By the time the child is 2.5 to 3 years old, a full set of temporary teeth is usually seen in children and the total number of these temporary teeth is 20.

B. Permanent Teeth.

Permanent teeth start to come in when the child is 6 years old. Permanent teeth gradually take the place of temporary teeth.

Thus, starting from 6 years, complete permanent teeth come up to the age of 16 to 17 years. It comes as the baby’s face and jaw grow and grow. The total number of permanent teeth is 32.

The types of teeth include incisors, canines, premolars and molars with a total of 32 teeth.

Sometimes congenital teeth are also seen in children. Which is known as natal tooth. These teeth are usually harmless. But problems can be seen due to these teeth in the process of breast feeding.

In children, due to thumb shaking and some types of DCs, teeth are also seen to come in late and are arranged horizontally or crookedly. This type of teeth is also called malocclusion of teeth.

8. Osseous Growth.

It is very important to know the osseous growth and maturation of the child’s height and body growth. Due to its growth, an increase in body height is seen and it starts from the intra-uterine period and continues for approximately 25 years.

Bone has its ossification centers at certain places. which can be identified with the help of radiological examination.

This growth depends on hormonal balance and nutritional status.

• Growth Chart (Growth Chart).

After assessing the growth of the child, it is plotted in a chart. Interpretation of this chart can identify whether the child’s growth is normal for his age, or any type of deviation.

It is necessary to fill the data given in this chart accurately, and with the help of it, the normal growth of the child can be interpreted with the help of the chart, if necessary, appropriate treatment or appropriate measures can be taken.

There are also bands of different colors in this chart like if the plotting of the child’s weight is in the green color band then it shows normal but the plotting done in the red color band shows malnutrition or nutritional deficiency.

• Assessment of Development (Assessment of Development).

Assessing the child’s development is an important indicator. Assessing development is complicated. Every child is different and unique compared to another child to assess child development. So it becomes a bit difficult to measure the developmental parameters but it can be measured accurately.

Following are the areas to assess a child’s development.

1. Motor development.

Motor movement means any kind of movement and action in the body. This motor development is seen through the maturation of nervous system, muscular and skeletal system. This function gradually matures as the child grows older and there is an increase in all his activities and coordination with it.
Following are the areas of motor development.

A. Gross motor development.

This developmental area can be classified as the child’s large muscular movements. Due to the increased mobility of the child, the child can perform different movements using large muscles. Like walking, standing, running, holding, climbing etc. can be assessed in gross motor development.

B. Fine motor development.

Fine motor development occurs due to the matching of the nervous system. In which certain reflexes gradually mature into activities intended for full activity.

In this development, the child uses small muscles and fibers, especially eye coordination, head coordination, hand to mouth coordination, grasping something, small activities with the help of limbs, etc. are considered fine motor activities.

2. Sensory development.

Due to the maculation of this nervous system and nerves, a person becomes aware of different types of specific stimuli like test, touch, smell, hearing, vision etc. after reaching the brain through the sensory nerves. This is the sensory function of the body.

In this type of development, a person becomes aware of and perceives all the stimulation in his environment.

One of these stimulations is that vision is not fully mature at birth. It takes 5 to 7 years to fully mature. All other stimulations are developed in the child from birth.

3. Speech development.

In this, the child’s language function develops gradually and due to the maturation of the nervous system, due to hearing stimulation and different impulses and verbal stimulation from the environment, the child’s language and speech develop gradually. By this gradual development the child develops proper language and speech.

In this development the child learns sounds that are not recognized at first. Then he learns to speak one word and gradually speaks a group of two words and then learns to make small words into sentences and gradually he learns to complete development and co-ordination of language and speech.

4. Personal and Social Development.

The personal and social development of the child includes the influence of the environment and culture of the family members in the environment or culture in which the child lives on his personal and social development. In which the child learns to recognize the social smile, mother, play with toys or copy any stimulation from the environment and tries to learn from it. Thus his personal and social development takes place.

5. Intellectual and Moral Development.

A child’s intellectual development depends on his genetic inheritance as well as environmental factors around him. According to the stimulation received due to it, the child learns new things and modification in his behavior is seen.

As the child grows in age, he follows the rules. Also the sense of right and wrong develops. It is a continuous process to bring about change in the child’s behavior and attitude.

6. Spiritual Development.

Apart from this, spiritual development is also seen in children according to their culture and tradition. In which his development is seen as per the belief of his family member and society. A child’s spiritual development depends on his socio-cultural and tradition.

Psycho Sexual Development (Psychosexual Development).

The gender of the child is determined at the time of conception. Sexual development after birth depends on many aspects like physical, mental, social, emotional, cultural etc. It plays an important role in developing the child’s personality.

Sigmund Freud has given different stages of psychosexual development. According to the stage, this type of development is seen.

• Stages Of Psycho Sexual Development.

According to Sigmund Freud, the psychosexual developmental stages are as follows.

1. Oral stage.

This is the first stage in the child. Which is seen during the infant (0 to 1 year) period. During this stage the child’s certification is limited to oral KVT. which is satisfied by stimulation of breast feeding and sucking. Mother is an important person for the child during this stage.

2. Anal stage.

This is the second stage. Which occurs during the toddler (1 to 3 year) period of life. Toilet training is generally introduced during this stage. So during this stage the child develops the capacity to pass urine and pass stool and hold it. Parents’ support is very important during this stage.

3. The phallic stage.

This stage is seen in children of pre school (3 to 6 years) during their 4 to 5 years of age. During this stage Oedipal complex develops in the child. In which the child is more attracted towards the parents of the opposite sex. For example, if there is a female child, her attraction towards her father is more. During this stage, the child feels enjoyment due to touching the genital organ.

4. Latency stage.

This stage is seen in children of school going (6 to 12 years) age. Which is usually a period of 6 to 12 years. During this stage, the child’s sexual interest remains latent (suppressed) and the child builds relationships and friendships with children of the same sex and age during this time. In which groups of children are formed and behavior of loyalty is developed in this stage. In this stage, the child’s behavior also becomes a little aggressive. Oedipal complex gets resolved during this stage.

5. Puberty and Genitality Stage.

This stage occurs during the period from 12 years onwards to adulthood. During this stage, secondary sexual characteristics develop in both male and female children and emotional changes are also observed. During this stage, the child becomes attracted to a person of the opposite sex and undergoes many physical and mental changes due to emotional and hormonal changes.

• Psycho Social Development Psycho Social Development.

Erection was a psychologist who in 1963 suggested that emotional development is a continuous process and gave his stages of psychosocial development which are as follows.

1. Sense of Trust vs Miss Trust.

This is the first stage. Which is seen during the period of infrancy. If the child is cared for by the mother or his parents during this period, trust develops in him. If separated, the child may experience anxiety and lack of trust.

2. Sense of Autonomy vs Doubt.

This is the second stage of psychosocial development. which occurs during the toddler period. During this period the child tries to do many activities on his own, which shows autonomy. Certain activities they cannot do or are restricted from doing. Which produces a feeling of doubt or shame in the child. Which is produced in the child due to the child not performing the individual task itself.

3. Sense of Initiative vs Guilt.

This third stage is observed in children during pre school i.e. 3 to 6 years period. In which the child tries to do new things, i.e. takes initiation. Due to completing the task, the child develops leadership skills or confidence to do any work. Guilt may develop in the child if the task is not completed.

4. Sense of industry vs inferiority.

This fourth stage occurs during the period of 6 to 12 years i.e. the school going period of the child. In which a feeling of industry is created for positive evaluation of any work and a feeling of inferiority is created for discouragement and incomplete evaluation.

5. Sense of Identity vs Diffusion (Role Confusion).

This is the fifth stage of psychosocial development. In which, during the period of 12 to 19 years, a child feels the feeling of creating his own identity by doing different tasks. He tries to create his personal identity and during this time his role is confusing. He himself selects his own role from those many roles.

6. Sense of Intimacy vs Isolation.

This stage of psycho social development occurs during the adolescence and adult periods. In which a person tries to establish his relationship with others. During this time he does not want to be isolated but because of social relationships he becomes isolated from others at times.

• Intellectual or Cognitive Developmental Theory of Piaget.

Piaget provided a theory of intellectual development. According to which it is divided into four main stages.

1. Sensory motor stage.

This stage is seen in children aged 0 (zero) to 2 years and in that stage children learn about the physical objects of the surrounding environment.

2. Pre operational stage.

This stage is seen in children aged 2 to 7 years. In it, children develop language and themselves live in the dream and fantasy period.

3. Concrete operational stage.

This stage is seen in children aged 7 to 11 years. In which children see the world of fact. Relationships and calculations as well as logical powers during this time

4. Formal operational stage.

This stage is seen from 11 to 15 years. In which children’s thoughts are related to logical thinking.

In addition, Kohlberg’s theory of moral development is given. In which moral development is 3 levels and complete development is seen in 6 stages.

Fowler offers a “stage theory of faith” for spiritual development. According to which spiritual development and faith are fully developed in 4 stages.

• Puberty Changes.

Puberty changes begin during the adolescence period. Adolescence period is classified differently according to its duration as early, middle and late. Different types of changes are seen in each of these periods.

As defined by UNICEF, puberty is a series of biological changes during which a child gradually transforms into an adult.

Many hormonal and physical changes occur during this time. Which is seen due to growth of endocrine system and musculo-skeleton system.

Secondary sex characteristics begin to develop during this period.
Adolescence period is the period from the onset of puberty to the maturation of sexual function. Generally this period is 10 to 19 years.

During the puberty period there are many common changes observed in boys and girls which are as follows.

Changes in boys.

His height and weight increase rapidly. His body starts to become muscular.

The size of his external genital organ increases.

Hair growth occurs on the margin of pubic hair, axillary hair, upper lip.

During the two year period of pubic hair growth, facial hair grows.

His voice becomes dark and thick.

Simmons discharge is seen during night sleep.

Changes in girls.

Increase in height and weight is seen fast.

Increase in breast tissue and nipple size is seen. That is called thelarchy. Apart from this, pigmentation is seen in the areola.

There is an increase in the transverse diameter of the pelvic cavity.

Hair growth is seen in the pubic part. Apart from this, the sweat gland is active in the axillary part and hair growth is also seen in this part.

Menstruation begins. First menstruation is known as menarche. Which is generally considered a sign of puberty.

In the last part of this period, the increase in height becomes less and then the height remains stable.

• Developmental Milestone (Develop Mental Milestone).

Development means functional maturation of body organs.
Milestone A child’s ability to develop certain functions during a certain age.

As children age, the capacity to develop function is not the same in all children. Some children achieve it earlier. Some children develop functions on time. Some children may also develop this pattern late.

This functional maturity is based on factors like genetic structure, neuromuscular development, environmental stimulation, intelligence etc.

Indian babies achieve their milestones earlier than European babies.

• Developmental Milestone of Infant (Developmental Milestone of Infant).

An infant is a child below 1 year of age. As the child ages after birth, the following functions develop. Recognize it as his milestone

1 to 3 months.

During this time, the child can lift up his chin in a prone position. His vision is developed up to 20 cm. A child cries when it feels hungry or has any kind of discomfort.

During this time the baby turns its head towards any sound. Smiles at Mother. Baby recognizes mother and social smile develops during this period.

A child can focus on a moving object. A baby produces a cooing sound which is the beginning of language development.

A child in a prone position is able to lift his head and a little chest by putting weight on his arms.

Recognizes the sound around him and also enjoys it.

3 to 6 months.

During this time the baby develops his head control. He can keep his head steady in upright position.

He can hold anything with his palm. Can hold objects with hands and place in mouth. Can laugh out loud. Can sit with support.

Can transfer an object from one hand to another. Can enjoy his mirror image. Others try not to copy.

Produces different types of sounds in which monosyllables speak single words such as m, d, b, etc.

Children recognize and enjoy the household members around them.

6 to 9 months.

A child can sit without support. He can walk on his abdomen. He can speak single words and can speak monosyllabic words. Can recognize unknown persons and show anxiety towards them.

9 to 12 months.

A child can sit without support. He can stand with support.

Bi syllabic word means two can speak two words. Like Baba, Dada, Mama, etc.

An object can be grasped with the help of the index finger and thumb (pincer grasp). Can understand emotions like anger, love, etc.

Can stand without support and walk with support. Some bi syllabi can speak with words meaning.

• Developmental Milestone Of Toddler (Developmental Milestone Of Toddler).

This is a period of 1 to 3 years. In which the mobility of the child increases very quickly. His socialization increases. Also many developmental changes are seen in the child.
The developmental milestones at this time are as follows.

12 to 15 months.

It can run. Some steps forward and some steps back. Can do small activities with the help of fingers. Like picking up anything, turning the pages of a book, etc.

15 to 18 months.

He can climb the steps of the stairs. Can drink from a cup by himself.
He can remove socks from shoes. Can point out body parts.

Stops putting toys in mouth. Nonlanguage develops to speak 6 to 20 words. Copies the actions of others.

18 to 24 months.

During this time the child can run. Can climb steps. Which has the capacity to step on another step after resting on one step.

Can wear shoes and shox. Can remove clothes. Can build a tower of 6 to 7 blocks.

Can draw horizontal and vertical lines.
Bladder control may develop during the day.
Can speak simple sentences.

24 to 36 months.

During this time, the child can run, jump, climb steps in a coordinated manner, stand on one leg.

Can drive a tricycle
Can put on and take off clothes.
Learn to use a toothbrush.
Can make a circle.

Can build a tower of 6 to 9 blocks.
Can store 250 words and can also make sentences.

No bladder control may develop during the night.
Fear develops from dark places.
Pierre enjoys playing with the children in the group.

• Developmental Milestone Of Pre School (Developmental Milestone Of Pre School).

This period is 3 to 6 years. During this period the following milestones are developed in the baby.

He can jump, run and jump.
Can form a cross (+) sign. Can make a tilt cross (X).

A rectangle can be formed during the age of 4 years and a triangle can be formed during the age of 5 years.

Letters can be copied.
Can describe stories and own experiences.

Works independently. Is physically aggressive. Lack of patience is seen in oneself.
Jelsi develops from Shiblings.

• Developmental Milestone of School Age (Developmental Milestones of School Age).

This period is 6 to 12 years. During this period the following developmental parameters are seen in the child.

He can run fast, jump. Can climb any place using good coordination.

His hand and eye coordination is developed.
Can write well and can take care of himself.

Can speak and understand complete sentences with feelings.
Can follow commands given by others.

Learns to play in a group, learns discipline. Can understand praise from others.

Writing and reading skills are developed. The family participates in the discussion.

Involves in peer groups for sex role identification and awareness.

Participate in coordinated and multi-purpose games and improve their mobility and coordination.

All parts of speech in the language can be spoken and understood correctly.
His behavior can be very aggressive.

• Important Milestones Up to Toddler (Important Milestones Up to Toddler).

Social Smile Six to eight weeks

Head holding three months

Five to six months of sitting with support

Seven to eight months of sitting without support

Five to six months to reach any object

Transferring objects from one hand to another in six to seven months

9 months grasping small objects with the help of his index finger and thumb

Creeping means walking with the help of both hands and feet by 10 to 11 months

9 months of standing with support

Twelve months of conception without support

10 to 12 months of walking with support

13 to 15 months of walking without support

15 months from outside eating with a spoon by yourself

Running 18 months

Climbing stairs 10 to 24 months

Speaking monosyllabic words at seven to eight months

8 to 9 months to speak a bye syllabic word

12 months to speak two to three words with meaning

24 months to speak simple sentences

Storytelling 36 months

15 to 18 months to remove shoes and shocks

Wearing shoes and socks 24 months

3 to 4 years to wear their complete dress

No bladder and bowel control during the day for two years

Three years of riding a bicycle

Three years to have knowledge about own name and caste

No night time bladder and bowel control for three years.

Intellectual development jean piaget
Moral development Lawrence Kohlberg and Piaget
Emotional Development Erikson
Psychosexual Development Sigmund Freud

• Assessment Of Development (Assessment of Development).

Developmental assessment is done to identify any kind of developmental deviation. In which DDST i.e. DENVER DEVELOPMENTAL SCREENING TEST is done to identify developmental delay in infants, toddlers, preschoolers etc.

This test is wildly popular around the world. It was done in 1967 to assess developmental parameters of children. Mainly 4 parameters are tested in this test such as gross motor, fine motor, language and personal social behavior. This test was tested with 105 parameters for major. It is very difficult to measure the parameters of the test, because if the parents of the child are not educated then the test is inappropriate for the children.

In this test, a modified DDST 2 or DENVER 2 was developed in 1992 with 125 parameters.

Apart from this, for screening of development DEVELOPMENTAL ASSESSMENT SCALE OF INDIAN INFANT (DASII), BARODA DST, TRIVENDRUM DST, etc. many tests were done to determine the developmental milestones of the child.

• Toilet Training Program (Toilet Training Program).

This program is initiated in the toddler period in the child. In which the child is made to use the toilet. Which is an important step for the child and his parents. Before starting this step it is necessary to decide when to start it. For this it is necessary to see some signs of readiness of the child.

When to start.

The time to start toilet training is generally done after the child is above 18 months. But the child should stay dry by nappy for some hours during the day and the child should inform the mother before passing urine or stool and is capable of holding it, this time is considered ideal for toilet training.

Toilet training can be started when the child explains to the mother with sign language or indicates by giving a sign to pass urine or stool.

Points to be remembered while starting toilet training.

To check for signs of child readiness.
Give the child information about the potty or toilet and explain how it is used by others with a pictorial image.

The time to start toilet training should be selected whenever the mother is going to stay at home for a full day.

Avoid using nappies during the day while training the baby, although it is imperative to use these nappies during the night.

At the time of starting this training, children should be dressed in clothes that can be easily removed.

Try to schedule the child’s toileting and set his routine accordingly.

Give the child more liquid and fiber in his diet so that he does not have constipation.

If the child does not cooperate with this program, wait until he is willing and keep trying this program.

Always give positive assurance and praise the child for his efforts and give him any gift or praise when the process is completed.

Do not make the child sit on the toilet for a long time so as not to create a feeling of punishment.

Clean the child properly after using the toilet and also give him education about hygiene.

Explain to the child about hand washing and follow the hand washing practices and hygiene steps.

The success of this program may take days to months so that the program is started according to the unique developmental pattern of the child without comparison with other children.

• Role of Parents In Sex Education (Role of Parents in Sex Education).

Educating children about sex and sexuality is an important task by parents. Parents may be afraid or feel hesitant about how to talk to their child about this matter. But giving the information to the child is very important.

It is an uncomfortable task for parents to inform the child about reproductive body parts and their functions.

The mother and father are also worried that any kind of experiment or implementation may be done by the child due to giving information about this matter.

It is necessary to create a good environment for giving sex education to the child in which he can ask anything and know anything.

Respect every belief of the child, understand it and give appropriate answers to it.
Developing proper communication habits with children so that children can have a conversation about anything.

Explain to the child about good and bad physical touch.
Ask the child to identify the roles of male and female in society.

Convince the child to maintain the sexual organ of the body its function and its hygiene.

All these things can be explained to the child through the medium of television or by showing any kind of picture or video.

It is necessary to answer the questions asked by the parents in correct and understandable language.

If the child does not ask any kind of questions about sex and sexuality, start the conversation from the front and give information.

.