Measurement of Growth Human Developmental Changes – JSS2 Basic Science Lesson Note (First Term)

Growth is the progressive increase in the size of a child or of parts of a child.

• Development: the progressive acquisition of skills such as head support, speaking, learning, expressing feelings and relating with other people.
• Maturity: the point at which the body is fully developed.
• Link between them: growth and development go together but at different rates.

Behavioural objectives

By the end of the lesson, students should be able to:

1. define growth, development and maturity;
2. state why growth and development are assessed;
3. list the factors that affect growth and development;
4. name the measurements used to measure growth and describe how to take them;
5. explain how good nutrition, emotional support and play promote development;
6. describe the stages of human development.

Why do we assess growth and development?

Growth and development are assessed to find out the state of health and nutrition of a child.

• Normal progress: continuous normal growth and development show a good state of health and nutrition.
• Abnormal progress: abnormal growth or growth failure is a symptom of disease.
• Physical examination: measurement of growth is therefore an essential part of it.

What factors affect growth and development?

Each child’s pattern of growth and development is determined by genetic and environmental factors.

• Genetic factors: they set the potential and the limits of growth and development.
• Favourable environmental factors: they help the child reach the genetic potential, for example adequate nutrition.
• Unfavourable environmental factors: acting singly or together, they slow or stop growth and development.

What are the unfavourable factors?

The unfavourable factors include malnutrition, infections, congenital malformations, hormonal disturbances, disability, and lack of emotional support, play and language training.

• Malnutrition: too little food or food that lacks the right nutrients.
• Infections: illnesses that repeatedly weaken the child.
• Congenital malformations: body defects present from birth.
• Hormonal disturbances: faults in the hormones that control growth.
• Disability: a physical or mental limitation that restricts normal progress.
• Lack of emotional support: the child is not given love, security and recognition.
• Lack of play: the brain and muscles are not stimulated.
• Lack of language training: the child is not taught to speak and understand.

What is catch-up growth?

Catch-up growth is a period of faster than normal growth that follows the removal of unfavourable factors.

1. Remove or reduce the unfavourable environmental factors to promote optimum growth.
2. The growth rate then rises above normal.
3. It stays high until the previous growth pattern is reached.
4. The rate then falls to the normal rate set by the child’s genetic factors.

• Height example: a child genetically determined to be tall grows slightly faster than one determined to be short.
• Intellect example: a child genetically determined to be clever develops intellect more quickly than one determined to be less intelligent.

How is growth measured?

Growth is measured using five measurements: weight, height, head circumference, mid-upper arm circumference (MUAC) and the eruption of teeth.

1. Weight
2. Height
3. Head circumference
4. Mid-upper arm circumference (MUAC)
5. The eruption of teeth

• Accuracy: to be useful, measurements must be taken accurately.
• Equipment: use reliable equipment and the correct measuring technique.

How is weight measured?

Weight is measured with a beam balance or a spring balance.

1. Place the child in weighing pants.
2. Hang the pants on the hook of the scale.
3. Read and record the weight.

How is head circumference measured?

Head circumference is the greatest distance around the head, measured with an unstretchable tape measure.

1. Encircle the head with the tape. Use a piece of string if there is no tape measure.
2. Pass it over the most prominent part of the occiput at the back.
3. At the front, pass it just above the supraorbital ridges (the eyebrow ridges).
4. Check that this gives the greatest distance around the head.
5. If string was used, measure the string with a ruler to get the head circumference.

How is mid-upper arm circumference (MUAC) measured?

MUAC is the distance around the middle of the upper arm, measured with a tape or, if there is none, a piece of string.

1. Place the tape or string around the upper arm.
2. Put it midway between the olecranon (point of the elbow) and the acromion process (tip of the shoulder).
3. Do not pull it too tightly.
4. Read the measurement.
5. If string was used, measure the string with a ruler to get the MUAC.

How are length and height measured?

Length is measured lying down in the first 3 years, and height is measured standing after 3 years of age.

Steps to measure length

1. Put a horizontal measuring board on the ground or a table.
2. Lay the child on his back with the head against the fixed headboard.
3. A helper holds the head so that the eye angle-external ear canal line is vertical, and keeps the body straight.
4. With one hand, the health worker presses the child’s knees down to straighten the legs fully.
5. With the other hand, the health worker places the sliding footboard firmly against the heels.
6. Read the child’s length on the meter scale.

Steps to measure height

1. The barefoot child stands with the feet together. The heels, buttocks and occiput lightly touch the measuring device.
2. Align the head so that the external eye angle-external ear canal plane is horizontal.
3. Tell the child to stand tall.
4. Gently stretch the child upward by pressure on the mastoid processes, with the shoulders relaxed.
5. Lower the sliding headpiece to rest firmly on the head.
6. Read and record the height.

What factors promote development?

The factors that promote development are good nutrition, emotional support, play and language training.

How does good nutrition promote development?

Good nutrition is essential for normal growth and development.

• The brain: unlike most other organs, it is not fully developed at birth.
• First 6 months: good nutrition in this period is extremely important.
• Effect of malnutrition: it may inhibit the growth of the brain in this period.
• Lasting harm: impaired brain growth may affect the child for the rest of life.
• Behaviour: a malnourished child is often tired, apathetic and not interested in learning new things.

How does emotional support promote development?

Emotional support is the love, care and respect a child receives, and it is needed from birth.

• First 5 years: they are critical for the foundation of skills developed later.
• Newborn: a baby starts with no knowledge and learns a great deal in the first year.
• Treatment: a child is a developing human being from birth and must be treated with love and respect.

What are the eight basic emotional needs of a child?

The eight basic needs for healthy emotional development are love, security, acceptance as an individual, self-respect, achievement, recognition, independence and authority.

1. Love: the child needs to feel loved continuously.
2. Security: the child needs to feel safe.
3. Acceptance as an individual: the child needs to be loved for what he is.
4. Self-respect (self-esteem): the child needs to feel valued and able to succeed.
5. Achievement: the child needs to do things for himself.
6. Recognition: the child needs parents to notice and praise new skills.
7. Independence: the child needs to learn to make decisions.
8. Authority: the child needs rules given with affection.

Love

• A child who does not feel loved will not develop properly.
• Such a child learns more slowly than other children.
• He becomes sad and lonely and loses interest in what goes on around him.

Security

• A child feels safe when his parents show love and take good care of him.
• He must know that parents will look after him, feed him when hungry, play with him and keep him comfortable.
• Love and security from the mother and family build a sense of trust, first in family members and later in people outside the family.

Acceptance as an individual

• The family should love the child for what he is.
• They should not compare him with other children.
• They should not call him slow or say he is not as good as another child.
• They should respect his likes and dislikes and accept that every child is unique.

Self-respect (self-esteem)

• Children need to feel that they are of great value and can do things by themselves.
• They need to know that success is possible and will be recognised.
• Anything suggesting that a child is inferior is very disturbing to him.

Achievement

• The child feels the need to achieve.
• Parents should not do for the child what he can do for himself.

Recognition

• The child needs to know that parents are happy when he learns something new.
• Parents should help the child, encourage achievement and show that they are proud of him.
• This helps the child feel secure and learn more easily.

Independence

• As the child grows, he should be allowed to decide more things for himself.
• Parents must not limit his independence and curiosity through overprotection and over-anxiety.

Authority

• The child needs his parents’ authority mixed with affection.
• Parents train him to obey the rules of the home, neighbourhood, school and society.
• Good behaviour is approved and rewarded.
• Unacceptable behaviour is clearly and firmly disapproved, and the child is allowed to face the consequences.
• The child thus learns to accept the restrictions that exist in life.

How does play promote development?

Play is an essential factor in the development of a child.

• Information: it is an irreplaceable source of information.
• Brain: it stimulates the brain.
• Muscles: it stimulates the muscles.
• Fun: it gives the child enjoyment.
• Result: together these support physical, mental and social development.
• Warning sign: all normal children like to play, so a young child who does not play may be ill.
• Advice: encourage play, even when it is noisy.

What are the stages of human development?

The stages of human development are childhood, puberty, adolescence and adulthood.

What is childhood?

Childhood is the stage from birth to puberty.

• Light body weight and small size.
• Very rapid growth.
• A very active, restless body.

What is puberty?

Puberty is the transition stage from childhood to adolescence, when a school-age child’s body turns into that of an adolescent.

• A very active body and well-formed bones.
• Rapid gain in height and weight.
• Development of secondary sexual characteristics.

What is adolescence?

Adolescence is the stage before adulthood.

• A well-formed reproductive system.
• Height and weight still increasing.

What is adulthood?

Adulthood is the stage of full maturity.

• No change in height, but weight and body size may change.
• Ageing shows as grey hair.
• There is a gradual decline in reproductive capacity and in the functioning of body organs.

What are the age ranges for the stages of development?

Human development is divided into four stages by age, as shown below.

Evaluation

1. Define growth and development.
2. Why is the assessment of growth and development important?
3. List five measurements used to measure growth.
4. Name four unfavourable factors that slow or stop growth and development.
5. List the eight basic needs for the healthy emotional development of a child.

Assignment

Describe, in numbered steps, how the head circumference of a child is measured when there is no tape measure. State how good nutrition in the first 6 months of life affects the child’s development.