When we say that development is characterized by “plasticity”, we mean that:
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IntroductionIn the context of childhood development, growth is defined as an irreversible constant increase in size, and development is defined as growth in psychomotor capacity. Both processes are highly dependent on genetic, nutritional, and environmental factors. Evaluation of growth and development is a crucial element in the physical examination of a patient. A piece of good working knowledge and the skills to evaluate growth and development are necessary for any patient's diagnostic workup. The early recognition of growth or developmental failure helps for effective intervention in managing a patient's problem. Stages in Human Growth and Development
Factors Affecting Growth and Development The growth and development are positively influenced by factors, like parental health and genetic composition, even before conception.[3]
Issues of ConcernMeasurement of Growth Anthropometry is the gold standard by which clinicians can assess nutritional status. The major anthropometric measurements for age up to 2 years are weight, length, weight for length, and head circumference. The major measurements used for children above two years are weight, height, body mass index (BMI), and head circumference for the 2-3 years age group.
Growth Velocity The growth velocity is different at different stages of life. Also, different tissues grow at different rates at the same stage of life. The lymphoid tissues can exceed adult size at six years of age. Girls are taller than boys at 12 to 14 years, but later they will not grow taller than their boy's counterpart. Growth velocity is maximum during infancy and adolescence. The head circumference reaches closer to adult size by six years of age. The prepubertal height velocity of less than 4 cm per year is of concern. During puberty, the height velocity is 10 to 12 cm per year in boys and 8 to 10 cm per year in girls. The prepubertal weight velocity of less than 1 kg per year is of concern. Weight velocity is highest during puberty, up to 8 kg per year. Stages of Development Development is a continuous process from neonatal to adulthood. Though the growth ceases after adolescence, adolescence is not the end for development. Each developmental stage has a new set of challenges and opportunities.
Psychosocial Development Erikson has postulated eight stages of psychosocial development.
Clinical SignificanceUnderstanding normal growth and development milestones are important for a clinician evaluating pediatric patients. It isn't easy to recognize aberrance if you are not familiar with normal. By using growth charts and doing the developmental screening, oftentimes, challenges in care can be identified early. Growth Charts
Developmental Screening Only 20% of the children with developmental delay in the United States receive early intervention before three years. Early intervention is useful in high-risk children to improve their cognitive and academic performance. Less than 50 % of clinicians are only using standardized screening tools in practice. Time constraints, lack of training are essential barriers in using the developmental screening tool. The Ages and Stages Questionnaire (ASQ), the Parents' Evaluation of Developmental Status, and the Child Development Inventory are standard screening tools used in practice. ASQ tool can be used for up to 66 months. The PEDS tool can be used up to eight years of age. Gross and fine motor milestones are assessed at every well-child visit in the first four years. Standardized developmental assessments using ASQ are mandatory at 9, 18, and 24 or 30 months.[18] The clinician may screen more frequently if there are risk factors like prematurity, lead exposure, or low birth weight. Autism screening needs to be done at 18 and 24 months of age. If the screening tool reveals developmental delay, the child needs referrals to developmental pediatricians. Children up to three years with developmental delay are referred to early intervention programs, and children above three years of age are referred to special education services. Red Flags in Growth and Development
Enhancing Healthcare Team OutcomesThe health care team should understand the developmental stages that their patients go through during early childhood. We should increase the awareness of health care professionals about the importance of standardized growth monitoring and the appropriate use of growth charts. Also, they need adequate training for using standard developmental screening tools. Every clinician and nurse managing pediatric patients should have appropriate awareness of referral service to early intervention for eligible patients. Interprofessional collaboration between clinicians, mid-level practitioners, and nurses can improve patient outcomes as developmental delays require prompt intervention when caught, and earlier is always better. Children up to three years with developmental delay are referred to early intervention programs, and children above three years of age are referred to special education services. References1.Delemarre-van de Waal HA. Environmental factors influencing growth and pubertal development. Environ Health Perspect. 1993 Jul;101 Suppl 2(Suppl 2):39-44. [PMC free article: PMC1519930] [PubMed: 8243404] 2.Lampl M, Veldhuis JD, Johnson ML. Saltation and stasis: a model of human growth. Science. 1992 Oct 30;258(5083):801-3. [PubMed: 1439787] 3.Merrick J. Child health and human development over the lifespan. Front Public Health. 2013 Mar 19;1:1. [PMC free article: PMC3854993] [PubMed: 24350175] 4.Jelenkovic A, Ortega-Alonso A, Rose RJ, Kaprio J, Rebato E, Silventoinen K. Genetic and environmental influences on growth from late childhood to adulthood: a longitudinal study of two Finnish twin cohorts. Am J Hum Biol. 2011 Nov-Dec;23(6):764-73. [PubMed: 21957002] 5.Silventoinen K, Bartels M, Posthuma D, Estourgie-van Burk GF, Willemsen G, van Beijsterveldt TC, Boomsma DI. Genetic regulation of growth in height and weight from 3 to 12 years of age: a longitudinal study of Dutch twin children. Twin Res Hum Genet. 2007 Apr;10(2):354-63. [PubMed: 17564525] 6.Schell LM, Gallo MV, Ravenscroft J. Environmental influences on human growth and development: historical review and case study of contemporary influences. Ann Hum Biol. 2009 Sep-Oct;36(5):459-77. [PubMed: 19626483] 7.Schell LM, Gallo MV, Denham M, Ravenscroft J. Effects of pollution on human growth and development: an introduction. J Physiol Anthropol. 2006 Jan;25(1):103-12. [PubMed: 16617215] 8.Castillo-Durán C, Cassorla F. Trace minerals in human growth and development. J Pediatr Endocrinol Metab. 1999 Sep-Oct;12(5):589-601. [PubMed: 10703530] 9.Koletzko B, Chourdakis M, Grote V, Hellmuth C, Prell C, Rzehak P, Uhl O, Weber M. Regulation of early human growth: impact on long-term health. Ann Nutr Metab. 2014;65(2-3):101-9. [PubMed: 25413647] 10.Hochberg Z. Developmental plasticity in child growth and maturation. Front Endocrinol (Lausanne). 2011;2:41. [PMC free article: PMC3364458] [PubMed: 22666215] 11.Nelson CA, Zeanah CH, Fox NA. How Early Experience Shapes Human Development: The Case of Psychosocial Deprivation. Neural Plast. 2019 Jan 14;2019:1676285. [PMC free article: PMC6350537] [PubMed: 30774652] 12.Stevenson RD. Use of segmental measures to estimate stature in children with cerebral palsy. Arch Pediatr Adolesc Med. 1995 Jun;149(6):658-62. [PubMed: 7767422] 13.Sarría A, Moreno LA, García-Llop LA, Fleta J, Morellón MP, Bueno M. Body mass index, triceps skinfold and waist circumference in screening for adiposity in male children and adolescents. Acta Paediatr. 2001 Apr;90(4):387-92. [PubMed: 11332928] 14.Cipriano GF, Brech GC, Peres PA, Mendes CC, Cipriano G, Carvalho AC. Anthropometric and musculoskeletal assessment of patients with Marfan syndrome. Rev Bras Fisioter. 2011 Aug-Sep;15(4):291-6. [PubMed: 21971724] 15.Rifas-Shiman SL, Gillman MW, Oken E, Kleinman K, Taveras EM. Similarity of the CDC and WHO weight-for-length growth charts in predicting risk of obesity at age 5 years. Obesity (Silver Spring). 2012 Jun;20(6):1261-5. [PubMed: 22158005] 16.Grummer-Strawn LM, Reinold C, Krebs NF., Centers for Disease Control and Prevention (CDC). Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR Recomm Rep. 2010 Sep 10;59(RR-9):1-15. [PubMed: 20829749] 17.A health professional's guide for using the new WHO growth charts. Paediatr Child Health. 2010 Feb;15(2):84-98. [PMC free article: PMC2865941] [PubMed: 21286296] 18.Lipkin PH, Macias MM., COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS. Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics. 2020 Jan;145(1) [PubMed: 31843861] What is plasticity in child development quizlet?Plasticity. The idea that abilities, personality, and other human traits can chang over time.
What happens during developmental plasticity?Developmental plasticity refers to the property by which the same genotype produces distinct phenotypes depending on the environmental conditions under which development takes place.
Is development a plasticity?Development is plastic, meaning that characteristics are malleable or changeable. Development is influenced by contextual and socio-cultural influences. Development is multidisciplinary.
What is developmental plasticity quizlet?What is developmental plasticity? Refers to changes in neural connections as a result of environmental interactions induced by learning that occurs during development.
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