Growth and

Development Phases

Yudianita Kesuma

Growth & Develoment phases

1. Prenatal period

Embryonic period (1 - 8 weeks of gestational)

Fetal period (9 weeks birth)

2. Newborn (neonatal period) 0-28 days

3. Infant period (1-2 years)
4. Chilhood period

Prescool period

School-age period

Adolescence period

Prenatal Growth & Development

Figure 1/ Overview of fetal 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 breastfeeding
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

School Aged

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

Physical development at puberty

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

Thankyou