Chapter 4:

Growth & Health in Childhood & Adolescence

September 26, 2023

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Part 1: Childhood

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 1.1: Physical Growth in Childhood
• During the first year, babies:
• Triple in weight
• Grow about 10 inches

• Changes in body proportions follow:

• A) proximodistal trend:
• B) cephalocaudal trend:

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 1.1: Physical Growth in Childhood

• Age 2-puberty: 7-8 cm, 3-4 kg / yr.

• Minimal sex diff’s

• Puberty: 10 cm, 7-8 kg / yr.

• Secular trends: marked changes in physical development that

have occurred over generations

• E.g.,
• E.g.,

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1.2: Health Promotion in Childhood
• Nutrition—Breast-feeding is superior to bottle-
feeding

• Need both macronutrients (carbs, fats, and

proteins) and micronutrients (essential vitamins and
minerals)

• Solid food:

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 1.2: Health Promotion in
Childhood
• Young children often show food ________________

• Best overcome by re-introducing new food (may take

up to 15 times)

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 1.2: Health Promotion in Childhood
• Fisher & Birch (1999)
• Restricting access to foods focuses children’s attention to them and
desire to eat them

• Using treats as bribes (to eat healthy foods) tends to:

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 1.2: Health Promotion in
Childhood
• Obesity rates (BMI > 95th percentile) continue to rise

• approx. ____% of Canadian children & teens

• Causes: overconsumption of high-fat, sugary foods

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1.2: Health Promotion in Childhood
• Causes (of obesity, continued):
• Heredity
• Lack of activity
• Lack of sleep
• Lack of access to healthy foods (“food deserts”)

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1.2: Health Promotion in Childhood
• Protective factor:

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 1.2: Health Promotion in Childhood
• Accidents are #1 cause of death in
children over age 1

• Most common:

• Others:

• Many could be prevented with:

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 1.3: Brain Development in Childhood

• The brain at birth:

• Contains most of the neurons it will

ever have.

• Will grow _____ times larger by

adulthood

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A NEURON
Information

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 1.3: Brain Development in Childhood
• Growth in brain size as a result of:
• Neuronal connections
• Synaptogenesis

• Myelination
• Insulates axons and:

• “Use it or lose it” process

• Synaptic pruning
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 1.3: Brain Development in Childhood

Cerebral cortex

- Processing center for :

- perception of patterns,
- execution of complex
motor sequences
- planning, decision
making
- speech.

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 1.3: Brain Development in Childhood
• Lateralization:
• Left and right hemispheres develop specialties

• Starts during:

• Handedness usu. established by:

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1.3: Brain Development in Childhood
• Two major classes of development:

• 1. Experience-expectant process
• Under genetic controls, occur in any
environment
• E.g.:

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1.3: Brain Development in Childhood
• Two major classes of development:

• 2. Experience-dependent process
• Initiated in response to experience

• E.g.:

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 1.3: Brain Development in Childhood

• High degree of plasticity in cerebral cortex during

early childhood

• Children better able to recover from brain damage

than adults

• Recovery greater for _____________ than for

_______________

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Part 2: Adolescence

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 Historical Context of Adolescence
• Many societies only distinguished between childhood and adulthood

• Term “adolescence” only applied to youth at the beginning of the

20th century

• “teenager” entered the vocabulary in the 1950s

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 Adolescence
• A time of transitions

• Biological, psychological, social, economic

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 2.1 Psychological Development
• Adolescent turmoil?
• G. Stanley Hall (1904): a time of “storm and stress”

• Anna Freud (1958): “to be normal during the

adolescent period is by itself abnormal”

• Dr. Phil: “the teenage years can be a parent’s worst

nightmare”

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 2.1: Psychological Development
• Adolescent turmoil?

• 1. conflicts with parents

• 2. mood instability

• 3. risky behaviour

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 2.1: Psychological Development
• Adolescent turmoil?

• BUT...
• The same data show overwhelmingly that pronounced turmoil is
confined to a minority (approx. _____%) of teens

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 2.1: Psychological Impact of Puberty

• In general, most adolescents react positively

• More positive when:

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 2.1 Psychological Impact of Puberty
• Moodiness tends to be associated
with activities, rather than hormones:

• Recreational activities:

• Adult-regulated activities:

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 2.1 Psychological Impact of Puberty

Rate of Maturation
Early Male Early Female
Positive self Emotional
image problems
Antisocial Low self-esteem
behaviours
Antisocial
behaviours
Eating disorders

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2.1 Psychological Impact of Puberty
Rate of Maturation
Late Male Late Female
Low self Self confident
esteem
Feelings of Positive body
inadequacy image

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 2.2: Health Promotion in Adolescence
• Teenagers need fairly high caloric intake because of high growth and
metabolism rates

• Girls:
• 13-15 need approx. 2200 calories / day
• 16-19: 2100 calories / day

• Boys:
• 13-15: 2800 calories / day
• 16-18: 3200 calories / day

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2.2: Health Promotion in Adolescence
• _______________ shifts sleep schedules

• Deprivation negatively affects behaviour control,

emotion, and attention.

• Important because:

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2.2: Health Promotion in Adolescence
• Many adolescents don’t get enough exercise

• Physical activity enhances psychological well-being,

social relationships

• Team sports have been shown to:

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 2.2: Health Promotion in Adolescence
• Depression
• most common psychological disturbance among
adolescents

• Emotional symptoms:

• Cognitive symptoms:

• Motivational symptoms:

• Physical symptoms:
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 2.2: Health Promotion in Adolescence
• Gender differences in depression

• After puberty, girls more likely to be

depressed, possibly because of:

• A) Gender roles

• B) Greater levels of stress during

early adolescence leads to more
rumination

• C)
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 2.2: Health Promotion in Adolescence
• Suicide

• 2nd highest cause of death for Canadian youth aged

15-24 (approx. 300 deaths / year)

• 10% girls & 5% boys make attempts serious enough to

require treatment; boys more likely to engage in fatal
suicide behaviour

• Higher attempt rates in certain groups

• Risk factors: 35
 2.2: Health Promotion in Adolescence
• Substance use

• Most common: _______________

• 2nd: ________________

• 3rd: _________________

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 2.2: Health Promotion in Adolescence
• Body image

• Def’n: Self-evaluation that the individual makes of his/her own body

• includes evaluation of:

• Weight

• Muscularity / body strength

• Shape and size of various body parts

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 2.2: Health Promotion in Adolescence
• Body image

• Adolescents grow to maturity in a culture that

emphasizes:

• Slimness for women

• Highly developed muscularity for men

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2.2: Health Promotion in Adolescence
• Anorexia nervosa - disorder marked by a
persistent refusal to eat and an irrational
fear of being overweight

• Affects ___% of adolescent girls

• Have distorted body image
• For diagnosis, person has to have
lost ____% of body weight
• Leads to many physical problems

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 2.2: Health Promotion in Adolescence
• Bulimia consists of binge eating and purging by vomiting or with laxatives.

• ______% of adolescent girls

• Sometimes accompanied by exercising obsessively

• Twice weekly occurrence for 3 months on average

• Usually normal weight; low self-esteem

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 2.2: Health Promotion in Adolescence

• Body dysmorphic disorder

• Distressing and/or impairing preoccupation with a non-
existent or slight imperfection in appearance

• Becoming more common in young men (esp. muscle

dysmorphia)

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 2.2: Health Promotion in Adolescence
• Risk factors for eating disorders

• ______________ pressures

• _______________ parenting (anorexia)

• perfectionism (anorexia)

• general susceptibility to internalizing disorders

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 2.2: Health Promotion in Adolescence

• Treatments for eating disorders

• Hospitalization (esp. anorexia)

• Individual and family psychotherapy

• Cognitive behaviour therapy (CBT)

• Antidepressants for those with clinical depression

• Less than half of those treated for anorexia completely recover

• Best prognosis:

• Treatment for bulimia successful in about ____ % of cases

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2.3: Brain Development in Adolescence
• Synaptic pruning & myelination: increased efficiency
of information processing

• Changes in
• A) prefrontal cortex (logic, reasoning)

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2.3: Brain Development in Adolescence
• Synaptic pruning & myelination: increased efficiency
of information processing

• Changes in
• B) limbic system (emotion)

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 2.3: Brain Development in Adolescence
• The maturation of the limbic system prior to the maturation of
the prefrontal cortex often leads to risky behaviour

• Belief in ________________
• Sensation seeking
• Impulsivity
• Overconfidence
• Susceptibility to ______ ___________

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