Growth and Development in Children

Growth and Development in Children

1. How does growth occur?

   • Growth Hormone released from hypothalamus and pituitary
   • Tissues will reproduce
   • The skeleton will grow

2. Growth rates

   • First years of growth = trunk length has the fastest growth rate
     • From then till puberty = legs have the fastest growth rate (lower leg problems – ankle and knee)
       • Puberty till full size = spine catches up (producing lower back problems)
   • The body can become disproportionate

3. Phases of development

   • Gains head control = 3 months
   • Lying will grasp foot = 5 months
   • Sit with straight back = 6 months
   • Pulls to standing = 9 months
   • Walk = 12-15 months
   • Stands of one leg with arms folded = 4 years
   • Hop = 5 years

4. Height and Weight

   • Boys
     • Puberty = 10 – 14 years
     • Adult height = 18 years
     • Weight gain mainly muscle mass
     • Increase in shoulder width = increased anchorage = increased strength
   • Girls
     • Puberty = 9 – 12 years
     • Adult height = 16 years
     • Weight gain mainly fat mass and less muscle
     • Increase in pelvic width = lower centre of gravity = balance

5. What is a growth spurt?

   • A rapid period of cell production at the growth plate
   • Results in an increase in bone length and therefore height
   • Can occur at different ages and for a varied length of time
   • Most common 0-5 years and 11-14 years
   • Associated problems
     • Muscle and soft tissues – do not grow causing them to stretch and adapt
     • Pain – joints under more tension/pain in bones
     • Balance and coordination impaired
     • Performance impaired

6. Sport

   • Resistance and muscle group training
     • Post-pubescent – will respond with increase in muscle mass
     • Pre-pubescent – will not increase muscle mass. Will respond with neurological adaptations (muscle fibre recruitment and motor coordination)
   • Guidelines
     • Children should do a minimum of 60 mins moderate – intense physical activity each day (DH 2004)
     • Physical activity in England is estimated to cost £8.2 bil a year (DH 2004)
     • A sedentary lifestyle is also estimated to cause 54,000 premature deaths per annum (dept for sport 2002)
     • Girls are less likely to meet targets
     • Children walking or cycling to school has fallen significantly
     • Fear of children playing outside

7. Common Pathologies

   • Osgood Schlatters
     • Osteochondritis of tibial tubercle
     • Related to overuse and growth
     • age 11-15, boys > girls
     • Treatment
       • rest
       • muscle stretches
       • electrotherapy
       • immobilisation
   • Sinding Larsens
     • Osteochondritis of ole of patella (tendon pulls on patella)
     • Related to growth and overuse, can occur in adults
     • Age 9 - 13, boys > girls
     • Treatment
       • Rest
       • Stretches
       • Surgery
   • Severs Disease
     • Traction apophysis (pull of Achilles)
     • 9 - 12 years
     • Can be linked to other diseases e.g. RA
     • Treatment
       • Rest
       • Stretches