Growth and

Development

Annisa Nurhayati
Febri Hanifa
Deasy Rahmi Apsari

Overview
Child conception 18 years (Convention
of Child Right /CRC and Indonesian Child
Protection Right)
anatomical growth (epipyphise clossing,
reproductive system maturation etc. )
Psychosocial development (adolescent
of
Child not a miniature
adult !!
adulthood)

Growth
Definition

Indicators

Growth : Increasing the physical size and structure of the body so that it
can be measured quantitative, such as length or weight

Determinant factors of growth

Internal:

Genetic : father, mother, grandpa,

grandma

Intrauterine process : nutrition,

disease, drug, polution, toxin ,
External : nutrition, disease,
polution, exercise, emotional
support

Weight

Body length

Head circumference

Upper arm circumference

Weight
The scales are calibrated to
zero
Baby weighed in supine
lying or sitting position
without clothes, while the
children were weighed in a
standing position without
shoes with minimal clothing
Weight is recorded to the
nearest until 0.01 in infants
and 0.1 in children

Body length
In children who can stand
stadiometer
Measured with bare legs and
minimal clothing
a. Look straight ahead
b. Relax the shoulders
c. Arm stands beside
d. Legs and knees straightened
e. The position of the feet flat

Head Circumference
Measuring tool flexible
metal tape
Head circumference at
birth is 35 cm.
It is not good for the
nutritional status of shortterm

Upper Arm Circumference

Energy reserves and
protein markers
Do with bows in the
middle point of the upper
arm.
In newborns upper arm
circumference was 11 cm

Percentile Graph BW and BH by Age of CDC 2000

(2-20 years)
Girls

Boys

Age (month)

Age (month)
Long

Long

Weight

Weight

INTERPRETATION
BW / A
>120% : better nutrition
80-120% : good nutrition
60-80% :
Without edema : less nutrition
Edema : malnutrition
(kwarsiorkor)
<60%
:
Malnutrition : without edema
(marasmus)
Edema : (marasmus - kwarsiorkor)

BH / A

90-110%BB
: Normal
/ TB
70-89% : high less
>120% : Obesity
<70%
: very less high
110-120%

: Overweight

90-110%: Normal
70-90% : less nutrition
<70%

: malnutrition

WHO Curves Weight 0-5 Years

BMI MEASUREMENT OF AGE

BMI :
BB (kg) /TB (M)2
Overweight >P85 -P95
Obesity >P95

Head Circumference

INTERPRETATION
Upper Arm Circumference
If age is unknown, nutritional
status was assessed by UAC / BH

For 1-5 years

>85%

<12,5 cm

12,5-13,5 cm :
> 13,5 cm

malnutrition
less nutrition

: good nutrition

: good nutrition
(normal)

80-85% : borderline/Protein
Less Calories I
75-80% : less
nutrition/Protein less
calories II
<75%
:malnutrition/Protein less
calories III

Child Development
Child development reflects increased maturity of
individual functions, and it is an important indicator in
assessing the quality of life of children.
Therefore, the development of children should be
monitored regularly.
Infants or children with a high risk of developmental
disorders, should be a priority, including premature
babies, low birth weight, history of asphyxia,
hyperbilirubinemia, intrapartum infection, maternal
diabetes mellitus, gemeli.

Child Development
Gross
Motor

Fine
motor
and
vision

Speech
languag
e and
hearing

Social,
emotion
al, and
behavio
ur

Gross Motor

Fine Motor and Vision

Speech, Language, and Hearing

Social, Emotional, and Behaviour

Denver Developmental Screening

Test (DDST)
Assessment is used extensively to examine children
aged 0-6 years as their development progress.

DDST Procedure
The first stage performed in all children:

3-6 months
9-12 months
18-24 months
3 years
4 years
5 years

The second stage: Conducted on those suspected

developmental delays at the first stage.

Preparation steps
1. Preparation place.
2. Preparation form: Form Denver II
3. Preparation tool:

Yarn.
Raisins.
Rattle with small handles.
Colored beams 10 inches wide.
Small glass bottle with 5/8 inch hole.
Small bell.
Tennis ball.
Red pencil.
Small doll with a bottle of milk.
Plastic cup with a handle / grip.
Blank paper.

Examination steps
Early detection of developmental disorders of children
aged <6 yrs, containing 125 task force organized in the
form into 4 sectors to encompass the following functions:
1. Personal social: Adjustment to the community and attention
to individual needs.
2. Fine Motor adaptive: hand-eye coordination, plays, using
small objects.
3. Language: Hear, understand and use the language.
4. Gross motor: Sit, road, jumping and general movement of
large muscles.

 Age scale are listed at the top of the form that is divided
from the age in months and years, from birth until the
age of 6 years.
Each space between the sign represents one month of
age, until the child is 24 months old. Then represent 3
months, until the child is 6 years old.
In each task development totaling 125, there are limits
growth of 25%; 50% and 90% of the population of
children pass on the development task.

6
9
12
_______________________________________________
25%
50%
75%

15
90%

Berjalan dg baik

25% of the population of children are able to run well at

the age of 11 months or more,
50% at age 12 1/3 months.
At the left end of the black area shows that 75% of the
population has been able to run well at the age of 13
months
At the right end of the black areas indicate the 90%
population of children are able to run both at the age of
15 months.

In some there is a developmental task of letters and

numbers on the left end of the box:
R (Report): The developmental tasks can be passed
based on the reports of parents / caregivers. However,
where possible, the assessor can pay attention to what
can be done by children.
Small figure shows a task that must be done in
accordance with the existing number on the form.
R
1

Steps
1. Greet parents / caregivers and child.
2. Explain to parents / caregivers development testing purposes, explain that this test is
not to determine the child's IQ.
3. Making good communication with children.
4. Calculate the age of the child properly.
5. Asked whether the child was born prematurely.
6. Write the date of examination over the age line.
7. Age lines drawn correctly.
8. Developmental tasks for each sector at least 3 tasks left lines of age and when
passing through the line continued until age as well as the right until the child fails in
3. Give the developmental task with proper assessment scores.
9. During the assessment, ask the parents / caregivers the typical behavior in their
children.

Years

Month

Day

Date of examine (26/4-12)

.26

........12......4.

date of birth (20/2-11)

-20

....-11........-2...

childs age :

.1................2..6

.......14

Date of examine(11/3-12)
.11

.12......3.

Date of birth (20/7-11)

-20

...-11.......-7.

childs age

..0....7.....21

 When a child is born premature, prematurity factor correction. For

children born more than 2 weeks before the expected date and aged
less than 2 years, then it should be corrected. (1 year = 12 months; 1
month = 30 days, 1 week = 7 days)

Year
Date of examine (11/3-12)
Date of birth (4/2-11)
Childs age:
Prematur 6 weeks
correction age

Month

Day

.....12........3....11

.....11........2......4
..1...........1......7
.....-1......-14
......11......23

 Pull the line above the age of lines down and write the
examination date at the top end of the age line.
9-9-

2004
6

12

-------------------------------------------------------------------------------------------------Date of examination 9 Sept 2004

Perform tasks for the development of each sector began
development of the sector easiest and begins with the task
of development is located to the left of the line of age, and
then proceed to the right of the line of age .

1. In each sector performed at least three tasks developments

closest to the left of the line of duty each age and
developmental age of the broken line
2. If the child is unable to perform one test in step 1 ("failed";
"reject"; "no chance"), perform additional tests to the left of the
line of the same age in the sector until the child can "pass" 3
task progress .
3. When children are able to do one task progress in step 1, do
additional development tasks to the right of the line of the
same age in the sector until the child "failed" at 3 development
tasks.

 Give assessment scores

Scores of each trial was written on rectangular box.
P: Pass. Children tested well, or mother / nanny to report child
can do it.
F: Fail. Children can not be tested by either or mother / nanny
to report child can not do well
No: No opportunity. Children do not have the opportunity to
test because there are obstacles. These scores should only be
used in the experiment with the sign of R
R: Refusal / reject. Children refuse to perform testing

Interprestasi Penilaian Individual

1.

Advanced

When passing the test are located on the right lines of age,
expressed on a child's development over these trials.
P

2.

Normal

When you fail or refuse to perform the task of development

of the right of the line of age, categorized as normal.
F

Similarly, if the child pass (P), failed (F) or reject (R) in the
task of development where the line lies between the ages 25
and 75 percentile, then categorized as normal.
P

3.

Caution

When a child fails (F) or reject (R) development tasks, where

the line lies on or between the ages 75 and 90 percentile.
C

4.

Delayed

When a child fails (F) or reject (R) test which is located to the
left Fof the line of the life complete.
R

5. No Opportunity.
In the developmental tasks based on the report, the parents
reported that their children had no chance to perform tasks
they will progress. These results are not included in the
conclusions.
NO

NO

 During the test development, observe the child's

behavior. Is there a typical behavior, compared with
other children. If there is a typical behavior ask the
parents / caregivers, whether they will conduct the dayto-day behavior of the children they will. When the test
is done during the development of a child is sick,
hungry. etc. can provide perlaku that inhibit the
development tests

Conclusion
Normal
If there are no delays and or at most one caution.
Do replicates at the next control.
Suspect
When obtained> 2 caution and / or> 1 delay.
Perform the test again in 1-2 weeks to eliminate momentary
factors such as fear, sickness or fatigue
Untestable
If there is a score refuse to> 1 trial is located to the left of
the line of age or refuse to> 1 trial that penetrated the life
line in the region of 75-90%
Perform the test again in 1 to 2 weeks.

Follow up
Development Screening
SUSPECT

NORMAL

EVALUATION FOR DIAGNOSTIC

(Development Assessment) STIMULATION

DEVELOPMENT PROBLEMS

EARLY INTERVENTION
STIMULATION

MONITORING/

NORMAL

MONITORING/

Closing
Give credit to the parents / caregivers for their actions
bring the child to do the test development.
Give a description of the development of the test
results, when to return, the suggestion in the house and
if there is a follow-up recommendation.
Thank you for visiting.

Kuesioner Pra Skrining

Perkembangan(KPSP)
KPSP form is a tool / instrument used to determine the
development of a normal child or there is deviation.
From the age of 3 months - 6 years (3 months for 2
years, then every 6 months until the age of 6 years)

Steps:
Determine the age of the child to make in a
month.
If the child's age is more than 16 days
rounded up to 1 month.
Example:Infants aged 3 months to 16 days
rounded up to 4 months, when infants aged 3
months and 15 days rounded up to 3 months.
After determining the age of the child select
KPSP an appropriate with the age of the child.

 KPSP consists of two kinds of questions,

which is :
Questions answered by the mother / nanny.
Example: "Can

a baby eat cake

alone?".
Command to the mother / nanny or officer to
perform tasks written on KPSP.
Example: "on

your baby supine

position, pull the baby on her wrist
slowly to a sitting position".
Questions answered one by one.
Each question has only one answer YES or
NO.

Interpretation of Results KPSP

Calculate answer Yes
(if the answer is can or often or sometimes)
Calculate answer No
(if the answer is has never beenornever)
If the answer is YES = 9-10, child development
developmentally appropriate (S)
If the answer is YES = 7 or 8, child development

dubious (M)
If the answer is YES = 6 or less, there may be

deviation (P)
Specify NO answer on what numbers only

3
month

6 month

9
bulan

12
month

15 month

18
month

21
month

24
month

30
month

36
month

42
month

48
month

54
month

60
month

66 bulan

72
month

Thank You