GROWTH AND DEVELOPMENT

Early childhood is a period of continued physical growth and maturation. Compared with infancy, physical growth is not as dramatic. Weight gain during the toddler stage is 1.8 to 2.7 kg per year (an average of 2.3 kg per year). At 2 years, the average weight is 12 kg, and by 2.5 years, the birth weight has quadrupled. By the preschool years, growth slows considerably. The average weight gain is ap­proximately 2.3 kg per year, and almost all organ systems

EARLY CHILDHOOD

>- Early childhood, which encompasses the period from 18 months through 5 years of age, is a period of continued growth and development.

>- During this time, the child passes through the stages of toddler (i.e., 18 months to 3 years) and preschooler (i.e., 3 years through 5 years).

>- The major achievements are the development and refine­ment of locomotion and language, which take place as children progress from dependence to independence.

>- During early childhood, the child begins to develop in­dependence. The toddler must acquire a sense of auto­nomy while overcoming a sense of doubt and shame. The preschooler must acquire a sense of initiative and develop a conscience.

>- Learning is ongoing and progressive and includes inter­actions with others, appropriate social behavior, and sex role functions.

-have reached full maturity. At 3 years, the average weight is 14.5 kg, and by 6 years, it has increased to 21 kg. Dur­ing early childhood, height increases an average 7.5 cm per year and comes primarily through an increase in leg length. At 2 years of age, the average height is 86.6 cm, and by 6 years, it has reached 116 cm. In the first 2 years of life, head circumference increases by 2.5 cm per year. After 2 years of age, head circumference growth slows, and by 5 years, the average increase in head circumfer­ence is 1.25 cm per year.⁷

The maturation of organ systems is ongoing during early childhood. The respiratory system continues its growth and maturation, but because of the relative imma­turity of the airway structures, otitis media and respiratory infections are common. The barrel-shaped chest that is characteristic of infancy has begun to change to a more adult shape. The respiratory rate of infancy has slowed and averages 20 to 30 breaths/minute. Respirations remain ab­dominal until 7 years of age.⁷

Neural growth remains rapid during early childhood. Growth is primarily hypertrophic. The brain is 90% of adult size by 2 years of age. The cephalocaudal, proxi-modistal principle is followed as myelinization of the cor­tex, brain stem, and spinal cord is completed. The spinal cord is completely myelinated by 2 years of age. At that time, control of anal and urethral sphincters and the motor skills of locomotion can be achieved and mastered. The continuing maturation of the neuromuscular system is in­creasingly evident as complex gross and fine motor skills are acquired throughout early childhood.

Growth and maturation in the musculoskeletal system continue with ossification of the skeletal system, growth of the legs, and changes in muscle and fat proportions. Legs grow faster than the trunk in early childhood; after the first year of life, approximately two thirds of the increase in

height is leg growth. Muscle growth is balanced by a corre­sponding decrease in adipose tissue accumulation.

During early childhood, many important psychosocial tasks are mastered by the child. Independence begins to develop, and the child is on the way to becoming a social being in control of the environment. Development and re­finement of gross and fine motor abilities allow involve­ment with a potentially infinite number of tasks and activities. Learning is ongoing and progressive and in­cludes interactions with others, appropriate social behav­ior, and sex role functions. Erikson described the tasks that must be accomplished in early childhood. The toddler must acquire a sense of autonomy while overcoming a sense of doubt and shame. The preschooler must acquire a sense of initiative and develop a conscience.¹⁷