5. Indicators of the physical development of children. A centile method for assessing physical development Given the observed variation in various indicators of a child's physical development, it is necessary to know the so-called normal, or Gauss-Laplacian, distribution.

II. Features of physical development 1. A pronounced lag in physical development that prevents the implementation of exercises and standards provided for by the curriculum; a sharp disproportion between the length of the limbs and torso.2. All types of deformations of the upper

Assessment Methods proper development premature baby and twins You can use the two methods below to check if your premature baby in development from a full-term baby as it should be in the norm, or there is

Methods for studying the physical development of children Anthropometric examination and determining the degree of physical development according to its evaluation tables (standards) is the responsibility of the average medical worker and educator, and their interpretation is the responsibility

Annex 2 Indicators of physical and neuropsychic development children. Preventive vaccination calendar 1. Preventive vaccination calendar (from the order of the Ministry of Health of Russia dated December 18, 1997 No. 375) 2. Physical development of children

Approximate norms of physical and psychomotor development children of the first year of life Ignatieva Tatiana, Nazirbekova Irina Age: (from the first breath to 28 days) - newborn. Physical parameters: height 46–55 cm; weight 2600–4500 g. Psychomotor development: flexor posture.

Appendix 1 The results of the analysis of the physical development of seven-year-old children in Krasnoyarsk In the context of a deep demographic crisis, it is necessary to pay Special attention education of the next generation. Indicators of physical development - one of the main parameters

The physical health of children is currently one of the most actual problems all over the world, which is primarily due to significant environmental degradation.

Maternal and child health 2016: key indicators

A fragile organism, which is in the process of development, is most susceptible to the influence negative factors, and therefore quickly and sharply reacts to each of them. Of course, one cannot say that physical health is influenced solely by the environment in which a person is located. However, the environmental situation in to a large extent affects its quality.

It is worth considering that the physical indicators of a child's health depend on a whole range of environmental, social and biological factors. This and living conditions, and hygiene, and balanced diet, and a full sleep, and a properly composed daily routine, and daily sufficient physical activity. Compliance with all of these factors contributes to the formation of a physically developed, healthy personality, while neglecting at least one of them entails a deviation from normal indicators and deterioration in the well-being of the child.

The main indicators of maternal and child health in 2016 should increase - this task is a priority among the main tasks of state policy.

Adaptive abilities of children as an indicator of the level of health

What is health? WITH scientific point view it essential component, without which the success of a person is unthinkable, including the physical, psychological and social welfare, the absence of any discomfort, malaise and disease.

Normal indicators of the health of children and adolescents allow not only the emerging personality to successfully grow and develop, but also to be socially active, to fulfill all the assigned functions and assignments. From this it follows that the success and prosperity of society and the state depend on the state of health of the younger generation, as well as National security countries.

According to statistics, the main indicators of children's health have decreased several times over the past decade. So, today, about 30% of primary school students have some or other deviations in health. Approximately 12% of schoolchildren have myopia, 17% have posture disorders, and 40% have impaired visual acuity.

On this moment doctors distinguish three main components of health: physical, psychological, behavioral.

Physical component implies the development of organs and systems of the body, their condition, functioning, as well as the level of growth.

Psychological component - psycho-emotional state, mental activity, social needs of a person, the adequacy of behavior in society.

Behavioral component - a manifestation of one's condition, the ability to communicate, express emotions, mood, the presence of a life position and the desire to benefit society.

The adaptive capabilities of children as an indicator of the level of health are also considered by pediatricians at each stage of a child's development. That is why various children's institutions take into account the anatomical and physiological characteristics of children, their susceptibility to certain factors, reduced or increased body resistance in certain age periods.

The research program depends on the age of the subjects. So, when examining children of early and preschool age, the development of motor skills of speech is taken into account.

What are the main indicators of the physical health of children and adolescents

One of key indicators health is the physical development of children and adolescents. The development of a child is determined by medical examinations held periodically in medical institutions or schools. Almost from birth, every child is measured height, body weight, chest circumference. The results obtained provide an opportunity to see the overall picture of the development of the child's body. In addition, the main indicators physical health children are the following conditions: teeth, mucous membranes of the eyes, oral cavity, condition of the skin, correspondence of the degree of puberty with the age of the subject, the presence / absence of body fat.

During the examination, functional indicators are also important. To do this, the vital capacity of the lungs, the muscle strength of the hands, and the backbone are measured.

The following factors influence the indicators of assessing the health of children and adolescents: the presence or absence of pronounced constitutional features of the physique; results of measurement and weighing; biological age; neuropsychic development.

In accordance with the results obtained, the health group is determined: 1, 2, 3, 4, 5.

1 group- healthy children with normal development.

2 group- healthy children, but with some functional abnormalities, as well as with reduced resistance to acute and chronic diseases.

3 group- children with chronic diseases, but with preserved functionality organism.

4 group- children with chronic diseases, with reduced functional capabilities of the body.

5 group- children with chronic diseases, with significantly reduced functional capabilities of the body. Those who belong to this group do not attend children's institutions and are exempted from mass regular examinations.

Indicators of a comprehensive assessment of the health status of children and adolescents

Indicators of a comprehensive assessment of the health status of children depend on such criteria as the presence or absence at the time of the survey chronic diseases; the state of the main organs and systems (circulatory, respiratory, cardiovascular, nervous, etc.); the degree of harmony of physical and neuropsychic development.

Indicators of the physical health of children and adolescents are recorded by pediatricians, district doctors, or health workers of preschool and school institutions during scheduled examinations. In other words, now it is not enough for a doctor to identify the presence or absence of any diseases in a child during an examination. It is important to maximize the range of indicators responsible for the development of biological and social functions of a growing organism, in a timely manner to detect the initial stages of deviations and chronic diseases.

Indicators of the psychological health of the child and its disorders

The physical state of health of children and its indicators are inconceivable without knowledge of how the nervous system child, what is the state of vision, hearing, development of memory, attention, speech and thinking. Physical development as an indicator of children's health should be supplemented with information about psychological state. Early detection deviations and referral of the child to specialists is important task pediatrician.

The mental health of children has always been given attention from an early age, as it necessary condition for development a full-fledged personality. Mental health is inextricably linked to physical health.

What is mental health and what are its indicators? This will be discussed below.

Mental health is considered to be inner harmony body, feelings, thoughts with external harmony - the connection between the person himself and the outside world, society.

Basic indicators mental health in children they are expressed in the following criteria: the ability to understand oneself and the people around; realizing its potential in various types activities; ability to make conscious and right choice; in a state of mental comfort; normal social behavior.

The psychological state is divided into three levels:

1. Creative. It includes children with a stable psyche, normal adaptation to environment, the ability to cope with stressful situations, find a way out in difficult life moments, the ability and desire to deal creatively with reality.

2. Adaptive. Children adapted to social environment, but characterized by increased anxiety.

3. Maladaptive. Children trying to adapt to certain conditions or circumstances, sacrificing their desires and abilities.

Psychological health can be adversely affected by factors such as dysfunctional family or unfavorable conditions in kindergarten/school, e.g. complicated relationship with a teacher or peers.

In many cases, the indicators of a violation of the psychological health of a child are influenced by the environment, complex relationships between family members, non-forming relationships with peers, non-perception of him as an individual in a team. However, there are also unfavorable hereditary factors, as well as acquired psychological diseases that appear against the background of severe stress.

Only a physically and psychologically healthy person can become a full-fledged, capable member of society.

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Any first meeting with a baby voluntarily or involuntarily begins with an assessment of his development: even non-medical people estimate by eye whether the height and weight correspond to his age. Watching a child or trying to make contact with him, adults, sometimes quite unconsciously, note how developed he is for his age. Such an approach to assessing the development of a child, based on everyday experience, is called empirical from the Greek word "empeiria" - experience. It is natural to assume that such an experience different people can be completely different, therefore, an estimate based on an empirical approach carries large errors.

Since the advent of pediatric science, scientists have been constantly trying to create scientifically developed normative tables for assessing any indicators, and especially those that undergo significant changes with age. This primarily applies to the assessment of the physical and psychomotor development of children.

The complexity of the work pediatrician consists not only in the fact that the child is often unable to tell what is happening to him. The difficulty is also connected with the fact that the younger the baby, the faster the dynamic changes in his development occur. In other words, we can say that the image of the norm of the child, as it were, "slides" according to his age. Therefore, when examining a baby, the doctor must first assess whether his development corresponds to age norm, and only then the pediatrician can determine how pronounced the deviations are and what they are associated with. Among the many causes of violations in the development of the child important place occupied by disease.
Parents can significantly help the pediatrician in monitoring the development of the baby if they know whether such important anthropometric indicators as length or height, body weight, chest and head circumference, body proportions, and psychomotor characteristics correspond to his age. There are much more opportunities to notice the very initial deviations from the norm in a son or daughter than in a doctor who sees a child at a reception. a short time. Therefore, it is very useful for mothers and fathers to learn how to correctly assess the development of their baby, using modern normative tables of the physical and psychomotor development of the child, which are also used by pediatricians. These standards are included in the new medical card of the child - form 112 "History of the development of the child."

When preparing for any visit to a pediatrician, measure the height, weight, chest and head circumferences of the child, evaluate the results using the tables, and inform the doctor at the appointment. By doing this, you will provide significant assistance to both the doctor and your baby. I would like to give one more piece of advice: every year, on the birthday of your son or daughter, take measurements and evaluate them, and also compare the indicators of the baby's psychomotor development with the norm. Under the condition of such careful monitoring of the development of the child in your family, there will never be a situation in which parents clutch their heads with an exclamation: “How is it that we did not notice that the child is so far behind in physical development!”

PHYSICAL DEVELOPMENT OF THE CHILD

Let's start the conversation with an assessment of the physical development of the child. First of all, parents need to be clear that a child is not a miniature adult! It grows and develops according to its own laws.

We are accustomed to counting the age of the child from the date of his birth. This age should be considered as a passport. In some countries, the starting point is not the time of birth, but the day of the alleged conception, which is biologically more correct. After all, a person's life does not begin from the day of his birth, but from the moment of the fusion of the nuclei of the germ cells of his parents: the father's sperm and the mother's egg. Once upon a time, each of us was a single fertilized egg, scientists called the zygote. It is in the nucleus of the zygote that the entire genetic material about a person: information is stored there about his gender, and about what maximum height he will reach, and what size of shoes he will wear when he becomes an adult, and what will be the color of his eyes, skin, hair, and what abilities and talents, and much, much more.

Anthropometric indicators reflect / g primarily the biological age of the child. It is very important to assess the biological age not so much in statics as in dynamics, while it is necessary to note the quality and rate of development of the child, changes in body proportions, appearance, his muscle strength, vitality and performance.

What laws are subject to the growth of a child? The growth of a child is a direct reflection of the process of its development. If the baby does not grow, he does not develop! The increase in body length is a very important and subtle indicator of the development of the child as a whole.

Many factors influence the growth process. First of all, growth depends on nutrition, on the provision of the body with the necessary for development. full range nutrients - nutrients: proteins, fats, carbohydrates, mineral salts, vitamins and many other substances.

To a large extent, the growth of a child is determined by heredity. It is known that growth is controlled by more than a hundred genes, which finally realize their influence by the age of 18. To some extent, it is possible to determine the effect of parental genes and predict the final growth of the child using the Tanner formula, which will be given below.

Growth is greatly influenced by certain hormones that regulate it through metabolic processes in the bone and cartilage tissue. It's a hormone thyroid gland, somatotropic hormone of the pituitary gland, insulin, as well as sex hormones - androgens of the adrenal glands and gonads.
From external factors the quality of care, the adequacy of physical activity, the duration of sleep, the psychological environment surrounding the child can have a significant impact on growth. It has been established that the baby lags behind in growth both with insufficient and with sharply excessive vertical physical activity. Jumping and sport games with jumping (volleyball, basketball, tennis, baseball) stimulate growth. The child grows most intensively during sleep, especially in the morning. Hence the conclusion: if a child is chronically sleep deprived or forced to wake up early and get up, this can negatively affect his growth.
Scientists have proven that growth slows down when love is scarce. The child grows well in an atmosphere of happiness and joy, when he feels protected and safe. And vice versa, mental stress, depression, a sense of threat and insecurity, the lack of sincere, and not feigned, parental love and care can lead to a slowdown in growth or insufficient implementation of the genetically embedded program of tall.

During periods of psychological difficult situations growth slows down. This happens, for example, when a child has difficulty getting used to kindergarten or school, does not tolerate the “extension program”, large school and extracurricular workloads, he does not have free time in which he can do only what he wants. This also includes streaks of school failures, and protracted family conflicts, especially when mom and dad are in a state of “chronic divorce”. All this creates a favorable platform for the development of depression and, as a result, the growth of the child slows down.

The sex of the child has a great influence on growth. It's no secret that boys grow faster and become taller than girls. The only exception is a short age period preceding the onset of puberty, when growth accelerates. In girls, this breakthrough occurs 1-2-3 years earlier than in boys. Approximately in the 4th-5th-6th grade, the group of children looks very funny: little boys among solid, grown-up and beginning to round girls with initial signs of puberty. However, this situation does not last long, after 13-14 years the boys take revenge and generally overtake the girls.

The smaller the child, the more intensively it grows, with age the growth rate decreases. Throughout childhood, the growth rate is different: periods of acceleration are replaced by periods of relatively slow growth. The baby grows especially fast in utero. Just think, starting with one fertilized egg measuring 200 microns, which is 1/50 of a millimeter, by the time of birth, the baby reaches 50 centimeters, that is, its growth in 9 months intrauterine life increases by 25,000 times!

After birth, the child grows especially intensively in the first year of life, adding 10-11 centimeters in height. After a year to 3-5 years, the growth rate slows down. There comes the so-called period of the first rounding, or the first completeness. At this age, children have a truly “angelic” appearance: the torso, arms and legs resemble cylinders in shape, well-defined subcutaneous fat gives the baby a plump look, there are constriction strings on the arms and legs, the tummy always looks full and slightly protrudes forward. At this time, all the children are similar to each other with their doll faces. At the end of this period, the child begins to assert itself and win back its own "I".

At 5-6 years old, the “angelic” look gradually disappears, the child stretches out, his “puffiness” seems to “dry up”, the contours of the muscles and bone landmarks become visible, the baby grows out of his clothes very quickly.

At the end of elementary school, from about 8-10 years old, there is a period of prepubertal rounding, when the growth rate slows down somewhat compared to the accumulation rate. subcutaneous fat. As a rule, starting from this age, the appetite increases sharply and the question “how to feed the child?” is replaced by the concern "how to feed him." As mentioned above, during this period, girls overtake boys both in height, and in mass, and in relation to sexual development. After 2-3 years, everything falls into place, the boys are again ahead of the girls in all respects.

Child growth rate by age

The period of the second rounding is soon followed by a very pronounced acceleration of growth, the so-called pubertal growth spurt, directly related to an increase in the production of sex hormones from the adrenal glands, testicles and ovaries, which very strongly stimulate the growth of bones and cartilage in length. The activating effect of sex hormones on growth occurs until puberty and the level of sex hormones will not reach the maximum. As soon as the body of a boy or girl is established high level these hormones, growth stops. That is why too early puberty can lead to stunted growth and short stature, and vice versa, delayed puberty with low levels of sex hormones often manifests itself in unusual tall stature. One way or another, but on average, by the age of 18, growth ends in most children.

Change in body proportions in the process of child development

The growth of various parts of the body during the life of the child also occurs unevenly. So, from the moment of birth to adulthood, the height of the head doubles, the length of the body - three times, the length of the arms - four times, the legs - five times. That is, human growth occurs in more by lengthening the legs. Due to the uneven growth of the skeleton in length throughout childhood, the proportions of the body also change. We would be very upset if, in adulthood, we retained the proportions of the neonatal period! In a newborn, relatively big head- it accounts for a quarter of his entire height, short arms and legs. In an adult, the height of the head is only a tenth of the length of the body. The median point in a newborn corresponds to the navel, and in an adult it is in the projection of the pubis.

The calculation of various proportionality indices helps the doctor to quite clearly determine the biological age of the child and its compliance with the passport one. One of the proportionality indices can be very easily used by parents at home when deciding whether it is time or not to send the child to school. This is the so-called Philippine test: the child is asked to try to reach the tip of the opposite ear through the top of the head without tilting the head. If a child cannot reach his ear, then his brain is not yet mature enough to absorb the curriculum. If, in addition, not a single permanent tooth has erupted in the baby, parents should seriously consider whether to equip their son or daughter in the first grade. For such children, the school load is likely to be unbearable, which will lead to health problems.

Philippine test

Growth can also be significantly affected by climatic and geographical conditions. It has been noticed that a great activation of growth, like everything else in wildlife, occurs in spring-summer period, in autumn and winter, the child does not grow so intensively. In cold climates and at high altitudes, people tend to be shorter in height.

It should also be remembered that the final growth is influenced by a person's belonging to certain ethnic groups. This is most clearly seen in relation to the growth of the inhabitants of the Scandinavian countries and the ethnic groups of southeast Asia.

The growth rates of the systems of organs and tissues of the child are different. The graph shows that the growth curves of all major internal organs, bones and muscles have a fairly uniform ascending character with two steeper rises corresponding to periods accelerated growth. In contrast to such a curve of general somatic growth, the brain grows rapidly only in the first years of life and by the age of five almost reaches the size of an adult. The growth curve of immune lymphoid tissue differs very significantly from the rest, its relative mass reaches 200% at the age of 3 to 6-7 years. This is a normal age-related physiological reaction of lymphoid tissue hypertrophy, when enlarged lymph nodes can be felt in a child, enlarged adenoids can be detected, and huge palatine tonsils can be seen. If they are not inflamed and "do not interfere with life", you do not need to touch them, but you should patiently wait until they begin to decrease on their own. This process of reverse development begins with the appearance of signs of puberty. And, finally, the schedule for the development of the organs of the reproductive system has a special form: for the time being, this system is in a "dormant" state, but at 11-12 years old in girls, and from 12-13 years old in boys it begins to "wake up", while in boys, the scrotum and testicles increase, the penis and prostate gland grow, and in girls, the mammary glands, uterus, tubes, ovaries, and external genitalia begin to develop.

It is very important for parents to know and take into account such asynchrony in the growth of various organs and systems of the child. This can protect the family from unnecessary worries and making ill-considered decisions, especially those related to the removal of adenoids and tonsils.

Growth rates of various organs and tissues depending on age:

a - lymphatic organs that provide immune protection; b - brain and spinal cord; in - torso and internal organs; G - reproductive system

How to measure a child correctly?

Definition of growth. For measuring length small child who cannot stand, use a simple measuring tape and measure on a table. Before the procedure, the tape must be stretched and fixed. You can also use a long ruler. The child is laid on the table so that the crown of the head touches the wall where the zero mark of the measuring tape or ruler is located. Try to lay the child evenly, and this is easier to do when he is calm: slept and fed. With gentle pressure on the knees, the baby's legs are straightened and the length - height - is marked with a ruler attached to the feet.
When measuring height in older children, you can use a "home height meter" - a special paper centimeter tape, previously pasted on the wall in the children's room. The child is placed barefoot on the floor with his back to the ruler. The body of the baby should be straightened, arms freely lowered along the body, knees unbent, and feet tightly shifted. The child's head should be in a position in which the edge of the lower eyelid and upper edge external auditory canal are located in the same horizontal plane. During the measurement, the child should easily touch the wall with three points: the back in the area of ​​the shoulder blades, the buttocks and the heels. A flat object is applied to the top of the head perpendicular to the stadiometer and growth readings are noted on the scale.

Determination of weight - body weight. Body weight is measured using modern electronic scales. It is necessary to ensure that the child is in the center of the scales. Depending on the age of the child, they are weighed in the supine, sitting or standing position. Small children are placed on a diaper, after weighing the baby, its weight should be subtracted from the result.
Weighing should be carried out in the morning, before feeding, when the child urinates and empties the intestines.

As for the daily weighing of the baby in the first weeks of life, it is not advisable to do this, since weight gains occur unevenly: on one day the child may not gain weight at all, and on the other, it may double. Due to the lack of weight gain, false suspicions of malnutrition may arise, which will create an unnecessary nervous situation in the family. If you are unsure whether your baby is getting enough food, weigh him once a week. With a weekly increase of 150-200 g, you should calm down.
Measurement of chest circumference. It is carried out with an ordinary centimeter tape, which is applied from behind under the lower angles of the shoulder blades with the arms abducted. Then the hands are lowered and the ends of the tape are connected at the level of the nipples and, against the background of calm breathing, the measurement result is recorded. In girls with well-developed mammary glands, the tape is applied over mammary glands at the site of attachment of the gland to chest. Record the result of the measurement.

Head circumference measurement. A centimeter tape is applied behind the occipital protuberances, and in front - along the superciliary arches, the ends are connected and the result is fixed.

Assessment of anthropometric indicators using centile tables

Dental tables for assessing the physical development of a child represent a kind of "mathematical photograph" of the distribution a large number children according to increasing indicators of height, weight, chest and head circumference (Tables 1-8). The practical use of these tables is extremely simple and convenient, combined with a good logical understanding of the evaluation results.

Percentage distribution of children by height

Percentage distribution of children by weight

The columns of the centile tables show the quantitative boundaries of the trait in a certain proportion (percentage, centile) of children given age and gender. At the same time, the values ​​characteristic of half of the healthy children of this sex and age, which corresponds to the interval of 25-50-75%. In our tables, this interval is shaded. Intervals that are close to the average are rated as below and above the average (respectively 10-25% and 75-90%). These indicators parents can also be regarded as normal. If the indicator falls into the zone of 3-10 or 90-97%, you should be alert and point this out to the doctor. This is an area of ​​attention that requires additional consultations and examination. If the child's indicator goes beyond 3 or 97%, it is very likely that the child has some kind of pathology that affects the indicators of his physical development.

Percentage distribution of children by chest circumference

Percentage distribution of children by head circumference

You can understand what a dental scale, for example, growth, is in the following example. Imagine 100 children of the same age and gender, lined up in order from smallest to tallest. The growth of the first three children is assessed as very low, from 3rd to 10th - low, 10-25th - below average, 25-75th - average, 75-90th - above average, 90-97 - tall and the last three guys - very tall.

Height, weight, etc. specific child can be placed in its own “corridor” of the centile scale of the corresponding table. Depending on which "corridors" the child's anthropometric data fell into, a value judgment is formulated and an appropriate tactical medical decision is made.

According to the same principle, the correspondence of body weight to the length-height of the child is assessed, while the distribution is built using the weight indicators of children with the same height.

An example of assessing the physical development of a newborn boy

Height-length - 50 cm, corresponds to the "average" indicators. Weight - 3800 g, corresponds to the assessment of "above average". Chest circumference - 37 cm, corresponds to the assessment of "wide". Head circumference - 36 cm, corresponds to the "average" values. Correspondence of weight to the length of the child's body - a moderate excess of weight relative to length, "above average".
To assess the adequacy of nutrition in schoolchildren, one should use the centile scales of the Ketled index, which most objectively reveals both insufficiency and excess body weight relative to height and does not depend much on the characteristics of the physique and constitution of the child.

Physical development of boys from 0 to 17 years

Physical development of girls from 0 to 17 years

Correspondence of body weight to the length / height of boys

Correspondence of body weight to length / height girls

Evaluation of the nutrition of boys 4-15 years old by body mass index (Quetelet index)

Evaluation of the nutrition of girls 4-15 years old by body mass index (Quetelet index)

CONCLUSION ON ANTHROPOMETRY

Assessment of length/height, weight, chest and head circumference

Assessing body weight for height (nutrition assessment)

Assessment of the hormonality of physical development

The harmony of the physical development of the child is determined by the maximum difference between the numbers of the corridors of the centile scale after assessing the indicators of growth, body weight (by age) and chest circumference.

Conclusion:

0-2 harmonic development
3 development disharmonic
4-7 development is sharply disharmonious

Somatotype assessment

The somatotype is determined only under the condition of the harmonious development of the child. Somatotype assessment is carried out by the sum of the numbers of centile corridors after assessing height, weight (by age) and chest circumference.

Conclusion:

3-10 microsomatic body type, "below average physical development"
11-16 mesosomatic body type, "average physical development"
11-13 "mesomicrosomatic type"
14-16 "mesomacrosomatic type"
17-24 macrosomatic body type, "physical development above average"

Predicting the final growth of the child

Parents are always interested in whether the child will inherit their height, how much he will eventually grow. Scientists have long been trying to calculate the final height of a child based on the height of his father and mother. Here are some tests that have received the most confirmation.

1. Based on the average height of the parents, the growth of the child by the period of its completion (18-19 years) will be:
for boys (father's height + mother's height): 2 + 5 cm;
for girls (father's height + mother's height): 2 - 5 cm.

This calculation can be done for a child of any age. To do this, it is necessary to find the dental zone for the calculated expected final height "according to the height of the parents on the scale of the dental distribution of body length in the last row of the table. This dental zone is most likely for the normal growth of the child after 2 years if he inherited the parents' growth genes.

2. According to Tanner's formulas, based on the height of the child at 3 years: final height for boys 1.27 x height at 3 years + 54.9 cm; final height for girls 1.29 x height at 3 years + 42.3 cm.

3. According to the tables developed by the scientists Garn and Roman, one can find the average most probable height for a child of any age based on the half-height of his parents (Tables 9.10).

4. According to bone age. This test is carried out on special purpose doctor when it is necessary to determine the biological age of the child. To do this, x-rays of the bones of the wrist joint are performed and, using special tables and formulas, the final growth of the child is calculated.

The average body length of boys in connection with the average growth of their parents according to S. M. Garn and C. G. Rohmann

The average body length of girls in connection with the average height of their parents according to S. M. Garn and C. G. Rohmann

ASSESSMENT OF THE CHILD'S PSYCHOMOTOR DEVELOPMENT

As we have already said, it is difficult to evaluate the development of a child empirically, in an empirical way, since the experience of all people is different. Parents with many children have a great opportunity to compare this baby with older brothers and sisters. If only one child grows up in the family, father and mother do not have the opportunity to accumulate knowledge on evaluating the development of a son or daughter, and short-term observations of other children during walks are insufficient. This is enough good reason for parents to familiarize themselves with the relevant literature.

As mentioned above, the child is developing dynamically, acquiring more and more new skills. Therefore, what is considered the norm for a newborn is a pathology for the rebirth of l months, normal development s-month-msh and reenka - p<ии-логия для годовалого малыша. При оценке психомоторного развития детей мы вновь встречаемся со «скользящим» образом возрастной нормы.

The concept of psychomotor development is very broad: it includes an assessment of the functions of hearing, vision, and other types of sensitivity; a very wide motor sphere - from assessing muscle tone and keeping the head in a vertical position in a newborn to purposeful hand movements and fine finger motor skills, from which the ability to write, sew, embroider is formed. The sphere of psychomotor development also includes the baby's social contacts from recognizing the mother's voice to group games with complex role-playing plots. For ease of testing, all this is conditionally designated as “leading lines of development”.

When assessing the development of a child, one should bear in mind the fact that a conclusion about the successful mastery of a child by one or another skill can only be given when the child is able to combine it with another necessary action. For example, a child, when taking a spoon, should try to scoop food into it, and then direct the hand with the spoon in the direction of the open mouth. Only in this case can we say that the child begins to master the skill of eating from a spoon on his own.

For successful psychomotor development, the constant communication of the child with the mother and family members is of great importance. Correct, gradually becoming more complicated communication with the baby is an excellent basis for the harmonious development of his psyche and movements. Lack of attention, pedagogical neglect can drastically slow down the process of learning about the world around. The consequence of this may be at first a tempo delay in mental development, which is soon joined by a more significant lag in the acquisition of new motor skills of the child. The sad ending of such inattention to the child can be dementia and complete social disadaptation, culminating in the inability to adapt to life in the outside world.

Evaluation of the psychomotor development of the child according to the evaluation tables

For a quick assessment of psychomotor development and a guide to the future, in 1989 we developed evaluation tables that were entered into the child's medical card "History of Development". These tables are very easy to use, at the same time very informative and visual.

A tabular assessment of the child's psychomotor development covers the first seven years of life. For ease of use, the tables are compiled according to the years of the child's life.

The leftmost column indicates the age, then - a set of skills that should appear in a child at a given age. The indicators of the normal average level of development were taken as a standard. With age, the number of indicators in one estimated period increases, as the range of lines of development of the baby expands. So, in the first year of life, signs are given that should appear for the first time in each of the 12 months of life. For convenience, five signs per month were selected. On the birthday, the development of the child is tested, he, as it were, “passes” a kind of “exam”, pulling out a “ticket” corresponding to his age, which contains five questions. With the correct "answer" to all questions, the baby receives an "excellent" rating. This means that the development of the baby is ideally suited to his age. The mark is given in the cells of the vertical column corresponding to his age, at the intersection with the horizontal lines of the "examination ticket".

If opportunities allow, then you can try to offer the baby to take an external “exam” for the next age period. At the same time, you may be surprised to find that the child is already completing tasks for the next age milestone! This means that your baby is developing ahead of his age, and you can even tell what the leading lines of development are!

Similarly, if a child is not doing any tasks for his age, you can make it easier for him. Going up the table, look for signs of this line of development at a younger age and check if the child performs this easier task. Having found a task in the problem line of development that the child performs well, we mark it in a horizontal line, after which it becomes clearly visible how significant the developmental lag of the baby is and in what direction the delay is going.

Having found a developmental delay in a child, first of all, the causes of an educational nature should be excluded. So, the baby may not be able to crawl if he is not given such an opportunity, and at the same time he is not able to crawl if he even has a slight paresis of the lower extremities. A child may poorly grasp and hold a toy if it has never been given to him, on the other hand, the same will be noted if the baby had a birth injury of the cervical enlargement of the spinal cord. A pediatrician and a neurologist will help you figure out all this.

Remember that a tabular assessment does not replace a doctor's examination, especially a pediatric neurologist. It only tentatively helps to quickly and easily assess whether the development of the child corresponds to the age norm.

Child development in the first year of life

Abbreviations: RN - newborn reflexes; A3, AC - visual, auditory analyzers; DO, DR - general movements, hand movement; RA, RP - active speech, speech-understanding; SR - sensory development; E - emotions; H - skills; SP - social behavior; And - game.

Child development in the second year of life

Abbreviations: RP - speech understanding; RA - active speech; SR - sensory development; I - game; D - movement; N - skills.

Development corresponds to age, if the child performs at least five tasks of the age minimum, with a smaller number, a neurologist should be consulted.

Child development in the third year of life

Abbreviations: RAG - speech grammar; RAV - active speech, questions; SRF - sensory development, form discrimination; SRC - sensory development, color discrimination; I - game; D - movement; KD - constructive activity; ID - game activity; BUT - dressing skills; NK - feeding skills.

Development corresponds to age, if the child performs at least eight tasks of the age minimum, with a smaller number, a neurologist should be consulted.

Child development in the fourth year of life

Child development in the fifth year of life

Child development in the sixth year of life

Child development in the seventh year of life

Denver Screening Test for Child Development

Abroad, the method of centile assessment of psychomotor development developed in Denver (USA) is the most common, and therefore it is called the Denver Screening Test for Evaluating Child Development (see figures). Most of the signs can be observed in everyday life, but some must be obtained specifically during testing. Testing instructions are given after the figures.

The final conclusion on the psychomotor development of the child is made on the basis of his ability to perform tasks characteristic of his age. For each of the sublevels, at least three completed and three failed tasks should be received that are closest to the age of the child. If the child did not cope with the tasks that 90% of his peers perform, then the answer is regarded as “negative”. If a child confidently completes a task that only 25% of their peers can master, the answer is assessed as “outperforming”.

Testing instructions

1. Try to make the child smile in response to a smile, to a conversation with him.
2. The child should independently examine his hands for a few seconds.
3. Parents can help the child guide the toothbrush and squeeze the paste onto the brush.
4. The child may choose not to lace up their boots or fasten buttons or zippers in the back.
5. Slowly move the thread in front of the child's face from side to side in an arc of about 8 degrees.
6. The child should grab the rattle when it touches the back of the hand or fingertips.
7. Holding the thread in front of the baby's face, drop it without moving your hands so that it quickly disappears from the baby's field of vision. It counts if the child tries to see where the thread went.
8. The child must transfer the cube from hand to hand without the help of the body, mouth, table, while he must not put the cube on the table.
9. It counts if the child can pick up the raisin by grabbing it with the thumb and any other finger (“tweezer grip”).
10. The line drawn by the child may deviate from the line drawn by the tester by no more than 30 degrees.
11. Clench your fist, stick out your thumb and shake it. It is counted if the child reproduces this movement, shaking the thumb.
12. It is counted if the child reproduces any closed curve.
13. Draw two vertical lines of different lengths on a piece of paper. The child must indicate which line is longer. Turn the piece of paper upside down and repeat the task. Three out of three or five out of six correct answers count.
14. Any lines intersecting close to the middle count.
15. Let the child first copy the square himself. If he fails, show him how to do it.
16. When you give the child to complete the 12th, 14th and 15th tasks, do not name the figures. Do not show how to draw a circle and a cross.
17. Each paired body part - two arms, two legs - counts as one.
18. Put the cube in the cup and gently shake it near the child's ear, but out of his sight. Repeat the same for the second ear.
19. Pick up five pictures that show a cat, a horse, a bird, a dog, a person. Point your finger at the picture and ask the child to say what is drawn on it (do not attribute the content to letters that do not carry meaning). If the child has named less than four pictures correctly, ask him to show the picture you name. Show the child the doll and ask him to show the nose, eyes, ears, hands, feet, belly, hair. It is counted if the baby correctly named six parts of the body out of eight.
20. Showing the child pictures, ask him: “Who flies? Who says "meow"? Talking? Sings? Galloping?" It is counted if the child names two or four pictures out of five.
21. Ask a reoenka: “what do you do when the igielolidpig jj,i_,jm iru ^ boils Hungry?” It is counted if the child answers two or three questions out of three.
22. Ask the child: “What are you doing with the cup? What is a chair for? How is a pencil used? In response, he must include verbs.
23. It counts if the child said how many cubes are on the sheet (one-five).
24. Ask the child to put the cube on the table, under the table, in front of you, behind you. Don't help him with your finger, or head movement, or look. Four correctly performed actions out of four are counted.
25. Ask the child: “What is a ball? Lake? Table? Horse? Banana? Curtain? Fence? Ceiling?" It counts if the baby names what the item is made of, how it is used, or gives it a general definition, for example: a banana is a fruit, and not which banana is yellow. Five to seven correct answers out of eight are counted.
26. Ask the child: “If the horse is big, then the mouse ... (what)? If the fire is hot, then the ice ... (which one)? If the sun shines during the day, then the moon ... (when)? Two correct answers out of three are counted.
27. Climbing the stairs, the child can hold on to the wall or railing, but without the help of an adult.
28. The child must throw the ball at a distance of three steps within the reach of the adult's hands.
29. The child must jump from a place to a distance of 21-25 cm.

Evaluation of test results

Psychomotor development is delayed if:

• two or more “negative” responses were received for any two or more of the four assessment sublevels;
• one sublevel received two “negative” responses, and another one “negative” response, and for the same sublevel there were no “outrun” responses.

There is a moderate lag in psychomotor development, if.

• one of the four sublevels has two or more "negative" answers;
• for any of the four sublevels, one “negative” response was received, and for the same sublevel there were no “leading” responses.

Psychomotor development is considered age-appropriate (normal) if the test results do not fall into the previous two categories.

In Russia, a similar technique for assessing the psychomotor development of children has not yet become widespread.

There are many other tables for assessing the development of a child, developed by various domestic and foreign authors. They can be found in various textbooks and monographs on pediatrics. We can recommend the book by V. I. Gordeev and Yu. S. Aleksandrovich “Quality of life - a new tool for assessing the development of children” (2001), which contains the main tests that make it possible to most fully characterize the development of the child and evaluate his intelligence in different periods of life.

All parents, without exception, worry about the health of their child. The issue of full-fledged physical, mental, neuropsychic development is especially worrisome for parents in the first year of a baby's life. How does the baby develop month by month? We offer for consideration an approximate plan for the formation of a peanut: we will evaluate the psychophysical development of a child up to a year old, the terms and norms according to WHO.

Calculator

Table of physical parameters up to a year

To assess the growth rate, weight gain and physical development of the baby, it is worth familiarizing yourself with the average generally accepted indicators of the stages of development of the child up to a year. However, we must not forget that all children have individual development schedules, exact compliance with the tables given is not mandatory, minor deviations from the norms are allowed. Do not forget also that boys and girls differ slightly in their neuropsychic development, but if the baby does not acquire skills and developmental indicators normal for his age for a long time, you should consult a doctor.

Table of physiological parameters of a child up to a year: (we recommend reading:)

So, how does a newborn baby grow during the first year? Consider the development of a child up to a year using a calendar divided by every 3 months from the birth of a baby.

From birth to 3 months

A newborn is born with developed hearing and vision. There is a vivid manifestation of innate reflexes: the child knows how to suck, swallow, blink and grab from the first minutes of life. However, while the baby is not able to roll over. A newborn from a position on the tummy cannot raise his head, but the instinct of self-preservation is triggered - he turns his head on his cheek.

The baby is able to hold the head for a few seconds, tries to raise it when lying on the tummy. In a month, a response occurs to sounds and sudden movements, expressed in involuntary separation of the handles and their subsequent pressing against the body. You can also observe spontaneous imitation of walking.

The baby raises and holds the head "standing" for 1 - 1.5 minutes, and from a position on the tummy, it can lift not only the head, but also the chest. Pays attention to sounds and bright light by turning the head and looking attentively. There is an intensive development of the vestibular apparatus. The child grabs and holds moving objects.

At 3 months, the baby should hold the head well for 1 to 3 minutes. From a lying position on the stomach, he can rise, leaning on his elbows. Begins to roll over, spin, change position, but there is still no clear coordination in the movements. He watches toys with interest, pulls his hands to them. He begins to put his fingers in his mouth, grab and pull the sheet.

I like the company of adults. Communication with parents is very captivating for the baby, the baby “comes to life”, shows joy, smiles, laughs. Can walk for a long time, turns his head to unfamiliar sounds. Now the baby is especially touching, do not forget to take photos more often as a keepsake!

Physical Features

neuropsychic development

From 4 months to six months

Being in a supine position on the back, the baby raises the head. If you put it on legs, it rests firmly on them. Begins to sit, can easily roll over from the back to the tummy. Freely lifts the body and rests on the palms when lying on the tummy. Carefully observes objects, can grab them. It is played with rattles (we recommend reading:).

The baby can sit, but still does not hold his back evenly, he can stand on his legs if he is held by the handles. Makes the first attempts to roll over from the tummy to the back. Holds an interesting object in the pen for a long time. Recognizes parents, begins to be afraid of strangers. According to Komarovsky, the baby already understands various voice intonations, begins to distinguish and understand the emotions of the mother.

At this stage, the child can already sit. He himself holds a flat back, easily spinning in all directions. With little help from an adult, he can stand on his feet, tries to walk. Begins to get up on all fours and move in this way. Already actively waving toys, picking up fallen objects.

There are also noticeable changes in speech:

• begins to express the first requests;
• the cooing is replaced by simple babbling sounds "ma", "pa", "ba".

Physical Features

neuropsychic development

From six months to 9 months

The baby can easily and quickly crawl on all fours, sit freely and for a long time. In a sitting position, he straightens and bends. Holding on to furniture, he can kneel, with the support of adults he can stand and step over. Interested in his mirror image. Can point with eyes at large objects, called adults.

According to the development calendar, at 8 months the child can sit down on his own and even stand on his feet (for more details, see the article:). Starts to play "patties", imitating hand clapping. With pleasure, she tries to take the first steps with the help of adults. The mimic movement of the face acquires a rich variety. The kid expresses interest, surprise, fear with facial expressions.

He easily finds the object of interest to him and persistently tries to reach him. He spends a lot of time in games - for a long time he can examine toys, knock them, throw them.

Standing on its feet, refuses support. He likes to walk, leaning on furniture, tries to get up on his feet from any position. Starts climbing on a hill - boxes, benches, pillows. At 9 months, motor skills become more complex, the baby can collect small parts of toys, sort out the designer, move cars.

Understands and can fulfill a simple request, such as “give the ball”, “wave your hand”. For games, he chooses a sitting position, easily and quickly memorizes new words. I like to look for fallen or hidden objects. Responds when called by name. Begins to distinguish words not only by intonation, but also by meaning. Can sort items by shape, color, size.

Physical Features

neuropsychic development

10 months to 1 year

After 10 months, the child, without help, gets to his feet and begins to walk. Starts to step over with the support of one handle. Can take a small object with fingers, gets upset when toys they like are taken away. Often and consciously imitates the movements of adults, can open-close, raise-throw, hide-find. The child pronounces simple one-syllable words.

The baby is developing rapidly. Basic movement skills are well developed. Can show many objects (toys, furniture, body parts, animals). Understands and fulfills most simple requests, expresses reluctance or denial by shaking the head.

The stage of development of fine motor skills of the fingers begins, it can tear a sheet of paper with two fingers. Great attention should be paid to the curiosity of the baby, encourage it and be sure to talk with the child as much as possible.

After 11-12 months, a difficult stage of development begins. Boys often develop a little slower than girls. The ability to walk independently appears. He can approach himself if he is called by name. Able to squat and straighten up without support. Picks up objects from the floor without sitting down. Can perform a difficult task: close doors, bring a toy from another room.

Shows interest in the process of undressing, bathing. Says about ten simple words. In a year, a child watches people and cars with interest. You can find more detailed information on the Internet by watching Komarovsky's video on the proper development of children from 0 to a year.

Physical Features

neuropsychic development

Bibliographic description:

Nesterova I.A. Health and physical development of children [Electronic resource] // Educational encyclopedia site

Consider the relationship between health and physical development of children, which is one of the key indicators of a child's health. The necessity of regular assessment of the level of physical development of the child in order to overcome possible diseases in the early stages of their occurrence is substantiated.

The value of the physical development of children

Health and physical development are closely related. In children with existing health disorders, physical development is slowed down or significantly worsened. The physical development of children is represented in the totality of the morphological and functional characteristics of the body in their relationship in childhood. It is inextricably linked with the education of cravings for a healthy lifestyle.

The problem of health and physical development of children is widely studied in medicine. Back in the 19th century, Russian scientists F.F. Erisman and N.V. Zak established that the physical development of children and adolescents from privileged circles is much higher compared to their peers from low-income families.

During the Soviet era, such scientists wrote about the health and physical development of children: A. N. Antonova, M. D. Bolshakova, M. A. Minkevich, E. P. Stromskaya, L. A. Sysin, L. L. Rokhlin , V. O. Mochan and others. At present, much attention is paid to the problems of child development and health in the works of such specialists as: V. V. Golubev, A.A. Baranov, N.V. Ezhova N.P., Shabalovi et al.

Indicators of the physical development of children

The health and physical development of children depends on the physical form and how often the child goes in for sports. An important role in assessing the health of children is played by indicators of the physical development of children.

The physical development of children is understood as a set of morphological and functional signs of the body, such as:

1. height,
2. chest circumference,
3. lung capacity,
4. muscle strength of the arms, etc.

The physical development of both a child and an adult is directly related to the activity of body systems:

1. cardiovascular,
2. respiratory,
3. digestive,
4. musculoskeletal, etc.

The state of the above systems is an indicator of the physical development of the child. It has been established that the body's resistance to adverse environmental influences and disease resistance depend physically on how the child is developed. Thus, the physical development and health of the child are interrelated and influence each other.

Many valeologists note that physical development as a category of health is directly related to the state of the cardiovascular, respiratory, digestive, musculoskeletal and other systems. This is undeniable. However, we must not forget that the level of physical development depends on the resistance of the organism to adverse environmental influences, resistance to disease and, accordingly, the state of internal organs.

The physical development and health of the child are interconnected and influence each other. Physical development reflects the processes of growth and development of the body and is one of the most important indicators of children's health.

Currently, more and more people talk about the acceleration of the child's body. It has unpredictable effects on the health and physical development of children. Acceleration is an accelerated rate of development called an organism. More than one theory of acceleration coexist in science. It is believed that this is the result of a general trend in the biology of modern man, which arose under the influence of scientific and technological progress. This is a change in nutrition, an increase in the activity of the Sun, a change in climatic conditions, urbanization, violations of genetic isolation (interethnic marriages), radiation from household appliances, etc.

The indicators of the physical development of the child are most often considered height and weight. They are evaluated by comparing the size of its growth with the norms presented in standard tables. Such tables are periodically compiled on the basis of mass surveys of children in certain regions, which have their own geographical, social and economic characteristics.

The child's body is characterized by rapid growth and continuous development. According to N.V. Ezhova in medical science distinguishes a number of periods of child development, which are shown in the figure below.

Periods of a child's life

The physical development of a child is influenced by many factors:

1. Heredity, in which a large role is played not only by the genes of the parents, but also by race and the genes of many generations of ancestors.
2. Nutrition of the child, which provides the physiological needs of the body. An unbalanced diet often leads to a deficiency or excess of certain substances, the development of various diseases.
3. Environmental conditions and child care.
4. Hereditary diseases, the presence of certain chronic diseases, severe injuries or infectious diseases.
5. Properly distributed physical activity, physical activity of the child, his psychological and emotional state.

Most often, the growth of the body ends by 16 - 18 years.

Physical development is a process strictly subject to certain biological laws.

One of the most important laws of the physical development of children is that the younger the age, the more actively the growth processes occur. Based on this, it can be argued that the body grows most actively in utero. For 9 months, the baby's body grows from several cells to an average size of 49 - 54 cm in height and 2.7 - 4 kg in weight. During the first month of life, the child grows by about 3 cm and adds a mass of 700 - 1000 g. On average, by the end of the first year, the child weighs about 10 kg and has a height of 73 - 76 cm. With increasing age, increases in the physical development of the child decrease.

Another important law of the growth of the child's body is the change in periods of stretching and rounding. Periods of the so-called extension are replaced by rounding periods - each period lasts about 1.5 - 3 years. The most pronounced periods of rounding at the age of 3 - 5 years, and periods of stretching - in adolescence.

Monitoring the indicators of the physical development of the child is necessary at each stage of development. It must be remembered that any disease affects the physical development of the child, violating it.

Assessment of the physical development of the child

To identify indicators of health and physical development of children, an analysis of indicators and calculations are carried out to identify various indices.

Assessment of physical development is carried out by comparing the individual indicators of the child with the normative ones. The first (basic), and in many cases the only method for assessing the physical development of a child is to conduct anthropometric studies and evaluate the data obtained. In this case, two main methods are used, shown in the figure.

Methods for assessing the physical development of children

Consider each method for assessing the health and physical development of children separately.

The method of tentative calculations is based on knowledge of the basic patterns of increasing the mass and length of the body, the contours of the chest and head. Appropriate normative indicators can be calculated for a child of any age. The permissible interval of deviations of actual data from the calculated ones is ± 7% for average indicators of physical development. The method gives only an approximate picture of the physical development of children and is used by pediatricians, as a rule, in the case of providing medical care to children at home.

The method of anthropometric standards is more accurate, since individual anthropometric values ​​are compared with the normative ones for the age and sex of the child. Regional standards tables can be of two types:

1. Sigma type.
2. centile type.

When using tables compiled according to the method of sigma standards, a comparison of actual indicators is carried out with the arithmetic mean value (M) for a given sign of the same age and sex group as in the child we are observing. The resulting difference is expressed in sigma (δ - standard deviation), determining the degree of deviation of individual data from their average value.

The results are evaluated as follows: with average physical development, individual values ​​differ from age standards (M) by no more than one sigma in one direction or another.

Depending on the size of sigma deviations, 5 groups of physical development are distinguished. They are shown in the figure below.

Groups of physical development in accordance with the size of sigma deviations.

Consider an example: The average height of 10-year-old boys is 137 cm, the standard deviation is 5.2 cm, then a student of this age, having a height of 142 cm, will receive a height estimate in shares of sigma equal to

142 – 137 / 5,2 = 0,96,

i.e., the height of the student is within M + 1σ and is assessed as average, normal growth.

The final data obtained for each sign of physical development, in sigma terms, can be visualized in the form of the so-called anthropometric profile, which is performed graphically and shows the differences in the physique of a given person from other persons. This method is widely used in dynamic medical monitoring of the physical development of children, athletes, military personnel and other population groups.

When using tables compiled according to the method of centile standards, it is necessary to determine the centile interval, which corresponds to the actual value of the sign, taking into account the age and gender of the patient, and give an estimate. The method is not mathematical and therefore better characterizes the variational series in biology and in particular in medicine. It is easy to use, does not require calculations, fully allows you to assess the relationship between various anthropometric indicators and is therefore widely used in the world.

At present, knowing the sex, age of the child and determining the anthropometric characteristics, it is possible to find out the degree of deviation of his physical development.

Centile - a certain proportion or percentage of the corresponding sign in children, depending on age and gender. This is a quantitative indicator of the physiological boundaries of a given trait.

For average, or conditionally normal, values ​​are taken in the range of 25-75 centiles (50% of all children). The interval from 10 to 25 centiles characterizes the area of ​​​​values ​​below the average, from 3 to 10 centiles - low, below 3 centiles - very low and vice versa, the interval from 75 to 90 centiles - the area of ​​\u200b\u200bvalues ​​above the average, from 90 to 97 centiles - high, above 97 centiles are very high. Above the 75th centile and below the 25th centile are the border zones of the quantitative characteristics of body length and weight, requiring caution when assessing the risk of serious deviations.

Scores outside the 97th and 3rd centiles reflect a clear pathology or disease.

Each length or weight result can be placed in the appropriate area, or "corridor", of the centile scale, which allows you to assess the child's physical development: average, above average, high, very high, below average, low and very low . If the difference between "corridors" between any 2 out of 3 indicators does not exceed 1, we can talk about harmonious development. If this difference is 2 "corridors", development should be considered inharmonious, and if 3 or more - disharmonious, i.e. evidence of a clear disadvantage.

When observing and measuring the child, the pediatrician gives an opinion on the physical development and recommendations in case of deviation from the norm.

But for an adequate assessment and timely correction of your child, the doctor must be familiar with:

1. with the previous development of the child,
2. with past illnesses,
3. with the child's characteristics.

Parents should clearly monitor the physical development of the child together with the pediatrician. This is necessary in order to prevent the development of diseases in time, such as endocrine, metabolic diseases, diseases of the cardiovascular system, etc.

Assessment of the physical development of the child occurs in strictly regulated periods indicated below.

So, control over the physical development of the child and its assessment are extremely important in today's extremely difficult environmental conditions. It is also necessary to emphasize the fact that the physical development and health of the child are interrelated indicators. Healthy children have adequate indicators of physical development. If the child has any diseases, then they worsen the indicators of physical development.

Constant monitoring of the physical development of children is necessary, it allows you to identify many diseases in the early stages, even before the start of health complaints by the child or his parents.

Literature

1. Golubev V.V. Fundamentals of pediatrics and hygiene of preschool children - M .: Publishing Center "Academy", 2011
2. Ezhova N.V. Pediatrics - Minsk: Higher School, 1999
3. Zhidkova O.I. Medical statistics: lecture notes - M .: Eksmo, 2011
4. Zaprudnov A. M., Grigoriev K. I. Pediatrics with children. – M.: GEOTAR-Media, 2011
5. Pediatrics. National leadership. Brief edition / Ed. A. A. Baranova. – M.: GEOTAR-Media, 2014.
6. Pishchaeva M.V. Denisova S.V. Maslova V.Yu. Fundamentals of pediatrics and hygiene of children of early and preschool age - Arzamas: ASPI, 2006.
7. Heavy O.V. Pediatrics. – New book, 2010.