Schemes of Age Periodization

The biological periodization accepted in HCT includes:

· the period of new-born (1-10 days);

· infancy - till 1 year;

· early childhood - 1-3 years;

· the first childhood - 4-7 years;

· the second childhood - boys of 8-12; girls - 8-11 years;

· teenage age - boys of 13-16; girls - 12-15 years;

· youthful age - young men of 17-21; girls - 16-20 years.

The social age periodization includes:

· day nursery age - till 3 years;

· preschool age - 3-7 years;

· junior school age - 7-10 years;

· middle school age - 11-14 years;

· senior school age - 15-18 years.

Physical Development of Children and Teenagers

Physical development is a complex of morphological and functional signs determining growth, formation of child’s organism, resources of its vital energy, tolerance and activity.

Physical development is one of the major parameters characterizing the health state of population and influence of various factors on it.

For estimation of health of children's contingents this parameter is most frequently used in connection with disease incidence.

The purposes of research of physical development are the following:

· revealing the laws of growth and development;

· estimation of individual and population level of health;

· studying the effect of environmental, social, genetic factors;

· estimation of efficiency of medical-prophylactic measures.

Methods of Research of Physical Development

Therequirements to research methods are the following:

· application of simple and accessible techniques,

· carrying out researches at one and the same time (better in the morning after sleep),

· sufficient accuracy of measurements.

Theresearch methods are subdivided into:

· Somatometric (anthropometric) - measuring height, body mass and circumference of the chest.

· Somatoscopic - the description of the form of skeleton, spinal cord, chest, legs, development of muscles, state of skin, sexual development by criteria of Tanner.

· Physiometric - measuring vital capacity of the lungs, chest excursion, muscle strength, arterial blood pressure, pulse rate.

 

Methods of Estimation of Physical Development

· Method of indexes, for example, Brock’s index:

height in cm - 100 cm =ideal weight in kg (with age correction).

For children this method is rarely used.

· Method of sigma deviations

     Sigma in statistics means a standard deviation. There are standard tables of physical development of children and teenagers according to age and sex on the basis of statistical researches of big contingents in which average indices of height, body mass and chest circumference with their sigma are included.

After determination of somatometric parameters of a concrete child, the average values from the table are subtracted from them, and difference is divided into the given sigma.

For example, a boy aged 10 has body mass of 45 kg, in the table for boys of this age the average body mass equals to 40 kg, sigma +- 2.5. Estimation: 45 – 40 kg = 5 kg/2.5 = + 2.

If quotient of division is from +1 up to –1, the development is average (it corresponds to the age norm); if it is +1 - + 2 - the development is above average; -1 - 2 - below average; more than +2 or below -2 - high or low.

The disadvantage of this method consists in the fact that each parameter is estimated separately, without interrelation with other parameters, and it is impossible to estimate harmonicity of physical development.

To eliminate this disadvantage the further development of method of sigma deviations has been suggested, i.e. drawing a diagram (profile) of physical development.

 

Fig 21. The Diagram (Profile) of Physical Development

 

The diagramgraphically represents the data received according to each parameter, if all quotients by 3 parameters are within the limits of 1σ the development is proportional (harmonious), up to 2 σ - disharmonious, more than 2 σ - sharply disharmonious.

 

Method of regression scales (regression sigma) shows on the basis of statistical researches what body mass and chest circumference should correspond to the given height. From the received parameters of body mass and chest circumference of the given child we deduct the average indices corresponding to the given height (from tables with estimated figures) and difference is divided into regression sigma, showing within what limits the range of mass and chest circumference in relation to height is possible at harmonious development.

Variants of estimation: development is harmonious within the limits of +1 up to -1 sigma; disharmonious - from +2 up to -2 σ and sharply disharmonious - more than +2 or less than -2 σ.

 

Method of centile lines (centiles). It is an American method mostly used in pediatrics.

For research not less than 100 children are necessary ranged according to increase of each parameter (height, weight, chest circumference), thus the first child is 1 centile, the last one - 100 centiles. The development is considered average between 16 and 84 centiles (+ - 2 σ for 100 observations). More often in pediatrics the range of 25-75 centiles is used.

The drawbacks of this method are: the interrelation of parameters and harmonicity of development are not estimated, and besides a great number of children are necessary for researches.

 

Recommendations for Practical Classes on the Theme

Key Questions

1.Anthropometric, anthroposcopic, physiometric methods of studying physical development of children and teenagers.

2.Methods of estimation of physical development of children and teenagers:

Method of indexes

Method of sigma deviations and profile of physical development

Method of regression scales

Method of centile lines

A complex method of estimation of physical development.

3.Determination of children’s health groups.

4.Determination of groups for physical training classes.

5.Method of comparison of physical development in various children collectives.

6.Laws of growth and development of a child’s organism.

7.Biological and social schemes of age periodization.

8.Acceleration. Theories, essence, consequences of deceleration phenomenon.

Self Test

1. Identify a centile range which testifies to a child’s height appropriate to his age?

*A. 25-75 B. 5-95 C. 16-84 D. 20-80 E. 3-97

2. How many health groups of children are known?

A. 2 B. 3 *C. 5 D. 4 E. 6

Problem Solving

1. On medical examination of a schoolboy aged 14 chronic tonsillitis and caries are revealed. On inspection – his height is average, physical development is harmonious. Determine the group of health.

2. Evaluate the physical development of Tanya L., aged 14 by method of scales of regress. Height of the child is 120 cm (+0.5 sigma regression), body weight - 20 kg (+0. 8 σR), chest circumference - 90 cm (+0.4σR).

Standards Answers:

1. The 3rd group of health, as the child has chronic tonsillitis.

2. Differences between all regression sigmas are not more than 1; therefore the physical development is harmonious.

 

Theme No 22.

Hygienic Requirements to Children's Preschool Institutions and Schools

Hygienic Requirements to Children's Preschool Institutions (CPI)

Types of CPI are: kindergarten (for children of 3-7 years), day nursery (till 3 years), children's center (day nursery + kindergarten), children's home, preschool children's home, specialized CPI for children with disorders of development, preschool health-improving institutions for summer vacation.