Evaluation of physical development by centile tables. Mandatory anthropometric data for assessing physical development

Every child is different - it's not a secret. However, there are indicators that children in certain age groups must meet the average statistical standards. Such parameters help the doctor to determine the possible presence of problems from the physical and mental development, and also to assume the presence of any disease.

Evaluation of a child's physical development is a very important moment for any doctor and, of course, for parents. What do all these scales, scores and tables mean in the life of the baby and where do they come from?

Newborn

When a child is just born, he immediatelygets its first evaluation. On the Apgar scale, the neonatologist places a certain number of points in the first and fifth minutes of the baby's life. From these two figures depends whether he will stay with his mother or he needs additional medical help, the question of the first vaccinations is being decided.

Baby up to a year

After the child turns one month old, the mother must carry the baby to the planned receptions to the pediatrician. This happens on schedule, when the baby is executed:

• one month;
• three months;
• six months;
• nine month;
• twelve months.

At these receptions, mandatoryevaluation of physical development by centile tables. They also record the age when the child began to smile, first sat down, got up, took the first steps, said the first word, the timing of teething. Measure:

• The weight.
• Length of body.
• Volume / circumference of the head.
• The size of the chest.
• Body temperature.
• The fontanel size.

Based on these data and possible complaintsmother, child can be sent for additional tests or specialist intake. In other cases, an evaluation of physical development is made for the centile tables. The norm of development according to these tables is always considered to be in the middle corridors, that is, in the range of 25-75 percent. But the child can also develop quite normally, if the data for all indicators are in the same range, lower or higher than the average (in this case they speak about the features of the build).

Centenary tables for boys under one year

To measure the growth of a baby for up to a year in the clinic use a special board with bumps. One of them is pressed the head of the child, the other - the legs.

Centenary tables for boys and girls also contain data on the size of the child's head. Inconsistency with the standards for this parameter is the reason to send the baby to a neurologist.

Factors affecting physical development

The child's physical health is the main indicator of his health status. It depends on several factors:

• climatic conditions;
• heredity;
• power supply;
• the level of material well-being of the family;
• observance of the daily routine;
• the relationship of parents to the child;
• psychological atmosphere in the family.

Mandatory anthropometric data for assessing the physical development of children after the year

Assessment of the physical development of children after the year occurs according to the following indicators:

1. Somatic parameters (weight in kg, height in cm, chest circumference in cm).
2. Somatoscopic indices (skin, mucous membranes, development of subcutaneous fat deposits, development of the musculoskeletal system, level of sexual development).
3. Physiometric indicators (muscle strength, lung capacity, blood pressure, pulse rate).
4. The general state of health (the transferred diseases, the presence of chronic ailments).

Methods for assessing physical development are strictlyare unified, since only by conducting measurements under the same conditions and with the same tools can we speak about the comparability and reliability of the results of the study.

Somatic Indices

Evaluation of the child's physical development is oftenoccurs in this way: the somatic developmental indicators of a particular child are compared with the centile tables according to age and sex. How do these tables look for boys, can be considered below.

For girls, growth rates are slightly different. Up to two years they are usually slightly smaller than boys, but after catching up and even ahead in growth.

Study of somatoscopic parameters

Methods for assessing physical development include a number of key indicators of measurement. They can be studied in the following table.

Physiometric indicators

Evaluation of the physical development of schoolchildren is also taking place through the measurement of the body's functional parameters:

1. The vital capacity (volume) of the lungs is an indicator of the strength of the respiratory musculature and lung volume. The measurement is performed using an air spirometer or a water spirometer. Age indicators for children of different sex and age will differ.

2. The strength of the muscles of the hands - the degree of development of the muscles. The measurement is carried out by an instrument called a manual dynamometer.
3. Stanovaya force - the force of the muscles that extend the body in the hip joints.
4. CHS - heart rate.

5. Arterial pressure begins to measure after seven years. Normally, from this age, the systolic (upper) should be within 100-120 mm Hg. st., and diastolic (lower) - 60-80 mm Hg. Art.

The evaluation of physical development by these indicators is made by comparing the individual indicators and the average values ​​characteristic for a given age and sex group of children.

Other methods for assessing development

Mandatory anthropometric data for assessing physical development are used in other methods:

1. Method of anthropometric standards / sigmadeviations. When using this method, the proportionality of development is calculated. This method is rarely used today, because it does not reflect the full picture of development, but explores the elements separately.
2. Scales of regression. Tables for evaluation by this method are based on correlation relationships, which is an undoubted advantage of the method. But it can not be used for children with disproportionate development on individual grounds.
3. One-dimensional scale Matveeva N. A. This method is used when entering the first class, in the transition to the 3, 8 and 6th grades. It takes into account eleven developmental features:
   - body weight,
   - growth;
   - circumference (volume) of the chest;
   - the number of molars;
   - lung capacity;
   - frequency (number of beats per minute) of the pulse;
   - the size of the fat fold in the navel;
   - the strength of the muscles of the left hand;
   - the strength of the muscles of the right hand;
   - minimum and maximum blood pressure.This method is sufficiently developed, but it hasthe same drawback as the method of anthropometric standards. Therefore, the evaluation of physical development will be more accurate if we use two-dimensional centile tables, which take into account the dependence of body length on mass.
4. Two-dimensional centile table. The evaluation is based on an eight-point scale that takes into account the relationship between sex, age, length and body weight.
5. The centenary table for IM Vorontsov. It uses a scale that takes into account the three main indicators - the length of the body, the weight of the child and the size of the chest. Tests (screenings) using this method are used in preventive examinations to identify a group of children with marked developmental abnormalities.
6. Comprehensive method.

Comprehensive method of assessing physical development

All the methods considered above take into account onlymorphological data of the evaluation of development, but for a growing person it is natural and necessary to take into account biological development. The integrated method includes:

• Assessment of biological age (degreematurity of the maturation of child systems and organs). Criteria: weight gain and body length for a year, age by the number of teeth, puberty, bone development.
• The type of constitution of a physique according to the ratio of the shape of the legs, abdomen, thorax, back, development of muscles, bones, fat tissue.
• Evaluation of the harmony of developmental features by the ratio of height and body weight.

Comprehensive assessment of physical development, whichspend in institutions of medical-preventive orientation, as well as in the conduct of detailed medical examinations, allows, depending on the totality of data, to divide children into five different groups of health:

• Group I. It includes children without chronic diseases, who are not ill or rarely sick, developing physically and mentally without departures.
• Group II. This group includes the category of children withoutchronic diseases and those suffering no more than four times a year, who are at risk of developing chronic diseases, there may be insignificant deviations in the level of functioning of systems and organs.
• Group III defines children with chronic diseases, pathologies (congenital, not interfering with the body to function normally), often ill (more than four times a year).
• Group IV. Children with developmental defects (congenital), chronic diseases, disturbing the normal state of health and the general state of the body.
• V group. This group includes children who are ill with serious chronic diseases, which cause obvious frustration and impairment of the functioning of the body.

Teens

The evaluation of the physical development of adolescents does not differ from the assessment methods used for all children. All tables and scales include data for children under 17 years old.

Although, of course, we must not forget that the development of girls after nine years and boys after eleven will be significantly different from the development of younger children.

In adolescence, there are significant changes in the proportions of the body and the development of organs and systems:

• Girls under 14 years are significantly ahead of their peers in terms of weight, height, size of the chest.
• During this period there is a strong jump in growth (girls will grow up to about 25 centimeters and add 25 kilograms, young men - 35 centimeters and 35 kilograms).
• By the age of 13-15, the formation of secondary sexual characteristics will be completed.
• The active formation of the nervous, psychic, cardiovascular, endocrine systems continues.
• Pulse and pressure are gradually approaching the parameters of an adult and at 18 years of age they will stop at 120 for 65 in girls and 115 for 60 in boys.

It is worth noting that the accelerating rates of physical development (acceleration) have significantly changed the norms of somatic indicators lately.