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

Каждый ребенок индивидуален – это не секрет.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.

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

Newborn

When a child is just born, he immediatelygets his first marks. On the Apgar scale, the neonatologist places a certain number of points in the first and fifth minute of a baby’s life. From these two numbers depends on whether he will stay with his mother or he needs additional medical care, the question of the first vaccinations is decided.

Baby up to a year

After the child is one month old, the mother must always carry the baby on a scheduled appointment with the pediatrician. This happens on schedule when the baby is performed:

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

На этих приемах в обязательном порядке проводится assessment of physical development on centile tables. They also write down the age when the child began to smile, sat down for the first time, stood up, took the first steps, said the first word, teething terms. Measure:

• Weight.
• Body length
• Head volume / circumference.
• The size of the chest.
• Body temperature.
• The size of the spring.

На основании этих данных и возможных жалоб mothers, the child can be sent for additional tests or reception of a specialist. In other cases, an assessment of physical development is given according to centile tables. The rate of development according to these tables is always considered to fall into 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, below or above the average (in this case they speak about the characteristics of the physique).

Centered tables for boys up to a year

To measure the growth of a baby up to a year in the clinic, use a special board with sides. To one of them they press the head of the child, to the other - the legs.

Centers tables for boys and girls also contain data for the size of the child’s head. Non-compliance with standards for this parameter is a reason to send the baby to a neurologist.

Factors affecting physical development

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

• climatic conditions;
• heredity;
• power supply;
• the level of material well-being of the family;
• adherence to the day;
• parental attitude to the child;
• psychological atmosphere in the family.

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

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

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

Methods for assessing physical development strictlythey are unified, since only by measuring under the same conditions and the same instruments, one can speak about the comparability and reliability of the research results.

Somatic indicators

Assessment of the physical development of the child oftenthis is how it happens: the somatic indicators of the development of a particular child are compared with centile tables according to age and sex. How these tables look for boys can be seen 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.

The study of somatoscopic indicators

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

Physiometric indicators

Evaluation of the physical development of schoolchildren occurs, among other things, by measuring the functional parameters of the body:

one.The vital capacity (volume) of the lungs is an indicator of the strength of the respiratory muscles and lung volume. Measurement is carried out using an air spirometer or water. Age indicators in children of different gender and age will differ.

2. The strength of the muscles of the hands - the degree of development of muscles. The measurement is carried out by a device called a hand-held dynamometer.
3. Stanovoy force - the force of the body extending muscles in the hip joints.
4. CHSH - heart rate.

5. Blood pressure starts to measure after seven years. Normally, at this age, the systolic (upper) should be in the range of 100–120 mm Hg. Art., and diastolic (lower) - 60-80 mm Hg. Art.

The assessment of physical development on these indicators is made by comparing individual indicators and average values ​​characteristic of this age and sex group of children.

Other development assessment methods

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

1. Anthropometric / Sigma Methoddeviations. When using this method, the calculation of proportionality of development is made. This method is rarely used today, as it does not display a complete picture of development, but explores the elements separately.
2. Regression scales.The tables for estimation by this method are made taking into account the correlations, which is an undoubted advantage of the method. But it can not be used for children with disproportionate development on certain grounds.
3. One-dimensional scale N. Matveyeva. This method is used when entering the first class, when moving to the 3rd, 8th and 6th grade. It takes into account eleven signs of development:
   - body weight,
   - growth;
   - circumference (volume) of the chest;
   - the number of molars;
   - lung capacity;
   - frequency (number of beats per minute) pulse;
   - The size of the fat fold in the navel;
   - muscle strength of the left hand;
   - muscle strength of the right hand;
   - the minimum and maximum blood pressure.This method is quite extensive, but it hassame drawback as anthropometric standards method. Therefore, the assessment 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. Evaluation occurs on an eight-point scale, which takes into account the ratio of gender, age, length and body weight.
5. Centile table according to I. M. Vorontsov.It uses a scale that takes into account three main indicators - the length of the body, the weight of the child and the size of the chest. Tests (screenings) according to this method are used during routine inspections to determine the group of children with severe developmental disabilities.
6. Complex method.

Comprehensive method for assessing physical development

All methods considered earlier only considermorphological data assessments of development, but for a growing person it is natural and necessary to take into account biological development. The complex method includes:

• Оценку биологического возраста (степени age appropriate maturation systems and organs of the child). Criteria: weight and length gain per year, age by number of teeth, puberty, development of bone apparatus.
• The type of constitution physique on the ratio of the shape of the legs, abdomen, chest, back, development of muscles, bones, adipose tissue.
• Assessment of the harmony of the developmental features by the ratio of height and body weight.

Comprehensive assessment of physical development, whichcarried out in treatment-and-prophylactic institutions, as well as when conducting comprehensive medical examinations, depending on the data set, allows children to be divided into five different health groups:

• I group. It includes children without chronic diseases, not sick or rarely ill, developing in the physical and mental plan without deviations.
• Group II. This group includes the category of children withoutchronic diseases and sick no more than four times a year, with the risk of developing chronic diseases, there may be insignificant deviations in the level of functioning of systems and organs.
• III group identifies 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 malformations (congenital), chronic diseases that disrupt the normal state of health and general condition of the body.
• V group. This group includes children suffering from serious chronic diseases that cause obvious disorders and dysfunctions of the body.

Teens

Assessment 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 of age.

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

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

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

It should be noted that the accelerating pace of physical development (acceleration) has significantly changed recently the norms of somatic indicators.