Assessment of physical development according to centile tables. Mandatory anthropometric data for assessing physical development

Each child is individual - this is not a secret. However, there are indicators that in children in certain age groups must comply with the average standards. Such parameters help the doctor determine the possible presence of problems from physical and mental development, as well as suggest the presence of any disease.

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

Newborn

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

Baby up to a year

After the child turns one month old, the mother must wear the baby for planned appointments with the pediatrician. This happens on schedule when the baby is executed:

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

At these receptions, an assessment of physical development according to centile tables is mandatory. They also record the age when the child began to smile, sat down for the first time, stood up, took the first steps, said the first word, the terms of teething. Measure:

• Weight.
• Body length.
• Volume / head circumference.
• Chest size.
• Body temperature.
• The size of the fontanel.

Based on these data and possible complaints from the mother, the child can be sent for additional tests or a specialist appointment. In other cases, an assessment of physical development is given on centile tables. The development rate according to these tables is always considered to be getting into the middle corridors, that is, in the range of 25–75 percent. But a 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 talk about the physique).

Centile tables for boys under one year old

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 - legs.

Centile tables for boys and girls also contain baby head size data . Non-compliance with the standards for this parameter is an occasion to refer the baby to a neurologist.

Factors Affecting Physical Development

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

• climatic conditions;
• heredity;
• nutrition;
• level of material well-being of the family;
• compliance with the daily routine;
• parental attitudes to the child;
• psychological atmosphere in the family.

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

Assessment of the physical development of children after a year is based on the following indicators:

1. Somatic indicators (weight in kg, height in cm, chest circumference in cm).
2. Somatoscopic indicators (condition of integument of the 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, heart rate).
4. General state of health (past diseases, the presence of chronic ailments).

The methods for assessing physical development are strictly unified, because only by taking measurements under the same conditions and with the same tools can we talk about the comparability and reliability of the research results.

Somatic indicators

Assessment of a child’s physical development often happens this way: somatic indicators of a particular child’s development are compared with centile tables according to age and gender. How 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 outstripping 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

Assessment of the physical development of students takes place, including by measuring the functional parameters of the body:

1. 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 sex and age will differ.

2. Strength of the muscles of the hands - the degree of development of muscles. The measurement is carried out by a device called a manual dynamometer.
3. Deadweight is the strength of the muscles that extend the body in the hip joints.
4. ChES - heart rate.

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

Assessment of physical development by these indicators is carried out by comparing individual indicators and average values ​​characteristic of a given age and gender group of children.

Other development assessment methods

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

1. Method of anthropometric standards / sigmal deviations. Using this method, the proportionality of development is calculated. This method is rarely used today, since it does not reflect the full picture of development, but explores the elements separately.
2. Regression Scales. Tables for evaluation by this method are made taking into account correlation relationships, which is an undoubted advantage of the method. But it cannot be used for children with disproportionate development on certain grounds.
3. One-dimensional scale N. A. Matveeva. This method is used when entering the first grade, when moving to the 3rd, 8th and 6th grades. It takes into account eleven signs of development:
   - body weight,
   - height;
   - circumference (volume) of the chest;
   - the number of molars;
   - lung capacity;
   - heart rate (beats per minute);
   - the size of the fat fold in the navel;
   - muscle strength of the left arm;
   - muscle strength of the right hand;
   - minimum and maximum blood pressure.
   
   This method is quite extensive, but has the same drawback as the method of anthropometric standards. 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. The assessment takes place on an eight-point scale, which takes into account the ratio of sex, age, length and body weight.
5. Centile table according to I.M. Vorontsov. It uses a scale that takes into account three main indicators - body length, baby weight and chest size. Tests (screenings) by this method are used during preventive examinations in order to determine the group of children with severe developmental disabilities.
6. The complex method.

A comprehensive method for assessing physical development

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

• Assessment of biological age (degree of compliance with the age of maturation of the systems and organs of the child). Criteria: weight gain and body length per year, age by number of teeth, puberty, development of the bone apparatus.
• The type of constitution of the physique in the ratio of the shape of the legs, abdomen, chest, back, muscle development, bones, adipose tissue.
• Assessment of the harmony of developmental features by the ratio of height and body weight.

A comprehensive assessment of physical development, which is carried out in institutions with a medical and preventive focus, as well as during extensive medical examinations, allows children to be divided into five different health groups, depending on the totality of the data:

• I group . It includes children without chronic diseases, not sick or rarely sick, developing physically and mentally without deviations.
• II group . This group includes the category of children without chronic diseases and those who are ill no more than four times a year, who have risks of developing chronic diseases, possibly insignificant deviations in the level of functioning of systems and organs.
• Group III identifies children with chronic diseases, pathologies (congenital, not preventing the body from functioning normally), often sick (more than four times a year).
• IV group . Children with malformations (congenital), chronic diseases that violate the normal state of health and the general condition of the body.
• V group . This group includes children with serious chronic diseases that cause obvious disorders and dysfunctions of the body.

Teens

Assessment of the physical development of adolescents is no different from assessment methods applicable to 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 be significantly different 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 14 years of age are significantly ahead of their peers in terms of weight, height, and chest size.
• During this period, there is a strong jump in growth (girls will have time to grow by about 25 centimeters and add 25 kilograms; boys - 35 centimeters and 35 kilograms).
• By 13-15 years, the formation of secondary sexual characteristics will be completely completed.
• Active formation of the nervous, mental, cardiovascular, endocrine systems continues.
• The pulse and pressure are gradually approaching the indicators of an adult and at 18 years old they will stop at the numbers 120 to 65 for girls and 115 for 60 for boys.

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