10/10/2012
HLTB02
Issues in Child Health and Development
Lecture 4: Measures of Child Health and Cognitive Development
- Scope of measuring child health
o Know what kind of child care services need to be devised based on our understanding of child
health
If you know that children are susceptible to a certain disease at a particular age, how
can we devise a service that can reduce the incidence of the disease?
o General child health performance
How is your child fairing against the norm?
o Children go through many different developmental stages (all specific to domains)
Know that certain pathways will impact the future health of a child (ex: latent, cumulative,
etc.)
Important to recognize when children progress slowly through stages or do not surpass
stages at all (ex: developmental disability or child abuse)
o Children’s basic physiology differs from that of adults
Children have less tolerance to pollutants than adults
- Physiological Measures
o Measures of the physical condition or state of the body
o How the body physically works
As children age, their heart rate decreases (infants have heart beats of 100-160 bps)
o Perry, 2000
Study looked at traumatized or maltreated children (chronic)
Post-trauma, male children have a higher resting heart rate (than the norm)
• Evidence of difference around the age of 4
• Difference visible at a younger age
Post-trauma, female children have a lower resting heart rate (than the norm)
• Evidence of difference around the age of 7
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• Difference visible at an older age than males
o Lung Function – Pulmonary Function Test (PFTs)
Measures the size and function of the lungs
Spirometry - measures exhaling or inhaling of air
Used to assess conditions related to the lung function of a child
Normalized by age, weight, and height
• Males tend to have bigger lungs than females
- Anthropometric Measures
o Focus on the variability in size and shape of the body
Focus on four building blocks: age, sex, length, and weight
o Indices that are used to measure anthropometric:
Nutritional status
• Weight-for-age category
o Weight of the child at specific ages
o Low values indicates underweight
o Can reflect some sort of chronic or acute under-nutrition (body cannot
absorb certain nutrition)
• Height-for-age
o Identifies chronic under-nutrition
• Weight-for-height
o Useful to measure short-term effects such as food supply, or acute under-
nutrition
• Undernourishment - food intake continuously insufficient to meet energy
requirements
• Under-nutrition - outcome of undernourishment, poor absorption and/or poor
biological use of nutrients
o Undernourishment can lead to under-nutrition
Past growth failures
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• Stunting for children is described as having a low length-for-age
o Over two, use length-for-age
o Under two, use height-for-age
• Types of past-growth failures:
o Chronic insufficient protein
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