220231201
Fall, 1998, Mondays at 6:30 - 9:00 p.m. Room 306, Robinson.
Instructor: Diane L. Markowitz, D.M.D., Ph.D, Department of Geography and
Anthropology.
Credit hours: 3
Course Level: Undergraduate, sophomore/junior.
Curricular Effect: This course is specifically designed to introduce students to the concepts of physical growth and development, with a view to recognizing normal growth and development among a variety of the world's populations. It will be of particular value to those individuals planning to become involved with children in any professional capacity.
Prerequisites: (any of the following) Human Biology, Anatomy and Physiology, Physical Anthropology or Biology I.
Implementation: The course will be offered once per year, beginning in the fall of 1998.
Course activities: In addition to reading relevant course material, hearing lectures and participating in class discussions, students will gain some experience in acquiring growth data on their own in order to evaluate the difficulty of developing accurate information for analysis. The Geography/Anthropology department has recently acquired state-of-the-art anthropometric equipment to be used in growth studies. With these instruments, students will practice on each other and then on available children - with the cooperation of the Elementary Education department and the IRB Committee - in order to produce their own limited study of growth. I also expect to arrange field trips for students to the Gastroenterology and Nutrition Department at Children's Hospital of Philadelphia and the Turner Nutritional Awareness Project of the University of Pennsylvania. Mastery of the material will be gauged via two one-hour tests, short in-class presentations and a final written library research project.
Human physical growth and development historically has been and remains an important subject for physical anthropologists to investigate. Students taking this course can expect to acquire a detailed understanding of the tempo of growth, the meaning of developmental milestones and the effect of the environment, health and heredity on body habitus. This information will be of value to students in Elementary Education, in Special Education, the School Nurse program and to pre-medical students interested in specializing in Pediatrics. Students who have already taken (or who are taking concurrently) the Psychology Department's course in Child Development will be able to relate the timing and intensity of growth and their relationship to health and nutrition to the appearance of important psychological milestones. Understanding the evolution of the variety of growth patterns seen in the world's populations will also be valuable in explaining the issue of work capacity and strength: a subject likely to be of interest to health and exercise science majors. Following the earliest growth studies performed on the children of French factory workers in the 19th century, the originator of modern human growth investigations - Franz Boas (the originator of the four-field approach in anthropology and first chairman of the department of anthropology at Columbia University) - demonstrated that all children pass the same developmental milestones, but at a rate affected by heredity, by nutrition, by climate and by interactions of all of these. This course will survey Boas' work and that of the best modern researchers on the subject, particularly Phyllis Eveleth, James M. Tanner and Barry Bogin.. We will examine the evidence for and against a variety of postulated causes of delayed growth, variety in trunk/limb proportions, fat patterning, sexual maturation and development of secondary sex characteristics.
A.) Teachers and school nurses: Students must become familiar with the signs of delayed or precocious development in order to recognize them and suggest to parents that a child be examined. Teachers who see a child every day are in a far better position to be the first to suggest a timely intervention than physicians who may see a child only once a year. Also, teachers who understand the normal development of secondary sex characteristics will be in a better position to predict and deal with expected changes in behavior peculiar to puberty. Teachers must be aware of the range of normal variation in growth and its tempo in order to adjust expectations of appropriate behavior for children. Well-nourished groups feature an impressive variety of normal body types and sizes. A child who is large for his age, for example, may present the appropriate proportions and physical and mental development for one of his chronological age: yet such a child is frequently expected (unreasonably) to behave in a very mature fashion. This is an error made frequently by those unfamiliar with the full range of normal development. New Jersey, as do many other states, has a large number of temporary agricultural workers, some of whom bring their families. If - and we hope they do - send their children to school, many graduates of Rowan are likely to teach them. If these children are significantly smaller than others, teachers should have some means of evaluating the cause of their small size. Is short stature genetic and therefore of minimal concern, the result of early malnutrition (the effects of which will now be eradicated through catch-up growth in a more plentiful environment), or the continuing effect of malnutrition which may also affect a child's performance in school...or some combination of all of these? What effect, in any, does malnutrition have on learning capacity? All these subjects will be explored.
B.) Special education teachers and psychologists should be aware of the effects of developmental abnormalities on their students as well. Delay seen in some congenital syndromes affects mental function but not necessarily hormonal function. Others, such as Allbright's Syndrome or adrenal hyperplasia may affect development but not intellectual ability.
C.) Health and exercise science teachers are required to teach health and nutrition in order to improve immediate and long-term health in their students. They should know that a body habitus - for example, a pattern of centralized body fat deposition - that is perfectly normal for one group (Native Americans and many Hispanics) may also be associated with increased risk for disease in adult life among other groups. Also, a child of African origin with average size parents who tracks consistently in the lower 3rd percentile for height may be displaying a growth delay of greater concern than if that child were of European or Asian origin. In this regard, students in this class will become familiar with the methods for charting growth and the benefits and disadvantages of each.
D.) Teachers, school nurses, pediatricians and parents need to be able to examine growth studies critically to determine their validity in use. In this course, students will also become familiar with some of the more useful means of forecasting growth, including dental and skeletal age and growth equations. Although students will not derive or prove the validity (or lack of validity) of these equations, they will become familiar with the benefits and drawbacks of each.
Upon completion, students will be able to:
1.) outline the full range of normal milestones of growth seen in the healthy child.
2.) understand normal physiologic and anatomic maturation and the hormonal influences on them.
3.) be able to note when developmental milestones are not being achieved in a normal fashion.
4.) describe a variety of factors which may delay the tempo of growth: illness, disease, stress, treatment with steroids, malnutrition, high altitude, heredity.
5.) understand the mechanisms by which these factors may interfere with growth.
6.) outline the methods used in forecasting and determining growth.
7.) describe and intelligently criticize the benefits and shortcomings of the most often-used equations for forecasting growth.
a.) critically assess the validity of major growth studies in the literature.
8.) describe the phenomenon of catch-up growth and explain in what circumstances it may be seen.
9.) describe and understand the effects of heredity, environment, malnutrition and disease on body habitus (including stunting and wasting) and on the passage of developmental milestones.
10.) become familiar with some of the known effects (in adulthood) of alterations in the tempo of child growth and development and in fat patterning.
11.) describe the major inter-populational differences (includes African, Asian, Native American, European and South Asian-derived populations) in tempo of growth, fat distribution, trunk/limb proportions and attained adult stature and be able to relate these to climate, altitude and heritability.
12.) understand the effects of illness, both infectious and non-infectious, on growth and development.
13.) describe and explain the secular trend in tempo of growth among well-nourished, industrialized populations in pubertal development and final attained height.
a.) understand its implications for adolescent behavior.
Foetus into Man by J.M. Tanner
Worldwide Variation in Human Growth by Phyllis B. Eveleth and James M. Tanner
Patterns of Human Growth by Barry Bogin
Malnourished Children in the U.S.: Caught in the Cycle of Poverty: Robert
B. Karp (ed.)
Diane L. Markowitz, D.M.D., Ph.D.
Coordinator: Honors Program
c/o Geography/Anthropology Dept.
Rowan University
201 Mullica Hill Road
Glassboro, NJ 08028
Telephone: 856-256-4500, Ext. 3981
e-mail: markowitz@rowan.edu