Assessing the physical condition of children: II. simple malnutrition: A problem of failing growth and development

Abstract

Summary This paper is concerned with a detailed account of the componentswhich are employed in the Grid technique to represent and define the physical status of growing children at a given moment and their physical progress from one observation to the next. To evaluate status it is necessary to fix upon three components: physique, development, and nutritional grade. To evaluate progress one needs to note only from a child's channel course and auxodrome how sequential states behave with the passing of time. Photographs of children arrayed in accordance with their Grid positionshelp to illustrate what physique, development, and nutritional grade signify when taken singly or in various combinations. The clearest understanding of what physique signifies is obtainedby comparing children in different channels who have reached the same developmental level; conversely, the best illustration of development is given by comparing children in the same channel who have reached different levels. Thus, for children in the same channel, increasing level leads merely to increase in absolute body size and not to alterations in physique. The role of age, which is concerned only with progress, is fully discussed.The sole value of age, in the matter of judging growth and development, is its function of determining, with the help of a child's auxodrome, whether that child is keeping to his own specific schedule of development or not. The outstanding and fundamentally important characteristic which physique, developmental rate, nutritional grade, and age schedule (auxodrome) possess is that in health they remain constant during the prolonged ten-to twelve-year period of school life in which children through the impetus of growth are undergoing continuous and ultimately great change in body size. The invariancy of these components when all else is changing sets the pattern of satisfactory growth no matter how children may differ or be alike in other respects. An evaluation of growth and development for the purposes of assessing the physical condition of children thus depends far more upon noting whether changes have occurred in the components that should normally remain constant than upon dealing with attributes that are changing from day to day.