Table age periods of child development. Age periodization of human development

Topics 4-5. Anatomical, physiological, psychological and social characteristics of a person at different age periods.

1. EDUCATIONAL RESULTS OF THE LESSON (purpose of the lesson):

During the lesson, the student must:

know: the concept of "age", "chronological", "biological" age, definitions of growth, development, patterns of growth and development in the age aspect, age periodization

analyze and evaluate: anatomical, physiological, psychological, social characteristics of a person at different age periods.

In the course of independent work, the student should pay attention to: on the peculiarities of the formation of body systems at different age periods

2.SELF-TRAINING MATERIAL:

Self-study questions:

1. Give definitions to the concepts "age", "biological age", "chronological age".

2. Tell us about the periods of ontogenesis, reflecting the stages of growth and development. Tell us about the age periodization.

3. Explain the concepts of "growth" and "development". What is their relationship?

4. What is meant by a "critical period of development"? Give examples of critical periods.

5. What are the main patterns of growth and development of children do you know?

6. What does physical development include?

7. What do they mean by the concepts of "acceleration" and "retardation"?

8. What is included in the concept of psycho-emotional and social development?

9. What is included in the concept cognitive development?

10. Describe the physical, psycho-emotional, social and cognitive development in different periods human growth and development.

11. Name the main age-related characteristics of the organism in different periods of human ontogenesis.

General concepts of the age and age periods of a person's life

The development of the human body occurs continuously, throughout life. In the process of individual development of a person, a number of periods can be distinguished, each of which has its own characteristic features. The duration of each of these periods is determined by the biological characteristics of the organism of a given species, and also largely depends on the action of social and environmental factors.

The concept of "period of life" of a person is closely related to the concept of "age".

Under age it is customary to understand:

1) the period of time from the birth of the organism to the present or any other moment;

2) biological evolution of the organism, i.e. a characteristic of his life, reflecting the moment of birth, growth, development, maturation and aging.

Distinguish between chronological (passport, calendar) and biological (anatomical and physiological) age.

Chronological age - this is the period from birth to the moment of its calculation, i.e. the difference between the date of the study and the date of birth.

Biological age - a set of signs characterizing the biological state of the organism, the level of its vitality and general health.

Chronological age has clear boundaries in time - hour, day, month, year. In this case, the biological characteristics of this particular organism are not taken into account.

Biological age is determined by the totality of metabolic, anatomical, functional, regulatory, psychological characteristics, adaptive capabilities of the organism. It also represents certain periods of time, but in contrast to the calendar time intervals of biological age, during which irreversible age-related changes occur, are less clearly limited. It is these time intervals that are used as criteria for the age periodization of a person's life, since many indicators functional development organism, its systems correlate primarily with biological age and, to a lesser extent, with calendar age.

The biological age may not correspond to the chronological one.

In some pathological conditions (for example, with progeria), the biological age is ahead of the calendar, and for some others, it lags behind it (for example, with infantilism). The discrepancy between the timing of the chronological and biological age also depends on the constitutional and racial characteristics of the organism, the state of human health, regional differences associated with climatic conditions, the regime and nature of nutrition, etc.

The allocation of age periods is rather arbitrary, and the idea of ​​age periods is relative, but for practical purposes such a division is necessary. The criteria by which certain stages of life, certain age periods of a person are determined, their duration depends on a number of factors: biological characteristics of the organism, social factors (environmental conditions, living standards), the level of scientific knowledge and the state of health care.

Age periods- these are certain terms, time intervals that are necessary to complete a certain stage of the morphological and functional development of individual tissues, organs, systems of the body and the whole organism as a whole.

During ontogenesis, three main periods can be distinguished:

The period of growth and development, the formation of functional systems, continuing until the age of morphological, sexual, psychological maturity;

Period of relative stability, maturity of the functional systems of the body;

The period of extinction, weakening and destruction of functional systems during the aging of the body, which occurs after the cessation of reproductive function.

The boundaries between certain age periods can not always be clearly established.

The division into age periods is most detailed for childhood, since the period of childhood is characterized by a continuous process of growth and development, when organs and functional systems the child changes according to known age limits.

V childhood there are 2 stages and 6 periods of development:

A. Intrauterine stage:

a) the phase of embryonic development (up to 2-3 months)

b) the phase of placental (fetal) development (from 3 months to birth)

B. Extrauterine stage:

1) neonatal period (neonatal) (first 4 weeks of life);

2) period of infancy - infant (1 month - 12 months);

3) preschool, or early childhood (from 1 year to 3 years);

4) preschool period (from 3 to 6-7 years old);

5) junior school period (from 7-8 to 10-11 years old);

6) senior school, or adolescent, period (from 11-12 to 16-18 years).

The most significant changes in the body children occur in the first year of life, when literally every month is accompanied by qualitatively new, very tangible shifts in development, which make it possible to very accurately and reliably single out these small stages of a child's life. Such a detailed and precise distinction cannot be made in any other age period.

In life an adult a person can also be distinguished by certain stages, or age periods. However, the classification of these periods and their time limits may change, which is associated with the development of scientific knowledge in the field of developmental physiology, human biology.

Currently, the following are distinguished periods in an adult's life:

1) adolescence (from 16 to 20 years old for women, from 17 years old to 21 years old for men);

2) mature age (from 20 to 55 years for women, from 21 to 60 years for men)

a) I subperiod - from 20 to 35 years old for women, from 21 years old to 35 years old for men

b) II subperiod from 35 to 55 years for women, from 35 to 60 years for men

On the border of mature and old age, due to the importance of the processes occurring in the body, a special age interval is distinguished - the climacteric period (from 45 to 60 years for women, from 50 to 60 years for men);

3) old age (from 55 to 75 years for women, from 60 to 75 years for men);

4) old age (from 75 to 90 years old);

5) late old age, or macrobiotic, age (after 90 years; such people are called centenarians).

The age limits of these periods are rather arbitrary, especially for older age groups. There is no universally accepted definition of old age in the world.

Usually the age of retirement is taken as the basis, but in different countries it is not the same, it is different for men and women, for different professional groups. In addition, with an increase in life expectancy, an improvement in living conditions, it can change.

The allocation of stages of human life is due to various anatomical, physiological, psychological, social characteristics, differences in some needs, as well as ways to satisfy them. Therefore, the periodization of human life is important for the development of recommendations for adequate modes of life, nutrition, prevention of diseases, etc.

In each age period, it is possible to distinguish especially significant critical or critical phases when the genetic program of development changes and the body's sensitivity to the effects of unfavorable environmental factors increases sharply. Critical periods are characterized by more significant physiological, psychological and morphological changes that require special attention in the formation of health in these periods of ontogenesis.

For example, the critical period of development is the age of the beginning of learning, when qualitative changes in the morphological and functional maturation of basic brain processes occur during the period of a sharp change in social conditions.

Critical periods include, first of all, the neonatal period, the period of puberty (puberty), menopause and the period of aging.

There are such critical periods in adulthood, and they are associated with both physiological and to a greater extent with psychological and social characteristics of a particular period of life.

The critical phases of the growth and development of children were developed by Yu.E. Veltischev. For the practitioner, the following critical periods are most important:

· 3-4 months of life - immunological and metabolic stress when trying to turn on their own defense systems (mother's protection or "passive immunity" falls, restructuring of phosphorus-calcium metabolism);

· from 12 to 24 months of age - a critical period associated with an upright position, activation of developmental opportunities, but against the background of a change in the position of organs, minimum level immune protection, leading to frequent morbidity and sensitization;

· critical period of 2-4 years is associated with a change in the leading position of thyroid hormones, which cause growth and development in early childhood, to an increase in the role of ACTH and glucocorticoids, which is characterized by a powerful membrane-protective effect, a decrease in vascular permeability, a decrease in acute morbidity, a rapid intellectual leap, but also the ability to quickly form chronic pathology.

· pre- and pubertal - during this period, the maximum tension of all systems, all protective and adaptive mechanisms, all body functions occurs.

Growth and development

With the concepts of "age period", "biological age" are closely related concepts such as "growth" and "development". At each stage of an age biography, there are specific features that reflect the stages of growth and the degree of development of the organism.

Growth and development a person is an ongoing process that occurs throughout his life, in which simple quantitative changes lead to fundamental qualitative shifts. The processes of growth and development are interconnected and interdependent.

Height- this is quantitative changes associated with an increase in the number and / or size of cells, the size and mass of organs, tissues, and the whole organism as a whole.

Development implies quality changes - morphological differentiation of tissues and organs, their functional improvement, the emergence of new knowledge, skills, skills or their disappearance, extinction over time, i.e. development can go along two lines - ascending (progress) and descending (regression). In addition, two forms of development are distinguished: evolutionary and revolutionary, spasmodic.

The development of a person continues throughout his life, starting from the moment of the formation of the zygote and ending with death; growth (an increase in length and an increase in body weight) ends at the end of adolescence, although cell and tissue growth occurs (for example, the growth of nails and hair continues even for some time after the biological death of the body).

The processes of growth and development are interrelated, which is manifested in the fact that certain stages of development can occur only when a certain body size is reached. So, puberty in girls can occur only when body weight reaches a certain value (for representatives of the European race, this is about 48 kg).

In those cases when growth processes are simultaneously observed in many different tissues of the body, one speaks of the phenomenon of so-called "growth spikes". First of all, this manifests itself in a sharp increase in the longitudinal dimensions of the body due to an increase in the length of the body and limbs.

In postnatal human ontogenesis, the following are distinguished "Growth spikes":

In the first year of life (1.5-fold increase in length and 3-4-fold increase in body weight per year, growth is mainly due to lengthening of the body);

At the age of 5 - 6 years (the so-called "half-height jump", as a result of which the child reaches about 70% of the body length of an adult (growth - mainly due to the lengthening of the limbs);

At the age of 13 - 15 years (pubertal growth spurt, both due to the lengthening of the trunk and due to the lengthening of the limbs).

As a result of each growth spurt, the proportions of the body change significantly, getting closer and closer to adults. In addition, quantitative changes are accompanied by qualitative changes in the functioning of organs and systems.

The processes of growth and development have a number of patterns, which include:

Genetic predetermination;

Staging;

Certain morphofunctional changes characteristic of each period of a person's life.

The main regularity of the relationship between growth and development is their discrepancy in time or space, i.e. they do not occur simultaneously: first, quantitative changes are observed, which then lead to qualitative ones.

This explains the growth spurt in certain age periods, the discrepancy between the timing of physical and psychosocial development (especially pronounced in adolescence), and a decrease in certain body functions at certain periods of life.

The degree and speed of changes that occur with a person are not the same in different periods of his life: the younger the body, the more intensive the processes of positive development are, with age they slow down significantly.

So, the growth rates are most significant in early childhood, when there is a significant increase in the main morphological indicators (body length by the end of the first year of life increases by 47-50%, in the second year - by 13-15%, in the third - by 9-10 % in relation to the previous one; in the future, the rate of increase in body length steadily decreases).

In childhood, growth and development occurs along an ascending line, in the form of progress; in adulthood, these processes are somewhat stabilized, and in old and senile age they turn into regression, i.e. development is on a downward trend.

There are the following the main patterns of growth and development of a child:

1. Slowing down of growth rates with age (growth for the first year is 47-50%, for the second - 13-15%, for the third - 9-10%).

2. Uneven growth rates: the first growth leap - from 0 to 1 year of life; a half-growth leap at 5–7 years, the second growth leap in the prepubertal period (Fig. 1).

3. Systemogenesis.

4. Reliability of the biological system (duplication and interchangeability of the cellular composition of the system.

5. Cranio-caudal growth gradient (distal segments grow faster than proximal (after birth)).

6. Alternation of directions in growth (periods of extension and rounding).

7. Sex specificity of growth (crosses of growth and weight in boys and girls).

8. Growth asymmetry.

A brief description of the anatomical, physiological, psychological and social characteristics of a person at different age periods (Volkov S.R., Volkova M.M., 2005)

In the period intrauterine development several sub-periods can be distinguished (the embryonic itself - from the moment of fertilization of the egg to implantation into the uterine mucosa; the sub-period of implantation - lasts about 2 days; actually embryonic - lasts 5-6 weeks; embryo-fetal - lasts 2 weeks, when the placenta is formed; fetal, or placental , - lasts from 9 weeks to the moment of birth). However, for practical purposes, it is convenient to divide into two main stages: the period of embryonic development and the period of placental development (fetal).

Fig. 2. Critical terms for the development of possible malformations in organ systems

The most important from the medical and biological point of view is the first of them (Fig. 2). It is during this period that the laying, formation and differentiation of organs, tissues and systems take place, the highest rates of their development are observed. At this stage, the embryo turns into a fetus with organs and systems characteristic of the early period of human development. Therefore, the impact of unfavorable factors, both external and internal, can cause damage to developing tissues and lead to gross anatomical and dysplastic malformations or even to the death of the embryo and spontaneous abortion.

During the period of placental development, there is an intensive development of tissues and organs, an increase in the weight and length of the fetus. Preparations for extrauterine existence are underway.

The first stage, from which the extrauterine life of a person actually begins, is childhood. In turn, the most important period from a medical and social point of view of childhood is the period newborns. This period can also be divided into two - early and late.

Early sub-period of newborn ( early neonatal ) - this is the period from the moment the umbilical cord is ligated until the end of the 7th day of life. It is characterized by the processes of adaptation of the organism to extrauterine existence. The most significant physiological changes occur in the respiratory system and the circulatory system - the lungs (the beginning of pulmonary respiration) and the pulmonary circulation begin to function, while the hemodynamic pathways of the intrauterine period are blocked and blood flow in the vessels of the lungs and brain increases. In the same hours and days, energy metabolism and thermoregulation are rebuilt, enteral nutrition of the child begins. It should not be forgotten that all organs and systems of a newborn child are underdeveloped, and the least mature and least differentiated is the nervous system. Due to the immaturity of the cerebral cortex, any irritation entering the central nervous system (CNS) causes its prolonged inhibition, which explains the almost constant sleep of the newborn, interrupted only during feeding. The fact that a child is born only with unconditioned reflexes (sucking, swallowing, searching, palmar-oral, etc.) is also due to the lack of differentiation of the cerebral cortex. At this time, the child is completely helpless.

Late neonatal the period lasting from the 7th to the 28th day of life is largely characterized by the intensive development of analyzers, primarily visual, the onset of coordination of movements, the formation of conditioned reflexes, the emergence and establishment of emotional, visual, tactile contact with the mother, the appearance of a smile and facial expressions joy in response to communication, which can be considered the beginning of the child's own mental life.

A distinctive feature of the neonatal period is the maximum intensity of all metabolic processes. Thus, the basal metabolic rate per 1 kg of body weight in a newborn is almost twice that in adults. Such important physiological acts as respiration, blood circulation, excretion also occur intensively (the number of respiratory movements reaches 45 per 1 min, the heart rate - up to 160 per 1 min). Plastic processes are also actively proceeding, body weight is growing rapidly, which is ensured by a significant functional stress of the digestive system. In this case, it is necessary to take into account the low enzymatic activity of the gastrointestinal tract.

The neonatal period is characterized by the resistance of the child's body to many infections (scarlet fever, measles, rubella, diphtheria, etc.), which is associated with passive immunity received from the mother during intrauterine development or as a result of breastfeeding. The own immune system is poorly developed, therefore, there is an increased sensitivity to pathogenic microorganisms.

In a newborn, there is also an imperfection of the neuroendocrine and renal regulation of water-salt metabolism, which determines the tendency to dehydration. As you know, water plays an extremely important role in life processes (metabolism, thermoregulation, maintaining the constancy of the internal environment, etc.). The body of a newborn contains about 1.5 times more water relative to body weight than the body of an adult. Over time, as it grows and develops throughout life, the body becomes depleted in water, especially intense in the first 6 months of life.

Other organs and systems of the newborn's body are also imperfect, all the main functions of which are in the state unstable equilibrium, and any adverse effect can provoke the development of the pathological process. It is during this period that some borderline states can be observed (erythema of newborns, physiological jaundice, sexual crisis, transient fever, etc.), which are on the border of normal and pathology and which never recur, but when exposed to negative factors, they can turn into a pathological process ...

Following the neonatal period, the period begins infancy, which conditionally starts from the 29th day of life and ends at 12 months. This period is characterized by the fact that the main processes of adaptation to extrauterine life have already been completed, the growth and development of the child are stormy, more intense than in subsequent years. Literally every day adds something new in physical, neuropsychic, motor, intellectual and social development. So, by the end of the first year of life, the child's body weight triples compared to the initial one, growth increases by 50%, head circumference - by 12 cm, chest circumference - by 13-15 cm. In this case, the proportions of the child's body are close to the proportions of an adult. High growth rates during this period are provided by a large relative energy consumption exceeding the energy requirement of an adult by 3 times, therefore, an infant needs a much larger amount of food per 1 kg of body weight than an adult. However, the continuing functional immaturity of the digestive tract requires careful attention, first of all, to the issues of rational feeding and regimen.

Motor and static functions continue to improve: by 2 months. the child, being in an upright position, holds his head well; from 5 months rolls over from back to stomach and back; by 7 months sits down on his own, by the end of the year begins to walk, manipulate toys.

Striking changes occur in the mental development of the child: appear conditioned reflexes, the movements of the eyeballs become coordinated, the child fixes his gaze on bright objects, follows their movements; auditory concentration appears; the child begins to recognize his loved ones, smiles, walks, and at 5-6 months. babbles the syllables "ba", "ma", "pa". By the end of the year, he utters the first meaningful words that can be formed into simple sentences, fulfills some simple requirements, understands prohibitions.

Physical development slows down somewhat by the year, mental development continues at a faster pace. However, all the basic functions of the body, all organs and systems remain in a state of unstable equilibrium, and any adverse effect can disrupt it.

The passive immunity characteristic of the neonatal period is lost by 2 months, and the formation of its own immune system is relatively slow, therefore there is a high probability of diseases, especially of the respiratory and digestive systems. Also, due to the lack of the body's ability to limit the pathological process within this or that organ or tissue, there is a tendency to diffuse reactions, generalization of inflammatory phenomena and the development of septic conditions.

Preschool the period (from 1 to 3 years) is characterized by a further rapid improvement of the child's motor skills and abilities, his psyche and speech, a greater maturity of the main physiological systems and individual organs. Active growth continues, but its pace has already been somewhat reduced. The main distinguishing features of a child of this age are his mobility, curiosity, active knowledge of the environment. Speech becomes richer, more expressive, more imaginative, sentences become complex, with good grammatical control. Emotional manifestations are expressed, the child's behavior is difficult to self-control, episodes of capriciousness, stubbornness, and shyness occur. This period also requires the correct organization of the child's regimen, his upbringing, in order to, if possible, protect the still unsettled child's psyche from excessive emotional stress, and the unformed organism from the negative influences of the external environment. At the same time, it is important not to miss the slightest opportunity for the all-round development of the child, because it is during this period, due to the plasticity of the central nervous system, that its main characterological features are formed, the foundations of future behavior are laid, the possibility of better adaptation to the world around them.

For preschool period (from 3 to 7 years) is characterized by another acceleration of growth rates, while the increase in body weight slows down somewhat. The development of the skeleton continues, the muscles grow stronger. The length of the limbs increases, the proportions of the body are even closer to those of an adult. Milk teeth, which appeared in earlier age periods, begin to change to permanent ones.

Actively developing intellectual abilities child. Children during this period speak fluently native language, many begin to read, writing and drawing skills appear, which is associated with the development and improvement of fine coordinated movements. Memory significantly improves, which contributes to a good memorization of poems, stories, assimilation of a foreign language. The functional capabilities of the child's body are gradually improving.

Thus, the immune system reaches a certain degree of maturity, which significantly reduces the tendency to diffuse and toxic reactions, but the incidence of infectious diseases remains high due to the increased contacts of the child with others.

V elementary school period (from 7 to 12 years), many organs and systems of the child reach full morphological and functional development. The formation of the bone skeleton is coming to an end, the muscular system continues to develop and strengthen. There is a complete replacement of milk teeth with permanent ones. At the same time, the first signs of sexual dimorphism appear in the structure of the skeleton, in physical development.

In this period, the structural differentiation of the cerebral cortex ends. Receives further development the child's intellect, independent judgments appear, volitional qualities, perseverance develop, the range of interests expands, individual differences in the psyche and behavior are manifested to a greater extent.

At primary school age, loads increase - both physical and psycho-emotional.

Senior school (teenage, pubertal) the period (from 12 to 16-18 years) is one of the most difficult and crucial stages of human life, both in terms of morphological and functional changes occurring in the body, and in terms of psychological adaptation to socio-economic conditions, which is associated with changes in social and legal status. Therefore, in this period, in addition to biological age, it is possible to distinguish the so-called legal adolescence, which is associated with the emergence of legal, legal responsibility, the beginning of permitted work activities and the termination of labor and legal benefits (from 14 to 18 years).

From the age of 15, the patient himself consents to the provision of medical assistance (surgery, complex diagnostic or therapeutic procedure, etc.). Before this age, consent to medical intervention is given by the child's parents. ??

Biologically, this period begins with the formation of secondary sexual characteristics, and ends with full puberty.

The most characteristic feature of the period is a significant activation of the endocrine apparatus: the functions of the gonads, the thyroid gland, and the hypothalamic-pituitary system are enhanced. The onset, duration, rates of puberty depend on the genetic program of the individual, constitutional type, climatic conditions, nutrition, excessive physical and psycho-emotional stress, alcohol consumption, smoking and other factors.

Signs that determine the onset of puberty are the enlargement of the mammary glands in girls and the enlargement of the testes in boys. In most girls, this occurs at 10-11 years old, then pubic hair appears, and after 1.5 years - in the axillary region.

In parallel, significant changes occur in the functioning of the sweat and sebaceous glands. At the age of 12-14, the first menstruation occurs - menarche. A regular menstrual cycle is established within about a year, its duration is individual. By the age of 15-16, secondary sexual characteristics in girls reach the stage of complete morphological and functional development, however, the hormonal background and reproductive function of the ovaries differ from those in women of mature age.

The beginning of a noticeable increase in the testes is considered the first sign of the onset of puberty (at 11.5-12 years). Pubic hair growth, which is the first visible sign of the onset of puberty in boys, occurs between the ages of 12-13. Thus, puberty in boys begins on average 1–1.5 years later than in girls. The next signs of puberty are successively advancing voice mutations, changes in the shape and enlargement of the cartilage of the larynx, hair growth on the face and in the armpits, but the nature of facial hair is not yet as pronounced as in adults. From 12-13 years old, there is an increase in the length and diameter of the penis. This process continues until the age of 16-17, when the size of the external genital organs becomes the same as in adults. It is by this age that secondary sexual characteristics in young men reach the stage of full maturity. An increase in the linear dimensions of the trunk and limbs and maturation of the skeleton are also associated with the activation of the endocrine system. This is the last period of rapid growth in childhood, and the process of increasing growth occurs more actively at the very beginning of puberty (annual gains are 10-12 cm, adolescents gain almost 25% of their adult height during this period), and by the age of 15-17, when the length of the body and legs reach the size of an adult, the pace of physical development is somewhat reduced. However, the volume of the chest, shoulder width, body weight continue to increase (in adolescence, a person gains up to 50% of his adult weight), muscle strength increases.

In adolescence, further morphological and functional changes occur in other organs and systems.

Adolescence is the most difficult period for psychosocial development for both boys and girls. During this period, a transformation of character takes place, the will is brought up, the individual traits of personality, temperament, constitution are most clearly manifested, behavior often acquires the features of deviant and delinquent.

However, there are also general specific socio-psychological characteristics characteristic of adolescents. This is the change of mood, and the desire for self-affirmation, independence (emancipation) from elders, rejection of their opinions, experience, and often laws. This is the desire for grouping with peers, and an increased sensitivity to the opinion of others about their abilities, appearance.

This is a kind of hobbies and related activities, and the emerging sexual desire and problems associated with its implementation. At this time, there is a process of restructuring of thinking from the concrete to the abstract, the worldview of an adult develops. All these moments in the life of adolescents, when exposed to any unfavorable biosocial factors, can lead to negative reactions from the central nervous system (affective reactions - aggressive, auto-aggressive, suicidal attempts, etc., pubertal neuropsychic anorexia, bulimia, body dysmorphic disorder, etc.) etc.), and in some cases - to the development of somatic diseases (arterial hypertension, chronic gastritis, etc.).

In general, for a child, in contrast to an adult, the disproportionality of the body and its individual parts is characteristic: the legs are relatively short, the body is long. The head is large, but with age, these proportions gradually level out (Fig. 3).

Fig 3. Proportions of the human body at different age periods.

At the end of the period of childhood, a large stage of life begins - the period of an adult, which begins with youthful age (from 16-7 years old to 20-21 years old). In accordance with the UN Convention on the Rights of the Child and the Family Code Russian Federation children are considered to be persons under the age of 18, therefore, in Russia, medical supervision of children and adolescents under 18 inclusive is carried out in the system of providing medical care to children, i.e. in children's and adolescent clinics, hospitals, centers.

Strictly speaking, it is quite difficult to establish clear biological boundaries of the end of childhood, puberty and the beginning of adulthood, adolescence, since adolescence is not strictly related to calendar age, and the end of this period merges with adolescence, therefore, many morphological, structural and functional changes organism, starting in adolescence, ends in adolescence.

Nevertheless, adolescence has some peculiarities. This period is characterized by the completion of physical development. So, the growth process slows down significantly: body length increases during this period by an average of only 1 cm per year. Body weight also grows at a lower rate. The formation of the skeleton is nearing completion. The morphological structure and functioning of all organs and systems acquire the features and properties of a mature organism.

At this age, the character is finally formed, the further formation of the personality, its self-affirmation takes place.

The age of civil and full legal responsibility is approaching: boys and girls receive the right to vote, at this time they have to serve in the army, many create their own families.

Mature age (from 20 to 55 years for women and from 21 to 60 years for men) covers most of a person's life, its length is quite large, the changes occurring in the body are quite significant, therefore this stage of life is divided into two sub-periods. The first of these begins at the end of adolescence and lasts until about 35 years; the second - lasts up to 55 years in women and up to 60 in men, including the intermediate menopause.

The first sub-period of adulthood is characterized by cessation of growth, full flowering and stability of all body functions. At this time, the individual traits of the organism and personality are most clearly manifested, and the prevailing morphological, physiological and mental properties of the organism remain generally relatively uniform and stable.

In this period, there are several important points in the age biography. The first of them, at the age of 20-25, causes more concern among girls. It is at this age (in certain ethnic and cultural groups, these periods may deviate by 4 years in one direction or another), one of the main tasks facing a girl in terms of psychosocial development is the task of creating a family and having a child. Men during this period, externally and internally, are not concerned with the problems of starting a family, but with the problems of establishing the greatest possible number of sexual contacts.

The following important points in the age biography of men and women, the age does not coincide, although the problems characteristic of both women and men are in many ways similar.

For women, the age of about 30 years, and for men - about 40 years is to a certain extent critical, and the main problems come down to determining their place in society, finding the meaning of life. The duration of this period is short and is about 3 years, ends in a stable state, until the next important period - menopause, which falls on the second stage of adulthood.

For the second subperiod of adulthood, a significant restructuring of the neuroendocrine system is characteristic, affecting the functioning of almost all organs and systems of the body and leading to a decrease in the intensity of metabolic processes, the appearance of the first clinical signs of diseases characteristic of older age groups. First, minor microstructural changes appear in various tissues, organs and systems, which indicate the beginning of their aging. These changes are accompanied by loss of intracellular fluid and death of parenchymal cells, replacement of functionally active tissue with inactive (adipose, connective elements) and accumulation in tissues of an excessive amount of various substances and decay products of some cellular structures. There is a decrease in the activity of many enzymes and a slowdown in metabolic processes.

Having reached a certain critical level, microstructural changes lead to a decrease in the functionality of individual organs and entire systems of the body, which is smoothed out to a certain limit by the development of compensatory processes. However, already at the age of 30-35 years, the first signs of aortic atherosclerosis appear, at the age of 40-50 years - cerebral atherosclerosis, at the same age, pulmonary emphysema develops more often. Thus, a person enters the next age period - old age.

Elderly age (from 55-60 to 75 years old) is characterized by the acceleration of aging processes, which is due to a decrease in the compensatory-adaptive capabilities of the body to increasing age-related changes in the structure and functions of tissues, organs and systems. The appearance of a person, his behavior, psyche are changing. Diseases characteristic of this age period appear and develop (coronary heart disease, hypertension, oncological diseases, etc.). Social status is changing, many people at this age stop working, become retirees. Significant changes are observed in mental activity: mental activity decreases, memory and ability to concentrate deteriorate, attention weakens, as well as the ability to concentrate on any one object, occupation, type of activity and switch attention from one type of activity to another.

V senile age (after 75 years) the involutional processes that began in previous periods become more pronounced, acquire an expanded character. At the same time, there is a sharp decrease in all basic physiological functions, a drop in the level of reliability of adaptive mechanisms, a gradual attenuation of life processes; the likelihood of natural death increases.

All manifestations of the aging process can be divided into chronobiological, coinciding with the calendar age (phenomena of osteoporosis, muscle atrophy, vascular sclerosis, etc.), and ontobiological, coinciding with the aging rate, biological age (changes in the cardiovascular, digestive systems, neurohumoral regulation, etc.) etc.). The chronobiological manifestations of aging are the more pronounced, the higher the species life span. Signs of aging are observed throughout the entire individual life of an organism at all levels of its organization: at the molecular level, at the cellular level, at the level of tissues, organs and systems, as well as at the level of a single whole, but in old age they are most pronounced. These signs, observed at the level of the whole organism, are manifested primarily by the external features of a person, characterized by changes in the shape, size of the body, its individual parts, which often makes it possible to establish the age quite accurately, although the individual rates of aging, the time of appearance of externally visible changes, the degree of their severity are very are different and are determined by both its biological characteristics, heredity, and environmental factors (living conditions, nutrition, labor, the presence of occupational and household hazards, etc.).

However, it is possible to identify common signs characteristic of old age. This stage of life is characterized by a decrease in the size of the body, its height, weight, senile atrophy, affecting, to a greater or lesser extent, all organs and systems. Thinning of the skin, the appearance of age spots, loss of elasticity and, as a result, the formation of wrinkles are observed; hair becomes gray, brittle, sparse. The eyes lose their usual shine, become dull, faded, visual acuity decreases, ptosis of the eyelids may develop, and increased lacrimation is often observed. Hearing acuity also decreases. There is a decrease in the jaws, loss of teeth. There is an increased fragility of bones, the phenomenon of osteoporosis and osteochondrosis, senile kyphosis may appear, muscles atrophy, their strength decreases, movements lose confidence, smoothness, gait becomes slow, careful. During this period, working capacity is significantly reduced, fatigue sets in faster - both physical and mental. The main age characteristics of a healthy person are presented in table. 2.

Table 2. Age characteristics of a healthy person

Options	Growth period	Mature age	Elderly and senile age
Leather	Pink, elastic, smooth	Pink, elasticity decreases, wrinkles appear	Pale, yellowish tint is possible, wrinkles are sharply expressed, flabby, turgor is reduced, elasticity is lost, age spots appear
Mucous membranes	Pink, shiny	Pink	Pale pink, cyanotic shade possible
Hair growth	Only on the head, the hair is soft, thin	Appears in the armpits and pubis; in men - on the limbs and body; gray hair appears on the head	Sparse, brittle, thinned hair, often graying, baldness
Teeth	Growth of milk teeth, their replacement with permanent	Complete set of permanent teeth	Loss of teeth, decrease in the size of the jaws
Skeleton development	Bone growth, skeletal formation	The skeleton is fully formed	Osteoporosis, osteochondrosis, possible deformities (kyphosis), fragile bones
Body proportions	Relatively short limbs and large head	Proportional, according to the type of constitution	Decrease in body size, height and weight, change in the shape of body parts
Breath	Depends on age: the younger the child, the more often and more superficial	Respiration rate - 16-18 in 1 min, rhythmic	Somewhat more often and more superficially than in adulthood, respiratory arrhythmia is possible
Palpitations	From 160 beats per minute in newborns to 60-90 - in adolescence and adolescence, severe respiratory arrhythmia in young children	60-90 beats per minute, rhythmic pulse, good filling and tension	Often a tendency to bradycardia (50-60), arrhythmias often develop, the pulse is small, empty
Analyzer system	Farsightedness in the neonatal period is replaced by normal vision, acute hearing; constant development of taste sensations	Visual acuity 1.0 from a distance of 5 m, whisper speech - 6 m; taste perception - individually	Decreased vision and hearing, development of senile hyperopia and hearing loss; decreased taste perception
Movement	Uncoordinated in the early period, more accurate - in the subsequent	Accurate, fully coordinated, smooth	Limited mobility of joints, gait is slow, unsteady, movements lose smoothness
Adaptive capabilities	Low in the early period, increases during growth	High enough, stable	Decrease with aging
Mental activity	Depends on the stage of development: labile, vulnerable during critical periods, stable during periods of equilibrium	Stable, highly dependent on the type of higher nervous activity	Labile, with a predominance of inhibition processes, mental activity decreases
Ability to self-satisfy needs	Complete dependence on others at an early age, limited - in preschool, complete independence - in older age periods	Full self-service ability	Limited, highly dependent on health status
Sexual function	Underdeveloped in the early periods, the onset of sexual desire in adolescence	Hypersexuality in adolescence and adolescence, individual stable in the future	Sexual activity, potency, ejaculatory capabilities are reduced; sexual arousal occurs more slowly, vaginal moisture decreases

The development of a person, as a biosocial creature, takes place in various spheres: physical, social, psychoemotional and related cognitive ( Volkov S.R., Volkova M.M., 2005).

Physical realm, or physical development, includes a set of morphological and functional properties organism corresponding to the chronological and biological age. In childhood, physical development is a dynamic process of growth - an increase in length, mass, individual body parts, organs and systems of the body - and biological maturation and formation of a mature organism. Since in childhood the processes of physical development proceed most intensively, it is assessed more often than in other age periods, when physical development, having reached a certain level, stabilizes. The most simple physical development can be assessed using anthropometric indicators, which include length (height), body weight, head and chest circumference. Anthropometric measurements entered the practice of medical examination in the 30s of the XIX century. For a more accurate assessment of physical development, they use centile tables, as well as various coefficients and indices.

Physical development, including, in addition to height and body weight, a number of physiometric indicators (muscle strength, vital capacity of the lungs - VC, etc.), serves as one of the criteria for working capacity, therefore, the assessment of physical development is widely used not only in pediatrics, but also in professional selection , in sports, school medicine.

The level of physical development, the rate of increase in height, increase in body weight, the sequence in the increase in various parts of the body are determined by many factors, among which are:

Hereditary (length and body weight of parents, grandmothers, grandfathers);

Biological (the health of an individual, his psychological, emotional state, the state of health of his parents);

Climatic and ecological;

Socio-economic (financial situation of the family, living conditions, the level of general culture and education of parents, the level of development of health care and medical culture, occupational hazards);

Lifestyle (regimen, nutrition, physical activity, bad habits, etc.).

In addition to these factors, the rates of growth and development are also subject to sexual (for example, puberty in girls and boys begins at different times, the main anthropometric, functional indicators in men remain higher than in women) and individual differences. These and other factors can affect physical development both positively and negatively. For example, both excessive physical activity and its lack can inhibit human growth, and adequate physical activity, being a stimulator of osteogenesis and the growth of cartilage and muscle tissue, contributes to the linear growth of a person.

Several factors have multidirectional effects on growth and development. Thus, a hot climate, as one of the factors affecting physical development, inhibits growth, but accelerates maturation, i.e. human development.

The degree of influence of certain factors depends on the strength and duration of their impact. Thus, a moderate and short-term nutritional deficiency does not lead to a significant delay in physical development; on the contrary, a pronounced deficiency of the basic components of nutrition can lead to a noticeable delay in development and even health problems.

In the middle and second half of the XX century. it was noted that the height and body weight of children increase from decade to decade, the time of biological maturation is accelerated in general (permanent teeth erupt earlier, growth zones are closed, puberty occurs at an earlier age). This phenomenon is called acceleration (from lat. accelero-accelerate). Since the 90s of the XX century. acceleration processes began to change deceleration, those. a slowdown in the development of new generations, which is manifested by a decrease in height and body weight, a slowdown in puberty, a decrease in muscle strength and endurance in adolescents of the late 20th - early 21st centuries. in comparison with their peers 60-80-ies of XX century.

Acceleration processes were associated with the improvement of social conditions, there were also theories of the influence of exogenous (including solar activity) and endogenous factors leading either to acceleration or retardation (retardation) of the physical development of mankind.

However, the acceleration affected psychoemotional and social development to a lesser extent.

Psycho-emotional and social development represents a specific aspect of human development associated with his interaction with environment and manifested by a set of mental processes and phenomena (sensations, perceptions, emotions, memory, etc.). The main function of the psyche is to search, based on the emerging need, for certain actions aimed at satisfying it, assessing these actions, and monitoring their implementation.

The psychoemotional and social development of a specific person is based on his mastery of social needs that have formed in the course of evolution and are necessary for an individual for life. Psycho-emotional development continues throughout a person's life.

Each stage of its development has its own inherent expectations of a given society, which an individual may or may not justify.

The theoretical psychologist Eric Erickson, the author of the theory of psychosocial personality development, formulated the tasks of certain stages of human development and showed what success or failure in solving them can lead to. Not everyone is able to overcome psychological failures that have arisen in the early stages of development, at an early age, so they have to solve many problems already in adulthood. And overcoming the difficulties of the previous stage is the key to successfully solving a psychological problem that arises at later stages of development, therefore, for normal psychoemotional and social development of a person, it is necessary to solve emerging problems at the stage at which they arose.

Psycho-emotional and social development of a person determines the quality of his life, his personal life, his relationship with people, professional satisfaction, as well as all aspects of physical health, as well as mental well-being directly affects the functions of the body, largely depend on it. In addition, adequate psychoemotional and social development inherent in a healthy person allows him to better adapt to different living conditions.

The development of a person is largely determined by his environment, which includes:

The immediate environment (family - children, parents, brothers, sisters, grandmothers, grandfathers, friends);

Professional environment (work colleagues, classmates);

Household environment (neighbors, acquaintances; people who have common interests with the individual);

The social group to which this individual belongs (in terms of education, income, living conditions);

Society as a whole.

Cognitive development a person, conditioned by his social essence, also continues throughout life, largely depends on the stage of his development (see Table 1.) and is closely related to the concept of "cognition". Cognition is a process of reflection and reproduction of reality in the consciousness of an individual. The result of cognition is new knowledge. In other words, cognitive development of a person is a process of development of his intellect, and in general it obeys the same laws as psychoemotional and physical development.

Table 1. Characteristics of the stages of human growth and development

The scope of change	Characteristics of the stage of growth and development
Stage 1. Neonatal period and infancy (0-1 years)
Physical	Body weight triples. Growth increases by 50% (about 25 cm). The head circumference increases by 12 cm, and the chest by 13-15 cm. From 1 month. tries to keep his head lying on his stomach, holds well from 2 months, from 5 months. turns from back to stomach, from 6 months - from stomach to back, from 7 months. crawls well, sits down on his own, walks on his own from 1 year old. First teeth - from 5-6 months, by 1 year 6-8 teeth
	Crying to make itself felt. From 1 month there is auditory and visual concentration, from 2 months. watches objects, smiles. From 3-4 months emotionally hums, recognizes loved ones, from 6 months. laughs loudly, babbles syllables. At 1 year old can say 8 - 10 simple words... At 6 months. distinguishes those who care for him. At 7 months. cries at the sight of strangers. Positive cognition is trust, negative cognition is distrust. A sense of trust arises when the child's needs are met consistently, through the image of a mother meeting his needs; he gets the feeling that the world is a safe place. Feelings of mistrust arise when the caregiver is either inconsistent or there is a frequent change of caregiver. The result of a positive choice is belief in the future, negative - suspicion, fear of the future.
Cognitive (up to 2 years old)	This is the sensory-motor (motor) stage. The child is studying the world through touch, hearing, smell, taste, as well as through physical perception. At first, the activity is focused on your body, then on events and objects. Ultimately targeting occurs
Stage 2. Prev preschool age(1-3 years)
Physical	In the second year, the child gains about 3 kg in body weight, growth increases by 7-8 cm, for the third - 2 kg and 5 cm, respectively. Makes movements that require coordinated muscle work: runs, walks up the stairs, jumps, climbs, plays with small objects. Learning to use the toilet. Dress up with a little help or by yourself. By the age of 2 he has 20 milk teeth. Eats on his own with a spoon, drinks from a cup
Psycho-emotional and social	Likes to play alone or with other children. Dislikes receiving orders. Learns to be independent. He is overwhelmed with a mass of impressions from the outside world, cannot analyze them on his own, resorts to the help of adults (period of questions). Positive cognition is independence; negative - addiction, doubt and shame. Children experience doubt and shame through abuse, controlling their body functions (bowel and bladder), or being in an overly restricted environment. The result of positive cognition is self-confidence, negative - a guilt complex, self-doubt
Cognitive	Responds well to the speech of adults. Shows items named by adults. Follows simple directions given slowly and clearly. Begins to speak in short phrases. Understands that the object, removed from sight, continues to exist. Likes to choose activities and toys by himself
Stage 3. Preschool age (3 to 7 years old)
Physical	The average weight gain per year is -2 kg, and the length is -5 cm. At 5-7 years old, milk teeth are replaced by large molars. Large engine skills are being improved. More control over small motor skills (draws, sculpts). Does a lot of self-care activities (getting dressed, eating, using the toilet)
Psycho-emotional and social	Has a clear idea of ​​himself. Reacts to the judgments of parents and other adults about him. More independent than in early childhood. Makes his choice. Plays easily with other children and loves group games. Observes and imitates adults. Likes daily routine and may feel insecure if the daily routine changes too often. Positive cognition is initiative, negative cognition is passivity. Children experience feelings of guilt and moral responsibility for their desires. The result of positive cognition is the ability to act independently, negative cognition is a feeling of social inadequacy.
Cognitive	Knows many names of people and names of places and things. Learns new words quickly. From the age of 5 he begins to read individual words. Counts. Groups the same items. Separates dissimilar items. Follows directions. Very curious and imaginative. Asks a lot of questions. Has a firm independent point of view, sometimes unable to understand that there are other views. Has a vague idea of ​​time
Stage 4. Junior school age (6-12 years old)
Physical	An annual increase in body weight is 2-3 kg, in height 5-6 cm. There is a change in milk teeth: at 7-8 years old - internal, 8-9 - external incisors, 10-11 years - anterior, 11-12 - posterior premolars and second molars. Movement coordinates well. Develops muscle tone, balance, strength and endurance. Large and fine motor skills are well developed, which is used for games and sports, cycling and dancing. From the age of 10 in girls and from the age of 12 in boys, puberty begins.
Psycho-emotional and social	Begins to form long-term friendships. Spends more time without parents. Forms small closed groups that do not allow other children, especially of the opposite sex. Begins to understand that other people have feelings too. Has a lot of emotions, sometimes it is difficult to express them. The onset of puberty, accompanied by hormonal changes, entails many dramatic mood swings. Positive cognition is hard work, negative cognition is restlessness. Students need to be able to enjoy success and mastery of new challenges. They come to this through the approval of the teacher and peers. Feelings of inferiority arise when students are unable to succeed or their knowledge is not recognized. The result of positive cognition is success in activity, negative - an inferiority complex
Cognitive	More attentive, remembers longer, and follows more complex directions. Thinks logically and makes decisions about the real world. Able to use new information. Can ask questions and resist adult decisions
Stage 5. Senior school (adolescence) age (from 12 to 16-18 years). Adolescence (16 to 20 for women, 17 to 21 for men)
Physical	Body weight increases by 7-25 kg (more often 17.5 kg), height - by 15-55 cm. Reaches reproductive maturity. Girls at the beginning of the period, as a rule, are taller than young men of their age, and at the end of the period - below
Psycho-emotional and social	Due to recent changes in his body, he feels awkward among parents and strangers. Easily embarrassed when undressing in front of adults or when talking about body, height, and sexual development. He is more responsible about his behavior. Often revolts against the authority of adults. Social and emotional experience wide because this is a time of strong friendship and early love relationships. Positive cognition is the formation of personality, negative cognition is the dispersion of personality. The first integral awareness of oneself and one's place in the world occurs. The result of positive cognition is a developed sense of one's own individuality, negative - a lack of understanding of one's own "I" or uncertainty in understanding one's own "I"
Cognitive	Thinks logically. Deals with abstract or concrete concepts. Reflects on himself personally. Planning for the future. Makes a decision by imagining alternatives, which makes the decision more difficult. Begins to judge himself more sensibly. He tries to change his physical appearance. Often comes up with an ideal world and idealizes himself. Disappointed easily. May set unrealistic goals
Stage 6. Young adulthood (20 to 35 years)
Physical	By the age of 23, the development of all body functions is completed. Growth for most women ends by the age of 17, for men - by the age of 21. Reaches the maximum muscle strength at the age of 25-30, then it begins to decrease. The best fine motor skills are developed up to 35 years old, after which fine motor skills

Developmental psychology studies facts and patterns mental development a healthy person. Traditionally, it is customary to divide its life cycle into the following periods:

1) prenatal (intrauterine);

2) childhood;

3) adolescence;

4) maturity (adulthood);

5) old age, old age.

In turn, each of the periods consists of several stages with a number of characteristic features.

All these stages have their own specifics associated with the level of physiological functioning, the degree of mental development of a person, his psychological qualities and prevailing desires, prevailing forms of behavior and activity.

Prenatal perioddivided into 3 stages:

♦ pre-embryonic;

♦ embryonic (embryonic);

♦ the stage of the fetus.

The first stage lasts 2 weeks and corresponds to the development of a fertilized egg before its introduction into the uterine wall and the formation of the umbilical cord. The second - from the beginning of the third week after fertilization until the end of the second month of development. At this stage, anatomical and physiological differentiation of various organs occurs. The third begins from the third month of development and ends by the time of childbirth. At this time, the formation of body systems takes place, which allow it to survive after birth. The fetus acquires the ability to survive in the air at the beginning of the seventh month, and from that time it is already called a child. Childhood period includes stages:

♦ birth and infancy(from birth to 1 year);

♦ early childhood(or "first childhood" - from 1 year to 3 years) - the period of development of functional independence and speech;

♦ preschool age(or "second childhood" - from 3 to 6 years), characterized by the development of the child's personality and cognitive processes;

♦ primary school age(or "third childhood" - from 6 to 11-12 years old) corresponds to the inclusion of a child in a social group and the development of intellectual skills and knowledge.

Adolescence is subdivided into two periods:

♦ teenage (or pubertal);

♦ youthful (juvenile).

The first period corresponds to puberty and lasts from 11-12 to 14-15 years. At this time, under the influence of constitutional changes, a teenager forms a new idea of ​​himself. The second period lasts from 16 to 20-23 years and represents the transition to maturity. From a biological point of view, the young man is already an adult, but he has not yet reached social maturity: adolescence is characterized by a feeling of psychological independence, although the person has not yet taken on any social obligations. Youth acts as a period of making responsible decisions that determine the entire future of a person's life: the choice of a profession and his place in life, the search for the meaning of life, the formation of his worldview and self-consciousness, the election of a life partner.

During the transition from one age stage to another, critical periods or crises are distinguished when the previous form of a person's relationship with the outside world is destroyed and a new one is formed, which is accompanied by significant psychological difficulties for the person himself and his social environment. Allocate small crises (crisis of the first year, crisis of 7 years, crisis of 17/18 years) andbig crises(birth crisis, 3 years old, teenage crisis 13-14 years old). In the case of the latter, the relationship between the child and society is being rebuilt. Small crises are outwardly calmer, they are associated with an increase in the skills and independence of a person. During periods of a critical phase, children are difficult to educate, stubborn, show negativism, obstinacy, disobedience.

Maturity. It is subdivided into a number of stages and crises. Stageearly maturity, or youth (from 20-23 to 30-33 years old), corresponds to the entry of a person into an intensive personal life and professional activity. This is the period of "formation", self-affirmation in love, sex, career, family, society.

In mature years, its crisis periods stand out. One of them - crisis 33-35 years old, when, having reached a certain social and marital status, a person begins to think with anxiety: “Is this really all that life can give me? Is there nothing better? " And some begin to feverishly change jobs, spouses, place of residence, hobbies, etc. Then comesshort stabilization period -from 35 to 40-43 years old, when a person consolidates everything that he has achieved, is confident in his professional skills, authority, has an acceptable level of career success and material wealth, his health, marital status and sexual relations are normalized.

Following a period of stability comescritical decade 45-55 years.A person begins to feel the approach of middle age: health worsens, signs of loss of beauty appear and physical form, alienation occurs in the family and in relations with matured children, there is a fear that nothing better will be obtained either in life, or in career, or in love. As a result, a feeling of fatigue from reality arises, depressive moods, from which a person hides either in dreams of new love victories, or in real attempts to “prove his youth” in love affairs, or a career takes off. The final period of maturity lasts from 55 to 65 years. This is a period of physiological and psychological balance, a decrease in sexual tension, a gradual withdrawal of a person from an active work and social life. The age from 65 to 75 is spoken of as the first old age. After 75 years, age is considered old: a person rethinks his whole life, realizes his Self in spiritual thoughts about the years he has lived - and either accepts his life as a unique destiny that does not need to be redone, or realizes that life has been wasted.

V old age(old age) a person has to overcome three sub-crises. The first of them is the reassessment of one's self, which is not related to the professional role, which for many people remains the main one until retirement. The second sub-crisis is associated with the awareness of the deteriorating health and aging of the body, which makes it possible for a person to develop the necessary indifference to this.

As a result of the third sub-crisis, self-concern disappears, and now the thought of death can be accepted without horror.

Faced with its inevitability, a person goes through a series of stages. The first one is denial. Thought "No, not me!" - the usual and normal reaction of a person to the announcement of a fatal diagnosis. Then comes the stage anger. It embraces the patient when asked "Why me?" For such a stage to come to an end, the dying person must pour out his feelings outside.

The next stage is"Bargaining". The patient tries to prolong his life, promising to be an obedient patient or an exemplary believer, trying to prolong his life with the help of the achievements of medicine and repentance before God for his sins and mistakes.

All these three phases constitute a period of crisis and develop in the described order, there are returns to the previous stage.

After the resolution of this crisis, the dying person enters the stage depression. He realizes: "Yes, this time it is me who will die." He withdraws into himself, often feels the need to cry at the thought of those whom he is forced to leave. This is the stage of preparatory sadness in which the dying person renounces life and prepares to meet death, accepting it as his last stage of life. He separates further and further from living people, withdrawing into himself - the state of “social death”(A person has already moved away from society, from people, as if he had died in the social sense).

The fifth stage - "acceptance of death. "A person realizes and agrees, resigns himself to the inevitability of near death and humbly awaits his end. This state "mental death "(psychologically, the person has already given up life, as it were).Clinical deathoccurs from the moment the heart stops working and breathing stops, but within 10-20 minutes it is still possible to bring a person back to life through medical efforts.

Brain death means complete termination the activity of the brain and its control over various functions of the body, as a result, the death of brain cells occurs.Physiological deathcorresponds to the extinction of the last functions of the body and the death of all its cells. According to some religious views and the opinion of a number of scientists, with the death of the body, the soul, the psyche of a person, does not die. There is a hypothesis that it continues to exist in the form of an information clot after the death of a person and is connected to the global information field. The traditional materialistic understanding denies the possibility of preserving the soul, the psyche of a person after his death, although the latest studies of physicists, doctors, psychologists are no longer so categorical.

Immediately after birth, there is a period called newborns... The basis for its isolation is the fact that at this time the baby is fed with colostrum for 8-10 days. A full-term newborn child has a body length from crown to heels, most often from 45 to 52 cm, body weight not less than 2500 g.The average body weight is 3400-3560 g for boys, 3250-3400 for girls. However, boys lag behind in skeletal maturity from girls for about 4 weeks. Body proportions differ sharply from those of an adult (Fig. 3). The head is 1/4 of the total body length, while in an adult, only 1/8 of the body length is per head. Up to three months, the head circumference is larger than the chest circumference. The navel is located slightly below the line dividing the body in half, while in an adult it is above this line. The pelvis and lower limbs are poorly developed.

Rice. 3. Age-related changes in body proportions(scheme according to Tegako L.I., 2003): 1) 2 months of intrauterine development, 2) 5 months, 3) 8 months,

4) newborn, 5) 1 year 8 months, 6) 7 years, 7) 13 years, 8) 16 years.

In newborns, subcutaneous adipose tissue is strongly expressed. Its rapid increase occurs after the 34th week of pregnancy. During this time, brown fat is formed. It accumulates around the neck, between the shoulder blades, and in the lumbar region behind the kidneys. Brown fat is the organ of heat production and protects the child from hypothermia. Thick fat pad also protects against damage during childbirth internal organs... Due to the strong development of subcutaneous adipose tissue and the weak development of the muscles, the torso of the newborn, as well as the limbs, have a cylindrical shape; the neck is short and thick.

V infancy basically, the external forms and proportions of the body, characteristic of a newborn, are preserved. During this period, the greatest intensity of growth is observed in comparison with all other periods of extrauterine life. Up to 9 months, the growth of subcutaneous fat deposits continues. There is a rapid increase in body weight and physical development. Body length increases from birth to one year, on average, 1.5 times, and weight triples. From 6 months, milk teeth begin to erupt; walking, movements of hands and fingers are formed; there is a perception, an image

memory, understanding of speech, as well as emotional development.

During the period early childhood When the child begins to move on his feet, the proportions of the body change somewhat, however, the predominance of the dimensions of the head and body over the limbs remains. Subcutaneous adipose tissue is still highly developed, which hides the outlines of the muscles. The body is almost cylindrical in cross section. The transverse abdominal line is well pronounced in the lower abdomen. The face is rounded and slightly profiled. It depends on poor development of the jaws and masticatory muscles, as well as the accumulation of fat in the cheek area (cheek fatty body). That is, this period is characterized by the type of rounded addition ( first fullness). At the end of this period, the eruption of milk teeth ends. After two years, the absolute and relative values ​​of the annual increase in body size decrease rapidly. During this period, the child's speech and visual-figurative thinking develop, as well as the mastery of everyday skills and actions with objects.

First childhood characterized by growth shift, which in time corresponds to the beginning of the change of teeth, which occurs at the age of 5-6 years. During this period, both absolute and relative limb lengthening... The development of musculature and the reduction of subcutaneous fat lead to the fact that the muscular relief of the body becomes noticeable. The torso is flattened anteroposteriorly, and the outer border between the chest and abdomen (waist) appears. This period is characterized by an elongated type characteristic of school age ( first pull).

The first growth shift is expressed, in particular, in the relative lengthening of the limbs. An indicator of this is the "Philippine test". It consists in placing the child's right hand on the crown of the head, and he must reach the upper edge of the left auricle. The "Philippine test" becomes positive in most children after 5 years of age. This test is considered as one of the indicators of the biological maturity of a child in older preschool age.

The proportions of the brush also change. Their indicator is "radial shift": the index finger becomes longer than the ring finger. This is observed in 20-25% of children at the age of 7. At 3.5 years, a clear predominance of the right hand is revealed, and in left-handers, the left hand.

The relative length of the lower extremities increases most sharply, which leads to a general change in body proportions.

The shape of the head and face undergoes significant changes. The growth of the cerebral skull begins to lag behind the facial one, and the face is relatively enlarged. The most intensive growth of the face occurs in the sagittal direction, due to this, its profiling is enhanced, the nose and chin protrude more strongly.

Psychologically, in the first childhood, the development of the child's personality begins, cognitive processes, the formation of conscience, morality and initiative.

The onset of the first growth shift can be timely, early, or late. As a result, individual differences in body size and proportions, as well as in psychological characteristics At this age, the body types of children can already be distinguished.

In second childhood the growth of the body in length slows down, while the weight increases to a greater extent ( second fullness). During this period, sex differences in body size and shape are revealed. At the end of the period, the production of sex hormones begins, which determines the development of secondary sexual characteristics.In girls at the age of 8-13, the mammary glands first form, the pelvis expands and the buttocks are rounded, pubic hair appears, then in the armpits. The uterus and vagina develop simultaneously with the formation of the mammary glands. To a much lesser extent, the process of puberty is expressed in boys. Only by the end of this period, they begin to accelerate growth of the testicles (11 years), scrotum (12 years), and then - the penis. During this period, the child is included in a social group and goes beyond the family. Intellectual skills and knowledge are developed.

Teenage years characterized by a jump in the longitudinal growth of the body, a second growth shift occurs (pubertal jump, second elongation). Along with this, body weight increases significantly. The onset of the growth shift varies individually: for boys it occurs at the age of 10.5-16 years, for girls - at 9.5-14.5 years. The proportions of the body change significantly, which depends primarily on the absolute and relative lengthening of the lower extremities, and in girls, also on the expansion of the pelvis. The most informative indicators of adolescent body maturation are the growth of the genitals and the severity of secondary sexual characteristics. Sexual development, as noted earlier, begins at the end of the second period of childhood and ends in adolescence. There are three phases of puberty: prepubertal (initial), pubertal (true maturation) and postpubertal (complete maturation). These phases have a number of common manifestations in boys and girls, but at the same time, significant differences between the sexes are revealed in the timing of the onset and completion of puberty, as well as in the order in which certain signs appear.

During adolescence, puberty occurs most intensively. In girls, the development of the mammary glands continues, there is growth of hair on the pubis and in the armpits. The clearest indicator of the middle phase of puberty in the female body is the onset of menstruation - menarche (10-16 years). In boys, by the age of 13, a change (mutation) of the voice occurs and pubic hair appears, and at the age of 14 - in the armpits and on the upper lip, swelling of the nipples, wrinkling and pigmentation of the scrotum, as well as a distinct change in body proportions occur. At the age of 14-15, the first emissions (involuntary sperm eruption) are noted.

The postpubertal period in boys is characterized by increased hair growth on the trunk and limbs, the appearance of a beard, a sharp slowdown and cessation of body length growth (at 19-20 years). In girls in this period, secondary sexual characteristics reach full severity, an adult mammary gland is formed. The growth of the body in length slows down sharply by the age of 16 and

ends at 18.

Sex differences in the growth and development of children consist not only in an earlier acceleration of growth and the appearance of signs of puberty in girls, compared with boys, but also in the composition of the body and functional indicators... In boys in puberty, the mass of the skeleton and muscles increases to a greater extent, due to which they develop greater physical strength and endurance, the heart and lungs become larger, systolic blood pressure rises and the heart rate decreases. In girls, the increase in muscle mass is not so great, but subcutaneous fat deposits become more significant.

In view of the significant individual differences in the development and growth of children, the concept is introduced biological age... Its indicators are:

1) skeletal age, which is determined by the presence of ossification centers and the formation of synostosis;

2) dental age, determined by the number and timing of the eruption of permanent teeth;

3) the severity of secondary sexual characteristics.

The biological age does not always coincide with the passport age, it can be ahead of it or lag behind.

In the psychological sphere in adolescence, the development of logical thinking and the formation of self-consciousness occur.

Due to the sharp morphological, hormonal and emotional shifts in adolescence and adolescence, there is a high probability of deviations in health indicators. Teenage crisis falls at 13 years old.

In adolescence basically, the processes of growth and formation of the organism come to an end, all the main dimensional characteristics of the body reach a definitive (final) value (Fig. 4). The formation of the reproductive system and the maturation of the reproductive function are coming to an end. The ovulatory cycles in women, the rhythm of testosterone secretion and the production of mature sperm in men are finally established. In the adolescent period, there is a peak in

intellectual and cognitive capabilities. The formation of a worldview and stabilization of character, the development of professional abilities and skills, the choice of a life position, the adoption of responsible life decisions, as well as the achievement of social maturity and independence are taking place.

Mature age- this is the time of relative stability of the organism. But this does not mean the absence of changes that may be associated with lifestyle, professional activities and socio-economic conditions in the broadest sense of the word.

Rice. 4. Age-related changes in body length and physique of men

(scheme according to Tegako L.I., 2003).

Let us give the values ​​of some anthropological indicators in adulthood (Table 2).