PRINCIPLES OF GROWTH AND DEVELOPMENT

Growth refers to an increase in some quantity over time. The quantity can be:Physical (e.g., growth in height, growth in an amount of money)Abstract (e.g., a system becoming more complex, an organism becoming more mature).

Development is used to denote an increase in skill or the ability to function (a qualitative change)can measured by the child’s ability to perform tasks, recording the parent’s description of the child’s progress or by standardized tests such as Denver II

* Psychosexual development* Psychosocial Development* Cognitive Development* Moral Development

Bullets on the Principles of Growth and Development

* CONTINUOUS PROCESSES UNTIL DEATH* ORDERLY SEQUENCE* DIFFERENT CHILDREN PASS THROUGH THE PREDICTABLE STAGES AT DIFFERENT RATES* ALL BODY SYSTEMS DO NOT DEVELOP AT THE SAME RATE* CEPHALOCAUDAL* PROXIMAL BODY PARTS TO DISTAL* GROSS TO REFINED SKILLS* THERE IS AN OPTIMUM TIME FOR INTITIATION OF EXPERIENCES OR LEARNING* NEONATAL REFLEXES MUST BE LOST BEFORE DEVELOPMENT CAN PROCEED* A GREAT DEAL OF SKILL AND BEHAVIOR IS LEARNED BY PRACTICE

FACTORS INFLUENCING GROWTH AND DEVELOPMENT

1. Genetics1. Gender2. Health3. Intelligence

2. Temperament1. Activity Levels2. Approach3. Rhythmicity4. Adaptability5. Distractability6. Threshold of response7. Mood quality8. Intensity of reaction

9. Attention Span3. Environment

1. Socio Economic level2. Parent Child Relationship

4. Nutrition

FACTORS INFLUENCING GROWTH AND DEVELOPMENT

1. Genetics1. Gender2. Health3. Intelligence

2. Temperament1. Activity Levels2. Approach3. Rhythmicity4. Adaptability5. Distractability6. Threshold of response7. Mood quality8. Intensity of reaction9. Attention Span

3. Environment1. Socio Economic level2. Parent Child Relationship

4. Nutrition

BASIC DIVISIONS OF CHILDHOOD

NEONATE First 28 days of life

INFANT 1 mo – 1 year

TODDLER 1 – 3 YEARS

PRESCHOOLER 3 – 5 YEARS

SCHOOL AGE 6 – 12 YEARS

ADOLESCENT 13 – 20 YEARS

THEORIES OF GROWTH AND DEVELOPMENT

Sigmund freud

- INFANT: - 0 – 18 MONTHS

- ORAL PHASE : infants suck for enjoyment or relief of tension as well as for nourishment

- Nursing implications- Provide oral stimulation or pleasure- Do not discourage thumbsucking- Breast feeding provides more stimulation than formula feeding

- Conflict- Weaning away from mother’s beast- Oral fixation- Oral receptive- Oral aggressive

- TODDLER: - 18 mos – 3 yr

- ANAL PHASE : pleasure in retention of feces and defecation- Interests in self-discovery, exertion of independence- Nursing implications- Help children achieve bowel and bladder control without undue emphasis

on its importance

- Conflict- Toilet training- Anal fixation- Anal Retentive- Anal Expulsive

- PRESCHOOLER - 4 TO 6 YEARS

- PHALLIC PHASE : pleasure zone to the genital area- Masturbation is common, exhibitionism- Child learns sexual identity through awareness of genital area- Nursi ng implications- Accept child’s sexual interest as normal- Help parents answer child’s questions about birth or sexual differences- Conflict- Oedipus / Electra Conflicts- Phallic fixation- Oedipus complex- Penis envy- Castration anxiety

- SCHOOL AGE - 7 TO 12 YEARS

- LATENT PHASE :children’s libido appears to be diverted into concrete thinking

- Child’s personality dev’t is dormant

- Nursing implications- Help the child have positive experiences so self esteem continues to grow

and prepare the child for the conflicts of adolescence

- ADOLESCENT- 13 TO 18 YEARS

- GENITAL PHASE : development of sexual maturity,- Establishment of satisfactory relationships with opposite sex

- Nursing implications- Provide appropriate opportunities for the child to relate with opposite sex- Allow child to verbalize feelings about new relationships

- Conflict- Social rules

ERIK ERIKSON

- INFANT- 0 – 18 MOS

TRUST VS MISTRUST* Child learns to love and be loved• The child's relative understanding of world and society come from the

parents and their interaction with the child.

Virtue: hope

Nursing Implications• Provide a primary care provider• Provide experiences that add to security• Provide visual stimulation for active child involvement

- TODDLER- 18 mos – 3 YRS

AUTONOMY VS SHAME• Child learns to be independent and make decisions for self• Builds o n children’s new motor and mental abilities

Virtue: willMain Question: "Can I do things myself or must I always rely on others?"

Nursing Implications• Provide opportunities for decision making• Praise for ability to make decisions rather than correctness of the decision• Parents need to understand that toddlers need to do what they’re capable

of doing, at their own space in their own time

- PRE SCHOOLER- 4 – 6 YRS

INITIATIVE VS GUILT• Child learns how to do things (basic problem solving) • Doing things is desirable

Virtue: PurposeMain Question: "Am I good or am I bad?"Nursing Implications• Initiate motor play in these children and expose children to play materials

such as finger paint, sand water and modeling clay• Parents must answer the child’s questions appropriately• Do not inhibit fantasy or play activity

- SCHOOL AGE- 7 – 12 YRS

INDUSTRY VS INFERIORITY• Child is interested in learning how to do things WELL

Virtue: Competence

Main Question: "Am I successful or worthless?"

Nursing Implications• Encourage their efforts to do their tasks• Praise and reward for finished results

- ADOLESCENT- 13 – 18 YRS

IDENTITY VS ROLE CONFUSION• Integrate images into a whole that makes sense• Learning who they are and what kind of person they will be

Virtue: FidelityMain Question: "Who am I and where am I going?Nursing Implications• Provide opportunities to discuss feelings about events important to him or

her• Offer support and praise for decision making

- YOUNG ADULT- 18 – 25 YRS

INTIMACY VS ISOLATION• ability to relate well with others

Virtue: LoveMain Question: "Am I loved and wanted?"Shall I share my life with someone or live alone?“

They become capable of forming intimate, reciprocal relationships (e.g. through close friendships or marriage) and willingly make the sacrifices and compromises that such relationships require.

- MIDDLE AGED- 30 - 45 YRS

GENERATIVITY VS STAGNATION

Virtue: Care Main Question: "Will I produce something of real value?“

• Socially-valued work and disciplines• Extend their concern from just themselves and their families to the

community and the world

• society and helping to guide future generations

- OLDER ADULT- 45 – SENIOR YRS

EGO INTEGRITY VS DESPAIR

Virtue: WisdomMain Question: "Have I lived a full life?“

• Feels good about the choices in life• retrospection: people look back on their lives and accomplishments.

JEAN PIAGET’S: COGNITIVE THEORY

Stage Age Span Nursing Implications

Sensori MotorNeonatal 1 mo Reflexive behavior

Beginning of mental imagesPrimary Circular 1 – 4 mos Hand – mouth; ear – eye coordination

Looks at objects and separates self

Enjoyable Activity: Rattle or tape of parent’s voice

Secondary Circular4 – 8 mos Learns to initiate, recognize, repeat pleasurable experiences from environment (object permanence)Memory traces are present Anticipates familiar eventsGood toy: mirrorGood game: peek-a-boo

Coordination of Secondary reactions

8 – 12 Can plan activities with specific goalsPerceives others can cause activity and activities of own body are separate from selfCan search for and retrieve toys that disappears from view Separation AnxietyGood toy: nesting toys (colored boxes)

Tertiary Circulation

12 - 18 Able to experiment to discover new propertiesSpace and time perception as well as permanenceTrial and error to discover new characteristicsGood game: Throw and retrieve

Invention of new means through mental combinations

18 – 24 mos Transition to pre operational though periodUse of memory and imitation to actSolves basic problems, foresee maneuvers that will succeed or failGood toy: blocks , colored plastic rings

Pre operational Thought

2 – 7 years Thoughts become symbolicCan arrive at answers mentally instead of through physical attemptthinking is basically concrete and literalEgocentric; static thinkingConcept of time NOW; Concept of distance as far as he can seeNo reversibility; lacks conservation Unable to state cause and effect relationshipGood toy: modeling clay

Concrete Operational;

7 – 12 years Systematic reasoningUse of memory to learn broad concepts and subgroupsClassification according to attributesReversibility is present; conservation intactGood activity: Collecting and classifyingExpose the child to other viewpoints

Formal Operations 12 years Can solve hypothetical problems with scientific reasoningUnderstands casualty and can deal with past present and futureAdult or mature thoughtGood Activity: talk time to sort attitudes and opinions

LAWRENCE KOHLBERG: MORAL DEVELOPMENT

Age Stage Description Nursing Implication

Pre-conventional2 – 3 1 Punishment/Obedience orientation

Child does right because the parent tells him to do it and to avoid punishment

Help the child determine the right actionsGive clear instructions to avoid confusion

4 – 7 2 IndividualismInstrumental purpose and exchangeCarries out actions to satisfy own needsDo something for another if that person does something for the child

Child is unable to recognize that like situations require like actionsUnable to take responsibility for self careBecause meeting own needs interferes with this

Conventional7 – 10 3 Orientation to

interpersonal relations of mutualityNeed to be good in own eyes and of others

Child enjoys helping others Allow child to help in tasksPraise for desired behavior

10 – 12 4 Maintenance of social order, fixed rules and authorityChild finds following rules satisfyingFollows rules of authority figures as well as parents

Child often asks what is rightMay have difficulty modifying a procedure because one method may not be rightFollows self care measures only if someone is there to enforce

Post conventional

12 5 Social Contract, utilitarian law-making perspectiveFollows standards of society

Adolescent is responsible for self care because he views this as standard of adult

behavior6 Universal ethical

principle orientationFollows internalized standards of conduct

Many adults do not reach this level of moral development