Principles of Growth and Development

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 BO BODY SYSTEMS DO DO NO NOT DE DEVELOP AT AT TH THE SA SAME RAT RATE E * CEPHALOCAUDAL * PROXIMAL BODY PARTS TO DISTAL * GROSS TO REFINED SKILLS * THERE IS AN OPTIMUM TIME FOR INTITI ITIATION ION OF EXPERIENCES OR LEARNING * NEON NEONAT ATAL AL REFL REFLE EXES XES MU MUST BE LOS LOST BE BEFORE FORE DEVE DEVEL LOPME OPMENT NT CAN PROCEED * A GR GREAT DE DEAL OF OF SK SKILL AN AND BE BEHAVIOR IS IS LE LEARN ARNED BY BY PRACTICE FACTORS INFLUENCING GROWTH AND DEVELOPMENT 1. Genetics 1. Gender 2. Health 3. Int Intell elligen igence ce 2. Te Tem mpe pera ram men entt 1. Acti Activi vity ty Le Leve vels ls 2. Approach 3. Rhyth ythmicit icity y 4. Adaptab ptabiilit lity 5. Dist Distra ract ctab abil ilit ity y 6. Th Thre resh shol old d of of res respo pons nsee 7. Mood qu quality 8. Inte Intens nsit ity y of of reac reacti tion on

9. Atten enti tio on Spa Span 3. Environment 1. Soci Socio o Eco Econo nomi micc leve levell 2. Pare Parent nt Chil Child d Relat Relatio ions nshi hip p 4. Nutrition FACTORS INFLUENCING GROWTH AND DEVELOPMENT 1. Genetics 1. Gender 2. Health 3. Int Intell elligen igence ce 2. Te Tem mpe pera ram men entt 1. Acti Activi vity ty Le Leve vels ls 2. Approach 3. Rhyth ythmicit icity y 4. Adaptab ptabiilit lity 5. Dist Distra ract ctab abil ilit ity y 6. Th Thre resh shol old d of of res respo pons nsee 7. Mood qu quality 8. Inte Intens nsit ity y of of reac reacti tion on 9. Atten enti tio on Spa Span 3. Environment 1. Soci Socio o Eco Econo nomi micc leve levell 2. Pare Parent nt Chil Child d Relat Relatio ions nshi hip p 4. Nutrition

BASIC DIVISIONS OF CHILDHOOD

NEONATE

First 28 days of life

INFANT TODDLER

1 mo – 1 year   1 – 3 YEARS

PRESCHOOLER

3 – 5 YEARS

SCHOOL AGE

6 – 12 YEARS

ADOLESCENT

13 – 20 YEARS

THEORIES OF GROWTH AND DEVELOPMENT Sigmund freud

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INFANT: 0 – 18 MONTHS

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

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

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

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TODDLER: 18 mos – 3 yr 

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

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Conflict Toilet training Anal fixation Anal Retentive Anal Expulsive

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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

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LATENT PHASE :children’s libido appears to be diverted into concrete thinking Child’s personality personality dev’t is dormant dormant

-  Nursing implications have positive experiences so self esteem esteem continues to grow - Help the child have and prepare the child for the conflicts of adolescence

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ADOLESCENT 13 TO 18 YEARS

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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

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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 • • •

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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: will Main 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 • • •

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PRE SCHOOLER  4 – 6 YRS

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

Virtue: Purpose Main 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 •

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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 • •

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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: Fidelity Main Question: "Who am I and where w here am I going? Nursing Implications Provide opportunities to discuss feelings about events important to him or  her  Offer support and praise for decision making •

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YOUNG ADULT 18 – 25 YRS

INTIMACY VS ISOLATION ability to relate relate well with others •

Virtue: Love Main 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.

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MIDDLE AGED 30 - 45 YRS

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

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

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society and helping to guide future generations

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OLDER ADULT 45 – SENIOR YRS

EGO INTEGRITY VS DESPAIR  Virtue: Wisdom Main 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 Motor  Neonatal Primary Ci Circular

1 mo 1 – 4 mo mos

Reflexive behavior   Beginning of mental images Hand – mouth; ea ear – eye co coordination Looks at objects and separates self 

Enjoyable Activity: Rattle or tape of parent’s voice Seco Second ndar ary y Cir Circu cula larr 4 – 8 mos mos

Coordination of  Secondary reactions

8 – 12

Tertiary Circulation

12 - 18 18

Lear Learns ns to init initia iate te,, rec recog ogni nize ze,, rep repea eatt  pleasurable experiences from environment (object permanence) Memory traces are present Anticipates familiar events Good toy: mirror  Good game: peek-a-boo Can plan activities with specific goals Perceives others can cause activity and activities of own body are separate from self  Can search for and retrieve toys that disappears from view Separation Anxiety Good toy: nesting toys (colored boxes) Able to to experiment to to discover ne new pr properties Space and time perception as well as  permanence Trial and error to discover new characteristics Good game: Throw and retrieve

Invention of new 18 – 24 mos mos means through mental combinations

Tran Transi siti tion on to to pre pre ope opera rati tion onal al tho thoug ugh h per perio iod d Use of memory and imitation to act Solves basic problems, foresee maneuvers that will succeed or fail Good toy: blocks , colored plastic rings

Pre operational Thought

Thoughts become symbolic Can arrive at answers mentally instead of  through physical attempt thinking is basically concrete and literal Egocentric; static thinking Concept of time NOW; Concept of  distance as far as he can see  No reversibility; lacks conservation Unable to state cause and effect relationship Good toy: modeling clay

Concrete Operational;

2 – 7 years

7 – 12 year yearss

Syst System emat atic ic rea reaso soni ning ng Use of memory to learn broad concepts and subgroups Classification according to attributes Reversibility is present; conservation intact Good activity: Collecting and classifying Expose the child to other viewpoints

Form Formaal Ope Opera rati tion onss 12 year yearss

Can solve olve hypo hypoth thet etic ical al prob proble lem ms with with scientific reasoning Understands casualty and can deal with  past present and future Adult or mature thought Good Activity: talk time to sort sort attitudes and opinions

LAWRENCE KOHLBERG: MORAL DEVELOPMENT Age Stage De Description

Nursing Implication

Pre-conventional 2 –3 1

Punishment/Obedience or orientation Help the child determine the Child does right because the parent right actions tells him to do it and to avoid Give clear instructions to avoid  punishment confusion 4–7 2 Individualism Child is unable to recognize that Instrumental purpose and like situations require like exchange actions Carries out actions to satisfy own Unable to take responsibility for  needs self care Do something for another if that Because meeting own needs  person does something for the interferes with this child Conventional 7 – 10

3

10 – 12

4

Orientation to Child enjoys helping interpersonal relations of others mutuality Allow child to help  Need to be good in own in tasks eyes and of others Praise for desired  behavior  Maintenance of social Child often asks order, fixed rules and what is right authority May have difficulty Child finds following modifying a rules satisfying   procedure because Follows rules of  one method may not authority figures as well  be right as parents Follows self care measures only if  someone is there to enforce

Post conventional 

12

5

Social Contract, utilitarian law-making  perspective Follows standards of  society

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

 behavior  6

Universal ethical  principle orientation Follows internalized standards of conduct

Many adults do not reach this level of  moral development