Principles Of Growth And Development

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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. Genetics 1. Gender 2. Health 3. Intelligence 2. Temperament 1. Activity Levels 2. Approach 3. Rhythmicity 4. Adaptability 5. Distractability 6. Threshold of response 7. Mood quality 8. Intensity of reaction

9. Attention Span 3. Environment 1. Socio Economic level 2. Parent Child Relationship 4. Nutrition FACTORS INFLUENCING GROWTH AND DEVELOPMENT 1. Genetics 1. Gender 2. Health 3. Intelligence 2. Temperament 1. Activity Levels 2. Approach 3. Rhythmicity 4. Adaptability 5. Distractability 6. Threshold of response 7. Mood quality 8. Intensity of reaction 9. Attention Span 3. Environment 1. Socio Economic level 2. Parent Child Relationship 4. Nutrition BASIC DIVISIONS OF CHILDHOOD NEONATE

First 28 days of life


1 mo – 1 year 1 – 3 YEARS


3 – 5 YEARS


6 – 12 YEARS


13 – 20 YEARS




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




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




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




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



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: 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 -


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 -


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 -


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 am I going? Nursing Implications • Provide opportunities to discuss feelings about events important to him or her • Offer support and praise for decision making



INTIMACY VS ISOLATION • ability to 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. -


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



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 Sensori Motor Neonatal

Age Span

Nursing Implications

1 mo

Primary Circular

1 – 4 mos

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

Enjoyable Activity: Rattle or tape of parent’s voice Secondary Circular 4 – 8 mos

Coordination of Secondary reactions

8 – 12

Tertiary Circulation

12 - 18

Learns to initiate, recognize, repeat 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 experiment to discover new 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 means through mental combinations

Transition to pre operational though period 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 years Systematic reasoning 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

Formal Operations 12 years

Can solve hypothetical problems with scientific reasoning Understands casualty and can deal with past present and future Adult or mature thought Good Activity: talk time to sort attitudes and opinions

LAWRENCE KOHLBERG: MORAL DEVELOPMENT Age Stage Description Nursing Implication Pre-conventional 2–3 1 Punishment/Obedience 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 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 10 – 12 4 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 5 Social Contract, Adolescent is  12 utilitarian law-making responsible for self perspective care because he Follows standards of views this as society standard of adult

behavior 6

Universal ethical principle orientation Follows internalized standards of conduct

Many adults do not reach this level of moral development

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