1. concepts of growth and development

8/4/2019 1. CONCEPTS OF GROWTH AND DEVELOPMENT

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Transcribed by: Santiago, Christian Angelo C.

HANDOUTS: Child Health Nursing

GROWTH & DEVELOPMENT

ACROSS THE LIFESPAN

Growth

generally used to denote an increase in

physical size or quantitative changes.

refers to quantitative change in an

individual as he progresses in

chronological age which includes

increase in size, height or weight.

Development

used to denote an increase in skill

(physical, mental, personal or social)

or the ability to function, a qualitative

change.

is the gradual and orderly unfolding of

the characteristics of the successive

stages of growth involving emerging

and expanding capacities of theindividual.

FACTORS AFFECTING GROWTH AND

DEVELOPMENT

1. Early foundations of human development are

critical.

2. No two individuals are alike.

3. Maturation and learning play important roles

in development.

4. Development follows a definite and

predictable pattern.

5. Every phase of development has characteristi

behavior.

6. Every phase of development has hazards.

7. Stimulation plays an important role in

development.

8. Cultural changes affect human development.

9. There are social expectations for every stage

of development.

10. There are traditional beliefs of all ages.

CHARACTERISTICS OF GROWTH

1. HR/ PR decreases with age

2. BP increases with age

3. RR decreases with age

4. Hgb increases after 1 year of age

5. GFR increased between 0-2 years BUT

decreases after 20 yrs. of age

6. Peristalsis decreases with age

7. Brain development reaches by 905 at the age

of 2

PRINCIPLES OF GROWTH AND

DEVELOPMENT

Directional

Cephalocaudal

Proximodistal

Continuous and orderly


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General to specific

Simple to complex

Unique

Heredity

Race

Gender

Environment

Interrelated

Physical

Psychological

Social

Cognitive

Skills

New skills predominate

THEORIES OF GROWTH AND

DEVELOPMENT

1. Freuds Psychosexual Theory

2. Eriksons Psychosocial Theory

3. Piagets Cognitive Development Theory

4. Kohlbergs Moral Development Theory

5. Havighursts Developmental Tasks

Psychosexual Theory (Sigmund Freud)

1. Oral

2. Anal

3. Phallic/ Oedipal

4. Latency

5. Genital

Psychosocial Theory

ERIKSONS DEVELOPMENTAL TASKS

AGE STAGE TASK

0-18mos Infancy TRUST vs.MISTRUST

18mos-3y Toddler AUTONOMY v

SHAME &

DOUBT

3-6y Preschool INITIATIVE vsGUILT

6-12y School age INDUSTRY vs

INFERIORITY

12-20y Adolescence IDENTITY vs

ROLE

CONFUSION

20-45y Young

Adulthood

INTIMACY vs

ISOLATION

40-65y Middle

Adulthood

GENERATIVIT

vs

STAGNATION

65+ Late Adulthood INTEGRITY vsDESPAIR

Take All the Initials InIdentifying

Intruders ofGentxt International

VS


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My Shy Girl InRome IsStill Desirable

Cognitive Development Theory (Jean Piaget)

STAGE AGE

Sensorimotor 0-2 yrs. Reflexes

Preoperational 2 - 7 yrs. Logic, symbols,egocentrism,

magical thinking

Concrete

Operational

7-11 yrs. Reason, time &

space,conservation &

permanence

Formal

Operational

11- 15 yrs. Abstract

thinking &

reality

Moral Development Theory

(Lawrence Kohlberg)

Preconventional - Reward or punishment

Conventional - approval, exchange of favors, law and

order

Postconventional - Legal rights, ethical principles

INFANCY (0 to 12 months of age)

Psychosexual stage: Oral

Psychosocial stage: Trust vs. Mistrust

Cognitive stage: Sensorimotor Reflexes

PLAY

Purposes:

1. To practice motor skills


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2. To gain coordination

3. To relate to objects and people

Type:

Solitary They love to play with their own bodies

Age-appropriate Toys

1. Mobiles

2. Teething rings

3. Rattles

4. Textured balls

5. Musical box

6. Large, soft cuddly toys

7. Squeeze toys

Greatest Fear

Stranger Anxiety after 6 months of age

AGE CHARACTERISTIC

NEWBORN When on prone, avoids

suffocation by turning hishead from side to side.

One month Lifts head intermittentlywhen on prone

Momentary visual fixation on

human faces and objects

Two months

Social smile Responds to familiar voices

by moving the whole body

No head control yet; head

lags when pulled to sitting

Sheds tears

Three months Can raise head, but not chest,

when on prone

Babbles and coos

Head in bobbing motion;

some head control when

pulled to sit

180o visual arc

Four months Can raise head and chest

when on prone

Grasps objects within reachand brings to mouth

Head control when pulled to

sit,

Sustains part of own weightwhen helped to standing

position

Laughs aloud

Five months Rolls over

Raking grasp

Six months Doubles birth weight

Eruption of first tooth

Sits within minimal support Can be pulled from sitting t

standing position

Seven months Plays with feet

Says dada or mama but

nonspecific

Creeps when on prone

Thumb-finger grasp

Eight months Sits alone steadily without

support for an indefiniteperiod

Nine months Can hold bottle

Neat pincer grasp

Crawls

Understands simple gesture

and requests

Take some steps when held

Ten months Pulls self to stand Responds to own name

Eleven months Stands with assistance

Attempts to walk with help

Twelve months Walks with help

Triples birth weight

Drinks from cup

Can say 2 words


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THE TODDLER(from 1 to 3 years of age)

Psychosexual stage: Anal

Psychosocial stage: Autonomy vs. Shame and

Doubt

Cognitive stage: Stage I (Preconceptual stage) of

the Preoperational Thought Period

(2-4 years) characterized by

egocentricity expressed in

relating everything to himself.

Type of Play : Parallel

Age-appropriate toys:

1. Push-pull toys

2. Pounding pegs

3. Building blocks

4. Stuffed toys

5. Toys to ride on

Greatest Fear

Separation anxiety most acute at 2-2

years of age

Specific Behavior traits

Toddlers are headstrong and negativistic

They are naturally active, mobile and curious,

which makes them vulnerable to accidents

There is a distinct decrease in appetite becaus

of the slower growth rate.

They are rigid, repetitive, ritualistic and

stereo-typed in their behavior. When things

are rearranged or are strange, when persons o

places are unfamiliar,

Toddlers go into temper tantrums in order tocontrol self and others.

Toddlers have very poor sense of time. Thei

time schedules revolve around their activities

not around the clock.

Since all 20 deciduous teeth are out by 2 -3

years, start teaching brushing of teeth at this

time.

1. Pattern of weight gain

a. First 6 months of life = 6-8 oz/week

b. Second 6 months of life = 2-4 oz/week

c. Second year of life = lb/month

2. Characteristics

a. Dawdling at meals

b. Fetish with foods

c. Appetite of three-year-olds is more capriciou

than that of one-year-olds


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Toddlerhood is the critical period for toilet

training.

1. Clues to readiness for toilet training:

Can already stand alone

Can walk steadily

Can keep himself dry for intervals of at least 2

hours

Can demonstrate awareness of voiding or

defecating

Is able to use words or gestures regarding

toileting needs

Is desirous of pleasing the primary caretaker

Age of achievement

a. Bowel control 18 months of age

b. Daytime bladder control 2 years of age

c. Nighttime bladder control 3 years of age

THE PRESCHOOLER(3 to 6 years of age)

Psychosexual stage: Phallic

Psychosocial stage: Initiative vs. Guilt

Cognitive stage: Stage II (Perceptual Intuitive

stage) of the Preoperational Thought Period

reasons can be given for beliefs and actions but

still considered prelogical and termed as

preoperational intuitive thinking.

Play

A. Type: associative or cooperative

B. Age-appropriate toys

1. Housekeeping toys

2. Playground equipments

3. Tricycles

4. Watercolors; finger-paints; clay

5. Picture/coloring books

6. Materials for cutting/pasting

7. Simple jigsaw puzzles

Greatest fears

A. Castration fear/body mutilation

B. Fear of the dark

Specific Behavior traits

They love to watch adults and imitate their

behavior


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They are very creative and curious, that is why

their favorite word is, WHY?

Imaginary playmates are common

They love to tell lies and brag or boast in

order to impress others

They enjoy offensive language

Age of sibling rivalry; oedipal

complex/electra complex

Questions about sex should be answered

honestly

Masturbation maybe seen in some do not

make fuss about it or punish the child; just give

toys to play with as substitute

THE SCHOOLAGE CHILD (6 to 12 years of

age)

Psychosexual stage (Freud):

Latency

Psychosocial stage (Erickson):

Industry vs. Inferiority

Cognitive stage (Piaget):

Concrete Operational Thought Period

thinking is now logical and there is an ability to

relate external events to each other, without

being egocentric; the child can understand

classes and relations and can handle numbers;

intellectual development proceeds rapidly

during this period.

Play

Type: Competitive

Age-appropriate toys

1. Dolls

2. Trains and model kits

3. Games; jigsaw puzzles; magic tricks

4. Books; table games

5. TV; video; records

6. Bicycles; skateboards

7. Collecting objects

Greatest Fears

A. Fear of replacement/displacement in scho

B. Loss of privacy

C. Fear of death

General behavior

1. Moral code/superegobecomes rigid

2. They are very modest/private

3. Although the influence of peers is very strong

eating habits are still set by the examples ofparents in the home.

4. When they become bored, they are boisterou

and hard to control


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THE ADOLESCENT (12 to 18 years)

Psychosexual stage: Genital

Psychosocial stage: Identity vs. role confusion

Cognitive stage: Formal Operational Thought

Period logical thinking and the ability to

reason; even theoretical hypotheses can be coped

with and concrete objects need not be introduced

for understanding.

General characteristics

Are bothered by the question: Who am I?

Tend to rebel against authority flexibility of

rules is necessary to give way to a growing

sense of independence; make available all sorts

of needed information

Sports that require strenuous physical exertionshould not be abused because muscles are still

functionally immature and can be injured by

indiscriminate exercise

May easily get tired because body size

increases faster than strength

More complete development of secondary

sexual characteristics

Improved motor coordination

Wisdom teeth appear (17-21 y.o.)

Masturbation as expression of sexual tension

Sexual fantasies

Experimental sexual intercourse

Play & Age-appropriate toys

Stage Play Toys

Infancy Solitary mobile, rattles, soft stuffe

toys, musical toys, squee

toys, teething toys, books

with textures

Toddler Parallel Push-pull toys, rocking

horses, dolls, large stuffe

toys, pounding toys, bloc

Preschool Cooperative,

Associative

Puppets, painting sets,

coloring books, largepuzzles, playground toys,

housekeeping toys, tricycswing slide

School Age Competitive Construction toys, use of

tools, handicrafts, model

kits, collections, hobbies,science toys, magic sets,

archery, dart games, ches

AGE APPROPRIATE PREPARATION

STAGE NSG

CONSIDERATION

FEARS

Newborn (+) parents; mummy

restraint

Loud noise; sudd

movt

6-12mos Model desired

behavior

Strangers; height

Toddler Simple explanation;

use distractions;

allow choice

Separation from

parents; animals;

strangers; change

environment

Preschool Encourage

understanding byplaying with

puppets,dolls;

demonstrate

equipment:

talk at childs eye

level

Separation from

parents; ghosts;scary people

School age Allow questions;

explain why; allow

to handle equipment

Dark; injury; bein

alone; death

Adolescent Explain long term

benefit;

accept regression;provide privacy

Social

incompetence; w

accidents; death


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1. concepts of growth and development

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