Principles of Growth and Development

Prepared by:ABIGAIL M. MADRIAGA, MAN, RN

Growth & Development

Growth- Increase in physical size or quantitative change

Development- Increase in skill or the ability to function - Qualitative change- maturation

Growth & DevelopmentPsychosexual Development- Type of development that refers to developing instincts or sensual pleasure- Freud

Psychosocial Development- Stages of personality development - Erickson

Moral Development- Ability to know right from wrong and to apply these to real life situations- Kohlberg

Cognitive Development- Refers to the ability to learn or understand from experience, to acquire and retain

knowledge, to respond to a new situation and to solve problems- Piaget

Principles of Growth and Development

a. Growth and development in an orderly sequenceb. Different children pass through the predictable stages at different ratesc. All body system do not develop at the same rate.d. Development is cephalocaudale. Development proceeds from proximal to distal body partsf. Growth and developement are continuous processes from conception to deathg. Development proceeds from gross to refined skillsh. There is an optimum time for initiation of experiences or learningi. Neonatal reflexs must be lost before development can proceedj. A great deal of skill and behavior is learned by practice

Factors Influencing Growth and Development

1. Genetics2. Gender3. Health4. Intelligence5. Temperament – usual reaction pattern of an individual or

an individual’s characteristic manner of thinking, behaving or reacting to stimuli in the environment

6. Environment7. Socioeconomic level8. Parent-child relationship9. Ordinal position in the family

Theories of Development

Theory- Systematic statement of principles that provides a

framework for explaining some phenomenon

Development Task- Skill or a growth responsibility arising of a particular time in an individual’s life the achievement of which will provide a foundation for the accomplishment of future tasks

Psychoanalytic Theory

- Sigmund Freud- Libido- sexual nature- Id- instinct- Ego – reality- Superego - society

Psychoanalytic TheoryPsychosexual Stage Nursing Implications

infant Oral stage - Child explores the world by using the mouth especially the tongue

-oral stimulation by giving pacifiers-do not discourage thumbsucking- Breastfeeding

toddler Anal Stage- Child learns to control urination and defecation

- Help child achieve bowel and bladder without due emphasis on it’s importance

preschooler Phallic stage- Child learns sexual identity through awareness of genital area

- Accept children’s sexual interest such as fondling their own genitals

- Answer questions about birth or sexual differences

School age Latent stage- child’s personality is inactive or dormant

- Help to have positive experiences with learning to continue with self esteem

adolescent Genital-help develop sexual maturity and learn to establish satisfactory relationship with opposite sex

- Provide opportunities to relate with opposite sex

- Allow to verbalize feelings about new relationship

Psychosocial Theory (Erickson)Developmental Task Nursing Implications

Infant Trust vs Mistrust-child learns to love and be loved

- -provide primary caregiver- Provide expriences that

add security- Provide visual stimulation

toddler Autonomy vs shame- Child learns to be independent

- Provide opportunities for decision making

- Praisepreschooler Initiative vs guilt

- Child learns how to do things- Provide opportunities for

exploring new places or activities

- Allow playSchool age Industry vs inferiority

- Child learns how to do things well

- Allow child to complete a task/project to feel rewarded for accomplishment

adolescent Identity vs role confusion-learn who they are and what kind of person they will be

- Discuss feelings about important events important to them

- Offer praise and support

Psychosocial Theory (Erickson)Developmental Task Nursing Implications

Young adult Intimacy vs isolation-ability to relate well with other people to form long lasting friendship

- Need for strong sense of identity before they can reach out fully and offer friendship or love

Middle aged adult Generativity vs stagnation-people extend concern to the community and the world

- Sense of generativity – self confident

- Without sense of generativity – self absorbed

Older adult Integrity vs despair- Older adult with integrity feel good about life choices

- -despair – wish life could begin over again to turn out differently

Stages of Cognitive Development (Piaget)

Stages of Development Age Span Nursing implications

Sensorimotor

Neonatal reflex 1 mo -stimuli are assimilated into beginning mental images- Behavior is reflexive

Primary circular reaction 1-4 mo - Hand-mouth and ear-eye coordination develop

- Toy-rattle or tape of parent’s voice

Secondary circular reaction 4-8 mo - Infant learns to initiate, recognize and repeat pleasurable experiences from environment

- Memory traces (+)- Infant anticipates familiar

events- - toy – mirror- Game-peek a boo

Coordination of secondary reactions

8-12 mos - Recognizes shapes and sizes of familiar objects

- Search and retrieve toys that are out of sight

- Toy- nesting toys – colored boxes

Stages of Cognitive Development (Piaget)

Stages of Development Age Span Nursing implications

Sensorimotor

Tertiary circular reaction 12-18 mos - Capable of space perception, and time perception as well as permanence

- Toy-throw and retrieveInvention of new means through mental combinations

18-24 mo - Uses memory and imitation to act

- Can solve basic problems- Toy – blocks, colored plastic

rings ( several uses)Preoperational thought 2-7 yr - Thoughts- symbolic, mental

answers- Egocentric- Static thinking- Time-now, distance – as far

as they can see- Toy-modelling clay

Stages of Cognitive Development (Piaget)

Stages of Development Age Span Nursing implications

Concrete operational thought 7-12 yr - Systematic reasoning- Classify and use of serials- Undesrtand conservation- Activity- colecting and

classifyingFormal operational thought 12yr - solve hypothetical

problems with scientific reasoning

- Understand causality and can deal with past,present and future

- Activity- talk time to sort attitudes and opinions

Stages of Moral Development (Kohlberg)

Age (yr) Stage Description Nursing Implication

preconventional Level I

2-3 1 Punishment /obedience orientation- Heteronymous

morality- Child does right

because parents tells them to and to avoid punishment

- Child needs to determine what are right actions, give clear instructions

4-7 2 - Individualism: instrumental purpose and exchange

- Carries out actions to satisfy own needs rather than society’s will

- Does something for another if tha person does something for the child

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

Stages of Moral Development (Kohlberg)

Age (yr) Stage Description Nursing Implication

Conventional le Level II

7-10 3 -orientation to interpersonal relations of mutuality- Child follows rules because of a need to be a “good” person in own eyes and eyes of others

- Child enjoys helping other because it is “nice” behavior

- Allow child to help- Praise for good

behavior

10-12 4 Maintenance of social order, fixed rules and authority- Follows rules of authority figures as well as parents in an effort to keep the “system” working

- Follow self care measures only if someone is there to reinforce

Post conventional Level III

Older than 12 5 Social contract-follows standards of society for the good of all people

- Adolescents responsible for self care because it is standards behavior of adult

6 Universal ethical principle orientation

- Many adults does not reach this level of moral development