Overview

▪ Covers the different stages of the child’s

PRINCIPLES OF GROWTH growth and development
AND DEVELOPMENT ▪ Important for the nurse to:
▪ provide specific care to the needs of the
growing child
FEU – IN MCN FACULTY LECTURERS 2020 ▪ assist the family to understand normal
limits. to be aware
of the deviation from normal

Overview Learning Outcomes

Groupings of acceptable standards.
1. Integrate knowledge and principles of normal growth
Newborn - immediately after birth until 1 mo.
and development with application of appropriate
Infancy - from 1 month until 12 months nursing care to the child and family.
Toddler - from 12 months until 3 years 2. Assess the child to determine if a stage of
Early childhood or preschool - from 3 to 6 yrs development has been achieved.
School age –from 6-12 years old 3. Formulate nursing diagnosis/es that address the
Adolescence - from around 12 or 13 and lasts wellness as well as both potential for and actual
delay in growth and development.
until the beginning of adulthood.

Learning Outcomes Topic Outline: Growth and Development

4. Implement safe and quality nursing

I. Growth and Development
interventions to support normal
II. Principles of Growth and Development
development and growth.
III. Factors affecting Growth and Development
5. Evaluate with the mother and family the health IV. Structures of Personality
outcomes of nurse-client relationship. V. Theories of Development
VI. Assessment for promotion of normal growth
and development

Topic Outline: Growth and Development

Definition of Terms

VII. Nursing diagnosis Abstract thought - capable of thinking in terms

VIII. Outcome identification and planning of possibility rather than limited to thinking
IX. Evaluation about what already is.
Accommodation - taking in information and
changing it to fix their existing ideas
Definition of Terms Definition of Terms

Animism – Animals and inanimate objects as Centering –the ability to see only one of the
being capable of thought and feelings also
object’s characteristics
)
known as magical thinking ( in children
Development - Indicates an increase in skill or
Assimilation - taking in information and the ability to function
changing it to fix their existing ideas
Growth - Increase in the number and size of
Conservation – the ability to discern truth, even
though physical properties change. cells; measured in terms of quantity;
orderly and predictable but not even.

Definition of Terms Definition of Terms

Egocentrism - when they are able to see only

Developmental task – a skill or a growth
one of the object’s characteristics
responsibility arising at a particular time in
Reversibility –the ability to retrace steps
an individual’s life, the achievement of which
Theory - a systematic statement of principles
will provide a foundation for the
that provides a framework for explaining
accomplishment of future tasks.
some phenomenon.
depends of the
age
-

group
Erikson 's
- Freud and theory

Definition of Terms Definition of Terms

Maturation - It means development of those Permanence - infants learn objects in the

cells until they are ready to function environment – their bottle, blocks, their bed,
Schemas – They are the finer units of each stage or even a parent – are permanent and
of cognitive development according to continue to exist even though they are out of
Piaget. sight or changed in some way
Role fantasy –how preschoolers would like
they are idealistic
something to turn out. La set boundaries

Definition of Terms Definition of Terms

Sensorimotor intelligence - is practical Temperament - the usual reaction pattern of an a

temper
-

intelligence during infancy, because words individual or an individual’s characteristic

and symbols for thinking and problem solving manner of thinking, behaving or reacting to
are not yet available at this early age stimuli in the environment. It is an inborn
characteristic
 I. Growth and Development
I. Growth and Development
DEVELOPMENT
Parameters of Growth:
Ways to measure development:
1. Weight - measured in grams, kilograms 1. Direct observation of child’s performance
or pounds. 2. Note parents’ description of child’s progress.
2. Height –measured in inches, feet or 3. Use of DDST (Denver Developmental Screening
centimeters. Test), modified as MMDST (Metro Manila
Developmental Screening Test) in the Phil.

I. Growth and Development I. Growth and Development

Five Main Areas of Development MATURATION

Specialists :

♦development of cells until they are ready to function

Developmental
1. Physical - height, strength, etc. ♦ an increase in human competence and adaptability
pediatrician
2. Emotional - trusting relationships, attitudes,
sense of self as an individual, feelings
DEVELOPMENTAL TASK
3. Intellectual - thinking and understanding
♦ a growth responsibility that arises at a certain time in
4. Social - interaction
the course of development
5. Spiritual - search for transcendental meaning
crawl - 17 walk -7 run

life is a cycle

II. PRINCIPLES OF GROWTH AND First

year of life

( toddler ; anal triple height from

DEVELOPMENT
phase )
-

birth

rapid growth

1.Growth and
identity vs .
role confusion development are
continuous
intimacy vs . isolation processes from
generativity us .
stagnation conception until
death.
integrity vs .
despair

II. PRINCIPLES OF GROWTH AND DEVELOPMENT

II. PRINCIPLES OF GROWTH AND DEVELOPMENT

5. Growth and development follows an orderly

2. All aspects of development are pattern
interrelated a. Cephalocaudal head to toe

3. Growth is continuous and gradual predictable but not uniform

b. Proximo-distal midline to outward

4. Growth is not uniform c. General to specific (Gross to refined)

3 uses big crayons
yo
 II. PRINCIPLES OF GROWTH AND DEVELOPMENT
II. PRINCIPLES OF GROWTH AND DEVELOPMENT

10. Each phase of development has

6. There are periods of accelerated &
characteristic behavior ( developmental hazards )
decelerated growth rate
11. There is an optimum time for initiation of
7. All individuals are different
developmental experiences or learning ( wait for the N 's . to mature )

8. Early foundations are critical ( Freud : personality is fixed at 5 o )

12. Most developmental skills and behaviors
y
.

9. Each phase of development has hazards

La
are learned by practice
physical hazards -
choking , falling

II. PRINCIPLES OF GROWTH AND DEVELOPMENT

III. Major Factors Influencing Growth and
Development
Babin
sky rooting
, ,
← 13. Neonatal reflexes must be lost before
motor development can proceed A. Genetics ( inherited from parents )
14. Development is affected by cultural ♦physical characteristics, learning style and
changes ( e.g . circumcision ) temperament. genetic abnormality
15. There are social expectations for every B. Gender women are lighter and shorter at birth ; prepuberty
-
women are taller (growth
spurt )

stage of development C. Health -

inheritance of genetic disease ; type I DM

16. Development is a product of heredity and D. Intelligence -

fast advancement in cognitive skills

environment ( genetics )

III. Major Factors Influencing Growth and Development

III. Major Factors Influencing Growth and Development
Reaction Patterns That Determine
E. Environment
Temperament
a. Socioeconomic level -
health care and nutrition ; vulnerable
to

diseases
b. Parent-child relationship -

supervision of parents ; bored 1. Activity level – differs widely ; mores a lot or little

c. Ordinal position in the family

=
-
eldest :
responsible thrive bean 2. Rhythmicity – with set patterns ; regular rhythm in physical
middle left out functions
d. Health
i

3. Approach –response on initial contact with

i.
: MD ST
" ←
's hearing test
vulnerable children youngest : spoiled
when
parents treat F. Temperament only child speak early a new stimulus.
-

: can
( some are
positive l some withdraws )
children differently
after have been reaction
they to stimuli
critically ill

excels in language
Eldest or only child
-

more slowly
Youngest develops language
-

may excel in other skills ( potty training on writing )

III. Major Factors Influencing Growth and Development III. Major Factors Influencing Growth and Development

Reaction Patterns That Determine Reaction Patterns That Determine

Temperament Temperament
→ trying to repeat an
activity
4. Adaptability – change one’s reaction to 7. Attention span and persistence after failing

stimuli over time. 1 there shouldn't be distress ) - remain interested to a project or activity
easily
5. Intensity of reaction 8. Threshold of response - intensity level of t -
→

← ( crying has emotions )

meets new ;
gets mad
situation with 6. Distractibility- shift easily to a new stimulation necessary to evoke reaction.
F - doesn't
their whole being situation. be careful in
giving toys
9. Mood quality - negative or positive condition easily get mad
•

( easily distracted children are

easy
to care for
happy and
laughing
 III. Major Factors Influencing Growth and Development III. Major Factors Influencing Growth and Development

Categories of Temperament Categories of Temperament

predictable rhythmicity ←
A. THE EASY CHILD C. The Intermediate Child
,
predictable rhythmicity ; positive qualities
approach , adapt to
♦ Easy to care for; 40% to 50% of children ♦ a combination of the easy and the difficult child
new situations readily ,
D. SLOW–TO-WARM-UP CHILD
have mild to moderate
B. THE DIFFICULT CHILD
-
-

intensity Adapts slowly to new situations; 15 % of

of reaction , 9
♦
have an overall positive ♦ Withdraw rather than approach new
mood quality children
situations; 10% of children
fairly inactive respond only mildly and adapt slowly to new
irregular habits , negative mood
quality
,
have ,

situations, and have a

general negative mood

Development Of Mental Function &

Personality Development IV. Structure of Personality
♦ Individual adjustment to his environment.
A. ID
♦ Covers appearances, abilities, motives, emotional
reactivity and experiences that have shaped him ♦ Developed during infancy
to his present person. ♦ Operates on pleasure principle to reduce
♦ Early experiences influence behavior later in life. tension or discomfort
♦ Mostly established by the age of five.

Structure of Personality Structure of Personality

B. EGO C. SUPER EGO

♦ Developed during toddler period
♦ Developed during preschool
♦ Reality principle
♦ Conscience- Morality principle
♦ Promotes satisfactory adjustment in relation
♦ Emerges at around age five.
to the environment.

Factors Affecting Personality development:

Factors Affecting Personality development:
3. Parents
1. Heredity ♦ age of the parents, occupation, economic
♦ characteristics present at birth: body build, status, religious orientation, level of
eye color, skin, hair type, certain aptitudes education and cultural heritage
2. Birth order 4. Culture
♦ First born, Middle child, Later born
 V. Theories of Child Development V. Theories of Child Development

Developmental theories provide road maps It is not so much chronologic age as the
for explaining human development. completion of developmental tasks that
Achievement of developmental task or growth defines whether a child has passed from
one developmental stage of childhood to
task which will provide a foundation for the
another.
accomplishment of future tasks.
Chronologic age

first real theory of personal development

ya
SIGMUND FREUD’S PSYCHOANALYTIC THEORY SIGMUND FREUD’S PSYCHOANALYTIC THEORY

Sigmund Freud described adult behavior as being A. The Infant provide

oral stimulation ,
don't discourage thumb
sucking

♦ “oral phase” ; infants are so interested in → explores the

the result of instinctual drives that have a primary world using mouth
oral stimulation or pleasure during this time.
sexual nature (libido). He described child
B. The Toddler potty training
development as being a series of Psychosexual
-

♦ “anal phase”; children’s interests focus on -17 bladder g

stages in which a child’s sexual gratification sphincter muscles

the anal region as they begin toilet training. → control of en v 't

becomes focused on a particular body part at ♦ Children find pleasure in both the retention →
messy or orderly

each stage. of feces and defecation.

learns to control urination and defecation

SIGMUND FREUD’S PSYCHOANALYTIC THEORY SIGMUND FREUD’S PSYCHOANALYTIC THEORY

C. The Preschooler awareness of genital area

←
♦“phallic phase.” Masturbation and E. The Adolescent having crushes
use of genitals
attracted to opposite
exhibitionism are usual ♦ “genital phase”; establishment of new sexual
six

Oedipus complex
- males
D. The School-Age Child nonactive I dormant personality dev 't aims and the finding of new love objects.
attracted to mom

Electra complex
- females ♦ “latent phase”; children’s libido appears to la
develops sexual maturity
be diverted into concrete thinking.
wants their dads and
for the child to relate with opposite
Provide appropriate opportunities
same gender interaction by help children have positive experiences w/ relationships
-

own sex

their self esteem continues to grow

learning w
-

ERIC ERIKSON’S THEORY OF

PSYCHOSOCIAL DEVELOPMENT
765 O
y
-

death
peaceful
35 65 0
y
-

work 4
helping others

Erikson describes eight developmental stages

self -

absorption

20
-
34 y
. o

covering the entire life span. At each stage, there

what to do

with life

12 -
19 y 0
.

is a conflict between two opposing forces. The

know who
they are

resolution of each conflict, or accomplishment of

G- 12
go
responsibility

the developmental task of that stage, allows the z -

Ce
y
-
O

individual to go on to the next phase of T

-

3
Y'
O
-
exploring
environment

development. birth
caretaker
-

ay
>
o ,
 ERIC ERIKSON’S THEORY OF ERIC ERIKSON’S THEORY OF
PSYCHOSOCIAL DEVELOPMENT PSYCHOSOCIAL DEVELOPMENT

A. The Infant learns to love and be loved C. The Preschooler learns to do things and find them desirable
♦ Trust versus mistrust (other terms are ♦ initiative versus guilt.

“learning confidence” or “learning to love”). D. The School-Age Child learns how to do things well
B. The Toddler learns to he independent ♦ industry versus inferiority

♦ Autonomy versus shame or doubt. E. The Adolescent learns who they are and what kind of
♦ identity versus role confusion. person they want to be

ERIC ERIKSON’S THEORY OF JEAN PIAGET’S THEORY OF

PSYCHOSOCIAL DEVELOPMENT COGNITIVE DEVELOPMENT

F. The Young Adult Piaget defined four stages of cognitive development.

♦ sense of intimacy versus isolation.
within each stage are finer units or schemas.
G. The Middle-Aged Adult
Each period is an advance over the previous one.
♦ sense of generativity versus stagnation.
To progress from one period to the next, children
H. The Older Adult
♦ integrity versus despair
reorganize their thinking processes to bring
them closer to adult thinking.

- Infant

-
practical skills

I,

schemas :

2 '

egocentrism
imagination
play pretend restricted
not
don't understand - a

conservation 3 .
to egocentricism
knows conservation

4 .
-a scientific experiment
- truth , justice ,

unconditional love

thinks about future

-

JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

A. The Infant B. The Toddler

♦Piaget referred to the infant stage as the ♦ Completes final stages of sensorimotor period
sensorimotor stage. and begin to develop some cognitive skills of
♦ Sensorimotor intelligence is practical the preoperative period, such as symbolic
intelligence thought and egocentric thinking.
♦ Gain the concept of permanence

works
schema -

understanding of how something

Initial schema
Disequilibrium -
new things are discovered Accumulation
- relates to what she
previously knows

information to bring back to

Schema forming -
resolved when parents reaffirm
-

provides
Assimilation process what it is
equilibrium
 JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

♦ The following are the characteristics of toddlers: C. The Preschoolers

♦ Moving on to a substage of preoperational
▪ Trial and error
thought, intuitive thought. only of its characteristics
→ sees one dlt lack of
▪ Object permanence
Preschoolers believe in the following:
conservation

▪ Begins ability to use symbols to represent ▪ Centering ▪ Role fantasy

or never

objects ▪ Lack of conservation ▪ Assimilation

▪ Draw conclusion only from obvious facts that ▪ Animism and magical thinking
they see

JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

JEAN PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

E. The Adolescent
D. The School-Age Child
♦ Formal operational thought begins.
♦ Beginning of concrete operational thought
♦ Adolescents are capable of the following:
▪ Recognize cause-and-effect relationships
▪ Abstract thinking
▪ Conservation
▪ Deductive reasoning, from general to
▪ Inductive Reasoning or specific to general
specific.
▪ Reversibility

LAWRENCE KOHLBERG’S
THEORY OF MORAL DEVELOPMENT Pre conventional

Lawrence Kohlberg studied the reasoning ability conventional

-71

of boys and, developed a theory on the way

children gain knowledge of right and wrong or
moral reasoning. - a
society 's rule
post conventional → intentions

stage

LAWRENCE KOHLBERG’S THEORY OF MORAL DEVELOPMENT LAWRENCE KOHLBERG’S THEORY OF MORAL DEVELOPMENT
PRE CONVENTIONAL
A. The Infant I to avoid punishment
B. The Toddler does right as told by parents
♦a pre-religious stage
♦ Preconventional stage: “punishment
♦ Infants have little concept of any motivating
obedience orientation”
force beyond that of their parents.
♦ “I help take care of my brother because if
♦ To support this stage of development,
I don’t, my mother will punish me”.
caregivers praise infants for doing what
Client help to determine
what are right actions

they have been asked to do.

needs

're
kn clear instructions to avoid confusion
 LAWRENCE KOHLBERG’S THEORY OF MORAL DEVELOPMENT LAWRENCE KOHLBERG’S THEORY OF MORAL DEVELOPMENT
PRECONVENTIONAL CONVENTIONAL

D. The School-Age Child orientation to interpersonal relations

C. The Preschooler → to
satisfy own needs

♦ Individualism and Exchange ♦ Conventional development: “nice girl, nice

♦ “Lie still now for me while I change your boy” stage.

dressing and I will read you a story when ♦ Children engage in actions that are “nice” or

I am through.” “fair” rather than necessarily right.

like ♦“When people see what I have done, they will
child is unable to recognize that like situations require
actions think I am a good person.”
for desired behavior
child
enjoys helping others ; praise

LAWRENCE KOHLBERG’S THEORY OF MORAL DEVELOPMENT VI. Assessment for Promotion of

POST CONVENTIONAL Normal Growth and Development
E. The Adolescent
♦ Postconventional development: Law and Measure and plot height and weight on a standard
Social Order growth chart for children at all health care visits to
♦“But there is no rule that says that I can’t do it.” document growth is occurring and the child’s
growth remains within a constant percentile.
social contract ,
utilitarian ,
law -

making perspectives

47 for the good of all people

VI. Assessment for Promotion of VI. Assessment for Promotion of

Normal Growth and Development Normal Growth and Development

Take a health history from both parents and Document a 24 hour recall history for
the child and observe what specific activities nutritional intake, sleep, and a description
the child can accomplish to establish whether of school and play behaviors.
developmental milestones (major markers of
normal development) are being met.

VII. Nursing Diagnosis

VII. Nursing Diagnosis
When assessment is completed, a child profile
▪ Delayed growth and development related to
can be devised and needs and problems
prolonged illness
identified. Examples of nursing diagnoses
▪ Readiness for enhanced family coping related
applicable to this area include:
to parent’s seeking information about child’s
▪ Risk for delayed growth and development
growth and development
related to lack of age-appropriate toys and
activities
VII. Nursing Diagnosis VIII. Outcome Identification and Planning

▪ Health-seeking behaviors related to appropriate To provide holistic nursing care, consider all
stimulation for infants aspects of a child’s health (physical, emotional,
▪ Imbalanced nutrition, less than body cultural, cognitive, spiritual, nutritional, and
requirements, related to parental knowledge social), remembering that each child’s
deficit regarding child’s protein need developmental progress is unique. Children
▪ Deficient knowledge related to potential long-term cannot be forced to achieve milestones faster
effects of obesity in school-age child than their own timetable will allow.

VIII. Outcome Identification and Planning

VIII. Outcome Identification and Planning
However, through anticipatory guidance, children
Interventions to foster growth and development
can be encouraged to reach maximum
include encouraging age-appropriate self-care in a
developmental potential. Nurses can play
child and suggesting age-appropriate toys or
important roles in suggesting expected outcomes
activities to parents. It may be necessary to help
and guidance to both a child and family on ways
parents accept a child’s delayed growth or
to encourage child development and preparing
motivate a child to reach anticipated upper limits.
children for new experiences.

VIII. Outcome Identification and Planning IX. Outcome Evaluation

Role modeling is an important ongoing Evaluation for specific growth and developmental
intervention with both children and families. milestones must be ongoing to be accurate and
Modeling, for example, can demonstrate that useful, because many children do not test well on
problem solving is a more effective approach to any given day. Ongoing evaluation is necessary
life’s challenges than “acting out” behaviors. also because it provides an opportunity for early
detection of various problems.

VII. Outcome Evaluation VII. Outcome Evaluation

If a child has difficulty achieving one Examples of expected outcomes are:

developmental task, for example, the next one ♦ Child, 5 years of age, expresses less
may be difficult to achieve as well. Evaluation negativism at next clinic visit.
must also be comprehensive. If a developmental
♦ At 9-month checkup, parents describe how
task involves only gross motor function, it may
they have made a safe space in their home
not be apparent that something is wrong with a
child’s fine motor function until the child is asked for their infant to crawl so that he is not
to perform fine motor tasks in school. confined to a playpen.
VII. Outcome Evaluation ACTIVITY
With the table provided below, compare the different
♦ Parents list household tasks they believe are theories of development according to the stages of
appropriate for a 6-year-old child by next development.
Freud’s Theory of Erikson’s Theory Piaget’s Theory Kohlberg’s
office visit. Age Group Psychosexual of Psychosocial of Cognitive Theory of Moral
Development Development Development Development
♦ Parents state the pattern they are using to The Infants
The Toddler
phase out high-carbohydrate, nonnutritive The Preschooler

snacks for their preschooler The School-Age

The Adolescent
•
•

20
Requirements to be submitted onNo

ACTIVITY

2. Create a picture collage of your growth and

development from birth to adolescent.
3. Describe yourself each stage