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

INFANT 1 mo – 1 year

TODDLER 1 – 3 YEARS

PRESCHOOLER 3 – 5 YEARS

SCHOOL AGE 6 – 12 YEARS

ADOLESCENT 13 – 20 YEARS

THEORIES OF GROWTH AND DEVELOPMENT

Sigmund freud

- INFANT:
- 0 – 18 MONTHS
- 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

- 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
 - 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

- ADOLESCENT
- 13 TO 18 YEARS

- 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

- 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

- 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

- 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

- 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

- 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 am I going?
Nursing Implications
• Provide opportunities to discuss feelings about events important to him or
her
• Offer support and praise for decision making
 - YOUNG ADULT
- 18 – 25 YRS

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.

- MIDDLE AGED
- 30 - 45 YRS

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

- 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 1 mo Reflexive behavior
Beginning of mental images
Primary Circular 1 – 4 mos 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 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
Coordination of 8 – 12 Can plan activities with specific goals
Secondary Perceives others can cause activity and
reactions 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)
Tertiary 12 - 18 Able to experiment to discover new properties
Circulation 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 Transition to pre operational though period

means through Use of memory and imitation to act
mental combinations Solves basic problems, foresee maneuvers
that will succeed or fail
Good toy: blocks , colored plastic rings

Pre operational 2 – 7 years Thoughts become symbolic

Thought 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 7 – 12 years Systematic reasoning

Operational; 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
 12 5 Social Contract, Adolescent is
utilitarian law-making responsible for self
perspective care because he
Follows standards of views this as
society standard of adult
 behavior

6 Universal ethical Many adults do not

principle orientation reach this level of
Follows internalized moral development
standards of conduct