Transcribed by: Santiago, Christian Angelo C.

HANDOUTS: Child Health Nursing GROWTH & DEVELOPMENT ACROSS THE LIFESPAN

5. Every phase of development has characteristic behavior. 6. Every phase of development has hazards. 7. Stimulation plays an important role in development. 8. Cultural changes affect human development.

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.

9. There are social expectations for every stage of development. 10. There are traditional beliefs of all ages.

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 the individual.

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

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.

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PRINCIPLES OF GROWTH AND DEVELOPMENT Directional Cephalocaudal Proximodistal

Continuous and orderly

General to specific Simple to complex

Psychosexual Theory (Sigmund Freud)

1. Oral 2. Anal

Unique Heredity Race Gender Environment

3. Phallic/ Oedipal 4. Latency 5. Genital

Psychosocial Theory
ERIKSONS DEVELOPMENTAL TASKS

Interrelated Physical Psychological Social Cognitive

AGE 0-18mos 18mos-3y

STAGE Infancy Toddler

TASK TRUST vs. MISTRUST AUTONOMY vs. SHAME & DOUBT INITIATIVE vs GUILT INDUSTRY vs INFERIORITY IDENTITY vs ROLE CONFUSION INTIMACY vs ISOLATION GENERATIVITY vs STAGNATION INTEGRITY vs DESPAIR

3-6y

Preschool School age Adolescence

Skills New skills predominate

6-12y 12-20y

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

20-45y 40-65y

Young Adulthood Middle Adulthood Late Adulthood

65+

Take All the Initials In Identifying Intruders of Gentxt International VS

My Shy Girl In Rome Is Still Desirable

Cognitive Development Theory (Jean Piaget)

STAGE Sensorimotor Preoperational Concrete Operational Formal Operational AGE 0-2 yrs. 2 - 7 yrs. 7-11 yrs. Reflexes Logic, symbols, egocentrism, magical thinking Reason, time & space, conservation & permanence Abstract thinking & reality

11- 15 yrs.

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

2. To gain coordination 3. To relate to objects and people Type: Solitary They love to play with their own bodies Four months

Age-appropriate Toys 1. Mobiles 2. Teething rings 3. Rattles 4. Textured balls 5. Musical box 6. Large, soft cuddly toys 7. Squeeze toys Seven months Six months Five months

pulled to sit 180o visual arc Can raise head and chest when on prone Grasps objects within reach and brings to mouth Head control when pulled to sit, Sustains part of own weight when helped to standing position Laughs aloud

Rolls over Raking grasp Doubles birth weight Eruption of first tooth Sits within minimal support Can be pulled from sitting to standing position

Greatest Fear Stranger Anxiety after 6 months of age Eight months AGE NEWBORN One month CHARACTERISTIC When on prone, avoids suffocation by turning his head from side to side. Lifts head intermittently when on prone Momentary visual fixation on human faces and objects Social smile Responds to familiar voices by moving the whole body No head control yet; head lags when pulled to sitting Sheds tears Can raise head, but not chest, when on prone Babbles and coos Head in bobbing motion; some head control when Nine months

Plays with feet Says dada or mama but nonspecific Creeps when on prone Thumb-finger grasp Sits alone steadily without support for an indefinite period Can hold bottle Neat pincer grasp Crawls Understands simple gestures and requests Take some steps when held Pulls self to stand Responds to own name Stands with assistance Attempts to walk with help Walks with help Triples birth weight Drinks from cup Can say 2 words

Two months

Ten months

Eleven months

Three months

Twelve months

There is a distinct decrease in appetite because 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 or places are unfamiliar, Toddlers go into temper tantrums in order to control self and others. Toddlers have very poor sense of time. Their 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.

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 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 Greatest Fear Separation anxiety most acute at 2-2 years of age 2. Characteristics a. Dawdling at meals b. Fetish with foods c. Appetite of three-year-olds is more capricious than that of one-year-olds

Specific Behavior traits Toddlers are headstrong and negativistic They are naturally active, mobile and curious, which makes them vulnerable to accidents

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 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 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.

Greatest fears A. Castration fear/body mutilation B. Fear of the dark Specific Behavior traits They love to watch adults and imitate their behavior

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

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 school B. Loss of privacy C. Fear of death 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;

General behavior 1. Moral code/superego becomes rigid 2. They are very modest/private 3. Although the influence of peers is very strong, eating habits are still set by the examples of parents in the home. 4. When they become bored, they are boisterous and hard to control

Stage Infancy

Toddler

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.

Preschool

School Age

Play & Age-appropriate toys Play Toys Solitary mobile, rattles, soft stuffed toys, musical toys, squeeze toys, teething toys, books with textures Parallel Push-pull toys, rocking horses, dolls, large stuffed toys, pounding toys, blocks Cooperative, Puppets, painting sets, Associative coloring books, large puzzles, playground toys, housekeeping toys, tricycle, swing slide Competitive Construction toys, use of tools, handicrafts, model kits, collections, hobbies, science toys, magic sets, archery, dart games, chess

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 exertion should 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
School age AGE APPROPRIATE PREPARATION STAGE NSG FEARS CONSIDERATION Newborn (+) parents; mummy Loud noise; sudden restraint movt 6-12mos Toddler Model desired behavior Simple explanation; use distractions; allow choice Encourage understanding by playing with puppets,dolls; demonstrate equipment: talk at childs eye level Allow questions; explain why; allow to handle equipment Explain long term benefit; accept regression; provide privacy Strangers; heights Separation from parents; animals; strangers; change in environment Separation from parents; ghosts; scary people

Preschool

Dark; injury; being alone; death Social incompetence; war; accidents; death

Adolescent