Chapter 5 Developmental Stages of the Learner

Developmental Characteristics
Chronological age versus stage of development Example: Children with chronic illness often are delayed developmentally; an adolescent who suffers a traumatic event may regress developmentally.

Developmental Characteristics (contd)

Rationale: Chronological age per se is not a good predictor of learning ability. At any given age, there can be a wide variation in physical, cognitive, and psychosocial variables. Developmental stage acknowledges that human growth and development are sequential, but not always specifically age-related.

Developmental Stages of Childhood

Pedagogy is the art and science of helping children learn. Infancy and Toddlerhood Preschooler School-aged Child Adolescence

Infancy and Toddlerhood

Piaget: sensorimotor stage
learning is through sensory experiences and through movement and manipulation of objects

Erikson: trust vs. mistrust (birth to 12 months) autonomy vs. shame and doubt (1-3 years)
building trust and establishing balance between feelings of love and hate; learning to control willful desires

Infancy and Toddlerhood (contd)

Salient Characteristics
cognitive
Example: responds to step-by-step commands; language skills develop rapidly during this stage

psychosocial
Example: aggravated by personal and external limits; routines provide sense of security

Infancy and Toddlerhood (contd)

Teaching Strategies
focus on normal development, safety, health promotion, and disease prevention use repetition and imitation stimulate the senses provide safety allow for play and manipulation of objects

Preschooler
Piaget: preoperational stage
egocentric; thinking is literal and concrete; precausal thinking

Erikson: initiative vs. guilt

taking on tasks for the sake of being involved and on the move; learning to express feelings through play

Preschooler (contd)
Salient Characteristics
cognitive
Example: animistic thinking; limited sense of time; egocentric; transductive reasoning

psychosocial
Example: separation anxiety; play is his/her work; fears loss of body integrity; active imagination; interacts with playmates

Preschooler (contd)
Teaching Strategies
build trust allow for manipulation of objects use positive reinforcement encourage questions provide simple drawings and stories focus on play therapy stimulate the senses

School-Aged Child
Piaget: concrete operations stage
developing logical thought processes and ability to reason syllogistically; understands cause and effect

Erikson: industry vs. inferiority

gaining a sense of responsibility and reliability; increased susceptibility to social forces outside the family unit; gaining awareness of uniqueness of special talents and qualities

School-Aged Child (contd)

Salient Characteristics
cognitive
Example: able to draw conclusions and intellectually can understand cause and effect

psychosocial
Example: fears failure and being left out of groups; fears illness and disability

School-Aged Child (contd)

Teaching Strategies
encourage independence use logical explanations and analogies relate to childs experience use subject-centered focus use play therapy provide group activities use drawings, models, dolls, painting, audiotapes and videotapes

Adolescence
Piaget: formal operations stage
abstract thought; reasoning is both inductive and deductive

Erikson: identity vs. role confusion

struggling to establish own identity; seeking independence and autonomy

Adolescence (contd)
Salient Characteristics
cognitive
Example: propositional thinking; complex logical reasoning; can build on past experiences; conceptualizes the invisible

psychosocial
Example: personal fablefeels invulnerable, invincible/immune to natural laws Example: imaginary audienceintense personal preoccupation

Adolescence (contd)
Teaching Strategies
establish trust identify control focus use peers for support and influence negotiate for change, contract focus on details make information meaningful to life

Adolescence (contd)
Teaching Strategies (contd)
ensure confidentiality and privacy use audiovisuals, role play, contracts, and reading materials allow for experimentation and flexibility within safe limits

Adulthood:Developmental Stages
Young Adulthood Middle-Aged Adulthood Older Adulthood

Adulthood:Teaching & Learning

Andragogy: the art and science of helping adults learn Adult Learning Principles: relates learning to immediate needs; selfdirected; teacher is facilitator; learner desires active role

Young Adulthood
Piaget: formal operations stage (begins in adolescence and carries through adulthood)
abstract thought; reasoning is both inductive and deductive

Erikson: intimacy vs. isolation

focusing on relationships and commitment to others in their personal, occupational, and social lives

Young Adulthood (contd)

Salient Characteristics
cognitive
Example: cognitive capacity is fully developed, but continuing to accumulate new knowledge and skills

psychosocial
Example: autonomous; independent; stress related to the many decisions being made regarding career, marriage, parenthood and higher education

Young Adulthood (contd)

Teaching Strategies
use problem-centered focus draw on meaningful experiences focus on immediacy of application allow for self-direction and setting own pace organize material encourage role play

Middle-Aged Adulthood
Piaget: formal operations stage
abstract thought; reasoning is both inductive and deductive

Erikson: generativity vs. self-absorption and stagnation

reflecting on accomplishments and determining if life changes are needed

Middle-Aged Adulthood (contd)

Salient Characteristics
cognitive
Example: ability to learn remains steady throughout this stage

psychosocial
Example: facing issues with grown children, changes in own health, and increased responsibility for own parents

Middle-Aged Adulthood (contd)

Teaching Strategies
maintain independence and reestablish normal life patterns assess positive and negative past learning experiences assess potential sources of stress provide information relative to life concerns and problems

Older Adulthood
Piaget: formal operations stage
abstract thought; reasoning is both inductive and deductive

Erikson: ego integrity vs. despair

coping with reality of aging, mortality, and reconciliation with past failures

Geragogy: the teaching of older persons, accommodating the normal physical, cognitive and psychosocial changes

Older Adulthood (contd)

Salient Characteristics
cognitive
fluid intelligencecapacity to perceive relationships, to reason, and to perform abstract thinking, which declines with aging crystallized intelligencethe intelligence absorbed over a lifetime, which increases with experience

psychosocial
Example: adjusting to changes in lifestyle and social status

Older Adulthood (contd)

Teaching Strategies
use concrete examples build on past experiences focus on one concept at a time use a slow pace use repetition and reinforcement provide brief explanations use analogies

Older Adulthood (contd)

Teaching Strategies (contd)
speak slowly and clearly use low-pitched tones minimize distractions rely on visual aids and supplement with verbal instructions use large letters and well-spaced print provide a safe environment give time to reminisce

Role of Family in Patient Education

Family is the most important variable influencing patient outcomes. JCAHO accreditation standards warrant family participation. The nurse educator and family should be allies. It is important to choose the most appropriate caregiver to receive information.

Summary
Readiness to learn in children is very subject-centered, and motivation to learn in adults is very problem-centered. Rate of learning and capacity for learning, as well as situational and emotional barriers to learning, vary according to stages of development.

Summary (contd)
Knowledge of tasks associated with each developmental stage will help individualize the approach to education in meeting the needs and desires of learners and their families. Nurses, as the main source of health education, must determine what needs to be taught, when to teach, how to teach, and who the focus of teaching should be in light of the developmental stage of the learner.