Principles of growth and development

 All children pass through predictable stages of growth and development

Parents often ask what to expect from their children regarding their progress
At health care visits. Such visits provide opportunities for you not only assess
Present growth and development but also to supply anticipatory guidance on
the topic (Butterworth & Kovas,2013)
 For these reasons, including growth and development is essential to
Establish complete and effective nursing care plans for children.
For promotion of normal growth and development

 Assessment to assess growth and development, measure and plot height and weight
on a standard growth chart for children at all health care visits to document that growth.
 Growth and development and the role of the nurse
Assess for growth and developmental milestones is a nursing role in the care of well and ill
children.
 Health Promotion and illness prevention
Determining a child’s developmental stage is often the primary focus of a well-child health
interview and examination. For instance, during her 24month checkup a mother might ask
if normal that her child can not yet pedal a tricycle, a question that cannot be answered
without full understanding of average ranges of motor coordination.
Parenting style and competence are major influences on the behavioral and mental health
of children (Barton & kirtley, 2012)
 Health restoration and maintenance
 Its equally essential to consider developmental stages when caring for sick child or one having surgery.
Preparing a 5- year old child for surgery, For example, It is equally essential to consider developmental
stages when caring for a sick child or one having surgery. Preparing a 5-year-old child for surgery, for
example, would be ineffective unless you know how much a 5-year-old child can be expected to
comprehend. You would need to assess if a child will understand things such as an anesthetic is a gas,
what a surgeon is, and what stitches are or how to best explain what these are. It is just as important to
keep developmental stages in mind when teaching parents

Principle of growth and development

Factors influencing growth and development

 Factors influencing growth and development

 Genetics from the moment of conception when a sperm and ovum fuse, the basic
makeup of an individual is cast .
 Gender on average girls born lighter (by an ounce or two) and shorter (by an inch
or two) than boys. Boys tend to keep this height and weight advantage until
prepuberty
 Health A child who inherits a genetically transmitted disease may not grow as
rapidly or develop as fully as healthy child depending on the type of illness and the
therapy or care available for the disease.
Intelligence children with high intelligence do not generally grow faster
Physically then other children but they do tend to advance faster in skills.
Temperament is the unusual reaction pattern of an individual or an individual’s
characteristic manner of thinking, behaving, or reacting to stimulate in the environment.
Temperament is not developed in stages but is an inborn characteristic set at birth.(some
adapt quickly other adapt slowly)
Reaction patterns
Chess and Thomas(1985) Are the researchers who identified nine separate characteristics
that define temperament or how children react to common situations. Each child’s patten is
made up of a combination of these individual element
 Activity level
 Rhythmicity
 Approach
 Adaptability
 Intensity of reaction
 distractibility
 Attention span and persistence
 Threshold of response
 Mood quality
Theories of child development

 A theory is a systematic statement of principles that provides a framework for explaining a phenomenon.
Developmental theories are theories that provides a framework for explaining a phenomenon.
 Developmental tasks are developmental task is a skill or a growth responsibility arising at a particular time in an
individual’s life, the achievement of which will provide a foundation for the accomplishment of future tasks.
 Freud’s Psychoanalytic Theory
 an Austrian neurologist and the founder of psychoanalysis, offered the first real theory of personality
development (Edmundson, 2007).
 Freud based his theory on his observations of mentally disturbed adults. He described adult behavior as
being the result of instinctual drives that have a primarily sexual nature (libido) that arise from within the
person and the conflicts that develop be- tween these instincts (represented in the individual as the id ),
reality (the ego), and society (the superego). He described child development as being a series of
psychosexual stages in which a child’s sexual gratification becomes focused on a particular body part.
 Criticisms of Freud’s Theory Freud relied on his knowledge of people with mental illness or looked at
circumstances that led to mental illness. This “looking at illness” rather than “looking at wellness” perspective limits
the applicability of the theory as a health promotion measure, although the behaviors he discussed are as
observable as ever.
 Infant birth to 18month “oral phase” because infants are so interested in
oral stimulation or pleasure during this time. According to this theory,
infants suck for enjoyment or relief of tension, as well as for nourishment.
 Toddler “anal phase” because during this time, children’s interests focus
on the anal region as they begin toilet training. Elimination takes on new
importance for them. Children find pleasure in both the retention of feces
and defecation. This anal interest is part of toddlers’ self-discovery, a way
of exerting independence, and probably accounts for some of the
difficulties parents may experience in toilet-training children of this age.
 Preschooler During the preschool period, children’s pleasure zone appears
to shift from the anal to the genital area. Freud called this period the
“phallic phase.” Masturbation is common during this phase. Children may
also show exhibitionism, suggesting they hope this will lead to increased
knowledge of the two sexes.
 School-Age Child saw the school-age period as a “latent phase,” a time in
which children’s libido appears to be diverted into concrete thinking. He
saw no developments as obvious as those in ear- lier periods appearing
during this time.
 Adolescent the adolescent period the “genital phase.” Freudian theory
considers the main events of this period to be the establishment of new
sexual aims and the finding of new love objects.
 Erikson’s Theory of Psychosocial Development
Erik Erikson (1902–1996) was trained in psychoanalytic theory but later
developed his own theory of psychosocial development, a theory that stresses
the importance of culture and society in development of the personality
(Erikson, 1993). One of the main tenets of his theory, that a person’s social view
of self is more important than instinctual drives in determining behavior, allows
for a more optimistic view of the possibilities for human growth. While Freud
looked at ways mental illness develops, Erikson looked at actions that lead to
mental health. Erikson describes eight developmental stages covering the
entire life span. At each stage, there is a conflict between two opposing
forces. The resolution of each conflict, or accomplishment of the
developmental task of that stage, allows the individual to go on to the next
phase of development.
 The Infant According to Erikson, the developmental task for infants is learning
trust versus mistrust (other terms are “learning confidence” or “learning to love”).
Infants whose needs are met when those needs arise, whose discomforts are
quickly removed, who are cuddled, played with, and talked to, come to view
the world as a safe place and people as helpful and dependable. However,
when their care is inconsistent, inadequate, or rejecting, this fosters a basic
mistrust: infants become fearful and suspicious of the world and of people.
 The Toddler Erikson defines the developmental task of the toddler age as
learning autonomy versus shame or doubt. Autonomy (self-government or
independence) builds on children’s new motor and mental abilities. Children
take pride in new accomplishments and want to do everything independently,
whether it is pulling the wrapper off a piece of candy, select- ing a vitamin
tablet out of the bottle, flushing the toilet, or replying, “No!” If parents recognize
toddlers need to do what they are capable of doing, at their own pace and in
their own time, then children develop a sense of being able to control their
muscles and impulses during this time.
 The Preschooler the developmental task of the preschool period is learning
initiative versus guilt. Learning initiative is learning how to do things. Children can
initiate motor activities of various sorts on their own and no longer merely
respond to or imitate the actions of other children or of their parents. The same
is true for language and fantasy activities.
 When children are given much freedom and opportunity to initiate motor play
such as running, bike riding, sliding, and wrestling or are exposed to such play
materials as finger paints, sand, water, and modeling clay, their sense of
initiative is reinforced.
 The School-Age Child Erikson viewed the developmental task of the school-age
period as developing industry versus inferiority, or accomplishment rather than
inferiority. During the preschool period, children learned initiative—how to do
something. During school age, children learn how to do things well.
 Jean Piaget a Swiss psychologist, introduced concepts of cognitive
development or the way children learn and think that have roots similar to those
of both Freud and Erikson and yet separate from each (Wadsworth, 2003).
Piaget defined four stages of cognitive development; within each stage are
finer units
 Kohlberg’s Theory Moral Development Lawrence Kohlberg (1927–1987), a
psychologist, studied the reasoning ability of boys and, based on Piaget’s
development stages, developed a theory on the way children gain knowledge
of right and wrong or moral reasoning.
 USING GROWTH AND DEVELOPMENT IN PRACTICE
An assessment of children’s growth and development should be included in all
children’s nursing care plans as whether they are growing and developing within
usual parameters is a significant mark of wellness. Because nurses do not work
alone but as members of a health care team.