At the end of the concept, the students will be able to:
• differentiate growth and development; • discuss the basic principles of growth and • • •

development; identify factors affecting growth and development; discuss major developmental theories; recognize the importance of growth and development as holistic framework for assessing and promoting health; identify the critical milestones for each developmental stage; and describe specific nursing interventions that are relevant to each developmental stage.

DEFINITION OF TERMS

DEFINITION OF TERMS
GROWTH

GROWTH
DEVELOPMENT

an increase in physical size a quantitative change

• an increase in physical size • a quantitative change

denotes an increase in skill or the ability to function a qualitative change Synonymous with MATURATION

DEVELOPMENT
• denotes an increase in skill or the ability to function

• a qualitative change
• Synonymous with MATURATION

DEFINITION OF TERMS
Psychosexual development
• developing instincts or sensual pleasures

Psychosocial development
• refers to Erikson’s stages of personality development

Moral development
• is the ability to know right from wrong and to apply these

to real-life situations.

Cognitive development
• refers to the ability to learn or understand from experience,

to acquire and retain knowledge, to respond to a new situation, and to solve problems.

Continuous processes

Proceed in an orderly sequence
Different children pass through predictable stages at different rates. Each individual proceeds at own rate. All body systems do not develop at the same rate.

Can be altered by nutrition, disease & congenital anomalies.

Certain stages are more critical than others. Directional.

Proceeds from gross to refined skills.
There is an optimum time for initiation of experiences or learning. Neonatal reflexes must be lost before development can proceed.

A great deal of skill and behavior is learned by practice. Development becomes increasingly differentiated. Children are individuals, not little adults, who must be seen as part of a family. Children are influenced by genetic factors, home and environment, and parental attitudes.

• Sex • Race & Nationality

Prenatal environment
   Nutritional deficiencies Mechanical problems Metabolic and endocrine problems Medical treatment Faulty placental implantation Smoking/alcoholism/use of certain drugs

  

 Natal  Anesthesia  Method of delivery  Immediate care

Post natal
 External
     Socioeconomic level Nutrition Illness & Injury Parent-Child relationship Ordinal Position in the Family

Internal
 Intelligence  Hormonal imbalance

FACTORS INFLUENCING G&D
GENETICS Family history of diseases may be inherited. Chromosomes carry genes that determine physical characteristics, intellectual potential, and personality. The greatest influence on physical growth and intellectual development. Beginning with the nutrition from the mother to exposures in utero such as alcohol, smoking, infections, drugs. Environmental exposures, such as radiation, chemicals. Family structure and community support services influence the environment in the process of growth and development of the child. Customs, traditions, and attitudes of cultural group influence the child’s growth and development.

NUTRITION PRENATAL AND ENVIRONMENTAL FACTORS FAMILY AND COMMUNITY CULTURAL FACTORS

GERMINAL: conception to 2 weeks EMBRYONIC: 2 weeks to 8 weeks FETAL: 8 weeks to 40 weeks

NEONATAL: birth to 28 days INFANCY: 1 to 12 months

TODDLER: 1 to 3 years PRESCHOOLER: 3 to 6 years

SCHOOL AGE: 6 to 12 years

PREPUBERTAL: 10 to 13 years ADOLESCENCE: 13 to 18 years

20 to 40 years

40 to 65 years

YOUNG-OLD: 65 to 74 years MIDDLE-OLD: 75 to 84 years OLD-OLD: 85 and over

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Conception Birth Newborn Infant Toddler Preschool School Age Adolescence Young Adulthood Middle Adulthood Late Adulthood


 

Each child displays definite predictable pattern. These patterns are universal and basic to all human beings. INDIVIDUAL DIFFERENCES: although the sequence is predictable, rates of growth vary, and individual variation exists in the age at which development milestones are reached.

Directional trends:
Cephalocaudal Proximodistal Differentiation

Sequential trends:
An orderly sequence; each childhood normally

passes through each stage Each stage is affected by the preceding stage and affects those stages that follow. Critical periods: time periods in which the child is especially responsive to certain environmental effects; sometimes called as sensitive periods. Positive or negative stimuli enhance or defer the achievement of a skill or function.

DEVELOPMENT OF ORGAN SYSTEMS

  

Growth of respiratory, digestive, renal and musculoskeletal proceeds fairly in childhood. Neurologic tissues grow rapidly in the first 2 years of life. Brain reaches mature proportions by 2 to 5 years. Lymphoid tissues also grow rapidly during infancy and childhood.

BONE DEVELOPMENT

Skeletal growth provides the best estimate of biological age since it has a genetically programmed developmental plan. Two processes:
 Growth

Creation of new cells and tissues Consolidation of tissues into a permanent form

 Maturation

TOOTH DEVELOPMENT

The foundations of child’s tooth structure are formed early in the fetal life. Major stages:
 Growth

 Calcification
 Eruption  Attrition

MOTOR DEVELOPMENT

Process wherein children learn to control and integrate their muscles in purposeful actions. The degree of nervous system maturity is reflected by the motor development. Motor behavior skills:
  

Reflexive or rudimentary General fundamental skills Specific skills Specialized skills

MOTOR DEVELOPMENT

Motor behavior skills:

Reflexive or rudimentary  Foundation of all other movements.  Required during infancy General fundamental skills  Common in all children  Develop during early childhood Specific skills  Emphasis on form, accuracy and adaptability  Develop during later childhood Specialized skills  They depend on the amount of repetition and concentrated application  Evolve slowly from late childhood through adolescence.

ENVIRONMENTAL MANIPULATION
AUDITORY STRATEGIES

VISUAL STRATEGIES

Monitor sound levels within the environment. Soft soothing music should be played for the newborn or even for school age children during their study periods at home. Includes use of color, form, texture, and lighting.

ENVIRONMENTAL MANIPULATION
OLFACTORY STRATEGIES

 Odors may affect children’s behavior  Sources of unpleasant odor must be removed.  Too warm or too cold environments may impose physiological demands on any child.

THERMAL STRATEGIES

PATTERN VARIATIONS

 Pattern encompasses variation in intensity, frequency, and phrasing of stimuli.

VESTIBULAR STIMULATION
Vestibular stimuli contribute to the neurologic rhythms of the body. This includes heart rate, respiratory rate, and neuron synapse activity. Carefully determine the need for stimulation, the type and quality of stimulation, the frequency of intervention, the intensity and quantity, and the rhythm of interval.

VESTIBULAR STIMULATION
Forms:

Manual rocking Swinging hammocks Stroking Using waterbeds

SLEEP PROMOTION
Intervention strategies:
 Establishing and maintaining sleep pattern  Facilitating sleep  Applying behavior management strategies  Applying relaxation techniques

MANAGEMENT OF PAIN
 Pain may be due to injury, disease, medical treatment, or non-specific states.  Strategies: Non-pharmacologic Relaxation Distraction Guided imaging Rubbing painful area Heat and cold application Pharmacologic

NUTRITIONAL SUPPORT
 Interventions to enhance nutritional status of children with nutritional deficits.  Strategies:
Non-nutritive sucking Structuring suck reflex Proper positioning Spacing of food intake Role modeling and socialization

 Both

lack an understanding of the concept of death.  Aware someone is missing, may experience separation anxiety.  Infants react to loss of caregivers with behaviors such as crying, sleeping more and eating less.  Toddlers may develop fearfulness, become more attached with remaining parent.

death as temporary and reversible. Magical thinking and egocentrism may lead to the belief that dead person will come back. View death as punishment; believe bad thoughts and actions cause death First exposure to death is frequently the death of pet. Common behaviors: nightmares, bowel and bladder problems, crying, anger, out-of-control behaviors.

View

death as irreversible, but not necessary inevitable.  Age 10 - understand death as universal and will happen to them. May believe death serves as punishment for wrongdoing. May deny sadness, attempt to act like adults. Common behaviors: difficulty with concentration in school, psychosomatic complaints, acting-out behaviors.

View

death as irreversible, universal and inevitable. Develop a better understanding between illness and death. Common behaviors: feeling of loneliness, sadness, fear, depression; acting-out behaviors may include risk-taking, delinquency, suicide attempts, and promiscuity.

View