LIFE PROCESSES

Introduction:

Biology is the science that deals with living things. Sometimes it is necessary to make a difference
between organisms that are alive, and other things that are not alive. This might not be as easy as it
seems. Various functions are going inside our body and inside the body of living organisms. These
functions are necessary to maintain the living being. The maintenance functions of living organisms
must go on even when they are not doing anything particular. Even when we are just sitting in front
of computer, even if we are just asleep, this maintenance job has go on. The processes which
together perform this maintenance job are life processes.

As a person moves through life from one cycle to another, he also experience a constant
progression of cellular life, death and regeneration, from the moment of conception to the moment
of death.

Life process: Definition:

Humans grow and age through various stages in their lifetime, a process known as the life process.

The word life processes means the processes take place in the human bodies which are needed for
the existence of life on earth. For example: digestion, respiration, excretion, reproduction, etc.
basically main life processes are also sleep, stress and homeostatic mechanism.

Following functions compromise the life processes:

1. Nutrition
2. Respiration
3. Excretion
4. Growth and repair
5. Reproduction
6. Movement
7. Sensitivity

1. Nutrition:

Nutrition is the process of getting energy from outside sources. Next process of nutrition is to break
down these sources to release energy. Process of getting nutrition can vary from organism to
organism and is affected by the external environment.

Based on mode of getting food organisms can be classified as follows:

a. Autotrophs
b. Heterotrophs

Autotrophs make their own food. All green plants are autographs. You must be aware that green
leaves contain a pigment called chlorophyll, which makes them green. Apart from colouring
purpose, chlorophyll plays a more important role of converting the sun’s photo energy to chemical
energy. The process of food preparation in plant is called photosynthesis. It involves making of
glucose with the help of carbon dioxide and water in the presence of sunlight.

Photosynthesis can be expressed by following chemical reaction:

6CO2+ 6H2O.......................C6H12O6 + 6O2 carbon dioxide+ water = glucose+ oxygen

Glucose thus formed is used by the plant to satisfy its energy needs. The excess amount is stored as
starch in various parts of the plant.

Experiment to show the presence of starch in a plant leaf:

Take a potted plant with variegated leaves for example, money plant or crotons. Keep the plant in
dark room for three days so that all the starch gets used up. Now keep the plant in sunlight for about
6 hours. Pluck a leaf from the plant. Mark the green areas in it and trace them on a sheet of paper.
Dip the leaf in boiling water for a few minutes. After this, immerse it in a beaker containing
alcohol. Carefully place the above beaker in a water bath and heat till the alcohol begins to boil.
What happens to the colour of the leaf? What is the colour of the solution? Now dip the leaf in a
dilute solution of iodine for a few minutes. Take out the leaf and rinse off the iodine solution.
Observe the colour of the leaf and compare this with the tracing of the leaf done in the beginning.
What can you conclude about the presence of starch in various areas of the leaf? Iodine after
reacting with starch turns its colour to blue.

Carbon dioxide uptake in plants:

Leaves have small pores called stomata. These pores open to allow entry of CO2 inside leaves.
Water flows into guard cells to swell them, which helps in opening of stomata opening.

Heterotrophs: Those organisms which are dependent on other organisms for their food are called
heterotrophs. Some animals, like humans have complex digestive system to break the food into
basic constituents to make them fit for oxidation. Certain organisms break the food outside their
body then absorb them. Fungi use some enzymes to break the food outside their body. Some
organisms take food from other organisms without killing them. Most of the parasites take nutrition
in this way.

Human digestive system:

Human digestive system is a complex and elaborates system. The digestive system carries out
following functions:

1. Intake of food
2. Digestion of food
3. Assimilation of food
4. Expulsion of waste products

Movement of food in the alimentary canal:

Alimentary canal constructs and expands in rhythmic fashion. This pushes food particles forward
through the alimentary canal. At every junction there is value like structure which prevents the back
flow of food. Sometimes these values or sphincters malfunction, which results in regurgitation of
food, results in burning sensation in mouth and throat.

2. Respiration:

Breaking down of nutrients to release energy is called respiration. The way cooking gas is burnt to
produce energy for kitchen the living organism burns food to release energy. A complex series of
oxidation-reduction goes inside the cell to burn food to produce energy. This energy is used to carry
out different activities inside a living organism.

The chemical reaction during respiration can be written as follows:

C6H12O6+ 6O26CO2+6H2O+ 674Kcal

Oxygen is required for oxidation of glucose during cellular respiration. In plants and smaller
animals this oxygen gets inside the organism by simple mechanism way called osmosis or by
difference in air pressure. But in larger organisms complex system is needed to carry out
transportation of oxygen inside the body and that of carbon dioxide out of body. This process is
called external respiration and is different from cellular respiration.

Haemoglobin: red blood cells in the blood contain haemoglobin which carries oxygen to the cell
and carbon dioxide away from the cells.

Arteries: arteries carry oxygenated blood from heart to different parts of the body.

Veins: veins carry deoxygenated blood from different parts of body to heart.

Heart: heart functions like a pump and helps in pumping in the deoxygenated blood to lungs for
oxygenation. Thereafter, heart pumps oxygenated blood to different parts of the body.

Lungs: lungs help in sucking in oxygen from air and pumping out carbon dioxide in the air.

3. Excretion:

As you may have noticed that burning petrol or diesel causes release of obnoxious fumes out of a
car, our body also produces such obnoxious substances. They are harmful and need to be expelled
out of our body. Expulsion of harmful substances, which are by-products of life processes, is called
excretion. In human body, many organs help in excreting harmful substances out of the body. For
example, some waste products through sweating, mouth expel some waste through spit, and rectum
expels waste through faeces. But the main excretory organ in the human body is kidney. Kidney
filters harmful substances from blood and expels them through urine. After all metabolic activities,
blood collects by-products from different parts of the body and passes through kidney to filter out
harmful products. Then only it goes to the heart for oxygenation. This is the reason a
malfunctioning kidney is a life threatening condition. People with bad kidney need to undergo
dialysis. In this process blood id filtered using artificial kidney or dialysis machine.

Transportation of water in plant:

Plants have special tube like structure made of special tissues called xylem and phloem. They create
capillary effect and the water rises from ground to the top of the tree. Apart from this evaporation
of water through leaves creates low pressure. This low pressure creates a pull effect. Both factors
combine resulting in transportation of water and minerals from roots to the top of the tree. The
biological terms for this are called Ascent of Sap.

4. Growth and repair:

All living things grow, even when they are mature. Immature organisms grow new cells to enable
them to grow to their mature size. This is achieved through cell division. The nucleus of a cell
contains the genetic information necessary to produce others of its kind. When new cells form, this
nucleus makes a copy of itself and then divides to form two new cells. This type of cell division is
known as mitosis. These new cells may be used simply for growth or to provide new cells to
replace old and damaged ones. Even mature organisms show growth, for example, human
fingernails and hairs.

Cellular healing:

The reproductive process begins at approximately the same time as the injury and is interwoven
with inflammation. Healing proceeds after the inflammatory debris has been removed. Healing may
occur by regeneration in which the gradual repair of the defect occurs by proliferation of cells of
the same type as those destroyed or by replacement.

5. Reproduction:

Without reproduction living things would not survive more than one generation. Single celled
organism such as bacteria reproduces by simple cell division. This type of reproduction is known as
asexual reproduction, where there is only one parent organism. Plants can also reproduce asexually
as well as sexually, where two parent organism are needed-male & female. The purpose of
reproduction is to maintain the population of a particular species. As living things get older, they
function less well and show signs of the negative effects of their environment such as damage to
tissues, and so on. Reproduction allows a copy of the genetic material of an organism to be passed
on to a new generation. Indeed, many scientists believe that the aim of reproduction is simply to
ensure the survival of DNA.

Ovulation:

At puberty (usually between ages 12 and 14, but earlier for some, 10 or 11 years of age is not
uncommon), the ova begin to mature. During a period known as the follicular phase, an ovum
enlarges as a type of cyst called a graffian follicle until it reaches the surface of the ovary, where
transport occurs. The ovum (or oocyte) is discharged into the peritoneal cavity. This periodic
discharge of matured ovum is referred to as ovulation. The ovum usually finds its way into the
fallopian tube, where it is carried to the uterus. If it meets a spermatozoon, the male reproductive
cell, a union occurs and conception takes place. After the discharge of the ovum, the cells of the
Graafian follicle undergo a rapid change. Gradually, they become yellow (corpus luteum) and
produce progesterone, a hormone that prepares the uterus for receiving the fertilized ovum.
Ovulation usually occurs 2 weeks prior to the next menstrual period.
The menstrual cycle:

The menstrual cycle is a complex involving the reproductive and endocrine systems. The ovaries
produce steroid hormones, predominantly estrogens and progesterone. Several different estrogens
are produced by the ovarian follicle, which consists of the developing ovum and its surrounding
cells. The most potent of the ovarian estrogens is estradiol. Estrogens are responsible for
developing and maintaining the female reproductive organs and the secondary sex characteristics
associated with the adult female. Estrogens play an important role in breast development and in
monthly cyclic changes in the uterus.

Progesterone is also important in regulating the changes that occur in the uterus during the
menstrual cycle. It is secreted by the corpus luteum, which is the ovarian follicle after the ovum has
been released. Progesterone is the most important for conditioning the endometrium (the mucous
membrane lining the uterus) in preparation for implantation of a fertilized ovum. If pregnancy
occurs, the progesterone secretion becomes largely a function of the placenta and is essential for
maintaining a normal pregnancy. In addition, progesterone, working with estrogens, prepares the
breast for producing and secreting milk. Androgens are also produced by the ovaries, but only in
small amounts. These hormones are involved in the early development of the follicle and also affect
the female libido.

Two gonad tropic hormones are released by the pituitary gland: FSH and LH. Follicle stimulating
hormone is primarily responsible for stimulating the ovaries to secrete estrogens. Luteinizing
hormone is primarily responsible for stimulating progesterone production. Feedback mechanisms,
in part, regulate FSH and LH secretion. For example, elevated estrogens levels in the blood inhibit
FSH secretion but promote LH secretion, whereas elevated progesterone levels inhibit secretion. In
addition, gonadotropin releasing hormone (GnRH) from the hypothalamus affects the rate of FSH
and LH release.

The secretion of ovarian hormones follows a cystic pattern that results in changes in the uterine
endometrium and in menstruation. This cycle is typically 28 days in length, but there are many
normal variations (21 to 42 days). In the proliferative phase at the beginning of the cycle (just
before menstruation), FSH output increases, stimulating oestrogen secretion. This causes the
endometrium to thicken and become more vascular. In the secretary phase near the middle portion
of the cycle (day 14 in a 28 day cycle), LH output increases, stimulating ovulation. Under the
combined stimulus of oestrogen and progesterone, the endometrium reaches the peak of its
thickening and vascularisation. The luteal phase begins after ovulation and is characterized by the
secretion of progesterone from the corpus luteum.

If the ovum is fertilized, oestrogen and progesterone levels remain high and the complex hormonal
changes of pregnancy follow.

If the ovum has not been fertilized, FSH and LH output diminishes, oestrogen and progesterone
secretion falls, the ovum disintegrates, and the endometrium, which has become thick and
congested, becomes hemorrhagic. The product consisting of old blood, mucus and endometrial
tissue is discharged through the cervix and into the vagina. After the menstrual flow stops, the cycle
begins again, the endometrium proliferates and thickens from estrogenic stimulation and ovulation
recurs.
During the time of coitus, the sperms and the ovum combine together to form zygote. The zygote
then undergoes multiple cell divisions to form the embryo then it develops as the foetus. On the day
of the expected date of delivery the foetus will be delivered as a baby from the mother’s womb.

6. Movement:

All living things move to some extent and this is perhaps most obvious with animals. Plants,
however, do move as well, for instance, when buds open. Many plants also follow the path of the
sun through the sky during the day. Movement is important for gathering nutrition and to evade
predators. Movement can also be internal, such as the movement of the heart muscles or the
muscles that push food through the digestive system. The energy for much of this movement comes
from respiration.

7. Sensitivity:

Sensitivity is an important function of organisms that helps them to survive in their environment.
Plants are sensitive to gravity, hence their roots grow downwards and they can obtain water. They
are also sensitive to light, which is way their leaves point towards the light. In these cases, gravity
and light are stimuli. The five human senses that we all come to learn have helped to ensure our
survival over thousands of generations:

Sight- to see danger, to see prey

Hearing- to be alerted to predators/prey

Smell- to be alerted to predators/prey, to avoid, potentially dangerous, food that has gone of.

Taste- avoid cating food that has gone off, to spit out poisons

Touch/feeling- to know when we have injured ourselves/to know when our body temperature is in
danger of rising/falling.

Growth & development:

Introduction:

The period of growth and development extends throughout the life cycle. However, the period in
which the principal changes occur is from conception to the end of adolescence. The most
important period of growth and development is a complex one, in which two cells joined as one
normally because a thinking, feeling person, who eventually takes a responsible place in society.
The term growth and development both refer to dynamic processes often used to interchangeably,
these terms have different meanings. The period of growth and development extends throughout the
life cycle; however, the period in which the principal changes occur is from conception to the end
of adolescence.
Growth:

According to Dorothy Marlow, “growth refers to the increase in physical size of the whole or any of
its parts and can be measured in inches or centimetres and in ponds or kilograms. Growth results
because of cell division and the synthesis of proteins. It causes a quantitative change in the child’s
body.

According to Potter and Perry, “growth refers to the changes that can be measured and compared,
for example, taking the height and weight of a paediatric client and comparing the measurements to
the standardized growth charts.

Development:

- It is an increase in the complexity of function and skill progression.

- It is a capacity and skill of a person to adapt to the environment.
- Development is the behavioural aspect of growth. E.g. A person develops the ability to
walk, to talk and to run.
- Development takes place from birth to death.

Growth and development are interdependent, interrelated processes. For e.g. an infant’s muscle,
bone and nervous system must grow to a certain point before the infant is able to sit up or walk.

Concept of growth and development:

 Growth is one of the parts of developmental process; in strict sense development in its
quantitative aspect is termed as growth.
 Growth may be referred to describe the changes, which take place in particular aspect of the
body and behaviour of an organism.
 Growth does not continue throughout life. It stops, when maturity has been attained.
 The changes produced by growth are the subject of measurement. They may be quantified
and are observable in nature.
 Growth may or may not bring development. A child may grow by becoming that fat but this
growth may not bring any functional improvement or development.
 The term growth refers to an increase in physical size of the whole body or any of its parts.
 Development refers to progressive increase in physical skill and capacity to function. It
causes qualitative change in the child’s functioning.
 Growth is essential feature of life of a child that distinguishes him or her from an adult.
 The maximum increase in the number of cells occurs in the fetal life as evidenced by an
increase in the DNA content of tissues.
 Children are influenced by genetic factors, home, environment and parental attitudes.
 Development is closely related to maturation of the nervous system, as primitive reflexes
disappear, they are replaced by a voluntary activity.
 Play is a natural medium for expression, communication an growth in children.
 Both rate and pattern of growth can be modified most obviously by nutrition.
 Growth is complex; it is measured both qualitatively and quantitatively over a period of
time.
Characteristics of growth and development:

1. Individual differences: Each child has an individual rate of growth, but the pattern of growth
shows less variability.
2. Readiness for certain tasks: The critical periods: measureable periods lasting from a few
days to few to few weeks, during which the learning of certain behaviours occurs are termed
as critical periods. These are defined as those points in which the maximal capacity for an
aspect of development is first present or at which structures to be developed are undergoing
rapid growth.
3. Rate of development: During the period of growth and development of the total body and its
subsystems, growth is sometimes rapid and at times it slows down. Rapid growth occurs
during gestation and during infancy, down during the school years.
4. Sequence of growth and development: growth and development proceeds from the head
down to the tail or in a cephalocaudal direction. This is particularly evident during the
period of gestation and the first year of life. Before birth the head end of the embryo, and
foetus enlarges and develops before the tail end does. Postnatal, the infant can control the
movement of the head before being able to stand and control the feet.

Principles of growth and development:

- Principle of continuity: development follows continuity, it goes from womb to tomb and
never ceases. An individual staring his life from a tiny cell develops his body, mind and
other aspects of his personality through a continues stream of development in these various
dimensions.
- Rate of growth and development is not in uniform: the rate of growth and development is
not steady and uniform at all times. It proceeds more rapidly in the early years of life but
slowdown in later years of infancy. Therefore at no stage the rate of growth and
development shows steadiness.
- Principle of individual differences: according to this principle, there are wide individual
differences among children with respect to their growth and development in various
dimensions; each child grows at his own unique rate.
- Principle of uniform pattern: although development does not proceed at a uniform rate and
show marked individual differences, yet it follows a definite sequence of pattern and
somewhat uniform in the offspring. For example, all offspring of human beings begin to
grow from head wards.
- Development proceeds from general to specific responses: in all phases of child
development, general activity proceeds specific activity, the responses are of a general sort
before they become specific.
- Principle of integration: the integration refers to the whole and its parts as well as of the
specific and general responses that make a child developed satisfactory in the various
dimensions of his growth and development.
- Principle of interrelation: the growth and development in various dimensions like physical,
mental, social etc. are interrelated and interdependent. Growth and development in any one
dimension affects the growth and development of the child in other dimensions.
- Development is predictable: with the help of rate of growth and development of a child, it is
possible for us to predict the range within which his nature of development is going to fall.
 - Principle of development direction: by cephalo-caudal development proceeds in the
direction of the longitudinal axis (head to foot). First the child gains control over his head
and arm and then his legs so that he can stand.
- Development is spiral and not linear: the child does not proceed straight on the path of
development with a constant or a steady pace. Actually he makes advancement during a
particular period but takes rest in the next following period to consolidate his development.
- Growth and development as a joint product of both heredity and environment: child at any
stage of his growth and development is a joint product of both heredity and environment.
His growth and development is indirectly influenced.
- Growth and development proceeds in an orderly sequence: growth in height occurs in only
one sequence, from smaller to longer. Development also proceeds in a predictable order.
- Development involves change: as the development progress the child undergoes change in
all aspects such a physical, psychological, social, spiritual etc.

Factors affecting growth and development:

Growth and development depend not on one but combination of many factors, all interdependent.
The relatively typically pattern of growth and development is influenced by hereditary and
environment. Also genetic inheritance and environmental influences are two primary factors in
determining a child’s pattern of growth and development.

Genetic factors:

- Heredity: the heredity of man and women determines their children. Hereditary decides the
size and shape of the body, hence family member bear resemblance. The characteristics are
transmitted through genes, which are responsible for family illness, e.g. diabetes.
- Sex: sex is determined at conception, after birth the male infant is both longer and heavier
than female infant. Boys maintain this superiority until about 11 years of age. Girls mature
earlier, reach the period of accelerated growth earlier than boys and are taller than boys on
average.
- Race: distinguishing characteristics called racial or sub racial developed in prehistoric
humans. Similar physical characteristics are seen in people belonging to the same race. As
too height, tall and short examples exist among all races and sub races. Among civilized
groups, intermarriage has produced mixed racial types.

Nutritional factors:

- Poor nutrition: nutrition plays a vital role in the body susceptibility to disease because poor
nutrition limits the body ability to resist infection. Poor nutrition also plays a major role in
the development of chronic illnesses. Growth and development suffering from protein
energy malnutrition, anaemic and vitamin deficiency states are retarded..
- Maternal nutrition: intrauterine growth retardation and consequently small size of the foetus
occur due to nutritional deficiency in mothers, infection and drugs used during pregnancy.

Environmental factors:
 - Physical environment: environmental forces act upon the individual. It is the exploding
force of an individual potentially to different stimulating forces. The physical environment
includes food, temperature, climate, resources etc.
- Mental environment: it includes the intellectual environment of the school, the libraries,
recreation rooms, labs etc.
- Social environment: it includes social association the child gets from the beginning. It also
includes cultural atmosphere of the society, e.g. religion, folklore, literature, art, music,
social conversations and political organizations.
- Socio-economic level: the child born into a family of low socio economic status may not
receive adequate health supervision could leave a child without immunization against
measles or other childhood illness.
- Cultural influences: groups of human being create their own cultures, whereas each
individual is influenced or shaped by the culture of which he or she is a part.
- Internal influences: there is evidence that all the hormones in the body affect the growth in
some manner. Deficiency of growth hormone retards growth while over production results
in gigantism.
- Characteristics of parents: parents with high intelligence quotient are more likely to have
children with higher level of inherited intelligence.

Prenatal environment:

Prenatal environment climate in which the child’s develops. The influence of the intra uterine
environment on the child’s future development is great, particularly since the uterus shields the
foetus from the full impact of external adverse condition.

Postnatal environment:

An environment that provides satisfying experiences promote growth. Since growth and
development are interrelated, growth in one area influences and in turn is influenced by growth in
all other areas.

Stages or period of growth (stages of life processes):

Prenatal period:

- Ovum- 0-14 days

- Embryo- 14 days
- Foetus- 9 wks –birth

Perinatal period:

- 28 weeks of gestation to 7 days after birth.

Postnatal period:

- New born- 1st four wks. after birth (1 month)

- Infancy- 1st year of birth
- Toddler- 1-3 years
- Pre-schooler- 3-6 years
 - Schooler- 6-10 years (girls)
6-12 years (boys)

Adolescents:

- Pre-pubescent- 10-12 yrs (F)

12-14 yrs (M)
- Pubescent- 12-14 yrs (F)
14-16 yrs (M)
- Post pubescent-14-18 yrs (F)
16-20 yrs (M)

Adulthood:

- Young adulthood 20-40 yrs

- Middle adulthood 40-60 yrs
- Late adulthood < 60 yrs

Old age:

Over the age of 65 yrs.

Stages of prenatal development:

- Pre-embryonic stage (Zygote or fertilized ovum). From conception to 2 weeks.

- Embryonic stage- 3 to 8 weeks
- Foetal stage- 9 weeks to till birth

Development of fertilized ovum:

When the ovum has been fertilized, it continues its passage through the uterine tube and reaches the
uterus 3 or 4 days later. During this time, segmentation or cell division takes place and the fertilized
ovum divides into 2 cells, then into 4, then in 8, 16 and so on until a cluster of cells is formed
known as morula (mulberry). These divisions occur quite slowly, about once every hour. Next, a
fluid filled cavity or blastocele appears in the morula which now becomes known as the blastocyst.
Around the outside of the blast cyst, there is a single layer of cells known as the trophoblast. The
remaining cells are clumped together at one end forming the inner cell mass. The inner cell mass
will become the foetus and amnion.

The inner cell mass:

While trophoblast is developing into placenta, which will nourish the foetus, the inner cell mass is
forming the foetus itself. The cells differentiate into three layers, each of which will form particular
parts of the foetus.

The ectoderm mainly forms the skin and nervous system.

The mesoderm forms bones and muscles and also the heart and blood vessels, including those
which are in the placenta. Certain internal organs also originate in the mesoderm.
The endoderm forms the mucous membranes and glands. The three layers together are known as
the embryonic plate. Two cavities appear in the inner cell mass, one on either side of the embryonic
plate.

The embryo:

This name is applied to the developing offspring after implantation and until 8 wks after
conception. During the embryonic period all the organs and systems of the body are laid down in
rudimentary form so that at is completion they have simply to grow and mature for a further 7
months. The conception is known as foetus during this time.

Growth and development of embryo and foetus 0-4 weeks after conception:

- Rapid growth
- Formation of the embryonic plate
- Primitive central nervous system forms.
- Heart develops and begins to beat
- Limb buds form

4-8 weeks:

- Very rapid cell division

- Head and facial features develop
- All major organs are laid down in primitive form
- External genitalia develops but sex not distinguishable
- Early movements
- Visible on ultrasound on 6 wks

8-12 weeks:

- Eye lids fuse

- Kidneys begin to function and the foetus passes urine from 10 wks.
- Foetal circulation functioning properly.
- Sucking and swallowing begin.
- Sex apparent
- Foetus moves freely.
- Some primitive reflexes present

12-16 weeks:

- Rapid skeletal development – visible on X-ray

- Meconium present in gut
- Lanugos appears
- Nasal septum and palate fuse.

16-20 weeks:

- Quickening- mother feels foetal movement

- Foetal heart beat heard on auscultation.
- Vernix caseosa appears.
 - Fingernails can be seen.
- Skin cells begin to be renewed.

20-24 weeks:

- Most organs become capable of functioning.

- Periods of sleep and activity.
- Responds to sound.
- Skin red and wrinkled.

24-32 weeks:

- Begins to store fat and iron.

- Testes descend into scrotum.
- Lanugos disappear from face.
- Skin becomes paler and less wrinkled.

32-36 weeks:

- Increased fat makes the body more rounded.

- Lanugo disappears from body.
- Head hair lengthens.
- Nails reach tips of the fingers.
- Ear cartilage soft.
- Planter creases visible.

36-40 weeks:

- Term is reached and birth is due.

- Contours rounded.
- Skull firm.

NEW-BORN:
The neonatal period is the first month of life.

Physical changes:

Up to 10% of birth weight is lost in the first few days of life, primarily through fluid losses by
respiration, urination, defecation and low fluid intake. Birth weight is usually regained by the
second week of life, and a gradual pattern of increase in weight, height and head circumference is
evident. During 1st month, weight increases on an average of 4-8 ounces per week, 0.6-2 cm in
length and 2 cm in head circumference.

Heart rate: heart rate ranges from 120-160 beats per minute.

Blood pressure: the average blood pressure is 74/46 mmHg.

Respiration: the new born’s respiratory movements are primarily abdominal and vary in rate and
rhythm, with an average rate of 30 to 50 breaths per minute.
Temperature: the axillary temperature ranges from 36∙C to 37.5∙C (96.8 degree F to 99.5 degree F).
Normal physical characteristics include continued presence of lanugo on the skin of the back,
cyanosis of hands and feet for the first 24 hours, soft protuberant abdomen. Soft skull bones
readjust within few days, producing a rounded appearance.

Psychosocial changes:

During the first month of life, parents and new born normally develop a strong bond that grows into
deep attachment. Feeding hygiene and comfort measures consume much of infant’s waking time.
These interactive experiences provide a foundation for the formation of deep attachments.

Neuromuscular development:

- Pupillary reflex: it may be elicited by shining a strong light such as flashlight on the eye.
- Rooting reflex: if a new-born’s cheek is brushed or stroked near the corner of the mouth, the
child will turn the head in that direction. This reflex disappears at about the 6th week of life.
- Glabellar reflex: elicited by striking the tip of the fingers in space between eye brows the
baby blinks.
- Sucking reflex: when a new born’s lips are touched, the baby makes a sucking motion. The
sucking reflex begins to diminish at about 6 month of age.
- Swallowing reflex: the swallowing reflex in the new born is the same as in the adult. Food
that reaches the posterior portion of the tongue is automatically swallowed.
- Extrusion reflex: a new born will extrude any substance that is placed on the anterior
portion of the tongue. This protective reflex prevents the swallowing of inedible substance,
disappearing at about 4 months of age.
- Palmer grasp reflex: new borns will grasp on object placed in their palm by closing their
fingers in it. It is a primitive reflex apparently from a time new borns clung to their mother
for safety. The reflex disappears at about age 6 weeks to 3 months.
- Step (walk) in place reflex: new born, who are held in a vertical position with their feet
touching a hard surface will take a new quick, alternating steps. This reflex disappears by 3
months of age.
- Placing reflex: the placing reflex is similar to the step in place reflex, except is elicited by
touching the anterior surface of new born’s leg against the edge of a bassinet or table.
- Planter grasp reflex: when an object touches the sole of a new born foot at the base of the
toes, the toes grasp in the reflex disappears at about 8-9 months of age in preparation for
walking.
- Tonic neck reflex: when new born lies on their backs, their hands usually turn to one side or
the other. The arm and the leg on the side to which the hand turns extend and the opposite
arm and leg contract. It is also called a boxer or fencing reflex, because the new born
position stimulates that of someone preparing to box of fence.
- Moro reflex: elicite by placing the infant in supine position, holding the head and neck
under the palm of right hand by lifting the child from the surface to 30 degree angle
dropping the head back on the other hand, child shows arms and legs extends and abducts,
fingers fanning open, thumb and forefinger shows C position.
- Babinski reflex: when the side of the sole of the foot is stoken in an inverted ‘J’ curve from
the heel upward, the new born fans the toes.
 - Deep tendon reflex: a patellar reflex can be elicited in a new born by tapping the patellar
tendon with the tip of the finger. The lower leg will move perceptibly if the infant has an
intact reflex.

Problems in new born:

- Pre term or low birth weight infant

- Asphyxia neonatorum
- Respiratory distress syndrome
- Meconium aspiration syndrome
- Cranial birth injuries:
o Caput succedaneum
o Cephalohematoma
o Intracranial haemorrhage
- Neuromuscular birth injuries:
o Facial paralysis
o Dislocation and fracture
- Opthalmia neonatorum

INFANT:
The period from 1 month to 1 year of age is characterized by rapid physical growth and change.

Physical changes:

Size increases rapidly during the first year of life.

Weight: birth weight doubles in approx. 5 months and triples by 12 months. An average weight
gain is 11/2 pounds in the first 5 months and ¾ pounds from 7-12 months.

Height: height increases an average of 1 inch during each of first 6 months and ½ inch the next 6
months. This 50% increase in birth height occurs primarily in the trunk, with the chest diameter
approx. That of head by the first birthday.

Fontanels: the fontanels become smaller, the posterior fontanel closes at about2 months, the
anterior at about 12-18 months.

Heart rate: at the end of 1st year is 80-150 beats/min.

Blood pressure: averages 90/50 mm of Hg.

Respiratory rate: is 30-35 breaths/min.

Cognitive changes:

The cognitive learns by experiencing and manipulating the environment. Developing motor skills
and increasing mobility expand an infant’s environment and with developing visual and auditory
skills, enhance cognitive development. Before acquisition of language, the extraordinary
development of the mind occurs through the child’s developing senses and motor abilities. For
example, a 1 month old can follow the path of a moving object. Improved visual acuity and eye-
hand coordination allow grasping and exploration of objects. Infants need opportunities to develop
and use their senses. Speech is an important aspect of cognition that develops during the first year
of life. Infants proceed from crying, cooling and laughing to imitating sounds, comprehending the
meaning of simple commands and repeating words with knowledge of their meaning. By 1 year,
infants not only recognize their names but also have 2 or 3 word vocabularies including Da-Da,
Ma-Ma and no.

Psychological changes:

During the first year, infants begin to differentiate themselves from others as separate beings
capable of acting on their own. Two or 3 month old infants begin to smile responsively rather than
reflexively. They can recognize differences in people. By 8 months, most infants can differentiates
a stranger from familiar person and respond differently to the two. Close attachment to primary
caregivers, most often parents, is usually established by this age. Infants seek out these persons for
support and comfort during times of stress. Play provides opportunities for the infant to develop
many motor skills. Much of infant play is exploratory as they use their senses to observe and
examine their own bodies and objects of their interest in their surroundings. Play becomes
manipulative as the child learns control of hands.

1 month:

Physical or biological development:

- Weight: 4.4+- 0.8 kg, gain above 680 g a month during first 6 months or 150-210 g a week.
- Length: 53 +- 2.5 cm, increases about 2.5 cm a month during first 6 months.
- Head circumference: increase about 1.5 cm a month during first 6 month
- Pulse: 130 +_ 20
- Respiration: 35 +- 10
- Blood pressure: 80/50 +_ 20/10
- Reflex: well developed sucking, rooting, swallowing and extrusion reflexes, moro reflexes
and tonic neck reflex
- Physiologic majority
- Breaths through nose

Motor development:

Gross motor:

- Head lags when baby is pulled from a supine to a sitting position.

- Head sags forward when baby is held in sitting position.
- Turn head to the side when prone.
- Makes crawling movements when prone on flat surface pushes with the feet against a hard
surface to move forward

Fine motor:

- Hold hand in tight fists

- Can grasp 9palmer reflex) but drops it immediately
Sensory development:

- Startled by sounds
- Fixates on objects brought in front of eyes or in their line of vision
- Protective blinking in response to bright light

Psychosocial, psychosexual and spiritual development:

- Beginning development of sense of trust, negative counterpart mistrust

- Totally egocentric
- Completely dependent on caregiver
- Shows regard for human faces
- Establish eye contact and smiles briefly
- Quiets, cuddles and molds when held
- Perceives self and parents as one

Intellectual and moral development:

- Cannot distinguish self from environment

- Repeat actions of own body (head to mouth movement)

Language and speech development:

- Responds to human voices

- Open and closes mouth as adult speaks
- Utters sounds of comfort when feeding
- Crying pattern developing

Play stimulation (visual, auditory, tactile and kinetic):

- Hold touch and rock infant gently

- Talk and sing softly to infant at close range. Provide pacifier for sucking pleasure
- Place large bright picture on crib or wall.

6 month:

Physical or biological development:

- Weight: 7.4, gains about 340 g a month

- Length: 65.5 cm, gains about 1.25 cm a month during second 6 months
- Head circumference: 43 cm, increases about 0.5 cm per month by second 6 month
- Pulse: 120
- Respiration: 32
- Blood pressure: 90/60
- Teething: two lower central incisors erupt
- Begins to bite and chew

Motor development:

Gross motor:
 - Sit, alone briefly
- Back is straight when sitting in high chair
- Springs up and down when sitting
- Lift chest and upper abdomen when prone
- Putting the weight on the arms
- Sustains most of his own weight when held in standing positions

Fine motor:

- Grasps with simultaneous flexion of fingers

- Begins to use fingers to feed self a cracker
- Retains transient hold on two objects, one in each hand

Sensory:

- Localize sounds made above the ear

- Retrieves a dropped object
- Enjoys more complex visual stimuli
- Moves in order to see an object

Psychosocial, psychosexual and spiritual development:

- Sense of trust: recognize parents and strangers. Begins to extend arms to be picked up.
- Intellectual and moral development

Language and speech development:

- Recognize familiar words

- Actively vocalize pleasure with cooing or crowing, cries easily, lallation or imperfect
imitation begins (6-9 months)

Play stimulation (visual, auditory, tactile and kinetic):

- Encourage him to look in mirror

- Repeat the names of parts of the face
- Make funny faces for infant to imitate
- Point out people, food, objects and repeat their names
- Talk to infant, repeat infants names
- Use the word ‘no’ when necessary
- Provide more complex cuddly toys
- Begin to place infant in walker

TODDLER (up to 3 years);

Toddlerhood ranges from the time when childhood begin to walk and run with ease, which is from
12-36 months. Toddlers are increasingly aware of their abilities to control and are pleased with
successful efforts with this new skill.

Physical changes:
The cardiopulmonary system becomes stable in this period. The heart rate and respiratory rate
slows to an average of 110 beats and 25 breaths per minute. The average blood pressure for a
toddler is 90/50 mmHg. The anterior fontanel closes between 12 to 18 months of age. The rate of
increase in weight and length slows. By 2 ½ years, the child weighs 4 times the birth weight, height
increase by approx. 3 inches a year. The average height of 2 year olds is 34 inches.

The rapid development of motor skills allow the child to participate in self-care activities such as
feeding, dressing and toileting. In the beginning toddler walks in an upright position with a broad-
stance and gait, soon the child begins to navigate stairs, using a rail or the wall to maintain balance
while progressing upward. Locomotion skills soon include running, jumping, standing on the foot
for several seconds and kicking a ball. Most toddlers can ride tricycles, climb ladders and run well
by their 3rd birthday. Fine motor skills move from scribbling spontaneously to drawing circles and
cross accurately. By 3 years the child draws simple stick people and can usually stack a tower of
small blocks. Increased locomotion skills, the ability to undress, and development of sphincter
control allow toilet training. At this stage, children usually show a willingness to please parents and
take pride of their accomplishments.

Cognitive changes:

Toddlers develop object permanence, ability to remember events and put thoughts into words at
about 2 years of age. They use symbols to represent objects, places and persons. Language- the 18
month old child uses approx. 10 words. The 24 month old child has a vocabulary of up to 300
words and in generally able to speak in two word sentences like “who’s that?” The moral
development of toddlers is only beginning and is also egocentric. Toddlers do not understand
concepts of right or wrong. However, they do grasp the fact that some behaviours bring pleasant
results (positive reinforcement) and others elicit unpleasant results (negative reinforcement).

Psychosocial changes:

A sense of autonomy emerges during toddlerhood. Children strive for independence by using their
developing muscles to do everything for themselves and become master of their bodily functions.
Firm consistent limits, patience and support allow toddlers to develop socially acceptable behaviour
and cope with frustration of learning self-control. Socially, toddlers remain strongly attached to
parents and fear of separating from them. In their presence, they feel safe and curiosity is evident in
their exploration of their environment. The child continues to engage in solitary play but also
begins to participate in parallel play.

Important developmental milestones at a glance up to 3 years:

 Social smile: 6-8 weeks

 Head holding: 3 months
 Sitting with support: 5-6 month
 Sitting without support: 7-8 months
 Reaches out to an object and hold it: 5-6 month
 Transfer objects from one hand to another: 6-7 month
 Holding small objects between index finger and thumb: 9 month
 Creeping: 10-11 month
 Standing with support: 9 month
  Standing without support: 10-12 month
 Walking without support: 13-15 month
 Feeding self with spoon: 12-15 month
 Running: 18 month
 Climbing upstairs: 20-24 month
 Says bisyllabus words (da-da, ba-ba): 8-9 month
 Says two word with meaning: 12 month
 Says ten words with meaning: 18 month
 Says simple sentence: 24 month
 Tells stories: 36 month
 Takes shoes and socks off: 15-18 month
 Put shoes and shocks on: 24 month
 Dresses self fully: 3-4 years
 Controls bladder and bladder at day time: 2 years
 Control bladder and bowel control at night time: 3 years
 Knows full name and sex: 3 years
 Rides bicycle: 3 years

PRESCHOOLER:
The preschool period refers to age between 3 and 5 years. Children refine the mastery of their
bodies and eagerly await the beginning of formal education. Physical development occurs at a
slower pace than cognitive and psychosocial development.

Physical changes:

Heart rate ranges from 60-100 beats and respiratory rate rages from 23-25 breaths/min. blood
pressure rises slightly to an average of 92/56 mmHg. Children gain about 5 pounds per year,
average weight at 3 years is 32 pounds. At 4 years is 37 pounds, and at 5 years is 41 pounds. Pre-
schoolers grow 2 ½ -3 inches per year, double their birth length around 4 years and stand an
average of 43 inches tall by their 5th birthday. Large and fine muscle coordination improves. Pre-
schoolers run well. Walk-up and down steps with ease. By 5 years, they can usually skip on
alternate feet, jump rope and begin to skate and swim. They learn to copy crosses and squares.
Triangles and diamonds are usually mastered between the age of 5 and 6 years.

Cognitive changes:

Pre-schoolers develop perceptual bound thinking, in which, children judge persons, objects and
events by their outward appearance or what seems to be. Thinking is hindered by their limited
attention and attending skills. Artificalism, the misconception that everything in the world has been
created by humanity. Another misconception is animism, the attribution of life to inanimate objects.
A third misconception is a type of reasoning called immanent justice, the notion that the world is
equipped with a built in code of law and order. The greatest fear of this age group appears to be that
of bodily harm and it can be seen in children’s fear of the dark, animals and medical personnel. Pre-
schoolers moral development expands to include a beginning understand of behaviours considered
socially right or wrong.
Language: pre-schoolers vocabularies continue to increase rapidly and by the age of 6 children have
more than 10,000 words that they can use to define familiar objects, identify colours and express
their desires and frustrations.

Psychosocial changes:

The word of pre-schoolers expands beyond the family into the neighbourhood where children and
adults. They have surplus of energy that permits them to plan and attempt many activities that may
be beyond their capabilities, such as pouring milk from a gallon into cereal bowl. Guilt arises
within children when children when they overstep the limits of their abilities and feel they have not
behaved correctly. The play becomes more social after the 3rd birthday as it shifts from parallel to
associative play. Most 3 year old children are able to play with one other child in a cooperative
manner. By the age 4, children plays in groups of two or three, and by 5 years, the group has a
temporary leader for each activity. In many play activities, pre-schoolers display awareness of
social context. Sex-role identification is strengthening and children most often assume roles of
persons of their own sex. Children frequently mimic or repeat social experiences.

Developmental tasks up to pre-schooler:

 Learning to walk: once the basic skills are mastered, he learns during later years to run,
jump and skip.
 Learning to take solid foods: the way the child is treated during the weaning period, the
schedule on which he is fed, and the age and suddenness of weaning, all have profound
effects upon his personality.
 Learning to talk: between the ages of twelve and eighteen months, the great moment of
speech arrives.
 Learning to control the elimination of body waste: to learn to urinate and defecate at
socially acceptable times and places. Toilet training is the first moral training that the child
receives. The stamp of this moral training probably persists in the child’s later character.
 Learning sex differences and sexual modesty: the kinds of sexual behaviour he learns and
the attitude and feelings he develops about sex in these early years probably have an abiding
effect upon his sexuality throughout his life.
 Achieving physiological stability: it takes as many as five years for the child’s body to settle
down to something like the physiological stability of the child.
 Forming simple concepts of social and physical reality: when a child’s nervous system is
ready, he must have the experience and the teachers to enable him to form a stock of
concepts and learn the names for them. On this basis, his later mental development is built.
 Learning to relate oneself emotionally to parents, siblings and other people: the way he
achieves this task f relating himself emotionally to other people will have a large part in
determining whether he will be friendly or cold, outgoing or introversive, in his social
relations in later life.
 Learning to distinguish right or wrong and developing a conscience: during the later years
of early childhood, he takes into himself the warning and punishing voices of his parents, in
ways that depend upon their peculiar displays of affection and punishment toward him.
Thus he develops the bases of his co science, upon which a later structure of values and
moral character will be built.
SCHOOL AGE CHILD (6-12 years):
This period ranges from 6 to 12 years of age or till puberty is attained. During these middle years of
childhood, the foundation of adult roles in work, recreation and social interaction is laid. During
these years, children become better at things, e.g. they can run faster.

Physical changes:

The rate of growth during these early school years is slower than any time since birth but continue
steadily. The school age child appears slimmer than the pre-schooler. The average increase in
height is 2 inches per year, and weight increases by 4-7 pounds per year. The average 12 year child
is 59 inches tall and weighs 88 pounds. Boys are slightly taller and heavier than girls during this
period. Approx. 2 years before puberty, children experience a rapid acceleration in skeletal growth.
The heart rate averages 70 to 90 beats/minute, respiratory rate 19 to 21 breaths/minute and blood
pressure normalize to 110/70 mmHg. Most children practice the basic gross motor skills of running,
jumping, balancing, throwing and catching during play, resulting in refinement of neuromuscular
function and skills. Most 6 year-old children can hold a pencil adeptly and print letters and words,
but by the age 12 years, the child can make detailed drawings and write sentences in script. The
improved fine motor capabilities of youngsters in middle childhood allow them to become very
independent in bathing, dressing and taking care of other personal needs.

Cognitive changes:

Cognitive changes provide the school age child with the ability to think in a logical manner about
here and now, and to understand the relationship between things and ideas. The thoughts of school
age children are no longer dominated by their perceptions. Around 7 years of age, children are able
to carry out operations (mental activities) in thought rather than in action. School age children now
have the ability to recognize that the amount or quantity of a substance remains the same even
when its shape or appearance changes. The young child can separate objects into groups according
to shape or colour, whereas the school age child understands that the same element can exist in two
classes at the same time. Children become thinker and less egocentric and capable of understanding
another’s view and feelings. They can solve the problems by their cognitive development.
Language growth is so rapid that it is no longer possible to match age with language achievements.
They can use different names for the same object or concept and they understand that a single word
may have many meanings.

Psychosocial changes:

Children strive to acquire competence and skills necessary for them to function as an adult.

Moral development-the need for a moral code and social rules becomes more evident as school age
children’s cognitive abilities and social experience increase. They view rules as necessary
principles of life.

Peer relationships:
Group and personal achievements become important to the school-age child. Play involves peers
and the pursuit of group goals. Learning contributes, collaborate and work cooperatively toward a
common goal becomes a measure of success. The school-age child prefers same sex peers to
opposite sex peers. During this time, clubs and peer groups become prominent. Group identify
increases as the school age child approaches adolescence.

Developmental tasks in school age:

 Learning physical skills necessary for ordinary games: to learn the physical skills that are
necessary for the games and physical activities that are highly valued in childhood-such
skills as throwing and catching, kicking, tumbling, swimming seat and handling simple
tools.
 Building wholesome attitudes toward oneself as a growing organism: to develop habits of
care of the body, of cleanliness and safety, consistent with a wholesome, realistic attitude
which includes a sense of physical normality and adequacy, the ability to enjoy using the
body, and a wholesome attitude toward sex. Sex education should be a matter of agreement
between school and parents, with the school doing what the parents feel they cannot do so
well. The facts about animal and human reproduction should be taught before puberty.
 Learning to get along with age-mates: to learn the give and take of social life among peers.
To learn to make friends and to get along with enemies. To develop a “social personality”.
 Learning an appropriate masculine or feminine social role: to learn to be a boy or a girl to
act the role that is expected and rewarded. The sex role is taught so vigorously by so many
agencies that the school probably has little more than a remedial function, which is to assist
boys and girls who are having difficulty with the task.
 Developing fundamental skills reading, writing and calculating; to learn to read, write and
calculate well enough to get along in society.
 Developing concepts necessary for everyday living: a concept is an idea which stands for a
large number of particular sense perceptions, or which stands for a number of ideas of lesser
degrees of abstraction. The task is to acquire a store of concepts sufficient for thinking
effectively about ordinary occupational, civic and social matters.
 Developing conscience, morality and scale of values: they develop an inner moral control,
respect for moral rules and the beginning of a rational scale of values takes place. Morality,
or respect for rules of behaviour, is imposed on the child first by the parents. Later,
according to Piaget, the child learns that rules are necessary and useful to the conduct of any
social enterprise, from games to government, and thus learns a “morality of cooperation or
agreement” which is a true moral autonomy and necessary in a modern democratic society.
 Achieving personal independence: this necessary to become an autonomous person, able to
make plan and to act in the present and immediate future independently of one’s parent’s
parents and other adults. The young child has become physically independent of his parents
but remains emotionally dependent on them.
 Developing attitudes toward social groups and institutions:
- By imitation of people with prestige in the eyes of the learner
- By collection and combination of pleasant or unpleasant experiences associated with a given
object or situation
- By a single deeply emotional experience, pleasant or unpleasant: associated with a given
object or situation.
ADOLESCENT (13-20 years):
Adolescence is the period of development during which the individual makes the transition from
childhood to adulthood, usually between 13-20 years.

Physical changes:

Physical changes occurs rapidly in this period. Sexual maturation occurs with the development of
primary and secondary sexual characteristics. Four main focus of the physical changes are:

 Increased growth rate of skeleton, muscle and viscera

 Sex specific changes, such as changes in shoulder and hip width
 Alteration in distribution of muscle and fat
 Development of the reproductive system and secondary sex characteristics.

Girls tend to begin their physical changes earlier than boys. The growth spurt for girls generally
begins between 8 and 14 years of age. Height increases 2-8 inches, and weight increases by 15-55
pounds. The male growth spurt usually takes place between 10 and 16 years of age. Height
increases approx. 4-12 inches, and weight increases by 15-65 pounds. The 20-25% of adult height
and 50% of adult weight is gained during this time period. Girls attain 90-95% of their adult height
by menarche and reach their height by 16-17 years of age, whereas boys continue to grow taller
until 18-20 years of age.

Cognitive changes:

Changes within mind and widening of social environment of the adolescent result in the highest
level of intellectual development, known as formal operations. The adolescents develops the ability
to determine possibilities, solves when problems occur and makes decisions through logical
operations. The teenager can think abstractly and deal effectively with hypothetical problems.
When confronted with a problem, the teenager can consider an infinite variety of causes and
solutions. By mid adolescence, there is an introspective quality emerging with regard to cognition.
At this time adolescents believe that they are unique and the exception, giving rise to their risk
taking behaviours. Language development is fairly complete by adolescence, although vocabulary
continues to expand.

Psychosocial changes:

The search for personal identity is the major task of adolescent psychosocial development.
Teenagers must established close peer relationships or remain socially isolated. Adolescent work at
becoming emotionally independent from their parents, while retaining parents ties. Choices about
vocation, future education and lifestyle must be made.

Sexual identity: achievement of sexual identity is enhanced by the physical changes of puberty.
Teenagers become interested in heterosexual relationships. The physical evidence of maturity
encourages the development of masculine and feminine behaviour.

Group identity: adolescents seek group identity because they need esteem and acceptance.
Popularity with opposite-sex and same sex peer is a major concern for teens.
Family identity: the movement toward stronger peer relationships is contrasted with adolescent’s
movements away from parents.

Moral identity: the development of moral judgement depends heavily on cognitive and
communication skills and peer interaction. Adolescents learn to understand that rules are
cooperative agreements that can be modified to fit the situation, rather than absolutes. Regarding
rules, adolescents learn to use their own judgement rather than use the rules to avoid punishment.

Health identity: another component of personal identity is perception of health. Healthy adolescents
evaluate their own health according to feelings of well-being, ability to function normally and
absence of symptoms.

Developmental tasks in adolescent:

 Achieving new and more mature relations with age mates of both sexes
 Achieving a masculine or feminine social role
 Accepting one’s physique and using the body effectively
 Achieving emotional independence of parents and other adults
 Achieving assurance of economic independence
 Selecting and preparing for an occupation
 Preparing for marriage and family life
 Developing intellectual skills and concepts necessary for civic competence
 Desiring and achieving socially responsible behaviour
 Acquiring a set of values and an ethical system as a guide behaviour

YOUNG ADULT:
Young adulthood is the period between the late teens and the mid to late 30s.

Physical changes:

The young adult has usually completed physical growth by the age of 20 years. Young adults are
usually quite active, experience severe illnesses less commonly than older age groups, tend to
ignore physical symptoms and often postpone seeking healthcare.

Cognitive changes:

Critical thinking habits increase steadily through young and middle adult years. Formal and
informal educational experiences, general life experiences and occupational opportunities
dramatically increase the individual’s conceptual, problem-solving and motor skills. Identifying
preferred occupational areas is a major task of young adults. Because young adults are continually
evolving and adjusting to changes in the home, workplace and personal lives, their decision making
processes are flexible.

Psychosocial changes:

The emotional health of young adult is related to the individual’s ability to address and resolve
personal and social tasks. The young adult is usually caught between wanting to prolong the
irresponsibility of adolescence and wanting to assume adult commitments. Alterations are made in
personal, social and occupational lives. During the young adult years, people generally give more
attention to occupational and social pursuits. During this period individuals attempt to improve their
socioeconomic status. They start preparing for marriage and to have their own family. The young
adult usually has emotional maturity to complement the physical ability and is therefore able to
develop mature sexual relationships and establish intimacy.

Developmental tasks in young adulthood:

 selecting a mate: until it is accomplished, the task of finding a marriage partner as at once
the most interesting and the most disturbing of the tasks of the early adulthood.
 Learning to live with a marriage partner: after the wedding, there comes a period of
learning how to fit two lives together. Mainly, this consists of learning to express and
control one’s feeling-anger, joy and disgust, love-so that one can live intimately and happily
with one’s spouse.
 Starting a family: to have a first chid successfully.
 Rearing children: with the gaining of children, the young children take over the
responsibility far greater than any responsibility they had ever had before. Now they are
responsible for human life that is not their own. To meet this responsibility, they must learn
to meet the physical and emotional needs of the young children. This means learning how to
manage the child and needs of growing children.
 Managing a home: family life is built around a physical center, the home and depends for its
success greatly upon how well managed this home is. Good home management is only
partly a matter of keeping the house clean, the furniture and plumbing and lighting fixtures
in repair, having meals well cooked, and the like.
 Getting started in an occupation: this task takes an enormous amount of the young man’s
time and energy during young adulthood. Often he becomes so engrossed in this particular
task that he neglects others. He may put off finding a wife altogether too long for his own
happiness.
 Taking on civic responsibility: to assume responsibility for the welfare of a group outside
of the family-a neighbourhood or community group or church or lodge or political
organization.
 Finding a congenial social group: marriage often involves the breaking of social ties for one
or both young people, and the forming of new friendships. Either the man or the women is
apt to move away from former friends. In any case, whether old friendships are interrupted
by distance or not, the young couple faces something of a new task in forming a leisure time
pattern and finding others to share it with. The young man loses interest in some of his
former bachelor activities, and his wife drops out of some of her purely feminine
associations.

MIDDLE ADULT:
Middle adulthood occurs between the mid to late 30s and mid-60s. In this period, the individual
makes lasting contributions through involvement with others.

Physical changes:
Major physiological changes occur between 40 and 65 years of age. The most visible changes are
greying of hair, wrinkling of the skin, and thickening of waist. Decrease in hearing and visual
acuity are often noted during this period. Often these physiological changes have an impact on self-
concept and body image. The most significant physiological changes during middle age are
menopause in women and climacteric in men.

Menopause: menstruation and ovulation occur in acyclic rhythm in women and menopause is the
disruption of this cycle, primarily because of the inability of the neuro hormonal system to maintain
its periodic stimulation of the endocrine system. The ovaries no longer produce oestrogen and
progesterone and blood levels of these hormones drop markedly. Menopause typically occurs
between 45 and 60 years of age.

Climacteric: it occurs in men in their late 40s or early 50s. It is caused by decreased levels of
androgens. Throughout this period and thereafter, a man is still capable of producing fertile sperm
and fathering a child.

Cognitive changes:

Changes in cognitive function of middle adults are rare except with illness or trauma. The middle
adult can learn new skills and information.

Psychosocial changes:

The psychosocial changes in the middle adult may involve expected events, such as children
moving away home, or unexpected events, such as marital separation or death of close one. Many
middle adults may find themselves in the “sandwich generation”, having responsibility of raising
their own children while caring for aging parents. These changes can result in stress that can affect
the middle adults overall level of health.

Developmental tasks in middle adulthood:

In the middle years, from about thirty to about fifty-five, men and women reach the peak of their
influence upon society, and at the same time, the society makes its maximum demands upon them
for social and civic responsibility. It is the period of life to which they have looked forward during
their adolescence and early adulthood. And the time passes so quickly during these full and active
middle years that most people arrive at the end of middle age and the beginning of later maturity
with surprise and a sense of having finished the journey while they were still preparing to
commence it.

The developmental tasks of the middle years arise from changes within the organism, from
environment pressure and above all from demands or obligations laid upon the individual by his
own values and aspirations.

- Achieving adult civic and social responsibility

- Establishing and maintain and economic standard of living
- Assisting teenage children to become responsible and happy adults
- Developing adult leisure-time activities
- Relating oneself to one’s spouse as a person
- Accepting and adjusting to the physiological changes of middle age
 - Adjusting to aging parents.

OLDER ADULT:
The age of 65 years is identified as the start of older adulthood.

Physical changes:

Older adult’s concepts of health generally depend upon personal perceptions of functional ability.
Therefore older adults engaged in activities of daily living usually consider themselves as healthy,
whereas those whose activities are limited by physical, emotional or social impairments may
perceive themselves as ill. There are frequently observed physiological changes in older adults that
are called normal.

Cognitive changes:

A common misconception about aging is that cognitive impairments are widespread among older
adults. Because of this misconception, older adult’s fear that they are, or soon will be, cognitively
impaired. Younger adults often assume that older adult are confused and no longer be able to
control their affairs. Symptoms of cognitive impairment such as disorientation, loss of language
skills, loss of ability to calculate and poor judgement are not normal aging changes. The three
common conditions affecting cognition are delirium, dementia and depression.

Psychosocial changes:

The psychosocial changes that occur with aging involve changes in roles and relationships. Roles
and relationships within the family change as parents become grandparents, adult children become
care givers for aging parents or spouse become widows or widowers. Group membership roles and
relationships changes as the older adult retires from work, moves from familiar neighbourhood or
sops attending social activities because of declining health status.

Developmental tasks in older adulthood:

- Adjusting to decreasing physical strength and health

- Adjusting to retirement and reduced income
- Adjusting to death of spouse
- Establishing an explicit affiliation with one’s age group
- Meeting social and civic obligations
- Establishing satisfactory physical living arrangements: the principal values that older people
look for in housing according to studies of this matter, are:
o Quiet
o Privacy
o Independence of action
o Nearness to relatives and friends
o Residence among own cultural group
o Cheapness
 o Closeness to transportation lines and communal institutions: libraries, shops,
movies, churches, etc.

THEORIES OF GROWTH AND DEVELOPMENT:

Erickson: Psychosocial developmental theory:

Erikson’s theory of human development focuses on the psychological and environmental aspects of
personality as the person progresses from birth to death. Erickson stresses that each individual is the
product of interactions between heredity, environment and culture. He emphasize that the rate of
development varies.

In his theory of human development, Erick.H. Erickson indicates that major personality changes
occur throughout each individual’s life cycle. Passage from one stage to another stage depends on
the successful acquisition of skills gained in the preceding stage. However, Erickson differs from
many other theorists in his suggestion that new experiences may provide opportunities to cope with
deficits in earlier stages.

Theory of psychosocial development has different stages, each with two possible outcomes.
According to the theory, successful completion of each stage results in a healthy personality and
successful interactions with others. Failure to successfully complete a stage can result in a reduced
ability to complete further stages and therefore, a more unhealthy personality and sense of self.

The main points of Erickson’s theory are:

1. Each stage of development contains a psychological challenge or critical period, during

which the person must deal with a major life change. If the person fails to meet the
challenge, ho or she faces certain difficulty in achieving the next level of development. For
example, infants, who do not achieve a sense of trust that their needs will be met will have
difficulty in achieving autonomy as toddlers.
2. In each stage of development, a significant person or group exerts a lasting influence on the
ongoing development of the child. For example, the person who acts as family caregiver is
most significant to the infant whereas the peer group has greater influence on the
adolescent.
3. Similar to Havighurst’s theory, the individual must accomplish certain tasks related to the
psychological challenge of each particular stage. Children are able to perform these tasks
with the help from parents, siblings and other important people.
4. Certain virtues are appropriate for each developmental stage. Virtues are beneficial,
challenging and exciting characteristics that emerge as individuals successfully accomplish
the tasks of that developmental stage and thus successfully resolve the psychological
challenge.

The stages are:

Trust versus mistrust: this stage occurs from birth to age 1 year. The child develops trust as the
primary caregiver meets his needs. If his needs are not met or are met unpredictably, he will
develop a sense of mistrust.
Autonomy versus shame and doubt: this stage occurs between ages 1 and 3 year. The child learns
control of his body functions and becomes increasingly independent, preferring to do things
himself. He learns autonomy, largely by imitating others. If he is not allowed independence or is
belittled for his efforts, he will develop a sense of shame and self-doubt.

Initiative versus guilt: the child enters this stage between ages 3 and 6 years. He learns about the
world through play. He develops a conscience and learns to balance his sense of initiative against
the wishes of his parents.

Industry versus inferiority: between ages 6 and 12, the child enjoys projects and working with
others and tends to follow rules. During stages competition with others s keen, and forming social
relationships takes on great importance. The child may have feeling of inferiority if unrealistic
expectations (or what he perceives as unrealistic expectations) are placed upon him, however if he
develops a sense of industry, he will feel competent to meet life’s expectations.

Industry versus role confusion: between ages 12 and 18, the adolescent experiences rapid changes
in his body. He’s preoccupied with how he looks and how others view him. While trying to meet
the expectations of his peers, he’s also trying to establish his own identity. If he’s unsuccessful in
accomplishing these tasks, he will suffer role confusion.

Sigmund Freud’s psychosexual theory:

According to Freud, all human beings pass through a series of five psychosexual stages. If these
psychosexual stages are completed successfully, the result is a healthy personality. If certain issues
are not resolved at the appropriate stage, fixation can occur. A fixation is a persistent focus on an
earlier psychosexual stage. Until this conflict is resolved, the individual will remain “stuck” in this
stage. For example, a person who is fixated at the oral stage may be over-dependent on others and
may seek oral stimulation through smoking, drinking or eating. These psychosexual stages are:

Age Name Pleasure source Conflict

Birth to 1 year-old Oral Mouth: sucking, Weaning away from
biting, swallowing mother’s breast
1-3 years old Anal Anus: defecating or Toilet training
retaining faeces
3-6 years old Phallic Genitals Oedipus (boys),
Electra (girls)
6-12 years or puberty Latency Sexual urges Self-confidence
sublimated into sports
and hobbies. Same sex
friends also help to
avoid sexual feelings.
Puberty onwards Genital Physical sexual Social roles
changes reawaken,
repressed needs, direct
sexual feelings
towards others leads to
sexual gratification.
Jean Piaget’s theory of cognitive development:
Piaget’s stage theory describe the cognitive development of children. Cognitive development
involves changes in cognitive process and abilities. In Piaget’s view’s, early cognitive development
involves processes based upon actions and later progresses into changes in mental operations.

Stages of cognitive development:

Age Stage Characterized by

Birth-2 Sensorimotor - Differentiates self from objects
years - Recognize self as agent of action and begins to act
intentionally, e.g. pulls a string to set mobile in motion
or shakes a rattle to make noise
- Achieves object permanence: realizes that things
continue to exist even when no longer present to the
sense
2-7 years Preoperational - Learns to use language and to represent objects by
stage images and words
- Thinking is still egocentric, has difficulty taking the
viewpoints of others
- Classifies objects by a single feature: for example
groups together all the red blocks regardless of shape or
all square blocks regardless of colour.
7-11 years Concrete - Can think logically about objects and events
operational - Achieve conservation of numbers (age 6 years), mass
(age 7 years), weight (age 9 years).
- Classifies objects according to several features and can
order them in series along a single dimension such as
size
11 years Formal operational - Can think logically about abstract propositions and test
and up hypothesis systematically
- Becomes concerned with hypothetical, the future and
ideological problems.

Theory of moral development (Kohlberg’s theory):

Kohlberg’s (1968) stages of moral development are not closely tied to specific age groups.
Research was conducted with males ranging age from 10-28 years. Kohlberg believed that each
stage is necessary and basic to the next stage and that all individual must progress through each
stage sequentially. He defined three major levels of moral development, each of which is further
subdivided into two stages each. Most people do not progress through all six stages.

Level 1: Preconventional level (prominent from ages 4-10 years):

Stage 1: punishment and obedience orientation

At the punishment and obedience orientation stage, the individual is responsive to cultural
guidelines of good or bad and right or wrong, but primarily in terms of the known related
consequences. Fear of punishment is likely to be the incentive for conformity (e.g. “I will do it,
because if I do not, I cannot watch TV for a week”.)
Stage 2: Instrumental relativist orientation

Behaviour at the instrumental relativist orientation stage is guided by egocentrism and concern for
self. There is an intense urge to satisfy one’s own needs, but occasionally the needs of the other are
considered. For the most part, decisions are based on personal benefits derived (e.g. “I will do it if I
get something in return, or occasionally”, “….because you asked me to”)

Level 2: Conventional level (prominent from ages 10-13 years and into adulthood):

Stage 3: interpersonal concordance orientation:

Behaviour at the interpersonal concordance orientation stage is guided by the expectations of other.
Approval and acceptance within one’s societal group provide the incentive to conform (e.g. “I will
do it because you asked me to,” “because it will help you,” “because it will please you”)

Stage 4: law and order orientation:

In this stage, there is a personal respect for authority. Rules and laws are required and override
personal principles and group mores. The belief is that all individual and groups are subject to same
code of order, and no one shall be exempt, e.g. “I will do it because it is the law.”

Level 3: Post-conventional level (can occur from adolescent onwards):

Stage 5: social contract legalistic orientation:

Individuals who reach stage 5 have developed a system of values and principles that determine for
them what is right or wrong, behaviours are acceptably guided by this value system, provided they
do not violate the human rights of others. They believe that all individual are entitled to certain
inherent human rights, and they live according to universal laws and principles. However, they hold
the idea that the laws are subject to scrutiny and change as needs within society evolve and change
(e.g. I will do it because it is the moral and legal thing to do, even though it is not my personal
choice.)

Stage 6: universal ethical principle orientation:

Behaviour at stage 6 is directed by internalized principles of honour, justice, and respect for human
dignity. Laws are abstract and written, such as the “Golden rule”, “equality of human rights”, and
“justice for all”. They are not the concrete rules established by society. The conscience is the guide,
and when one fails to meet the self-expected behaviours, the personal consequences is intense guilt.
The allegiance to these ethical principles is so strong that the individual will stand by them even
knowing that negative consequences will result. (e.g. “I will do it because I believe it is right thing
to do even though it is illegal and I will be imprisoned for doing it”). Kohlberg’s final level of
moral reasoning is based upon universal ethical principles and abstract reasoning. At this stage.
People follow these internalized principles of justice, even if they conflict with laws and rules.
Theory of spiritual development:

Fowler’s theory concerning the development of faith:

Fowlers (1974) developed a staged theory of faith, which parallels the formal developmental
process proposed by Piaget and Kohlberg, although differing in emphasis on emotion and feeling.

According to Fowlers, faith is human universal that is expressed through beliefs, rituals and
symbols specific to religious traditions. It is multidimensional and a way of learning about life.

Persons may acquire their religious beliefs and preferences in childhood and may deepen those
convictions as their beliefs develop or they may change religious beliefs in adulthood.

Stage 1: Primal faith (infancy):

- This stage embodies the trust between parents and infants

- Parents and child from a mutual attachments and progress through a period of give and take.

Stage 2: Intuitive-Projective faith (early childhood):

- Most typical from ages 3 to 7 years. This stage is characterized by the forming long lasting
images and feelings.
- The cultural beliefs of the family influences the child’s concepts of health and sex.

Stage 3: Mythic-Literal faith (childhood and beyond):

- Beginning at about age 7 years, children’s beliefs from the perspective of others.
- In addition, they are able to stories, practiced and beliefs at the family and the community,
the child reaches stage 3 of faith development.

Stage 4: Synthetic-conventional faith (Adolescence period and beyond):

- In this stage, a person’s experience extends beyond the family to peers, teachers and other
members of the society.
- As a result of cognitive abilities, the individual is aware of the emotions, personality pattern,
ideas, thoughts and experiences of self and others that is “mutual interpersonal perspective-
taking”.
- As a result, the individual has a cluster of values and beliefs in concern with others.

Comparison of stage theories of human development:

Age period Freud Erickson Sullivan Piaget Kohlberg
Infancy Oral Trust/mistrust Infant Sensorimotor Preconvention
(birth-1 year) (birth-2 year) (birth-7 year)
Toddler (1-3 Anal Trust/mistrust Infant Sensorimotor Preconvention
years)
Preschool (3- Phallic Initiative/guilt Early Preoperational Preconvention
6 years) childhood
School age Latency Industry/inferiority Late Concrete Conventional
(6-12 years) childhood operations
Adolescence Genital Identity/role Early Formal Post
(12-19 years) confusion adolescence operations conventional

Bibliography:

- Shebeer P. Basheer & S. Yassen Khan, A concise text book of advanced nursing practice,
edition 1st, published by.EMMESS medical publishers, page no.194-197, 570-620.
- I Clement, basic concepts of community health nursing, published by JAYPEE brother’s
medical publishers, edition 2nd, page no. 430-483.
- Navdeep kaur Brar & HC Rawat, textbook of Advanced Nursing Practice, published by
Jaypee the health science publisher, edition 1st, page no. 763-817.