THE DEVELOPMENTAL

STAGES OF THE LEARNER

LEARNING OUTCOME
• Identify the physical, cognitive, and psychosocial characteristics of
learners that influence learning at various stages of growth and
development
• Discuss the appropriate teaching strategies effective for learners at
different developmental stages
Three Different Orientations to learning :

• Pedagogy - is the art and

science of helping children to
learn
• Andragogy -the term used by
Knowles (1990) to describe his
theory of adult learning; the
art and science of teaching
adults
• Geragogy -art and science of
teaching older persons
THREE MAJOR STAGE RANGE FACTORS
ASSOCIATED WITH LEARNER READINESS

üPHYSICAL
üCOGNITIVE
ü PSYCHOSOCIAL MATURATION
Three Important Contextual Influences Act on and
Interact with the individual to produce
development
• Normative Age- graded
influences that are strongly
related to chronological age
and are similar for individuals
in a specific age group
• Normative History - graded
influences that are common to
people in a certain age cohort or
generation because they have
been exposed to similar
historical circumstances
• Normative life events - are the
unusual or unique circumstances
positive or negative that are
turning points in individual’s
lives that causes them to
change directions
INFANCY (0-12 MONTHS OLD )AND
TODDLERHOOD ( 1-2 YEARS OF AGE )
• The field of growth and
development is highly complex
• focus of instruction for health is
geared towards the parents
COGNITIVE DEVELOPMENT IN CHILDREN( Jean
Piaget)
• (Infancy and Toddlerhood)
Sensorimotor Period - this
period refers to the
coordination and integration of
motor activities with sensory
perception

• at the end of the 2nd year of

life “ object permanence
develops “
• motor activities promotes
understanding of the world and
an awareness of themselves as
well as others reactions in
response to their own actions
(Note: Parenst are encourage to
create a safe environment to
decrease risk for injury )
• toddler has basic reasoning ,
understands object permanence ,
has the beginning of memory ,
and begins to develop an
elementary concept of causality
• limited ability to recall past
happening or anticipate future
events
• oriented with the “ here and
now” and little tolerance to
delayed gratification
• short attention span
• easily distracted
• not amenable to corrections of their own
ideas
• asking question is the hallmark of this age
group
• curiosity abounds as they explore places
and things
• can respond to simple step by step
commands and obey directives
• language skill is rapidly acquired
• engage in fantasizing and make
believe play
• limited capacity to understand
cause and effect
• separation anxiety , feel insecure
when in an unfamiliar
environment
PSYCHOSOCIAL DEVELOPMENT IN CHILDREN (Erik
Erickson )
• Infancy- TRUST VS MISTRUST
• Toddlerhood- AUTONOMY VS SHAME
AND DOUBT
• their newly discovered independence
often is expressed by demonstration
of negativism
• they may express their their level of
frustration and feelings of
ambivalence by temper tantrums
• play is a parallel activity
TEACHING STRATEGIES
• Patient education for infancy and toddlerhood need not be illness
related
• less time is devoted in teaching parents about illness
• more time is spent in teaching aspects of normal development,
safety, health promotions , and disease prevention
• assessing the child's anxiety level is the first priority for teaching
intervention when a child is becomes ill or injured
• toddlers are capable of some degree of
understanding procedures and
interventions
• parents should be present whenever
possible during formal and informal
teaching and learning activities
• health teaching should take place in an
environment familiar to the child ( home
and daycare centers )
• developing rapport with children
through simple teaching helps to elicit
their cooperation and involvement
• approach should be WARM, HONEST,
CALM, ACCEPTING , AND MATTER OF
FACT
• warm tone of voice, a gesture of
encouragement , or a word of praise
goes a long way in attracting childen's
attention
STRATEGIES FOR SHORT TERM LEARNING
• read simple stories from books with lots
of pictures
• use dolls and puppets to act out feelings
and behaviors
• use simple audiotapes with music and
videotapes with caryrtoon characters
• role play to bring the child's imagination
closer to reality
• give simple, non threatening ,concrete,
explanations to accompany visual and
tactile experiences
• perform procedures on a teddy bear or doll
first to help the child anticipate what an
experience will be like
• keep teaching sessions brief ( no longer
than about 5 minutes )
• cluster teaching sessions close together
• explain things in straight forward and
simple terms because children take take
their world literally and concretely
• Individualize the pace of teaching according
to the child's response and level of
attention
STRATEGIES FOR LONG TERM LEARNING
• focus on rituals, imitation , and
repetition of information in the
form of words nd actions to hold
the child's attention
• Use reinforcement as
opportunity for children to
achieve permanence of learning
through practice
• employ the teaching methods
of gaming and modellling as a
means by which children can
learn about the world and test
their ideas over time
• parent's act as role models
because their values and beliefs
serve to reinforce a healthy
behavior
EARLY CHILDHOOD ( 3-5 YEARS OLD ) 3-5 years old COGNITIVE
STAGE -Preoperational PSYCHOSOCIAL INITIATIVE VS. GUILT
• uses symbols to represent
something
• recalls past experiences,
anticipates future events
• can classify objects, vaque
understanding of their
relationships
• still egocentric
• thinking remain literal and
concrete
• PRECAUSAL THINKING -to describe the way in which preoperational
children use their own existing ideas or views, to explain cause-and-
effect relationships.
people can make things happen but unaware of causation as a result
of invisible physical and mechanical forces
ANIMISTIC THINKING -tendency to endow inaminate objects with
life and consciousness
Artificialism- refers to the belief that environmental characteristics can
be attributed to human actions or interventions.
Transductive reasoning- child fails to understand the true relationships
between cause and effect.[
• very curious ( focuses on whys?
unconcerned with how?)
• fantasy and reality are not well
differentiated
• limited sense of time but
understands the timing of
familiar events
• sexual identity
• fear of body mutilation and pain
• egocentric causation - belief that illness is cause by their own
transgressions
• takes task for the sake of being involved and on the move
• excess of energy and the desire to dominate may lead to frustration
• interact with playmates
• role play is typical of this stage
TEACHING STRATEGIES
• Allow tho express their fears
openly
• choose words carefully in
describing a procedure
FOR SHORT TERM LEARNING

üProvide physical and visual

stimuli
üteaching sessions no more than
15 minutes , schedule must be
sequential at close intervals
ürelate information needs to
activities
üencourage to participate in
selecting between a limited
number of teaching -learning
options
FOR SHORT TERM LEARNING

üarrange small group sessions

ügive praise and approval
ügive tangible rewards
üallow to manipulate equipment
üuse story books to emphasize humanity of health care personnel
LONG TERM LEARNING
üenlist a help of parents who can play a vital role in modelling a
variety of healthy habits
üreinforce positive health behaviors and the acquisition of specific
skills
Middle and late childhood Approximate age 6-11
years of age
COGNITIVE STAGE: CONCRETE OPERATIONS
PSYCHOSOCIAL STAGE: INDUSTRY VS. INFERIORITY
• learning is approach with
enthusiastic anticipation
• logical, rational, reason
inductively and deductively
• can think more objectively .
listent to others
• use questioning selectively
• syllogistic reasoning - can consider 2
premises and draw a logical conclusion
from them
• understand cause and effect in a concrete
way
• clings on to cherished beliefs
• can concentrate on extended periods , can
tolerate delayed gratification
• understand time , oriented to past and
present , have some grasp and interest in
the future
• causal thinking - can incorporate the idea
that illness is related to cause and effect
• gain awareness on their unique talents
and special qualities
• school environment facilitates their
development of a sense of responsibility
an reliability
• fears- failure of being left out of groups ,
illness and disability
TEACHING STRATEGIES
• Hands on experience
• explain illness , treatment plans , procedures in simple , logical terms
• teaching must be presented in concrete terms with step by step
instruction
FOR SHORT TERM LEARNING
• Allow to take responsibility for their own health care
• Teaching sessions can be extended to last up to 30 minutes
• use diagrams, models, pictures , digital media, printed materials ,
computer, tablet as adjuncts to various teaching methods
• Use analogies as an effective means of providing information
• use one to one teaching sessions
• provide time for clarification , validation , reinorcement
• employ group teaching sessions with others of similar age
• provide much needed nurturance and support
FOR LONG TERM LEARNING
• Help school-aged children acquire skills
that they can use to assume self care
responsibility for carrying out therapeutic
treatment
• Assist them in learning to maintain their
own well being and prevent illness from
occuring
ADOLESCENCE Approximate age 12-19 years of age
COGNITIVE STAGE
Formal Operations
PSYCHOSOCIAL STAGE
IDENTITY VS. ROLE CONFUSION
• marks the transition from childhood to
adulthood
• propositional reasoning -ability to reason
is both deductive and inductive , can
hypothesize and can apply the principle
of logic to situations never encountered
• egocentrism - obsessed of what they
think as well as what others are thinking
• imaginary audience- explains their
pervasive self consciousness
• personal fable - belief that they are
invulnerable
• indulge in comparing their self image with
an ideal image
• demand personal space, control, privacy ,
and confidentiality
TEACHING STRATEGIES
• Provide privacy , understanding , honest , and straightforward
approach , and unqualified acceptance in the face of their fears of
embarrassment , losing independence , identity , and self control
FOR SHORT TERM LEARNING
• Use one to one instruction to ensure confidentiality of sensitive
information
• Choose peer group discussion sessions
• share decision making whenever possible
• Give rationale for all that is asaid and done
• Approach them with respect, tact,openness, and flexibility
• expect negative response , which are common when their self image
and self integrity are threatened
• Avoid confrontation acting like an authority
FOR LONG TERM LEARNING

• accept adolescent’s personal fable and imaginary audience as valid,

rather than challenging their feelings of uniqueness and invincility
• allow them to test their own convictions
YOUNG ADULTHOOD Approximate age 20-40
years old COGNITIVE STAGE
Formal Operations
PSYCHOSOCIAL STAGE Intimacy Vs. Isolation
• physical abilities for most young adults are
at their peak, and the body is at its
optimal functioning
• cognitive capacity is fully developed , can
continue to accumulate new knowledge
and skills from an expanding reservoir of
formal and informal experiences
• individuals work to establish trusting ,
satisfying, and permanent relationships
with others
TEACHING STRATEGIES
• Allow them the opportunity for mutual collaboration in health
decision making
• Encourage to select what to learn and how they want materials to be
presented and which indicators to used to determine achievement
• do well with written patient education materials , audiovisuals and
CAI’s to self pace their learning independently
MIDDLE AGED ADULTHOOD
Appropriate age 41-64 years age
COGNITIVE STAGE Formal Operations
PSYCHOSOCIAL STAGE Generativity Vs. Self Absorption and
Stagnation
• midlife is the transition period
between yound adulthood and
older adulthood
• adults realize that half of of their
potential life has been spent ,
questions their level of
achievement and success
• physiological changes begin (skin and
muscle tone decreases, metabolism slows
down, body wt increases , endurance and
energy levels lessen, hormonal changes
bring variety of symptoms , hearing and
visual acuity starts to diminish )
• dialectical thinking -ability to search for
complex and changing understanding to
find variety of solutions to any given
situation or problem
TEACHING STRATEGIES
• Focus on maintaining independence and reestablishing normal life
patterns
• Assess positive and negative past experiences with learning
• Assess potential sources of stress caused by midlife crisis issues
• Provide information to coincide with life concerns and problems
OLDER ADULTHOOD Approximate age 65 year and
above
COGNITIVE STAGE: Formal Operations
PSYCHOSOCIAL STAGE: Ego integrity Vs. Despair
COGNITIVE CHANGES :
• Decreased ability to think abstractly ,
process information
• Decreased short term memory
• Increase reaction time
• Increased test anxiety
• Stimulus persistence ( afterimage)
• Focuses on life experiences
TWO KINDS OF INTELLECTUAL ABILITY
• CRYSTALLIZED INTELLIGENCE -intelligence
absorbed over a lifetime ( ex. vocabulary ,
general information, arithmetic,etc)
increases as the person age, can be
impaired by dse. state

• FLUID INTELLIGENCE - capacity to

perceived relationships, to reason, and to
perform absract thinking , declines as
degenerative changes occur
SENSORY /MOTOR DEFICITS :
• Auditory changes
• Hearing loss specially high pitched tones, consonants( S,Z,T,F, and G) and rapid
speech
• Visual changes
• Farsighted
• Lenses becomes opaque (glare problem )
• Smaller pupil size ( decreased visual adaptation to darkness )
• Decreased peripheral perception
• Yellowing of lense ( distorts low tone colors blue,green, violet )
• Distorted depth perception
• Fatique/ decreased energy levels
• Pathophysiology ( CHRONIC ILLNES)
• PSYCHOSOCIAL CHANGES
• Decreased risk taking
• Selective learning
• Intimidated by formal learning
COGNITIVE CHANGES :
• Use concrete examples
• Build on past life experiences
• Make information relevant and meaningful
• Present one concept at at time
• Allow time for processing /response (slow pace )
• Use repetition and reinforcement of information
• Avoid written exams
• Used verbal exchange and coaching
• Establish retrieval plan ( use one or several clues )
• Encourage active involvement
• Keep explanation brief
• Use analogies to illustrate abstract information
SENSORY /MOTOR DEFICITS :

• Speak slowly, distinctly

• Used low pitched tones
• Avoid shouting
• Use visual aid to supplement verbal instruction
• Avoid glares used soft white light
• Provide sufficient light
• Use white back grounds and black print
• Used large letters and well spaced print Avoid color coding with
pastel blues, greens, purples , and yellows
• Increase safety precautions/ provide a safe environment
• Ensure accessibility and fit of prostheses) ex glasses, hearing aid
• Keep session short
• Provide for frequent rest periods
• Allow extra time to perform
• Establish realistic short term goals
• PSYCHOSOCIAL CHANGES:
• Give time to reminisce
• Identify and present pertinent material
• Use informal teaching sessions
• Demonstrate relevance of information to daily life
• Assess resources
• Make learning positive
• Identify past positive experiences