Care of Mother, Child, Adolescents and Well ● Sometimes they skip a stage,

Client (LEC) occasionally child will progress in a

Pedia different order
Growth and Development
3. Different children pass through the
Growth predictable stages at different rates.
● used to denote an increase in physical All stages of development have a
size or a quantitative change range of time
● Example a. Example: 2 children may pass
○ Height through the motor sequence at
■ cm/in different rates
○ Weight i. boy 1 walk at 9 months
■ kg/lbs both develop normally
= follow
Development ii. boy 2 walk at 14
● is used to indicate an increase in skill or months predictable
the ability to function a qualitative sequence merely at
change. different rates
● Developmental Milestones
○ major marker of normal 4. All body systems do not develop at the
development same rate
● Developmental Task a. Examples
○ a skill or growth responsibility i. Neurologic tissue
arising at a particular time experiences its peak
● Example growth during the first
○ Ability to run, talk, walk year
● Synonyms ii. Genital tissue grows
○ Maturation/Differentiation little until puberty

Principles of Growth and Development 5. Development is Cephalocaudal

1. Growth & Development are a. Cephalo
continuous process from conception i. Head
until death b. Caudal
2. Growth & development proceed an i. Tail
orderly sequence ● Example:
● Growth ○ Newborn can lift head off the
● proceeds from smaller bed when lying in a prone
to larger position
● Development proceeds at a ○ 2 months can lift head & chest
predictable order off the bed
● Example ○ 4 months can lift head & chest
○ Sit – Creep – & part of the abdomen
Stand – Walk – ○ 5 months has enough control to
Run turn over
 ○ 9 months can control 8. There is an optimum time for
extremities to crawl initiation of experiences of learning. A
○ 1 year Child can stand up child cannot learn tasks until the
● Motor development has proceeded in a nervous system is mature enough to
cephalocaudal order allow particular learning.
a. Example
6. Development proceeds from proximal i. Child cannot learn to sit
to distal body parts no matter how much
a. Example you teach him, until
i. Upper extremities he/she achieves back
ii. Newborn control
1. makes little use ii. If the child is not given
of hands and an opportunity for
arms learning he/she will
iii. 3-4 months have difficulty for
1. has enough arm learning
control to
support the 9. Neonatal reflexes must be lost before
upper body development can proceed. It is
weight on replaced by purposeful
forearms can a. Example
coordinate i. Cannot learn to grasp
hands to scoop with skill until grasp
objects reflex lost
iv. 10 months ii. Cannot learn to walk
1. can coordinate until pacing reflex is
the arm and lost
thumb and
index finger to 10. A great deal of skill and behavior is
use a pincer learned by practice.
grasp a. Example
i. Infant practice over &
7. Development proceeds from gross to over taking a first step
refined skills before they accomplish
a. Example securely.
i. child able to control
distal body parts such as Factors Influencing Growth and Development
fingers, can perform 1. Genetic influences
motor skills a. Physical characteristics
ii. 3y colors with large i. e.g. eye color, height
crayons b. Gender related characteristics
iii. 12y write with fine pen i. female born lighter
male only up to puberty
 ii.female shorter than mainly with
male adults
c. Race & cultural influences 2. Children learn
i. Caucasians taller and by watching
bigger other children
3. A first born or
2. Environmental Influences only child who
a. Quality of nutrition has no example
i. Children cannot grow to watch,
taller than their
genetically programmed
height potential if there
is hindrance.
ii. ex. Inadequate nutrition
b. Socio Economic Level
i. Health care costs and
proper diet costs money
ii. may not receive
adequate health
supervision or good
nutrition
iii. e.g. Immunization
c. Parent child relationship
i. Children who are loved
Growth and Development Theories
thrive better than those
I. Psychosexual Theory (by Sigmund
who are not
Freud)
ii. An interruption could
● underlying motivation to human
interfere with the child’s
development is an energy form
desire to eat, improve
or life instinct called LIBIDO
and advance
● an unconscious mind is the
d. Ordinal position in the family
mental life of a person of which
i. Position of child in the
the person is unaware.
family has a bearing
● Proposed concepts like:
ii. Example:
○ ID
1. An only child
■ developed
or the oldest
during infancy
child in a
■ “I know what I
family
want and I want
generally excel
it now”
in language
■ pleasure
development
principle
because
■ seeks
conversation is
immediate
 pleasure & resolution of these crisis is
gratification supportive to the person’s ego.
○ EGO ● Resolution of the conflicts at
■ developed each stage enables the person to
during toddler function effectively in society.
period ● Nurses can strengthen the
■ “I can wait for client’s positive resolution of a
what I want” developmental task by
■ reality principle providing the individual with
■ balances the ID appropriate opportunities &
& SUPEREGO encouragement
○ Super EGO
■ developed III. Cognitive Theory (by Jean Piaget)
during ● Cognitive development
preschool age ○ orderly sequential
■ the conscience process in which a
■ Censoring variety of new
Force experiences (stimuli)
● Fixation must exist before
○ inability of the person intellectual abilities can
to proceed to the next develop. (Piaget)
stage due to anxiety ● manner in which people learn to
○ If an individual does not think, reason & use language.
achieve a satisfactory ● It involves a person’s
progression at this intelligence, perceptual ability,
stage, the personality and ability to process
becomes fixated. information
conflict or stress, can ● It represents a progression of
delay or prolong mental abilities from illogical to
progression through a logical thinking, from simple to
stage or cause a person complex problem solving, &
to regress to a previous from understanding concrete
stage. ideas to understanding abstract
concepts.
II. Psychosocial Theory (by Erik ● Assimilation
Erikson) ○ process through which
● envisions life as a sequence of humans encounter &
levels of achievement react to new situations
● resolution of task can be by using the
complete, partial or mechanisms they
unsuccessful already possess.
● Developmental tasks viewed as ● Accommodation
a series of crisis, & successful ○ is a process of change
whereby cognitive
 processes mature
sufficiently to allow the
person to solve
problems that were
unsolvable before
● Adaptation
○ or coping behavior, is
the ability to handle the
demands made by the
environment.

IV. Moral Theory (by Lawrence

Kohlberg)
● Moral
○ “relating to write &
wrong”
● Morality
○ requirements necessary
for people to live
together in society
● Moral Behavior
○ way a person perceives
those requirements &
responds to them
● Moral Development
○ pattern of change in
moral behavior with age
● Levels and stages are not always linked
to a certain development stage. Some
people progress to a higher level of
moral development than others.

V. Spiritual Theory (by James Fowler)

● “Faith is a relational
phenomenon; it is where we
invest commitment, belief, love,
risk and hope.” (Fowler)
● evolve from a combination of
knowledge & values.