MODULE 3: GROWTH AND DEVELOPMENT

Lesson 1: Theoretical Approaches to the Growth and Development of Children

A. Growth and Development and the Role of the Nurse

B. Principles of Growth and Development

Growth- increase in physical size or quantitative change.
Development- increase in skill or the ability to function (a qualitative change)
Maturation- is a synonym for development
Psycho-sexual Development- refers to developing instincts or sensual pleasure (Freudian theory)
Moral Development- the ability to know right from wrong and to apply these in real-life situations (Kolberg’s)
Cognitive Development- refers to the ability to learn or understand from experience, to acquire and retain knowledge, to
respond to new situations, and to solve problems. (Piaget’s)
Patterns of Growth
Cephalocaudal- Development proceeds from head to tail.
Proximodistal- Development proceeds from the middle of the body to the distal parts of the body.
Gross to refined skills- Once able to control distal body parts, they are able to perform fine motor skills.
C. Factors Influencing Growth and Development
Genetics
Gender- On average girls are born lighter (by an ounce or two) and shorter (by an inch or two)
Health
Intelligence
Temperament- The usual reaction pattern of an individual, or an individual’s characteristic manner of thinking, behaving, or
reacting to stimuli in the environment (Chess and Thomas, 1995)
Reaction Patterns- Chess and Thomas identified NINE SEPARATE CHARACTERISTICS THAT DEFINE TEMPERAMENT or how
children react to situations.
 ACTIVITY LEVEL - reflects the two extremes of motor activity
 RHYTHMICITY - a child who has rhythmicity manifests regular rhythm in physiologic functions.
 APPROACH -refers to a child’s response on initial contact with a stimulus.
 ADAPTABILITY -is the ability to change one’s reaction to stimuli over time.
 INTENSITY OF REACTION- children demonstrate such overt symptoms of anger or have mild or low-intensity
reaction to stress.
 DISTRACTABILITY - the ability to easily shift their attention to a new situation.
 ATTENTION SPAN AND PERSISTENCE- Attention span, the ability to remain interested in a project or activity
 THRESHOLD OF RESPONSE- the intensity level of timulation that is necessary evoke reaction.
 MOOD QUALITY- a happy and laughing child has a positive mood quality.
Nursing Implications Regarding Temperament
Children who have a normal activity level and regular rythmicity, who approach and adapt to new situations
easily, and who have a long attention span, a high level of persistence, and a positive mood quality are “ideal”
or “easy” children to care for, from a parents point of view.

CAREY-MCDEVITT INFANT TEMPERAMENT QUESTIONNAIRE

-instrument used to evaluate temperament, consist of 95 responses
can be answered by parent for 25 minutes, when the child is
between 4-8mnths
General Categories of Child’s responses to:
-Feeding
-Sleeping
-Soiling and wetting
-Dressing
-Bathing
-Diapering
-To people and new situations

4 GROUPS OF CHILDREN
1. Difficult: arrhythmic, withdrawing, low in adaptability, intense, and negative in
mood
2. Slow to warm up: inactive, low in approach and adaptability, and negative in mood
3. Intermediate: some characteristics of both groups
4. Easy: rhythmic, approaching, adaptable, mild, and
in mood.

Environment
 Socioeconomic Level- children born into families of low socioeconomic means may not receive adequate health
supervision or good nutrition. Poor health supervision can leave them without immunization against measles or other
childhood illnesses and therefore vulnerable to diseases that could cause permanent neurologic damage if complications occur.
Parent-child Relationship- Cultural norms within the family play a role in determining when a child is expected to achieve
particular development milestones

D. Using Growth and Development in Practice

Lesson 2: Nursing Process for Promotion of Normal Growth and Development

A. The Family with an Infant

B. The Family with a Toddler
C. The Family with a Preschooler
D. The Family with a School Age Child
E. The Family with an Adolescent
a. Assessment
b. Nursing Diagnosis
c. Planning and Intervention
d. Evaluation
e. Documentation

Lesson 3: Health Promotion and Disease Prevention in Different Stages of Growth and Development

A. Health Promotion of an Infant and Family

B. Health Promotion for a Toddler and Family
C. Health Promotion for a Preschooler and Family
D. Health Promotion for a School Age and Family
E. Health Promotion for an Adolescent and Family
a. Assessment
b. Nursing Diagnosis
c. Planning and Intervention
d. Evaluation
e. Documentation

Lesson 4: Scope and Standards and Patient’s Bill of Rights

A. Scope and Standard
-Scope and Standards of Maternal and Child Practices in the Philippines
-Legal Considerations of Maternal and Child Practice
-Ethico-moral considerations of Maternal-Child Practice
-Ethical and Social Issues in Perinatal Practice
a. Contraception
b. Advances in Genetics and Genetic Technology
c. Alternative Methods of Birth
d. Common Reproductive Issues
e. Reproductive Health Bill and other existing DOH Programs on Maternal and Child Care
B. Patients Bill of Rights and Obligations
Communication and Teaching with Children and Families