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Sept 19
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Human Growth and Development N51279

Prejudice: travellers, refugees, homeless, addicts

Interpersonal and interactive skills: patience, listening, time management, understanding,
empathy, respect, body language, eye contact, explain in terms that are understood by the
client, clarifying that you have perceived the correct message
Apply skills and knowledge
Two case studies - 30% each
Exam - 40%

Understand the concept of humans growth and development from conception to old age
Major development stages
PILES: Physical
Intellectual
Language
Emotional
Social

Nature/Nurture
Theorists: Ainsworth/Bowlby
Piaget
Vygotsky
Freud
Erikson
Kubler Ross

Understand patterns of development

Concept of normative development
Pattern of physical development
Stages of emotional, social, cognitive development
Individual variation
Socialisation: Family, community, government
Friendship formation
Gender role development
Factors of holistic development: Teratogens - impact development negatively, alcohol,
thalidomide
Family
Social
Culture
Environment

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Sept 20
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Interactive skills: Demonstrating
Role Modelling
Body language; open, expressive, approachable
Sense of humour
Forming bonds
Finding common ground
Good communication
Paying attention
Build trust
Reciprocal communication

Need for Achievement: Drive/Motivation

Sense of purpose

Self-esteem: How you view yourself

Self worth

Self-fulfilment: What brings you joy/fulfilment

Recognise individuality:

Bronfenbrenner’s Bioecological theory:

Self -> Family -> Community -> Government

Fundamentals of Nursing:
● Awareness of fears, anxiety, and prejudice
● Non-judgemental
● Approach people as individuals
● Treating people with respect

Equal status act - 9 Grounds: no discrimination

Confidence and empathy while dealing with people

● So understanding
● Be non-judgemental
● Listen carefully
● Do what you set out to do

Case studies 60% (2x30%)

Exam 40%

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Sept 29
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What happens after fertilisation?

● A sperm enters an ovum and the nuclei combine into 46 pairs
● There are 4 major steps:
○ Sperm contacts the egg
○ Sperm and nucleus enter the egg
○ Egg becomes activated and developmental changes happen
○ Sperm and egg nuclei fuse
● Words to know:
○ Fuse: to physically join together
○ Ovum: Egg cell
○ Cleavage: process of cell division during development
○ Differentiation: the process of forming different kinds of cells from
similar cells of the early embryo
○ Embryo: an organism in an early stage of development
○ Morula: solid ball of cells formed from cleavage
○ Blastula: hollow ball of cells formed from cleavage
○ Gastrula: a hollow ball of cells with and “in pushing” and 3 layers
(germ layers)
● What happens now?
○ Development of the zygote, the study of which is known as
embryology
○ The zygote undergoes and series of mitotic cell divisions called
cleavage
● Stages of development
○ Fertilised ovum (zygote)
○ 2 cell stage
○ 4 cell stage
○ 8 cell stage
○ Morula
○ Blastula
○ Gastrula
Layers:
● Endoderm
○ Innermost layer
○ Goes on to form the gut, digestive tract, liver, pancreas, bladder
● Mesoderm
○ In the middle
○ Goes on to form muscles, skeleton, circulatory system, blood, gonads,
and different organs
● Ectoderm
○ Outermost layer
○ Forms the skin and nervous system

Early human development summary

● Meiosis makes sperm in males and ovum in females
● Sperm and ovum unite nuclei to form a zygote
● Zygote undergoes cleavage and becomes gastrula with 3 germ layers

Human Prenatal Development

● Gestation lasts for 266 days from fertilisation till birth
● Development begins in the oviduct/fallopian tube
○ About 24 hours after fertilisation the zygote has divided to form a 2
celled embryo
○ The embryo passes down the oviduct by cilia and peristalsis
 ○ 5th day, the embryo enters the uterus
○ Embryo floats free for several days
● The Placenta
○ Site of nutrient, gas, and waste exchange
○ Secretes hormone that maintains pregnancy
■ Trophoblast cells release human chorionic gonadotropin
(HCG) which signals the corpus luteum to enlarge and produce
progesterone
○ Develops from the embryonic chorion and maternal uterine tissue
○ Chorionic villi are formed from the chorion and project into the
endometrium of the uterus

Problems during Prenatal Development

● Most prenatal development occurs normally with little variation
● There are however a number of things that can go wrong
● Usually caused by genetics or environment
Environmental Problems
● Harmful environmental elements that can affect the foetus are known as
teratogens
Teratogens and Risk
● Teratogens are any agent that causes a structural abnormality following foetal
exposure during pregnancy.
● The overall effect depends on dosage and time of exposure
○ 1941: Rubella (Blindness, heart defects)
○ 1950’s: Methylmercury (Neurotoxicity)
○ 1960’s: Thalidomide (Phocomelia, stunted limb growth)
○ 1970’s: Alcohol (foetal alcohol syndrome)

Effects of Teratogens by week exposure

● 1-6 weeks: CNS
● 2-7 weeks: Heart
● 3-8 weeks: Extremities
● 3-8 weeks: Eyes
● 5-8 weeks: Palate
● 6-10 weeks: External Genitalia

Absolute Risk: the rate of occurrence of an abnormal phenotype among individuals

exposed to the agent (eg foetal alcohol syndrome)

Relative Risk: the ratio of the rate of the condition among the exposed and the non-
exposed (eg smokers risk of having a low birth weight baby compared to non-smokers)

Known or strongly suspected teratogens:

● Alcohol
● Androgens
● ACE Inhibitors
● Antithyroid medications
● Warfarin
 ● Carbamazepine, Phenytoin, Valproic Acid used as anticonvulsants
● Folic Acid Antagonist used as anti-inflammatory and cancer treatment
● Cocaine
● Lead, Mercury
● Lithium (bipolar meds)
● NSAID’s (Non-steroidal anti-inflammatory drugs)
● Tetracycline antibiotics
● Thalidomide

Pre-Embryonic Stage
● Time of fertilisation and up to implantation
● First 2 weeks of gestation
● Exposure to teratogens in this period may lead to improper implantation and
spontaneous abortion

Critical period - Embryonic Stage

● From day 14-18 to day 54-60 post-conception
● Period of most extensive organ differentiation (heart - first 38 days, arms/legs
- first 49 days)
● Exposure to teratogens during this period can cause structural and functional
birth defects

Foetal Period
● From day 56 of gestation to delivery
● Differentiation of the palate, external genitalia, and ear are examples for this
period
● Structural defects as well as foetal growth retardation can occur

Thalidomide
● Introduced in 1956 as a sedative and anti-nausea agent
● Withdrawn in 1961
● Discovered to be human teratogen causing absence of limbs or limb
malformations in newborns
● 15000 children born victims of thalidomide
● Half of these died at birth
● Resulted in new drug testing rules

Foetal Alcohol Syndrome

● Actual physical damage to the brain
● Irreversible
● Can lead to secondary mental health disabilities due to life long frustration
● It can affect their ability to:
○ Learn as a result of brain damage
○ Mental retardation
○ Learning disabilities language processing difficulties
○ Learning differences
○ Get along with others due to sensory damage
John Bowlby - Attachment Theory
● First five years of life are most important
● Child’s relationship with parents, mother in particular, has enormous effect on
the child’s development
● Separation from parent can cause psychological distress or trauma
● Mother - child pair
● 3 months to 6 years most important
● Did not claim the most important attachment figure must be the mother
● Did stress that babies need one central person who is their mother figure
● Believed babies without a mother’s relationship suffered from maternal
deprivation
● Believed that a child can still be deprived while at home if mother fails to
provide necessary loving care
● Three factors
○ Age child lost their mother
○ Length of time since separated
○ Degree of deprivation child experiences

Mary Ainsworth - Strange Situation

● Developmental psychology
● Elaborated on blowlby’s research
● Identified three major styles of attachment that children have to parents or
caregivers
● Strange Situation studies how infants are attached to mothers
● Observes how different infants reacted to a stranger with and without the
presence of their mother and how the reacted when reunited with their mother
○ Type A - Avoidant
■ Does not display distress or shows distress to being left alone
rather than mother’s absence, does not react anxiously to
stranger, completely ignores mothers or avoids mother
○ Type B - Secure
■ Child plays happily and reacts positively to stranger, becomes
distressed when mother leaves the room, distress related to
mother’s absence, child consoled quickly by mother, avoids
stranger when alone
○ Type C - Ambivalent/Resistant/Insecure
■ Child is fussy and wary while mother is in the room, clingy
before separation, not always welcome when mother returns,
resists comfort from stranger, both seeks and resists comfort
from mother, may display angry behaviour and try to struggle
free
○ Type D - DIsorganised
■ Added later. Relates to babies who display disorganised or
disoriented patterns of behaviour that can’t be classed under
other categories. All four categories seem predictive of
psychopathology in later life
● Type B was the most common attachment noted by Ainsworth although their
was variation between cultures.
 ● Four types of parents:
○ Sensitive-insensitive: Sensitive parents were positive and encouraged
physical contact, able to see things from child’s point of view
○ Accepting-rejecting: Accepting are tolerant of restrictions imposed by
having a baby, regard as positive life change
○ Cooperating-interfering: Cooperating see relationship with child as
valuable interaction, do not impose on wishes
○ Accessible-ignoring: Accessible are more there for the child, take
more notice of child’s needs and wishes
○ Type B: Sensitive, Accepting, cooperating, accessible
○ Type A: Rejecting, insensitive
○ Type C: Rejecting, interfering, ignoring

Birth
● Hormonal response begins labour
● Contractions cause the cervix to dilate or open
● Baby can then move down the birth canal
● Mucus plug is expelled from the cervix which is known as “waters breaking”
● Stage 1:
○ Contractions every 15 mins
○ Open cervix
○ Contractions last several seconds every 10 minutes
○ Dilated to 10
● Stage 2:
○ Baby’s head moves down the birth canal
○ Can last minutes or up to 2 hours
● Stage 3:
○ Placenta is expelled
○ Usually shortest
● After birth baby is assessed on/for:
○ Apgar scale
○ Infant reflexes
○ Weight/length
○ Head circumference
○ Heel prick test for metabolic disorders and cystic fibrosis
Apgar Scale
● Used to assess the health of newborns 1 and 5 minutes after birth
● Evaluates heart rate, respiratory rate, muscle tone, body colour, reflex
● Given a score of 0, 1 or 2 on each
● 7-10 indicates good health
● 5-7 indicates fair condition
● 3 or below indicate poor condition
● Developed by Dr. Virginia Apgar
○ Appearance (colour)
○ Pulse (heart rate)
○ Grimace (reflex irritability)
○ Activity (muscle tone)
○ Respiration (breathing)
Metabolic Disorders
● Are inherited (passed on through mother’s or father’s genes) disorders that
affect the way the body converts food and nutrients into energy and waste

The Senses
● Smell - Neonates can differentiate different smells and they can recognise
their mother’s odour (MacFarlane, 1975 cited in O’brien 2022)
● Hearing - infants show a preference for sounds that were transmitted through
the womb in the final months of pregnancy (DeCasper & Spence, 1986 cited
in O’Brien, 2022)
● Sight - Neonates can see things within a 30cm range, can recognise primary
caregiver. Least developed.
● Touch - Newborns are responsive to touch and temperature, one of the first
senses to develop
● Taste - Preference for sweet substances and will grimace at bitter/sour
flavours. Explanation: breast milk is sweet while poisonous substances tend
to be bitter

The brain
● At birth the baby already has about all of the neurons it will ever have. The
brain doubles in size in its first year, and by age three it has reached 80% of
its adult volume
Case study
● Give details of needs being met or not met under the following headings
○ Biological and physiological needs
○ Safety needs, shelter, to feel secure, safe and limits
○ Social needs, belongingness, love, acceptance, family affiliation to others
○ Esteem needs, achievement, independence,, gain approval and recognition
○ Cognitive needs, knowledge

● Biological
○ Met: Healthy food, shelter, exercise
○ Not met:
● Safety
○ Met: safe environment (for now), responsible care givers, light on
○ Not met: Uncertainty about length of safety, trust issues
● Social
○ Met: Is in social environment (school), good relationship with caregivers,
plays sports with other children, activities with foster parents
○ Not met: trouble making friends, seen as bully, doesn’t cooperate, difficulty
with trust
● Esteem
○ Met:
○ Not met: Poor self image, shame, embarrassment, lack of confidence
● Cognitive:
○ Met: Support teacher
○ Not met: Can’t concentrate in school
Nature and Nurture:
● Adaptation: the tendency to respond to the demands of the environment to
meet one’s goals
● Organisation: the tendency to integrate particular observations into coherent
knowledge
● Assimilation: how people process incoming information into a form they can
understand
● Accommodation: the process by which people adapt current knowledge
structures in response to new experiences
● Equilibration: the process by which people balance assimilation and
accommodation to create stable understanding

Piaget’s Stages of Cognitive Development

● Sensorimotor
○ Birth - 2 years
○ Infants know the world through their senses and through their actions
● Sub 1
○ Birth - 1 month
○ Infants begin to modify reflexes to make them more adaptive
● Sub 2
○ Birth - 4 months
○ Begin to organise separate reflexes
● Sub 3
○ 4 - 8 months
○ Infants become increasingly interested in the world around them. By
the end of this stage object permanence, the knowledge that objects
continue to exist even when they are out of view, typically emerges
● Sub 4
○ 8 - 12
○ Children make A not B error, the tendency to look for objects where
they were found before, not where they were hidden
● Sub 5
○ 12 - 18
○ Actively explore the potential uses to which objects can be put
● Sub 6
○ 18 - 24
○ Infants become able to form enduring mental representations. The first
sign of this capacity is deferred imitation, the repetition of other
people’s behaviour a substantial time after it occurred.

Object Permanence
● Objects are tied to infants awareness of them
● Hidden toy experiment

Socio-emotional Development
● Freud: The Oral Stage (0-2 years) the mouth is the prime source of pleasure
and for survival and the baby instinctually sucks and develops trust and
personality. He thinks that if the baby is weaned too early could become
fixated at the oral stage, and that the personality becomes pessimistic,
aggressive and distrustful