MODULE Content For Growth and Development Copy 1 4

ANGELES UNIVERSITY FOUNDATION
Angeles City
College of Nursing
NCM 0107
CARE OF MOTHER, CHILD AND ADOLESCENT WELL
First Semester, Academic Year 2021-2022
MODULE 8 CONTENT
GROWTH AND DEVELOPMENT
Module Overview
This module is designed and prepared to provide BSN II students the adequate
knowledge and skills in describing principles of growth and development and developmental
stages according to major theorists. This module presents 1) knowledge of factors influencing
growth and development 2) principles 3) theories and 4) characteristics of growth and
development from birth to adolescence.
Understanding the stage of development a child has reached is important,

because parents will ask a nurse what to expect from their child regarding developmental
progress. Likewise, understanding the psychosocial developmental stage a child has reached
helps in planning care that considers not only age but development progress as well. The child’s
age and stage of physical growth also provides the entire health care team much-needed
information about treatment concerns. For all these reasons, learning about growth and
development is essential to the development of complete and effective nursing care plans for
children.
Module Learning Outcome:
Pursuant to the Commission on Higher Education (CHED) Memorandum Order No. 15,
the required policies, standards and guidelines in the nursing program parallels this
module’s aim to satisfactorily meet the following learning outcomes.
Course Learning Outcome 1. Apply concepts, theories and principles of sciences and
humanities in the formulation and application of appropriate nursing care during
childbearing and childrearing years.
Learning Outcome 1: Integrate concepts, theories and principles of sciences and

humanities in the formation and application of appropriate nursing care (of well mother,
child, adolescent) during childbearing and childrearing years. (P01a)
At the end of the module, the learners will be able to:
1. Differentiate growth from development

2. Describe the principles of growth and development.
3. Describe the developmental stages according to major theories.
4. Identify the factors influencing growth and development.
5. Describe the characteristics of growth and development.
6. Assess a child to determine the stage of development the child has reached.
1 | GWORTH AND DEVELOPMENT

7. Plan nursing care to assist a child in achieving and maintaining normal growth and
development.
8. Create a concept map per group based on the different stages from birth to adolescence
Activity 1 10-item multiple choice quiz will be given through

Kahoot/ the poll results of myCLASS Bigbluebutton.
Multiple Choice: Choose the BEST answer:
1. The following principles of growth and development are all correct, EXCEPT:
A. Growth and development are continuous processes from conception, until death
B. All body system develop at the same rate
C. Development is cephalocaudal
D. There is an optimum time for initiation of experiences or learning
2. The infant attends to speaking voice and social smile by:
A. 1 month
B. 2 months
C. 3 months
D. 4 months
3. The infant sits alone without support by:
A. 2 month
B. 4 months
C. 6 months
D. 8 months
4. All of the following are cognitive development of the toddler: EXCEPT:
A. Coordination of Secondary Education

B. Tertiary Circular Reaction
C. Invention of New Means Through Mental Combination
D. Preoperational Thought - Symbolic
5. Types of play for infant:
A. Solitary
B. Observation
C. Parallel
D. Associative
6. The toddler needs to be independent and make decisions for self in his psychosocial
development which is:
A. Initiative versus Guilt

B. Trust versus Mistrust
C. Autonomy versus Shame/ Doubt
D. Industry versus Inferiority
7. The stage of separation anxiety wherein the child may turn away from parents approach, prone
to minor ailments and often lies on abdomen:
A. Regression
B. Protest
C. Denial
D. Despair
8. As a result from their frustrations by restraints to their behavior, the Toddler will show:
A. Temper tantrums
B. Use the word “No”
C. Ask many questions
D. Separation Anxiety and Regression
9. Who among the following is/ are the significant persons of school - age children:
A. Mother
B. Parents
C. Peers
D. Peer Group
10. Nutritional need of a schooler will be best met by:
A. Provide short meals because of the brief attention span and environmental distraction
B. Provide protein - rich food at breakfast to sustain the prolonged physical and mental
effort required at school
C. Provide finger foods because they are very active and may rush through the meal
D. Provide snacks frequently because of active life - styles and irregular eating patterns

Characteristics of growth and development
GENERAL CONCEPTS:
GROWTH – is generally used to denote an increase in physical size or a quantitative change.
- indication of growth includes ht., wt., bone size and dentition (cm, inches, lbs., kg)
DEVELOPMENT – is used to denote an increase in skill or the ability to function or a qualitative

change.
- Development can be measure by observing a child’s ability to perform specific tasks, or by

using standardized tests such as Denver Dev. Screening Test.
FACTORS INFLUENCING GROWTH AND DEVELOPMENT
1. Genetic Influences – from the moment of conception when a sperm and ovum fuse, the
basic genetic make-up of an individual is determined.
2. Gender
3. Race and Nationality
4. Parent-Child Relationship
5. Ordinal Position in the Family
6. Health
7. Socioeconomic Level
PRINCIPLES OF GROWTH AND DEVELOPMENT
1. Growth and development are continuous processes from conception until death.
2. Growth and development proceed in an orderly sequence.
3. Different children pass through the predictable stages at different rates.
4. All body system do not develop at the same rate.
5. Development is cephalocaudal.
6. Development proceeds from proximal to distal body parts
7. Development proceeds from gross to refined skills
8. There is an optimum time for initiation or experiences or learning
9. Neonatal reflexes must be lost before development can proceed.
10. A great deal of skill and behavior is learned by practice.
THEORIES OF DEVELOPMENT
Developmental Task – is a skill or a growth responsibility arising at a particular time in an

individual’s life, the successful achievement of which will provide a foundation for the
accomplishment of futured tasks.
1. FREUD’S PSYCHOANALYTIC THEORY
Sigmund Freud (1856 – 1939), an Austrian neurologist and founder of psychoanalysis

offered the first real theory of personality development.
He described child development as being a series of psychosexual stages in which the

child’s interests become focused on a particular body site.

2. ERICKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT
Erickson (1902 -1996) was trained in psychoanalytic theory but later developed his own
theory of psychosocial development that considers the importance of culture and society in
development of the personality.
One of the main concepts of his theory, that a person’s social view of himself of herself
is more important than instinctual drives in determining behavior, allows for a more
optimistic view of the possibilities for human growth.
According to Erikson, the successful resolution of each conflict, or accomplishment of

the development task of that stage, allows the individual to go on the next phase of
development.
3. PIAGET’S THEORY OF COGNITIVE DEVELOPMENT
Piaget (1896-1980), a Swiss psychologist, introduced concept of cognitive development.

Within each stage are finer units or scheme.
To progress from one period to the text, the child reorganizes his or her thinking processes
to bring them closer to reality.
4. KOHLBERG’S STAGES OF MORAL DEVELOPMENT
According to Kohlberg (1984), recognizing these moral stages is important when caring
for children to help identity how a child may feel about an illness, whether the child can be
depended on to carry out self-care activities, or whether the child has internalized standards
of conduct so he or she does not “cheat” when away from external control.
Moral stages closely approximate cognitive stages of development, because a child must
be able to think abstractly before being able to understand how rules the child cannot see
apply to him or her, even when no one is there to enforce them.
Activity 2: The learners will watch videos on:

a. Piaget’s Theory of Cognitive Development
https://youtu.be/IhcgYgx7aAA
b. 8 Stages of Development by Erik Erikson
https://youtu.be/aYCBdZLCDBQ
https://youtu.be/6XxFmXkD8M8
c. Kohlberg’s 6 Stages of Moral Development

https://youtu.be/bounwXLkme4

Activity 3: Question and answer on the Discussion Board
What are my realizations after watching the selected videos

on the Theories of Growth and Development?
INFANTS (BIRTH TO 1 YEAR)
A. Physiologic Growth and Development
1. Babies usually gain weight at the rate of 5-7 ounce weekly for 6 months.
By 4 to 6 months of age, infants usually reach twice their birth weight and
three times their birth weight by age 12 months.
2. Rate of increase in height is largely influenced by the baby’ size at birth
and by nutrition.
3. Motor and Social Development
MOTOR AND SOCIAL DEVELOPMENT IN INFANCY TO PRESCHOOLER
AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

1 month - Lift their head and turn it - Can differentiate between
easily to the side faces and other objects
- Has gross head lag
- Have a strong grasp
reflex
- Able to follow object to
midline
2 months - Raise the head and - Differentiates a cry
maintain the position, but - Has social smile
cannot raise their chest - Makes cooing sounds
high enough to look
around
- Can hold head fairly
steady when sitting up,
although it does tend to
bob forward
3 months - Holds head and chest up - Squeal with
when prone pleasure/laughs out loud
- Has slight head lag when - Turn their heads to
pulled in sitting position attempt to locate a sound
- Reach for attractive
objects in front of them
- Follows object past
midline
4 months - Lifts chest off the bed and - Very “talkative”, cooing,

look around actively, babbling and gurgling
turning the head from when spoken to
side to side - Recognize familiar
- Can turn from front to objects
back
- No longer demonstrating
head lag in sitting
position
- Brings the hands together
and pull at their clothes
5 months - Rests weight on the - says some simple vowel
forearm when prone sounds (goo-goo and
- Turn completely over gah-gah)
- Can straighten his or her
back when propped in a
sitting position
- Grasps object with whole
hand

6 months - Rest their weight on their - Starts to imitate sounds
hands with extended
arms
- Can raise their chest and
the upper part of their
abdomen off the table
- Can sit momentarily
without support
- Support nearly their full
weight when in a
standing position
- Holds objects in both
hands
7 months - Sits alone but only when - Imitates vowel sounds
the hands are held well (oh-oh; ah-ah; oo-oo)
forward for balance - Shows beginning fear of
- Can transfer a toy from strangers
one hand to another
8 months - Can sit securely without - Has peaked fear of
additional support strangers
-
9 months - Creeps and crawls - Says first word (da-da or
- Sits so steadily that they ba-ba)
can lean forward and - Very aware of the
regain their balance changes in tone of voice

MOTOR AND SOCIAL DEVELOPMENT IN INFANT TO PRESCHOOLER

10 months - Pull themselves to a - Master another word
standing position by such as bye-bye
holding onto objects - Beginning of object
- Brings the thumb and first permanence
finger together in a pincer - Recognize their name
grasp and listen acutely when
spoken to
11 months - Learns to “cruise” by - Imitates speech sounds
holding onto objects - Reacts with frustration
when restricted
12 months - Stands alone at least - Can generally say two
momentarily words besides ma—ma
- Hold a cup and spoon to and da-da, use those two
feed self words with meaning
- Helps to dress (pushes
arm to sleeve)
15 months - Walks alone well - 4-6 words
- Can seat self in chair - Enjoy being read to
- Can creep upstairs - Drops toys for adult to
- Puts small pellets into recover (exploring sense
small bottles of permanence)
- Scribbles voluntarily with
a pencil or crayon
- Holds a spoon well but
may still turn it upside
down on the way to
mouth

18 months - Can run and jump in - 7-20 words
place. - Uses jargoning
- Can walk up and down - Names 1 body part
stairs holding onto a - Imitates household
person’s hand or railing chores
- Typically places on one - Begins parallel play
step before advancing
- No longer rotates a
spoon to bring it to mouth
24 months - Walks up stairs alone still - 50 words, 2-word
using both feet on same sentences (noun-pronoun
step at same time and verb), such as Daddy
- Can open doors by go” “me come”
turning door knobs,
unscrew lids
30 months - Can jump down from - Verbal language is

chairs increasing steadily.
- Makes simple lines or - Knows full name; can
strokes for crosses with a name 1 color and holds

pencil up fingers to show age
- Imitating parents’ actions

3 years - Runs - Vocabulary of 900 words
- Alternates feet on stairs - Able to take turns
- Rides tricycles - Very imaginative
- Stands on one foot
- Undress self
- Stacks tower of blocks
- Draw a cross
4 years - Constantly in motion; - Vocabulary extends to
jumps, skips 1,500 words
- Can do simple buttons - Pretending is major
activity
5 years - Throws overhand - Vocabulary of 2,100
- Draw a 6-part man words
- Can lace shoes - Likes games with
numbers and letters
B. PSYCHOSEXUAL DEVELOPMENT
Oral Phase (0-1 year) – Infants seek for enjoyment or relief of tension, as well
as for nourishment.
Nursing Implications:
1. Provide oral stimulation by giving pacifiers.

2. Do not discourage thumbsucking.
C. PSYCHOSOCIAL DEVELOPMENT
Trust vs. Mistrust (0-8 mos.) – Child learns to love and be loved. Significant
person: Mother / Primary caregiver.
1. Responds promptly to an infant's needs.

2. Provide a predictable environment in which routines are established.
3. Provide experiences that add to security, such as cuddling, soft sounds,
touch or stroking, and rocking.
D. COGNITIVE DEVELOPMENT
Sensorimotor
1. Neonatal Reflex – 1month

- stimuli are assimilated into beginning mental images.
Behavior entirely reflexive.

2. Primary Circular Reaction – 1-4 months
- hand-mouth and ear – eye coordination develop. Infants spend much
time looking at objects and separating self from them.
- Beginning intention of behavior is present. Enjoyable activity for this
period: A rattle or parent’s voice recording, colorful musical hanging
objects over the crib.
3. Secondary Circular Reactions – 4-8 months

- Infants learn to imitate, recognize and repeat pleasurable experiences
from environment
- Memory traces are present and anticipate familiar events.
Good toy: Mirror, plastic blocks and rings (can grasp but not swallow)
Good game: Peek-a-Boo
4. Coordinating of Secondary Reactions – 8-12 months
- Perceives that others can cause activity and that activities of own body
are separate from activity of objects.
- Can search for and retrieve toy that disappears from view.
- Recognize shapes and sizes of familiar objects.
- Because of increased sense of separateness, infant experiences
separations anxiety when primary care-given leaves.
Good toys: Nesting toys such as different size colored boxes to use for
put-in, take-out toys. Toys that pull apart such as large plastic beads. Toys
with wheels that push back and forth.
Type of Play: OBSERVATION – Infant watches particular play intently,

although not actively engaged in it.
MORAL DEVELOPMENT
Preconventional Stage I: Punishment-Obedience Orientation. Child does right

because a parent tells him or her to and to avoid punishment.
1. Provide help to children to determine what are the right actions.

2. Gives clear instructions to avoid confusion.
3. Gives praise for doing as asked.
E. NUTRITION
1. Breastfeeding
Breastmilk is still BEST milk for babies.
Advantages:
1. It is readily available, convenient and economical.

2. Its composition is most suitable for infants.
3. It has immunologic substances, which help in the prevention of infections.
4. It enhances closeness between mother and child.
5. It prevents indigestion and diarrhea.
Procedure for Breastfeeding
1. The mother is taught to wipe her nipples gently with washcloth and plain
water to remove the small white crusts of milk, which have leaked out.
2. Before each feeding, the mother is taught to wash her hands, hold her baby,
and get into a comfortable position, either seated on a chair or lying on her
side in bed.
3. Position the body such that we can have a good grasp of her breast.
4. Press the breast tissue near the infant’s nose such that it does not interfere
with the baby’s breathing.
5. Allow to nurse 2-5 minutes at each break during the first few days after
delivery, later, when there is ample milk, the baby is breastfeeding from 10-20
minutes on each breast.
I. BOTTLEFEEDING
The common types of milk formula used by Filipino mothers are:
1. Evaporated Milk – this is whole milk with 60% of its water removed. Average
dilution of formula 1 ounce or 30cc of milk to 2 ounces or 60cc of water.
2. Condensed Milk – evaporated whole milk, which contains 45% sugar, it has
100 calories per ounce.
Disadvantages:
a. The sugar content is too high, making the baby look pale, fat, fiabby, and
prone to diarrhea due to the fermentation of sugar.
b. Mothers also tend to dilute the milk to make it less sweet; extremely
diluted milk does not give sufficient nutrients to supply body needs.
3. Dried Milk – This is milk, which the water has completely evaporated. It is
good for babies who cannot tolerate the FAT of whole milk.
Dilution: 3 ½ level tablespoonful of dried milk to 7 ounces of water.
4. Propriety Infant Milk – The composition of this kind of milk stimulates breast
milk. It provides a “complete” diet for the infant and contains added vitamins
and iron. However, it is relatively expensive. May come in powdered or liquid
form.
F. Hospitalization Reactions
Infants adapt well if fed, touched, and cared for. In later infancy they
experience separation anxiety; exhibit total body rigidity, protest, detach from
parents and exhibit withdrawal behavior.
Nursing Interventions:
1. Encourage parents to stay with, visit, and continue routines of home care
for infants as much as possible.
2. Establish a sense of trust.
3. Maintain same nurse assignments and maintain routine.
4. Speak to, look at and touch infant.

5. Provide comfort sources as needed, such as pacifiers, bottles, blankets.
6. Make the environment safe such as side rails up, equipment out of reach.
7. Monitor growth and development
8. Provide appropriate interaction and toys
TODDLERS (1-3 years)
A. Physical Development
a. Toddlers develop from having no voluntary control to being able both to

walk and speak.
b. They learn to control their bladder and bowels by 3 years
c. They now usually appear chubby with relatively short legs and large head,
with pronounced lumbar lordosis and a protruding abdomen.
d. Two years old can be expected to weigh approximately four times their
birth weight.
Gains only about 5 to 6 lbs. (2.5 kg) and 5 inches (12 cm.) a year during
this period
e. Fine muscle coordination and gross motor skills improves.
f. Receptive language skills and expressive language skills are developing
quickly.
Receptive – ability to understand words.
Expressive – ability to use or weigh the words.
B. Psychosexual Development
ANAL PHASE (2-3 years)
a. Child learns to control urination and defecation.

b. Child finds pleasure and a sense of control in both the retention and
defecation of feces. This anal interest is part of the toddler’s SELF-
DISCOVERY, a way of exerting independence.
Nursing Implications
1. Help children achieve bowel and bladder control without undue emphasis
on its importance.
2. If at all possible, continue bowel and bladder training while the child is
hospitalized.

3. Toilet training should be a pleasurable experience, and appropriate praise
can result in a personality that is creative and productive.
C. Psychosocial Development
AUTONOMY VS. SHAME AND DOUBT (18 months – 3 years)
a. Child learns to be independent and makes decisions for himself.

b. They begin to develop their sense of autonomy by asserting themselves
with the frequent use of the word “NO”.
c. TEMPER TANTRUMS results from their frustration by restraints to their
behavior.
d. They are curious and ask many questions.
e. Response to stress: SEPARATION ANXIETY AND REGRESSION
ROBERTSON’S STAGES OF SEPARATION ANXIETY
1. PROTEST – The child cries loudly and demandingly; rejects any

attempts to be comforted.
2. DESPAIR – The child wails rather than cries; may turn away from
parent’s approach; often lies on abdomen, facial expression flat; may
loss weight and develop insomnia, loses developmental skills; prone to
minor ailments such as URTI; IQ measures lower than formerly.
3. DENIAL – The child is silent, face expressions less
- Deterioration in developmental milestones is apparent.
- May respond quickly but superficially to all caregivers.
- May have difficulty forming close relationships during life.
Significant Person: Mother/Primary caregiver
1. Provide opportunities for decision-making, such as offering choices of clothes

to wear or toys to play with.
2. Praise for ability to make decisions (they are proud of their accomplishments)
rather than judging correctness of any one decision.
3. Help the toddler to develop inner control by setting and enforcing consistent,
reasonable limits.
D. Cognitive Development
1. SENSORIMOTOR
Tertiary Circular Reaction – 12-18 months

a. Child is able to experiment to discover new properties of objects and
events.
b. Capable of space perception and time perceptions as well as
permanence.
INVENTION OF NEW MEANS THROUGH MENTAL COMBINATION
18-24 mos.
a. Uses memory and limitation to act.

b. Can solve basic problems, foresee maneuvers that will succeed or fail.

Good Toys: Blocks, colored plastic rings, those with several uses.
2. PREOPERATIONAL THOUGHT (2-7 years)
a. Thought becomes more symbolic; can arrive at answers mentally

instead of through physical attempt.
b. Comprehends simple abstractions but thinking is basically concrete
and literal.
c. Child is egocentric to see the viewpoint of others.
d. Displays static thinking, inability to remember what he or she started to
talk about so that at the end of a sentence the child is talking about
another topic.
Good Toy: items that require imagination, such as modelling clay
Good Activity: trips to the park, reading books
Type of Play:
1. PARALLEL PLAY – two children play side by side but seldom attempt
to interact with each other.
2. SOLITARY PLAY – involvement in independent activities
E. MORAL DEVELOPMENT
Pre-conventional Stage I: Punishment – Obedience Orientation
See infancy Moral Development
F. NUTRITION
1. By this time, toddlers can eat most foods and adjust to these meals each
day.
2. By age 3, most deciduous teeth have emerged, the toddler is able to bite
and chew adult table food.
3. They know how to feed themselves.
4. Meals should be short because of the toddler’s brief attention span and
environmental distractions.
5. Often toddlers display their liking of rituals by eating foods in a certain
order, cutting foods a specific way, or accompanying a certain food with a
particular drink.
6. Caloric requirement is decreased because of a decrease in the rate of
growth, but an adequate need for iron, calcium vit. D and A rich food
should be provided.
G. REACTION TO HOSPITALIZATION
1. Experience separation anxiety

2. Feel a loss of control and rituals
3. May exhibit temper tantrums or regression
4. Fear injury and pain: Fear of the unknown

5. May bite and kick during interaction
NURSING INTERVENTIONS:
1. Encourage parents to stay with, visit, and continue routines of home care as
much as possible.
2. Establish trust with parents and child.
3. Provide familiar routines and items or security objects such as security
blanket.
4. Maintain the same nurse assignment.
5. Allow child a sense of independence.
6. Allow to play and interact with family members.
7. Stay with child when parents leave so a sense of abandonment is not felt.
8. Monitor growth and development and provide appropriate interactions and
toys. Motor development is important during this age.
PRESCHOOLERS (3-5 years)
1. During this period, physical growth slows, but control of the body and
coordination increase greatly.
2. They appear taller and thinner than toddlers because children tend to
grow more in height than in weight.
3. They are able to wash their hands, face and brush their teeth.
4. They run skillfully and can jump three steps, can balance on their toes and
dust themselves without assistance.
5. They are self-conscious about exposing their bodies.
PHALLIC STAGE (4-5 years) – Child learns sexual identity through

awareness of genital area. They play with their bodies largely out of curiosity.
1. Accept child’s sexual interest, such as fondling his or her own genitals, as
a normal area of exploration.
2. Help parents answer child’s questions about birth or sexual differences.
ELECTRA / OEDIPUS COMPLEX
The phase of close emotional relationship with both parents’ changes to

the phase Freud referred to as the ELECTRA or OEDIPUS complex. At this
time, the child focuses feelings of love chiefly on the parent of the opposite
sex, and the parent of the same sex may receive some hostile feelings.
INITIATIVE VS. GUILT (3-5 years)
a. Child learns how to do things (basic problem solving) and that doing things
is desirable.
b. They have to solve problems in accordance to their consciousness
c. The personalities develop.
d. Erickson views the crisis at this time as important for the development of
the individual’s self-concept.
Significant Person: Parents

. Provide opportunities for exploring new places or activities.

. Allow play to include activities involving water; clay (for modelling) or
finger paint.
. Enhance the development of the preschoolers by praising effort at new
activities and providing opportunities to repeat new activities until they are
mastered.
. Initiative is also encouraged when parents answer their child’s questions
(intellectual initiative) and do not inhibit fantasy and play activity.
4 Adaptive Mechanism Learned During Preschool Years
1. IDENTIFICATION – occurs when the child perceives the self as similar to

another person and behaves like that person.
2. INTROJECTION – is the assimilation of the attributes of others.
3. IMAGINATION – preschoolers have active imagination and fantasize in
play.
4. REPRESSION – removing experiences, thoughts, and impulses from
awareness.
PREOPERATIONAL THOUGHT (2-7 years) – intuitive thought (substage)

1. They still have immature perception.
2. Preschool thinking is also influenced by ROLE FANTASY or how children
would like something to turn out.
3. They believe that wishes are as real as facts; that dreams are as real as
day-time happenings.
4. Preschoolers learn through trial and error, and they think of only one idea
at a time.
5. They do not understand relationships such as those between mother and
father.
6. Preschoolers become concerned about death as something inevitable, but
they do not discuss it. They also associate death with others rather than
themselves.
7. Reading skills also start to develop at this age. They like fairy tales and
books about animals and other children.
Good Games: Make believe games; Hide and seek games that require simple
rules and cooperation.
Good Activity: Picnic, visit to zoo
Good Toys: Those that encourage role - playing, construction trucks, dress-
up dolls, toy cooking ware.

Type of Play: ASSOCIATIVE PLAY – children play together in a similar
activity
E. Moral Development
PRECONVENTIONAL STAGE II (4-7 years) INDIVIDUALISM /

INSTRUMENTAL – RELATIVE ORIENTATION
1. Preschoolers tend to do good out of self-interest rather than out of true
intent to do good or because of a strong spiritual motivation.
2. Preschooler imitate what they see (MODELLING)
3. They usually control their behavior because they want love and approval
of their parents.
4. MORAL BEHAVIOR. Taking turns at play or sharing.
1. Encouraging parents to give preschoolers recognition for actions such as

sharing.
2. Encourage parents to answer preschoolers “why” questions and discuss
values with them.
3. Since they do things for others only in return for things done for him or her.
This means it may be necessary to remind the child of the actions taken
on his or her behalf or TRADE-OFF ACTIONS.
F. Nutrition
1. The preschooler eats adult foods and should have the required amounts
from the four food groups.
2. Children at this age are very active and may rush through the meal to
return to playing. May provide finger food, such as chicken, hot-dogs on
sticks.
3. Children at this age may enjoy helping in the kitchen, and both girls and
boys should be encouraged to do so.
G. Reaction to Hospitalization
1. Experience separating from family but not to the point of anxiety.

2. Fear loss of routines and schedules.
3. Fear bodily injury believes all inside can come out any hole in skin
(Bandaid age).
4. Believes hospitalization is punishment for bad thoughts and actions.
5. May have nightmares.
Nursing Responsibilities
1. Encourage parents to stay or visit frequently.

2. Provide familiar routines and allow independence in daily care as much as
possible.
3. Keep night light on during sleep and allow familiar items with the child.
4. Explain in simple terms what procedures are going to be done just prior to
being done.
5. Utilize play therapy as much as possible to diminish fears.
6. Encourage interaction and play with other children in the hospital in age
group.
7. Monitor growth and development.

SCHOOL-AGE CHILDREN (6-12 years)
a. The school-age child gains weight rapidly, and this appears less thin than
previously.
b. At 6 years, both boys and girls are about the same height.
c. Children of both sexes have a growth spurt, girls between 10 and 12
years, boys between 12 and 14 years. Girls may well be taller than boys at
12 years although boy are usually stronger because of muscles develop-
mental
d. Very little change takes place in the reproductive and endocrine systems
until the pre-puberty period.
e. During pre-puberty, at about age 9, endocrine functions slowly increase
and some of the secondary sex characteristics, apocrine, and sweat
glands begins to develop and increase in secretions.
f. Sexual maturation in girls occurs between the years 12 to 18; in boys,
between 14 and 20 years.
g. School-age children perfect their muscular skills and coordination. Thus,
by 9 years, most children are becoming skilled in games of interest, such
as football or basketball.
LATENT STAGE (6-12 years)
During this time, the focus is directed toward physical and intellectual
activities, while sexual tendencies seem to be repressed.
Encourage child with physical and intellectual pursuits.
INDUSTRY VS. INFERIORITY (6-12 years)
1. At this time, children begin to create and develop a sense of competence

and perseverance.
2. They are motivated by activities that provide a sense of worth.
3. They concentrate on mastering skills that will help them function in the
adult world.
4. Children compare their skills with those of their peers, in a number of
areas, including motor development, social and language. This
comparison assists in the development of self-concept.

Significant Person: Peers, Teacher
1. Motivate to be industrious and provide recognition.

2. Guiding children to perform tasks in which they are likely to succeed.
3. Teaching the child how to get along with peers by collaborating,
compromising, cooperating and competing.
Adaptive Mechanism Developed by a Schoolchild:
1. REGRESSION – returning to a form of behavior that was suitable at an earlier

time.
2. MALINGERING – pretending to be ill rather than facing something
unpleasant.
3. RATIONALIZATION – attempt to justify behavior by logical reason and
explanation.
4. RITUALISTIC BEHAVIOR
CONCRETE OPERATIONAL THOUGHT (7-12 years)
1. During this stage, the child changes from egocentric interactions to

cooperative interactions
2. School age children also develop an increased understanding of concepts
that are associated with specific objects.
3. They develop logical reasoning from intuitive reasoning.
4. They also learn about cause and effect relationships at this age.
5. They now learn the value of money and time periods.
Good Activity: collecting and classifying natural objects such as seashells,

vegetables, etc., Field trips and hobbies.
NURSING IMPLICATIONS:
1. To promote proper development of cognitive abilities, the nurse should

screen the child for any vision or hearing problems.
2. Promotes cognitive development by encouraging reading, showing
interest in the child’s work, and providing a home environment in which the
child can complete home assignments.
3. They enjoy watching TV and playing video games, and parents or
significant others may have to set limits on these activities.
4. Parents should be aware of the child’s progress in school, have realistic
expectations of their child’s abilities, and be encouraged to report any
concerns to the teacher or to the school nurse.
Type of Play: COOPERATIVE PLAY – children play with an organized

structure or complete for desired goal or outcome.
1. Conventional Level Stage III (7-10 years) – Good Boy – Nice Girl / Stage /
Interpersonal Concordance

It is the orientation of interpersonal relations to mutuality. Child
follows rules because of a need to be a “good” person in their own eyes
and the eyes of others.
1. Allow child to help with bed making and other activities.

2. Praise for desired behavior such as sharing.
2. Conventional Level: Stage IV (10-12 years)

LAW AND ORDER ORIENTATION
a. Child finds following rules satisfying.

b. Follows rules of authority figures as well as parents in an effort to keep
the “system” going.
F. Nutrition
1. School-age children require a balanced diet including 2,400 Kcal per day
2. School-age children eat three meals a day and one or two nutritious
snacks.
3. They need a protein – rich food at breakfast to sustain the prolonged
physical and mental effort required at school.
4. Parents should be aware that children learn many of their food habits by
observing their parents.
G. Reactions to Hospitalization
1. Experience fear of separation from family and friends.

2. Fear of getting behind in school.
3. Fear of body mutilation and loss of independence.
4. Exhibit stress by attempting to negotiate, crying, fighting withdrawal, and
attempting to be brave.
5. They ask many questions.
1. Describe illness; treatments, and procedures to child and parent.

2. Allow questions and answer in simple terms.
3. Allow independence and choices as much as possible.
4. Encourage doing schoolwork.
5. Set limits, establish routines.
6. Utilize play therapy or playing with other children of the same age.
7. Tell the child crying okay, provide the child with privacy after procedures to
recompose self.
8. Monitor growth and development.
ADOLESCENCE (12 -20 years)
1. The period during which the person becomes physically and

psychologically mature and acquires a personal identity.

2. It is the period of Puberty, the first stage of adolescence in which sexual
organs begin to grow and mature. Also referred to as Adolescent Growth
Spurt.
3. Growth is fastest for boys at about 14 years and the maximum height is
often reached at about 18 or 19 years. With girls, at about 15-16 years.
4. Both primary and secondary sex characteristics develops.
5. Female internal reproductive organs reach adult size about age 18-20
years.
GENITAL STAGE (18 years and after)
Adolescent develops sexual maturity and learns to establish satisfactory

relationships with the opposite sex
1. Provide opportunities for the child to related with opposite sex.

2. Allow child to verbalize feelings about new relationships.
IDENTITY VS. ROLE CONFUSION (12-20 years)
Adolescents learn who he or she is and what kind of person he or she will be
by adjusting to a new body image, seeking emancipation from parents,
choosing a vocation, and determining a value system.
Significant Person: PEER GROUPS
The peer groups have a number of functions. It provides a sense of

belonging, pride, social learning, and sexual roles. In adolescence, the peer
groups change with age, they start as single-sex groups, evolves to mixed
groups, and finally narrow to couples who share activities.
1. Provide opportunities for the adolescent to discuss feelings about events

important to him or her.
2. Offer support and praise for decision-making.
FORMAL OPERATIONAL THOUGHT (Over 12 years)
1. Adolescents are highly imaginative and idealistic.

2. Adolescent’s capacity to absorb and use knowledge is great.
3. They usually select their own areas for learning; they explore interests
from which they may evolve a career plan.
4. The main feature of this stage is that people can think beyond the present
and beyond the world of reality.
5. They consider things that do not exist but that might be and consider
ways, things that should be or ought to be.

6. Thought processes: logical, organization, and consistency, Mature or adult
thought.
7. Can solve hypothetical problems with scientific reasoning.
8. Understands causality and can deal with the past, present, future.
1. Post - Conventional Level: Stage V – SOCIAL CONTRACT, LEGALISTIC

ORIENTATION – standard of behavior is based on adhering to laws that
protect the welfare and rights of others. Personal values and opinions are
recognized and violating the rights of others is avoided.
2. Post - Conventional Level: Stage VI – UNIVERSAL – ETHICAL
PRINCIPLES – Universal moral principles are internalized. Person
respects other humans and believes that relationships are based on
mutual trust.
F. Nutrition
1. The need for protein, calcium, Vit. D, iron, B complex and calories
increase during adolescence because of growth spurt.
2. An adequate diet for an adolescent is 1 qt. of milk per day as well as
appropriate amount of meat, vegetables, fruits, breads, and cereals.
3. Teenagers have active lifestyles and irregular eating patterns. They tend
to snack frequently, often eating high-calorie foods such as doughnuts,
softdrinks, ice creams, and fast foods.
4. Parents can provide healthy snacks such as fruits and cheese and at the
same time limit the amount of junk foods available in the home.
5. The teenager’s food choice is related to physical, social, and emotional
factors and impulses and may not be influenced by teaching.
6. Common problems related to nutrition and self-esteem among
adolescents include obesity, anorexia, nervosa, and bulimia.
G. Reactions to Hospitalization
1. They experience fear of being different, embarrassment, bodily injury,

separation from family and friends, loss of privacy, and loss of
independence.
2. May exhibit overconfidence, withdrawal, non-compliance with regimen,
regression and acting out.
1. Maintain honest and open communication.

2. Provide information regarding illness and treatments.
3. Encourage questions and provide under-standable answers.
4. Provide privacy.
5. Encourage interactions with faculty, friends and others in age group who
are hospitalized.
6. Assist with maintaining homework.
7. Allow decision making as much as possible.
8. Set limits.

The learners will accomplish a 30-item multiple choice quiz; this will be
accomplished within 30 minutes at a given date and time
The learners will create a Concept Diagram illustrating link

between the different theories on a particular stage of
development assigned to their group.
Summary and conclusion
All children pass through predictable stages of growth and development. To

make care holistic, it is important to consider all aspects of the child’s health physical,
emotional, cognitive and social and remember that each child’s developmental progress
is unique. A child cannot be forced to achieve a milestone faster than that child’s own
timetable will allow. Through anticipatory guidance, a child, however, can be
encouraged to reach his or her maximum developmental potential. Nurses can play an
important role in offering guidance to both the child and family toward this end.
Reflection Question/Learning: posted in the Discussion

tab of MyClass
1. What are the significant concepts that you learned

from the sessions pertaining to Growth and
Development?
2. How did you find the activities for Growth and
Development?
References:
Adopted From:
The Self – Instructional Modules in Maternal and Child Health Nursing
Author: Dr. Zenaida S. Fernandez
PRESCRIBED TEXT:
Silbert-Flagg, J. and Pilliteri, A. (2018). Maternal child health nursing: Care of the
childbearing and childrearing family. Volume 1 and 2 (Philippine edition); 8 edition. th
Philadelphia: Lippincott
Books:
Green, C. (2016). Maternal newborn: nursing care plans. (3rd edition). Burlington, MA: Jones and Bartlett
Learning.
Visovsky,C (2019) Introductory maternity and pediatric nursing, Philadelphia: Wolters Kluwer

Williams and Wilkins Health. 6. Hockenberry, M. (2017). Wong’s essentials of pediatric nursing. St. Louis.
PREPARED BY:
Ma. Corazon Tanhueco, RN, MAN

NCM 0107 Instructor
Contributor:
DRA. ANGELA MARIE GONZALES

NCM 0107 Instructor
Peer Evaluator/s:
BRENDA B. POLICARPIO RN, RM, MN

NCM 0107 Instructor
Reviewed By:
Jennie C. Junio, RN, MAN

Level II Academic Coordinator
Debbie Q. Ramirez, RN, PhD

Assistant Dean, College of Nursing
APPROVED BY:
Zenaida S. Fernandez, RN, PhD

Dean, College of Nursing

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ANGELES UNIVERSITY FOUNDATION

Understanding the stage of development a child has reached is important,

Module Learning Outcome:

Learning Outcome 1: Integrate concepts, theories and principles of sciences and

At the end of the module, the learners will be able to:

1. Differentiate growth from development

1 | GWORTH AND DEVELOPMENT

Activity 1 10-item multiple choice quiz will be given through

Multiple Choice: Choose the BEST answer:

2. The infant attends to speaking voice and social smile by:

3. The infant sits alone without support by:

4. All of the following are cognitive development of the toddler: EXCEPT:

A. Coordination of Secondary Education

5. Types of play for infant:

A. Initiative versus Guilt

2 | GWORTH AND DEVELOPMENT

10. Nutritional need of a schooler will be best met by:

3 | GWORTH AND DEVELOPMENT

GROWTH – is generally used to denote an increase in physical size or a quantitative change.

DEVELOPMENT – is used to denote an increase in skill or the ability to function or a qualitative

- Development can be measure by observing a child’s ability to perform specific tasks, or by

FACTORS INFLUENCING GROWTH AND DEVELOPMENT

PRINCIPLES OF GROWTH AND DEVELOPMENT

Developmental Task – is a skill or a growth responsibility arising at a particular time in an

1. FREUD’S PSYCHOANALYTIC THEORY

Sigmund Freud (1856 – 1939), an Austrian neurologist and founder of psychoanalysis

He described child development as being a series of psychosexual stages in which the

4 | GWORTH AND DEVELOPMENT

According to Erikson, the successful resolution of each conflict, or accomplishment of

3. PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

Piaget (1896-1980), a Swiss psychologist, introduced concept of cognitive development.

4. KOHLBERG’S STAGES OF MORAL DEVELOPMENT

Activity 2: The learners will watch videos on:

c. Kohlberg’s 6 Stages of Moral Development

5 | GWORTH AND DEVELOPMENT

What are my realizations after watching the selected videos

INFANTS (BIRTH TO 1 YEAR)

A. Physiologic Growth and Development

MOTOR AND SOCIAL DEVELOPMENT IN INFANCY TO PRESCHOOLER

AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

6 | GWORTH AND DEVELOPMENT

MOTOR AND SOCIAL DEVELOPMENT IN INFANCY TO PRESCHOOLER

AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

7 | GWORTH AND DEVELOPMENT

AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

MOTOR AND SOCIAL DEVELOPMENT IN INFANCY TO PRESCHOOLER

AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

30 months - Can jump down from - Verbal language is

8 | GWORTH AND DEVELOPMENT

MOTOR AND SOCIAL DEVELOPMENT IN INFANCY TO PRESCHOOLER

AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT

1. Provide oral stimulation by giving pacifiers.

1. Responds promptly to an infant's needs.

1. Neonatal Reflex – 1month

9 | GWORTH AND DEVELOPMENT

3. Secondary Circular Reactions – 4-8 months

Good game: Peek-a-Boo

4. Coordinating of Secondary Reactions – 8-12 months

Type of Play: OBSERVATION – Infant watches particular play intently,

Preconventional Stage I: Punishment-Obedience Orientation. Child does right

1. Provide help to children to determine what are the right actions.

Breastmilk is still BEST milk for babies.

1. It is readily available, convenient and economical.