THEORIES OF GROWTH AND DEVELOPMENT:

INTRODUCTION:

The period of growth and development extends throughout the life cycle,
however, the period in which, the changes occurs from conception to the end of
adolescence. Growth and development are terms often used interchangeably. each
depends upon the other and in a normal child they parallel each other, but the terms
are not the same.

Growth refers to an increase in physical size of the whole or any of its parts
and can be measured in inches or centimeters and in pounds or kilograms. Growth
results because of cell division and the synthesis of proteins. It causes a quantitative
changes in the child’s body.

Development refers to the progressive increase in skills and capacity to

function. It causes a qualitative change in the child’s functioning.

STAGES OF GROWTH AND DEVELOPMENT:

Nurses will find a clear understanding of the stages of growth and

development useful in the case of children of various ages.

1. prenatal period/antenatal period. (from conception to delivery)

2. new born period ( birth to 7 days)
3. neonatal period ( birth or 7 days to one month)
4. infancy ( 1 month to one year)
5. toddler (1 year to 3 years)
6. pre school age ( 3 years to 6 years)
7. school age ( 6 years to 12 years)
8. adolescence (from puberty to the beginning of adult life)
 early adolescence ( 12-13 years)
 middle adolescence (14-16 years)
 late adolescence (17-20 years)
9. adulthood ( from 20-60 years)
 early adulthood ( 20-40 years)

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  middle adulthood (40-60 years)
10.old age (60 years and above)

THEORIES OF GROWTH AND DEVELOPMENT:

many theories have been devised to study the development of children. The
development of children can be divided into several areas, intellectual, moral,
emotional, sexual, social and speech and spiritual. There are some theories are
important to deal with the development of children. They are,
i. psychosocial development.
ii. Psychosexual development.
iii. Cognitive/intellectual development.
iv. Moral development.
v. Spiritual development.
vi. Emotional development.
vii. Social development.
viii. Language and speech development.
ix. Body image development.

THEORY OF PSYCHOSOCIAL DEVELOPMENT: (ERICKSON)

The most widely accepted theory of personality development is that

advanced by Erickson (1963). Although built on Freudian theory, it is known as
psychosocial development and emphasize a healthy personality as opposed to a
pathologic approach.
Each psychosocial stages has two components, the favorable and the
unfavorable aspects of the core conflicts and progress to the next stage depends on
resolution of this conflict.

I. Trust vs mistrust ( birth to 1 year)

The first and most important attribute to develop for a healthy
personality is a basic trust. Establishment of basic trust dominates the first year of life
and describes all the child’s satisfying experiences at this age. It consistent of loving
care by a mothering person is essential to development of trust.
Mistrust develops when trust promoting experiences are deficient or
lacking or when basic needs are inconsistently or inadequately met. The result is faith
and optimism.
II. Autonomy vs shame and doubt(1-3 years)

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e development of autonomy during the toddler period is centered on children’s
increasing ability to control their bodies, themselves and their environment. They
want to do things for themselves using their newly acquired motor skills of walking,
climbing, and manipulating and their mental powers of selection and decision making.
Negative feeling of doubt and shame arise when children are made
to feel small and self conscious. When their choices are disastrous, when others shame
them or when they are forced to be dependent in areas in which they capable of
assuming control. The favorable outcome are self-control and willpower.

III. Initiative vs guilt (3-6 years)

Children explore the physical world wit all their senses and
powers. They develop a conscience. No longer guided only outsiders, there is an inner
voice that threatens. Children’s sometimes undertake goals or activities that are in
conflict with those of parents or others, and being made to feel that their activities or
imaginings are bad produces a sense of guilt. The lasting outcomes are direction and
purpose.

IV. Industry vs inferiority. (6-12 years)

The children’s are ready to be workers and producers. They want

to engage in tasks and activities that they can carry through to completion. They need
and want real achievement. It is a decisive period in their social relationship with
others. Feeling of inadequacy and inferiority may develop if too much is expected of
them.

V. Identity vs role confusion. (12-18 years)

The children become overly pre occupied with the way they
appear in the eyes of others as compared with their own self concept. Adolescence
struggle to fit the roles they have played and those they hope to play with the current
roles and to come to a decision regarding an occupation. Inability to solve the core
conflict results in role confusion.

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THEORY OF PSYCHOSEXUAL DEVELOPMENT: (FREUD)

Sigmand freud considered the sexual instincts to be significant in the

development of the personality. However he used to the term psychosocial to describe
any sensual pleasure.

i. Oral stage: (birth to 1 year)

During infancy the major source of pleasure seeking is
centered on oral activities such as sucking, biting, chewing, and vocalizing. The
preferred method of oral gratification can provide some indication of personality they
develop.

ii. Anal stage: (1-3 years)

Interest during the second year of life centers in the anal region
as sphincter muscles develop and children are able to withhold or expel fecal material
at will. At this stage the climate surrounding toilet training can have lasting effects on
children’s personalities.

iii. Phallic stage: (3-6 years)

During this stage the genitals become an interesting and
sensitive area of the body. Children recognize differences between the sexes and
become curious about the dissimilarities. This is the period around the controversial
issues of Oedipus and Electra complexes.

iv. Latency period: (6-12 years)

During this period children elaborate on previously acquired
traits and skills. Physical and psychic energy are channeled into acquisition of
knowledge and vigorous play.

v. Genital stage: (age 12 and older)

The last significant stage begins at puberty with maturation
of the reproductive system and production of sex hormones. The genital organs
become the major source of sexual tensions and pleasures but energies are also
invested in forming friendships and preparation for marriage.

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THEORETIC FOUNDATIONS OF MENTAL DEVELOPMENT:

The term cognition refers to the process by which developing individuals

become acquainted with the world and the objects it contains. Children are born with
interested potentials for intellectual growth, but they must develop into that potential
through interaction with the environment.

With cognitive development, children acquire the ability to reason

abstractly, to think in a logical manner, and to organize intellectual functions or
performance into higher order structures. Language, morals, and spiritual development
emerge as cognitive abilities advance.

THEORY OF COGNITIVE DEVELOPMENT: ( PIAGET)

Cognitive development consists of age-related changes that occur in

mental activities. Thus intellectual development occurs from infancy on through the
years when behavior changes as a result of,
1) Maturation of innate capacities.
2) Conditioning – learning by association of a stimulus with a
response.
3) Reinforcements of appropriate behaviors.
4) Imitation of the behavior of others.
5) Insight.

Each stage is derived from and builds on the accomplishments of the

previous stage in a continuous, orderly process. It is divided into the following stages.
They are,

I. Sensory motor ( birth to 2 years)

In the sensory motor stage the children’s progress from reflex activity
through simple repetitive behaviors to initiative behavior.
They develop a sense of “cause and effect” as they direct behavior toward objects.
Problem solving is primarily trial and error.
Display a high level of curiosity, experiment and enjoyment of
novelty and begin to develop a sense of self as they are able to differentiate
themselves from their environment. They become aware that objects have
permanence, that an object exists even though it is no longer visible.

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 Towards the end of the sensory motor period children begin to use
language and representational thoughts.

II. Pre operational stage (2 – 7 years)

The predominant characteristics of the pre operational stage of
intellectual development is egocentrism, which in this sense does not mean selfishness
or self centeredness, but the inability to put oneself in the place of another.
They are unable to see the things from any perspective other
than their own, they cannot see another’s point of view.
The pre conceptual phase is age 2 to 4 and intuitive thought
phase is age 4 to 7 years. The two main phases are totally egocentric thought to social
awareness and the ability to consider other view points.
Language continues to develops during the preschool period.
Speech remains primarily a vertical of egocentric communication.
Though imaginative play, questioning and other interacting,
they begin to elaborate concepts and to make simple associations between ideas.
(e.g.) all women with big bellies have babies.

III. Concrete operations: ( 7- 11 years)

In this age thought becomes increasingly logical and coherent,
children are able to classify , sort, orders, and otherwise organize facts about the world
to use in problem solving.
Adolescents are capable of mentally manipulating more than
two categories of variables of the same time. (e.g.) the relationship between speed,
distance, and time in planning a trip.
The children realize that physical factors such as volume,
weight, and number remain the same even though outward appearances are changed.
Though progressive changes in thought process and relationships with other thought
becomes less self-centered . thinking has become socialized.

IV. Formal operations: ( 11 to 15 years)

Formal operational thought is characterized by adaptability and
flexibility. Adolescents can think in abstract terms, use abstract symbols, and draw
logical conclusions from a set of observations. (e.g.) they can solve the following
questions.
If A is larger than B. and B is larger than C. which symbol is the largest?
The answer is A.
Although they may confuse the ideal with the practical , most contradictions in
the world can be death with and resolved.

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THEORY OF MORAL DEVELOPMENT ( KOHLBERG )
Moral development as described by Kohlberg(1968), is based on
cognitive developmental theory and consists of the following three major levels, each
of which has two stages. They are,

a) pre conventional level.

b) Conventional level.
c) Post conventional level or principled level.

Pre conventional level:

The conventional level of moral pre operational level of cognitive development
and intuitive thought. The children integrate for their action in physical or pleasurable
consequences. (e.g) good / bad and right or wrong.

1st stage: the children determine the goodness or badness of an action in terms of
consequences. They avoid the punishment and obey without question.

2nd stage: the children determine the right behavior which is satisfies their own needs.
Although elements of fairness, give and take, and equal sharing are evident, they are
interpreted in a very practical, concrete manner without loyalty, gratitude or justice.

Conventional level:

At the conventional stage children are concerned with conformity and

loyalty. The maintenance of family, group or national expectations regardless of
consequence.
Obeying the rules , doing ones duty, showing respect for authority, and
maintaining the social order is the correct behavior. This level is correlated with the
stages of cognitive development.

Post conventional level:

The post conventional level the individual has reached the cognitive stage of
formal operations. In general individuals rights and standards that have been
examined and agreed by the entire society
The rules are reaching the consensus which becomes important on the legal
point of view, there is also emphasis on the possibility for changing law in terms of
societal needs and rational considerations..
THEORY OF EMOTIONAL DEVELOPMENT:

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 Personality is the composite physiologic, psychologic and sociologic
qualities of individuals.

The theory of Eriksson concerning emotional development

 Emotional development wrote Eriksson (1963), a psychologist and

psychoanalyst, is a continuous process.
 In each stage of child’s emotional development, a central problem exists for
which a solution should be found.
 Solving each problem at the child’s particular stage of development lays basis
for progress to the next stage.
 Proper guidance and the solution of the sequence of problems are necessary
at each stage of development to secure functional harmony in adult life.

a) Birth to one year ( the infant)

 Sense of trust.
 Infant’s learn to trust the adults , usually the parents who loves for them and
are sensitive to their needs.
 A negative outcome of the period of infancy is a sense of mistrust.
b) One year to three year. Sense of autonomy.

 Infants develops from clinging, dependent creatures into human beings with
minds and wills of their own.
 In this stage in their maturing , they will have degree of self control caused not
by fear but by have a feeling of self control.
 If they don’t, they will doubt their own worth and that of others and will have a
sense of shyness , doubt, and shame.

c) Three to six years: ( the pre school child)

 Sense of initiation.
 Children at this age want to learn what they can do for themselves.
 They have active imaginations, imitating adult behavior and wanting to share
in adult activities.
 The negative outcome is a personality is overwhelmed by guilt.

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d) Six to twelve year’s. ( the school age child)

 Sense of industry.
 Children in these age group have a strong sense of duty.
 They want to engage in tasks in their social world that they can carry out
successfully and they want their success to be recognized by adult’s and by
their peers.
 The negative outcome is development of a sense of inferiority.

e) Twelve years ( the beginning of adolescence)

 Sense of identity.
 Adolescents want to clarify who they are and what their roles in society are to
be.
 This will brings self-esteem.
 The danger is identify diffusion, for they face in reality and in their dreams of
the future a life full of conflicting desires, possibilities and chances.

f) Sense of intimacy
.
 After puberty, youth outgrow the “gang age” that age when they find it
essential to belong to a group of their own sex and age.
 Failure to establish intimacy results in psychologic isolation-keeping relations
with others on a formal basis that lacks warmth.

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THEORY OF SOCIAL DEVELOPMENT:

Infancy(0-1year)

Toddler(1-3years)

Preschool(4-5years)

Six years to puberty(6-11yrs)

Adolescence(12-18years)

Infant : self.
Toddler : parent, dependent.
Preschool : family, beginning independence.
School age : neighborhood, dependence>independence.
Adolescence: community, dependence = independence.
Maturity : beyond own community, dependence < indpendance.

Psychologic horizons of youth. Horizons expand in the growing years.

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 Socialization, or social development, means training a child in the
culture of group.

 Children’s are prepared for their adult roles through a process of

socialization that takes place from birth to adulthood.
 Children learn to socialize by meeting and communicating with
people of various ages and by participating in the activities of family
life and in the doing’s of their peer and community group.

THEORY OF SPIRITUAL DEVELOPMENT:

Fowlers theory concerning the development of faith:

 Fowlers (1974) developed a staged theory of faith, which parallel the

formal developmental process proposed by piaget and Kohlberg
although differing in emphasis on emotion and feeling.
 According to fowler, faith is human universal that is expressed
through beliefs, rituals, and symbols specific to religious traditions. It
is multi dimensional and a way of learning about life.

 Persons may acquire their religious beliefs and preferences in

childhood and may deepen those convictions as their develops or they
may change religious beliefs in adulthood.

Stage 1. primal faith. (infancy)

 This stage embodies the trust between parents and infants.

 Parents and child from a mutual attachment and progress through a
period of give and take.

Stage 2. intuitive – projective faith. (early childhood)

 Most typical from ages 3 to 7 years. This stage is characterized by the

forming long lasting images and feelings.

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  The cultural beliefs of the family influences the child’s concepts of
health and sex.

Stage 3. mythic – literal faith. (childhood and beyond)

 Beginning at about age 7 years , children’s beliefs from the

perspectives of others.
 In addition they are able to stories, practiced and beliefs at the family
and the community, the child reaches stage 3 of faith development.

Stage 4. synthetic – conventional faith ( adolescence period & beyond)

 In this stage a persons experience extends beyond the family to peers ,

teachers and other members of society.
 As a result of cognitive abilities, the individuals is aware of the
emotions, personality patterns, ideas, thoughts, and experiences of self
and others that is “mutual interpersonal perspective- taking”.
 As a result , the individual has a cluster of values and beliefs in
concern with others.

THEORY OF LANGUAGE AND SPEECH DEVELOPMENT:

The term language development refers to the increasing quantity, range, and
complexity of language is a complex system of grammatical and semantic properties.
The actual utterances of the language is called speech. Children are able to speak it.

The steps of pre lingual speech are the same for all children, reflex
vocalization, bubbling, imitation of sounds finally, verbal utterances. In general, a
child’s grammatical development is rapid during the preschool years, is well advanced
by school age, and is very much like that of an adult by the middle elementary school
years.

The child’s articulations, or the ability to pronounce words correctly so that

they are understood, develops along with the language ability. Articulation skills
require the co ordinations of the tongue and lower jaw. Auditory discommunication or
the ability to hear the difference between sounds, is also important in speech
development. Sound imitation and word production assists in the child’s ability to
recognize correctly articulated before they van say them themselves.

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 Vocabulary, or semantic development progresses from infancy throughout
life. By 10 or 12 months the infant usually says the first word having meaning.
Vocabulary development then slows down while the child is learning to walk. The
most dramatic vocabulary development takes place between 18 months and 3 years of
age.

The first born child in a family develops language and speech earlier than
those children born later, probably because of the attention received from adults.
Single children develop language earlier then those with siblings. Girls learn language
and speak earlier than boys, probably because boys have slower rates of
neurophysiologic maturation.

The development of language may be impaired or related by many factors.

Congenital defects of the oral cavity and nasopharynx , maternal deprivation,
deafness, mental retardation, and emotional problems and respiratory difficulties.

Individual and group differences alter children’s language development.

There may be differences in verbal knowledge, fluency of ideas, oral speech ability,
abstract reasoning ability in using language and articulation.

DEVELOPMENT OF BODY IMAGE:

From infancy children slowly develop a body image , a mental picture of what
their body is like along with certain attitudes towards it and its parts. The body image ,
although , constantly changing is based on knowledge of the body according to past
and present perceptions of its biologic configuration, physiologic functioning and
developmental maturation and on the social reinforcement of others. It includes both
conscious and unconscious feeling about the body.

The development of body image is a dynamic process proceeding throughout of

life. It includes giving to one’s body of any point in line the characteristics of certain
and distinctness from others.

CONCLUSION:

Different authors given different theories for growth and development. These
theories says child’s physical, social, psychological and sexual development. Child

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will go through different stages of development that development is very important in
child’s life.

BIBLIOGRAPHY:

Marlow, R. Dorothy and Reciding A. Barbara (2002), “text book of pediatric

nursing’, 1st edition, published by Harcourt India, new delhi. Page no: 171-
181.
Neeraja, K.P. (2006) “ text book of growth and development for nursing students”, 1st
edition Elsevier publication, page no: 5-26.
Hockenberry J. Marilyn (2005), “ wong’s essentials of pediatric nursing”, 7th edition,
Elsevier publication, page no: 79-102.
Berk . E. Laura (2005) “ child development” 6th edition, pearson, prentice hill, page
no: 390-400.
Dutta .A.K. 92007) “ advances in pediatrics “ 1st edition, Jaypee brothers medical
publishers, page no: 40-56.

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