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Principles of Growth and Development
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Principles of Growth and Development
• Growth
– Physical increase in the body’s size and
appearance caused by increasing numbers of
new cells
• Development
– Progressive change in the child toward maturity
• Maturation
– Completed growth and development
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Patterns of Growth and Development
• Cephalocaudal development
– The child is able to control the head and neck
before being able to control the arms and legs
• Proximodistal development
– Growth starts in the center and progresses
toward the periphery, or outside
– The child can control movement of the arms
before being able to control movement of the
hands
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Patterns of Growth and Development (cont.)
• Developmental tasks
– Basic achievements associated with each stage
of development
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors Related to
Growth and Development
• Height
• Weight
• Standards of growth
• Standards of development
• Body proportions
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Influences on Growth and Development
• Genetics
• Nutrition
• Environment
– Play and
entertainment
– The homeless family
• Divorce
• Being a latchkey child
• Being
a runaway child
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Growth and Development of the
Body Systems
• Nervous system
• Sensory organs
– Eyes
– Ears
• Respiratory system
• Cardiovascular and hematologic systems
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Growth and Development of the
Body Systems (cont.)
• Gastrointestinal system
• Endocrine system and hormonal function
• Genitourinary system
• Musculoskeletal system
• Integumentary and immune systems
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Theories of Child Development
• Sigmund Freud
– Concerned primarily with the libido
• Erik Erikson
– Series of 8 developmental tasks or crises
• Jean Piaget
– Brought new insight into cognitive development
• Kohlberg
– Development of moral reasoning in children
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Freud’s 3 Levels of Consciousness
• Id
– Controls physical needs and instincts of the body
• Ego
– The conscious self; controls the pleasure principle
of the id by delaying the instincts until an
appropriate time
• Superego
– The conscience or parental value system
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Psychosexual Stages in Freud’s Theory
• Oral (0–2 years)
– The newborn first relates almost entirely to the
mother; first experiences with body satisfaction
come through the mouth
• Anal (2–3 years)
– The child’s first encounter with the serious need
to learn self-control and take responsibility
• Phallic (3–6 years)
– Interest moves to the genital area as a source of
pride and curiosity
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Psychosexual Stages in Freud’s Theory (cont.)
• Latency (6–10 years)
– The time of primary schooling; the child is
preparing for adult life but must await maturity
to exercise initiative in adult living
• Genital (11–13 years)
– Physical puberty is occurring at an increasingly
early age; social puberty occurs even earlier
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Erikson’s Stages of
Psychosocial Development
• Trust vs. mistrust
– The infant learns that his or her needs will be met
• Autonomy vs. doubt and shame
– The toddler learns to perform independent tasks
• Initiative vs. guilt
– The child develops a conscience and sense of right
and wrong
• Industry vs. inferiority
– The child competes with others and enjoys
accomplishing tasks
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Erikson’s Stages of
Psychosocial Development (cont.)
• Identity vs. identity confusion
– The adolescent goes through physical and emotional
changes as he or she develops independent self
• Intimacy vs. isolation
– The young adult develops intimate relationships
• Generativity vs. self-absorption
– The middle-aged adult finds fulfillment in life
• Ego integrity vs. despair
– The older adult is satisfied with life and
achievements
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Piaget’s 4 Stages of
Cognitive Development
• Sensorimotor phase
– The infant uses the senses for physical satisfaction
• Preoperational phase
– The young child sees the world from an egocentric
point of view
• Concrete operations phase
– The child learns to problem-solve in a systematic
way
• Formal operations phase
– The adolescent has own ideas and can think in
abstract ways
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Kohlberg’s Stages of Development of Moral
Reasoning in Children
• Preconventional level (premoral level)
– No moral sensitivity; time of egocentrism
• Conventional level
– As concrete operational thought develops,
children can engage in moral reasoning
• Postconventional level (principled level)
– The adolescent must have attained the formal
operational stage
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Theories of Child Development
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Other Theorists
• Arnold Gesell
• Carl Jung
• John Bowlby
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Communicating With Children and
Family Caregivers
• Principles of communication
• Infants
• Young children
• School-age children
• Adolescents
• Caregivers
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Nurse’s Role Related to
Growth and Development
• Understanding factors and influences and normal
or expected patterns related to growth and
development of the infant, child, and adolescent
• Talking to the child at his or her level of
development
• Teaching and working with family caregivers
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins