MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.

Development used to indicate an increase

Outline
Growth and Development in skills or the ability to function, qualitative
Principles of Growth and Development change (a.k.a Maturation)
Major Factors Influencing Growth and
Development
Structure of Personality Ways to measure:
Theories of Child Development
Sigmund Freud’s Psychoanalytic Theory
Eric Erikson’s Theory of Psychosocial 1. Observation of child’s performance
Development 2. Note parents’ description of child’s
Jean Piaget’s Theory of Cognitive
Development progress
Lawrence Kohlberg’s Theory of Moral 3. Use of DDST (Denver Developmental
Development
Assessment for Promotion of Normal Growth Screening Test), modified as MMDST
and Development (Metro Manila Developmental
Nursing Diagnosis
Outcome Identification and Planning Screening Test) in the PH
Outcome Evaluation
5 Main Areas of Development

Growth and Physical – height, strength

Development Emotional – trusting rs, attitudes, feelings

Growth is focused on the physical Intellectual – thinking and understanding

Social – interaction
characteristics of an individual
Spiritual – search for transcendental meaning
Parameters of Growth
• Psychosocial Development - sensual

1. Weight – measured in grams, kg, pounds pleasure

2. Height – inches, feet, cm • Moral Development – to know what is

right from what is wrong, applied in real
life situations (Kohlberg)
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
• Cognitive Deve – ability to learn / - Before being able to use the toilet the
understand / acquiring knowledge, infant should learn to walk first
child’s response to new situations
(Piaget) Principles of Growth
Maturation and Development

- Development of cells until they are

ready to function
- An increase in human competence and
adaptability

Developmental Task

– growth responsibility that arises at a

certain time in the course of
development
1. Growth and develop are continuous
processes from conception until death
2. All aspects of development are
interrelated
3. Continuous and gradual
4. Not uniform
5. Follows an orderly pattern
a. Cephalocaudal (head to toe)
b. Proximo-distal (motor development)
• 3 -4 mos the infant has a good control in
their upper extremities (ex. Picking up
food or things)
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
• Nearest part to the center of the body to • Neonatal reflexes are replaced
the farthest (arms to fingers) by purposeful movement
c. General to specific (gross to refined) 14. Development is affected by cultural
• Perform fine motor skills (ex. Writing ) changes
6. There are period of accelerated and 15. There are social expectations for every
decelerated growth rate stage of development
• Children would pass thru 16. Development is a product of heredity
growth and development in a and environment
predictable manner but each
individual may have their Major Factors
Influencing Growth
different time or rate?
7. All individuals are different
8. Early foundations are critical and Development
9. Each phase of development has hazards
10. Each phase of development has A. Genetics – physical characteristics,

characteristic behavior learning style, and temperament, genetic

11. There is an optimum time for initiation abnormality

of developmental experiences or B. Gender – girls are born lighter than boys

learning by 1 oz / inch and girls start puberty 6

12. Most developmental skills and behaviors mos-1yr than boys

are learned by practice C. Health – depending on what type of

• Infant would practice over and illness and available therapy

over before successfully taking D. Intelligence – a child with high

their first step intelligence do not grow faster

physically, they may fall behind in skills
• Children may fall behind g and
because they spend time reading rather
d because of illnesses
than doing things to develop their motor
13. Neonatal reflexes must be lost before
skills
motor development can proceed
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
would approach new situations in
unruffled manner, some may smile or
E. Environment
cry to strangers
- those children with low socioeconomic
4. Adaptability – change one’s reaction to
level will not receive the adequate
stimuli over time, they could be
nutrition needed such as immunizations
adaptable to any change without distress
- Parent-child relationship – the time
5. Intensity of reaction – children may
spend with the children is important,
react to situations with their body like
inadequacy with parent love would
tantrums when hungry or wet diaper
interfere with the child’s emotional state
6. Distractibility – shift easily to a new
that can affect their development
situation
- Ordinal position in the family –
7. Attention Span and Persistence – ability
youngest children develop slow in
to remain interested to a project or
language, only child has good speaking
activity
skills because they talk to adult often
8. Threshold of response – intensity level
- Health
of stimulation necessary to evoke
F. Temperament – the reaction pattern of
reaction (low threshold – high
an individual, individual’s characteristic
stimulation, high threshold – low
of thinking or behaving in the
stimulation)
environment, easy child or difficult child
9. Mood quality – negative or positive
• Reaction patterns that determine
condition, jakol jakol lang (just always
temperament
keep on laughing)
1. Activity level – differs widely
• Categories of temperament
2. Rhythmicity – with set patterns, they
a. The easy child – easy to care for, 40 –
have regular rhythm in physiologic
50 % of children
patterns, they have the same task
b. The difficult child – withdraw rather
everyday
than approach new situations’ 10%
3. Approach - response on initial contact
with a new stimulus, some children
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
c. The intermediate child – combination of - Promotes satisfactory adjustment in
the easy and difficult child relation to the environment
d. Slow-to-warm-up child – adapts slowly 3. Super Ego
to new situations. 15% - Developed during preschool
- Conscience – morality principle
Development of Mental - Emerges at around age 5
Function and Personality
Factors Affecting Personality
Development
Development
- Individual adjustment to his
environment 1. Heredity

- Covers appearances, abilities, motives, - Characteristics present at birth: body

emotional reactivity and experiences build, eye color, skin, hair type

that have shaped him to his present 2. Birth Order

person - 1st born, middle, later

- Early experiences influence behavior 3. Parents

later in life - Age of parents, occupation, economic

- Mostly established by the age of five status, religious orientation, level of

education and cultural heritage

Structure of 4. Culture

Personality Theories of child

1. ID development
- Developed during infancy
- Operates in pleasure principle to reduce - Developmental theories provide road

tension or discomfort maps for explaining human development

2. Ego - Achievement of developmental tasks or

- Developed during toddler period growth tasks which will provide a

- Reality principle
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
foundation for the accomplishment of - This theory is based on mentally
future tasks disturbed adults
- Chronologic age - Libido arouse from within the person
- It is not so much chronologic age as the A. The Infant
completion of developmental tasks that - “Oral Phase” – infants are so interested
defines whether a child has passed from in oral stimulation (or pleasure) during
1 developmental stage of childhood to this time
another - Infants usually suck for enjoyment or
• Developmental Skills - Skill or relief and nourishment
growth responsibility arising in B. The Toddler
a particular time in an - “Anal Phase” – children’s interests
individual’s life, foundation of focus on the anal region as they begin
the accomplishment of future toilet training
task - Children find pleasure in both the
retention and defecation of feces
Sigmund Freud’s - Anal phase bcs children’s interest is
focused on 1 region – elimination or
Psychoanalytic urination

Theory C. The Preschooler

- “Phallic Phase” – masturbation and
exhibitionism are usual
D. The School-Age Child
- “Latent Phase” – children’s libido
appears to be diverted into concrete
thinking
- The preschooler enjoy pleasure zones -
- Austrian neurologist, founder of
shift from anal to genital
psychoanalysis – real theory of
personality development
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
E. The Adolescent A. The Infant
- “Genital Phase” – establishment of new - Trust vs mistrust (learning confidence ,
sexual aims and the finding of new love learning to love)
objects B. The Toddler
- Considers the main events of this period - Autonomy vs. shame or doubt
as the establishment of new sexual phase - Autonomy - self-government or
and findings of new love teams independence
C. The Preschooler
Eric Erikson’s - Initiative vs. guilt
Initiative – learn how to do things
Psychosocial
-
D. The School-Age Child

Development - Industry vs. inferiority

- Industry – accomplishment, rewards,
they will know that they are doing well
if they are rewarded
E. The Adolescent
- Identity vs. role confusion
- Interpersonal dimension would emerge

- Trained psychoanalytic theory during adolescence as identity vs role

confusion
- Adolescent would bring everything that
they learned about themselves or in their
lives
F. The Young Adult
- Sense of intimacy vs. isolation
- Intimacy – ability to relate well with
- Importance of culture and society other people
-
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
G. The Middle-Aged Adult - Sensory intelligence – practical
- Sense of generativity vs. stagnation intelligence
H. The Older Adult - Preoperational – children would relearn
- Integrity vs. despair some of the things they learned during
sensorimotor
Jean Piaget’s Theory
of Cognitive
Development

A. The Infant
- Piaget ref. to the infant stage as the

- Psychologist sensorimotor stage

- The way the children would learn and - Sensorimotor intelligence is practical

think intelligence
- Gain the concept of permanence
B. The Toddler
- Completes final stages of sensorimotor
period and begin to develop some
cognitive skills of the preoperative
period such as symbolic thought and
egocentric thinking
- The toddler would explore both
permanence and different actions
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
Child would be able to think what - animism and magical thinking – they
should be done and what would be the think of magic and in animating animals
solution for the problem or objects
- Investigate things or situations that are - Assimilation – taking an information
given to them and changing it to something that they
- Ff. are characteristics of toddlers: like
1. Trial and error D. The School-Age Child
2. Object permanence - Beginning of concrete operational
3. Begins ability to use symbols to thought
represent objects - Recognize cause-and-effect
4. Draw conclusion only from obvious relationships
facts that they see - Conservation
C. The Preschooler - Inductive reasoning or specific to
- Moving on to a substage of general
preoperational thought, intuitive thought - Reversibility
- They believe in the ff.: - Discover concrete solutions to everyday
1. Centering problems
2. Lack of conservation - Inductive reasoning – proceeds from
3. Animism and magical thinking specific to general, the school age tends
4. Role fantasy to reason out from a situation
5. Assimilation E. The Adolescent
- During this time children would tend to - Formal operational thought begins
look at an object and only see its - Adolescents are capable of the ff.:
characteristics 1. Abstract thinking
- centering – when given a banana they 2. Deductive reasoning, from general
can only see the color and not observe to specific
its other features - They are not only limited to thinking
about concrete thots because they
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.
already have abstract or - Infant’s learn from the reactions of their
scientific/deductive reasoning parents (scold – wrong/bad, praise –
good)
Lawrence Kohlberg’s - Development of trust is important in

Theory of Moral
moral development
- Those who have trust bound to have

Development moral conscience when they grow older

B. The Toddler
- Preconventional stage: “punishment
obedience orientation”
- “I help take care of my brother because
if I don’t, my mother will punish me”
- Psychologist - Centered mostly in what the parents
would say
- A child is good because the parent says
he/she must be good and not because
they know what is good and bad
- The toddler would only obey their
parents
C. The Preschooler
- Individualism and exchange
A. The Infant
- “lie still now for me while I change your
- Pre-religious stage
dressing and I will read you a story
- Infants have little concept of any
when I am through”
motivating force beyond that of their
- Tend to do good out of self interest
parents
- Egocentrism
- To support this stage, caregivers praise
- The action of the toddler is trade-off for
infants for doing what they have been
several actions
asked to do
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.

Assessment for
- Imitate what they could see Promotion of Normal
D. The School-Age Child
- Conventional development: “nice girl, Growth and
Development
nice boy” stage
- Children engage in actions that are
“nice” or “fair” rather than necessarily - Measure and plot height and weight on a
right standard growth chart for children at all
- “when people see what I have done, they health care visits to document growth is
will think I am a good person” occurring and the child’s growth
- Sharing is nice, stealing is not remains within a constant percentile
- May lie about their actions because they - Take a health history from both parents
disguise that they are involve in such an and the child and observe what specific
action (bad action) activities the child can accomplish to
E. The Adolescent establish whether developmental
- Postconventional development: law and milestones (major markers of normal
social order development) are being met
- “but there is no rule that says that I can’t - To see if there is a lag in the
do it” development of the child
- Capable of abstract thought - Document a 24 hr recall history for
- They do what is right regardless of if nutritional intake, sleep, and a
anyone is watching them description of school and play behaviors
- They carry out self-care measurements - From birth history, delivery of child
even when someone is not present
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.

Outcome Identification
and Planning

Nursing Diagnosis

- Every child’s developmental progress is

unique and cannot force achieve
milestones

- Incases of delayed growth we have to

help the parents accept this and motivate
the child
MATERNAL AND CHILD NURSING CARE

Principles of Growth and

Development
LEC 1/24/23 – Aly G.

Outcome Evaluation

- A plan can always be changed to

achieve the desired outcome