COGNITIVE THEORY

• Believed that learning was proceeded by the interplay of assimilation

(adjusting new experiences to fit prior concepts) and accommodation
(adjusting concepts to fit new experiences)

GROWTH & DEVELOPMENT Sensorimotor • Use of reflexes (0 – 1 month)

• Primary Circular (1 – 4 mos): does not
(0 – 2 years)
GROWTH DEVELOPMENT recognize external environment;
“everything around me is an extension of
Quantitative Qualitative my body”
• Secondary Circular (4 – 8 mos): child
Increase in physical size/mass Increase in skill and competency recognizes external environment;
of behavior touches body parts and recognize as part
of self
Measured by height (cm, inch) and Measured by developmental • Coordination of Secondary Schema (8 – 12
weight (kg, lbs) tasks (observation, description, mos): child realizes that external
DDST) environment can appear and disappear,
similar to “peek-a-boo”
PRINCIPLES OF GROWTH AND DEVELOPMENT • Tertiary Circular (12 – 18 mos): child
• Continuous, Orderly and Sequential develops rituals/routine
o Principle: Womb to tomb • Invention of New Means (18 – 24 mos):
• Optimum time is needed to produce a new skill start of imagination
o Principle: Wholistic readiness Preoperational • Preconceptual (2 – 4 yo): peak of
• Primitive reflexes have to be lost before meaningful behavior can begin
• Practice makes perfect (2 – 7 years) egocentrism and negativism; concept
• Patterns direct growth and development of ownership but not willing to share
• Intuitive (4 – 7 yo): no understanding of
o Cephalocaudal - head to toe conservation (size, weight, volume);
o Proximo-distal - center to periphery
o Gross to refined - simple to complex animism (putting life into non-living
• Each individual is unique objects); magical thinking
o Principle: Nature (genetics) vs. Nurture (environment) Concrete Operational • Seriation and Collection: able to classify
• Rates proceed with among different parts (7 – 11 years) and collect items
o Principle: Asynchronism (rate or speed the child grows) • Inductive reasoning is present
o Growth spurt: fast growth (infant and adolescent) → peripheries
o Growth gap: slow growth (toddler, preschool, school age) → Formal Operational • Abstract thinking
central (11 – 15 years) • Deductive reasoning is present
• Concept of time (past, present, future)
DEVELOPMENTAL THEORIES • Formulates hypothesis
1. Sigmund Freud: Psychosexual Theory
2. Erik Erikson: Psychosocial Theory
3.
4.
Jean Piaget: Cognitive Theory
Lawrence Kohlberg: Moral Development Theory
MORAL DEVELOPMENT THEORY
• The environment (family) hones the morals of the child
• Moral development starts at the age of 2 and beyond
PSYCHOSEXUAL THEORY
• There are parts of the body where a certain child gets satisfaction or has Level 1 Stage 0: Egocentric Judgment (0 – 2 yo)
a principal task (known as erogenous zones) Preconventional • Inability to take the perspective of others
• If the erogenous zone is not satisfied or the principal task is not obtained, • Negating other’s opinions
the child will have a fixation over that zone • Favorite word: “No”
• Cannot teach morality
EROGENOUS Stage 1: Punishment-Obedience (2 - 3 yo)
STAGE ZONE PRINCIPAL TASK FIXATION
• Driven by avoiding punishment
Infancy Oral Weaning (from Smoking • Healthiest form of discipline: timeouts
(Birth to 18 breastmilk, to bottle, Overeating • Child recognizes what is wrong
mos) to solid food) Nail biting Stage 2: Instrumental Relativist (3 - 7 yo)
Toddler Anal Toilet training Orderliness, • Driven by self-interest and rewards
(18 mos to obsessiveness • Positive reinforcement drives the child to do
3 yrs) good
If not, messiness • Child will not easily believe/rely on one person
only
Preschool Phallic Gender identity, Pride, vanity,
(3-6 yrs) complexes exhibitionism Level 2 Stage 3: Good boy, Nice girl (7 – 10 yo)
Conventional • Driven by social approval (compliments)
School Age Latent Learning and morality None (Libido is
(6-12 yrs) formation inactive) • “What I think is right is according to people’s
right”
Teaching right vs. Stage 4: Law and Order (11 – 12 yo)
wrong, simple tasks, • Driven by conforming to guidelines and
street smarts, rules
learning best inside • Obeys and acknowledges authority
school
Adolescent Genital Identification of Previous or Level 3 Stage 5: Social Contract
(13-18 yrs) gender identity multiple Post-Conventional • Driven by balance of social order and
fixations individual rights
Matured sexual or • Legalistic orientation: what is expected of you
intimate relationships as an individual
Stage 6: Universal Ethical
PSYCHOSOCIAL THEORY • Driven by internal morals and principles
• Trust is the foundation of all psychosocial tasks
• If trust cannot be established, the child can be suspicious, paranoid, and References:
schizophrenic
• Represented by a task and crisis
Berman, A. T., Snyder, S., & Frandsen, G. (2020). Kozier & erb’s
fundamentals of nursing (11th ed.). Upper Saddle River,
STAGE PSYCHOSOCIAL TASK NJ: Pearson.
Infancy (birth to 1 year) Trust vs. Mistrust
Silbert-Flagg, J. (2022). Maternal & Child Health Nursing: Care of
Toddler (1 – 3 years) Autonomy vs. Shame & Doubt the childbearing & childrearing family. Saint Paul, MN:
LWW.
Preschool (3 – 6 years) Initiative vs. Guilt
School Age (6 – 12 years) Industry vs. Inferiority
Adolescent (12 – 18 years) Identity vs. Role Confusion/Role
Diffusion
 SHORT QUIZ 10. The best method to explain a procedure to a hospitalized
preschool-age child is to:
1. According to developmental theories, which important event is A. Show the child a pamphlet with pictures showing the
essential to the development of the toddler? procedure.
A. The child learns to feed self. B. Have the 5-year-old next door tell the 4-year-old about
B. The child develops friendships. the experience.
C. The child learns to walk. C. Demonstrate the procedure on a doll.
D. The child participates in being potty-trained. D. Show the child a video of the procedure.

2. A 3-year-old child in a daycare program is seen playing with his 11. Which nursing action would help foster a hospitalized 3-year-
toys in the playroom. Which actions, according to the cognitive old’s sense of autonomy?
theory, is aligned with his cognitive level at this age? A. Let the child choose what time to take the oral
A. He is able to classify and collect different kinds of blocks antibiotics.
B. He recognizes his external environment as different from B. Allow the child to have a doll for medical play.
himself C. Allow the child to administer her own dose of co-
C. He does not allow his playmates to borrow his dinosaur amoxiclav via oral syringe.
toy D. Let the child watch age-appropriate videos.
D. He starts to use his body reflexes SELECT ALL THAT APPLY
3. A 16-year-old male is hospitalized for cystic fibrosis. He will be 12. Which of the following stages in Erikson’s psychosocial
admitted for 2 weeks while he receives IV antibiotics. Which action development theory are related to the early childhood years (ages
taken by the nurse will most enhance his psychosocial 1 to 6)? Select all that apply.
development? A. Trust vs. Mistrust
A. Fax the teen’s teacher and have her send in his B. Autonomy vs. Shame and Doubt
homework. C. Initiative vs. Guilt
B. Encourage the teen’s friends to visit him in the hospital. D. Industry vs. Inferiority
C. Encourage the teen’s grandparents to visit frequently. E. Identity vs. Role Confusion
D. Tell the teen he is free to use his phone to call or text
friends. 13. According to Piaget’s theory of cognitive development, which
4. Which comment should the parent of a 2½-year-old expect abilities are characteristic of the Preoperational stage (ages 2-7)?
from the toddler about a new baby brother? (Select all that apply)
A. “When the baby takes a nap, will you play with me?” A. Use of symbolic thinking
B. “Can I play with the baby?” B. Egocentrism
C. “The baby is so cute. I love him.” C. Logical operational thought
D. “It is time to put him away so we can play.” D. Conservation of mass
E. Development of imagination
5. Freud identified stages of psychosexual development. Which of 14. Both Erikson and Freud proposed developmental theories with
the following stages would a 5-year-old child most likely be distinct stages. Which of the following correctly pairs Erikson’s
experiencing, according to Freud’s theory? psychosocial stages with Freud’s psychosexual stages during early
A. Oral childhood? Select all that apply.
B. Anal A. Trust vs. Mistrust – Oral
C. Phallic B. Autonomy vs. Shame and Doubt – Anal
D. Latency C. Initiative vs. Guilt – Phallic
6. Which statement accurately describes how the school nurse D. Industry vs. Inferiority – Latency
should approach an 11-year-old to do a physical assessment? E. Identity vs. Role Confusion – Genital
A. Ask the child’s parents to remain in the room during the 15. A 10-year-old child is in the Conventional level of Kohlberg’s
physical exam. stages of moral development. Which of the following moral
B. Auscultate the heart, lungs, and abdomen first. behaviors are consistent with this stage? (Select all that apply.)
C. Explain that the physical exam will not hurt. A. Obeys rules to avoid punishment
D. Explain what the nurse will be doing in basic B. Seeks approval from peers by conforming to social
understandable terms. norms
SITUATION. Nurse Ronald is taking care of children admitted in C. Makes decisions based on societal rules and laws
the Pediatric Ward at Cebu City Medical Center. He intends to use D. Considers universal ethical principles
what he learned at nursing school and apply it to the care of E. Understands the concept of a social contract
hospitalized pediatric clients.
7. Which activity can Nurse Ronald provide for a 9-year-old to
encourage a sense of industry?
A. Allow the child to choose what time to take his
medication.
B. Provide the child with the homework his teacher has
sent.
C. Allow the child to assist with his bath.
D. Allow the child to help with his dressing change.
8. A 16-year-old is having a discussion with Nurse Ronald about
the teen’s recent diagnosis of lupus. In explaining the child’s
prognosis, the nurse uses the knowledge that adolescents are:
A. Preoccupied with thoughts of the here and now.
B. Able to understand and imagine possibilities for the
future.
C. Capable of thinking only in concrete terms.
D. Overly concerned with past events and relationships.
9. How can Nurse Ronald best facilitate the trust relationship
between infant and parents while the infant is hospitalized? The
nurse should:
A. Encourage the parents to remain at their child’s bedside
as much as possible.
B. Keep parents informed about all aspects of their child’s
condition.
C. Encourage the parents to hold their child as much as
possible.
D. Advise the parents to participate actively in their child’s
care.