Study Guide: Understanding Human Growth and Development

Key Concepts

1. Understanding Growth and Development

 Normal Growth & Development: Helps professionals predict, detect,

and prevent potential health issues in clients.
 Developmental Theory: Understanding developmental theory aids in
assessing and responding to clients' needs but does not directly help
with predicting compliance or selecting health literacy materials.

2. Types of Development

 Biophysical Development: Refers to the physical growth and

changes in the human body (e.g., height, weight, head circumference).
 Psychosocial Development: Involves personality, thinking, and
behavior. It explores how individuals develop their social relationships
and emotional intelligence.
 Cognitive Development: Refers to how individuals learn to think,
reason, and make sense of the world.
 Moral Development: Involves changes in thoughts, emotions, and
behaviors related to beliefs about what is right and wrong.

Developmental Patterns

 Cephalocaudal Development: Growth begins at the top (head) and

moves downward (to the feet).
 Proximodistal Development: Growth starts from the center of the
body and moves outward.

Developmental Theories & Key Theorists

1. Erik Erikson’s Theory of Psychosocial Development:

a. Focuses on personality development across eight stages, each
with two opposing conflicts.
b. Stages:
i. Trust vs. Mistrust (Infancy)
ii. Autonomy vs. Shame/Doubt (Toddler)
 iii. Initiative vs. Guilt (Preschool)
iv. Industry vs. Inferiority (School Age)
v. Identity vs. Role Confusion (Adolescence)
vi. Intimacy vs. Isolation (Young Adult)
vii. Generativity vs. Stagnation (Middle Adult)
viii. Integrity vs. Despair (Older Adult)
c. Success vs. Failure: Mastery of each stage leads to positive
outcomes (e.g., trust, autonomy), while failure can lead to
challenges in later stages (e.g., mistrust, inferiority).
2. Jean Piaget’s Theory of Cognitive Development:
a. Cognitive development occurs in four stages:
i. Sensorimotor (Birth to 2 years): Development of object
permanence, exploration using senses.
ii. Preoperational (2-7 years): Development of symbolic
thinking, egocentrism, and animism.
iii. Concrete Operational (7-11 years): Mastery of
classification, reversibility, and conservation.
iv. Formal Operational (11 years and beyond): Ability for
abstract and hypothetical thinking.
3. Lawrence Kohlberg’s Theory of Moral Development:
a. Focuses on how individuals develop moral reasoning.
b. Moral development unfolds in three levels (Pre-conventional,
Conventional, Post-conventional), with distinct stages:
i. Pre-conventional: Obedience and punishment, self-
interest.
ii. Conventional: Conformity and interpersonal accord, law
and order.
iii. Post-conventional: Social contract, universal principles.

Developmental Milestones and Impact

 Wellness Across the Life Span: Absence of illness and meeting

developmental milestones.
 Failure to achieve milestones can impact the achievement of future
milestones and overall health.
 Developmental Tasks: If tasks are not mastered, the individual may
face difficulties progressing to the next stage.
Erikson’s Psychosocial Development Stages & Conflicts

1. Trust vs. Mistrust (Infancy):

a. Success = Trust in caregivers and the environment.
b. Failure = Mistrust in others.
2. Autonomy vs. Shame and Doubt (Toddlerhood):
a. Success = Autonomy, making independent choices.
b. Failure = Shame and doubt about their abilities.
3. Initiative vs. Guilt (Preschool):
a. Success = Initiative, exploring new things and taking on tasks.
b. Failure = Guilt over failures, avoidance of new tasks.
4. Industry vs. Inferiority (School Age):
a. Success = Industry, competence in school and social activities.
b. Failure = Inferiority, feelings of incompetence.
5. Identity vs. Role Confusion (Adolescence):
a. Success = Clear sense of identity.
b. Failure = Confusion about personal values and future roles.
6. Intimacy vs. Isolation (Young Adult):
a. Success = Forming deep, meaningful relationships.
b. Failure = Isolation, difficulty forming relationships.
7. Generativity vs. Stagnation (Middle Adult):
a. Success = Generativity, contributing to the next generation.
b. Failure = Stagnation, lack of purpose.
8. Integrity vs. Despair (Older Adult):
a. Success = Integrity, acceptance of life and legacy.
b. Failure = Despair, regret and dissatisfaction with life.

Piaget’s Cognitive Development Stages

1. Sensorimotor Stage (Birth to 2 years):

a. Exploration through senses.
b. Hallmark: Object permanence (understanding that objects
continue to exist even when not visible).
2. Preoperational Stage (2-7 years):
a. Development of symbolic thinking.
b. Hallmarks: Egocentrism (inability to see from others'
perspectives), Animism (belief that inanimate objects have
feelings).
c. Magical Thinking: Children believe their thoughts can influence
events.
 3. Concrete Operational Stage (7-11 years):
a. Ability to perform mental operations.
b. Hallmarks: Reversibility (ability to reverse actions),
Classification (sorting by characteristics), Conservation
(understanding that quantity remains the same even if
appearance changes).
4. Formal Operational Stage (11 years and beyond):
a. Abstract and hypothetical thinking.
b. Hallmarks: Ability to reason about possibilities and
consequences, early egocentrism and invulnerability (risk-taking
behaviors due to perceived invulnerability).

Kohlberg’s Theory of Moral Development

 Pre-conventional Level: Moral reasoning is based on self-interest

and obedience to avoid punishment.
 Conventional Level: Focuses on conformity to social norms and law.
 Post-conventional Level: Moral reasoning based on principles of
justice and individual rights.

Practical Applications for Healthcare Professionals

 Erikson’s Theory in Practice: Understanding psychosocial stages

can help professionals identify potential crises in clients’ lives and
provide support to overcome conflicts (e.g., trust, identity).
 Piaget’s Theory in Practice: Professionals can tailor their care to the
client’s cognitive development stage (e.g., using appropriate language
for different developmental stages).
 Kohlberg’s Theory in Practice: Helps healthcare providers
understand moral reasoning in patients, especially in end-of-life care
and decision-making scenarios.

Summary

 Understanding developmental theories (Erikson, Piaget, Kohlberg) is

crucial for professionals in providing appropriate care and support.
 Recognizing milestones and failure to achieve them can have long-
term effects on an individual’s health and wellness.
  While developmental theory aids in predicting and supporting growth,
it does not directly influence practical skills, such as health literacy or
client compliance.

This study guide synthesizes key developmental theories and their relevance
to healthcare, focusing on Erikson, Piaget, and Kohlberg’s contributions to
understanding human growth.

Study Guide on Piaget and Kohlberg’s Theories of Cognitive and Moral

Development

Piaget’s Theory of Cognitive Development

Jean Piaget’s theory outlines how children’s cognitive abilities develop in

distinct stages as they seek mental balance with their surroundings. These
stages cover both the structure and function of cognitive abilities as they
change over time.

Key Concepts:

 Egocentrism: Difficulty in seeing things from another person’s

perspective. This is prevalent in the preoperational stage.
 Animism: The belief that inanimate objects have feelings and
thoughts. Found in the preoperational stage.
 Object Permanence: The understanding that objects continue to
exist even when they are not visible. A hallmark of the sensorimotor
stage.
 Reversibility: The ability to mentally reverse actions or steps to
return to the starting point. Present in the concrete operational stage.
 Classification: The ability to sort items based on characteristics such
as color, size, or shape. A feature of the concrete operational stage.
 Conservation: Understanding that quantity does not change despite
changes in shape or appearance. Found in the concrete operational
stage.
 Magical Thinking: Strong reliance on fantasy or imagination,
common in the preoperational period.
Piaget’s Stages of Cognitive Development:

1. Sensorimotor Stage (Birth to 2 years):

a. Children explore the world through their senses.
b. They develop object permanence (understanding that objects
continue to exist even when they are not visible).
c. Cognitive growth progresses from reflexes to repetitive actions
and finally to imitative behavior.
2. Preoperational Stage (2 to 7 years):
a. Children begin to use symbols and mental images to represent
objects.
b. They engage in magical thinking and are egocentric (unable to
see the world from another's perspective).
c. Key characteristics: Animism and egocentrism dominate this
stage. Logical reasoning is still limited.
d. Example: A child may think that their teddy bear is hungry and
needs food.
3. Concrete Operational Stage (7 to 11 years):
a. Children can perform logical operations and understand the
concept of conservation.
b. They can classify objects based on characteristics like size,
weight, and color.
c. They begin to understand reversibility, where actions can be
mentally reversed.
d. Key characteristics: Conservation, classification, and
reversibility.
4. Formal Operational Stage (11 years and beyond):
a. Thinking becomes more abstract and hypothetical.
b. Adolescents develop the ability to think logically about possible
outcomes and future events.
c. They experience egocentrism through the imaginary audience
(belief that others are constantly watching them) and the
personal fable (belief in uniqueness and invulnerability).

Kohlberg’s Theory of Moral Development

Lawrence Kohlberg expanded on Piaget’s cognitive development theory by

proposing stages of moral reasoning, which reflect how people develop a
sense of right and wrong. Kohlberg identified three major levels of moral
development, each containing two stages.
Key Concepts:

 Moral Development: The changes in a person’s thoughts, emotions,

and behaviors that guide their understanding of right and wrong.
 Moral Reasoning: The thought process individuals use to make
judgments about moral issues.

Kohlberg’s Levels and Stages:

1. Preconventional Morality (Stage 1 and Stage 2)

a. Morality is guided by external rewards and punishments.
Individuals make decisions based on what will lead to rewards or
avoid punishment.

Stage 1: Punishment and Obedience Orientation:

b. Morality is externally controlled. The focus is on avoiding

punishment.
c. Example: "I must obey the rules or I will be punished."

Stage 2: Instrumental Relativist Orientation:

d. Behavior is driven by self-interest. Individuals focus on what they

can gain from an action.
e. Example: "I will do this favor for you, and you can do something
for me in return."
2. Conventional Morality (Stage 3 and Stage 4)
a. Moral reasoning is influenced by societal expectations and the
desire to gain approval from others. The individual seeks to
uphold laws and rules to maintain social order.

Stage 3: Good Boy-Nice Girl Orientation:

b. Individuals seek approval from others and aim to meet the

expectations of their group.
c. Example: "I will clean the classroom so my teacher will like me."

Stage 4: Society-Maintaining Orientation:

d. Focus shifts to maintaining social order and fulfilling one's duty

to society.
e. Example: "I will not attend the party because alcohol will be
served, and I am not old enough to drink."
3. Postconventional Morality (Stage 5 and Stage 6)
 a. Morality is based on abstract principles, such as justice and
human rights, and individuals evaluate laws in light of their
impact on these principles.

Stage 5: Social Contract Orientation:

b. Individuals recognize that laws are created for the common good
but can be changed if they do not serve society's best interests.
c. Example: "Laws should ensure that everyone has access to food
and shelter, but a starving person might need to steal to
survive."

Stage 6: Universal Ethical Principle Orientation:

d. Decisions are based on self-chosen ethical principles, such as the

Golden Rule, which may lead to civil disobedience.
e. Example: "If the laws are unjust, it is morally right to break them
to fight for justice."

Comparison Between Piaget and Kohlberg:

 Piaget: Focused on cognitive development and how children’s

thinking evolves through stages of intellectual growth.
 Kohlberg: Built on Piaget’s ideas by emphasizing moral development
and how individuals learn to differentiate between right and wrong as
they grow.

Summary:

 Piaget’s Stages of Cognitive Development: Sensorimotor,

Preoperational, Concrete Operational, Formal Operational.
 Kohlberg’s Stages of Moral Development: Preconventional (Stage
1 and 2), Conventional (Stage 3 and 4), Postconventional (Stage 5 and
6).
 Key Terms for Piaget:
o Egocentrism: Inability to understand perspectives other than
one’s own.
o Animism: Belief that inanimate objects have feelings and
thoughts.
o Object Permanence: Understanding that objects exist even
when not visible.
 Key Terms for Kohlberg:
 o Preconventional Morality: Guided by rewards and
punishment.
o Conventional Morality: Driven by societal expectations and
relationships.
o Postconventional Morality: Guided by universal ethical
principles.

This guide covers the main ideas and stages of both Piaget's and Kohlberg's
theories, providing a foundation for understanding how cognitive and moral
development unfold through childhood and adolescence.

Study Guide: Health Promotion and Risks for the Preschool-

Aged Child and School-Aged Child
Health Promotion and Risks for the Preschool-Aged Child (Ages 3 to 5)

Developmental Overview:

 The preschool period spans ages 3 to 5, a time of significant cognitive,

social, and physical development.
 Physical development slows down, while cognitive and psychosocial
development accelerates. This period is also marked by an eagerness
to begin school.
 Magical thinking and egocentrism are common at this stage. Children
may believe that wishes or expectations can impact reality (magical
thinking), and they often struggle to see situations from other people's
perspectives (egocentrism).
 Ritualism (the need for sameness) typically disappears by this stage.

Play and Social Interaction:

 Associative play: Preschoolers play with others but lack structured

organization or rules in their play.

Motor Development:

 Fine motor skills: Preschoolers develop greater dexterity, allowing

them to manipulate small objects, draw, and dress independently.
 Gross motor skills:
o By age 3: Walking, running, climbing, and jumping.
o By age 4: Skipping, hopping on one foot, and catching a ball.
o By age 5: Skipping on alternating feet, jumping rope, swimming,
and skating.
Physical Growth:

 Height increases by 2.5 to 3.5 inches per year.

 Weight gain is 2–3 kilograms per year.
 By age 5, the average height is 43.5 inches.

Nutritional Requirements:

 Preschoolers need about 1800 calories per day.

 Portion sizes should be smaller (about half the size of an adult's
portion).
 Caregivers should model healthy eating habits, as preschoolers imitate
adult behavior.

Sun Safety:

 Even 40 minutes of sun exposure, such as while building a sandcastle,

can result in sunburn.
 Encourage physical activity such as kicking a soccer ball rather than
less active play.

Health Screenings:

 Vision screening: Begins during preschool years.

 Early detection of strabismus (crossed eyes) is important to prevent
amblyopia (lazy eye) by age 6.

Vaccinations at 5 Years:

 Varicella (chickenpox)
 Measles, Mumps, Rubella (MMR)
 Diphtheria, Tetanus, and Acellular Pertussis (DTaP)
 Annual influenza
 Polio (IPV)
 Mnemonics: Remember "Very Dim" for this age group.

Common Risks and Safety Measures:

 Unintentional Injury is the leading cause of death in preschoolers,

with common causes including:
o Motor vehicle accidents
o Suffocation
o Drowning
o Poisoning
  Car Safety: The safest place for a preschooler is in the back seat of
the vehicle, using a front-facing car seat.
 Safety Education: Teach the preschooler how to avoid danger,
including pedestrian safety. For example, teaching children to stop and
look both ways before crossing the street.
 Poisoning Prevention: Store chemicals, medications, and vitamins in
locked cabinets and away from children. Do not call medicines or
vitamins "candy," as this can lead to accidental ingestion.

Health Promotion and Risks for the School-Aged Child (Ages 6 to 12)

Developmental Overview:

 The school-aged period spans from 6 to 12 years, marked by rapid

physical, cognitive, and psychosocial development. Puberty signals the
transition to adolescence.
 Children develop stronger independence and begin learning life skills,
including responsibility for their health and safety.

Physical Growth:

 Height increases by about 2 inches per year, with a total increase of

1-2 feet by age 12.
 Weight increases by 2-3 kilograms per year, nearly doubling by age
12. For example, a 6-year-old weighing 37 pounds will weigh about
74 pounds by age 12.

Health Screenings:

 Routine screenings for height, weight, body mass index (BMI),

hearing, vision, and scoliosis are important.
 Diabetes screening is not typically conducted during this stage
unless other risk factors are present.

Nutritional Needs and Obesity Prevention:

 Encouraging healthy eating habits is vital as school-aged children often

begin to make food choices independently. Caregivers must help them
choose nutrient-rich foods.
 Obesity is a growing concern, so it’s crucial to model healthy eating
and encourage regular physical activity (at least 60 minutes of
activity per day).
Stress Management:

 School-aged children often face stress due to academic pressure,

social challenges, and family issues.
 Healthcare professionals can support children by identifying stressors
and teaching coping strategies such as deep breathing,
progressive relaxation, and positive imagery.
 Parents and teachers should be involved in these interventions for
maximum effectiveness.

Vaccinations at 11-12 Years:

 Annual influenza
 Tetanus, Diphtheria, Pertussis (Tdap) between ages 11-12.
 Meningococcal conjugate (MenACWY) first dose at 11-12 years.
 Human Papillomavirus (HPV) two-dose series at 11-12 years (three
doses if starting after age 15).
 COVID-19 vaccination for children ages 5 and older.

Common Risks and Safety Measures:

 Unintentional Injury remains the leading cause of death in school-

aged children, with causes including:
o Motor vehicle accidents
o Suffocation
o Drowning
o Poisoning
 Motor Vehicle Safety: School-aged children should remain in a
booster seat in the back seat until they meet height or age
requirements (typically 4 feet 9 inches or ages 8-12).
 Bicycle Safety: Teach children to:
o Ride in the same direction as traffic, using bike lanes.
o Stop and look both ways before crossing streets.
o Use hand signals when turning.
o Always wear a helmet.
 Pedestrian Safety: Reinforce the importance of looking both ways
before crossing streets and obeying traffic signals.

Additional Safety Tips:

 Never allow a child to ride in the back of a pickup truck.

  Water Safety: Reinforce water safety rules to prevent drowning,
especially around pools, bathtubs, and any open water.

Risk-Taking Behavior:

 As children grow, they may take more risks, attempting activities

beyond their ability. Safety education and parental supervision are
essential.
 School-aged children should be taught to make safe choices,
particularly when engaging in physical activities or new experiences.

Summary of Key Points for Preschool-Aged and School-Aged Children:

 Preschoolers (3-5 years):

o Rapid cognitive, social, and physical growth. Magic thinking and
egocentrism are common.
o Safety, including car safety, poison prevention, and play safety,
is critical.
o Growth is slow but steady, and proper nutrition and sun safety
are essential.
o Vaccinations: Varicella, MMR, DTaP, Polio, Annual influenza.
 School-Aged Children (6-12 years):
o Significant physical, cognitive, and psychosocial growth.
o Health screenings for height, weight, and vision are important.
o Obesity and stress management are key health concerns.
o Vaccinations: Tdap, MenACWY, HPV (11-12 years), Annual
influenza.

By focusing on health promotion, nutrition, safety, and age-appropriate

development, caregivers and healthcare professionals can ensure that
children thrive during these stages of growth.