Week 10 11 20241026003725

Pamantasan ngCabuyao
Banay banay, Cabuyao City, Laguna 4025, Philippines

COLLEGE OF HEALTH AND ALLIED SCIENCES
COURSE CODE: NCM 107 LEC
COURSE This course deals with concepts, principles, theories, and techniques in the
DESCRIPTION: nursing care of individuals and families during childbearing and childrearing
years toward health promotion, disease prevention, restoration and
maintenance, and rehabilitation.
COURSE INTENDED 1. Explain the overview of Growth and Development

LEARNING OUTCOMES: 2. Describe principles of growth and development and developmental
stages according to major theorist
3. Formulate nursing diagnoses that address wellness as well as both a
potential for and an actual delay in growth and development
LEARNING MATERIAL 10
FOR WEEK NUMBER:
I. TITLE: Care of Mother, Child and Adolescent (WELL CLIENTS)
II. OBJECTIVES: The students can be able to discuss the principles of growth and development
III. INTRODUCTION: This learning material focuses on the concept of growth and development
IV. CONTENTS:
Growth and Development
A. Theoretical Approaches to the Growth and Development of Children
B. Nursing Process for the Promotion of Normal Growth and Development

1. The Family with an Infant
2. The Family with a Toddler
3. The Family with a Pre-schooler
4. The Family with a School Age Child
5. The Family with an Adolescent
C. Health Promotion and Disease Prevention in Different Stages in the Growth and
Development
Growth and Development
LECTURE NOTES COMPILATION Page 1 of 16

1st Semester A.Y. 2024-2025
A. Theoretical Approaches to the Growth and Development of Children
• Growth is used to denote an increase in physical size or a quantitative change. Growth in weight, for example, is
measured in pounds or kilograms; growth in height is measured in inches or centimeters.
• Development indicates an increase in skill or the ability to function (a qualitative change). Development is
measured by observing a child’s ability to perform specific tasks such as how well a child picks up small objects, by
recording the parent’s description of a child’s progress, or by using standardized tests such as the Ages & Stages
Questionnaires. Maturation is a synonym for development.
Sexual development is a specific type of development that refers to developing instincts or sensual pleasure
(Freudian theory)
Psychosocial development refers to Erikson’s stages of personality development. Kohlberg’s theory of moral
development is the ability to know right from wrong and to apply these to real-life situations.
Cognitive development refers to the ability to learn or understand from experience, to acquire and retain knowledge,
to respond to a new situation, and to solve problems (see the section that follows on Piaget’s theory of cognitive
development). It is measured by intelligence tests and by observing children’s ability to function effectively in
different environments.
General principles include:
 Growth and development are continuous processes from conception until death.
 Growth and development proceed in an orderly sequence
 Children pass through the predictable stages at dif erent rates.
 All body systems do not develop at the same rate.
 Development proceeds from proximal to distal body parts.
 Development proceeds from gross to refined skills
 There is an optimum time for initiation of experiences or learning.
 Neonatal reflexes must be lost before development can proceed
Factors Influencing Growth and Development
 Genetics
 Gender
 Health
 Intelligence
 Temperament
 Environment





Micronutrients

Theories of Child Development
A theory is a systematic statement of principles that provides a framework for explaining a phenomenon.
Developmental theories are theories that provide road maps for explaining human development.
Developmental tasks are a skill or a growth responsibility arising at a particular time in an individual’s life, the
achievement of which will provide a foundation for the accomplishment of future tasks
Sociocultural theories are those that stress the importance of environment on growth and development.
Learning theory suggests children are like blank pages that can be shaped by learning.
Cognitive theorists such as Piaget stress learning skills are the key to achieving success in life. Epigenetic theories
stress that genes are the true basis for growth and development.
FREUD’S PSYCHOANALYTIC THEORY
 Freud (1856–1939), an Austrian neurologist and the founder of psychoanalysis, offered the first real theory of
personality development (Freud, 1962; Freud & Brill, 1995
 The theory, based on Freud’s observations of mentally disturbed adults, described adult behavior as being
the result of instinctual drives of a primarily sexual nature (libido).
 described child development as being a series of psychosexual stages in which a child’s sexual gratification
becomes focused on a particular body part at each stage.


Criticisms of Freud’s Theory
To construct his theory, Freud relied on his knowledge of people seen in his practice and looked at circumstances that
lead to mental illness (Freud & Brill, 1995). This “looking at illness” rather than “looking at wellness” perspective
limits the applicability 1679 of the theory as a health promotion measure. The theory is also criticized as being
gender biased because females are viewed in a less favorable light than males. Gender bias has the potential to
perpetuate gender inequality, which doesn’t provide a level playing field for women (Brandt, 2011).
ERIKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT
Erik Erikson (1902–1996) was trained in psychoanalytic theory but later developed his own theory of psychosocial
development, a theory that stresses the importance of culture and society in development of the personality
(Erikson, 1993). One of the main tenets of his theory, that a person’s social view of self is more important than
instinctual drives in determining behavior, allows for a more optimistic view of the possibilities for human growth.
Whereas Freud looked at ways mental illnesses develop, Erikson looked at actions that lead to mental health. He
describes eight developmental stages covering the entire life span. At each stage, there is a conflict between two
opposing forces. The resolution of each conflict, or accomplishment of the developmental task of that stage, allows
the individual to go on to the next phase of development. Table 28.5 summarizes Erikson’s developmental stages
through adolescence as compared to Freud’s stages.
The Infant
According to Erikson (1993), the developmental task for infants is learning trust versus mistrust (other terms are
“learning confidence” or “learning to love”). When an infant is hungry, a parent feeds and makes the infant
comfortable again. When an infant is wet, a parent changes his or her diaper and the infant is dry again. When an
infant is cold, a parent holds the baby closely. By these simple processes, infants learn to trust that when they have a
need or are in distress, a parent will come and meet that need.
The Toddler
The developmental task of the toddler is to learn autonomy versus shame or doubt. Autonomy (self-governance or
independence) arises from a toddler’s new motor and mental abilities. Children not only take pride in the new things
they can accomplish but also want to do everything independently, whether it is pulling the wrapper off a piece of
candy, selecting a vitamin tablet out of a bottle, flushing the toilet, or replying, “No!”
The Preschooler
The developmental task of the preschool period is learning initiative versus guilt, or learning how to do things such as
drawing, building an object from blocks, or playing dress up. Children initiate motor activities of various sorts on their
own or no longer merely respond to or imitate the actions of other children or their parents. The same is true for
language and fantasy activities.
The School-Age Child
Erikson (1993) viewed the developmental task of the school-age period as developing industry versus inferiority, or
self-confidence rather than inferiority. During the preschool period, children learned initiative (i.e., how to do things).
During school age, children learn how to do things well. A school-age child, while doing a project, will ask, “Am I
doing this right? Is it okay to use blue?” When they are encouraged in their efforts to do practical tasks or make
practical things and are praised and rewarded for the finished results, their sense of industry grows (Fig. 28.5).
Parents who see their children’s efforts at making and doing things as merely “busy work” or who do not show
appreciation for their children’s efforts may cause them to develop a sense of inferiority rather than pride and
accomplishment.

The Adolescent
The new interpersonal dimension that emerges during adolescence is the development of a sense of identity versus
role confusion. To achieve this, adolescents must bring together everything they have learned about themselves as a
son or daughter, an athlete, a friend, a fast-food cook, a student, a garage band musician, and so on, and integrate
these different images into a whole that makes sense. If adolescents cannot do so, they are left with role confusion or
are left unsure of what kind of person they are or what kind of person they want to become. Some adolescents may
seek a negative identity: being identified as a drug abuser or runaway is not a positive identification but may be
preferable to seemingly having no identity at all. Body piercing and tattooing are ways adolescents can help establish
their identity because they are outward expressions of who adolescents think they are (Fig. 28.6).
The Late Adolescent
The developmental crisis of late adolescence is achieving a sense of intimacy versus isolation. Intimacy is the ability
to relate well with other people in preparation for developing future relationships.
A Criticism of Erikson’s Theory
Erikson’s main contribution to human development was the creation of stages, so that development can be broken
down into separate phases for study. A criticism of his theory is that life does not occur in easily divided stages, and
trying to divide it that way can create superficial divisions.
PIAGET’S THEORY OF COGNITIVE DEVELOPMENT
Jean Piaget (1896–1980), a Swiss psychologist, introduced concepts of cognitive development, or the way children
learn and think. The theory has roots similar to those of both Freud and Erikson, but with differing aspects (Inhelder
& Piaget, 1958). Piaget defined four stages of cognitive development, within the stages of growth, then finer units or
schemas. To progress from one period to the next, children reorganize their thinking processes to bring them closer
to adult thinking. These stages of cognitive development are summarized in Table 28.6.


The Infant
Piaget referred to the infant stage as the first four stages of the sensorimotor stage. Sensorimotor intelligence is
practical intelligence because an infant is not yet able to use words and symbols for thinking and problem solving at
this early age. At the beginning of life, babies relate to the world through their senses, using only reflex behavior.
During this stage, infants learn objects in the environment—their bottle, blocks, their bed, or even a parent—are
permanent and continue to exist even though they are out of sight or changed in some way.
The Toddler
The toddler period is one of transition as children complete the fifth and sixth stages of the sensorimotor period and
begin to develop some cognitive skills of the preoperative period, such as symbolic thought and egocentric thinking
(see Chapter 30). Children use trial and error to discover new characteristics of objects and events. A toddler sitting in
a high chair who keeps dropping objects over the edge of the tray is exploring both permanence and the different
actions of toys. For example, during these periods, toddlers:
• Complete their understanding of object permanence.
• Begin to be able to use symbols to represent objects.
• Start to draw conclusions only from obvious facts that they see.
The Preschooler
Preschool children move on to a substage of preoperational thought termed intuitive thinking. During this period,
when young children look at an object, they are able to see only one of its characteristics. For example, they see a
banana is yellow but do not notice that it is also long. Intuitive thinking is noticeable when children are learning
about medicine (they observe it tastes bitter but cannot understand it is also good for them).
Intuitive thinking contributes to the preschooler’s lack of conservation (the ability to discern truth, even though
physical properties change) or reversibility (ability to retrace steps).
Preschool thinking is also strongly influenced by role fantasy or how children would like something to turn out.
Children use assimilation (taking in information and changing it to fit their existing ideas) as a part of this.

The School-Age Child
Piaget viewed school age as a period during which concrete operational thought begins because school-age children
can be seen using practical solutions to everyday problems as well as begin to recognize cause-and-effect
relationships. A child who understands water does not change in amount just because it is poured from one glass to
another has grasped the concept of conservation. Conservation of numbers is learned as early as age 7 years,
conservation of quantity at age 7 or 8 years, conservation of weight at age 9 years, and conservation of volume at age
11 years (Wadsworth, 2003). Reasoning during school age tends to be inductive or proceeds from specific to general:
A schoolage child holding a broken toy reasons the toy is made of plastic, and therefore, all plastic toys break easily.
The Adolescent
Adolescence is the time when cognition achieves its final form or when formal operational thought begins. When this
stage is reached, adolescents are capable of thinking in terms of possibility—what could be (abstract thought)—
rather than being limited to thinking about what already is (concrete thought). This makes it possible for adolescents
to use scientific reasoning. They can use deductive reasoning in addition to the induction reasoning they used during
school age or can move from the general to the specific (e.g., plastic toys break easily, the toy they are holding is
plastic; therefore, it will break easily).
A Criticism of Piaget’s Theory
Piaget is criticized because he used only a small sample of subjects to establish his theory (his own children). Because
children today begin activities to learn counting and identifying color or reading much earlier than they did at the
time the theory was 1690 devised, the age groups and norms may no longer be accurate. Playing computer games
during the preschool period will probably impact the rate and type of children’s cognitive developments in the future.
KOHLBERG’S THEORY OF MORAL DEVELOPMENT
One more developmental theory that has relevance to maternal and child health nursing is Kohlberg’s (1927–1987)
theory of moral development. A German psychologist, Kohlberg (1984) studied the reasoning ability of boys and,
based on Piaget’s development stages, developed a theory on the way children gain knowledge of right and wrong or
moral reasoning. These stages, as described by Kohlberg, are summarized in Table 28.7.


KEY POINTS FOR REVIEW
 Knowledge of growth and development is important in health promotion and illness prevention because it
lays the basis for assessments and anticipatory guidance.
 Including growth and development guidelines in nursing care helps to achieve care that not only meets QSEN
competencies but also best meets a family’s total needs.
 Genetic factors that influence growth and development are gender, ethnicity, intelligence, and health.
 Environmental influences include quality of nutrition, socioeconomic level, the parent–child relationship,
ordinal position in the family, and environmental health.
 To meet growth and development milestones, children (like adults) need to follow basic guidelines for a
healthy diet, such as eating a variety of foods, maintaining an ideal weight, avoiding extreme levels of
saturated fat, eating foods with adequate starch and fiber, and avoiding too much sugar.
 Temperament is a child’s characteristic manner of thinking, behaving, or reacting. Helping parents
understand the effect of temperament is a nursing role.
 Common theories of development are Freud’s psychoanalytic theory and Erikson’s theory of psychosocial
development. Both of these theories describe specific tasks children must complete at each stage of
development to become a well-adapted adult.
 Piaget’s theory of cognitive development describes ways children learn.
 Kohlberg advanced a theory of moral development or how children use moral reasoning to solve problems.
 Although growth and development occur in known patterns, the rate that a child develops and grows varies
from child to child. Caution parents not to be concerned that two siblings are very different as long as they
both fit within usual parameters.
Reference:
Maternal and Child Health Nursing Care of Childbearing and Childrearing Family 8 th Edition
By JoAnne Silbert-Flagg and Adelle Pilliteri


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Pamantasan ngCabuyao

Banay banay, Cabuyao City, Laguna 4025, Philippines

COURSE CODE: NCM 107 LEC

COURSE INTENDED 1. Explain the overview of Growth and Development

I. TITLE: Care of Mother, Child and Adolescent (WELL CLIENTS)

Growth and Development

A. Theoretical Approaches to the Growth and Development of Children

B. Nursing Process for the Promotion of Normal Growth and Development

Growth and Development

LECTURE NOTES COMPILATION Page 1 of 16

A. Theoretical Approaches to the Growth and Development of Children

General principles include:

Factors Influencing Growth and Development

LECTURE NOTES COMPILATION Page 2 of 16

LECTURE NOTES COMPILATION Page 3 of 16

LECTURE NOTES COMPILATION Page 4 of 16

LECTURE NOTES COMPILATION Page 5 of 16

LECTURE NOTES COMPILATION Page 6 of 16

LECTURE NOTES COMPILATION Page 7 of 16

Theories of Child Development

FREUD’S PSYCHOANALYTIC THEORY

LECTURE NOTES COMPILATION Page 8 of 16

LECTURE NOTES COMPILATION Page 9 of 16

Criticisms of Freud’s Theory

ERIKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT

The School-Age Child

LECTURE NOTES COMPILATION Page 10 of 16

The Late Adolescent

A Criticism of Erikson’s Theory

PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

LECTURE NOTES COMPILATION Page 11 of 16

LECTURE NOTES COMPILATION Page 12 of 16

• Complete their understanding of object permanence.

• Begin to be able to use symbols to represent objects.

LECTURE NOTES COMPILATION Page 13 of 16

The School-Age Child

A Criticism of Piaget’s Theory

KOHLBERG’S THEORY OF MORAL DEVELOPMENT

LECTURE NOTES COMPILATION Page 14 of 16

LECTURE NOTES COMPILATION Page 15 of 16

KEY POINTS FOR REVIEW

By JoAnne Silbert-Flagg and Adelle Pilliteri

LECTURE NOTES COMPILATION Page 16 of 16

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