Principles of Growth and Development

Neonate: Stage immediately after the birth until 28  Neonatal reflexes must be lost before motor
days development can proceed
Infant: 1 month to 12 months  A great deal of skill and behavior is learned by
Toddler: 12 months to 3 years old practice.
Preschool(early childhood): 3 years old to 6 years old  Development is a product of heredity
School age: 6 years old to 12 years old Factors influencing growth and development
Adolescent: 13 years old to 17 years old  Genetics
Growth  Environment
 increase in the number and size of cells  Temperament(ugali)
 Measured in terms of quantity  Health
 Weight measured in grams, kilogram or pounce  Intelligence
 Height measured in inches, or centimeters  Gender
Development Gender
 Increase in skill and ability to function. Intelligence- Children with high intelligence do not
 Viewed as a qualitative changes in the child that generally grow faster physically than other
is demonstrated by functioning or skills and children, but they do tend to advance faster in skills.
that is achieved through maturation and Children of high
learning. intelligence actually fall behind in physical skills
Ways to measure Development because they spend their time with books or mental
 by observing a child’s ability to perform specific games rather than with games that develop motor
tasks such as how well a child picks up small skills.
objects Temperament—the typical way a child reacts to
 by recording the parent’s description of a situations. It is the usual reaction pattern of an
child’s progress individual or an individual’s
 by using standardized tests such as characteristic manner of thinking, behaving, or
DDST(Denver development screening test), in reacting to stimuli in the environment.
the PH, it is modified as MMDST(metro manila Categories temperament
development screening test)  The Easy Child
Children are rated as “easy to care for” if they have a
 Freud’s theory of Psychosexual development predictable rhythmicity, approach and adapt to new
 Erickson’s theory of Psychosocial development- situations readily, have a mild-to-moderate intensity
Refers to personality development of reaction, and have an overall positive mood
 Kohlberg’s theory of Moral development- refers quality.
to knowing right from wrong  The Intermediate Child
 Piaget’s Theory of Cognitive Development- Some characteristics of both easy and difficult groups
refers to the ability to learn and understand are present.
from experience, acquire and retain knowledge,  The Difficult Child
respond to new situations and solve problems Children are “difficult” if they are irregular in habits,
have a negative mood quality,
Principles of Growth and development and withdraw rather than approach new situations.
 Growth and development are continuous  The Slow-to-Warm-Up Child
processes from conception until death. Children fall into this category if, overall, they are
 Growth and development proceed in an orderly fairly inactive, respond only mildly and adapt slowly
sequence to new situations, and have a general negative mood.
 Children pass through the predictable stages at NUTRITION
different rates. Protein
 All body systems do not develop at the same Protein is the major component of bones, skin, hair,
rate. and muscle
Infancy- most rapid period of growth Carbohydrate
Pre-school- most slow and uniform rate of growth Carbohydrates are the main and preferred fuel of the
Puberty- 2nd most rapid growth rate body to supply energy, so they are essential to the
After puberty- decline in growth rate till death functioning of body systems and the neurologic
 Development is cephalocaudal. system, in particular.
Development proceeds from proximal to distal body This makes carbohydrates vitally important to infants
parts and toddlers because their brain cells are actively
 Development proceeds from gross to refined growing. As all athletes learn, sugar supplies an
skills. immediate but short-
 There is an optimum time for initiation of term source of energy; starches, as a rule, supply
experiences or learning. “a child cannot learn sustained energy.
task until the nervous system mature enough to Fat
allow that particular learning”
Dietary fat is a second source of energy for the body. they are capable of doing at their own pace and
It can be an immediate energy own time, then children develop sense of being
source or can be stored if not used, then released able to control their muscle and impulses.
when energy is required. Some fat  When caregivers are impatient and do
deposits also serve as insulating material for everything for them, this enforces a sense of
subcutaneous tissues; in infants, fats are shame or doubt. They will doubt their ability to
necessary to ensure myelination of nerve fibers do it, they will stop trying and cannot do it
Preschooler
Theories of Child Development initiative versus guilt,
Sociocultural theories - stress the importance of  When children are given much freedom and
environment on growth and development. opportunity to initiate motor play their sense of
Learning theory - children are like initiative is reinforced
blank pages that can be shaped by learning.  When children are made to feel their motor
Cognitive theorists such as Piaget stress learning skills activity is bad, their questions are a nuisance, or
are the key to achieving success in life. their play is silly, they can develop a sense of
Epigenetic theories stress that genes are the true guilt
basis for growth and development.  Those who do not develop initiative have
FREUD’S PSYCHOANALYTIC THEORY limited brainstorming and problem-solving skills
 based on Freud’s observations of mentally later in life;
disturbed adults, described adult behavior as School-Age Child
being the result of instinctual drives of a  industry versus inferiority “self-confidence
primarily sexual nature (libido) rather than inferiority”
 He described child development as being a  Parents praised and rewarded them for the
series of psychosexual stages finished results, their sense of industry grows
Infant  Parents who do not show appreciation for their
Oral stage: Child explores the world by using the children’s efforts may cause them to develop a
mouth. Infant suck for enjoyment or relief of tension sense of inferiority rather than pride and
as well as for nourishment accomplishment.
Toddler Adolescent
Anal stage: Child learns to control urination and  identity versus role confusion
defecation. Children’s interet focus on the anal  adolescents must bring together everything
region as they begin toilet training they have learned about themselves as a son or
Preschooler daughter, an athlete, a friend, a studen and so
Phallic stage: Child learns sexual identity through on, and integrate these different images into a
awareness of genital area. Masturbation is common whole that makes sense.
in this phase. Children may show exhibitionism,  If adolescents cannot do it, they are left with
suggesting they hope this will lead to increased role confusion
knowledge of the two sexes Late Adolescent (young adult)
School-age child  intimacy versus isolation
Latent stage: Child’s personality development  Intimacy is the ability to relate well with other
appears to be nonactive or dormant. Children’s libido people in preparation for developing future
appears to be diverted into concrete thinking relationships.
Adolescent Middle age adult(30’s)
Genital stage: Adolescent develops sexual maturity  Generetivity vs stagnation
and learns to establish  Those who have devoted themselves to only
satisfactory relationships with others. one role are more likely to find themselves at
ERIKSON’S THEORY OF PSYCHOSOCIAL the en dof middle age with narrow perspective
DEVELOPMENT and lack of ability to cope with changes
a theory that stresses the importance of Older adult
culture and society in development of the personality  Integrity vs despair
Infant  Older adult with integrity feeling good the life
 trust versus mistrust “learning confidence” or choices they have made
“learning to love”  Those with a feeling of despair with life, could
 If the needs are met, the infant learn to TRUST begin over again so that things could turn out
but If care is inconsistent, inadequate, or differently
rejecting, infants learnMISTRUST
Toddler PIAGET’S THEORY OF COGNITIVE DEVELOPMENT
 autonomy versus shame or doubt. To progress from one period to the next, children
 toddler enjoys active, independent exploration reorganize their
as part of building a sense of autonomy. thinking processes to bring them closer to adult
 Children take place in new accomplishments thinking.
and want to do everything independently,
parents recognize toddlers need to do what
 most strongly in “mother or father say so”
Infant rather than in spritual or social motivation.
sensorimotor stage. Preschooler (4 to 7 years old)
 infants relate to the world through their senses,  Preconventional (Level I)
using only reflex behavior  Individualism
 infants learn objects in the environment—their  Carries out actions to satisfy own needs.
bottle, blocks, their bed, or even a parent—are  Unable to take responsibility for self-care than
permanent and continue to exist even though society’s.
they are out of sight or changed in some way  Will do something for another if that person
 Gaining a concept of permanence also does something for him or her.
contributes to separation anxiety, which can School-age (plastic stage)
begin between 8 and 12 months of age  Conventional (Level II)
Toddler  Developing Good Interpersonal Relationships
 preoperative period  Children follow rules because of a need to be”
 symbolic thought and egocentric thinking good” person in own eyes and eyes of others
 Children use trial and error to discover new adolescent
characteristics of objects and events.  Postconventional (Level III)
 Complete their understanding of object  Follows standards of society for the good of all
permanence. people
 Start to draw conclusions only from obvious  Adolescents being capable of abstract thought,
facts that they see. they become capable of internalizing standards
of conduct( they do what they thing is right
Preschooler regardless of wheter anyone is watching
intuitive thinking
During this time, preschoolers believe in the following
 Centering, when they are abale to see only one
of its characteristics
 lack of conservation (the ability to discern
truth, even though physical properties change)
or reversibility (ability to retrace steps)
 Assimilation thinking, taking in information and
changing it to fix their existing ideas
 Children believes their wishes are as real as
facts and dreams are as real as daytime
happenings during this stage
 Magical thinking- animals and inanimate
objects as being capable of thought and feelings
School-Age Child
 concrete operational thought
 Reasoning tends to be inductive or proceeds
from specific to general
 Capable of using practical solutions to everyday
problems as well as begin to recognize cause-
and-effect relationships.
 Reversebility- ability to retrace steps
 Conservation- ability to discern truth ,even
though physical properties changes.
Adolescent
 Formal operational thought
 abstract thought- capable of
thinking in terms of possibility rather than being
limited to thinking about what already is
 use deductive reasoning -general to specific
 use scientific reasoning
KOHLBERG’S THEORY OF MORAL DEVELOPMENT
Toddler (2 to 3 years old)
 Preconventional (Level I)
“Punishment/obedience Orientation”
 Child does right because a parent tells him or
her to and to avoid punishment.
 Toddlers begin to formulate a sense of right and
wrong but their reason for doing it is centered
  In the cardiovascular system, heart rate slows
from 110 to 160 beats/min to 100 to 120
beats/min by the end of the first year.
 Infants are prone to develop a physiologic
anemia at 2 to 3 months of age. This occurs
Nursing care of a Family because the life of a typical red cell is 4 months,
so the cells the child had at birth begin to
with Infant disintegrate at that time, yet new cells are not
Standard schedule for healthcare visits yet being produced in adequate replacement
numbers.
is for 2-week, 2-month, 4-month, 6-  An infant’s immune system becomes functional
month, 9-month, and 12-month visits by at least 2 months of age; an infant can
A standard schedule for healthcare visits is for 2- actively produce both immune globulin (Ig)G
week, 2-month, 4-month, 6- month, 9-month, and and IgM antibodies by 1 year. The IgA, IgE, and
12-month visits IgD are not plentiful until preschool age, which
PHYSICAL GROWTH is the reason why infants continue to need
Weight . protection from infection.
 During the first 6 months, infants typically  The ability to adjust to cold is mature by age 6
average a weight gain of 2 lb per month. months. By this age, an infant can shiver in
 During the second 6 months, weight gain is response to cold (which increases muscle
approximately 1 lb per month. activity and provides warmth) and has
 average 1-year-old boy weighs 10 kg (22 lb) developed additional adipose tissue to serve as
 average girl weighs 9.5 kg (21 lb). insulation. The amount of brown fat, which
protected the newborn from cold, decreases
Height during the first year as subcutaneous fat
 An infant increases in height during the first increases.
year by 50%, or grows from the average birth  At birth, the gastrointestinal tract is immature
length of 20 in. to about 30 in. (50.8 to 76.2 in its ability to digest food and mechanically
cm). move it along. These functions mature
 Infant growth is most apparent in the trunk gradually during the infant year. Although the
during the early months. ability to digest protein is present and effective
 During the second half of the first year, it at birth, the amount of amylase, which is
becomes more apparent as lengthening of the necessary for the digestion of complex
legs occurs carbohydrates, is deficient until approximately
Head Circumference the third month. Lipase, necessary for the
 By the end of the first year, the brain already digestion of saturated fat, is decreased in
reaches two thirds of its adult size. amount during the entire first year
 Suggest to parents they continue to place the
infant on the back to sleep but to spend
MOTOR DEVELOPMENT
 To assess motor development, both gross
“tummy time” daily with the infant placed in a
motor development (ability to accomplish large
prone position to prevent this flattening.
body movements) and fine motor development,
Body Proportion
measured by observing or testing prehensile
 The circumference of the chest is generally less
ability (ability to coordinate hand movements),
than that of the head at birth by about 2 cm.
are evaluated
 As early as 6 months and in most by 12 months,
head and chest circumference are equal. Gross Motor Development
Teeth  Four positions—ventral suspension, prone,
 The first baby tooth (typically lower central sitting, and standing—are used to assess
incisor) usually erupts at age 6 months, gross motor development
followed by a new one monthly Ventral suspension refers to an infant’s appearance
 Fluoride supplementation should be when held in midair on a horizontal plane and
administered at 6 months of age supported by a hand under the abdomen.
 Some newborns may be born with teeth (natal  One-month-old infants lift their head
teeth) or have teeth erupt in the first 4 weeks momentarily and then drop it again. Two-
of life (neonatal teeth) month-old infants hold
Body Systems  their head in the same plane as the rest of
 The respiratory rate of an infant slows from 30 their body, a major advance in muscle
to 60 breaths/min to 20 to 30 breaths/min by control.
the end of the first year. Because the lumens of  By 3 months, infants lift and maintain their
the respiratory tract remain small and mucus head well above the plane of the rest of the
production by the tract to clear invading body in ventral suspension.
microorganisms is still inefficient. Prone Position
  By 1 month of age, they lift their head and  By 4 months, infants bring their hands
turn it easily to the side together and pull at their clothes
 Four-month-old infants lift their chests off  By 5 months, infant can accept objects that
the bed and look around actively, turning are handed to them by grasping with the
their head from side to side and from front whole hand. They can reach and pick up
to back objects without the object being offered
 By 6 months, infants can raise their chests and often play with their toes as objects.
and the upper part of their abdomens off
the table.  By 6 months, grasping has advanced to a
 By 9 months, a child can creep from the point where a child can hold objects in
prone position. Creeping means the child both hands, will drop one toy when a
has the abdomen off the floor and moves second one is offered. They can hold a
one hand and one leg and then the other
spoon and start to feed themselves. The
hand and leg, using the knees on the floor
to locomote Moro, the palmar grasp, and the tonic neck
reflexes have completely faded
Sitting Position  By 7 months, infants can transfer toys
 When placed on his or her back and then from one hand to the other. They hold a
pulled to a sitting position, a newborn has first object when a second one is offered.
 By 8 months, random reaching and
extreme head lag; this lag is present until
ineffective grasping disappear as a result
about 1 month of advanced eye–hand coordination.
 By 2 months, infants can hold their head  by 10 months is the ability to bring the
fairly steady when sitting up, although thumb and first finger together in a pincer
their head does tend to bob forward and grasp. Children can pick up small objects.
will still show head lag when pulled to a They offer toys to people but then cannot
sitting position. release them
 A 4-month-old child reaches an important  by 12 months, infants can hold a crayon
milestone by no longer demonstrating well enough to draw a semi-straight line.
head lag when pulled to a sitting position. They enjoy putting objects such as small
 A 5-month-old infant can be seen to blocks in containers and taking them out
straighten his or her back when held or again. They can offer toys and release
propped in a sitting position. them.
 By 6 months, infants can sit momentarily Language Development
without support  By 2 months, they can differentiate their
 A 7-month-old child can sit alone but only cry
when the hands are held forward for  By 3-month-old infant will squeal with
balance. pleasure or laugh out loud in response to a
 An 8-month-old child can sit securely nodding, smiling face, or a friendly tone of
without any additional support voice
 At 9 months, infants sit so steadily that  By 4 months, infants are very talkative,
they can lean forward and regain their cooing, babbling, and gurgling when
balance. They may still lose their balance spoken to. They definitely laugh out loud.
 By 5 months, an infant says some simple
if they lean sideways, which is a skill not
vowel sounds (e.g., “goo-goo,” “gah-
achieved for another month.
gah”).
Standing Position  By 9 months, an infant usually speaks a
first word: “da-da” or “ba- ba.”
 At 10months, an infant can pull  By 10 months, an infant masters another
themselves to a standing position by word such as “bye-bye” or “no.”
holding onto the side of a playpen or a low  By 12 months, infants can generally say
table, but they cannot let themselves down two words in addition to “ma-ma” and
again as yet. “da-da,”
 At around 11 months, an infant learns to
“cruise” or move about the crib or room by Play
holding onto objects such as the crib rails, One month: interested in watching a mobile over
chairs, walls, and low tables their crib or playpen
 At 12 months, the child can stand alone at Two months: infants will hold
least momentarily light, small rattles for a short period of time but then
drop them.
Fine Motor Development Three months: infants can handle small blocks or
 By 2-month-old infant will hold an object small rattles.
for a few minutes before dropping it. The Four months: Infant need a playpen or a sheet spread
hands are held open, not closed in fists. on the floor so they have an opportunity to exercise
 By 3 months, infants reach for attractive their new skill of rolling over
objects in front of them
Five moths :infants are ready for a variety of objects
to handle, such as plastic rings, blocks, squeeze toys,
clothespins, rattles, and plastic keys
six months: child can sit steadily enough to be ready
for bathtub toys such as rubber ducks or plastic boats
Because they are starting to teethe,
most at this age enjoy a teething ring to chew on.
Eight months:infants are sensitive to differences in
texture. They enjoy having toys with different feels to
them.
Ten months: infants are ready for peek-a-boo and
they can clap,
Eleven months: children have learned to cruise or
walk by holding on to low tables
Twelve months:infants enjoy putting things in and
taking things out of
containers. They like little boxes that fit inside one
another.
Vision
 Blurry at first
 Within 1 week, the baby can focus at
about 7-10 inches
 By 1 month, the baby can focus on objects
3 feet away
 By 3-5 months, the baby’s vision is almost
as good as adult
 Prefer pattern’s with high contract
 Alternating stripes, Bull’s eyes,
Prefer color red
 Two-month-old infants focus well (from
about age 6 weeks) and so are able to
follow moving objects with the eyes
(although still not past the midline).
 Three-month-old infants can follow an
object across their midline\
 Four-month-old infants are able to
recognize familiar objects, such as a
frequently seen bottle, rattle, or toy
animal.
Hearing
 It develops before birth
 At 4 months of age, when infants hear a
distinctive sound, they turn and look in
that direction. *3-4Babies begin
 By 5 months of age, infants demonstrate
they can localize sounds downward and to reaching
the side
 Six-month-olds have progressed to being Hand-eye coordination
able to locate sounds made above them
 By 10 months, infants can recognize their * 6months
name and listen acutely when spoken to
Smell: don’t put juice in a bottle
 Infants can smell accurately within 1 or 2
hours after birth. Solid beginning to be
Taste
 Baby prefer sweet introduced: cereal first---
 By 2 weeks, baby can distinguish taste
vegetables---fruits
SUMMARY OF INFANT *8-10months
GROWTH AND
DEVELOPMENTAL Start using spoon
MILESTONES