Growth and development

Mr.Kabangasheshe
Definition of Terms

• Growth: Is an increase in weight and size which also

involve the cell size and number
• Development: Is an integrated, differentiation and
growth leading to maturity and independent action
or function.
It is the special kind of change that is cumulative
and occurs over time in the context of social setting.
Factors affecting growth and
development (Environment)
 Environment: Psychologists under this school of
thought believe that the environment plays an im-
portant role in developmental psychology.
Environment as a factor affecting
growth and development (Environ-
ment) cont
Developmental psychologist like John Watson (1924 to 1958 ) a
prominent American psychologist wrote:
“give me a dozen of health infants well formed and my own spec-
ified world to bring them up in and
I will guarantee to take any one at random and train him to become any
type of specialist I might select- doctor, lawyer, merchant, chief and yes
even beggar and thief regardless of his talent ,tendencies, abilities, voca-
tion, race of his ancestor’.
This shows that according to him the environment tends to influence
growth and development.
Factors affecting growth and
development (Genetics)
• Genetics: There is increasing evidence of the importance of heredity
in the formation of individual personality.
• There is genetic evidence that prove that physical attributes like
height, complexion, hair texture, etc and internal structures are in-
herited.
Factors affecting growth and
development (Genetics) cont
• These physical attribute affects personality struc-
ture, e.g. identical twins who, because they devel-
oped from the same original germ cell are endowed
with the same set of genes and tend to posses the
same pattern of intelligence.
• Non identical twin on the other hand who do not
share the same set of genes present intelligence
only as similar as that found in ordinary siblings
Factors affecting growth and
development (Genetics) cont
• The other example is that persons with endogenous mental defects
certainly tend to produce mentally defective offspring.
• Heredity may therefore be likened to a liquid contained in the bottle
of environment. Both the environment and heredity are equally im-
portant and can not in reality be consider independently.
Forms of Human development

• Cognitive development: This development of men-

tal processes that help us to deal with the environ-
ment.
• Language development: This looks at the develop-
ment or acquisition of language.
• Personality development: It explore the develop-
ment of personality or principle of underlying self.
• Social development: Development of gender iden-
tity and gender roles
 Current theories of growth and
development
• There are a number of theories of development .some of
these include:
 Cognitive development theory
Psychosexual theory
Maturation theory
Social learning theory
Attachment theory.
NB: In this lecture we shall just discuss cognitive theory ac-
cording to Jean piaget and psychosexual development the-
ory by Sigmund Freud.
Cognitive development (Piaget)

• Piaget was interested in understanding the mental

processes that help us deals with the environment.
• Jean Piaget (1896-1980) believed that cognitive de-
velopment takes place in distinct stages.
• His study was done through observation of his sub-
jects (his own children).
• He came up with four stages of cognitive develop-
ment
 Cognitive development (Piaget

• He said man always try to adapt to his environment. This

adaptation process attempts to bring about equilibrium.
• The adaptation process takes place by assimilation and ac-
commodation.
1. Assimilation: It means taking in new ideas or experiences
to knowledge that was accumulated through prior experi-
ences .e.g. a new concept of a train may be assimilated into
the original concept of the car. In as far as the child is con-
cerned there is no significant difference between train and
car.
Cognitive development (Piaget)
cont
• The old knowledge offers a better “fit” to
some of the new experiences than others.
• If the fit is poor then something should be
done. This is when accommodation comes in.
Cognitive development (Piaget)
cont
2.Accommodation: This involves modification of the
existing schemata in order to understand the new
one. e.g. when a two year old is exposed for the
first time to a cell phone , the child will in the first
place try absorbing it into its established schemata.
acting toward it as a familiar object, attempting to
test it, bang it, bounce or throw it.
Cognitive development (Piaget)
cont
• However once he realizes the unique properties of the cell phone he
will develop a new schema of action to cover the concept of the cell
phone.
 Stages of cognitive development

SENSORY MOTOR STAGE (0-2years) since infants nei-

ther talk nor read and probably does not think like an
adult.
• Piaget asserted that they learn by seeing ,hearing
and smelling and through motor activities by touch-
ing, grasping, throwing things and so on.
• He therefore called this stage sensory motor stage.
Stages of cognitive development
cont
• During this stage the infant progresses from basi-
cally reflexes oriented activities which are limited
to organism’s awareness of themselves, other peo-
ple and objects in their surrounding e.g..
• O-2 months the child has random activities they
don’t have goals in their activities.
• 2-4 months they begin to see purpose in their activi-
ties and become more coordinated with their hands
and eyes.
Stages of cognitive develop-
ment cont
• 4-8 months the child easily bring about desired con-
sequences e.g. the child can kick or throw a toy
• At 12 months the child will begin to enjoy activities
like holding and dropping objects
• At 18 months just before 24 months the child begins
to develop some ability of imagination, planning
and creativity. The child also learn to use language
at this very stage.
Stages of cognitive develop-
ment cont
• PRE OPERATIONAL STAGE (2 -7 years):
• Here the child begins to internalize the world
around it.
• Child engages in symbolic play e.g. use of stick as a
gun or doll as a real baby.
• The schemata is limited because it cant categorize
the world around it.
• There is over generalization e.g. if the child saw a
goat it might point at it and say dog ,because in as
far as the child is concerned anything on four legs is
a dog.
Stages of cognitive develop-
ment cont
• Here the child also experiences “egocentrism” in-
ability to consider other aspects of things or being
self centered.
• For example the child might find it hard to believe
that its mother is also its daddy's wife or its mother
is also its brothers mother.
• During this stage the child may also talk to him or
herself.
• There is inability to understand the reverse of
things.
Stages of cognitive develop-
ment cont
• CONCRETE OPERATIONAL STAGE(7-12 years). This is characterized by:
• Ability to reverse actions, processes and activities.
• Child is able to over come egocentrism. The child become a social be-
ing.
• They are able to play in groups
• They are able to categorize things in series
Stages of cognitive develop-
ment cont
• The problem is that their mind is still concrete they understand the
world in terms physical objects. If they want to change their action
into cognition, they need a teaching aid.
• They can not understand abstract things that have some thing to do
with symbolism.
Formal operational stage 12
year and above
• At this stage the child is able to think like an adult.
• They are able to understand hypothetical situation.
• At this stage the person has all the mental tools needed to adopt to
its environment.
• The child also experience adolescent egocentrism.
Formal operational stage 12
year and above
• They become self focused
• They think that the world revolve around them
• This is seen in talking, walking, dressing and selection of friends ,even
deviant behaviour.
Implication to nursing practice

• Children may be egocentric ,there the nurse should exercise patience

with the child.
• Children may not understand hypothetical situation, therefore the
nurse show be aware of the Child's limitation.
• Adolescents may be egocentric therefore should be handled deli-
cately, because the y may be fragile.
PERSONALITY DEVELOPMENT(SIGMUNG FREUD
1856-1939)

• PERSONALITY: This refers to one’s characteristics or

trait that set him/her apart from everybody.
• Sigmund Freud lived at the time when there was a
belief that human being are controlled by their own
rational thinking.
• He was a psychiatrist, did psycho analysis.
• By working with his patients he came up with the
theory that human behavior is determined by in-
stinct or drives which are largely unconscious
PERSONALITY DEVELOPMENT (SIGMUNG FREUD
1856-1939)

• He said there are basically three hypothetical facets of human per-

sonality i.e. Id. Ego and Superego.
 1. The Id

• The Id: This is the part of the mind that always seeks pleasure and
usually the kind of behavior it seeks is sexual in nature.
• It operate on the pleasure principle without regard to what is obtain-
ing on the ground. it develops right from infancy
PERSONALITY DEVELOPMENT (SIGMUNG FREUD
1856-1939)

• He said these body parts are what the child will be focused on at var-
ious ages as it grows.
• He claimed that failure to gain gratification from these areas will re-
sult in “fixation” in adulthood.
• As a result of this he came up with five (5) psychosexual stages.
PERSONALITY DEVELOPMENT (SIGMUNG FREUD
1856-1939)

• He argued that human life is predominated by sex-

ual instincts or pleasures. He called this sexual en-
ergy “libido”
• This energy is released in order to have the required
satisfaction it craves.
• He also grouped up the will be different outlets
through which libido release will be met.
• He called these areas the ‘Erogenous zone’ or ero-
genic zones.
Oral stage (0-1years)

• At this stage the erogenous zone is the mouth.

• During this time the child enjoys in mouth manipulation activities,
such as sucking.
• Sucking is directed toward the breast or feeding bottle.
• If oral needs are not met appropriately in order to release this sexual
energy. Eg. By restriction of breast feeding.
Oral stage (0-1years) cont

• The child will show sign of “oral fixation” such as thumb sucking, fin-
ger nail bitting, pencil chewing in childhood, overeating, chewing of
gum and smoking later in life.
Anal stage (1-3 years)

• Here the erogenous zone shifts from the mouth to

the anal region.
• The child will derive pleasure from anal activities
e.g. holding and releasing urine and faeces, they
may also enjoy excreting faeces anyhow.
• During this stage toilet training becomes critical.
• If the parents become too strict with the child it will
show signs of “anal fixation” because the sexual en-
ergy is trapped.
Anal stage (1-3 years) cont

• The manifestation will manifest in form of extreme orderliness and

cleanliness or messiness and disorder.
• It may even manifest in form of stinginess.
Phallic stage (3-6years)

• The Id impulse now transfers to the genitals

• The child feel sexually attracted to the parent of the opposite sex.
This is called “Oedipus complex” for boys and “Electra complex for
girls.
• At this stage the girl child will show vivid inferiority as compared to
the boy child.
Phallic stage (3-6years) cont

• It will envy having a penis and become closer to the father.

• At this stage this is important because it sets a stage for future het-
erosexual feelings.
• For fear of punishment the child will give up this desire, such as cas-
tration the child will start identifying with same sex parent.
Phallic stage (3-6years) cont

• This is called “identification”

• As a result the superego is formed.
• During the withdrawal period, if the child over identifies with the
parent of the same sex. This can lead to homosexuality later in life.
Latent stage/ stage limbo
(6-11years)
• During this stage the sexual instincts die down, and the superego de-
velops further.
• The child concentrates on developing gender roles.
• The child acquires social values from adults outside the family and
from play with the same sex peers.
Genital stage (Adolescence)

• Puberty causes the same sexual impulses of the phallic stage to reap-
pear.
• The sexual feeling reappear but this it is with a higher intensity.
• The feelings will be directed toward the opposite sex (heterosexual) if
the earlier stages were successful.
• This will lead to marriage and the birth and rearing of children.
Genital stage (Adolescence)
cont
• However if the were not the person will have strong feeling towards
same sex (homosexuality).
• The child will also be selective of the friends he/she chooses.
• These experiences go into the unconscious as repressed material.
These repressed material manifest in form of wet dream and slip of
the tongue.
2. The ego

• The ego screens the Id or materials from the Id

• It operates on reality principle and attempts to protect the self from
un desirable or threatening situations by the use of the defense
mechanisms .
Functions of the ego

The common defense mechanism used by the Ego are:

Repression
Denial
Projection
Reaction formation
Sublimation
Compensation
Introjections
Identification
Rationalization
displacement
Projection

• It is a mechanism where the guilt laden wish or ac-

tion by an individual are rejected by the person and
instead blamed on another person. E.g.
• A nurse on duty who wants to knock off early asks
the fellow nurse to give a report on her behalf and if
that person refuses, that he or she is busy the per-
son will accuse that person that you have refused
because you just want to go and meet your boy
friend.
Repression

• This happens when the demand comes from the Id that is inapprop-
priate.
• The ego will take into consideration the situation obtaining on the
ground.
• The ego will push this demand into the unconscious.
• This demand does not die but may find its expression in the dream
or slip of the togue.
Repression cont

• E.g. if the a nurse feels attracted to the patient, then he/she realizes
that this is unprofessional
• This may come in form of this nurse addressing this patient as darling
only to realize that this is inappropriate he/she may say sorry its just
the slip of the tongue.
Denial

The ego does not only protect the self from the id alone but the envi-
ronment as well e.g.. The ego may protect the self from painful and
stressful experiences and feelings by denying their existence.
For example when a patient is told of the life threatening illness he/she
may say that its not true.
Reaction formation

• It is a defense mechanism where instead of portraying your exact

emotion about something, you portray the exact opposite.
• E.g. a person feels attracted to a certain person instead of accepting
the exact emotion, he may say he really irritates me.
• This is in order to hide the exact feeling.
regression

• This is where a person avoid s tension by reverting to a behavior pat-

tern which belong to an earlier developmental stage.
• E.g. a an old man aged 90 who is about to die may start calling out
his mother’s name in a desperate attempt to return to an earlier
source of solace and support.
Sublimation

• This usually occurs when the direct fulfillment of love and hate out-
lets is denied by the environment, then it become necessary to
rechannel the frustrated tension energy into alternative socially ac-
ceptable love and hate outlets.
Sublimation cont

• For example a young pediatric nurse may successfully rechannel of

her own frustrated maternal love fulfillment drive into love fulfill-
ment with her child patient.
• This is a positive rechannelled love outlet
Introjection

• This is where one unconsciously absorbs unto one self tension out-
let.emotional attitudes ,standard and ideals from people around one.
• E.g. a person who grows up in a violent environment may consider
violence as a best solution to resolving differences.
Compensation

• A mechanism concerned with alternative satisfaction when motiva-

tion for recognition, honour and physical powers are frustrated by
real or imagined inadequacy within the individual.
• E.g a compensatory sense for blindness may be a sense of smell,
hearing and taste.
Compensation cont

• However it may be a responsibility of the nurse and occupational

therapist to anticipate the sense of loss in the patient and thus intro-
duce compensatory activities before depression, uselessness, isola-
tion and despair sets in.
Rationalization

• Here a person unconsciously justifies ideas and be-

haviour about one feels guilty, inferior or anxious.
• For example wre an incompetent nurse is told by
the in charge that she is unreliable and useless and
without any prospect of success.
• Instead of letting this destroy her self image, she
may simply say that sister does not like me.
Displacement

• Is where one transfers the emotion concern with one person onto
another usually weak individual.
• For instance a nurse may be angry with her ward in charge ,but be-
cause she cant dare not reveal her true aggressive feeling to the sis-
ter, she takes out on her patient in a domineering behaviour, aggres-
sion or unkindness.
Identification

• Is a way by which a person identifies with the agroup or individual,

sharing his emotions .
• E.g. when a person joins a group, he/she may want to be like them
• The pattern of tension expresion adopted by the group governs the
way its members are expected to behave or express themselves.
Identification cont

• Identification may prove very valuable in achieving happy and peace-

ful outlets in a hospital ward
• When the nursing staff create a happy, confident and friendly atmos-
phere in the ward.
Identification cont

• Individual patients will identify with them, directing their own ten-
sion energy into positive outlets such as friendly conversations, and
helpfulness.
THE SUPEREGO

• Apart from the ego the Id requires control from the Superego.
• The superego is a collection of moral values of society. For instance
when you see some one beautiful you feel attracted to the even if
thy are someone's wife r husband.
• The superego will tell the Id that that is unacceptable in this society.
Superego cont

• The stronger the morals values the society one lives in the stronger
the superego is going to be.