Considering the Psychosocial Development of Students Who Visit the Health Office

By Carol Dietz, RNSchool Nurse

Poudre School District

Erik Erikson 1902 -1994Theory of Psychosocial Development

Trust vs. MistrustBirth to 18 months

Positive resolution = Feelings of trust from environmental supportNegative consequence = Fear of others

Autonomy vs. Shame and Doubt18 months to 3 years

Positive resolution = Self-sufficiency if exploration is encouragedNegative consequence = Doubts about self, lack of independence

Initiative vs. Guilt 3 to 6 years

Positive resolution = Discovery of ways to initiate actionsNegative consequence = Guilt from actions and thoughts

Characteristics for age group• Egocentrism – the inability to take others

perspective• Increased curiosity = constant questioning• Cooperative play• Imaginary friends normal and healthy• Magical thinking - thoughts assume a

magical power capable of influencing events

• Inaccurate memory recall

Health Concern• 7 – 8 colds per year due to immature respiratory system

Most Common Health Problems of Early ChildhoodInfectious Diseases

Varicella, Pertussis (Whooping Cough), Measles, MumpsPrevented by vaccines

Conjunctivitis (pink eye)

Erythema Infectiosum (Fifth Disease)

Scarlet Fever

PoisoningNon Pharmaceuticals – Personal care products (perfume, aftershave), Cleaning products, Plants, Foreign bodies (toys)Pharmaceuticals – Analgesics (ibuprofen, pediatric acetaminophen), topicals (diaper care products), cold medicine, vitamins

Child Maltreatment- Neglect and Abuse

Talking with Children Who Reveal Abuse

• Provide a private time and place to talk.• Do not promise not to tell; tell them that you are required by law to report the

abuse.• Do not express shock or criticize them or their family.• Use their vocabulary to discuss body parts.• Avoid using any leading statements that can distort their report.• Reassure them that they have done the right thing by telling.• Tell them that the abuse is not their fault and that are not bad or to blame.• Determine their immediate need for safety.• Let the child know what will happen when you report the abuse. Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of Infants and Children 8th Ed. Mosby, St. Louis.

PSD Mandatory Reporting Requirements for Child Abuse/Neglecthttps://eweb.psdschools.org/documentlibrary/downloads/Student_Services/Child_Abuse/Child_Abuse_Instructions_and_Form.pdf

Widening Environmental Influences“As a socializing agent second only to the family,

the school exerts a profound influence on the social development of children.”

Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of Infants and Children 8th Ed. Mosby, St. Louis.

Industry vs. Inferiority6 -12 years

Positive resolution = sense of competenceNegative consequence = feelings of inferiority

Characteristics for Age Group Less intense emotions Interests expand Same-sex friendships Best friends Desire for rules/conformity/fairness Clubs and organized sports Eager to build skills Eager to participate in meaningful

and socially useful work

Failure to develop a sense of accomplishment may result in a

sense of inferiority.

Common Health Problems of Middle Childhood

Skin lesions and woundsBacterial infections

Viral infectionsDental Cavities

Recurrent Abdominal Pain (RAP)Attention Deficit Hyperactivity Disorder (ADHD)

Helping Children in School• Be supportive – through

companionship share ideas and thoughts

• Share an interest in reading• Support and encourage activity

rather than passivity• Encourage originality• Foster the development of

hobbies and collections• Encourage children to wonder

and reflect during free time• Encourage family experiences and

trips to places of interest

• Encourage questions – help children discover sources for information or places in which to explore and investigate

• Stimulate creative thinking and problem solving – help children try out new solutions to problems without fear of making mistakes

• Be positive – every child should experience some success each day

• Use rewards rather than punishment

Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of Infants and Children 8th Ed. Mosby, St. Louis.

Identity vs. Role Confusion13 – 21 years

Positive resolution = Awareness of uniqueness of self, knowledge of role to be followedNegative consequence = Inability to identify appropriate roles in life

Characteristics of Age Group Changes in Reproductive hormones

Onset of puberty Identity development Moral development Spiritual development Development of autonomy Increased sexuality Peer group as major influence

Adolescent Egocentrism

State of self-absorption in which the world is viewed from one’s own point of view.

Makes adolescents highly critical of authority figures such as parents and teachers, unwilling to accept criticism, and quick to find fault with other’s behavior.

Feldman, R. (2006). Development Across the Lifespan 3rd ed. Prentice Hall, New Jersey.

Imaginary AudienceFictitious observers who pay as much

attention to the adolescents’ behavior as adolescents do themselves

Personal Fables

View that what happens to them is unique, exceptional and shared by no one else.

Leads to feelings of invulnerability to the risks that threaten others.

Feldman, R. (2006). Development Across the Lifespan 3rd ed. Prentice Hall, New Jersey.

2010 Leading Cause of Death in the United States by Age

National Vital Statistics Reports, Volume 60, Number 4 “Deaths, Preliminary Data for 2010” January 11, 2012

Age 1 - 4 Age 5 -14 Age 15 -241. Accidents 1. Accidents 1. Accidents

Motor Vehicle 32% Motor Vehicle 55% Motor Vehicle 60% Other 68% falls, drowning, fire

Other 45% falls, firearms, fire

Other 45% falls, poisoning, firearms

2. Birth defects 2. Cancer 2. Homicide3. Homicide 3. Birth defects 3. Suicide4. Cancer 4. Suicide 4. Cancer5. Heart disease 5. Homicide 5. Heart disease6. Influenza, pneumonia 6. Heart disease

7. Chronic lower respiratory disease

10. Diabetes Mellitus

PSD Statistics• During fall semester of 2010, 166 students

were admitted to PVHS Emergency Services for psychiatric related emergencies

• During the same time period, 131 PSD students were admitted to Mountain Crest, our local psychiatric hospital

• Over the last 10 years, PSD has had 10 student deaths due to suicide.

Melanie Voegeli-Morris LCSW, Poudre School District, Student Assistance Services Coordinator

Early AdulthoodIntimacy vs. Isolation

Age 21 - 39Positive resolution = Development of loving relationships and close friends

Negative consequence = Fear of relationships with others

Middle AdulthoodGenerativity vs. Stagnation

Age 40 - 65

Positive resolution = Sense of contribution to continuity of life

Negative consequence = Trivialization of one’s activities

Late AdulthoodEgo integrity vs. Despair

Age 65 and older

Positive resolution = Sense of unity in life’s accomplishments

Negative consequence = Regret over lost opportunities