Chapter 8Growth and Development

Growth

• Physical changes in body– Height– Weight– Motor sensory adaptation– Development of sex organs

Development

• Increase in mental, emotional, and social capabilities– Intellectual (cognitive) ability– Variety in expression of emotions– Ability to cope with complex situations– Social and interpersonal skills

Key Terms

• Physical– Growth of body

• Psychosocial– Psychological and social development

• Cognitive– Intellectual processes

Key Concepts

• Human needs vary throughout lifespan• Generalizations helpful

– But not absolute• Consider each patient unique

Question

• If a patient is anxious, which concept of growth and development is being demonstrated?A. PhysicalB. PsychosocialC. Cognitive

Answer

• B. Psychosocial• Psychosocial includes both psychological

and social– Psychological

• Emotions– E.g., love, hate, fear, anxiety

Answer

• B. Psychosocial• Physical

– Growth of body• Cognitive

– Intellectual processes

Life Stages

• Time frames for studying growth and development

• Start at conception and end with death• Certain changes and needs characterize

each stage

Life Stages

• 1950: Erik Erikson’s stages of psychosocial development– Do not include physical aspects– Conflicts encountered in each stage– Resolving these conflicts advances person to

next stage

Life Stages

• Psychosocial development can be delayed if conflict not resolved

• Process continuous over lifespan• Stress can cause regression to earlier

stage• Baby boomers

Prenatal

• Conception to birth• Zygote• Embryo stage• Fetus• Rapid physical growth• No psychosocial stage

Infancy

• Birth to 1 year• Neonate• Infant• Physical growth• Cognitive skills• Trust versus mistrust

Toddler

• 1 to 3 years• Physical changes• Motor sensory ability• Cognitive skills• Autonomy versus shame and doubt

Preschooler

• 3 to 6 years• Physical changes• Motor sensory ability• Cognitive skills• Initiative versus guilt

School-Age Child

• 6 to 12 years• Physical changes• Motor sensory ability• Cognitive skills• Industry versus inferiority

Adolescence

• 12 to 20 years• Physical changes• Motor sensory ability• Cognitive skills• Identity versus role confusion

Question

• Which of the following stages does a toddler fall within according to Erik Erikson’s stages of psychosocial development?A. Autonomy versus shame or doubtB. Trust versus mistrustC. Initiative versus guilt

Answer

• A. Autonomy versus shame or doubt• Toddler

– Autonomy versus shame or doubt• Infancy

– Trust versus mistrust• Preschooler

– Initiative versus guilt

Young Adulthood

• 20s and 30s• Physical changes• Motor sensory ability• Cognitive skills• Intimacy versus isolation

Middle Adulthood

• 40 to 65 years• Physical changes• Motor sensory ability• Cognitive skills• Generativity versus stagnation• Chronic illness more likely to appear

Later Adulthood

• Young-old– 65 to 74 years

• Middle-old– 75 to 84 years

• Old-old (frail elderly)– 85 years to death

Later Adulthood

• Physical changes• Motor sensory ability• Cognitive skills• Ego integrity versus despair

Care Considerations

• Do not assume• Do not stereotype• Each stage has different care needs• All need respect, compassion, and empathy

Question

• Which of the following age groups would include the care consideration of giving explanations along with the rationale?A. ToddlerB. PreschoolerC. Adolescent

Answer

• C. Adolescent• Adolescent would benefit most by giving

rationales– Toddler and preschooler not as cognitively

developed

Other Theories

• Piaget’s Cognitive Stages• Kohlberg’s Moral Stages• Gilligan’s Stages of the Ethic of Care

Piaget’s Cognitive Stages

• Focus on children only• Sensorimotor• Preoperational• Concrete operational• Formal operational

Kohlberg’s Moral Stages

• Focus on moral development of humans• Pre-conventional• Conventional• Postconventional

Gilligan’s Stages of the Ethic of Care

• Included females in her study• Preconventional• Conventional• Postconventional

Question

• Which of the theorists focused on moral development in males?A. KohlbergB. GilliganC. Piaget

Answer

• A. Kohlberg’s theory focused on moral development in males.

• Gilligan – ethics of care focused on development in females

• Piaget – focus on children’s cognition

Future Trends

• Change in viewing and caring for later adulthood patients

• Older people healthier, more active, and more verbal

William H. Thomas

• Does not assign specific ages• Cyclic nature of aging

– Infant– Adolescent– Adult– Senescence– Elderhood

Question

• True or False:– Dr. William Thomas breaks the life span into

five groupings with a specific assigned age range for each.

Answer

• False• Dr. William Thomas has five groupings

– But does not assign specific age ranges

Death and Dying

• Terminal illness• Natural process

– Last stage of human development• Elisabeth Kübler-Ross• Need for open communications• Life review

Stages of Dying

• Denial• Anger• Bargaining• Depression• Acceptance

Question

• True or False:– Moving away from the family home to go to

school can result in a process similar to the death and dying stages identified by Elisabeth Kübler-Ross.

Answer

• True• When there is a perceived loss, the

suffering and grieving process can be initiated