Overview of Growth and

Development
May 28, 2016

Growth and Development

An understanding of human
development can facilitate accurate
assessment of health and health
practices of people of all ages.
The development periods are prenatal,
infant, toddler, preschool age, school
age, adolescent and young middle and
older adults.

Growth- refers to the changes in

structure and size. The changes in
height, weight and body proportion.
During adulthood, continued growth
takes place, although more in specific
body s. parts. Metabolic and
biochemical processes change as life
progresses toward maturity; cells of
the central nervous system change as
maturity progresses.

Development- refers to changes in

skill and capacity to function. In
contrast to growth which is a
quantitative or precisely measureable
change, development is qualitative.
Development evolves from maturation
of physical and mental capacities and
learning.

Developmental Periods
The prenatal period begins at
conception and ends with birth and is
one of the most important
development periods because
development proceeds at an extremely
rapid rate.

Cont..
Period

Age

Characteristics

Infancy

0- 18 months

Infant fully dependent

on others for basic
needs. Ends child
begins walking alone
and possesses the
beginning speech
sound of language.

Toddler period

12 or 18 months to 3
years

Motor development
progresses
significantly. Child
achieves a degree of
physical and
emotional autonomy
while maintaining a
close identity and
toward peers

Cont..
Period

Age

Characteristics

Preschool period

3-5 or 6 years

Child has increased

interest in and
involvement with
peers and may have
social interactions
with many people.

School- Age period

5 or 6 to 10 years

Marked by entrance
into elementary
school. Interests turn
away from family and
toward peers

Cont..
Period

Age

Characteristics

adolescence

Onset of puberty; 1114 years

A period of transition,
adjustment and
personal exploration.
Ends when individual
demonstrates
readiness to assume
full adult
responsibilities of
financial, emotional,
and social
independence.

Young adulthood

Getting started in an
occupation or career,
finding and learning
to live with a partner
and starting and
rearing a family,

Period

Cont..
Age

Characteristics

Middle adulthood

Being established in a
marriage, an
occupation or career,
and a community.
May continue to be a
time of transition.
Must adjust to
physiological changes
in of middle age.

Older adulthood

Must adjust to
decrease physical
strength and health,
retirement, reduced
income, decreasing
independence, and
death of spouse,
friends and self. May
be a time of
continues

 Growth and Development are

complex, interrelated processes that
are influenced by and, in turn, can
affect the health of an individual. The
nurse who understands these
relationships is aware of the need for
age specific health screening,
nursing history questions, and health
teaching.

Theories of Development
Theories of development provide a
framework from thinking about human
growth, development and learning. But
why do we study development? If we
have ever wondered about what
motivates human thought and
behavior, understanding these theories
can provide useful insight into
individuals and society.

Theories of psychosexual,
psychosocial and cognitive
development are employed to gain a
holistic view of the progression of
individual development throughout
lifespan. These theories were
developed by Freud, Ericson, Piaget,
Gilligan, and Kohlberg.

The purpose of Psychology Theories

1. Theories provide a framework for
understanding human behavior, thought,
and development. By having a broad base
of understanding about the hows and
whys of human behavior, we can better
understand ourselves and others.
2. Theories create a basis for future research.
Researchers use theories to form
hypotheses that can then be tested.

3. Theories are dynamic and always

changing. As new discoveries are
made, theories are modified and
adapted to account for new
information.

Freuds Stages of Psychosexual

Development
What is Psychosexual Development?
Describes how personality develops
during childhood. Freud believed that
personality develops through the series
of childhood stages in which the
pressure- seeking energies of the id
psychosexual energy, or libido, was
described as the driving force behind
behavior.

 If these psychosexual stages are completed

successfully, the result is a healthy
personality. If certain issues are not resolved
at the appropriate stage, fixation can occur. A
fixation is a persistent focus on an earlier
psychosexual stage. Until this conflict
resolved, the individual will remain stuck at
the oral stage. For example, a person who is
fixated at the oral stage maybe over
dependent on others and my seek oral
stimulation through smoking, dinking, or
eating.

Freuds Stages of Psychosexual

Development
The Oral Stage- Birth to 1 year
During the oral stage, the infants primary
source of interaction occurs through the mouth,
so the rooting and sucking reflex is especially
important. The mouth is vital for eating, and the
infant derives pleasure from oral stimulation
through gratifying activities such as tasting and
sucking. Because the infant is entirely
dependent upon caregivers (who are responsible
for feeding the child), the infant also develops a
sense of trust and comfort through this oral
stimulation.

 The Anal Stage- 1 -3 years

During the anal stage, Freud believed that the
primary focus of the libido was on controlling
bladder and bowel movements. The major
conflict at this stage is toilet training the
child has to lean to control his or her bodily
needs. Developing this control leads to a
sense of accomplishment and independence.
Freud believe that positive experiences during
this stage served as the basis for people to
become competent, productive and creative
adults.

 The Phallic Stage- 3-6 years

During the phallic stage, the primary focus of the
libido is on the genitals. At this age, children also
begins to discover the differences between males and
females.
Freud also believed that boys begin to view their
fathers as the rival for the mothers affections. The
Oedipus complex describes these feelings of wanting
to posses the mother and the desire to replace the
father.
Electra complex has been used to described a similar
set of feelings experienced by young girls. Freud
however, believed that girls instead experience penis
envy.

 Eventually, the child begins to identify

with the same- sex parent as a means of
vicariously possessing the other parent.

 The Latent period- 6- Puberty

During the latent period, the libido interest
are suppressed. The development of the
ego and superego contribute to this period
of calm. The stage begins around the time
that children enter into school and become
more concerned with the peer
relationships, hobbies and other interest.
This stage is important in the development
of social and communication skills and
self-confidence.

 The Genital Stage: Puberty to Death

During the final stage of psychosexual
development, the individual develops a
strong sexual interest in the opposite sex.
This stage begins during puberty but last
throughout the rest of a persons life.
The focus was solely on individual needs,
interest in the welfare of others grows
during this stage. If the other stages have
been completed successfully, the individual
should now be well- balanced, warm and
caring. The goal of this stage is to establish
a balance between the various life areas.

Eriksons theory of Psychosocial

development
What is Psychosocial Development
Erik Eriksons theory of psychosocial
development is one of the best
known theories of personality in
psychology. Ericksons theory
describes the impact of social
experiences across the whole
lifespan.

 One of the main elements of Eriksons

psychosocial stage is the development of
ego identify.
Ego Identity- is the conscious sense of
self that we develop through social
interaction. Accdg. To Erikson, our ego
identity is constantly changing due to new
experiences and information we acquire in
out daily interactions with others.

In addition to ego identity, Erikson also

believed that a sense of competence
motivates behaviors and actions. Each
stage in Eriksons theory is concerned
with becoming competent in an area of
life. If the stage is handled well, the
person will fell a sense of mastery,
which is sometimes referred to as ego
strength or ego quality.

In each stage, Erikson believed people

experience a conflict that serves as a
turning point in development. In
Eriksons view. These conflicts are
centered on either developing a
psychological quality or failing to
develop that quality. During these
times, potential for personal growth is
high, but so is the potential for failure.

Psychosocial Stage 1 (Infancy)

Trust Vs. Mistrust
The first stage of Ericksons theory of
psychosocial development occurs between
birth and one year of age and is the most
fundamental stage in life.
Because an infant is utterly dependent, the
development of trust is based on the
dependability and quality of the childs
caregivers.
If a child successfully develop trust, he or
she will feel safe and secure in the world.

 Caregivers who are inconsistent,

emotionally unavailable, or rejecting
contribute to feelings of mistrust in
the children they are care for. Failure
to develop trust will result in fear and
a belief that the world is inconsistent
and unpredictable.

Stage 2 (Toddler Stage)- Autonomy

vs. Shame and Doubt
Takes place during childhood and is
focused on children developing a
greater sense of personal control.
Erikson believed that toileting was a
vital part of this process. Erikson
believed that learning to control
ones bodily functions lead to a
feeling of control and a sense of
independence.

 Other important events include gaining more

control over food choices, toy preferences and
clothing selection.
Children who successfully complete this stage
feel secure and confident, while those who do
not are left with a sense of inadequacy and selfcontrol.
Erikson believed that achieving a balance
between autonomy and shame and doubt would
lead to will, which in the belief that children can
act with intention. Within reason and limits.

Stage 3 (Preschool stage)- Initiative

vs. Guilt
During the preschool years, children
begin to assert their power and
control over the world through
directing play and other social
interactions.
Children who are successful at this
stage feel capable and able to lead
others. Those who fail to acquire
these skills are left with a sense of
guilt, self-doubt and lack of

Stage 4 (Middle Childhood Stage/

School Age)- Industry vs. Inferiority
Through social interactions, children begin
to develop a sense of pride in their
accomplishments and abilities.
Children who are encouraged and
commended by the parents and teachers
develop a feeling of competence and
belief in their skills. Those who receive
little or no encouragement from parents,
teachers, or peers will doubt their abilities
to be successful.

Stage 5 (Adolescence)- Identity vs.

Role Confusion
During adolescence, children explore their
independence and develop a sense of self
Those who receive proper encouragement
and reinforcement through personal
exploration will emerge from this stage
with strong sense of self and a feeling of
independence and control. Those who
remain unsure od their beliefs and desires
will feel insecure and confused about
themselves and the future.

 Completing this stage successfully

leads to fidelity, which Erikson
described as an ability to live by
societys standard and expectations.

Stage 6 (Young Adulthood) Intimacy

vs. Isolation
This stage covers the period of early
adulthood when people are
exploring personal relationships.
Erikson believed it was vital that
people develop close, committed
relationships with other people.
Those who are successful at this step
will form relationships that are
committed and secure.

 Remember that each step builds on

skills learned in previous steps.
Erikson believed that a strong sense
of personal identity was important
for developing intimate relationships.
Studies have demonstrated that
those with a poor sense of self tend
to have less committed relationships
and are more likely to suffer
emotional isolation, ,loneliness, and

 Successful resolution of this stage

results in the virtue known as love. It
is marked by the ability to form
lasting, meaningful relationships with
other people.

Stage 7(Middle Adulthood)Generativity vs. Stagnation

During adulthood, we continue to
build our lives, focusing on our career
and family.
Those who are successful during this
phase will feel that they are
contributing to the world by being
active in their home and community.
Those who fail to attain this skill will
feel unproductive and uninvolved in
the world.

 Care is the virtue achieved when this

stage is handled successfully. Being
proud of your accomplishments,
watching your children grow into
adults, and develop a sense of unity
with your life partner are important
accomplishments of this stage.

Stage 8 (Older Adulthood)- Integrity

vs. Despair
This phase occurs during old age and
is focused on reflecting back on life.
Those who are unsuccessful during
this stage will feel that their life has
been wasted and will experience
many regrets. The individual will be
left with feelings of bitterness and
despair.

 Those who feel proud of their

accomplishments will feel a sense of
integrity. Successfully completing this
phase means looking back with few
regrets and a general feeling of
satisfaction. These individuals will
attain wisdom, even when
confronting death.

The strengths of Eriksons

theory
One of the strengths of psychosocial theory
is that it provides a broad framework from
which to view development throughout the
entire lifespan. It also allows us to emphasize
the social nature of human beings and the
important influence that social relationships
have on development. Some research also
suggests that people who form strong
personal identities during adolescence are
better capable of forming intimate
relationships during early adulthood.

Limitations of Psychosocial
theory

One major weakness of psychosocial

theory is that the exact mechanisms
of resolving conflicts and moving
form one stage to the next are not
well described and developed. The
theory fails to detail exactly what
type of experiences are necessary at
each stage in order to successfully
resolve the conflicts and move to the
next stage.

Piagets Theory of Cognitive

Development
Jean Piaget developed a stage theory of
intellectual development that included four
distinct stages: the sensorimotor (birth- 2); the
preoperational stage (2- 6); the concrete
operational stage (7-12) and the formal
operational stage (adolescence- adulthood)
Piagets stage theory describes the cognitive
process and abilities. Early cognitive
development involves processes based upon
actions and later progresses into changes in
mental operations.

Jean Piaget Stages of Cognitive

Development
The Sensorimotor Stage- During this
stage, infants and toddlers acquire
knowledge though sensory
experiences and manipulating
objects.
The Preoperational Stage- At this
stage, kids learn through pretend
play but still struggle with logic and
taking the point of view of other
people.

 The Concrete Operational Stage- Kids

at this point of development begin to
think more logically, but their thinking
can also be very rigid. they tend to
struggle with abstract and
hypothetical concepts.
The Formal Operational Stage- The
final stage of Piagets theory involves
an increase in logic, the ability to use
deductive reasoning, and an
understanding of abstract ideas.

Kohlbergs Stages of Moral

Development
Level and Stages

What is right

Reasons for doing

right

Level A: Pre
conventional
Stage 1- Punishment
and obedience
Stage 2- Individual
instrumental purpose
and exchange

Avoiding breaking
rules, obey for
obediences sake,
and avoid doing
physical damage to
people and property
Following rules when
it is someones
immediate interest

Avoiding punishment
and the superior
power of authorities
Serving ones own
needs or interests in
a world where one
must recognize that
other people have
interests as well.

Cont..
Level and Stages

What is right

Reasons for doing

right

Level B:
Conventional
Stage 3- Mutual
interpersonal
expectations,
relationships, and
conformity
Stage 4- Social
system and
conscience
maintenance

Living up to what is
expected by relatives
and friends or what is
generally expected in
ones role as son,
sister, friend, and so
on
Being good is
important
Fulfilling actual duties
to which one has
agreed

Needing to be good in
ones own eyes and
those of others.
Following the golden
rule
Keeping institution
going as whole using
self-respect or
conscience to meet
ones defined
obligations

Cont..
Level C: Post
conventional and
principled
Stage 5: Prior rights
and social contract or
utility

Stage 6: Universal
Ethical Principles

Being aware that

persons hold a variety
of values and
opinions, most of
which are relative to
ones group
Realizing that some
nonrelative values
and rights, such as
life and liberty, must
be upheld in any
society.
Acting in accordance
with the principles
laws violate universal
ethical principles
Understanding the
quality of human

Feeling obligated to
obey the law because
one has made a
social contract to
make and abide the
laws for good of all;
the greatest good for
the greatest number.

As a rational person,
seeing validity of
principles and
becoming committed
to them

Gilligans Model of Moral

Development
Other studies on moral development in
women and men by Gilligan have
demonstrated gender differences in
describing high morality.
Women discussed issues of selfishness
versus responsibility, of exercising care, and
the avoidance of hurting.
Men described terms of justice, fairness and
the rights of individuals.
Gilligans theory of moral development
suggest that there is a different process of
moral development in women in society.

Gilligans Model of Moral

Development in Women
Level

Characteristics

1. Individual survival

What is practical and best for self,

realizing connections to others.

2. Goodness as self -sacrifice

Sacrifices wants and needs to

fulfill others wants and needs.

3. Nonviolence

Moral equality of self and others.

Summary
Individuals make many choices that
affect their health each day and multiple
factors may influence how these choices
are made. The stage of motor, social,
and cognitive development can greatly
influence how the person perceives a
situation and the choices arising from
that situation. The nurse who has
studied development has a clearer idea
of how a person may respond to a given
idea or situation at a specific age or
stage of development.