Post on 07-Apr-2018
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Growth and Development II
Victoria Craig-Cherry MSN, APN
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Developmental Tasks fromBirth through Adolescence
Neonates and infants (birth to1 year)
Adjustment to environment outside the uterus
Toddlers (1 to 3 years) Progress from no control to walking andspeaking
Control elimination
Acquire information about environment
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Developmental Tasks fromBirth through Adolescence
Preschoolers (4 and 5 years)
Physical growth slows
Control of body and coordination greatly increases
World enlarges with relatives, friends, etc.
School-age children (6 to 12 years)
Deciduous teeth are shed
Includes preadolescence (or prepuberty)
Period ends with onset of puberty
Skills learned are important for later life
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Developmental Tasks fromBirth through Adolescence
Adolescents (12 to 18 years)
Physically and psychologically mature
Acquire personal identity
Ready to enter adulthood
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Physical Development:Neonates and Infants
Weight
Doubles by 5 mo
Triples by 12 mo
Length
Gains 13.75 cm (5.5 in.) by6 mo
Additional 7.5 cm (3 in.) by12 mo.
Head and ChestCircumference
Head > chest at birth
Head = chest 9-10 mo.
Head < chest after 1 yr.
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Physical Development:Neonates and Infants
Anterior fontanel closes between 9 and 18 mo.
Posterior fontanel closes between 2 and 3 mo.
Vision
Birth - blinks in response to bright light 1 mo - focus on objects
4 mo - almost complete color vision, follows object in180 arc
5 mo - reaches for objects 6-10 mo - focus on object and follow in all directions
12 mo - depth perception developed
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Physical Development:Neonates and Infants
Hearing Intact at birth
Moro reflex to loud noises
2-3 mo - vocalize to sounds and voices 3-6 mo - looks for sounds, pause to listen,
responds to angry/happy voices
6-9 mo - may look at named objects/people
9-12 mo - understands some words, usesgestures, say one or two words
12 mo - responds to simple commands
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Physical Development:Neonates and Infants
Smell and Taste Intact at birth
Touch Well developed at birth
Poor temperature regulation
Diffuse response to pain
Reflexes Reflexes present at birth
Disappear to permit voluntary movement
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SIDS Video
Click here to view a video on sudden infant death syndrome.Back to Directory
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Motor Development: Neonatesand Infants
Uncoordinated at birth
1 mo - lifts head when prone, head lag present
4 mo - minimal head lag
6 mo - sits without support
9 mo - reach, grasp, transfer object from
hand to hand
12 mo - fine motor skills begin todevelop
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Physical Development: Toddlers
Lose the baby look by age 2
Gain 35 kg (710 lb) between ages 1
and 3
Height spurts between ages 1 and 2, then
slows
By 24 mo., head circumference 80% adult
size
Vision continues to mature; 20/40 at age 2
Hearing, taste, smell, and touch increasinglydeveloped
Fine and gross motor skills improve
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Physical Development:Preschoolers
Body appears out of proportion as extremitiesgrow more quickly
Weight gain generally slow
Doubles birth length by age 5
20/30 normal vision at age 5
Hearing at optimal levels
Shows taste preferences Motor abilities strengthen as child begins to
master physical activities
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Physical Development: School-age Children
Major weight gain at age 912 (girls) and 1012(boys)
Growth spurt at age 1012 (girls) and 1214
(boys) 20/20 vision established between ages 911
Well-developed senses of hearing and touch
Increased perspiration and other prepubertalchanges
Motor abilities well developed during this period
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Physical Development:Adolescents
Body parts reach adult size, beginningwith head, hands, and feet
Rapid growth in height and weight forboys, slower in girls
Glandular changes cause increased sweatand acne
Primary and secondary sexualcharacteristics develop
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Psychosocial Development(Erikson)
Neonates and Infants Trust versus mistrust
Toddlers
Autonomy versus shame Preschoolers
Initiative versus guilt
School-age Children
Industry versus inferiority
Adolescents Identity versus role confusion
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Cognitive Development(Piaget): Neonates and Infants
Sensorimotor Phase
Perceptual recognition(48 mo.)
Responds to newstimuli, remembersobjects, looks for them(6 mo.)
Concept of both spaceand time develops (12mo.)
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Cognitive Development(Piaget): Toddlers
Completes SensorimotorPhase
Trial-and-error problem
solving Solving problems mentally
Preconceptual Phase (2 yr)
Learn sequence of time
Develop some symbolicthought
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Cognitive Development(Piaget): Preschoolers
Intuitive Thought Phase
Still egocentric, but subsiding
Learn through trial and error
Think of one idea at a time
Do not understand relationships
5 yr count pennies, reading skills develop
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Cognitive Development(Piaget): School-age Children
Concrete OperationsPhase
Cooperative
interactions Intuitive reasoning
Cause-and-effect
Concepts of money
and time learned Reading skills well
developed
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Cognitive Development(Piaget): Adolescents
Formal Operations Phase
Thinking beyond the present
Idealistic thinking
Abstract thinking
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Moral Development(Kohlberg)
Neonates and infants
No related stage
Pleasure/pain
Parent tone of voice, facial expressions
Toddlers
Preconventional level
Stage 1: Punishment and reward
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Moral Development(Kohlberg)
Preschoolers
Prosocial behavior
Modeling moral behavior
School-age children Preconventional level
Stage 1: Punishment and reward
Stage 2: Instrumental-relativist
Conventional level Stage 3: Good boy-nice girl
Stage 4: Law and order
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Moral Development(Kohlberg)
Adolescents
Conventional Level(Young Adolescent)
Postconventional orPrincipled Level
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Spiritual Development(Fowler)
Toddlers
Undifferentiated
Preschoolers
Intuitive-projective
School-age children
Mythic-literal
Adolescents
Synthetic-conventional
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Assessment: Neonates andInfants
Apgar scoring
Denver Developmental Screening Test (DDST-II)
Physical development Growth in normal range
Appropriately size fontanels Vital signs in normal range
Ability to habituate to stimuli and clam self
Motor development Gross and fine skills in normal range
Appropriate reflexes
Symmetrical movements
No hyper- or hypotonia
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Assessment: Neonates andInfants
Sensory development Follows moving objects Responds to sound Coos, babbles, laughs
Imitate sounds Psychosocial development
Interacts with parents through movement andvocalizations
Development in activities of daily living (ADL) Eats, drinks appropriate amounts Exhibits elimination patterns normal for age Exhibits normal rest and sleep patterns
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Assessment: Toddlers
Physical development
Physical growth in normal range
Vital signs in normal range
Vision, hearing within normal range
Motor development
Achieves gross and fine motor milestones
Psychosocial development
Achieves milestones
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Assessment: Toddlers
Development in ADL
Feeds self
Eats variety of foods
Begins to develop bowel and bladder control
Rest and sleep patterns appropriate for age
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Assessment: Preschoolers
Physical development
Physical growth within normal range
Vital signs in normal range
Vision, hearing within normal range
Motor development
Achieves gross and fine motor milestone
Psychosocial development
Achieves milestones
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Assessment: Preschoolers
Development in ADL
Control of bowel and bladder functions
Performs simple hygiene activities
Dresses and undresses self
Engages in bedtime rituals
Demonstrates ability to put self to sleep
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Assessment: School-ageChildren
Physical development
Physical growth within normal range
Vision, hearing within normal range
Vital signs in normal range
Demonstrate male or female prepubertalchanges
Motor development Possesses coordinated motor skills for age
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Assessment: School-ageChildren
Psychosocial Development
Achieves milestones
Development in ADL
Concern for personal cleanliness andappearance
Expresses need for privacy
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Assessment: Adolescents
Physical development
Physical growth within normal range
Demonstrates male or female sexual
development within standards
Vital signs within normal range for gender
Hearing, vision within normal range
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Assessment: Adolescents
Psychosocial development
Interacts well with parents and others
Likes self
Has plans for future Choose lifestyle and interests that fit own identity
Determines own beliefs and values
Begins to establish a sense of identity in family
Seeks help from appropriate people as needed
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Assessment: Adolescents
Development in ADL
Knowledge of physical development,menstruation, reproduction, and birth control
Exhibits healthy lifestyle practice
Demonstrates concern for personalcleanliness and appearance
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Health Promotion Guidelines:Neonates and Infants
Health examinations Birth, 2 weeks, 2, 4, 5, and 12 mo
Protective measures Immunizations Fluoride supplementation as needed Screening for TB and PKU Prompt attention to illness Appropriate hygiene
Infant safety Importance of supervision
Home environmental safety Feeding measures Appropriate toys
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Health Promotion Guidelines:Neonates and Infants
Nutrition
Breast and formulafeeding
Solid foods Iron supplementation
Elimination
Characteristics
Frequency
Diarrhea
Rest/Sleep
Patterns
Sensory stimulation
Touch stimulation Visually stimulating
toys
Hearing loss screening
and intervention
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Health Promotion Guidelines:Toddlers
Health examinations
15, 18 months and then
as recommended by physician
Protective measures Immunizations
Screening for TB, lead poisoning
Fluoride supplementation as
needed
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Health Promotion Guidelines:Toddlers
Safety
Supervision
Teaching
Home environmentsafety
Outdoor safety
Appropriate toys
Nutrition
Nutritious meals andsnacks
Mealtime manners Dental care
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Health Promotion Guidelines:Toddlers
Elimination
Toilet training
Rest/Sleep
Sleep disturbances
Play
Adequate space
Toys for acting on behavior
Motor and sensory stimulation
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Health Promotion Guidelines
Additional safety and health concerns fortoddlers
Injuries Visual problems
Respiratory and ear infections Dental caries
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Health Promotion Guidelines:Preschoolers
Health Examinations
Every 1-2 years
Protective measures
Immunizations Screening for TB,
vision, hearing, dental
Fluoride treatment
Preschooler safety
Education
Play safety
Prevention ofpoisoning
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Health Promotion Guidelines:Preschoolers
Nutrition
Nutritious meals andsnacks
Elimination Proper hygiene
Rest/Sleep
Sleep disturbances
Play
Group play activities Teach simple
cooperative andinteractive games
Toys for dress-up
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Health Promotion Guidelines
Additional safety and health concerns forpreschoolers
Injuries Visual problems Dental caries Respiratory tract and ear infections
Communicable disease Congenital abnormalities correction
H l h P i G id li
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Health Promotion Guidelines:School-age Children
Physical development As recommended
Protective measures
Immunizations Screening for TB
Periodic vision, speech, hearing, dentalscreening
Fluoride treatment
Sexual education
H l h P i G id li
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Health Promotion Guidelines:School-age Children
Safety
Sports safety
Education
Nutrition No skipped meals
Balanced diet
Obesity
Play and SocialInteraction
Organized group
activities Parental expectations
Parentalresponsibilities
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Health Promotion Guidelines
Additional safety and health concerns forschool-age children
Communicable Diseases
Dental Cavities
Injuries
Obesity
H l h P i G id li
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Health Promotion Guidelines:Adolescents
Health Examinations
As recommended
Protective measures
Immunizations
Periodic screenings for TB, vision, hearing,dental screening
Accurate sexual information
H lth P ti G id li
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Health Promotion Guidelines:Adolescents
Safety Issues
Motor vehicle safety
Sports safety
Substance abuse
Emotional disturbances
Nutrition and exercise
Health snacks
Appropriate food intake and exercise
H lth P ti G id li
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Health Promotion Guidelines:Adolescents
Social Interaction
Positive relationships
Peer group activities
Home environment Family responsibilities
and participation
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Health Promotion Guidelines
Additional safety and health concerns foradolescents
Consequences of Risky Behavior
Injury Sexually transmitted disease Teen pregnancy
Psychological and Emotional Challenges
Addiction Schizophrenia may appear Suicide
Infectious Diseases