At the end of the concept, the students will be able to:

• differentiate growth and development;

• discuss the basic principles of growth and development;

• identify factors affecting growth and development;

• discuss major developmental theories;

• recognize the importance of growth and development as holistic framework for assessing and promoting health;

• identify the critical milestones for each developmental stage; and

• describe specific nursing interventions that are relevant to each developmental stage.

DEFINITION OF TERMS

GROWTHan increase in physical sizea quantitative change

DEVELOPMENTdenotes an increase in skill or the ability to functiona qualitative changeSynonymous with MATURATION

DEFINITION OF TERMS

GROWTH

• an increase in physical size

• a quantitative change

DEVELOPMENT

• denotes an increase in skill or the ability to function

• a qualitative change

• Synonymous with MATURATION

DEFINITION OF TERMS

Psychosexual development• developing instincts or sensual pleasures

Psychosocial development• refers to Erikson’s stages of personality development

Moral development• is the ability to know right from wrong and to apply these

to real-life situations.

Cognitive development• refers to the ability to learn or understand from experience,

to acquire and retain knowledge, to respond to a new situation, and to solve problems.

Continuous processes

Proceed in an orderly sequence

Different children pass through

predictable stages at different

rates.

Each individual proceeds at own

rate.

All body systems do not develop at

the same rate.

Can be altered by nutrition, disease

& congenital anomalies.

Certain stages are more critical

than others.

Directional.

Proceeds from gross to refined

skills.

There is an optimum time for

initiation of experiences or

learning.

Neonatal reflexes must be lost

before development can

proceed.

A great deal of skill and behavior is learned by practice.

Development becomes increasingly differentiated.

Children are individuals, not little adults, who must be seen as part of a family.

Children are influenced by genetic factors, home and environment, and parental attitudes.

• Sex

• Race & Nationality

Prenatal environment

Nutritional deficiencies

Mechanical problems

Metabolic and endocrine

problems

Medical treatment

Faulty placental implantation

Smoking/alcoholism/use of certain

drugs

Natal Anesthesia Method of delivery Immediate care

Post natal

External

Socioeconomic level

Nutrition

Illness & Injury

Parent-Child relationship

Ordinal Position in the Family

Internal

Intelligence

Hormonal imbalance

FACTORS INFLUENCING

G&DGENETICS Family history of diseases may be inherited.

Chromosomes carry genes that determine physical characteristics, intellectual potential, and personality.

NUTRITION The greatest influence on physical growth and intellectual development.

PRENATAL AND ENVIRONMENTAL FACTORS

Beginning with the nutrition from the mother to exposures in utero such as alcohol, smoking, infections, drugs.Environmental exposures, such as radiation, chemicals.

FAMILY AND COMMUNITY

Family structure and community support services influence the environment in the process of growth and development of the child.

CULTURAL FACTORS Customs, traditions, and attitudes of cultural group influence the child’s growth and development.

GERMINAL: conception to 2 weeksEMBRYONIC: 2 weeks to 8 weeks

FETAL: 8 weeks to 40 weeks

NEONATAL: birth to 28 daysINFANCY: 1 to 12 months

TODDLER: 1 to 3 yearsPRESCHOOLER: 3 to 6 years

SCHOOL AGE: 6 to 12 years

PREPUBERTAL: 10 to 13 yearsADOLESCENCE: 13 to 18 years

20 to 40 years

40 to 65 years

YOUNG-OLD: 65 to 74 yearsMIDDLE-OLD: 75 to 84 years

OLD-OLD: 85 and over

1. Conception2. Birth3. Newborn4. Infant5. Toddler6. Preschool7. School Age8. Adolescence9. Young Adulthood10. Middle Adulthood11. Late Adulthood

Each child displays definite predictable pattern.

These patterns are universal and basic to all human beings.

INDIVIDUAL DIFFERENCES: although the sequence is predictable, rates of growth vary, and individual variation exists in the age at which development milestones are reached.

Directional trends:Cephalocaudal

Proximodistal

Differentiation

Sequential trends:An orderly sequence; each childhood normally

passes through each stage

Each stage is affected by the preceding stage and affects those stages that follow.

Critical periods: time periods in which the child is especially responsive to certain environmental effects; sometimes called as sensitive periods.

Positive or negative stimuli enhance or defer the achievement of a skill or function.

DEVELOPMENT OF ORGAN SYSTEMS

Growth of respiratory, digestive,

renal and musculoskeletal

proceeds fairly in childhood.

Neurologic tissues grow rapidly

in the first 2 years of life.

Brain reaches mature

proportions by 2 to 5 years.

Lymphoid tissues also grow

rapidly during infancy and

childhood.

BONE DEVELOPMENT

Skeletal growth provides the

best estimate of biological

age since it has a genetically

programmed developmental

plan.

Two processes:

Growth Creation of new cells and tissues

Maturation Consolidation of tissues into a permanent

form

TOOTH DEVELOPMENT

The foundations of child’s

tooth structure are formed

early in the fetal life.

Major stages:

Growth

Calcification

Eruption

Attrition

MOTOR DEVELOPMENT

Process wherein children learn

to control and integrate their

muscles in purposeful actions.

The degree of nervous system

maturity is reflected by the

motor development.

Motor behavior skills:

Reflexive or rudimentary

General fundamental skills

Specific skills

Specialized skills

MOTOR DEVELOPMENT

Motor behavior skills:

Reflexive or rudimentary

Foundation of all other movements.

Required during infancy

General fundamental skills

Common in all children

Develop during early childhood

Specific skills

Emphasis on form, accuracy and adaptability

Develop during later childhood

Specialized skills

They depend on the amount of repetition and concentrated

application

Evolve slowly from late childhood through adolescence.

ENVIRONMENTAL MANIPULATIONAUDITORY STRATEGIES

Monitor sound levels within the environment.Soft soothing music should be

played for the newborn or even for school age children during their study periods at home.

VISUAL STRATEGIES

Includes use of color, form, texture, and lighting.

OLFACTORY STRATEGIES

Odors may affect children’s behaviorSources of unpleasant odor must be

removed.THERMAL STRATEGIES

Too warm or too cold environments may impose physiological demands on any child.

PATTERN VARIATIONS

Pattern encompasses variation in intensity, frequency, and phrasing of stimuli.

ENVIRONMENTAL MANIPULATION

VESTIBULAR STIMULATIONVestibular stimuli contribute to the

neurologic rhythms of the body.This includes heart rate, respiratory

rate, and neuron synapse activity.Carefully determine the need for

stimulation, the type and quality of stimulation, the frequency of intervention, the intensity and quantity, and the rhythm of interval.

Forms:

Manual rocking

Swinging hammocks

Stroking

Using waterbeds

VESTIBULAR STIMULATION

SLEEP PROMOTIONIntervention strategies: Establishing and maintaining

sleep pattern Facilitating sleep Applying behavior

management strategies Applying relaxation

techniques

MANAGEMENT OF PAIN Pain may be due to injury, disease, medical

treatment, or non-specific states.

Strategies:

Non-pharmacologic

Relaxation

Distraction

Guided imaging

Rubbing painful area

Heat and cold application

Pharmacologic

NUTRITIONAL SUPPORT Interventions to enhance nutritional

status of children with nutritional deficits.

Strategies:

Non-nutritive sucking

Structuring suck reflex

Proper positioning

Spacing of food intake

Role modeling and socialization

Both lack an understanding of the concept of death.

Aware someone is missing, may experience

separation anxiety.

Infants react to loss of caregivers with behaviors such

as crying, sleeping more and eating less.

Toddlers may develop fearfulness, become more

attached with remaining parent.

View death as temporary and reversible.

Magical thinking and egocentrism may lead to the

belief that dead person will come back.

View death as punishment; believe bad thoughts

and actions cause death

First exposure to death is frequently the death of pet.

Common behaviors: nightmares, bowel and bladder

problems, crying, anger, out-of-control behaviors.

View death as irreversible, but not necessary inevitable.

Age 10 - understand death as universal and will happen

to them.

May believe death serves as punishment for

wrongdoing.

May deny sadness, attempt to act like adults.

Common behaviors: difficulty with concentration in

school, psychosomatic complaints, acting-out behaviors.

View death as irreversible, universal and inevitable.

Develop a better understanding between illness and

death.

Common behaviors: feeling of loneliness, sadness, fear,

depression; acting-out behaviors may include risk-taking,

delinquency, suicide attempts, and promiscuity.