GROWTH AND

DEVELOPMENT

The UWISON, Mona

NURS 4010
 Objectives
• Differentiate among the terms growth,
development and maturation.

• Describe principles of growth and

development

• Discuss factors influencing growth

and development
 Objectives

• Identify the stages of development.

• Recognize major developmental

milestones for infants, toddlers,
preschoolers, school-age children, and
adolescents
 Objectives

• Describe major theories of

development formulated by Freud,
Erickson and Piaget.

• Describe the role of play in the growth

and development of children and
adolescents.
• Explain the difference
between the terms growth
and development.
 Definition of terms

• Growth
– Increase in physical size (quantitative
change)
– E.g. ↑in height, weight, BP, # of words
in the vocabulary

(London et. al, 2011 ; Pillitteri, 2012)

 Definition of terms
• Development
– Increase in skill or capability,
increase in the ability to function
(qualitative change)
– E.g. picking up raisons
– Maturation and development are
interchangeable

(London et. al, 2011; Pillitteri, 2012/2014)

 Development
• Psychosexual development
– Developing instincts or sensual pleasure –
Freudian Theory

• Psychosocial development
– Personality development- Erickson’s Theory

Pillitteri, 2012/2014
 Development

• Moral Development
– The ability to know right from wrong and
to apply these to real life situations-
Kolhberg’s Theory

Pillitteri, 2012/2014
 Development
• Cognitive development (Piaget’s Theory)
– The ability to
• Learn and understand from experience
• Acquire and retain knowledge to respond to a
new situation
– Measured by
• Intelligence tests
• Observing children’s ability to function
effectively in their environment

Pillitteri, 2012/2014
• Explain the principles of
growth and development
 Principles of Growth and
Development
• “Growth and development are continuous
processes from conception until death”
• “Growth and development proceed in an
orderly sequence”
• “Different children pass through the
predictable stages at different rates”

Pillitteri, 2012 p.787

 Principles of Growth and
Development cont’d
• “All body systems do not develop at the
same rate”
• “Development is cephalocaudal”

• “Development proceeds from proximal to

distal body parts”
Pillitteri, 2012, p. 787
 Principles of Growth and
Development cont’d
• “Development proceeds from gross to
refined skills”

• “There is an optimum time for initiation of

experiences or learning”

Pillitteri, 2012, p. 787

 Principles of Growth and
Development cont’d
• “Neonatal reflexes must be lost before
development can proceed”

• “A great deal of skill and behaviour is

learned by practice”

Pillitteri, 2012, p. 787

 • Identify the factors that
influence growth and
development.

• Explain how each factor

affects growth and
development.
•
Factors influencing Growth
and Development
• Genetics • Environment
• Gender – Socioeconomic level
• Health – Parent –child relationship
• Intelligence – Ordinal position in family
– Health
• Temperament
– Nutrition

Pillitteri, 2014
 • What are the age
categories for the stages
of growth and development
according to Freud,
Erickson, Piaget, Kolhberg.
 Stages of Growth and
Development
• Infancy • Middle Childhood
– Neonate – School age
• Birth to 28 days
– 6 to 12 years
– Infancy
• 1 month to 1 year
• Late Childhood
– Adolescent
• Early Childhood
Toddler – 13 years to 21
1-3 years
– Preschool Young adult 21-30
• 3-5 years
 Theories of Development
Freud Erickson Piaget

Infant Oral Phase Trust vs Mistrust Sensorimotor

Toddler Anal Phase Autonomy vs Preoperational

Shame and Doubt thought (2-7 yrs)

Preschooler Phallic Phase Initiative vs Guilt

School-age Latent/latency Industry vs Concrete

Phase Inferiority operational thought
7-12 yrs
Adolescent Genital Phase Identity vs Role Formal operational
Confusion Thought (12yrs)

Pillitteri, 2012/2014
 Nursing Interventions:
Infants (0-1yr)
• Encourage parents to hold and stay
with infant
• Provide opportunities for sucking
• Provide toys that give comfort or
stimulate interest
• Pain control (trust)

London et al , 2011; Pillitteri, 2014

123rf.com
 Nursing Interventions:
Toddlers (1-3 yrs)
• Toilet-training procedures
– Do not begin toilet-training in hospital
– Accept regression during hospitalization
• Encourage independent behaviors –
feeding, hygiene, dressing self
• Give short explanations
• Reward appropriate behavior

London et al , 2011; Pillitteri, 2014

dreamstime.com
 Nursing Interventions: Masterfile.com

Preschoolers (3-6 yrs)

• Encourage parental involvement
• Provide safe versions of medical
equipment for play
• Accept sexual interest as normal
• Give clear explanations about illness –
explain that child is not responsible for
the illness
• Allow child to draw – many
emotions come through in art
London et al , 2011; Pillitteri, 2014
 Nursing Interventions:
School-Age (6-12yrs)
• Provide gowns, covers, and underwear
• Explain treatments and
procedures
• Encourage school work
• Encourage hobbies,
favorite activities
agefotostock.com

London et al , 2011; Pillitteri, 2014

 Nursing Interventions:
Adolescents (12/13-18yrs)
• Provide privacy
• Interview separately from
parents when possible
• Encourage participation in moappp.org

care and decision-making

• Encourage peer visitation
• Provide information on sexuality
London et al , 2011; Pillitteri, 2014
 • Identify two
developmental milestones
for each of the age
groups?
Development During Infancy
• Time of rapid growth and change
• Birth weight
– Doubles by 4-6 months
– Triples by 1 year
• Begins to understand 123rf.com

meanings of sounds and words

• By 1 year, able to feed self

London et al , 2011; Pillitteri, 2014

 Major Developmental
Milestones During Infancy
• Rolls over
• Sits up
• Stands
• Able to say 1 or 2 words
123rf.com

• Uses pincer grasp well

London et al , 2011
 Development: Toddlers
• Typically independent and negative
• Proud of new accomplishments
• Rate of growth and food intake slows
• Birth weight quadruples by 2 years
• At 2 years, child is one-half
of adult height

dreamstime.com
London et al , 2011
 Major Developmental
Milestones: Toddlers
• Walks up and down stairs
• Undresses self

dreamstime.com
• Scribbles on paper
• Kicks a ball
• Uses short sentences

London et al , 2011
Milestones: Toddlers

Pillitteri, 2012, p. 844

Milestones: Toddlers

Pillitteri, 2012, p. 847

Development: Preschoolers
• Most children in daycare or school
• Increased social activities and contacts
• Language skills well-developed
• Writing ability improved
• Physical skills developed

masterfile.com
London et al , 2011
 Major Developmental
Milestones: Preschoolers
• Uses scissors
• Rides bicycle with training wheels
• Throws a ball
• Holds a bat

Masterfile.com
• Writes a few letters
• All parts of speech are
well-developed
London et al , 2011
Milestones: Preschoolers
 Development: School-Age
Children
• Very industrious
• Find activities they enjoy and excel in
• Contributes to sense of achievement,
self esteem
• Peers becoming

agefotostock.com
more important

London et al , 2011
Major Developmental Milestones:
School-Age Children
• Possesses reading ability
• Rides a two-wheeled bike
• Jumps rope

agefotostock.com
• Plays organized sports
• Mature use of language

London et al , 2011
 Development: Adolescents
• Transition: End of childhood and
beginning of adulthood
• Identity formation: “Who am I?”
• Puberty and rapid growth changes
• New activities

moappp.org
• Less dependent on
parents for transportation
• Peers are important
London et al , 2011
 Major Developmental
Milestones: Adolescents
• Fine motor skills well-developed
• Gross motor skills improve due to growth
spurts

moappp.org
• Able to apply abstract
thought and analysis

London et al , 2011
• What is the role of play in
growth and development?
 Children at Play
• Play is the “work of childhood”
• Play contributes to:
– Cognitive growth
– Physical development: Gross motor skills
and fine motor skills
– Social interaction

London et al , 2011
• What are the defining
characteristics of the following
types of play?
– solitary
– parallel
– fantasy
– cooperative
 Infants at Play
• Primarily enjoy solitary play
• Others may teach infants how to play
with new objects
• Progress from reacting to objects
(rattle) to manipulating them
• Once they become mobile, sphere of
play enlarges

London et al , 2011
 Toddlers at Play
• Increased motor skills allow new types
of toys and play
• Play becomes more social, often with
other toddlers – parallel play
• Imitates behavior
• Manipulating objects helps them to
learn about their qualities (Example:
Square block will not fit in round hole)

London et al , 2011
 Preschoolers at Play
• Interacts with others during play
• Enjoys large motor activities
• Increased manual dexterity
• Fantasy play

London et al , 2011
 School-Age Children at
Play
• Increased physical abilities allow for
wide variety of play
• Understanding of rules of a game – like
for rules to be followed during play
• Cooperative play

London et al , 2011
 Adolescents at Play
• Increased maturity leads to new
activities and ways to play
• Peer group becomes focus of activities
• Less reliant on parents for
transportation
• Social interactions important

London et al , 2011
The Nursing Process

• How would you use the nursing

process to address a growth and
development need
• Questions ?
 References
• Pillitteri, A. (2010). Maternal and child health nursing: Care of
the childbearing & childrearing family (6th ed). Philadelphia:
Lippincott Williams & Wilkins.
• London, M.L., Ladewig, P.W., Ball, J.W., Bindler, R.C. & Cowen, K.J.
(2011). Maternal & child nursing care(3rd ed.). New Jersey:
Pearson Education Inc.