BASIC HUMAN NEEDS, GROWTH AND

DEVELOPMENT

Man is a wanting animal and rarely reaches a state of complete

satisfaction except for a short time. As one desire is satisfied, another pops up to

take its place. When this is satisfied, still another comes into the foreground,

etc. it is a characteristic of the human being throughout his whole life that he

practically always desires something.

- Maslow (1970)

Basic needs refer to those things that are necessary to sustain life. It is the

minimum requirements of a community for a decent standard of life. Basic

needs consists of adequate food, shelter, and clothing plus some household

equipment and furniture. They also include essential services provided by and

for the community-at-large such as safe drinking water, sanitation, health and

education.

A need is something that is necessary for an organism to live a healthy life.

Needs are distinguished from wants in that, in the case of a need, a deficiency

causes a clear adverse outcome: a dysfunction or death. In other words, a need

is something required for a safe, stable and healthy life (e.g. air, water, food,

shelter) while a want is a desire, wish or aspiration. When needs or wants are
backed by purchasing power, they have the potential to become economic

demands.

Basic needs such as air, water, food and protection from environmental dangers

are necessary for an organism to live. In addition to basic needs, humans also

have needs of a social or societal nature such as the human need to socialise of

belong to a family unit or group. Needs can be objective and physical, such as

the need for food, or psychological and subjective, such as the need for self-

esteem.

Every being on this earth has certain basic needs to be fulfilled, so are the

humans having such needs. A basic human need is the quest/want of something

or the requirement for biological, social, spiritual, and psychological

functioning experienced by the person without which he cannot survive.

The nine basic human needs:

1, Security

2, Adventure

3, Freedom

4, Exchange

5, Power

6, Expansion
7, Acceptance

8, Community

9, Expression

Each of us has three primary needs, meaning three needs that are more

important than the other six needs, which we have to lesser degree. When

people do not get their needs met, they can become agitated, belligerent or

driven to use the negative aspects of their needs. Each of the needs is described

with their positive aspects and their negative aspects. Each person is responsible

for seeing that they get their own needs met-this is an inside job, not something

that is fulfilled by another person. People who share the same needs will feel a

connection or common bond. Two people who do share at least one common

need will feel little connection with another person. Co-workers who do not

share similar needs will have a hard time working together. Close friends,

partners and mate relationships will usually share two or three needs in

common.

Security:

Security is the needs to feel safe, to feel assured that they know what is going to

happen, to know ahead of time what the plans are. What constitutes security can

be different for different people.

Examples of how security manifests for different people:

 Having lots of money in the bank

 Having a planned saving

 Having a secured job

Adventure:

Adventure is the need for an adrenaline rush, to have new experiences, to travel,

to have big experiences, to have drama in their life, to have a sense of

anticipation about upcoming events.

Examples:

Planning new trips (even if they are never taken)

Freedom:

Freedom is the need for independence and spontaneity. It is also the need to

have choices and to feel in control of making those choices. What constitutes

freedom for one person may be very different from another’s need and

perception of freedom.

Example:

Having choices and making their own choice.

Exchange:

Exchange is the need to trade information and knowledge with others, not just

to mingle or socialize, but to deliver and receive something of value. That

something of value may be information, conversation, communication, energy,

friendship, services, money, gifts, love, justice, shared experiences.

Example:

Participating with other in discussions of all types

Power:

People with a need for power need to be in a position of authority and

responsibility. They need to explore power, leadership and accomplishment to

be good organizes and accept responsibility, setting an example of leadership.

Example:

Managing a company, a division or a department.

Expansion:

Expansion is the need to build something to add onto, to create an empire, to

expand horizons to go where no one has gone before.

Example:

Building a company.
Acceptance:

Acceptance is the need to accept you and be accepted by others. This includes a

feeling of belonging. People with a need for acceptance are usually very easy

going and pleasant to have in a group.

Example:

Being accepted by neighbours.

Community:

People with a need for community like people around them. They are highly

social and will express their enjoyment of gatherings. These are the best folks to

put in charge of parties and company gatherings. They will seek out people and

are able to maintain large number of relationships.

Example:

Participating in classes, groups, and clubs.

Expression:

Expression is the need to be artistic, to be seen, to be heard, to be felt. It is the

need to express oneself through word actions, dress, art and self-creations of all

types.

Example: writing books, poems, articles.

Abraham Maslow (1954) attempted to synthesize a large body of research

related to human motivation. Prior to Maslow, researchers generally focused

separately on such factors as biology, achievement, or power to explain what

energizes, directs, and sustains human behaviour. Maslow posited a hierarchy of

human needs based on two groupings: deficiency needs and growth needs.

Within the deficiency needs, each lower need must be met before moving to the

next higher level. Once each of these needs has been satisfied, if at some future

time a deficiency is detected, the individual will act to remove the deficiency.

Maslow’s Hierarchy of Human needs:

Definition:- A basic human need is want of something or requirement for

biological, social or spiritual functioning experienced by a person without

which a person cannot survival.

Hierarchy.:- Hierarchy means that in any list of items some items are classed

as more important than others.

Abraham Maslow identified in 1968 five basic levels of basic human needs that

are arranged in the order of priority for satisfaction. They are,

1, physiological needs.

2, safety and security needs.

3, love and belonging needs.

4, self-actualization.

According to Maslow’s theory the lower level needs must be satisfied before the

individual attempts to satisfy needs of the higher level. He found that all these

needs are interrelated and some needs cannot be met unless related needs are

met. For example the need for hydration (the normal water volume in the body)

can be seriously changed, if the need for elimination of urine is not met. A need

can make itself felt either by internal or external stimuli, e.g. The need for

blood. He also found individuals who satisfy their basic needs are healthier,

happier and more effective than those whose needs unsatisfied.

Basic human needs and related actions:

Physiological needs:

They are the lower level needs. They have the highest priority overall the other

needs because they are essential to life. They include the needs for air, food,

water, temperature, maintenance, rest, or sleep, elimination, sexuality and

avoidance of pain. Some physiological needs are more important to survive than

others, e.g. the need for oxygen takes priority over the need for food or water.

Also the body can survive longer without food than without water. A primary

nursing function is to meet these needs as they are vital to the survival of

patients.

Safety and security needs:

These needs come next in priority. They can be aliened through adequate shelter

and protection from harmful factors in the environment. Safety means physical

as well as psychological safety. Individuals usually feel most secure in a

familiar routines and with people they can trust and the things they can know.

An important function of the nurse is the promotion of patient’s physical safety

and emotional security in a health care setting. E.g. Bed railings for an

unconscious patients.

Love and belongings:

Once individuals are satisfied with the basic physiological safety and security

needs, they seek their need for love and belonging. These needs include

understanding, group acceptance, affection, mutual trust, and the feeling of

belonging to others. Every individual either sick or well desires the

companionship and recognition of his family or friends. The nurse should

always consider love and belonging needs of the patients by way of care and by

establishing a nurse-client relationship based on mutual understanding and trust.

Self-esteem needs:

It is necessary to feel pride, to feel a sense of accomplishment, in what one

does, and to believe that others also share this regard. Self-esteem gives the

individual confidence, independence, worth, strength, adequacy, usefulness and

importance. Lack of self-esteem gives a feeling of inferiority, inadequacy,

weakness and helplessness. The feeling of self-dislike leads to frustration and

sense of failure. Nurses can meet patients self-esteem needs by accepting their

values and beliefs, encourage them to set attainable goals and facilitating

support by family or friends

self-actualization needs:

self-actualization is the highest level of human needs. When the needs for self-

esteem is satisfied the individual strives for self-actualization, of ones potential

through full development of one’s unique capabilities is a strong desire of a

human being. The intelligent individual seeks information, analysis it, and

searches for it meaning.

Aesthetic needs very by its importance from individual to individual. A patienbt

with highly developed aesthetic sensibilities will be distressed by unpleasant

sights, sounds and odours. The nurse must focus on the strengths and

capabilities rather than on problems to meet patient’s self-actualization needs.

She must aim at caring the total individual need and must provide a sense of

hope to maximize his potentials.

ACTIVITIES OF DAILY LIVING:

Activities of daily living are the activities usually performed in the course of a

normal day in the individual’s life such as eating, working or brushing the teeth.

The activities of daily living are interrelated to enable to human survive.

Individuals need help when they are unable to carry them out themselves

because of illness.

The Activities of daily Living includes:

Maintaining safe environment:

It is important to maintain a safe environment at all times. Every day activities

are aimed at maintaining a safe environment ego activities to achieve personal

and domestic cleanliness and aimed to decreasing the number of

microorganisms to maintain a safe environment.

Communication:

Communication is the process of exchanging thoughts, ideas, or feelings from

one individual to another. Communication not only involves the use of verbal

language as in talking and writing. But also involves the nonverbal transmission

of information by facial expressions, postures and body gesture. This activity is

important for good interpersonal interaction and human relationships.

Breathing:

In breathing process, the cell of the body receives air, essential for all body

cells, without which human life will not exist.

Eating and drinking:

They are essential activities of the daily living. Human life cannot be sustained

for all the body cells, without eating and drinking. Many people in the world die

daily due to starvation.

Elimination:

Eliminating likes eating and drinking is necessary and on integral activity of

everyday life, eliminating is regard as a highly private activity.

Personal cleansing and dressing:

Cleanliness and good grooming are commended in most cultures. Apart from

taking pride in their appearance, people have a social responsibility to ensure

cleanliness of body and clothing. Activities included are washing, bathing, care

of hair, nails, teeth, mouth and clothing.

Controlling body temperature:

An individual is able to maintain body temperature of a constant level

irrespective of the degree of heat or cold in the surrounding environment.

Regulation of body temperature is essential for different biological processes.

People have to perform certain deliberate activities to avoid the hazards and

discomfort of heat and cold by varying the amount of clothing, regulating the

amount of physical activity, etc.

Mobilization:

It is an essential and highly valued human activity. Mobilizing includes the

movement produced by groups of large muscles

Working and playing:

Most people are either working or playing, when not at sleep. Working provides

income from which essential cost and other activities are financed. Work and

play are important for physical and mental health.

Expressing sexuality/reproduction:

It is a component of health. The specific activity which is directly associated

with sex is sexual relationship. This essential for the continuation of human
race. There are many other ways in which human sexuality can be expresses.

Style of dress, physical appearance, and in many forms of verbal and non-verbal

communication are other ways in which sexuality is expressed.

Sleeping:

Sleep is essential for healthy living. The body process does not stop during

sleep therefore, it is considered as an activity.All individuals have periods of

activity and sleep (one third of the adult life) it is an important activity of daily

living.

Spirituality:

It is the individual’s relationship with the nonmaterialistic life force or higher

power. Spirituality may include religion. Religion is often characterized by set

forms of worships and codes of conduct.

Dying:

Dying is also included in the activities of living. It is the final act of living.

Factors influencing activities of daily living:

1, Physical factors:

The body’s structure and function have a major influence on how the body

functions. Body’s physical ability alters according to the age; eg reduced

physical ability in the old age. The physical factor of the body has an important
influence on the individual’s activities of daily living throughout the life. Eg.

Cardiopulmonary system with the ADL of breathing, the musculoskeletal

system with the ADL of mobilizing.

2, psychological factors:

It includes both intellectual and emotional aspects:

A, intellectual aspects: intellectual skills like thinking, reasoning and problem

solving are essential for survival and affected all activities of daily living.

Intellectual development continues from childhood to adolescence. During old

age overall intellectual functioning becomes less efficient and may cause

problems to the activities of daily living. Eg. Memory loss affects safety.

B, emotional aspects: like the intellectual aspects, the emotional aspect is also

related with the activities of daily living. The development of one’s personality

is one of the outcomes of emotional development which influences the activities

of the daily living. Eg. Communicating.

C, socio-cultural factors: They influence the living life span of an individual.

They also influence the person’s individuality in living and effect the way each

person carries out the activities of the daily living. Ego cultural factor, social

factor.

D, environmental factors: The atmosphere is the immediate environmental

factors as it is in contact with the exposed skin and the outer garments. The
temperature and the humidity in the atmosphere may influence ADL such as

controlling body temperature, working and playing. In many developing

societies lack of safe water and proper sanitation produces an unsafe

environment which may lead to health problems.

Politico-economic factors:

Every citizen is the subject of a state. The citizen is the subject of a state. The

citizen is legally bound to obey the orders of the state. An individual’s activities

of daily living are influenced by its norms.

Implication of human needs in nursing practice:

Knowledge of human needs helps nurses to:

1. understand themselves, so that they can meet their personal needs outside the

health care setting, eg: maintenance of body temperature.

2. Set priorities as in giving core. Eg: working and playing will assume a low

priority during a period of critical illness.

3. Better to understand patient’s behaviour so that they can respond

therapeutically rather than emotionally eg: a patient putting on his signal light

repeatedly may convey the message of need for safety.

4. Relieve the distress of patients, eg: helping a patient to meet his unmet need

of love and affection.

5. To get used to all ages and in all health care settings both at health and

illness. It is an approach for holistic nursing care.

6. Help client to develop and grow eg: nurse can help clients to move towards

self-actualization by helping them to find meaning on their illness experience.

7. Provide a frame work and be applied in the nursing process at the individual

and family level.

 GROWTH AND DEVELOPMENT

The term growth and development both refer to dynamic processes often used

interchangeably, these terms have different meanings. The period of growth and

development extends throughout the life cycle; however, the period in which the

principal changes occur is from conception to the end of adolescence.

Growth refers to the increase in physical size of the whole or any of its parts and

can be measured in inches or centimetre and in pounds or kilograms. Growth

results because of cell division and the synthesis of proteins. It causes a

quantitative change in the child’s body.

- Dorothy Marlow

Growth refers to the changes that can be measured and compared, for example-

taking the height and weight of a paediatric client and comparing the

measurements to the standardized growth charts.

- Potter and Perry

DEVELOPMENT:

It is an increase in the complexity of function and skill progression.

It is a capacity and skill of a person to adapt to the environment.

Development is the behavioural aspect of growth. E.g.:- a person develops the

ability to walk, to talk and to run.

 Development takes place from birth to death.

Growth and Development are independent, interrelated processes. For eg:-an

infant muscle, bones and nervous system must grow to a certain point before the

infant is able to sit up or walk.

Characteristics of Growth and Development: -

Individual differences:- each child has an individual rate of growth, but the

pattern of growth shows less variability.

Readiness for certain tasks:- the critical periods; measurable period lasting

from a few days to few weeks, during which the learning of certain behaviours

occur, are termed as critical periods.

Rate of development:- during the period of growth and development of the

total body and its subsystems, growth is sometimes rapid and at times it slows

down.

Stages of Growth and Development:

Prenatal period:

Ovum - 0-14 days

Embryo - 14 days

Foetus - 9 weeks – Birth

Postnatal period:

New born - 1st four weeks after birth

Infancy - 1st year of birth

Toddler - 1-3 years

Pre-schooler - 3-6 years

Schooler - 6-10 years (girls)

6-12 years (boys)

Adolescents:

Pre-pubescent- 10-12 years (F)

12-14 years (M)

Pubescent - 12-14 years (F)

14-16 years (M)

Post pubescent- 14-18 years (F)

16-20 years (M)

Adulthood:

Young adulthood- 20-40 years

Middle adulthood- 40-60 years

Late adulthood- <60 years

Old age - over 65 years

Stages of prenatal development:

Pre – embryonic stage (zygote or fertilized ovum) from conception to 2 weeks.

Embryonic stage – 3-8 weeks

Foetal stage - 9 weeks to till birth.

Development of fertilized ovum:

When the ovum has been fertilized, it continues its passage through the uterine

tube and reaches the uterus 3 or 4 days later. During this time segmentation or

cell division takes place and the fertilized ovum divides into 2 cells, then into 4,

then 8, 16 and so on until a cluster of cells is formed known as morula. These

division occurs quite slowly, about once every hour. Next, a fluid filled cavity

or blastocoels appears in the morula which now becomes known as the

blastocysts. Around the outside of the blastocyst there is a single layer of cells

known as the trophoblast. The remaining cells are clumped together at one end

forming the inner cell mass. The inner cell mass will become the fetus and

amnion.
The inner cell mass:

While the trophoblast is developing into the placenta , which will nourish the

foetus, the inner cell mass is forming the foetus itself. The cells differentiate

into three layers, each of which will form particular parts of foetus.

The ectoderm mainly forms the skin and nervous system.

The mesoderm forms bones and muscles and also the heart and blood vessels,

including those which are in the placenta. Certain internal organs also originate

in the mesoderm.

The endoderm forms mucous membranes and glands. The three layers together

are known as the embryonic plate. Two cavities appear in the inner cell mass,

one on either side of the embryonic plate.

The embryo:

This name is applied to the developing offspring after implantation and until 8

weeks after conception. During the embryonic period all the organs and systems

of the body are laid down in rudimentary form so that at its completion they

have simply to grow and mature for a further 7 months. The conceptus is known

as a foetus during this time

Growth and development of embryo and foetus 0-4 weeks after conception:

 Rapid growth.
  Formation of the embryonic plate.

 Primitive central nervous system forms.

 Heart develops and begins to beat.

 Limb buds form.

4-8 weeks:

 Very rapid division

 Head and facial features develop

 All major organs are laid down in primitive form.

 External genitalia develops but sex not distinguishable.

 Early movements

 Visible on ultrasound on 6 weeks.

8-12 weeks:

 Eye lids fuse

 Kidneys begin to function and the foetus passes urine from 10 weeks.

 Foetal circulation functioning properly

 Sucking and swallowing begin.

 Sex apparent.

 Foetus moves freely.

 Some primitive reflexes present.

12-16 weeks:

 Rapid skeletal development-visible on X-ray.

 Meconium present in gut

 Lanugo appears

 Nasal septum and palate fuse.

16-20 weeks:

 Quickening

 Foetal heart beat heard on auscultation.

 Vernix caseosa appears

 Fingernails can be seen

 Skin cells begin to be renewed

20-24 weeks:

Most organs become capable of functioning.

Periods of sleep and activity.

Responds to sound.

Skin red and wrinkled.

24-28 weeks:

Survival may be expected if born.

Eyelids are open.

Respiratory movements.

28-32 weeks:

Begins to store fat and iron

Testes descend into scrotum

Lanugo disappears from face

Skin becomes paler and less wrinkled

32-36 years:

Increased fat makes the body more rounded.

Lanugo disappears from body

Head hair lengthens

Nails reach tips of fingers

Ear cartilage soft

Plantar created visible.

36-40 weeks:

Term is reached and birth is due.

Contours rounded
Skull firm.

Growth and development of Neonate:

The arrival of the newborn designs highly vulnerable period during which

may psychological and physiological adjustments to extra uterine life is must

be made. When a baby is born an orderly change occurs from foetal life to

extra uterine life. It includes physical, psychological, psychosexual; and

cognitive changes. These changes are most prominent from one year of age,

even though it starts from one year of age, even though it starts from the

neonatal period itself.

Terminologies:

Neonate or newborn: It refers to the baby ages from birth to four weeks.

First week of age is known as early neonatal period. Late neonatal period

ranges from 7-28 days.

Vernix caseosa: A layer of greasy material which covers the skin of a foetus

or newborn.

Mongolian spot: Blue black areas seen on the back and buttock of babies

which usually disappear by first year.

Milia: white pinpoint pimples caused by obstruction of sebaceous gland.

Stork bites: Flat red areas on the nape of the neck and eyelids.
 Adjustment to extra uterine life to all systems:

Immediate adjustments:

1, Respiratory system: The most critical and immediate physiologic change

required of the newborn is the onset of breathing. The stimuli that help to

initiate respiration are primary.

A, chemical stimuli: chemical factors is the blood ( low oxygen, high carbon

dioxide and low pH) which initiate impulses that excite the respiratory centre in

medulla.

B, thermal stimuli: it is the sudden chilling of the infant who leaves a warm

environment and enters a relatively cooler atmosphere. This abrupt change in

temperature excites sensory impulses in the skin that are transmitted to the

respiratory centre.

The initial entry of air into the lungs is opposed by the surface tension of fluid

that filled the foetal lungs and alveoli. However foetal lung fluid that filled the

foetal lung and alveoli. However foetal lung fluid that filled the foetal lungs and

alveoli is removed by the pulmonary capillaries and lymphatic vessels. Some

fluid is also removed during normal forces of labour and delivery. As the chest

emerges from birth canal, fluid is squeezed from the lungs through the nose and

mouth. Following emergence of the new-born’s chest, brisk recoil of the thorax

occurs. Air enters the upper airway to replace the lost fluid.
In the alveoli the surface tension of the fluid is reduced by a surfactant. This

surfactant reduces the surface tension of the fluid that lines the alveoli and

respiratory passages resulting in uniform expansion and maintenance of lung

expansion at low intra alveolar pressure. Deficient surfactant production causes

unequal inflation of alveoli on end expiration.

2, circulatory system:

Equally important as the initiation of respiration are the circulatory changes that

allow blood to flow through lungs. This change occurs more gradually and is

the result of pressure changes in the lungs, heart and major vessels. The

transition from foetal circulation ensures that the most vital organs and tissue

receive the maximum concentration of oxygenated blood. Foetal brain requires

the highest concentration of oxygen. The lungs are essentially non-functional

and the liver is partially functional. Therefore less blood is needed in these

organs. Blood carrying oxygen and nutritive materials from the placenta enters

the foetal systems through the umbilicus via the large umbilical vein, the blood

then travels to the liver where it divides part of the blood enters the portal and

hepatic circulation of the liver and the remained travels directly to the inferior

vena cava through the ductus venous. Because of the higher pressure of the

blood entering the right atrium from the inferior venacavait is directed

posteriorly in a straight pathway across right atrium and through foramen ovale

to the left atrium. In this way the better oxygenated blood enters the left atrium
and left ventricle to be through the aorta to the head and upper extremities.

Blood from the head and upper extremities entering the right atrium from

superior venacava is directed downward through the tricuspid valve into right

ventricle, from where it is pumped through pulmonary artery. When the major

portion is shunted to the descending aorta via the ductus arterosis, a small

amount flows to and from the non-functioning foetal lung. Blood is returned to

the placenta from the descending aorta through the two umbilical arteries. Once

the lungs are expanded the inspired oxygen dilates the pulmonary vessels which

decreases the pulmonary vascular resistance and consequently increases

pulmonary blood flow. As the lung receive blood, the pressure in the right

atrium, right ventricle and pulmonary artery decreases. At the same time, there

is progressive rise in systemic vascular resistance from the increased volume of

blood through the placenta at cord clamping. This increases the pressure in the

left side of the heart. Since blood flows from an area of high pressure to one of

low pressure, the circulation of blood through the foetus shunts is reversed.

Physiologic status of other systems:

Thermoregulation:

Heat regulation is most critical to the newborn’s survival. Although the

newborn capacity for heat production is adequate several factors predispose the

newborn to excessive heat loss, they are:

a, Newborn’s large surface area facilitates heat loss to the environment.

Newborn produces only two third as much heat per unit area. However the large

body surface is partially compensated for by the newborn’s usual position of

flexion, which decreases the amount of surface area exposed to environment.

b, Radiation of conservation of body heat due to thin layer of subcutaneous fat.

Since core body temperature is approximately 100 F higher than surface body

temperature, this temperature gradient causes a heat transfer from a higher to

lower temperature.

c, Newborn mechanism for producing heat. Unlike adult, who can increase heat

production through shivering, a chilled neonate cannot shiver but production

through shivering, a chilled neonate cannot shiver but produces heat through

NONSHIVERING THERMOGENESIS. It is produced by stimulating cellular

respiration the resulting oxygen consumption can be 3 times of any other body

tissue.

A unique thermogenic source to a full term newborn is BROWN ADIPOSE

TISSUE or BROWN FAT. It has a greater capacity for heat production through

intensified metabolic activity then does ordinary intensified metabolic activity

than does ordinary adipose tissue. Heat generated in the BAT is distributed to

other parts of the body through blood. Superficial deposition of BAT is located

between the scapulae, around neck, in the axilla and behind the sternum. Deeper
layers surround the kidneys, trachea, oesophagus, some major arteries and

adrenals.

Haemopoietic system:

The blood volume of the newborn depends on the amount of placental transfer

of blood. The blood volume of the full term infant is about 80-85 ml/kg of body

weight. Immediately after birth the total blood volume averages 300ml, but

depending upon how long the newborn is attached to placenta, as much as

100ml can be added to the blood volume.

Fluid and electrolytes:

Changes occur in total body water volume, extracellular fluid volume, and

intracellular fluid volume during transition from foetal to postnatal life. At term

foetus is composed of 73% fluid as compared to 58% in adult. The infant has a

proportionately higher ratio of extracellular fluid than the adult and

consequently has a higher level of total body sodium chloride and a lower level

of total body sodium, chloride and a lower level of potassium, magnesium and

phosphate. The rate of fluid exchange is 7 times higher in newborn than adult,

and the newborn metabolism is twice as greater in reaction to body weight. As a

result twice as much acid is formed, leading to more rapid development of

acidosis. In addition immature kidneys cannot sufficiently concentrate urine to

conserve the body water. These factors make the infant more prone to problems

of dehydration, acidosis and over hydration.

Gastrointestinal system:

The ability of the newborn to digest, absorb and metabolize food stuff is

adequate but available to catalyse proteins and simple carbohydrates but

deficient production of pancreatic amylase impairs utilization of complex

carbohydrates. A deficiency of pancreatic lipase limits the absorption of fats,

especially with ingestion of food that has high saturated fatty acids content such

as cow’s milk. Liver is the most immature organ of the digestive system. The

activity of the enzyme ‘glucoronictransferace’ is reduced to conjugation of

bilirubin with glucuronic acid, which contribute to PHYSIOLOGIC

JAUNDICE of the newborn. Some salivary gland is functioning at birth but

majority do not begin to secrete saliva until 2-3 months, when drooling is

common. The stomach capacity is limited to 90ml, thus newborn require

frequent small feeds.

The infant’s intestine is longer in relation to body size than an adult’s. so there

are larger number of secretary glands and a larger surface area for absorption as

compared with adult intestine. These waves combined with an immature,

relaxed cardiac sphincter, make regurgitation a common recurrence. Progressive

changes in the stooling pattern indicating functioning of GI tract, which

includes the following: Meconium-infants first stool; composed of amniotic

fluid and its constitutes, intestinal secretions, shed mucosal cells, and possibly

blood. The passage of meconium should occur within the first 24 to 48 hours

although it may be delayed up to 7 days in very low birth weight infants.

Transition stools-usually appear by third day after initiation of feeding,

greenish-brown to yellowish brown, thin and less sticky than meconium, may

contain some milk curds. Milk stools usually appear by fourth day. In breast

feeding newborn’s, stool is yellow to golden, is pasty in consistency and has an

odour similar to that of sour milk. In formula feed newborn stools are pale

yellow to light brown, are firmer in consistency and have a more offensive

odour.

Genitourinary system:

All structural components are present in the renal systems, but there is a

functional deficiency in the kidneys ability to concentrate urine and to cope with

conditions of fluid and electrolyte fluctuations, such as dehydration or a

concentrated solute load. The total urine output per 24 hours is about 200-300ml

by the end of the first week. The bladder involuntarily empties when stretched

by a volume of 15 ml resulting in as many as 20 voiding per day. The first

voiding occurs within 24 hours. The urine is colourless and odourless and has a

specific gravity of 1.020.

Male genitalia develop at birth, although their maturation varies. The tests of

male descend into the scrotum before birth. Occasionally they remain in the
abdomen or inguinal canal called undescended testes or cryptorchidism. Non

retract ability of the foreskin and glans separate, beginning in prenatal period.

This process gradually completed in 3-5 years.

Female genitalia may be slightly swollen. Blood tinged mucus may be

discharged from the vagina. This is due to hormonal withdrawal from mother at

birth.

Integumentary system:

Newborn have all the structures within skin present but many of their functions

are immature. Epidermis and dermis are loosely bound to each other and are

very thin. Slight friction across the epidermis such as from rapid removal of

tape, can cause separation of layers and blister formation or loss of epithelium.

The sebaceous glands are very effective late in foetal life and in early infancy

because of high level of maternal androgens. They are most densely located on

scalp, face and genitalia. Plugging of the sebaceous gland cause milia.

Vernix caseosa: a cheese like substance that covers the skin of the newborn, is

made of cells and glandular secretions, is thought to protect the skin from

irritation and the effects of watery environment. Milia may be seen on nose and

chin and will be disappearing within a few weeks. Stroke bite seen on the nap of

the neck and on the eyelids. The eccrine glands are functional at birth and

palmer sweating on crying reaches levels equivalent to those of anxious adults

by 3 weeks of age, observing palmer sweating is helpful in assessing pain. .the

eccrine glands produces sweat in response to higher temperature as compared to

adults and retention can cause milia. The apocrine gland remains small and non-

functional till puberty.

Musculoskeletal System:-

At birth skeletal system contains large amount of cartilage than ossified bone,

although the process of ossification is fairly rapid during the first year. The nose

for example is predominantly cartilage at birth and is frequently flattened by the

force of delivery. The six skull bones are relatively soft and not yet joined. The

sinuses are incompletely formed at birth. Growth in size of the muscular tissue

is caused by hypertrophy, rather than hyperplasia of cells. Immune Systems:-

The neonate is born with several defences against infection. The first line of

defence is the skin and mucus membranes which protect the body from invading

organisms. The second line of defence is the cellular elements of the

immunologic system, which produces several types of cells capable of attacking

a pathogen. The neutrophils and monocytes and phagocytes, cells that engulf,

ingest and destroy foreign agents. Eosinophils also probably have a phagocytic

property, since in the presence of foreign protein they increase number. The

lymphocytes are capable of converted to other cell types such as monocytes and

antibodies. Although the blood has phagocytic properties in it, the inflammatory

response of the tissues to localize an infection is immature. The third line of

defence is the formation of specific antibodies to an antigen. This process

requires exposure to various agents for antibody production to occur. Infants are

not capable of producing their own immunoglobulins until the beginning of the

second month of life but receive considerable passive immunity in the form of

immunoglobulin from the maternal circulation and from human milk. They are

protected against most childhood diseases including diphtheria, measles, polio

and rubella for about three months provided that the mother has developed

antibodies to these illnesses.

Endocrine system:-

Generally the endocrine system of the newborn is adequately developed, but

their functions are immature. For eg- the posterior lobe of pituitary gland

produces limited quantities of ADH or vasopressin which inhibit diuresis. This

renders the newborn highly susceptible to dehydration. The effect of maternal

sex hormone is particularly evident in the newborn. The labia are hyper typical

and the breast in both sexes may be engorged and secrete milk (witches

milk),during the first few days of life to as long as 2month of age. Female may

have pseudo menstruation due to sudden drop in progesterone and oestrogen

levels.

Neurologic System: At birth the nervous system is incompletely integrated but

sufficiently developed to extra uterine life. The autonomic nervous system is

crucial during transition because it stimulates initial respirations helps maintain

acid base balance and partially regulate temperature control. Myelination of the

nervous system follows the cephalocaudal proximodistal laws of development

and is closely related to the mastery of fine and gross motor skills. Tracts that

develop myelin earliest are the sensory, cerebellar and extrapyramidal. This

accounts for the acute senses of taste, smell, hearing as well as the perception of

pain, in the newborn. All cranial nerve are myelinated except the optic and

olfactory nerves.

Sensory Functions:- Are well developed and have a significant effect on

growth and development including the attachment process.

Vision:-

At birth the eyes are structurally incomplete. The cornea centralism is not yet

completely differentiated from the macula. The ciliary muscles are immature

limiting the ability of the eyes to accommodate and fixate on an object for any

length of time. The pupils reflect to light, the blink reflex is responsible to a

minimal stimulus, and the corneal reflex is activated by a light touch. Tear

glands do not begin to function until 2-4 weeks of age. The newborn has the

ability to momentarily fix on bright or moving objects that is within 20cm and

in midline of the visual field. In fact infant ability to fixate on coordinate

movement is greater during the first hour of life than in succeeding several days.

Visual acuity is between 20/100 and 20/400 depending upon the visual

preference.:-medium colors (red, orange , blue),black, and white contrasting

patterns, especially geometric shapes checker-large objects with medium

complexity rather than small complex objects, and reflecting objects over dull

ones.

Hearing:-

Ones the amniotic fluid has drained from the ears, the infants probably has

auditory acuity similar to that of adult. The newborn able to detect a loud sound

of about 90 decibels, and reacts with a startle reflex. Newborn’s response too

low frequency differs from that of higher frequency. Former tends to decrease

an infant’s most activities and crying whereas the later elicits an altering

reaction.

Smell:-

Newborns react to strong odours by turning their head away. Breast fed

newborn are able to smell breast milk. Also they are able to differentiate the

smell between the breast milk 14 of their mother from other women. Maternal

doctors are believed to influence attachment process and successful breast

feeding.

Tastes:-

The newborn can differentiate taste difference between different types of

solution and elicit different facial reflexes. A tasteless solution elicits no facial

expression. A sweet elicits an eager suck and a look of satisfaction sour solution
elicits a usual puckering of lips and bitter produces upset expressions. They

prefer glucose water to sterile water. The newborn perceives tactile sensation in

any part of the body although face , hands and soles of the feet seem to be most

sensitive. There is increasing documentation that touches and motion are

essential for normal growth and development. However painful stimuli,

pinprick is upsetting. Most neurologic reflexes are primitive reflexes

Development of the new born:-

 Physical growth:- Newborn loses some weight shortly after birth. This

weight usually is regained within 10 to 12 days. Most newborns gain about 4 oz

(113 g) to 8 oz (227 g) a week and grow about 1 in. (2.5 cm) to1.5 in. (3.5 cm)

in the first month.

 Cognitive development: Cognition is the ability to think, learn, and

remember. Newborn's brain is developing rapidly. To promote healthy brain

growth every time mother need to interact in a positive way with baby.

 Emotional and social development: Newborns quickly learn to

communicate. They seek interaction with you and express how they feel with

sounds and facial expressions. At first, instinctual behaviours, such as crying

when uncomfortable, are the baby's ways to signal his or her needs. Soon

newborn starts to subtly communicate and interact with mother. For example,

baby's eyes will track mother’s movements. And his or her face will brighten
when mother cuddle and talk soothingly. Even at a few days old, baby may try

to mimic by sticking out tongue.

 Language development:- Newborn is listening to and absorbing the basic

and distinct sounds of language. This process forms the foundation for speech.

 Sensory and motor skills development:. Newborns have all five senses.

Newborn quickly learns to recognize face, the sound of voice, and how you

smell. Newborn's sense of touch is especially developed, particularly around the

mouth. Baby also has a strong sense of smell. After a few days, newborn hears

fairly well and responds most noticeably to high-pitched and loud sounds. Baby

recognizes and prefers sweet tastes to those that are sour, bitter, or salty. Vision

is developing quickly but is believed to be the weakest of the senses. Motor

skills develop as baby's muscles and nerves work together. Movements are

mostly controlled by reflexes, such as the rooting reflex, which is when a

newborn's head turns and his or her mouth "reaches" toward a touch. Hands are

tightly fisted when the baby is alert.

Growth and Development Of The infant:-

Babies change more in the first year of life than at any other time. From 1 to 12

months of age, most babies grow and develop in these main areas:-

Physical growth:- A baby's growth is dramatic during this first year. Babies

grow taller, and their heads get bigger. The first year is characterized by rapid
physical growth. A normal baby doubles its birth weight in six months and

triples it in a year. During that time, there is great expansion of the head and

chest, thus permitting development of the brain, heart, and lungs, the organs

most vital to survival. The bones, which are relatively soft at birth, begin to

harden, and the fontanelles, the soft parts of the newborn skull, begin to calcify,

the small one at the back of the head at about 3 months, the larger one in front at

varying ages up to 18 months. Brain weight also increases rapidly during

infancy: by the end of the second year, the brain has already reached 75% of its

adult weight.

Growth and size depend on environmental conditions as well as genetic

endowment. For example, severe nutritional deficiency during the mother's

pregnancy and in infancy are likely to result in an irreversible impairment of

growth and intellectual development, while overfed, fat infants are predisposed

to become obese later in life. Human milk provides the basic nutritional

elements necessary for growth; however, in Western cultures supplemental

foods are generally added to the diet during the first year.

The newborn infant sleeps almost constantly, awakening only for feedings, but

the number and length of waking periods gradually increases. By the age of

three months, most infants have acquired a fairly regular schedule for sleeping,

feeding, and bowel movements. By the end of the first year, sleeping and

waking hours are divided about equally.

Cognitive development: Babies make great advances in being able to learn and

remember

 Emotional and social development: Babies start to show their emotions and

how they feel about other people.

Language development: Babies quickly learn language by what is spoken

around them.

Sensory and motor development: Babies become strong enough to sit. Some

will stand, and others will begin to take their first steps:

Each baby grows and gains skills at his or her own pace. It is common for a

baby to be ahead in one area, such as language, but a little behind in another.

Babies who were born early or have health problems may grow and develop at a

slower pace.

Growth and Development of the Toddler:

Toddler:- Toddler ranges from the time when children begin to walk

independently until they walk and run with ease which is form 12 to 36 months.

The toddler is characterized by increasing independence bolstered by greater

physical mobility and cognitive abilities.

Toddlers are 16 increasingly aware of their abilities to control and are pleased

with the successful effort with this new skill. The ages between 2 and 5 are
often called the preschool years. During these years, children change from

clumsy toddlers into lively explorers of their world. A child develops in these

main areas.

Physical growth of the toddler:-

1) Biological growth:- The rate of biological growth slows down compared

with that during infancy.

2) Weight and height:- the toddler rate of weight gain markedly differ in

comparison with the infant. The toddler gains about 1.8 to 2.7 kg a year. The

average weight at 2 years of age is 12 kg. at 2 ½ years of age the child’s weight

is about four times that at birth. The gain in height is greater than that of weight

during the toddler period. Height increases about 10 to 12.5 Cms per year and is

largely a result of growth in the length of the legs. The height of 2 years of age

is about 85 cms. Boys tend to be slightly taller than girls, although this

difference is slight.

3) Body proportion:- The young toddler has a relatively large head in

comparison with the size of the rest of the body. The head circumference in the

second year increases by 25cm. by 2 years of age the chest circumference

exceeds that of the head.

4) Dentition:- At 2 years, the toddler has about 16 teeth, and 21/5 years the full

set of 20 temporary teeth have erupted.

Growth of the pre-schooler:-

Ages 2 through 6 are the early childhood years, or preschool years. Like infants

and toddlers, pre-schoolers grow quickly—both physically and cognitively

Children begin to lose their baby fat, or chubbiness, around age 3. Toddlers

soon acquire the leaner, more athletic look associated with childhood. The

child's trunk and limbs grow longer, and the abdominal muscles form,

tightening the appearance of the stomach. Even at this early stage of life, boys

tend to have more muscle mass than girls. The pre-schoolers' physical

proportions also continue to change, with their heads still being

disproportionately large, but less so than in toddlerhood.

Three‐year‐old pre-schoolers may grow to be about 38 inches tall and weigh

about 32 pounds. For the next 3 years, healthy pre-schoolers grow an additional

2 to 3 inches and gain from 4 to 6 pounds per year. By age 6, children reach a

height of about 46 inches and weigh about 46 pounds. Of course, these figures

are averages and differ from child to child, depending on socioeconomic status,

nourishment, health, and heredity factors.

Development of the toddler up to pre-schooler:-

 Physical development: In these years, a child becomes stronger and starts to

look longer and leaner.

 Cognitive development: A child this age makes great strides in being able to

think and reason. In these years, children learn their letters, counting, and

colours.

 Language: By age 2, most children can say at least 50 words. By age 5, a

child may know thousands of words and be able to carry on conversations and

tell stories.

 Sensory and motor development:

By age 2, most children can walk up stairs one at a time, kick a ball, and draw

simple strokes with a pencil. By age 5, most can dress and undress themselves

and write some lowercase and capital letters.  Each child grows and gains skills

at his or her own pace. It is common for a child to be ahead in one area, such as

language, but a little behind in another.

 Learning what is normal for children this age can help you spot problems

early or feel better about how your child is doing.

Growth and development of school age children:-

School-age period is between the age of 6 to 12 years. The child's growth and

development is characterized by gradual growth.

Biological changes:-

Growth in height and weight assumes a slower but steady pace as compared

with the earlier years. Between ages 6 to 12, children will grow an average of

5cm per year to gain 30-60 cm in height and will almost double their weight,

increasing 2 to 3 per year.

Age 6: Male/female

Weight:- 16-23.5 kg

Height:- 106.6-123.5 cm

Age 7: Male/female

Weight:- 17.7-30 kg

Height:- 111.8-129.7 cm

Age 8-9: Male/female

Weight:- 19.6-39.6 kg

Height:- 117-141.8 cm

Age 10-12: Male/female

Weight:- 24.3-58 kg

Height:- 127.5-162.3 cm
Physiological changes:-

Mature of the gastro-intestinal system is reflected in fewer stomach upset, better

maintenance of blood glucose and an increased stomach capacity, which

permits retention of food for longer period. The school age child does not need

to be fed carefully.

 Physical maturation is evidenced by other body tissues and organs.

 Bladder capacity, greater in girls than boys.

 Heart grows slowly in the middle years and small in size when compared with

the size in the other age period. Heart rate and respiratory rates steadily

decreases and blood pressure increases during this age period

 Immune system becomes more competent in its ability to localize infection

and produce an antibody-antigen response.

 Bones continue to grow and musculoskeletal system continues to mature, in

size and coordination.

Sensory and motor changes:-

At the age of 6 year:

Aware of hand as a tool

Returns to finger feedings

 Likes to draw and print

Colour vision reaches maturity

Uses knife to spread butter or jam on bread.

At the age of 7 years:

Repeats the performance to master them

More caution in performing new things

Uses brush and combs the hair

At the age of 8-9 years:

Often graceful

Always on the go; jumps skip.

Increased smoothness and speed in fine motor control

At the age of 10-12 years:

Mostly children will have the normal characteristics similar to adults.

Developmental tasks of school age children:

Develop the concepts of number

Counts 13 pennies/coins

Knows the time as morning and afternoon.

 Knows right from left hand

Does simple calculation

Perform bed time activities

Takes bath alone

More independent in doing things

Occasional temper tantrum can be seen.

Cognitive development:-

At 7-11 years, the child now is in the concrete operational stage of cognitive

development. He is able to function on a higher level in his mental ability.

Greater ability to concentrate and participate in self-initiating quiet activities

that challenge cognitive skills, such as reading, playing computer and board

games.

Emotional development:-

The school–age child:

• Fears injury to body and fear of dark.

• Jealous of siblings (especially 6–8 years old child).

• Curious about everything.

• Has short bursts of anger by age of 10 years but able to control anger by 12

years.

Social development:-

• Continues to be egocentric.

• Wants other children to play with him.

• Insists on being first in every thing

• Becomes peer oriented.

• Improves relationship with siblings.

• Has greater self–control, confident, sincere.

• Respects parents and their role.

• Joints group (formal and informal).

• Engage in tasks in the real world.

Growth & Development of Adolescence:-

Adolescence is a transition period from childhood to adulthood. It is based on

childhood experiences and accomplishments.

It begins with the appearance of secondary sex characteristics and ends when

somatic growth is completed and the individual is psychological mature.

Stages of adolescence:-

Early adolescence- (9-13 years):- this is characterized by growth and

development of secondary sexual characteristics.

Mid adolescence- (14-15 years):- this stage is distinguished by the development

of a separate identity from parents, of new relationship with peer groups, and

the opposite sex and experimentation.

Late adolescence- (16-19 years):- at this stage adolescents have fully developed

physical characteristics, and form a distinct identity and have well-formed

option and ideas.

Physical growth:

Weight:

• Growth spurt begins earlier in girls (10–14 years, while it is 12–16 in boys)

• Males gains 7 to 30kg, while female gains 7 to 25kg.

Height:

• By the age of 13, the adolescent triples his birth length.

• Males gains 10 to 30cm in height.

• Females gains less height than males as they gain 5 to 20cm.

Growth in height ceases at 16 or 17 years in females and 18 to 20in males

1- Secondary sex characteristics in girls:

• Increase in transverse diameter of the pelvis.

• Development of the breasts.

• Change in the vaginal secretions.

• Growth of pubic and axillary hair.

• Menstruation (first menstruation is called menarche, which occurs between 12

to 13years).

2- Secondary sex characteristics in boys:

• Increase in size of genitalia.

• Swelling of the breast.

• Growth of pubic, axillary, facial and chest hair.

• Change in voice.

• Rapid growth of shoulder breadth.

• Production of spermatozoa (which is sign of puberty).

Cognitive development: Through formal operational thinking, adolescent can

deal with a problem.

Emotional development: This period is accompanied usually by changes in

emotional control. Adolescent exhibits alternating and recurrent episodes of

disturbed behaviour with periods of quite one. He may become hostile or ready

to fight, complain or resist everything.

Social development: He needs to know "who he is" in relation to family and

society, i.e., he develops a sense of identity. If the adolescent is unable to

formulate a satisfactory identity from the multi-identifications, sense of self-

confusion will be developed according to Erikson:-

Adolescent shows interest in other sex.

He looks for close friendships.

Early adulthood growth and development

Age frame is from about late teens to thirty (20-40 years)

Peak of physical health and fitness (occurs on average at approximately age

30)

Height of cognitive abilities

Healthy, vigorous, energetic

Physical growth:-

In 20 years
 May still gain height

Gain in muscle, fat

Brain still increasing in size and weight (although no new neurons are being

formed)

Senses optima

Developmental task:-

Establish personal and economic independence

Forming a support group of friends and others

Developing work skills/career

Making a commitment in a relationship

Establishing a family

Managing optimal healthy lifestyles

Middle Adulthood development:-

Age frame from about the thirties to the mid sixties

Expand personal and social involvement and responsibility

Adjusting to physiological and emotion changes

Reaching and maintaining job satisfaction/ preparing for retirement

 Observing maturation of children

Managing chronic health conditions

Late Adulthood development:-

Age time frame from mid sixties to death. Aging is influenced by heredity,

nutrition, exercise, lifestyle choices such as smoking, and lifelong adjustments

to change.

Young-Old development task:-

Age frame 65-74 years

If healthy may not experience ages from middle years

Beginning social and emotional adjustments to decreasing physical strengths

and changes in body such as vision and hearing limitations

Adjusting to retirement with loss of job related activities

Adjusting to changing family roles with children, spouse and grandchildren.

Middle Old and Old- Old development task:-

Middle old, 75-84

Adjusting to more chronic conditions, such as arthritis

Adjusting to losses of abilities to drive car

 Losses of friends and siblings

Need to accept life’s experiences

Old-Old, 85 and older

Accept physical limitations and dependence on others

Acceptance of losses (deaths and activities).

Acceptance to alternate living conditions, such as assisted living or long term

care.

Freud theory (sexual development)

Infancy stage - Oral sensory stage

Toddler stage - Anal stage

Preschool stage - Genital stage

School-age stage - Latency stage

Adolescence stage - Pubertal stage

Piaget theory (cognitive development):

Infancy stage - up to2 years - sensory -motor

Toddler stage - 2-3 years - pre-conceptual phase

Preschool stage - Up to 4years - pre-conceptual phase

School-age stage - 7-12 years concrete-operational

Adolescence stage - 12-15 years - preoperational formal operations 15 years -

through life - formal operations

Piaget was born in Switzerland in the late 1800s and was a precocious student,

publishing his first scientific paper when he was just 11 years old. His early

exposure to the intellectual development of children came when he worked as

an assistant to Alfred Binet and Theodore Simon as they worked to standardize

their famous IQ test.

Much of Piaget's interest in the cognitive development of children was inspired

by his observations of his own nephew and daughter. These observations

reinforced his budding hypothesis that children's minds were not merely smaller

versions of adult minds.

Up until this point in history, children were largely treated simply as smaller

versions of adults. Piaget was one of the first to identify that the way that

children think is different from the way adults think.

Instead, he proposed, intelligence is something that grows and develops through

a series of stages. Older children do not just think more quickly than younger

children, he suggested. Instead, there are both qualitative and quantitative

differences between the thinking of young children versus older children.

Based on his observations, he concluded that children were not less intelligent

than adults, they simply think differently. Albert Einstein called Piaget's

discovery "so simple only a genius could have thought of it. "Piaget's stage

theory describes the cognitive development of children. Cognitive development

involves changes in cognitive process and abilities. In Piaget's view, early

cognitive development involves processes based upon actions and later

progresses to changes in mental operations.

The Stages

Through his observations of his children, Piaget developed a stage theory of

intellectual development that included four distinct stages:

The Sensorimotor Stage

Ages: Birth to 2 Years

Major Characteristics and Developmental Changes:

 The infant knows the world through their movements and sensations

 Children learn about the world through basic actions such as sucking,

grasping, looking, and listening

 Infants learn that things continue to exist even though they cannot be seen

 They are separate beings from the people and objects around them
  They realize that their actions can cause things to happen in the world

around them

During this earliest stage of cognitive development, infants and toddlers acquire

knowledge through sensory experiences and manipulating objects. A child's

entire experience at the earliest period of this stage occurs through basic

reflexes, senses, and motor responses.

It is during the sensorimotor stage that children go through a period of dramatic

growth and learning. As kids interact with their environment, they are

continually making new discoveries about how the world works.

The cognitive development that occurs during this period takes place over a

relatively short period of time and involves a great deal of growth. Children not

only learn how to perform physical actions such as crawling and walking; they

also learn a great deal about language from the people with whom they interact.

Piaget also broke this stage down into a number of different substages. It is

during the final part of the sensorimotor stage that early representational

thought emerges.

Piaget believed that developing object permanence or object constancy, the

understanding that objects continue to exist even when they cannot be seen, was

an important element at this point of development.

By learning that objects are separate and distinct entities and that they have an

existence of their own outside of individual perception, children are then able to

begin to attach names and words to objects.

The Preoperational Stage

Ages: 2 to 7 Years

Major Characteristics and Developmental Changes:

Children begin to think symbolically and learn to use words and pictures to

represent objects.

Children at this stage tend to be egocentric and struggle to see things from the

perspective of others.

While they are getting better with language and thinking, they still tend to think

about things in very concrete terms.

At this stage, kids learn through pretend play but still struggle with logic and

taking the point of view of other people. They also often struggle with

understanding the idea of constancy.

For example, a researcher might take a lump of clay, divide it into two equal

pieces, and then give a child the choice between two pieces of clay to play with.

One piece of clay is rolled into a compact ball while the other is smashed into a

flat pancake shape. Since the flat shape looks larger, the preoperational child
will likely choose that piece even though the two pieces are exactly the same

size.

The Concrete Operational Stage:

Ages: 7 to 11 Years

Major Characteristics and Developmental Changes

 During this stage, children begin to thinking logically about concrete

events

 They begin to understand the concept of conservation; that the amount of

liquid in a short, wide cup is equal to that in a tall, skinny glass, for

example

 Their thinking becomes more logical and organized, but still very

concrete

 Children begin using inductive logic, or reasoning from specific

information to a general principle.

The Formal Operational Stage

Ages: 12 and Up

Major Characteristics and Developmental Changes: At this stage, the adolescent

or young adult begins to think abstractly and reason about hypothetical

problems
Abstract thought emerges

Teens begin to think more about moral, philosophical, ethical, social, and

political issues that require theoretical and abstract reasoning

Begin to use deductive logic, or reasoning from a general principle to specific

information.

Erikson’s Theory

Erikson’s (1963) psychosocial theory states that an individual’s development

proceeds throughout life. Each of his eight developmental stages includes

psychosocial tasks that need to be mastered.

1.Trust vs Mistrust :- The first stage of Erikson's 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 child's

caregivers. If a child successfully develops 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 care for.

Failure to develop trust will result in fear and a belief that the world is

inconsistent and unpredictable.

• Psychosocial Conflict: Trust vs Mistrust

• Major Question: "Can I trust the people around me?"

• Basic Virtue: Hope

2. Autonomy vs Shame & doubt :- This stage occurs between the ages of 18

months

to approximately age two to three years. According to Erikson, children at this

stage are

focused on developing a greater sense of self-control. Gaining a sense of

personal control

over the world is important at this stage of development. Toilet training plays a

major role;

learning to control one’s body functions leads 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 self-doubt.

Psychosocial Conflict: Autonomy versus Shame and Doubt

Major Question: "Can I do things myself or am I reliant on the help of

others?"
 Basic Virtue: Will

3. Initiative vs. Guilt:- This stage occurs during the preschool years, between

the ages of three and five. During the initiative versus guilt stage, 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 initiative. Play and imagination takes on an

important role at this stage. Children have their sense of initiative reinforced by

being given the freedom and encouragement to play. When efforts to engage in

physical and imaginative play are stifled by caregivers, children begin to feel

that their self-initiated efforts are a source of embarrassment. Success in this

stage leads to a sense of purpose, while failure results in a sense of guilt.

• Psychosocial Conflict: Initiative versus Guilt

• Major Question: -Am I good or bad?

• Basic Virtue: Purpose

4. Industry vs .Inferiority:- This stage covers the early school years from

approximately age 5 to 11. Through social interactions, children begin to

develop a sense of pride in their accomplishments and abilities. During the

industry versus inferiority stage, children become capable of performing

increasingly complex tasks. As a result, they strive to master new skills.

Children who are encouraged and commended by 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 ability to be

successful. According to Erikson, this stage is vital in the development of self-

confidence. During school and other social activities, children receive praise

and attention for performing various tasks such as reading, writing, drawing and

solving problems. Children need to cope with new social and academic

demands. Success leads to a sense of competence, while failure results in

feelings of inferiority.

• Psychosocial Conflict: Industry versus Inferiority

• Major Question: "How can I be good?"

• Basic Virtue: Competence

5. Identity vs. Role Confusion:- This stage occurs during adolescence between

the ages

of approximately 12 to 18.In the adolescent years, youths develop a desire for

independence

from parents, achieve physical maturity and are concerned with the question of

―Who am I?‖

Achievement of the task result in a sense of confidence, emotional stability, and

a view of the
self as a unique individual. Commitments are made to the choice of career and

to relationship

with members of other genders. Parents are available to Offer support when

needed and to

encourage the development of an independent sense of self. Non achievement

results in sense

of self – consciousness, doubt, and confusion about once role in life.

• Psychosocial Conflict: Identity Versus Confusion

• Major Question: "Who am I?

• Basic Virtue: Fidelity

6. Intimacy vs. Isolation:- This stage takes place during young adulthood

between the ages of approximately 19 and 40. During this period of time, the

major conflict centers on forming intimate, loving relationships with other

people. Erikson believed it was vital that people develop close, committed

relationships with other people. Success leads to strong relationships, while

failure results in loneliness and isolation.

• Psychosocial Conflict: Intimacy Versus Isolation

• Major Question: "Will I be loved or will I be alone?

• Basic Virtue: Love

7. Generativity vs. Stagnation:- This stage takes place during middle adulthood

Between the ages of approximately 40 and 65.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.

• Psychosocial Conflict: Generatively Versus Stagnation

• Major Question: "How can I contribute to the world?"

• Basic Virtue: Care

8. Integrity vs. Despair:- This stage occurs during late adulthood from age 65

through the end of life. During this period of time, people reflect back on the

life they have lived and come away with either a sense of fulfillment from a life

well lived or a sense of regret and despair over a life misspent. 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. Those who are unsuccessful during this phase will feel that

their life has been wasted and will experience many regrets. The individual will

be left with feelings of bitterness and despair.

• Psychosocial Conflict: Integrity versus despair

• Major Question: "Did I live a meaningful life?

• Basic Virtue: Wisdom

Research study:

Exploring the relationship between money attitudes and Maslow’s

hierarchy of needs, mark olison.

Iowa State University, Ames, IA, USA

Abstract: This study explores the relationship between basic human needs and

money attitudes in a university-age cohort utilizing Maslow’s theory of

hierarchical needs. Results con-firmed relationships between needs and money

attitudes. Specifically, all of Maslow’s needs appear to be strongly related to the

money attitudes of evaluation and anxiety. In addition, men’s and women’s

needs are highly correlated with obsession, budget, anxiety and particularly

evaluation. Findings support existing literature and point to the importance of

understanding money attitudes and level of need satisfaction among individuals

and families, particularly from a counselling and educational standpoint.

Implications and possible areas for future research are discussed.

Summary:

Basic human needs are the indispensable need of our body. For living a healthy

and meaningful life we have to fulfil all the needs. Nurses have a great role in

achieving the needs of the individual, family community. Nurses must have
thorough knowledge regarding the needs of an individual and should know how

to plan and give care to the patient according to the priority of need. In this

seminar I have covered basic human needs, Maslow Hierarchy of need, growth

and development, its principles and its occurrence in different stages of life, and

theories related to development like, Freud theory and Erikson theory.

Conclusion: Through this seminar I learned more about the growth and

developmental needs of human being. Milestones and developmental task of

each stage of life. The role of cognitive, emotional and social development in

different stage of life.

Bibliography:

Kozier, ―Fundamental Of Nursing‖ 5th Edition, page no. 18-21, 40-41.

Shabeer P. Basheer, ―A Concise Book of Advanced Nursing Practice‖ 1st

edition, 2012, EMMESS medical publishers, page no. 648-675.

Dutta parul ,Child Health Nursing‖,3rd edition, jaypee publishers, page no. 76-

80.

www.ncbi.com

www.pubmed.com

www.wikepedia.com