Growth and

Development
Concept
Introduction
Source:
Cooperative Extension System Extension "CARES" for America's
Children and Youth Initiative
March, 2001
 Objectives
• Describe the physical growth
patterns of an infant through to
school age
• Discuss the cognitive development
based on two major theories of
Erikson and Piaget and its
important for nursing care
• Discuss the child development
based on social, psychosocial and
spirituality theory and its
important for nursing care
• Apply knowledge of growth and
development to determine
 Definition
• Growth and development: the
sum of numerous changes that
happen during the lifetime of an
individual
• Growth: quantity changes
• Development: qualitative
changes
 Principles of growth and
development
• Growth is an orderly process,
occuring in systematic fashion
• Rates and patterns of growth are
specific to certain parts of the
body
• Wide individual differences exist
in growth rate
• Growth and development are
influenced by multiple factors
 Principles of growth and
development
• Development proceeds from the
simple to the complex and from the
general to specific
• Development occurs in a
cephalocaudal and a proximodistal
progression
• There are critical periods for
growth and development
• Rates in development vary
• Development continues throughout
the individual’s life span
 Patterns of Growth and
Development
• Direction: the child’s pattern of
growth is in a head to toe or
cephalocaudal and proximodistal
• Mass to specific
• Simple to complex
 Patterns of Growth and
Development (cont’…)
• Developmental pace: fixed, precise order,
but it does not progress at the same rate
or pace. When a spurt occurs in one area,
minimal advances may take place in
another area
• Sensitive periods: periods termed
critical, sensitive, vulnerable and optimal
are those times in the lifetimes of an
organism when it is more susceptible to
positive or negative influences
• Individual differences: Gender influence,
fast growth, slowly growth
Directional Trends
• Chepalocaudal : head-to-nail
– Head control before control of the trunk
• Proximodistal : near-to-far
– Mastery of the hand before
manipulated the finger
• Differentiation
– Simple to complex activities and
function
Bilateral and symmetric pattern
 Biological Growth and
Physical Development
• External Proportions
– Head: fastest growing during fetal
development
– Head: 2 months of gestation: 50% of
total body length
– Infancy: The trunk dev predominates
– Childhood: the legs more rapid
– Adolescence: The trunk once again
elongates
 Dimensions of Growth and
Development
• Physical growth
• Motor skills: fine and gross
• Teeth
• Sleep
• Language
• Cognitive
• Social and emotional
Proportion changes
- Prenatal posture: flexion
- Consist of two primary parts: thorac and sacrum
-Thoracal part is more rigid than sacrum
Head growth is faster than other
parts of body
Musculoskeletal growth and development
Physical growth
-Linear growth
-Body weigth
Sensory Development:
Vision
Sensory Development: Hearing
Neuron growth
1. Nervous growth is fastest during embryonal
stage
2. Anatomically complete at birth, except
myelination: rapid for 2 years and complete by 7
years
3. Posterior fontanelle closed by 6 weeks
4. Posterior fontanelle closed by 18 weeks
5. Primitive reflexes dispear in few month
 Teeth
• Teeth eruption is a growth
indicator, especially a molar
teeth
• Late molar teeth eruption is as
health problem indicator, such as
endocrine problems, nutrition
problems, and teeth malposition
Lymphoid System
 Lymphoid System
• Lymphoid system has developed
well at birth
• Achieve an adult size before 6
years
• During 10-12 years, this system
develops double an adult size
• And then decreases to adult size
at the end of adolesence stage
 Organ System
Development
• All systems develop during
development stages
• Vary in every age periods
• For example: Body surface and
body weight are very important
indicator at the begining stage
of development
• A physical growth related to a
hormonal growth is a key
element during the adolescent
period.
 Physiological Changes
• Basic function changes involve
metabolism, temperature, and
sleep and rest
• Body metabolism is influenced
by intrinsic and extrinsic factors
such as: body weight, age, sex,
emotion, exercise, season,
hormon, environmental
temperature
• BMR of children shows spesific
 Motor Skills
Development
• Motoric function depend on
bone, musculoskeletal, and
nervous system maturation
• The acquisition of gross motor
skills precedes the development
of fine motor skills
• Both processes occur in a
cephalocaudal fashion: head
control preceding arm and hand
control, followed by foot control
Sleep
1. Neonates : 16 hours a sleep per
day up to 80% REM sleep
2. Infants: 50% REM = 1/3rd of their
day begin sleep in REM
3. Adult: 20% REM, begins in non
REM for 60 minutes
 Language
1. Prelinguistic
2. Holophrasic
3. Telegraphic
4. Preschool
5. Middle childhood
6. adolescence
 Piaget’s Theory of
Cognitive Development
• Children are not little adults
• Need active interaction with the
environment
• Maturation and experience are
more important than formal
learning
• 4 stages of qualitative leaps in
problem solving and logical
reasoning
 Piagetian Cognitive
Development
1. Organization of knowledge to
make it useful: Operation and
schema
2. Adaptation and adjustment to
deal with changes in the
environment: assimilation and
accomodation
 Piagetian Cognitive
Development
Operation Schema
• Are internalized • Are actions or
actions (plans and strategies for
rules) that are part dealing with the
of a child’s environment that
cognitive structure can be generalized
to many situations
 Piagetian Cognitive
Development
Assimilation Accomodation

? ?
 Stages Cognitive
Development
• Sensorimotor stage (0-2 years):
use senses to investigate ; develop
object permanent.
• Pre-operational stage (2-7 years):
start to use symbolism language,
no ability to use conversation,
animism, egocentricity, artificial.
• Concrete operational stage (7-12
years): conservation develops,
concrete literal thinker
• Formal operations (> 12 years):
abstractions, ethics, hypotheses,
 Erikson’s Phychosocial
Theory
• Emphasizes importance of
culture and historical times
• 8 stages “ cradle to grave”
 Erikson’s Phychosocial
Theory
• Trust vs Mistrust (0-2 yrs)
• Autonomy vs Shame or Doubt (2-
3 yrs)
• Initiative vs Guilt (4 yrs)
• Industry vs Inferiority (middle
childhood)
• Identity vs Role confusion
(adolesence)
• Intimacy vs Isolation
• Generativity vs Stagnation
 Temperament
• The manner of thinking,
behaving, or reacting
characteristic of an individual
(Chess & Thomas, 1999) and
refers to the way in which a
person deals with life.
• The easy child
• The difficult child
• The slow-to-warm-up child
 Freud’s Psychosexual
Development
• Oral
• Anal
• Phallic
• Latency
• Genital Period
 Kohlberg’s Moral
Development
• Pre-conventional
• Conventional
• Post-conventional
(autonomous or principled
level)
 Fowler Spiritual
Development
• Undifferentiated
• intuitive-projective
• mythical-literal
• synthetic-convention
• individuating-reflexive
 Factors that Influence
Development
• Heredity
• Neurons-endocrine
• Nutrition
• Interpersonal Relationships
• Socioeconomic Level
 Factors that Influence
Development
• Disease
• Environmental Hazards
• Stress in Childhood
• Influence of Mass Media
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