INTRODUCTION:

Growth and development is determining a childs developmental stage is often in primary focus of a health interview. Growing up is a complex phenomenon due to many interrelated facets involved. Maturing also involves growth in their ability to perform skills, to think, to relate to people and to trust or have confidence in themselves. Infants rapidly grow both in size and their ability to perform tasks. Physical Growth The physiologic changes that occur in the infant year reflect increasing maturity and growth of body organs. Infant development occurs in an orderly and predictable manner that is determined intrinsically. It proceeds from cephalic to caudal and proximal to distal as well as from generalized reactions to stimuli to specific, goal-directed reactions that become increasingly precise. Extrinsic forces can modulate the velocity and quality of developmental progress. Each developmental domain must be assessed during ongoing developmental surveillance within the context of health supervision. Generalizations about development cannot be based on the assessment of skills in a single developmental domain (ie, one cannot describe infant cognition based on gross motor milestones). However, skills in one developmental domain do influence the acquisition and assessment of skills in other domains. It is essential to understand normal development and acceptable variations in normal developmental patterns to recognize early patterns that are pathologic and that may indicate a possible developmental disability. Assessment of the quality of skills and monitoring the attainment of developmental milestones are essential to early diagnosis of developmental disabilities and expedient referral to early intervention program

INFANTS PROFILE:
A record shows that the baby boy of Mr. and Mrs. James Cid was born on March 7, 2011, baby Z was delivered at Northern Mindanao Medical Center. He is 6 months old. They live in Brgy. Macabalan, block 3, piaping itum. Zeeno was their first baby. He was a healthy baby and normal in weight. He is also a cute baby. He registered a body length of 59 cm and weighted approximately 5.3 kls. His head circumference measured 42 cm. And his chest circumference is measured 45 cm. Zeeno is a very energetic baby, he always enjoy playing with his toys. He is always trained by her mother how to do this and do that. He always turns his head when he heard a noise. He cant still sit without support and cant use syllable like ma-ma, da-da.

III. Theories
a. Freud's Psychosexual Stages of Development Freud advanced a theory of personality development that centered on the effects of the sexual pleasure drive on the individual psyche. At particular points in the developmental process, he claimed, a single body part is particularly sensitive to sexual, erotic stimulation. These erogenous zones are the mouth, the anus, and the genital region. The child's libido centers on behavior affecting the primary erogenous zone of his age; he cannot focus on the primary erogenous zone of the next stage without resolving the developmental conflict of the immediate one. A child at a given stage of development has certain needs and demands, such as the need of the infant to nurse. Frustration occurs when these needs are not met; Overindulgence stems from such an ample meeting of these needs that the child is reluctant to progress beyond the stage. Both frustration and overindulgence lock some amount of the child's libido permanently into the stage in which they occur; both result in a fixation. If a child progresses normally through the stages, resolving each conflict and
2

moving on, then little libido remains invested in each stage of development. But if he fixates at a particular stage, the method of obtaining satisfaction which characterized the stage will dominate and affect his adult personality.

The Oral Stage The oral stage begins at birth, when the oral cavity is the primary focus of libidal energy. The child, of course, preoccupies himself with nursing, with the pleasure of sucking and accepting things into the mouth. The oral characterwho is frustrated at this stage, whose mother refused to nurse him on demand or who truncated nursing sessions early, is characterized by pessimism, envy, suspicion and sarcasm. The overindulged oral character, whose nursing urges were always and often excessively satisfied, is optimistic, gullible, and is full of admiration for others around him. The stage culminates in the primary conflict of weaning, which both deprives the child of the sensory pleasures of nursing and of the psychological pleasure of being cared for, mothered, and held. The stage lasts approximately one and one-half years. The Anal Stage At one and one-half years, the child enters the anal stage. With the advent of toilet training comes the child's obsession with the erogenous zone of the anus and with the retention or expulsion of the feces. This represents a classic conflict between the id, which derives pleasure from expulsion of bodily wastes, and the ego and superego, which represent the practical and societal pressures to control the bodily functions. The child meets the conflict between the parent's demands and the child's desires and physical capabilities in one of two ways: Either he puts up a fight or he simply refuses to go. The child who wants to fight takes pleasure in excreting maliciously, perhaps just before or just after being placed on the toilet.

If the parents are too lenient and the child manages to derive pleasure and success from this expulsion, it will result in the formation of an anal expulsive character. This character is generally messy, disorganized, reckless, careless, and defiant. Conversely, a child may opt to retain feces, thereby spiting his parents while enjoying the pleasurable pressure of the built-up feces on his intestine. If this tactic succeeds and the child is overindulged, he will develop into an anal retentive character. This character is neat, precise, orderly, careful, stingy, withholding, obstinate, meticulous, and passiveaggressive. The resolution of the anal stage, proper toilet training, permanently affects the individual propensities to possession and attitudes towards authority. This stage lasts from one and one-half to two years. The Phallic Stage The phallic stage is the setting for the greatest, most crucial sexual conflict in Freud's model of development. In this stage, the child's erogenous zone is the genital region. As the child becomes more interested in his genitals, and in the genitals of others, conflict arises. The conflict, labeled the Oedipus complex (The Electra complex in women), involves the child's unconscious desire to possess the opposite-sexed parent and to eliminate the same-sexed one. In the young male, the Oedipus conflict stems from his natural love for his mother, a love which becomes sexual as his libidal energy transfers from the anal region to his genitals. Unfortunately for the boy, his father stands in the way of this love. The boy therefore feels aggression and envy towards this rival, his father, and also feels fear that the father will strike back at him. As the boy has noticed that women, his mother in particular, have no penises, he is struck by a great fear that his father will remove his penis, too. The anxiety is aggravated by the threats and discipline he incurs when caught masturbating by his parents. This castration anxiety outstrips his desire for his mother, so he represses the desire. Moreover, although the boy sees that though he cannot posses his mother, because his father does, he can posses her vicariously by identifying with his father and becoming as much like him as possible: this identification indoctrinates the boy into his appropriate sexual role in life. A lasting trace of the
4

Oedipal conflict is the superego, the voice of the father within the boy. By thus resolving his incestuous conundrum, the boy passes into the latency period, a period of libidal dormancy. On the Electra complex, Freud was more vague. The complex has its roots in the little girl's discovery that she, along with her mother and all other women, lack the penis which her father and other men posses. Her love for her father then becomes both erotic and envious, as she yearns for a penis of her own. She comes to blame her mother for her perceived castration, and is struck by penis envy, the apparent counterpart to the boy's castration anxiety. The resolution of the Electra complex is far less clear-cut than the resolution of the Oedipus complex is in males; Freud stated that the resolution comes much later and is never truly complete. Just as the boy learned his sexual role by identifying with his father, so the girl learns her role by identifying with her mother in an attempt to posses her father vicariously. At the eventual resolution of the conflict, the girl passes into the latency period, though Freud implies that she always remains slightly fixated at the phallic stage. Fixation at the phallic stage develops a phallic character, who is reckless, resolute, self-assured, and narcissistic--excessively vain and proud. The failure to resolve the conflict can also cause a person to be afraid or incapable of close love; Freud also postulated that fixation could be a root cause of homosexuality. Latency Period The resolution of the phallic stage leads to the latency period, which is not a psychosexual stage of development, but a period in which the sexual drive lies dormant. Freud saw latency as a period of unparalleled repression of sexual desires and erogenous impulses. During the latency period, children pour this repressed libidal energy into asexual pursuits such as school, athletics, and same-sex friendships. But soon puberty strikes, and the genitals once again become a central focus of libidal energy.

The Genital Stage In the genital stage, as the child's energy once again focuses on his genitals, interest turns to heterosexual relationships. The less energy the child has left invested in unresolved psychosexual developments, the greater his capacity will be to develop normal relationships with the opposite sex. If, however, he remains fixated, particularly on the phallic stage, his development will be troubled as he struggles with further repression and defenses. b. Erik Homburger Erikson

Psychosocial development as articulated by Erik Erikson describes eight developmental stages through which a healthily developing human should pass from infancy to late adulthood. In each stage the person confronts, and hopefully masters, new challenges. Each stage builds on the successful completion of earlier stages. The challenges of stages not successfully completed may be expected to reappear as problems in the future.

Psychosocial Development Stages Summary Stage Infancy (birth to 18 months) Basic Conflict Trust vs. Mistrust Important Events Feeding Outcome

Early Autonomy vs. Childhood (2 to Shame and Doubt 3 years)

Children develop a sense of trust when caregivers provide reliabilty, care, and affection. A lack of this will lead to mistrust. Toilet Training Children need to develop a sense of personal control over physical skills and a sense of independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt.

Preschool (3 to 5 years)

Initiative vs. Guilt

School Age (6 to 11 years)

Industry vs. Inferiority

Adolescence (12 to 18 years)

Identity vs. Role Confusion

Young Adulthood (19 to 40 years)

Intimacy vs. Isolation

Middle Adulthood (40 to 65 years)

Generativity vs. Stagnation

Maturity(65 to death)

Ego Integrity vs. Despair

Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt. School Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority. Social Teens needs to develop a sense Relationships of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self. Relationships Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation. Work and Adults need to create or nurture Parenthood things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world. Reflection on Older adults need to look back Life on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and despair.

Exploration

Psychosocial Development Stages

Infancy (Birth -18 months)

Psychosocial Crisis: Trust vs. Mistrust

Developing trust is the first task of the ego, and it is never complete. The child will let its mother out of sight without anxiety and rage because she has become an inner certainty as well as an outer predictability. The balance of trust with mistrust depends largely on the quality of the maternal relationship.

Main question asked: Is my environment trustworthy or not? Central Task: Receiving care Positive Outcome: Trust in people and the environment Ego Quality: Hope Definition: Enduring belief that one can attain ones deep and essential wishes Developmental Task: Social attachment; Maturation of sensory, perceptual, and motor functions; Primitive causality.

Significant Relations: Maternal parent

Erikson proposed that the concept of trust versus mistrust is present throughout an individuals entire life. Therefore if the concept is not addressed, taught and handled properly during infancy (when it is first introduced), an individual may be negatively affected and never fully immerse themselves in the world. For example, a person may hide themselves from the outside world and be unable to form healthy and long-lasting relationships with others, or even themselves. If an individual does not learn to trust themselves, others and the world they may lose the virtue of hope, which is directly linked to this concept. If a person loses their belief in hope they will struggle with overcoming hard times and failures in their lives, and may never fully recover from them. This would prevent them from learning and maturing into a fully-developed person if the

concept of trust versus mistrust was improperly learned, understood and used in all aspects of their lives.

Younger Years (1 1/2 - 3 Years)

Psychosocial Crisis: Autonomy vs. Shame & doubt

If denied independence, the child will turn against his/her urges to manipulate and discriminate. Shame develops with the child's self-consciousness. Doubt has to do with having a front and back -- a "behind" subject to its own rules. Left over doubt may become paranoia. The sense of autonomy fostered in the child and modified as life progresses serves the preservation in economic and political life of a sense of justice.

Main question asked: Do I need help from others or not?

Early Childhood (3-6 Years)

Psychosocial Crisis: Initiative vs. Guilt

Initiative adds to autonomy the quality of undertaking, planning, and attacking a task for the sake of being active and on the move. The child is learning to master the world around them, learning basic skills and principles of physics; things fall to the ground, not up; round things roll, how to zip and tie, count and speak with ease. At this stage the child wants to begin and complete their own actions for a purpose. Guilt is a new emotion and is confusing to the child; she may feel guilty over things which are not logically guilt producing, and she will feel guilt when her initiative does not produce the desired results.

Main question asked: How moral am I?

Middle Childhood (7-12 Years)

Psychosocial Crisis: Industry vs. Inferiority

9

To bring a productive situation to completion is an aim which gradually supersedes the whims and wishes of play. The fundamentals of technology are developed. To lose the hope of such "industrious" association may pull the child back to the more isolated, less conscious familial rivalry of the oedipal time.

Main question asked: Am I good at what I do?

Adolescence (12-18 Years)

Psychosocial Crisis: Identity vs. Role Confusion

The adolescent is newly concerned with how they appear to others. Ego identity is the accrued confidence that the inner sameness and continuity prepared in the past are matched by the sameness and continuity of one's meaning for others, as evidenced in the promise of a career. The inability to settle on a school or occupational identity is disturbing.

Main question asked: "Who am I, and what is my goal in life?"

Early Adulthood (19-34 years)

Psychosocial Crisis: Intimacy vs. Isolation

Body and ego must be masters of organ modes and of the other nuclear conflicts in order to face the fear of ego loss in situations which call for self-abandon. The avoidance of these experiences leads to openness and self-absorption.

Middle Adulthood (35-60 Years)

Psychosocial Crisis: Generativity vs. Stagnation

10

Generativity is the concern of establishing and guiding the next generation. Simply having or wanting children doesn't achieve generativity. Socially-valued work and disciplines are also expressions of generativity.

Main question asked: Will I ever accomplish anything useful?

Later Adulthood (60 years - Death)

Psychosocial Crisis: Ego integrity vs. despair

Ego integrity is the ego's accumulated assurance of its capacity for order and meaning. Despair is signified by a fear of one's own death, as well as the loss of self-sufficiency, and of loved partners and friends.

c. Piaget's Theory

Piaget's theory focuses on the cognitive development of a person, it consists of four stages; the Sensorimotor Stage (birth to about 2 years of age), the Preoperational Stage (about 2 yrs. to about 7 yrs.), the Concrete Operational Stage (about 7 yrs. to about 12 yrs.), and the Formal Operational Stage (about 12 yrs. through adulthood). For the purposes of this project, I have chosen to focus on the Preoperational Stage and the Concrete Operational Stage. Piaget's Preoperational Stage: This is the second stage in Piaget's theory. According to Piaget, this stage occurs between the ages of 2-7years. This stage is often broken down into two sub stages; 2-4 years of age and 5-7 years of age. The later sub stage is often thought of as a transition stage from preoperational thought to operational thought. The major development of this stage is symbolic thinking. Children begin to give labels to objects they see in everyday life. They also develop what are a known as schemes for recognizing new objects. For example, in the early part of this stage,
11

language skills are developing very rapidly, a child may learn that the four-legged creature running around the house is symbolized by the word "dog." Upon seeing a cat, which is similar to a dog because it walks on all fours and is a household pet, the child may label it as a dog. This is because the cat falls into the same scheme as the dog (i.e. walks on all fours and is kept as a pet). Of course, as a child grows older, she will realize the differences between cats and dogs. Although Language skills are developing quickly in this stage, it is not until later that the words used by a child have a socially agreed upon meaning (Ginsberg, 79) . A certain word or phrase can mean a number of different things to a child. The words that children use in the earlier sub stage stage usually have a personal meaning. As children progress through this stage and they acquire labels or symbols, their vocabularies will expand very quickly. These labels and symbols enable a child to think about an object, such as the pet dog, even when the dog is not physically present. This is an advancement form the sensorimotor stage in which children are incapable of thinking about objects that are not physically present. Not only do these labels help the child to think about things that are not present, but they also allow children to interact socially with their parents, teachers and peers through verbal communication. Children use verbal communication to express their thoughts and receive new information. Children in this stage may also engage in symbolic play. Symbolic play is when a child assimilates a concrete object with a scheme which already exists for a familiar object (Ginsgerg, 79). For example, as a children, many people pretend to be rock stars and use a household broom as a guitar. Both the guitar and the broom have similar features (long and skinny at one end and short and wide at the other). Children not only form verbal and mental symbols for objects, but also concrete symbols which they many times use in play. Also in this stage, children exhibit what Piaget calls preoperational egocentrism. This refers to a child's inability to view a situation form any other perspective beside her own. This leads to many conflicts with peers. Each child believes that her perspective is

12

the only perspective. Therefore, children do not realize when they have hurt some one else's feelings or why what they have done may be wrong. This also hinders a child's ability to communicate with others. A child will assume that the person she is talking to has the same perspective and knowledge that she does and will therefore leave out specific details that are needed in order to understand what the child is trying to say. Children in this stage also display illogical thinking (Yussen, 174-77). Examples of this are lack of conservation (the inability to realize that when objects change in form they do not necessarily change in amount), irreversibility (the inability to realize that certain processes can be undone or reversed), single classification (inability to understand that one object can be classified in more than one way), and transductive reasoning (seeing similarities between two or more concrete objects or events when there is actually no relationship). The behaviors and characteristics of this stage are most commonly observed in preschool and the first few years of elementary school. Towards the end of this stage, in the second sub stage, children begin to display somewhat logical thinking and the realization that perspectives besides their own do exist.

Piaget's Concrete Operational Stage: This is the third stage of Piaget's theory. This stage is observed in children ages 7-12 years old. As noted earlier, children begin to display somewhat logical thinking towards the end of the preoperational stage. Piaget suggests that in the concrete operational stage, a child's thought processes become organized and integrated with one another. These larger thought processes were given the termoperations. Operations allow children to think logically. This brings about many differences between these two stages (Ormond, 35).

13

In this stage, children can grasp many concepts that were difficult for them to grasp during the preoperational stage (Yussen, 179-80. They understand the concept of conservation as discussed in the preoperational stage. They are able to understand that changes in the form of an object do not cause changes in amount because they are able to see that the process of changing the form can usually be easily reversed and the object can be restored to its original form (reversibility). Children in this stage can also classify one object in more than one way (multiple classification) and they demonstrate deductive reasoning (the ability to draw conclusions from given facts and information, an advancement from transductive reasoning described in the preoperational stage). As children grow and develop in this stage, their logical thinking skills increase and they are able to handle more complex problems, but they still have some difficulty with abstract thinking. A child in this stage has trouble thinking about objects and events that do not have concrete evidence (such as hypothetical situations). Also in this stage, children can decenter, that is, come to the realization that other people's thoughts and perspectives differ from their own. They realize that they can be wrong and that other people's thoughts and feeling as well as their own do not reflect reality. This is known as relativism. Children are able to think about two or more aspects of a problem simultaneously (Yussen, 178).

d. Havighursts Developmental Task Theory Robert Havighurst emphasized that learning is basic and that it continues throughout life span. Growth and Development occurs in six stages. Developmental Tasks of Infancy and Early Childhood: 1. Learning to walk. 2. Learning to take solid foods 3. Learning to talk 4. Learning to control the elimination of body wastes 5. Learning sex differences and sexual modesty

14

6. Forming concepts and learning language to describe social and physical reality. 7. Getting ready to read Middle Childhood: 1. Learning physical skills necessary for ordinary games. 2. Building wholesome attitudes toward oneself as a growing organism 3. Learning to get along with age-mates 4. Learning an appropriate masculine or feminine social role 5. Developing fundamental skills in reading, writing, and calculating 6. Developing concepts necessary for everyday living. 7. Developing conscience, morality, and a scale of values 8. Achieving personal independence 9. Developing attitudes toward social groups and institutions Developmental Tasks of Adolescence: 1. Achieving new and more mature relations with age-mates of both sexes 2. Achieving a masculine or feminine social role 3. Accepting one's physique and using the body effectively 4. Achieving emotional independence of parents and other adults 5. Preparing for marriage and family life Preparing for an economic career 6. Acquiring a set of values and an ethical system as a guide to behavior; developing an ideology 7. Desiring and achieving socially responsible behavior Developmental Tasks of Early Adulthood 1. Selecting a mate 2. Achieving a masculine or feminine social role 3. Learning to live with a marriage partner 4. Starting a family 5. Rearing children 6. Managing a home

15

7. Getting started in an occupation 8. Taking on civic responsibility 9. Finding a congenial social group Developmental Tasks of Middle Age 1. Achieving adult civic and social responsibility 2. Establishing and maintaining an economic standard of living 3. Assisting teenage children to become responsible and happy adults 4. Developing adult leisure-time activities 5. Relating oneself to ones spouse as a person 6. Accepting and adjusting to the physiologic changes or middle age 7. Adjusting to aging parents. Developmental Tasks of Later Maturity 1. Adjusting to decreasing physical strength and health 2. Adjusting to retirement and reduced income 3. Adjusting to death of a spouse 4. Establishing an explicit affiliation with ones age group 5. Meeting social and civil obligations 6. Establishing satisfactory physical living arrangement (http://faculty.mdc.edu).

16

Growth and Development Actual Assessment

1st visit:
Weight: 5.3 kg. Length: 59 cm.

2nd Visit:
Weight: 5.3 kg. Length: 59 cm.

Head Circumference: 42 cm.

Head Circumference: 41 cm.

Temperature: 36.2C

Temperature: 36.4C

Respiration: 33 cpm

Respiration: 33 cpm

Heart Rate: 107 bpm

Heart Rate: 105 bpm

Anterior Fontanels: open

Anterior Fontanels: open

Posterior Fontanels: close

Posterior Fontanels: close

Number of teeth: 0

Number of teeth: 0

Regarding to the data that we identified, it shows that baby CC is normal related to his age because as we know that the anterior fontanel of a baby (infant) is still open until 3yrs. old and the posterior fontanel is close before 3 months.

17

GROWTH AND DEVELOPMENT INFANCY (1 month to 1 year) 1 Visit Zeeno Lennart William Cid 5 months 5.3 kls. 59 cm 41 cm 44 cm 36.4C 33 cpm 105 bpm Open Close 0
st

Name Age Weight Length Head Circumference Chest Circumference Temperature Respiration Heart Rate Anterior Fontanel Posterior Fontanel Number of Teeth

2 Visit Zeeno Lennart William Cid 6 months 5.3 kls. 59 cm 42 cm 45 cm 36.2C 35 cpm 107 bpm Open Close 0

nd

Moves his/her mouth in the direction of the cheek being touched. Grasps an object place in his/her hand, clings to it momentarily and lets go. Makes walking motions when the soles at his/her feet touch a solid surface. Hears and turn his/her head to noise. Pulls an extremity away from a painful stimulus. Uses syllable repetition like ma-ma, bye-byes, da-da. Can roll over completely. Uses babbling sounds. Creeps and crawl. Plays in close proximity to another but no significant interaction takes place. Can sit without support. Enjoys peek-a-boo. Reach, grasp a rattle and transfer it from one hand. Walk with some assistance.

X X

X X

X X X

X X X

18

Evaluation:
Baby Z is a good case in associating theories with actual occurrences in a childs growth and development. Baby Z growth is markedly accelerated. His physical and biological structure, in fact, encompasses that of what is expected for his age. Again, this is related to genetic factors. He has also, perfected his muscular skills and coordination through basketball and other sports. Noticeably, Baby Z has created and developed a sense of competence and perseverance. He is highly motivated with activities that provide a high sense of worth. Without a doubt, Baby Z will least likely develop trust and mistrust. His self- concept continues to mature and he continually recognizes similarities and differences between him and other children. She receives good feedback from peers, babies and parents thats why he feels competent and self-assured. Indeed, Baby Z is one lucky kid who almost has it all. And most especially he has loving parents and siblings.

19

REFERRALS AND RECOMMENDATIONS

I advised Baby Zs mother that an annual physical examination would be beneficial for Baby Zs health. This includes: follow up for updated immunizations for viruses and infections, screening for diseases like tuberculosis and hepatitis B, periodic vision, speech and hearing screening, Regular dental screening and fluoride treatment if necessary and also providing accurate information about sexual issues like sex and reproduction since Baby Z is approaching the toddler stage. For ensuring safety and security, I advised baby Z siblings and mother to provide him proper equipment for him toys since he is highly playful. It is also important to provide him an opportunity for a variety of organized group activities, for him to develop more his social skills. Moreover the family, especially the parents should be realistic with their expectation of baby Z capacities and capabilities. This would incur less pressure for baby Z thus making his home environment conducive for emotional growth and maturity.

20

Bibliography:

Dizon,. General Psychology. Manila: Rex Bookstore, 2003 Uriarte, Gabriel G. General Psychology. Manila, 2007 http://www.answers.com/Psychosocial%20Development http://www.victorianweb.org/science/freud/develop.html http://www.answers.com/Psychosocial%20Development https://www.msu.edu/~compeaua/piagettheory.html http://www.peoi.net/Courses/Coursesen/nursepractice/ch/ch6a.html
http://pedsinreview.aappublications.org/content/18/7/224.extract

21

Documentation:

22