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THEORIES OF GROWTH AND
The period of growth and development
extends throughout the life cycle.
Changes occur is from conception to the
Growth and development is a process
where the person thinks normally,
eventually & takes a responsible place in
It is important for a nurse to understand the
early periods as well as the total life cycle of
an individual to better understand the
behavior of parents and others who provide
care of the child.
WHY IS IT IMPORTANT?????
To know the expected growth of a child at a
To plan for the nursing management
of total care of the child.
To better understand the reason for
particular condition & illness those occur in
various age groups.
To teach parent how to observe and to use
their knowledge so that they may help
their children achieve optimal growth &
Growth refers to an increase in physical
size of whole or any of its part and can be
measured in inches/ centimeters and in
Marlow; 6th edition
Development refers to progressive
increase in skill and capacity.
Marlow; 6th edition
CHARACTERISTICS OF GROWTH &
It is similar to all.
It proceed from general to specific.
Development proceed at different rates.
Growth is complex & continuous.
Development comes from
maturation and learning.
There are individual difference.
Development proceed in stages.
There are predictable pattern
Of growth and development.
Early development is more significant than
TYPES OF PHYSICAL GROWTH
BIOLOGICAL SENSORY MOTOR
GROWTH GROWTH GROWTH
changes in general body growth:
• Changes results from different rates of
growth in different parts of the body during
consecutive stages of development.
eg :- the infants head constitutes
1/4th of the entire length of
the body at birth, where as
the adult’s head is only 1/8th
of body length.
Length or height:
• Some children reach adult
heights in their early teens,
but others continue to grow
throughout late adolescence.
• The periods of rapid growth are
infancy & puberty.
Weight is influenced by all
the increments in size &
is probably the best gross
index of nutrition & health.
The circumference of the
head is an important
measurement since it is
related to intracranial volume.
Chest measurements increase as the child
grows & the shape of the chest changes. At
birth the transverse & antero-posterior
diameters are nearly equal. The transverse
diameter increases more rapidly than does
the antero-posterior diameter.
• Motor development depends on the
maturation of the muscular, skeletal &
nervous systems. The sequences of skills
follow the cephalo - caudal & proximal
• Motor development is termed as –
1. Gross motor
2. Fine motor
Gross motor activities include –
• Turning, reaching, sitting, standing &
Fine motor development is -
the involvement of reflexes. The child learns to
use hands & fingers for thumb apposition,
palmer grasp, release, pincer grasp and so on.
• The sensory system is functional at birth,
the child gradually learns the process of
associating meaning with a perceived stimuli.
• As myelination of the nervous system is
achieved, the child is able to respond to
According to Piget, there are four stages of
1. Sensory motor stage
2. Pre – operational stage
3. Concreter operational stage
4. Formal operational stage
SENSORIMOTOR STAGE (0 – 2
• Sensorimotor (Birth to 2 yrs) - Sensory
organs & muscles become more functional.
• In this stage child mainly concern with
learning about physical object.
• Stage 1: Use of reflexes (Birth to 1month)
Movements are primarily reflexive
• Stage 2: Primary circular reaction (1-4
months) Perceptions center around one’s
body. Objects are perceived as extensions of
• Stage 3: Secondary circular reaction (4-8
months) Becomes aware of external
environment. Initiates acts to change the
• Stage 4: Coordination of secondary schemata
(8-12 months)Differentiates goals and goal-
• Stage 5: Tertiary circular reaction(12-18
months) Experiments with methods to reach
goals. Develops rituals that become
• Stage 6: Invention of new means (18-24
months) Uses mental imagery to understand
the environment. Uses fantasy.
b. Pre-operational (2-7 years) -
• Emerging ability to think
Pre-conceptual stage (2-4 year) -
• Thinking tends to be egocentric .Exhibits use
Intuitive stage(4-7 years) -
• Unable to break down a whole into separate
parts. Able to classify objects according to
c. Concrete Operations (7-11 years)
• Learns to reason about events in the here-
• Children develop the capacity to think
systematically, but only when they can
refer to actual objects and use hands-on
• Then they begin to internalize some tasks.
This means they no longer need to depend
on what is seen.
• They become capable of reversing
For example, they understand that 3 + 1 is the
same as 1 + 3. When real situations are
presented, they are beginning to understand
others’ points of view.
d. Formal Operations (11+ years)
• Able to see relationships and to reason in
• According to Piaget, young people develop
the capacity to think in purely abstract ways.
Problem solving and reasoning are key skills
developed during this stage.
LEVEL I: (Pre-conventional) -(Birth to 9 years)
Authority figures are obeyed.
• Stage 1: (Punishment & obedience
• A deed is perceived as “wrong” if one is
punished; the activity is “right” if one is not
( Instrumental-relativist orientation )
“Right” is defined as that which is acceptable
to & approved by the self. When actions
satisfy one’s needs, they are “right.”
Conventional (9-13 years)
• Cordial interpersonal relationships are
• Approval of others is sought through one’s
(Interpersonal concordance) : Authority is
(Law and order orientation): Individual feels
“duty bound” to maintain social order.
Conventional (9-13 years)
• Cordial interpersonal relationships are
• Approval of others is sought through one’s
• Post-conventional (13+ years) Individual
understands the morality of having
democratically established laws.
(Social contract orientation)
• It is “wrong” to violate others’ rights.
(Universal ethics orientation)
• The person understands the principles of
human rights & personal conscience
.Person believes that trust is basis for
Level – 1
(Orientation of Individual Survival Transition):
• Concentrates on what is best for self,
• Dependent on others.
Transition 1: From Selfishness to
• Recognizes connections to others.
• Makes responsible choices in terms of self
Level – 2 (Goodness as Self-sacrifice) :
• Puts needs of others ahead of own,
• Feels responsible for others,
• Is dependent,
• May use guilt to manipulate others when
attempting to “help.”
Transition 2: From Goodness to Truth :
• Decisions based on intentions &
consequences, not on others’ responses,
• Considers needs of self and others, Wants
to help others while being responsible to
• Increased social participation.
Level – 3 (Morality of Nonviolence) :
• Sees self and others as morally equal,
assumes responsibilities for own decisions,
basic tenet to hurt no one including self,
conflict between selfishness and selflessness,
Self-judgment is not dependent on others’
perceptions but rather on consequences &
intentions of actions.
Infant :Trust, hope and love compete with
environmental inconsistencies or threats
Stage 1: (Intuitive- projective faith)
• Imitates parental behaviors and attitudes
about religion and spirituality.
• Has no real understanding of spiritual
School-aged child :
• Accepts existence of a deity.
• Religious & moral beliefs are symbolized
• Appreciates others’ view points.
• Accepts concept of reciprocal fairness.
Stage 3: (Synthetic-conventional faith)
• Questions values & religious beliefs in an
attempt to form own identity.
Stage 4: (Individuative-reflective faith)
Late adolescent &young adult:
• Assumes responsibility for own attitudes &
Stage 5: (Conjunctive faith)
• Integrates other perspectives about faith
into own definition of truth.
Stage 6: (Universalizing faith)
• Makes concepts of love & justice
• Vygotsky, believed that children learn
through social and cultural experiences.
Interactions with peers and adults help
children in this process.
• While interacting with others, children learn
the customs, values, beliefs, and language of
their culture. For this reason, families and
teachers should provide plenty of social
interaction for young children.
• Vygotsky believed language is an important
tool for thought and plays a key role in
• One of Vygotsky’s most important
contributions was the zone of proximal
1. Bodily-Kinesthetic Intelligence
• Ability to control one’s own body
movements and manipulate objects.
• Use of fingers, hands, arms, and legs to
solve problems, express ideas, construct,
2. Musical-Rhythmic Intelligence
• Ability to recognize, create, and appreciate
pitch, rhythm, tone quality.
• Ability to use different forms of musical
3. Logical-Mathematical Intelligence
• Ability to use logic, reason, mathematics to
• Ability to apply principles of cause-and-
effect and prediction.
• Appreciation of patterns as well as
4. Verbal-Linguistic Intelligence
• Ability to use well-developed language
skills to express self and understand others.
• Sensitivity to sounds, rhythm, and meaning
5. Interpersonal Intelligence
• Ability to understand feelings, behaviors,
and motives of others.
• Ability to work effectively with others.
6. Intrapersonal Intelligence
• Ability to understand personal strengths,
weaknesses, talents, and interests.
• Knowledge of skills, limitations, emotions,
desires, and motivations.
7. Visual-Spatial Intelligence
• Ability to form mental images.
• Ability to visualize the relationship of
objects in space.
• Ability to distinguish between living things
such as plants and animals.
Stage 1: Trust vs. mistrust –
(Birth to 1 year)
• Infant learn to trust parents who care for
them and sensitive to their needs.
• If basic needs of infants are not met the
infant develops sense of mistrust.
Stage 2: Autonomy vs. shame (1 to 3 years) –
• During this stage, toddlers use their new
motor and mental skills. They want to be
independent and do things for themselves.
• At this age, toddlers start to become self-
sufficient. They need to learn to choose and
decide for themselves. To do this, toddlers
need a loving, supportive environment.
• Positive opportunities for self feeding,
toileting, dressing, and exploration will
result in autonomy, or independence.
• On the other hand, overprotection or lack
of adequate activities results in self-doubt,
poor achievement, and shame.
Stage 3: initiative vs. guilt ( 3 to 6 years)–
• This a period of energetic and active
• The child can develop a sense of
accomplishment and satisfaction in his or
• Children at this stage need to develop a
sense of purpose. This happens when adults
direct children’s urges toward acceptable
social practices. As the child oversteps his
limits he or she experiences a feeling of
Stage 4: industry vs. inferiority (6 to 12 yrs)
• At this time, children enjoy planning and
carrying out projects.
• This helps them learn society’s rules and
• During this stage, children gain approval
by developing intellectual skills such as
reading, writing, and math.
• The way family, neighbors, teachers,
and friends respond to children affects
their future development.
• Children can become frustrated by
criticism discouragement, or if parents
demand too much control.
• Feelings of incompetence and insecurity
Stage 5: identity vs. role confusion (12 to 15
• In this stage two tasks are who they are
and what is their place in this world.
• Success makes individual well adjusted
and individual who have not made any
commitment to any occupation inferiority
feeling may develop.
Stage 6: intimacy vs. absorption (late
• In this stage adult forms intimate
relationships with others.
• They develops a sense of intimacy with
• Failure to develop such intimacy results
in psychological isolation.
PSYCHO – SEXUAL
Stage 1: oral stage (0 to 1 years) –
• During this stage, the mouth is the
pleasure center for development.
• Freud believed this is why infants are
born with a sucking reflex and desire
their mother's breast.
• If a child's oral needs are not met
during infancy, he or she may
develop negative habits such as nail
biting or thumb sucking to meet this
Stage 2: anal stage (1-3 years of age) -
• During this stage, toddlers and
preschool-aged children begin to
experiment with urine and feces.
• The control they learn to exert over
their bodily functions is manifested in
• Improper resolution of this stage, such
as parents toilet training their children
too early, can result in a child who is
uptight and overly obsessed with order.
Stage 3: Phallic (3-6 years of
• During this stage,
pleasure in their genitals
and, according to Freud,
begin to struggle with
sexual desires toward the
opposite sex parent (boys
to mothers and girls to
• For boys, this is called the
involving a boy's desire for
his mother and his urge to
replace his father who is
seen as a rival for the
• The Electra complex,
involves a girl's desire for
her father's attention and
wish to take her mother’s
Stage 4: Latency (6-12 years of age):
• During this stage, sexual instincts subside,
and children begin to further develop the
superego, or conscience. Children begin to
behave in morally acceptable ways and
adopt the values of their parents and other
Stage 5: Genital (12+ years of age):
• During this stage, sexual impulses
reemerge. If other stages have
been successfully met,
adolescents engage in
appropriate sexual behavior,
which may lead to marriage and
Studying and understanding child growth
and development are important parts of
teaching young children. No two children
are alike. Children differ in physical,
cognitive, social, and emotional growth
patterns. Understanding child development
will help make you a successful caregiver or
early childhood teacher. Theories of
development can help caregivers
understand how to best work with children.