Nurs 207 - Development Flashcards
Define development
The sequence of physical, psychosocial, and cognitive developmental changes that take place over the human lifespan
Scope of Development
The extent to which development influences an individual spans the entire life course - from birth to death.
Normal human development is organized and progressive and usually occurs in a predictable sequence
Delayed ————— Expected ————— Advanced
Attributes and Criteria
Developmental Level Developmental Delay Developmental Milestone Developmental Regression Developmental Arrest
Developmental Level
an individuals stage of development or ability to independently achieve an outcome
Developmental Delay
an essential element of neurological and/or cognitive maturation has not occurred within an age range and should be investigated
Developmental Milestone
an ability or specific skill that most individuals can accomplish in a certain age range
Developmental Regression
the loss of developmental milestones
Developmental Arrest
plateau of developmental change in some category and is noted when chronologic age continues to progress but developmental change does not
Physical/Physiological Development
- refers to the growth and changes in body tissues and organ systems and the resultant changes in body functions and proportions
Includes cellular proliferation, differentiation, and maturation that occurs in each organ and system that allows integrated human functioning necessary for life and health
Physiological growth and development occur in a bilateral and symmetrical way, progressing in a cephalocaudal (head-to-toe) direction and proximodistally (from midline to periphery)
Motoric Development
- separated into 2 major categories: gross and fine motor.
Generally, motoric development progresses from the achievement of gross motor to fine motor skills - known as refinement.
Gross motor skills
Gross motor skills - involve the use of large muscles to move about in the environment
(ie. sitting, standing, maintaining balance, cruising, walking, running, walking up stairs without assistance, and more complex physical tasks such as playing soccer
Fine motor skills
Fine motor skills - involve the use of small muscles in an increasingly coordinated and precise manner
(ie. batting at an object, reaching and holding an object, transferring an object from hand to hand, holding a pencil in a refined grasp, making marks with a pencil, writing letters, writing words, creating artwork, using hands and fingers to eat, draw, dress, and play)
Fine motor development is contingent upon cognitive and neurological development
Social /Emotional Development
- includes the development of self-understanding, understanding others, and understanding social interactions.
Usually occur in this order → self, others, and social interaction
Knowledge of social and emotional skills is critical because it directs effective communication with an individual(s) and may impact suggested environmental strategies for an individual to obtain optimal functioning.
Cognitive Development
- relates to working memory capacity, cognitive self-regulation, and the processing and use of information about the environment and objects in the environment.
Individuals have an increasing understanding between self and information over time
Development of critical thinking skills and executive functioning, which includes learning, forming concepts, understanding, problem-solving, reasoning, remembering, and thinking abstractly
Combination of cognitive and advanced social/behavioural development enable moral and spiritual development
Communication Development
- language involves a set of rules shared by a group of people that allows the communication of thoughts, ideas, and emotions
3 components of speech: Articulation, Voice, Fluency
Articulation
pronunciation of sounds
Voice
production of sound by vocal cords
Fluency
rhythm of speech
Adaptive Development
- refers to the acquisition of a range of skills that enable independence at home and in the community
- Adaptive skills are learned
- Include self-care activities such as dressing/undressing, eating/feeding, toileting, grooming, management of one’s immediate environment, functional behaviour within the community such as crossing the street safely, going to the store, and following the rules of politeness when interacting with others
- Requires advanced and complex skills in each of the other developmental domains and efficient sensory integration processes
- Examples include: cooperation, a level of moral and ethical decision making, abilities to follow social and cultural folkways, mores, taboos, rules, and laws
Piaget’s Theory of Cognitive Development
- addresses the development of children’s intellectual organization and how they think, reason, perceive and make meaning of the physical world
- Recognized people move through these specific periods at different rates but in the same sequence or order
Period 1 - Sensorimotor (birth to 2 years)
Period 2 - Preoperational (2 to 7 years)
Period 3 - Concrete Operations (7 to 11 years)
Period 4 - Formal Operations (11 to adulthood)
Period 1 Sensorimotor
Birth to 2 years
- Infant develops the action pattern for dealing with the environment (include mouthing, looking, vocalizing, grasping, or hitting
Period 2 Pre-operational
2 to 7 years
- Children learn to think with the use of symbols and mental images
- Parallel play
- Child starts to use other language
- understanding who they are as a person (may not understand beyond themselves)
- iimitate the behaviour of another person
Period 3 Concrete Operations
7 to 11 years
- able to apply logic to a situation
- can describe a process without actually performing it
- understanding processes on how to do things (critical thinking starting)
Period 4 Formal Operations
(11 to adulthood)
- ethics, morality, politics, and/or religion start to become understandable
- thinking moves to abstract and theoretical subjects
- organize thoughts
- reason possibilities
Kohlberg’s Moral Development Theory
Identified 6 stages of moral development occurring at three levels
Theorized that a child’s moral development does not advance if the child’s cognitive development does not also mature
Level 1 - Pre-conventional
Level 2 - Conventional
Level 3 - Post-conventional
Kohlberg’s Level 1 - Pre-conventional
up to 9
right or wrong based on punishment vs reward
Kohlberg’s Level 2 - Conventional
10 - 18 (adolescence)
sees moral reasoning based on his/her own personal internalization of societal and others expectations
wants to please others/doing things for others (less egocentrism)
Kohlberg’s Level 3 - Post-conventional
> 19
higher level ethical thinking
determined by personal values
finds a balance between basic human rights and obligations and societal rules and regulations
start to envision an ideal society
Erikson’s Theory of Eight Stages of life
- each person goes through 8 stages of development, each person needs to accomplish a particular task before moving to the next stage
Erikson Stage 1
Infancy - Birth to age 1 year
Trust vs Mistrust
Infant learns to trust others
Erikson Stage 2
Toddler - 1 to 3 years
Autonomy vs Sense of shame and doubt
Toddler learns to be independent and develops self confidence
Erikson Stage 3
Pre-school - 3 to 6 years
Initiative vs Guilt
Child learns to initiate his or her activities
(use fantasy and imagination)
Erikson Stage 4
Middle Childhood - 6 to 11 years (puberty)
Industry vs Inferiority
Child learns new skills (increased competence in physical, cognitive, and social areas)
Erikson Stage 5
Adolescence - 12 to 18 years
Identity vs Role confusion
Acquiring a sense of identity
Erikson Stage 6
Young Adulthood - 18 to 35 years
Intimacy vs Isolation
Form close, personal relationships
Erikson Stage 7
Middle Adulthood - 35 to 65 years (True adulthood)
Generativity vs Self-absorption and stagnation
See beyond personal needs and accomplishments and view the needs of society (help younger people)
Dissatisfaction with one’s achievements often leads to self-absorption stagnation
Erikson Stage 8
Old Age - Age 65 years and older
Integrity vs Despair
Reflect on life and either feel satisfaction or disappointment
How does growth and development influence approaches to nursing care
Risk Recognition
Developmental Assessment
Influences Care Delivery
The ability to provide patient-centred, quality care requires nurses to understand and assess the different aspects of an individual’s development and appropriately adjust the care they provide. It is also important for nurses to recognize when expected developmental progression in any area is not occurring so that collaborative interventions can be initiated.
Times during which development is rapidly occurring (ie. infancy, childhood, and older adulthood) deserve special attention and in-depth knowledge because nursing care will need to responsively adjust and nurses will need to adapt to the developmental changes of the patient more frequently and on an individual basis.
Infancy
Period from 1 month to 1 year = dramatic physical growth
Infancy physical changes
size increases rapidly during the first year; birth weight doubles in approx. 5 months and triples in 12 months
patterns of body function stabilize as evidenced by predictable sleep, elimination, and feeding routines
Infants psychosocial changes
Separation – by the first year infants begin to differentiate themselves from other people, understanding they are separate beings capable of acting on their own
Initially, infants are unaware of the boundaries to self, but through repeated experiences with the environment, they learn where self ends and where the external world begins
At 2 or 3 months of age, infants begin to smile responsively rather than reflexively
They can recognize differences in people when their sensory and cognitive capabilities improve
By 8 months, most infants can differentiate a stranger from a familiar person and respond differently between the two
Close attachment to the primary care provider (commonly parents) is usually established by this age
By age 9 months, children play simple social games such as patty-cake and peekaboo’s
More complex interactive games such as hiding seek, involving objects, are possible by 1 year of age
Infant main cause of death for babies between 1 and 12 months of age)
Sudden Infant Death Syndrome (SIDS)
Infant main cause of death between 6 and 12 months of age
Injury
Toddler
1 - 3 years
Toddler physical changes
rapid development of motor skills allows toddlers to participate in self-care activities, such as feeding, dressing, and toileting
Locomotion skills eventually include running, jumping, standing on one foot for several seconds, and kicking a ball
Most can ride tricycles, climb ladders, and run well by their 3rd birthday
By 3, children draw simple stick people and can usually stack a tower of small blocks
Children usually show a willingness to please parents and take pride in their accomplishments
Toddler cognitive changes
By 2 years, toddlers complete the development of object permanence, the ability to remember events, beginning ability to put thoughts into words
Toddlers recognize they are separate beings from their mothers, but they are unable to assume another person’s point of view
They use symbols to represent objects, places, and people – imitate other people, pretend one object is another
An 18 month old uses approx. 50 words
A 2 year old has a vocab up to 200 words and is generally able to speak in two-word sentences
Word most often used is “No” until well into the 3rd year
Moral development is only beginning and is also egocentric
Toddler health risks
Injury
Drowning
Poisoning
Car safety
Pre-schooler
3-5
Pre-schooler physical changes
Large and fine muscle coordination improves
Run well, walk up and down steps with ease, learn to hop
By age 5, they can usually skip on alternate feet, can jump rope, and begin to skate and swim
Learn to copy crosses and squares. Triangles and Diamonds are usually mastered between ages 5 and 6.
Preschooler cognitive changes
Children judge people, objects, and events by their outward appearance or what seems to be true
Thinking is hindered by their limited attention and attending skills
Artificialism – the misconception that everything in the world has been created by humanity may result in children asking questions such as “Who build the mountains?”
Animism – the attribution of animal life to inanimate objects, often results in statements such as “Trees cry when they get their branches broken”.
At about the age of 4, the intuitive phase of preoperational though develops
Children’s ability to think more complexly is demonstrated by their ability to classify objects according to their size or colours.
Egocentricity persists, but during these 3 years, it begins to be replaced with social interaction
As children near the age of 5, they begin to use or can be taught to use rules to understand causation.
Knowledge of the world remains closely linked to concrete (perceived by the senses) experiences
Moral development expands – beginning understanding of behaviours considered socially right or wrong
continue to be motivated, by the wish to avoid punishment and desire to obtain a reward
Vocabularies continue to increase rapidly
By the age of 6, children know more than 2100 words and can construct sentences using 5 or 6 words
Preschool psychosocial changes
Curiosity and developing initiative lead to the active exploration of the environment, development of new skills, and the making of new friends
Children become more social after their 3rd birthday as they shift from parallel play to associative play
Most able to play together in a cooperative manner
4 years – groups of 2/3.
5 years- group has a temporary leader for each activity
Pretending allows children to understand others points of view, develop skills in solving social problems, and become more creative
Toddler psychosocial changes
Children strive for their independence
Their strong wills are frequently exhibited in negative behaviour when caregivers attempt to direct their actions
socially, toddlers remain strongly attached to their parents and fear separation from them
begin to participate in parallel play, which is playing beside rather than with another child
They learn the joy of sharing
Preschool health risk
Unintentional injury
School age
6 to 12
School age physical changes
Slower rate of growth but steady
Most children practice the basic gross motor skills of running, jumping, balancing, throwing, and catching during play which results in refinement of neuromuscular function and skills
Fine motor skills improve and as control is gained over fingers and wrists children become proficient in a wide range of activities
Independent in bathing, dressing, and taking care of other personal needs
School age cognitive changes
Able to think in a logical manner and to understand the relationship between things and ideas
thoughts are no longer dominated by their perceptions, their ability to understand the world
Considerably less egocentric
Develop the ability to concentrate on more than one aspect of a situation
More capable of understanding another person’s view/feelings
School age psychosocial changes
Erikson - Industry vs Inferiority
- Positively recognized for success feel a sense of worth
Strive to acquire competence and skills necessary for them to function as adult
12 year old children are able to Consider what society would be like without rules because of their ability to reason logically and their experiences with group play
True or false. Forgetfulness is NOT a part of ageing
TRUE
Health Concern across the lifespan
Failure to Thrive
- a loss of weight and a subsequent loss of linear growth
Failure to thrive may be due to:
3 reasons
Organic Causes – arising from something happening inside the body – physiological condition (celiac disease, cystic fibrosis)
Exogenous or non-organic – (Outside source) – poor nutrition, food scarcity, neglect, abuse, parental mental illness, anemia (could be organic)
Mixed – combination of both
Failure to thrive is common in:
Common in Old-Old (Alzheimer’s)
Frequently diagnosed in infants under age of 1
Can happen at any age
Direct impact to growth and development – particularly physical growth
