Pediatric Growth & Development Flashcards
Sensorimotor Stage
Birth to 2 years
- knowledge gained on physical interaction/experiences & sense
- Progress from reflex behavior –> simple repetitive tasks –> imitating activity
- crucial events: object permanence, physical mobility, separation
Object Permanence
infant realizes that objects continue to exist even when they can no longer see them; correlates to the development of memory
Separation
infant learns to differentiate themselves from the objects in the environment; occurs with separation anxiety/stranger anxiety (major stressor from like 6-7 months to 3 years of age)
Infancy Cognitive development
- Sensorimotor Stage
- Trust vs. mistrust
Trust vs. Mistrust
Birth to 12 months
- complete dependency on caregiver for all needs to be met
- Process: child expresses need through crying –> caregiver hears sounds & determines what the need is –> caregiver meets the need –> infant learns to express their needs & know they will be met
- positive outcome: hope, build a sense of trust & bond attachment with caregiver
- negative outcome: mistrust of people, environment & themselves
Play in infancy
- solitary: need to be played with too, not just left alone
- need interaction with others via talking, singing, reading, rocking, etc..
- Sensorimotor stimulation: visual, auditory, tactile & kinetic learning
- play peek-a-boo (encourage memory & object permanence)
- toys: rattles, soft cloth books, mobiles, teething toys, books with texture, blocks
Care of hospitalized infant
- encourage attachment: caregiver at bedside
- appropriate stimulation: pacifier, Lovie, music, eliminate negative stimulation
- meet needs immediately
- separation anxiety normal
- consistency in care
Cognitive development of toddlers (12 months - 3 years)
-sensorimotor stage through 24 months
-language skills: main development
-inability to transfer information: repeat behaviors to see if the same result will occur each time the object does the same behavior
-inability to categorize
-egocentrism
pre-conceptual/pre-operational for 2-4 years (can’t think in a logical manner, problem solving is based on what they see/hear, not what they can recall)
-Autonomy vs. Shame/Doubt
Autonomy vs. Shame/Doubt
1 - 3 years
- Negativism
- Ritualistic
- Animism
- Individualism
- Conflict occurs between the need to develop autonomy & giving up dependence on others
- Positive outcome: willpower
- Negative outcome: shame/doubt, lack of independence
Negativism
the practice of being negative or skeptical in attitude while failing to offer positive suggestions (toddlers love to say no)
Animism
giving lifelike qualities to an inanimate object
Individualism
child has separated themselves
- still need/depend on loved ones, but have autonomy
- experience less stranger-danger
Egocentrism
cognitive inability to see a situation from another person’s view/perspective
Play of the toddler
- parallel play: alongside but not with each other
- imitative
- freedom of expression
- talking, reading, music, imitating animal sounds
- toys: push/pull, trucks, balls, finger paints, puzzles, blocks, dolls, reading, tactile, bubbles, sand
Care of the sick toddler
- encourage autonomy
- ritualism: stick to bedtime routines, eating, playing, etc…
- inability to conserve: give as small cup as possible with liquid meds
- separation: promote parents at beds
- anxiety/fear the their body is going to leak out; fear invasive non-painful procedures
- regression of developmental milestones (ie. potty training)
- play: for coping, distraction…
Pre-operational Cognitive Development
2 -7 years
- egocentrism shifting to the beginning of social awareness & ability to consider other points of view
- transductive thinking
- animism
- irreversibility
- magical thinking: thoughts are all-powerful
- inability to conserve: judge what they see by the immediate perceptual clues
- global organization: if you change one thing, you change their whole world
- centration
- time: vague, base don what they know
Transductive thinking
unable to perceive from general to specific (deduction) or specific to general (induction)
Irreversibility
cannot undo something cognitively
-ex: “stop running” doesn’t mean start walking, need to say “stop running & walk”
Centration
there’s a focus on one specific aspect rather than all possibilities
-ex: if they don’t like spinach, they’ll say all green food is bad and won’t eat all green food
Initiative vs. Guilt
3 - 6 years
- looking for balance between their new individuality & responsibilities, and learning to control their impulses
- individuation complete: stranger anxiety is over
- conscience developing: start to learn right from wrong
- positive outcome: purpose (discipline so they know what is right/wrong, without hindering their ability to live & think to the fullest)
- negative outcome: guilt (negative feedback when exploring); they feel it’s wrong to be independent
- very sociable & willing to please
Play of a preschooler
- associative: have group play in similar/identical activities, but without rigid organization or rules; only some interaction
- imagination: make-believe is reality when playing; imaginary friends
- imitative: imitate peers, parents, etc…
Care of sick/hospitalized preschooler
- encourage independence
- pre-conceptual thinking: hard from them to imagine an event without experiencing it first; respond well to anticipatory guidance; need repetition for a sense of mastery
- anxiety/ fear of loss of body parts
- regression
- loss of control: perceived restriction & increased dependency
- play
Concrete operational cognitive development
7-11 years
- move from perceptual thinking to conceptual thinking (look through options & understand what consequences are without having to experience it); base their judgement on reason
- decrease in egocentrism: understand a variety of perspectives
- conservation
- classification
- reversibility
- read
Conservation
understand that physical matter doesn’t appear/reappear by magic
Classification
- group objects according to shared attributes
- time of collection (ie. rocks, stickers)
Reversibility
can think through an action, consider the consequences & don’t need to experience the action to anticipate the results
Industry vs. Inferiority
6-12 years
- stage of accomplishment
- reinforcement: extrinsic vs. intrinsic
- want to engage in completing tasks that have real world impacts (socially useful work0
- discover pleasure in intellectual activities & have a sense of purpose
- positive outcome: compétence (goal = achieve a sense of personal & interpersonal competence through acquisition of social & technical skills)
- negative outcome: inferiority (failure to gain a sense of accomplishment); happens because child was repeatedly told they’re a failure, and they become unwilling to attempt a new task
School age (6-11) social development
- peer approval
- sexual tranquility: boys are friends with boys, girls with girls
- hero worship
- body image begins to develop: need reassurance about uniqueness & sameness of their bodies
- form groups clubs: learn to argue, persuade & compromise to maintain friendships
- aware of social norms: modify their norms in order to be accepted
- parents: primary influence on shaping values & personality, standard for behavior
- kids begin to develop emotional ties to other adults
- still want someone else to be in charge; want & need restrictions
Play of school age child
-cooperative: learn to play together for a common goal
teams, rules: give them a sense of belonging, have a strong need for conformity
-increase in physical & intellectual ability
Care of hospitalized school age child
- use real words & honesty; can understand simple causal explanations
- want a sense of accomplishment: allow them to help with various tasks
- separation: fear separation from their peers
- anxiety/fear of unknown: they want the facts/information so they gain a sense of control
- regression
- loss of control: allow them to make decisions when appropriate
- boredom is a huge problem
Adolescent major tasks achieved
-physical/sexual maturity
-education/occupational decisions
Early adolescence: 12-14 year; changes in puberty
Middle adolescence: 15-17 year; dominate peer orientation
Late adolescence: 18-20 year; transition to adult
Formal operational thinking
11-15 years
- ability to think in abstract terms, possibilities etc…
- can consider long-term consequences related to behavior
- adolescent egocentrism
- imaginary audience
- personal fable
Adolescent egocentrism
extreme self-absorption that’s significant in their development of a sense of self
Imaginary audience
so self aware that they think everyone is focused on their behavior
Personal fable
the belief that one’s feelings are completely unique to them
Identity vs. Role Confusion
12-18 years
- integrate the past, present & future to ask themselves “where am I going?”
- goal is to become a self-governing, autonomous person capable o making independent decisions & take responsibility for your actions
- sexuality & emotions
- positive outcome: stable picture of self
- negative outcome: confusion
Play in adolescence
- group sports
- video games, music
Care of hospitalized adolescent
- can talk about health promotion & be future oriented; help them to be actively involved in decision making
- fear separation from their peers & a loss of status
- anxiety: surrounding body image; need privacy; need to know what they’ll look like if something is going to change
- loss of control: feel isolated & act with fear, acting out, withdrawing
- encourage self-care, wear their own clothes, make choices
Cognition
mental process by which knowledge is acquired
- assimilate, process & act on information
- leads to ability to reason, think logically, organize & think abstractly
Jean Piaget’s cognitive stage of development
Sensorimotor: birth - 2 years
Pre-operational: 2 - 7 years
Concrete operational: 7 - 11 years
Formal operational: 11-15 years
Erik son’s stages of psychosocial development
Trust vs. mistrust: birth - 12 months Autonomy vs. shame/doubt: 1 - 3 years Initiative vs. guilt: 3 - 6 years Industry vs. inferiority: 6 - 12 years Identity vs. role confusion: 12 - 18 years
Play - the work of a child
- major socializing agent
- vehicle for exploring, experimenting
- essential to emotional, mental & social well-being
- gives a sense of control
- provides diversion, recreation
- effective for managing stress
Communication with children
- be honest
- use developmentally appropriate language
- talk directly to the chid
- listen to the child
- recognize & acknowledge mastery of skills
