bsc nursing 3 rd year

1. Prepared by: Mr. Bhargav mehta
Ped. Department

2. Theories of Child Development
 Sigmund Freud-theories focus on libido
 Levels of consciousness
 Id-controls physical need and instincts of the body
 Ego-conscious self, controls the pleasure principle of the
id by delaying the instincts until the appropriate time
 Superego-conscience or parental value system
 Interact to check behavior and balance each other
 The child has to adequately resolve a particular stage of
development would have a fixation (compulsion)

3.  Psychosexual stages
 Oral stage (ages 0-2 years)
‒ The newborn first relates almost entirely to
the mother; the newborn’s first experiences
with body satisfaction come through the
mouth
Theories of Child Development
cont’d

4. Theories of Child Development
(cont.)
 Psychosexual stages (cont.)
 Anal stage (ages 2-3 years)
‒ The child’s first encounter with the serious
need to learn self-control and take
responsibility
‒ Toilet training-first experiences of creativity
the “mud pie period”

5. Theories of Child Development
(cont.)
 Psychosexual stages
 Phallic stage (ages 3-6 years)
‒ Also called the infant genital stage
‒ Interest moves to the genital area as a source of
pride and curiosity
‒ Begins to understand what it means to be a boy
or a girl (learn to identify with the parent of the
same sex)
‒ Oedipus/Electra complex
‒ Superego begins to develop

6. Theories of Child Development
(cont.)
 Psychosexual stages (cont.)
 Latency stage (ages 6-10 years)
‒ The time of primary schooling (learning);
the child is preparing for adult life but must
await maturity to exercise initiative in adult
living
‒ Develops sense of moral responsibility (the
superego) based on what has been taught
through the parent’s words and actions

7.  Psychosexual stages (cont.)
 Genital stage (ages 11-13 years)
‒ Physical puberty is occurring at an
increasingly early age; social puberty occurs
even earlier
Theories of Child Development
(cont.)

8. Theories of Child Development
(cont.)
 Erik Erikson
 Formulated a series of eight developmental tasks or
crises
 Trust vs. mistrust
‒ The infant learns that his or her needs will be met
‒ Trust is established and then reinforced at each stage
 Autonomy vs. doubt and shame
‒ The toddler learns to perform independent tasks- environment
and body
‒ Positive responses from caregivers the child gains self respect
and pride

9. Theories of Child Development
(cont.)
 Erik Erikson (cont.)
 Initiative vs. guilt
 The child develops a conscience and sense of right and wrong
 Accepts punishment for doing wrong (relieves feelings of guilt)
 Do not have a concept of time
 Industry vs. inferiority
 The child competes with others and enjoys accomplishing tasks
 Praise helps build self-esteem and avoid feelings of inferiority
 Identity vs. identity confusion
 The adolescent goes through physical and emotional changes as
he or she develops independent self

10. Theories of Child Development
(cont.)
 Erik Erikson (cont.)
 Intimacy vs. isolation (early adulthood)
 The young adult develops intimate relationships
 Generativity vs. self-absorption (young and middle)
 The middle-aged adult finds fulfillment in life (marriage, family,
profession, career, religious vocation)
 If not fulfilled becomes self-absorbed or stagnant and ceases to develop
socially
 Ego integrity vs. despair (old age)
 The older adult is satisfied with life and achievements
 Least understood

11. Cognitive Theories of Child Development
 Jean Piaget-
 Cognitive development or intellectual development
-develops quality called intelligence
-all children move through phases in the same order, but
at his or her own pace
 Sensorimotor phase (0-2 years)
 The infant uses the senses for physical satisfaction
 Understanding of cause and effect develops
 Development of sense of self as separate from the
external environment
 Preoperational phase (2-7 years)
 The young child sees the world from an egocentric
point of view
 No concept of quantity (if it looks like more, it is more)
 Sense of time not yet developed
 Express self with language , understanding of symbolic
gesture

12.  Concrete operations phase
 The child learns to problem-solve in a systematic way
 Mastering numbers, relationships and reasoning
 Learning to differentiate and classify
 Classify and organize information about their
environment
 Can consider another person’s point of view
 Formal operations phase
 The adolescent has own ideas and can think in abstract
ways
 Begins to understand jokes based on double meanings
 Enjoys reading and discussing theories and philosophies
 Can observe and draw logical conclusions
 Making and testing hypothesis

13. Theories of moral Development
 Lawrence Kohlberg
Stages of development of moral reasoning in children
1. Preconventional level (premoral level) - stages (0-2)
(moral judgment based on what will bring them reward or
punishment)
- Stage 0-(during the first 2 years)-what pleases the child, good is
what I like and want and bad is what hurts
- Stage 1-(2-3 years)-punishment and obedience orientation :
behavior motivated by fear of punishment
- Stage 2- (4-7 years)-instrumental relativist orientation:
behavior motivated by egocentrism and concern for self. self-
indulgence, follows the rules to benefit themselves, “an eye for an
eye”

14. 2. Conventional morality level- (stages 3 – 4)
(correct behavior is that which those in authority
approve and accept)
‒ Stage 3 (7-9 years)-interpersonal concordance
orientation : motivated by experience of others,
strong desire for approval and acceptance. ”good-
boy” orientation, pleasing others is very important
‒ Stage 4 (10-12 years)- law and order orientation :
showing respect to others, obeying the rules and
respect for authority.

15. 3. Postconventional level (principled level) –(stages 5-
6)
‒ Stage 5- (13-18 years)-social contract legalistic
orientation: respect for universal laws and moral
principles, guided by culturally accepted values define
personal standards and personal rights.
‒ The end no longer justifies the means
‒ Stage 6- universal ethical principle orientation:
honor, justice, and respect for human dignity

16. Spiritual developmental theory
by. fowler
Well known as theory of faith. Faith is universal feeling that is
expressed through beliefs, rituals and symbols, specific to
religious tradition.
As described by fowlers, faith is an on going process in which
individual form and reform their way of seeing the word.
1. Stage I : primal faith – 0 to 3 years-
the primary care givers provides the infant and young
children with a verity of experiences that encourage the
development of mutual trust and love.
2. Stage II: intuitive projective faith- 3 to 7 years
child forming long lasting images and feelings.
Imagination, perception and feelings are the mechanisms by
which child explores and learns about the world.

17. 3. Stage III: mythic – literal faith (7 to 12 years)
beliefs are derived from perspective of others.
During this stage they are able to differentiate their
thinking from that of others. Stories become the gatewat
to learning about life.
4. Stage IV: synthetic conventional faith (adolescence
and beyond)
experience extends beyond the family to peers,
teachers and other members of society. Has a cluster of
values and beliefs concerning others.

18. Theories of Child Development
(cont.)
 Other theorists
 Arnold Gesell
 Developmental landmarks
 Carl Jung
 Archetypes
 Responses to actions critical
Q#3

19. Developmental Considerations for
Communicating with Children and
Family Caregivers
 Primary source of data collection during a well-child
visit or in any health crisis situation
 Principles of communication
 Spoken and written words
 Body language, facial expressions, voice intonations, and
emotions behind the words
 Listening is one of the most important aspects of
communication
 Silence is a form of communication

20. Developmental Considerations for
Communicating with Children and
Family Caregivers
 Principles of communication (cont.)
 Time management is an important aspect of
communication
 Direct the focus of a conversation
 Play is an important form of communication for children
 Avoid communication blocks
 Use of an interpreter

21. Developmental Considerations for
Communicating with Children and
Family Caregivers (cont.)
 Communicating with infants
 Comfort measures
 Communicating with young children
 Allow the caregiver to hold the young child as you initiate
conversation
 Young children tend to be frightened of strangers
 Allow young children to handle or explore equipment
 get down on eye level with them
 Cannot separate fantasy from reality

22. Developmental Considerations for
Communicating with Children and
Family Caregivers (cont.)
 Communicating with school-age children
 Begin by calming down or connecting with the child
 Be sensitive to the child’s concern about body integrity
 Play, re-enactment, or artwork can give insight into how
well a child understands a procedure or experience

23. Developmental Considerations for
Communicating with Children and
Family Caregivers (cont.)
 Communicating with adolescents
 Might be challenging
 Adolescents respond positively to individuals who show a
genuine interest in them
 Adolescents might need to relate information they do not
wish others to know
 Let adolescents know that you will listen in an open-
minded, nonjudgmental way

24. Developmental Considerations for
Communicating with Children and
Family Caregivers (cont.)
 Communicating with caregivers
 View the caregivers as experts in the care of their child and
you as their consultant
 Include caregivers in providing information, problem
solving, and planning of care
 Pay attention to the verbal and nonverbal cues a parent
uses to convey concerns, worries, and anxieties about the
child

25. Developmental Considerations for
Communicating with Children and
Family Caregivers (cont.)
 Communicating with caregivers (cont.)
 To elicit information, it might be useful to compare what is
actually happening with what the parent expects to be
happening
 Each individual in the room, including the health care
provider, might have a different idea about the nature of
the problem
 Provide anticipatory guidance related to normal growth
and development, nurturing childcare practices, and safety
and injury prevention

26. The Nurse’s Role Related to Growth
and Development
 Understanding factors and influences and normal or
expected patterns related to growth and development of
the infant, child, and adolescent
 Talking to the child at his or her level of development
 Teaching and working with family caregivers
 Be aware that the child’s age and stage of growth and
development can affect the way the child copes with the
situation or responds to treatment