Chapter 21: Developmental Concepts

concrete operational stage

7-12 years -the child can think logically about concrete objects and can thus add and subtract -child understands conversation -7-11 years logical thinking is beginning. Starting to think about other people. Can classify articles/objects according to two of more characteristics -logical thinking**

PRENATAL/INDIVIDUAL/CAREGIVER factors

< 15 and > 35 (moms) may affect or be risk for fetal development. Substance abuse, lack of prenatal care, inadequate nutrition and substance abuse can harm the fetus. TBI, vision/hearing impairments, chronic illness, lead poisoning, substance abuse may affect development.

The pace of growth and development is specific for each person

Both physical and psychological skills and maturation vary among people. Racial variations may also be seen. For example, Asian children tend to be smaller than White children of the same age.

Kohlberg's Moral Development Theory

Kohlberg's preconventional level of moral development is based on external control, as the child learns to conform to rules imposed by authority figures. -follows piaget -cultural, caregiver, communication

instrumental relativist stage

Right and wrong is determined by what we are rewarded for & by doing what others want -any concern for others is motivated by selfishness

universal ethical principle

We now live in accordance with deeply held moral principles which are seen as more important than the laws of the land.

accommodation in development

altering one's existing thought process to manage more complex information

growth definitions

an increase in body size or changes in body cell structure, function, and complexity

what leads to physical and/or psychosocial development in children

child abuse (extreme physical and emotional harm or deprivation)

Cephalocaudal development

head to toe -head and brain first, then trunk, then legs and feet

caregiver factors

mental illness/retardation, learning disabilities

Anal Stage (Freud)

neuromuscular control. Toilet training (8 months to 4 years) -18 months to 3-4 years

what factors are directly related to obesity

nutritional influences -overeating/inactivity -genetics

hereditary definition

passing on of physical or mental characteristics genetically from one generation to another

patients are part of a unit

patients are members of families and that the family unit can have both positive and negative influences on the development of individual members

environment factors

poverty and violence

assimilation definition

process by which a person interprets information to fit the current level of cognition

what to expect from people during difficult times

regression

erickson theory

theory of psychosocial development -based on Freud's work, but includes developmental stages, developmental goals/tasks, psychosocial crises, and the process of coping

what could happen within each stage of development

they may retain behaviors from a previous stage, attain goals of current stage or exhibit behaviors of the next stage

havighurst theory

thoery based on developmental tasks

principle task of anal stage

toilet training

what part of the unconscious mind affects behavior

memories, motives, fantasies, fears

identity v. role confusion

-adolescence -transitions to adulthood. Hormonal changes-mood swings and secondary sex characteristics. Rebellion...Role confusion occurs? Sense of direction.

principles of growth and development

-orderly and sequential -follow regular and predictable trends -differentiated and integrated -aspects of growth occur at different stages and rates (can be modified)

human development

-pattern of movement or change that begins at conception and continues through the life span -includes growth and decline -development can be positive or negative

formal operational stage

12-adult -adolescent can reason abstractly and think in hypothetical terms -12 years + abstract thinking and deductive reasoning. General to specific situations and alternatives are considered. Try to bring meaning -abstract, meaning**

preoperational stage (Piaget)

2-6 years -child uses symbols (words and images) to represent objects but doesn't reason logically -child has the ability to pretend -egocentric -play, increased language**

breakdown of months in the sensorimotor stage

-0-1 month can suck (basic reflexes) -1-4 months-discovers random enjoyment out of behaviors-smiling or thumb sucking -4-8 months-relates one's own behavior to a change in environment ie. Manipulate a spoon to eat. -8-12 months coordinates one thought pattern at a time—keep throwing stuff on floor -12-18 months-understand simple commands-knows about objects even If out of sight -18-24 months: develop reasoning and can anticipate events.

faith definition

(1) spiritual dimensions of a person's life regardless of religious affiliation; (2) confident belief in something for which there is no proof or material evidence

genomics definition

(1) study of the structure and interactions of all genes in the human body, including their interactions with each other as well as the environment; (2) emerging discipline in which genomic information about a person is used in their clinical care (e.g., for diagnostic or therapeutic decision making)

Kohlberg's preconventional level

-At stage 1, punishment and obedience orientation, the motivation for choices of action is the fear of physical consequences of authority's disapproval. As a result of the consequences, a perception of goodness or badness develops. -At stage 2, instrumental relativist orientation, the thought of receiving a reward overcomes fear of punishment, and thus actions that satisfy this desire are selected.

Factors influencing growth and development

-Genetic history (Prenatal, individual, and caregiver factors) -Environment and nutrition -Health-illness state -Culture

Erikson's Theory of Psychosocial Development

-Helps us to understand the whole person. -Understand how life events may influence a person. -May need to look at multiple theories to develop rationales for influence on growth and development. -psychosocial crises, stages of development, developmental goals/tasks

Freud's Theory of Psychoanalytic Development

-Id: "I want to do that now" -Superego: "It's not right to do that" -Ego: "maybe we can compromise" -Libido: pleasure seeking instincts

A nurse is caring for a homeless toddler in a community free health clinic. When developing a plan of care for the child, which of the following factors that affect growth and development should be considered? (Select all that apply.) a)Nutrition b)Caregivers c)Poverty d)Climate e)Social Skills

-Nutrition, caregivers, poverty, and climate are all factors that affect growth and development with regard to the toddler's homeless situation. -As this child is a toddler, social skill is not a factor to be considered at this time and does not affect the growth and development of this child.

parts of preconventional level (Kohlberg)

-Punishment & Obedience -Instrumental- Relativist

postconvential level kohlberg

-The postconventional level of moral development involves moral judgment that is rational and internalized into standards or values. -At stage 5, social contract and utilitarian orientation, correct behavior is defined in terms of society's laws. Laws can be changed, however, to meet society's needs while maintaining respect for self and others. -Stage 6, universal ethical principle orientation, represents the person's concern for equality for all human beings, guided by personal values and standards, regardless of those set by society or laws.Justice maybe internalized at an even higher level than society's level. Few adults ever reach this stage of development. -An individual in this stage of development may believe it acceptable to steal experimental animals in order to save the animals' lives. They believe it to be the moral thing to do even though they are breaking state and federal laws.

After a child plays in the yard, his mother asks him to pick up his toys and put them in the toy bin in the garage. Knowing that he does not want to spend time in his room as a punishment, the child follows his mother's directions. What stage of moral development, according to Kohlberg, is this child demonstrating? a)Preconventional level: stage 1 b)Preconventional level: stage 2 c)Conventional level: stage 3 d)Conventional level: stage 4

-The preconventional level is based on external control as the child learns to conform to rules imposed by authority figures. -At stage 1 (punishment and obedience orientation), the motivation for choices of action is fear of physical consequences of authority's disapproval. -At stage 2 (instrumental relativist orientation), the thought of receiving a reward overcomes fear of punishment, so actions that satisfy this desire are selected. The conventional level involves identifying with significant others and conforming to their expectations.

how to understand the whole person

-Understand how life events may influence a person. May need to look at multiple theories to develop rationales for influence on growth and development.

Growth and development follow regular and predictable trends

-cephalocaudal -proximodistal -symmetric: both sides growing equally

principles of physical development

-cephalocaudal: downwards (head to toe) -proximodistal: outwards (arms and legs, then hands and feet)

Level 2 (Kohlberg)

-conventional morality -stage 3: interpersonal concordance: doing what is right according to majority to be a good boy or girl -stage 4: law and order: doing what is right b/c it is your duty and helps society

concepts of growth and development

-growth: increase in body size or changes in body cell structure, function, and complexity -development: orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning

phallic stage (freud)

-increased interest in gender differences and his/her own gender. Conflict and resolution of that conflict and resolution of conflict with parent of the same sex—intimate sexual possessiveness for the opposite sex parent. Curiosity with genitals and masturbation. (3 to 7 years) Oedipus complex in boys and the Electra complex in girls, based on feelings of intimate sexual possessiveness for the opposite-sex parent) -3 or 4 years to 5-7 years

trust v. mistrust

-infancy -rely on caregivers—meet basic needs warmth, food, and comfort. -Mistrust=/ inconsistent and unsafe care

Piaget's Cognitive Developmental Theory

-infant to adolescence -cognitive development from infancy to adolescence -Learning occurs as a result of the internal organization of an event, forming plan and serving as a base for further schema one grows and develops.

Stages of Erikson's Theory

-infant: (drive & hope) basic trust/basic mistrust -toddler: (self control & will power) autonomy v. shame/doubt -pre-schooler: (direction & purpose) initiative v. guilt -school-age: (method & competence) industry v. inferiority -adolescent: (devotion & fidelity)identity v. role confusion -young adult (affiliation & love): intimacy v. isolation -middle age (production & core): generatively v. stagnation -older adult (wisdom): ego-integrity v. despair

oral stage: Freud

-infants use their mouth as gratification and exploration. Pleasure from biting, chewing, sucking...conflict with weaning. -3 to 18 months

parts of conventional stage of Kohlberg

-interpersonal concordance -law and order

conventional level of kohlberg

-involves identifying with significant others and conforming to their expectations. The person respects the values and ideals of family and friends, regardless of consequences. -In stage 3, "good boy-good girl" orientation, the person strives for approval in an attempt to be viewed as good. -stage 4, law and order orientation, behavior follows social or religious rules from a respect for authority. -In his later work, Kohlberg maintained that many adults are at this stage because they think abstractly and view themselves as members of society.

Ego Integrity vs. Despair

-later adulthood -reminiscence about life events and sense of fulfillment and purpose occurs. -Despair may occur if think life has been a failure

Generativity vs. Stagnation

-middle adulthood -concern for next generation. -Desire to make a contribution to the world. -If not met-self absorbed and regress to meeting only own needs and decreased coping.

Level 3 (Kohlberg)

-postconventional morality -stage 5: social contract or legalistic: doing what is right even if it is against the law b/c the law is too restrictive -stage 6: universal ethical principles: doing what is right b/c of our inner conscious which has absorbed the principles of justice and equality and sacredness of life

preoperational stage broken down

-pre-conceptual 2-4 years -intuitive 4-7 years. Play activities help kid to understand life events and relationships. Increased use of language.

Level 1 (Kohlberg)

-preconventional morality -stage 1: punishment and obedience: doing what is right due to fear of punishment -stage 2: hedonistic: doing what is right for personal gain, perhaps a reward

Levels and ages of Kohlberg's Moral stages

-preconventional: up to age of 9 -Conventional: most adolescents and adults -postconventional: 0-15% over 20s

initiative v. guilt

-preschool -confidence gained as a toddler allows preschooler to take initiative in learning so that the child actively seeks out new experiences and explores the how and why of activities. Attempts new things. -If the child experiences restrictions or reprimands for seeking new experiences and learning, guilt results, and the child hesitates to attempt more challenging skills in motor or language development.

how to address people

-remain flexible and respect uniqueness of each person -Nurse must plan care and be based on patient's general and unique health care needs and revise the plan as growth process evolves.

industry v. inferiority

-school age -finish projects/recognized for accomplishments. -If not meet expectations, self worth is questioned. -SCHOOL Industry versus inferiority is the fourth stage of Erik Erikson's theory of psychosocial development, which happens after the third stage of initiative versus guilt. The stage occurs during childhood between the ages of approximately six and eleven

latency task (freud)

-sex-role identification with parent of the same sex preparing the child for adult roles and development (7 to 12 years) -5-7 years through puberty

genital stage (Freud)

-sexual interest (sexual relationships). Sexual pressure conflicts during adolescence (12 to 20 years) -from puberty on

parts of postconventional stage of Kohlberg

-social contract -universal ethical principle

autonomy v. shame and doubt

-toddler -motor and language skills develop -Toddler learns from environment and gains independence. Is encouraged to dress and feed self. the toddler (ages 1 to 3 years) learns from the environment and gains independence through encouragement from caregivers to feed, dress, and toilet self. -If the caregivers are overprotective or have expectations that are too high, shame and doubt, as well as feelings of inadequacy, may develop in the child.

intimacy v. isolation

-young adulthood -unite with self-identity with identities of friends and make commitments to others. -Fear-isolation and loneliness

sensorimotor stage

0-2 -infant explores the world through direct sensory and motor contact -object permanence and separation anxiety develop during this stage

6 Stages of Moral Development (Kohlberg)

1. obedience 2. self-interest 3. social acceptance 4. law 5. greater good 6. universal ethical principles

frued psychosexual stages

1. oral: the mouth (sucking, swallowing) 2. anal: anus (withholding or expelling feces) 3. phallic: penis or clit (masturbation) 4. latent: little or no sexual motivation 5. genital: penis or vagina (sexual intercourse)

A nurse is assessing children using Kohlberg's theory of moral development. What are examples of milestones achieved in the preconventional level of this theory? (Select all that apply.) a)The child learns to follow parent's rules. b)The child identifies with family members and conforms to their expectations. c)The child is motivated by punishment for not conforming to rules. d)The child strives for approval in an attempt to be viewed as "good. e)The child develops moral judgment that is rational and internalized into self. f)The child develops a perception of goodness or badness.

A, C, F -In Kohlberg's preconventional level the child learns to follow parent's rules, is motivated by punishment for not conforming to rules, and develops a perception of goodness or badness. -The conventional stage would be represented by the child identifying with family members and conforming to their expectations. The conventional stage would also be represented by the child striving for approval in an attempt to be viewed as "good". -The postconventional stage is represented by the child developing moral judgment that is rational and internalized into self

According to Sigmund Freud's theory of development, which of the following infants is most likely to be experiencing a significant conflict in his or her development? a)An infant whose mother is weaning him in order to facilitate her return to work b)A baby boy who is being raised by a single mother and who has minimal contact with adult males c)An infant who is in daycare 3 mornings per week d)A baby whose impoverished mother is unable to afford nutritious food

A. Freud's theory of development characterizes the stage from birth through 18 months as the oral stage. Consequently, the changes in sucking behavior that accompany weaning are a major conflict. This event is considered to be more developmentally significant than contact with the opposite sex, temporary separation from the mother or deficits in nutrition

Which one of the following developmental theorists expanded the work of Freud to include cultural and social influences in addition to biologic processes? A. Erikson B. Galligan C. Freud D. Piaget

A. Erikson

growth and development are orderly and sequential and continuous and complex

All humans experience the same growth patterns and developmental levels.. Within each developmental level, certain milestones can be identified. For example, the timing of when the infant rolls over, crawls, walks, or talks is fairly predictable.

Growth and development are both differentiated and integrated

As nerve pathways develop, they become more specialized, allowing the growing child to respond to different stimuli. Throughout the lifespan, each new learned ability builds on previously learned abilities so that increasingly complex tasks can be accomplished. For example, the toddler learning to use a spoon combines motor skills, hand-eye coordination, cognitive patterning, and social imitation from watching others. As children grow and develop, the task of learning to use a spoon becomes basic, forming the foundation for learning skills requiring more manual dexterity.

A nurse is caring for a toddler in a pediatric clinic. Based on the age of the child, the nurse understands the child should be in Piaget's Preoperational stage. Which of the following activities should the nurse anticipate observing in this stage? a)The child rolls a ball. b)The child rides a broom like a horse. c)The child uses trial and error to solve puzzles. d)The child can classify marbles by size and color.

B. Symbols -Piaget's Preoperational stage involves the use of symbols to represent the child's environment. -An example includes the child riding a broom like it is a horse. Another example would include the child dressing up like mom or dad. -The child rolling a ball would be an example of the Sensorimotor stage. -The use of trial and error to solve puzzles is a higher level skill. This represents the Formal Operational stage. -Classifying marbles by size and color is an example of Concrete Operational stage.

Which component of Freud's theory is the part of the mind that serves as a mediator between a person's desires and the constraints of reality? A. The unconscious mind B. The id C. The ego D. The superego

C. The ego The ego is the conscious part of the mind that serves as a mediator between the desires of the id and the constraints of reality so that one might live within one's social, physical, and psychological environment.

comparing Erickson & Freud

Erickson: psychoSOCIAL, entire lifespan, 8 stages Freud: psychoSEXUAL, 0-5 years, 5 stages

Different aspects of growth and development occur at different stages and at different rates, and can be modified

Muscles and bones both grow most rapidly during the first year of life. Toddler/preschool years, bone growth slows, but muscle fibers increase in size and strength. The most intense period of speech development is between 3 and 5 years of age. Sexual maturity begins during the preadolescent years and progresses into the adult years, but is based on gender and sex role identity established from birth.

Human Genome Project (HGP)

National and international research project to help map 20,000-25,000 genes in the human chromosomes. Data hope to provide information about tests, diagnosis and treatment of certain genetic disorders.

genetic heredity

Our characteristics come from our parents, genetic-23 pairs of chromosomes help determine our differentiation (height, bone size, and eye and hair color)_certain diseases (cancer and diabetes also have a heredity factor).

A 2-year-old grabs a handful of cake from the table and stuffs it in his mouth. According to Freud, what part of the mind is the child satisfying? a. Id b. Superego c. Ego d. Unconscious mind

a

A nurse caring for older adults in a long-term care facility encourages an older adult to reminisce about past life events. This life review, according to Erikson, is demonstrating what developmental stage of the later adult years? a. Ego integrity b. Generativity c. Intimacy d. Initiative

a

A school nurse is studying Kohlberg's theory of moral development to prepare a parent discussion addressing the problem of bullying. According to Kohlberg, which factor initially influences the moral development of children? a. Parent/caregiver-child communications b. Societal rules and regulations c. Social and religious rules d. A person's beliefs and values

a

A nurse researcher studies the effects of genomics on current nursing practice. Which statements identify genetic principles that will challenge nurses to integrate genomics in their research, education, and practice? Select all that apply. a. Genetic tests plus family history tools have the potential to identify people at risk for diseases. b. Pharmacogenetic tests can determine if a patient is likely to have a strong therapeutic response to a drug or suffer adverse reactions from the medication. c. Evidence-based review panels are in place to evaluate the possible risks and benefits related to genetic testing. d. Valid and reliable national data are available to establish baseline measures and track progress toward targets. e. Genetic variation can either accelerate or slow the metabolism of many drugs. f. It is beyond the role of the nurse to answer questions and discuss the impact of genetic findings on health and illness.

a, b, e

The nurse caring for infants in a hospital nursery knows that newborns continue to grow and develop according to individual growth patterns and developmental levels. Which terms describe these patterns? Select all that apply. a. Orderly b. Simple c. Sequential d. Unpredictable e. Differentiated f. Integrated

a, c, e, f

A nurse is teaching parents of preschoolers what type of behavior to expect from their children based on developmental theories. Which statements describe this stage of development? Select all that apply. a. According to Freud, the child is in the phallic stage. b. According to Erikson, the child is in the trust versus mistrust stage. c. According to Havighurst, the child is learning to get along with others. d. According to Fowler, the child imitates religious behavior of others. e. According to Kohlberg, the child defines satisfying acts as right. f. According to Havighurst, the child is achieving gender-specific roles.

a, d, e

accommodation definition

ability to adjust the eye to see at various distances; (2) process by which intellectual acts are changed to handle increasingly complex information

genome definition

all the DNA in an organism, including its genes

when does assimilation occur (Piaget)

as one grows and develops -integrate new experiences into existing schemata

interpersonal concordance

being good is what pleases others. the child adopts a conformist attitude to morality -right and wrong are determined by the majority

law and order

being good means doing your duty to society. Obey laws without question and show a respect for authority. most adults do not progress past this stage

A nurse examining a toddler in a pediatric office documents that the child is in the 90th percentile for height and weight and has blue eyes. These physical characteristics are primarily determined by which of the following? A. Socialization with caregivers B. Maternal nutrition during pregnancy C. Genetic information on chromosomes D. Meeting developmental tasks

c

A nurse is interviewing a 42-year-old patient who is visiting an internist for a blood pressure screening. The patient states: "I'm currently a sales associate, but I'm considering a different career and I'm a little anxious about the process." According to Levinson, what phase of adult life is this patient experiencing? a. Entering the adult world b. Settling down c. Midlife transition d. Entering middle-adulthood

c

A nurse who is working with women in a drop-in shelter studies Carol Gilligan's theory of morality in women to use when planning care. According to Gilligan, what is the motivation for female morality? a. Law and justice b. Obligations and rights c. Response and care d. Order and selfishness

c

various stages of development

cognitive, psychosocial, moral, spiritual

gilligan theory

conception of morality from the female viewpoint

Id defintion

concerned with self gratification easy and quickest way-defense mechanisms are used to cope in reducing stress if id's impulses cannot be satisfied

Ego definition

conscious part of mind that serves as a mediator b/t desires of id and constraints of reality so one can function in life.

The school nurse uses the principles and theories of growth and development when planning programs for high school students. According to Havighurst, what is a developmental task for this age group? a. Finding a congenial social group b. Developing a conscience, morality, and a scale of values c. Achieving personal independence d. Achieving a masculine or feminine gender role

d

Proximodistal development

gross to fine motor movement -both sides equally grow

what has a strong effect on development

environmental and cultural influences

what shapes experiences with caregivers

environmental factors like psychological and social contact through positive and negative experiences with the caregivers

epigenomics

epigenetic changes that occur in many genes or the entire organism

what is linked to nutritional and emotional deprivation?

failure to thrive (condition of early infancy)

libido definition

general pleasure seeking instincts rather than pure genital gratification

principle task of genital stage

genital intercourse

Development definition

increase in the complexity of function and progression to skill advancement

what can substance abuse by adolescents and young adults cause

increased incidence of teen pregnancy, violence, accidents, suicide

development is always _______

individualized -wide variation is considered normal

what can lead to the development of fewer brain cells in infants

infants who are malnourished in utero compared to those with adequate prenatal nutrition

moral development definition

influence of cultural effects on one's perceptions of justice in interpersonal relationships

what shapes moral, cognitives, and spiritual development?

interactions with families, school, communities, health influence, culture

superego definition

internalization of rules (developed during first year of life) so that socially acceptable behaviors are practiced.

principle task of latent stage

learning

cognitive development definition

learning that occurs as a result of the internal organization of an event, which forms a mental schema (plan) and serves as a base for further schemata as one grows and develops (Piaget's theory of cognitive development)

what affects growth

love, affection, nutrition, race, and illness

punishment and obedience stage

right & wrong defined by what they get punished for. If you get told off for stealing then stealing is wrong

social contract

right and wrong determined by personal values, although they can be over-ridden by democratically agreed laws -when laws infringe our own sense of justice we can choose to ignore them

principle task of phallic stage

sexual identity

underlying drive for human behavior

sexuality (libido)

developmental pace is ______ for each person

specific and individualized

what development is most intense

speech -bones grow a lot in the beginning, muscle fibers grow next

Epigenetics definition

study of the changes that occur in organisms due to modification of gene expression and hereditability

what increases the risk for congenital anomalies, low birth weight, and prematurity in developing fetus

substance abuse by a pregnant woman

what environmental challenges can compound the effects of poor nutrition

substandard housing or inadequate medical care

developmental tasks definition

successful achievement of psychomotor, psychosocial, or cognitive skills at certain periods in life; failure to obtain the developmental task can lead to unhappiness and difficulty with later tasks

when is alcohol/ drug abuse more likely in teens

teens who have poor family relationships, low self-esteem, poor social skills

gould theory

theory based on specific beliefs and developmental phases

vinson theory

theory based on the organizing concepts of individual life structure

piaget theory

theory of cognitive development

fowler theory

theory of faith development

kohlberg theory

theory of moral development

freud theory

theory of psychoanalytic development

principle task of oral stage

weaning

what is physical development influenced by

what has been inherited and carried through chromosomes