pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
CHAPTER 2
Developmental anD
Behavioral ScienceS
mary Jo Gilmer, phD, mBa, rn-Bc, Faan, and
paula chiplis, phD, rn, cpnp
Children have unique minds, bodies, and needs. Careful attention to these differences and
consideration of psychosocial and physical growth are essential in assessing, analyzing, and planning
care for children. In addition, family context and cultural and spiritual dimensions of care affect a
child in a multitude of ways; family dynamics, roles, and values should be a part of each plan of care.
pSYchoSocial, coGnitive, anD ethical-moral
Development
Psychosocial theorists whose frameworks are useful in pediatric health care are presented below.
erikson’s life Stages
Erik Erikson, a developmental psychologist and psychoanalyst, presented a now widely accepted
theory of personality development in 1963. His theory of psychosocial development emphasizes
healthy growth through 8 stages, 5 of which occur in childhood. Through identification of key
conflicts or critical periods in personality development, Erikson described a favorable and
unfavorable aspect of each psychosocial stage (Table 2–1).
pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
,pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
12 PEDIATRIC NURSING REVIEW AND RESOURCE MANUAL, 3RD EDITION
TABLE 2–1.
ERIKSON’S LIFE STAGES
AGE PSYCHOSOCIAL STAGE
Infant (0–12 months) Trust vs. mistrust
Toddler (1–3 years) Autonomy vs. shame, doubt
Preschooler (4–6 years) Initiative vs. guilt
School age (7–12 years) Industry vs. inferiority
Adolescent (13–18 years) Identity vs. role confusion
piaget’s levels of cognitive Development
A well-known theory of cognitive development was described by the Swiss developmental
psychologist Jean Piaget. According to Piaget, cognitive development consists of age-related
changes that occur in an orderly and sequential manner (Table 2–2).
TABLE 2–2.
PIAGET’S LEVELS OF COGNITIVE DEVELOPMENT
AGE COGNITIVESTAGE CHARACTERISTICS
0–2 years Sensorimotor Learns through senses and motor activity. Object
permanence (something exists even when out of sight)
develops and is a basis for stranger anxiety.
2–7 years Preoperational Egocentrism shifts to social awareness, magical thinking,
and animism. Play is essential as a way of understanding
the world and working out experiences.
7–11 years Concrete Understands cause and effect and conservation of
matter.
11–15 years Formal Achieves intellectual thought with abstract thinking and
ability to consider different outcomes.
Through assimilation, children incorporate new knowledge, skills, ideas, and insights into their
familiar cognitive schemas. Through accommodation, children change and organize existing
schemas to solve increasingly difficult tasks.
maslow’s hierarchy of needs
Abraham Maslow theorized that human needs are hierarchical and range from fundamental
physiological needs to higher levels of self-actualization. In prioritizing ways to address child and
family needs, ensure the fundamental needs are met before attempting to address higher-level
needs. The first four needs are basic or “deficiency needs.” Self-actualization is a growth need.
1. Physiological needs include breathing, food, water, sex, sleep, homeostasis, excretion.
2. Safety needs include security of body, employment, resources, morality, family, health, property.
pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
CHAPTER 2
Developmental anD
Behavioral ScienceS
mary Jo Gilmer, phD, mBa, rn-Bc, Faan, and
paula chiplis, phD, rn, cpnp
Children have unique minds, bodies, and needs. Careful attention to these differences and
consideration of psychosocial and physical growth are essential in assessing, analyzing, and planning
care for children. In addition, family context and cultural and spiritual dimensions of care affect a
child in a multitude of ways; family dynamics, roles, and values should be a part of each plan of care.
pSYchoSocial, coGnitive, anD ethical-moral
Development
Psychosocial theorists whose frameworks are useful in pediatric health care are presented below.
erikson’s life Stages
Erik Erikson, a developmental psychologist and psychoanalyst, presented a now widely accepted
theory of personality development in 1963. His theory of psychosocial development emphasizes
healthy growth through 8 stages, 5 of which occur in childhood. Through identification of key
conflicts or critical periods in personality development, Erikson described a favorable and
unfavorable aspect of each psychosocial stage (Table 2–1).
pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
,pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
12 PEDIATRIC NURSING REVIEW AND RESOURCE MANUAL, 3RD EDITION
TABLE 2–1.
ERIKSON’S LIFE STAGES
AGE PSYCHOSOCIAL STAGE
Infant (0–12 months) Trust vs. mistrust
Toddler (1–3 years) Autonomy vs. shame, doubt
Preschooler (4–6 years) Initiative vs. guilt
School age (7–12 years) Industry vs. inferiority
Adolescent (13–18 years) Identity vs. role confusion
piaget’s levels of cognitive Development
A well-known theory of cognitive development was described by the Swiss developmental
psychologist Jean Piaget. According to Piaget, cognitive development consists of age-related
changes that occur in an orderly and sequential manner (Table 2–2).
TABLE 2–2.
PIAGET’S LEVELS OF COGNITIVE DEVELOPMENT
AGE COGNITIVESTAGE CHARACTERISTICS
0–2 years Sensorimotor Learns through senses and motor activity. Object
permanence (something exists even when out of sight)
develops and is a basis for stranger anxiety.
2–7 years Preoperational Egocentrism shifts to social awareness, magical thinking,
and animism. Play is essential as a way of understanding
the world and working out experiences.
7–11 years Concrete Understands cause and effect and conservation of
matter.
11–15 years Formal Achieves intellectual thought with abstract thinking and
ability to consider different outcomes.
Through assimilation, children incorporate new knowledge, skills, ideas, and insights into their
familiar cognitive schemas. Through accommodation, children change and organize existing
schemas to solve increasingly difficult tasks.
maslow’s hierarchy of needs
Abraham Maslow theorized that human needs are hierarchical and range from fundamental
physiological needs to higher levels of self-actualization. In prioritizing ways to address child and
family needs, ensure the fundamental needs are met before attempting to address higher-level
needs. The first four needs are basic or “deficiency needs.” Self-actualization is a growth need.
1. Physiological needs include breathing, food, water, sex, sleep, homeostasis, excretion.
2. Safety needs include security of body, employment, resources, morality, family, health, property.
pediatric-
pediatric-
pediatric-
Developmental
Developmental
Developmental
and Behavioral
and Behavioral
and Behavioral
Sciences
Sciences
Sciences
MaryMary
Jo Gilmer,
Mary
Jo Gilmer,
JoPhD,
Gilmer,
PhD,
MBA,PhD,
MBA,
RN-BC,
MBA,
RN-BC,
FAAN,
RN-BC,
FAAN,
and
FAAN,
Paula
and Paula
and
Chiplis,
Paula
Chiplis,
PhD,
Chiplis,
PhD,
RN,PhD,
CPNP.pdf
RN, CPNP.pdf
RN, CPNP.pd
