Unit 6
Edelman: Ch 15
1. Overview of growth and development
2. Growth
a. Quantifiable change in structure
b. In the body, this change means an increase in the number and/or size of the cells,
resulting in an increase in the size and weight of the whole, or any of its parts
c. During childhood, physical changes in height, weight, and head circumference, or
growth parameters, are measured and charted regularly
d. also refers to the increases (and as we age, decreases) in the size of specific
organs and systems
e. genetic factors, prenatal and postnatal exposures, nutrition, environmental
factors, emotional health as well as traditional cultural practices that influence
childrearing, lifestyle, and health care practices influence growth
3. Growth patterns
a. Growth is not steady throughout life
b. The periods of extremely rapid growth (prenatal, infancy, and adolescence) are
contrasted with slower rates of growth (toddler, preschool,and school-age periods)
c. Different parts of the body increase in size at different rates
d. during early life the head is the fastest growing section (1/4 of length vs 1/9 in
adults), followed by the trunk, and then the arms and legs
4. Growth charts
a. Accurate growth assessment depends on precise measurement of growth
parameters using proper equipment, correct and consistent techniques, careful
plotting of measurements, and thoughtful interpretation of the data
b. Use 2006 WHO growth charts for 0-24months
c. Use 2000 CDC growth charts for 2-20 years
d. growth charts describe weight-for-age, length (or stature)-for-age, weight-for-
length, and BMI-for-age, and include the 5th and 95th and the 3rd and 97th
percentiles
e. a single measurement taken at one point in time, although helpful in providing a
, baseline, does not allow for the best assessment of a child’s growth
f. instead, Serial measurements, plotted on a growth chart over time, best reflect a
child’s pattern of growth
g. Slowed growth, plateaus, or decreases in height, weight, and head circumference,
as well as rapid increases, raise questions for health care providers about the
adequacy of a child’s nutritional intake, syndromes or disease states, neglect, or
emotional problems
5. Concept of development
a. Development refers to gradual change and expansion of ability and advance in
skill from a lower to a more-advanced complexity
b. is a qualitative change, so is more challenging to describe because can’t use units
6. Developmental patterns
a. one stage of development building on and leading to the next
i. early developmental pattern:
1. Cephalocaudal- head to toe (Infants gain neck and head control
before controlling the movements of the extremities)
2. Proximodistal- midline to periphery (Infants’ central nervous
systems develop before peripheral nervous systems)
3. Differentiation- follows a pattern simple to complex, and general
to specific (Infants use a whole-hand grasp before learning the
finer control of the pincer grasp, and they coo or babble before
they speak)
b. Although the sequence of development is predictable, the exact timing of the
sequencing is individual because individuals develop at their own rate, on their
own schedule
c. Denver Developmental Screening Test is a screening tool that assists health care
providers in monitoring children’s development in each of these areas from birth
to 6 years of age
d. Social expectations can influence when developmental tasks are learned, but
cultural expectations can determine which developmental tasks are learned
e. Learning is the process of gaining specific knowledge or skills that result from
, exposure, experience, education, and evaluation
f. Maturation is an increase in competence and adaptability that reflects changes in
the complexity of a structure that makes it possible for that structure to begin to
function or to function at a higher level
g. Learning cannot occur unless the individual is mature enough to understand and
control behavior (toilet training can’t be learned until sphincters have matured)
7. Theories of Development
a. Psychosocial Development Theory (Erik Erikson)
i. development of identity of the self through successive stages that unfold
throughout the life span
ii. based on the need of each person to develop a sense of trust in self and
others and a sense of personal worth
AGE GROUP PSYCHOSOCIAL STAGE LASTING OUTCOMES
1. Infancy Basic trust versus basic mistrust Faith and hope
2. Toddler stage Autonomy versus shame and doubt Self-control and willpower
3. Preschool stage Initiative versus guilt Direction and purpose
4. School age Industry versus inferiority Method and competence
5. Adolescence Identity versus role confusion Devotion and fidelity
6. Young adulthood Intimacy versus isolation Affiliation and love
7. Middle adulthood Generativity versus stagnation Production and care
8. Older adulthood Ego integrity versus despair Renunciation and wisdom
iii. based on critical stages, each requiring resolution of a conflict between
two opposing forces
iv. Each stage depends on the preceding stage, which must be accomplished
successfully for the person to proceed
v. acknowledges the influence of other people and the environment but
maintains that it is ultimately the individual who must master each of the
conflicts
, b. Cognitive Development Theory (Jean Piaget)
i. viewed children as biological organisms interacting with their
environment, and his theory contends that cognitive development reflects
children’s attempts to make sense of their worlds
ii. major criticism of his work is that he underestimated children’s
capabilities and gave little or no consideration for cultural differences
iii. concerned primarily with structure rather than content, with how the mind
works rather than with what it does
iv. Each person is striving to maintain a balance, or equilibrium, between
assimilation and accommodation
v. Through a natural unfolding of ability, the child acquires sequentially
predictable cognitive abilities; given adequate environmental stimuli and
an intact neurological system, the child gradually matures toward full
ability to conceptualize
vi. believed that development preceded learning
STAGE AGE CHARACTERISTICS
Sensorimotor Birth to Begins with a predominance and reliance on reflexes that
2 years permit the body to learn
Reflexes decrease and voluntary acts develop
Imitation predominates
Thought is dominated by physical manipulation of objects and
events
Develops the concept of object permanence and the ability to
form mental representations
Preopera- 2 to 7 Advancing use of language and movement
tional years
Development of egocentric, animistic, and magical thinking
Uses representational thought to interpret and learn, not in
terms of general properties, but in terms of the relationship
Edelman: Ch 15
1. Overview of growth and development
2. Growth
a. Quantifiable change in structure
b. In the body, this change means an increase in the number and/or size of the cells,
resulting in an increase in the size and weight of the whole, or any of its parts
c. During childhood, physical changes in height, weight, and head circumference, or
growth parameters, are measured and charted regularly
d. also refers to the increases (and as we age, decreases) in the size of specific
organs and systems
e. genetic factors, prenatal and postnatal exposures, nutrition, environmental
factors, emotional health as well as traditional cultural practices that influence
childrearing, lifestyle, and health care practices influence growth
3. Growth patterns
a. Growth is not steady throughout life
b. The periods of extremely rapid growth (prenatal, infancy, and adolescence) are
contrasted with slower rates of growth (toddler, preschool,and school-age periods)
c. Different parts of the body increase in size at different rates
d. during early life the head is the fastest growing section (1/4 of length vs 1/9 in
adults), followed by the trunk, and then the arms and legs
4. Growth charts
a. Accurate growth assessment depends on precise measurement of growth
parameters using proper equipment, correct and consistent techniques, careful
plotting of measurements, and thoughtful interpretation of the data
b. Use 2006 WHO growth charts for 0-24months
c. Use 2000 CDC growth charts for 2-20 years
d. growth charts describe weight-for-age, length (or stature)-for-age, weight-for-
length, and BMI-for-age, and include the 5th and 95th and the 3rd and 97th
percentiles
e. a single measurement taken at one point in time, although helpful in providing a
, baseline, does not allow for the best assessment of a child’s growth
f. instead, Serial measurements, plotted on a growth chart over time, best reflect a
child’s pattern of growth
g. Slowed growth, plateaus, or decreases in height, weight, and head circumference,
as well as rapid increases, raise questions for health care providers about the
adequacy of a child’s nutritional intake, syndromes or disease states, neglect, or
emotional problems
5. Concept of development
a. Development refers to gradual change and expansion of ability and advance in
skill from a lower to a more-advanced complexity
b. is a qualitative change, so is more challenging to describe because can’t use units
6. Developmental patterns
a. one stage of development building on and leading to the next
i. early developmental pattern:
1. Cephalocaudal- head to toe (Infants gain neck and head control
before controlling the movements of the extremities)
2. Proximodistal- midline to periphery (Infants’ central nervous
systems develop before peripheral nervous systems)
3. Differentiation- follows a pattern simple to complex, and general
to specific (Infants use a whole-hand grasp before learning the
finer control of the pincer grasp, and they coo or babble before
they speak)
b. Although the sequence of development is predictable, the exact timing of the
sequencing is individual because individuals develop at their own rate, on their
own schedule
c. Denver Developmental Screening Test is a screening tool that assists health care
providers in monitoring children’s development in each of these areas from birth
to 6 years of age
d. Social expectations can influence when developmental tasks are learned, but
cultural expectations can determine which developmental tasks are learned
e. Learning is the process of gaining specific knowledge or skills that result from
, exposure, experience, education, and evaluation
f. Maturation is an increase in competence and adaptability that reflects changes in
the complexity of a structure that makes it possible for that structure to begin to
function or to function at a higher level
g. Learning cannot occur unless the individual is mature enough to understand and
control behavior (toilet training can’t be learned until sphincters have matured)
7. Theories of Development
a. Psychosocial Development Theory (Erik Erikson)
i. development of identity of the self through successive stages that unfold
throughout the life span
ii. based on the need of each person to develop a sense of trust in self and
others and a sense of personal worth
AGE GROUP PSYCHOSOCIAL STAGE LASTING OUTCOMES
1. Infancy Basic trust versus basic mistrust Faith and hope
2. Toddler stage Autonomy versus shame and doubt Self-control and willpower
3. Preschool stage Initiative versus guilt Direction and purpose
4. School age Industry versus inferiority Method and competence
5. Adolescence Identity versus role confusion Devotion and fidelity
6. Young adulthood Intimacy versus isolation Affiliation and love
7. Middle adulthood Generativity versus stagnation Production and care
8. Older adulthood Ego integrity versus despair Renunciation and wisdom
iii. based on critical stages, each requiring resolution of a conflict between
two opposing forces
iv. Each stage depends on the preceding stage, which must be accomplished
successfully for the person to proceed
v. acknowledges the influence of other people and the environment but
maintains that it is ultimately the individual who must master each of the
conflicts
, b. Cognitive Development Theory (Jean Piaget)
i. viewed children as biological organisms interacting with their
environment, and his theory contends that cognitive development reflects
children’s attempts to make sense of their worlds
ii. major criticism of his work is that he underestimated children’s
capabilities and gave little or no consideration for cultural differences
iii. concerned primarily with structure rather than content, with how the mind
works rather than with what it does
iv. Each person is striving to maintain a balance, or equilibrium, between
assimilation and accommodation
v. Through a natural unfolding of ability, the child acquires sequentially
predictable cognitive abilities; given adequate environmental stimuli and
an intact neurological system, the child gradually matures toward full
ability to conceptualize
vi. believed that development preceded learning
STAGE AGE CHARACTERISTICS
Sensorimotor Birth to Begins with a predominance and reliance on reflexes that
2 years permit the body to learn
Reflexes decrease and voluntary acts develop
Imitation predominates
Thought is dominated by physical manipulation of objects and
events
Develops the concept of object permanence and the ability to
form mental representations
Preopera- 2 to 7 Advancing use of language and movement
tional years
Development of egocentric, animistic, and magical thinking
Uses representational thought to interpret and learn, not in
terms of general properties, but in terms of the relationship
