Growth and development theory

1. CHILD HEALTH NURSING I
UNIT V
THEORIES OF
GROWTH & DEVELOPMENT

2. Why should you know about your child's growth
and development?
Human life starts from a single ferlized cell. This cell is under constant interaction with
the environment in the mother’s womb and after birth with the outside world. This
interaction leads to the Growth and Development of the child. The increasing of an
organ or limb of the baby, in size and weight is Growth. Division of each cell and their
growing into thousands in number, or their changing tissues, blood or bone, is part of
the process of Development.
The primary purpose of studying the growth and development of children is to
understand them better. As a NURSE, teacher or a parent, you, can manage children
more effectively if you are aware of how they grow and develop in a systematic manner
right from the moment of conception. An orderly pattern is found in the growth of
every organ of the body and area of development.
Although the development process is continuous, the rate or speed of development
varies at different ages of the child. For example, children grow most rapidly during the
first three years of life. In their middle childhood, i.e., from 6 - 12 years, their rate of
growth is comparatively slow whereas it is accelerated again when they approach
adolescence. A knowledge of the trends and patterns of growth and development will
enable you to know how children grow and develop; when and what to expect from
them, how to guide them in each stage and provide the environment for their optimum
development.

3. STAGESOFGROWTH&
DEVELOPMENT

4. STAGES OF GROWTH AND
DEVELOPMENT:-
Prenatal period: Conception to birth, encompassing
the embryonic period (conception to 8 weeks) and the
fetal period(8 weeks -ending in birth).
Newborn(Neonatal) period: from birth to 2 to 4 weeks
Infancy: from 2-4 weeks to one year.
Toddler: from 1-3years ofage.
Early child hood (Preschool): From 3 to 6 years.
Late child hood (School): From the puberty to the
beginning of the adult life is called adolescence.

5. PHYSICALGROWTH&
DEVELOPMENT

6. PHYSICALGROWTH&
DEVELOPMENT
Physical growth &development canbe divided
into 3areas
Biological growth
Motor development
Sensory development

7. BIOLOGICALGROWTH
Changes in general body growth:
Changes results from different rates of growth in
different parts of the body during consecutive stages of
development
eg :- the infants head constitutes 1/4th of the entire
length of the body at birth, where as the adult’s head is
only 1/8th of body length

8. BIOLOGICALGROWTH
Length orheight:
Some children reach adult heights in their early teens,
but others continue to grow throughout late
adolescence.
The periods of rapid growth are infancy &puberty.

9. BIOLOGICALGROWTH
Weight:
 Weight is influenced by all the increments in size &is
probably the best gross index of nutrition &health.
 Obesity may result from a glandular deficiency, but it
is more likely due to over eating to a diet containing
too much starch &fat and too little protein or lack of
exercises.

10. BIOLOGICAL GROWTH
Head circumference:
The circumference of the head is an important
measurement since it is related to intracranial volume.
An increase in circumference permits an estimation of
the rate of brain growth. This measurement has a
relatively narrow normal range of a particular age
group.

11. BIOLOGICALGROWTH
Thoracic diameter:
Chest measurements increase as the child grows &the
shape of the chest changes. At birth the transverse &
anteroposterior diameters are nearly equal. The
transverse diameter increases more rapidly than does
the anteroposterior diameter i.e the width becomes
greater than the depth.

12. BIOLOGICALGROWTH
Abdominal &pelvicmeasurements:
The abdominal circumference is not fixed by a bony
cage as in the chest; consequently it is affected by the
infant’s nutritional state, muscle tone, gaseous
digestion &even the phase of respiration. The pelvic
bi-cristal diameter (the maximal distance between the
external margins of the iliac crest) is not affected by
variations in posture &musculature &is a good index
of a child’s slenderness or stockiness.

13. MOTORDEVELOPMENT
Motor development depends on the maturation of the
muscular, skeletal &nervous systems. The sequences
of skills follow the cephalocaudal &proximal
direction.
Motor development is termed as 1. Gross motor.
2. Fine motor

14. MOTORDEVELOPMENT
Gross motor activities include turning, reaching, sitting,
standing &walking.
Fine motor development is the involvement of reflexes.
The child learns to use hands & fingers for thumb
apposition, palmer grasp, release, pincer grasp and so
on.
Motor development is not affected by sex, geographic
residence, or level of parental education, although
adequate nutrition &good health exert a positive
influence. Motor development varies widely in young
children.

15. SENSORYDEVELOPMENT
The sensory system is functional at birth, the child
gradually learns the process of associating meaning
with a perceived stimuli. As myelination of the
nervous system is achieved, the child is able to
respond tospecific stimuli.

16. THEORIESOFGROWTH&
DEVELOPMENT
TYPES OF THEORIES OF GROWTH &
DEVELOPMENT:
Intellectual development or Jean piaget theory or cognitive
development.
Moral development orJean piaget &Lawrence Kohlberg
theory.
Emotional development or Erik. H Erikson theory or
psychosocial development.
Development of sexuality or Sigmund Freud’s theory or
psycho-sexual theory or development.
Spiritual development or James. W Fowler’s theory.
Language development.
Development of selfconcept.

17. CATEGORIES
Categories of development:
Theoretical foundationsof personality development:
Psycho-sexual development (Freud)
Psycho-social development (Erickson)
Theoretic foundations of mentaldevelopment:
Cognitive development (Piaget)
Language development
Moral development (Kohlberg)
Spiritual development(Fowler’s)
Development of selfconcept:
Body image
Self esteem

27. THEORYOF“LAWRENCEKOHLBERG& JEANPIAGET”:
(Motor development)
Moral development described by Kohlberg(1963) is
based on cognitive developmental therapy &consist of
following three levels.
Kohlberg postulates six stages of potential moral
development organized in three levels.
Pre-conventional morality.
Conventional morality.
Post-conventional morality.

28. Level-1: pre-conventional morality:-
The pre-conventional level of moraldevelopment
parallels the pre-operational level of cognitive
development &intuitivethought.
Culturally oriented to the labels of good/ bad &right/
wrong, children integrate these in terms of physical
pleasurable consequences of their actions.
They avoid punishment &obey without question
The elements of fairness, give &take, and equal
sharing are evident, they are interpreted in a very
practical, concrete manner without loyalty, gratitude
or justice.

29. Stage 0: the good is what I like &want (0-2 years of
age)
The infants & younger toddlers are egocentric, liking
or loving that which helps them and disliking or
hating that which hurts them.
Stage 1:punishment- obedience orientation (2-3
years).
The older toddlers & young pre-school children
believe that if they are not punished, their acts are
right. If they are punished their acts are wrong.
Children therefore, act to avoid displeasing those who
are in power. This is the stage where mothers
repeatedly say“NO-NO”.

30. Stage 2 : Instrumental hedonism and concrete
reciprocity (4 to 7 years of age). Children focus on the
pleasure motive. They consider those actions right that
meet their own needs or those of other. They carry out
rules tosatisfy themselves

31. Level II CONVENTIONALMORALITY
This level corrects the behaviour and the authority, if
the behaviour not acceptable the children feel guilty.
Stage 3: Orientation to interpersonal relations of
mutuality (7 or 8 to 9 years). Children of early school
age are becoming socially sensitive and want to gain
the approvalof others.
If their actions help them gain the approval of their
family, peers, teachers they are right. Disturbed
relationships result their actions arewrong.

32. Stage 4: Maintenance of social order, fixed rules, and
authority (10-12years ofage).
Children want to do what is right and what they
consider to be their duty. They obey rules for their own
sake. Children see justice as reciprocity between the
individuals and the social system.
For example they assume responsibility on the school
safety patrol and when carrying out their duties, show
respect for those in authority. They want to maintain
order among their peers.

33. LEVEL– III POST CONVENTIONAL,AUTONOMOUS,
(OR) PRINCIPLED LEVEL:
Stage 5: Adolescence &adulthood.
Adolescent make choices on the basis of principles that
have been thoughtabout, accepted &internalized.
What ever actions conform to these principles are
considered right inspite of the praise or blame of others.
5(a) : Social contract, utilitarian law makingprespective.
5 (b) : Higher law and conscience orientation. They are
concerned that good laws be created that will maximize the
individual’s welfare. They do not want something without
paying for it, and if they belong to group they work towards
its goal.

34. Stage 6 : Universal ethical principle of orientation.
This is the level of highest moral value, and period in
which individual can motivate, evaluate themselves.
They have reached the level of self-actualization.