This document discusses Erik Erikson's stages of psychosocial development and how they relate to common health issues seen in students visiting the school health office. It covers the stages from birth through late adulthood, outlining key characteristics and health concerns for each developmental period. For example, it notes that ages 3-6 focus on initiative vs guilt, with 7-8 colds per year common due to an immature respiratory system. It provides guidance for talking to children who disclose abuse and statistics on adolescent mental health issues and leading causes of death by age in the US.

1. Considering the Psychosocial
Development of Students Who Visit
the Health Office
By Carol Dietz, RN
School Nurse
Poudre School District

5. Erik Erikson 1902 -1994
Theory of Psychosocial Development

7. Trust vs. Mistrust
Birth to 18 months
Positive resolution = Feelings of trust from environmental support
Negative consequence = Fear of others

8. Autonomy vs. Shame and Doubt
18 months to 3 years
Positive resolution = Self-sufficiency if exploration is encouraged
Negative consequence = Doubts about self, lack of independence

9. Initiative vs. Guilt
3 to 6 years
Positive resolution = Discovery of ways to initiate actions
Negative consequence = Guilt from actions and thoughts
Characteristics for age group
• Egocentrism – the inability to take
others perspective
• Increased curiosity = constant
questioning
• Cooperative play
• Imaginary friends
normal and healthy
• Magical thinking - thoughts assume a
magical power capable of influencing
events
• Inaccurate memory recall
Health Concern
• 7 – 8 colds per year due to immature
respiratory system

10. Most Common Health Problems of Early Childhood
Infectious Diseases
Varicella, Pertussis (Whooping Cough), Measles, Mumps
Prevented by vaccines
Conjunctivitis (pink eye)
Erythema Infectiosum (Fifth Disease)
Scarlet Fever
Poisoning
Non Pharmaceuticals – Personal care products (perfume, aftershave), Cleaning products, Plants, Foreign bodies (toys)
Pharmaceuticals – Analgesics (ibuprofen, pediatric acetaminophen), topicals (diaper care products), cold medicine, vitamins
Child Maltreatment
- Neglect and Abuse

11. Talking with Children Who Reveal Abuse
• Provide a private time and place to talk.
• Do not promise not to tell; tell them that you are required by law to report the
abuse.
• Do not express shock or criticize them or their family.
• Use their vocabulary to discuss body parts.
• Avoid using any leading statements that can distort their report.
• Reassure them that they have done the right thing by telling.
• Tell them that the abuse is not their fault and that are not bad or to blame.
• Determine their immediate need for safety.
• Let the child know what will happen when you report the abuse.
Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of Infants and Children 8th Ed. Mosby, St. Louis.
PSD Mandatory Reporting Requirements for Child Abuse/Neglect
https://eweb.psdschools.org/documentlibrary/downloads/Student_Services/Child_Abuse/Child_
Abuse_Instructions_and_Form.pdf

12. Widening Environmental Influences
“As a socializing agent second only to the family,
the school exerts a profound influence on the social
development of children.”
Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of Infants and Children 8th Ed. Mosby, St. Louis.

13. Industry vs. Inferiority
6 -12 years
Positive resolution = sense of competence
Negative consequence = feelings of inferiority
Characteristics for Age Group
 Less intense emotions
 Interests expand
 Same-sex friendships
Best friends
 Desire for rules/conformity/fairness
Clubs and organized sports
 Eager to build skills
 Eager to participate in meaningful
and socially useful work
Failure to develop a sense of
accomplishment may result in a
sense of inferiority.

14. Common Health Problems of Middle Childhood
Skin lesions and wounds
Bacterial infections
Viral infections
Dental Cavities
Recurrent Abdominal Pain (RAP)
Attention Deficit Hyperactivity Disorder (ADHD)

15. Helping Children in School
• Be supportive – through
companionship share ideas and
thoughts
• Share an interest in reading
• Support and encourage activity
rather than passivity
• Encourage originality
• Foster the development of
hobbies and collections
• Encourage children to wonder
and reflect during free time
• Encourage family experiences and
trips to places of interest
• Encourage questions – help
children discover sources for
information or places in which to
explore and investigate
• Stimulate creative thinking and
problem solving – help children
try out new solutions to problems
without fear of making mistakes
• Be positive – every child should
experience some success each
day
• Use rewards rather than
punishment
Hockenberry, M. & Wilson, D. (2007) Wong’s Nursing Care of
Infants and Children 8th Ed. Mosby, St. Louis.

16. Identity vs. Role Confusion
13 – 21 years
Positive resolution = Awareness of uniqueness of self, knowledge of role to be followed
Negative consequence = Inability to identify appropriate roles in life
Characteristics of Age Group
 Changes in Reproductive hormones
Onset of puberty
 Identity development
 Moral development
 Spiritual development
 Development of autonomy
 Increased sexuality
 Peer group as major influence

17. Adolescent Egocentrism
State of self-absorption in which the
world is viewed from one’s own point of
view.
Makes adolescents highly critical of
authority figures such as parents and
teachers, unwilling to accept criticism,
and quick to find fault with other’s
behavior.
Feldman, R. (2006). Development Across the Lifespan 3rd ed.
Prentice Hall, New Jersey.

18. Imaginary Audience
Fictitious observers who pay as much
attention to the adolescents’ behavior as
adolescents do themselves

19. Personal Fables
 View that what happens to them is
unique, exceptional and shared by no
one else.
 Leads to feelings of invulnerability to
the risks that threaten others.
Feldman, R. (2006). Development Across the Lifespan 3rd ed.
Prentice Hall, New Jersey.

20. 2010 Leading Cause of Death in the United States by Age
National Vital Statistics Reports, Volume 60, Number 4 “Deaths, Preliminary Data for 2010” January 11, 2012
Age 1 - 4 Age 5 -14 Age 15 -24
1. Accidents 1. Accidents 1. Accidents
Motor Vehicle 32% Motor Vehicle 55% Motor Vehicle 60%
Other 68%
falls, drowning, fire
Other 45%
falls, firearms, fire
Other 45%
falls, poisoning, firearms
2. Birth defects 2. Cancer 2. Homicide
3. Homicide 3. Birth defects 3. Suicide
4. Cancer 4. Suicide 4. Cancer
5. Heart disease 5. Homicide 5. Heart disease
6. Influenza, pneumonia 6. Heart disease
7. Chronic lower
respiratory disease
10. Diabetes Mellitus

21. PSD Statistics
• During fall semester of 2010, 166 students
were admitted to PVHS Emergency Services
for psychiatric related emergencies
• During the same time period, 131 PSD
students were admitted to Mountain Crest,
our local psychiatric hospital
• Over the last 10 years, PSD has had 10 student
deaths due to suicide.
Melanie Voegeli-Morris LCSW, Poudre School District, Student Assistance Services Coordinator

22. Early Adulthood
Intimacy vs. Isolation
Age 21 - 39
Positive resolution =
Development of loving
relationships and close
friends
Negative consequence =
Fear of relationships with
others

23. Middle Adulthood
Generativity vs. Stagnation
Age 40 - 65
Positive resolution =
Sense of contribution to
continuity of life
Negative consequence =
Trivialization of one’s
activities

24. Late Adulthood
Ego integrity vs. Despair
Age 65 and older
Positive resolution = Sense of
unity in life’s accomplishments
Negative consequence =
Regret over lost opportunities