The document summarizes several theories of human growth and development: - Erik Erikson's psychosocial development theory which describes development through 8 stages from infancy to late adulthood. Each stage involves resolving a psychosocial crisis. - Jean Piaget's cognitive development theory which outlines 4 stages of cognitive development from infancy through adulthood. - Lawrence Kohlberg's theory of moral development which describes development through 3 levels and 6 stages of increasingly sophisticated moral reasoning. - Sigmund Freud's psychosexual development theory which proposes that personality develops through 5 psychosexual stages from infancy to young adulthood, each focused on pleasure in a different erogenous zone.

1. THEORIES
OF
GROWTH
AND DEVELOPMENT
By NK
Bsc (Hons) Nursing

2. Objectives
In the end of the presentation, students will be able to :-
 Enlist the different types of theories of growth and development.
 Describe the Erik Erikson’s psychosocial development theory and its stages.
• Enumerate the nursing interventions which can help the child to achieve the psychosocial
development successfully.
 Discuss the Jean Piaget’s cognitive development theory and its important concepts.
• Describe all the stages of Cognitive development theory.
 Discuss the Lawrence Kohlberg’s moral development theory.
• Describe the different levels and stages of Moral development theory.
 Discuss the Sigmund Freud’s psychosexual development theory and its various components.
• Describe all the stages of Psychosexual development theory.

4. ERIK ERIKSON
PSYCHOSOCIAL
DEVELOPMENT

5. THEORY
• It describes the human life cycle as a series of 8 ego developmental
stages from birth to death.
• Each stage presents a psychosocial crisis, the goal of which is to
integrate physical, maturation and societal demands.
• Result of one stage may not be permanent, but can be changed by
experience(s) later in life.
• It focuses on psychosocial tasks that are accomplished throughout the
life cycle.
Psychosocial development occurs through a life long series of crisis
affected by social and cultural factors.

6. STAGE 1
• AGE – infancy, birth to 18 months
• PSYCHOSOCIAL CRISIS – Trust vs mistrust
• TASK – Attachment to the mother
• VIRTUE – Hope
• SUCCESSFUL RESOLUTION OF CRISIS – trust in persons; faith and
hope about the environment and future
• UNSUCCESSFUL RESOLUTION OF CRISIS – General difficulties
relating to persons effectively suspicion, trust-fear conflict, fear of the
future.

7. STAGE 2
• AGE – Toddler – 18 months to 3 yr
• PSYCHOSOCIAL CRISIS – Autonomy vs shame and doubt
• TASK – Gaining some basic control over self and environment
• VIRTUE - Will
• SUCCESSFUL RESOLUTION OF CRISIS – Sense of self-control and
adequacy willpower
• UNSUCCESSFUL RESOLUTION OF CRISIS – Independence-fear
conflict, severe feelings of self- doubt.

8. STAGE 3
• AGE – Preshooler, 3-6 yr
• PSYCHOSOCIAL CRISIS – Initiative vs guilt
• TASK – Becoming purposeful and directive
• VIRTUE - Purpose
• SUCCESSFUL RESOLUTION OF CRISIS – Ability to initiate one’s own
activities; sense of purpose.
• UNSUCCESSFUL RESOLUTION OF CRISIS – aggression-fear
conflict, sense of inadequacy or guilt

9. STAGE 4
• AGE – School age, 6-12 yr
• PSYCHOSOCIAL CRISIS – Industry vs inferiority
• TASK – Developing social, physical and learning skills
• VIRTUE - Competency
• SUCCESSFUL RESOLUTION OF CRISIS – Competence, ability to
learn and work
• UNSUCCESSFUL RESOLUTION OF CRISIS – Sense of inferiority,
difficulty learning and working

10. STAGE 5
• AGE – Adolescence, 12-20 yr
• PSYCHOSOCIAL CRISIS – Identity vs role confusion
• TASK – Developing sense of identity
• VIRTUE - Fidelity
• SUCCESSFUL RESOLUTION OF CRISIS – Sense of personal identity
• UNSUCCESSFUL RESOLUTION OF CRISIS – Confusion about who
one is; identity submerged in relationship[s or group memberships

11. STAGE 6
• AGE – Early adulthood, 20 to 35 yr
• PSYCHOSOCIAL CRISIS – Intimacy vs isolaton
• TASK – Establishing intimate bounds of love and friendship
• VIRTUE - Love
• SUCCESSFUL RESOLUTION OF CRISIS – Ability to love deeply and
commit oneself.
• UNSUCCESSFUL RESOLUTION OF CRISIS – Emotional isolation,
egocentricit

12. STAGE 7
• AGE – Middle adulthood, 35 to 65 yr
• PSYCHOSOCIAL CRISIS – Generativity vs stagnation
• TASK – fulfilling life goals that involve family, career, and society
• VIRTUE - Care
• SUCCESSFUL RESOLUTION OF CRISIS – Ability to give and care for
others
• UNSUCCESSFUL RESOLUTION OF CRISIS – Self-absorption;
inability to grow as a person

13. STAGE 8
• AGE – Late adulthood, 65 yr to death
• PSYCHOSOCIAL CRISIS – Integrity vs despair
• TASK – Looking back over one’s life and accepting its meaning
• VIRTUE - Wisdom
• SUCCESSFUL RESOLUTION OF CRISIS – Sense of integrity and
fulfillment
• UNSUCCESSFUL RESOLUTION OF CRISIS – Dissatisfaction with life

14. Nursing Interventions to assist the client in
achieving Erikson’s stages of development
Infancy
• Hold the infant often.
• Offer comfort after painful procedures.
• Meet the infant’s needs for food and hygiene.
• Encourage parents to room in while hospitalised.
Toddler
• Allow self-feeding opportunities
• Encourage child to remove and put on own clothes
• Allow for choice

15. Cont..
Preschooler
• Offer medical equipment for play
• Accept the child’s choices and expressions of feelings
School age
• Encourage the child to continue schoolwork while hospitalised
• Encourage the child to bring favorite pastimes to the hospital
Adolescence
• Take the health history and perform examinations without parents present
• Introduce the adolescent to other teens with the same health condition

16. Cont..
Early adulthood
• Include support from client’s partner or significant other
• Assist with rehabilitation and contacting support services as needed before
returning to work
Middle adulthood
• Assist in choosing creative ways to foster social development
• Encourage volunteer activities
Late adulthood
• Listen attentively to reminiscent stories about his or her life’s accomplishments
• Assist with making changes to living arrangements

17. Jean Piaget
COGNITIVE
DEVELOPMENT

18. THEORY
• It defines cognitive acts as ways in which the mind organize and
adapts to its environment (i.e., mental mapping).
Important concepts :-
SCHEMA – refers to an individual’s cognitive structure or framework of
thought.
SCHEMATA – Categories that an individual forms in his or her mind to
organise and understand the world.
o A young child has only a few schemata which gradually increased.
Adults use a wide variety of schemata.

19. Cont..
ASSIMILATION – Ability to incorporate new ideas, objects and
experiences into the framework of one’s thoughts.
o Growing child will perceive and give meaning to new information
according to what is already known and understood.
ACCOMMODATION – Ability to change a schema to introduce new
ideas, objects or experiences. Changes the mental structure so that
new experiences can be added.
EQUILIBRATION – A mechanism to achieve a balance between
applying previous knowledge (assimilation) and changing behaviour to
account for new knowledge (accommodation).

20. Stage 1 – SENSORIMOTOR STAGE
• AGE – birth to 2 yr
• Development proceeds from reflex activity to imagining and solving
problems through the senses and movement.
• Infant or toddler learns about reality and how it works.
• Infant or toddler does not recognize that objects continue to be in
existence, even if out of the visual field.

21. Stage 2 – PREOPERATIONAL STAGE
• AGE – 2 to 7 yr
• Child learns to think in terms of past, present and future.
• Child moves from knowing the world through sensation and movement
to pre-logical thinking and finding solutions to problems.
• Child is egocentric
• Child is unable to conceptualize and requires concrete examples.

22. Stage 3 – CONCRETE OPERATIONAL
STAGE
• AGE – 7-11 YR
• Child is able to classify, order and sort facts.
• Child moves from pre-logical thought to solving concrete problems
through logic.
• Child begins to develop abstract thinking.

23. Stage 4 – FORMAL OPERATIONAL STAGE
• AGE – 11 yr to adulthood
• Person is able to think abstractly and logically.
• Logical thinking is expanded to include solving abstract and concrete
problems.

24. Lawrence Kohlberg
MORAL
DEVELOPMENT

25. THEORY
• Moral development is a complicated process involving the acceptance
of the values and rules of society in a way that shapes behaviour.
• Classified in a series of levels and behaviors.
• Is sequential but people do not automatically go from 1 stage or level
to the next as they mature.
• Stages or levels of moral development cannot be skipped.

26. LEVEL 1 – PRECONVENTIONAL
MORALITY
Age :–
birth to 2 yr
Stage 0
Age :–
2 to 4 yr
Stage 1
Age :–
4 to 7 yr
Stage 2

27. STAGE 0 – EGOCENTRIC JUDGEMENT
• The infant has no awareness of right or wrong.
STAGE 1 – PUNISHMENT-PBEDIENCE ORIENTATION
• At this stage, children cannot reason as mature members of society. Children view
the world in a selfish way, with no real understanding of right or wrong.
• Child obeys riles and demonstrations acceptable behaviour to avoid punishment
and to avoid displeasing those who are in power, and because the child fears
punishment from a superior force, such as a parent.
• A toddler typically is at the first substage of the preconventional stage, involving
punishment and obedience orientation, in which the toddler makes judgements
based on avoiding punishment or obtaining a reward.

28. • Physical punishment and with holding privileges tend to give the toddler a negative
view of morals.
• Withdrawing love and affection as punishment leads to feelings of guilt in the toddler.
• Appropriate discipline includes providing simple explanations of why certain
behaviors are unacceptable, praising appropriate behavior, and using distractions
when the toddler is headed for an unsafe action.
STAGE 2 – INSTRUMENTAL RELATIVIST ORIENTATION
• Child conforms to rules to obtain rewards or have favors returned. Child’s moral
standards are those of others, and child observes them either to avoid punishment or
obtain rewards.
• Preschooler is in preconventional stage of moral development.
• In this stage, conscience merges and the emphasis is on external control.

29. LEVEL 2 – CONVENTIONAL
MORALITY
• The child conforms to rules to please others. Has increased awareness of
others’ feelings.
• A concern for social order begins to emerge. A child views good behaviour
as that which those in authority will approve.
• If the behaviour is not acceptable, the child feels guilty.
Stage 3 • Age :- 7 to 10 yr
Stage 4 • Age :– 10 to 12 yr

30. STAGE 3 – GOOD BOY OR NICE GIRL ORIENTATION
• Conformity occurs to avoid disapproval or dislike by others.
• Involves living up to what is expected by individuals close to the child or what
individuals generally expect of others in their roles such as daughter, son, brother,
sister & friend.
• Being good is important and is interpreted as having good motives and showing
concern about others. Being good also means maintain mutual relationships, such
as trust, loyalty, respect and gratitude.
STAGE 4 – LAW AND ORDER ORIENTATION
• Child has more concern with society as a whole. Emphasis is on obeying laws to
maintain social order. Moral reasoning develops as the child shifts focus of living to
society.
• School-age child is at the conventional level of the conformity stage and has an
increased desire to please others.
• Child observes and to some extent internalizes the standards of others. Wants to
be considered “good” by those individuals whose opinions matter to her or him.

31. LEVEL 3 – POSTCONVENTIONAL
MORALITY
• The individual focuses on individual rights and principles of
conscience.
• The focus is on concerns regarding what is best for all.
Age ;-
Adulthood
Stage 5
Stage 6

32. STAGE 5 – SOCIAL CONTRACT AND LEGALISTIC ORIENTATION
• Person is aware that others hold a variety of values and opinions and that most
values and rules are relative to the group.
• The adolescent gives and takes and does not expect to get something without
paying for it.
STAGE 6 – UNIVERSAL ETHICAL PRINCIPLES ORIENTATION
• Conformity is based on universal principles of justice and occurs to avoid self-
condemnation.
• Involves following self chosen ethical principles.
o Development occurs in adolescent at about 13 yr of age, marked by development
of an individual conscience & a defined set of moral values.
o Adolescent can now acknowledge a conflict between 2 socially accepted
standards and try to decide between them,
o Control of conduct is now internal in standards observed & in reasoning about
right and wrong.

33. Sigmund Freud
PSYCHOSEXUAL
DEVELOPMENT

34. THEORY
COMPONENTS OF THE THEORY :-
1. Levels of awareness
2. Agencies of the mind
3. Concept of anxiety and defense mechanisms
4. Psychosexual stages of development

35. Levels of awareness
UNCONSCIOUS LEVEL OF AWARENESS
• Unconscious is not logical and is governed buy the Pleasure Principle, which refers to
seeking immediate tension reduction.
• Memories, feelings, thoughts or wishes are repressed and are not available to the
conscious mind.
• These repressed memories, thoughts or feelings, if made prematurely conscious, can cause
anxiety.
PRECONSCIOUS LEVEL OF AWARENESS
• The Preconscious is called the subconscious.
• Includes experiences, thoughts, feelings or desires that might not being immediate
awareness but can be recalled to consciousness.
• Can help to repress unpleasant thoughts or feelings and can examine and censor certain
wishes and thinking.

36. Cont..
CONSCIOUS LEVEL OF AWARENESS
• Conscious mind is logical and is regulated by the Reality Principle.
• Includes all experiences that are within an individual’s awareness and that the
individual is able to control and includes all information that is remembered easily and
is immediately available to an individual.

37. Agencies of the mind
THE ID
• Source of all drives, present at birth, operates according to the Pleasure
Principle.
• Does not tolerate uncomfortable states and seeks to discharge the tension and
return to a more comfortable constant level of energy.
• Acts immediately in an impulsive, irrational way and pays no attention to the
consequences of its actions, therefore, often behaves in ways harmful to self
and others
• Primary process is a psychological activity in which the id attempts to reduce
tension – not capable, therefore, a secondary psychological process must
develop if the individual is to survive. When this occurs, the structure of
second system of the personality, the ego, begins to take form.

38. Cont..
THE EGO
• Functions include reality testing and problem solving follows the Reality
Principle
• Begins its development during the fourth or fifth month of life
• Emerges out of the id and acts as an intermediary between id and external
world.
• Emerges because the needs, wishes & demands of id require appropriate
exchanges with the outside world of reality.
• The ego distinguishes between things in the mind and things in the external
world.

39. Cont..
THE SUPEREGO
• Necessary part of socialization that develops during the phallic stage at 3 to 6
yr of age
• Develops from interactions with the child’s parents during the extended
period of childhood dependency
• Includes internalization of the values, ideals, & moral standards of parents
and society
• Consists of the conscience and the ego ideal.
• Conscience refers to capacity for self evaluation and criticism, when moral
codes are violated, the conscience punishes the individual by instilling guilt.

40. Anxiety and defense mechanisms
• Ego develops defences or defense mechanisms to fight off anxiety
• Defense mechanisms operate on an unconscious level, except for
suppression, so the individual is not aware of their operation.
• Defense mechanisms deny, falsify or distort reality to make it less
threatening.
• An individual cannot survive without defense mechanisms, however, if
the individual becomes too extreme in distorting reality, interference
with healthy adjustment and personal growth may occur.

41. Psychosexual stages of development
• Human development proceeds through a series of stages from infancy
to adulthood
• Each stage is characterized by the inborn tendency of all individuals to
reduce tension and seek pleasure.
• Each stage is associated with a particular conflict that must be
resolved before the child can move successfully to the next stage.
• Experiences during the early stages determine an individual’s
adjustment patterns and the personality traits that the individual has as
an adult.

42. Stage 1 – ORAL STAGE
• AGE – Birth to 1yr
• During this stage, the infant is concerned with self-gratification.
• The infant is all id, operating on the Pleasure Principle and striving for
immediate gratification of needs.
• When the infant experiences gratification of basic needs, a sense of
trust and security begins.
• The ego begins to emerge as the infant begins to see self as separate
from the mother; this marks the beginning of the development of a
sense of self.

43. Stage 2 – ANAL STAGE
• AGE - 1 to 3 yr
• Toilet training occurs during this period, and the child gains pleasure
from the elimination of the feces and from their retention.
• The conflict of this stage is between those demands from society and
the parents and the sensations of pleasure associated with the anus,
• The child begins to gain a sense of control over instinctive drives and
learns to delay immediate gratification to gain a future goal.

44. Stage 3 – PHALLIC STAGE
• AGE – 3 TO 6 Yr
• The child experiences pleasurable and conflicting feelings associated with the genital
organs.
• The pleasures of masturbation and the fantasy life of children set the stage for the
Oedipus complex.
• The child’s unconscious sexual attraction to and wish to possess the parent of the
opposite sex, the hostility and desire to remove the parent of the same sex, and the
subsequent guilt about these wishes is the conflict the child faces.
• The conflict is resolves when the child identifies with the parent of the same sex.
• The emergence of the superego is the solution to and the result of these intense
impulses.

45. Stage 4 – LATENCY STAGE
• AGE – 6 to 12 yr
• Tapering off of conscious biological and sexual urges.
• The sexual impulses are channelled and elevated into a more culturally
accepted level of activity
• Growth of ego functions and the ability to care about and relate to
others outside the home is the task of this stage of development.

46. Stage 5 – GENITAL STAGE
• AGE – 12 yr and beyond
• It emerges at adolescence with the onset of puberty, when the genital
organs mature.
• The individual gains gratification from his or her own body.
• During this stage, the individual develops satisfying sexual and
emotional relationships with members of the opposite sex.
• The individual plans life goals and gains a strong sense of personal
identity.