NURSING 379 TEST ONE Growth & Development

Preparing the caregiver for the child's next stage or growth and development needs; anticipating and preventing problems before they arise

Therapeutic care to eliminate or reduce psychological or physical stress.

Injuries: More than 20,000 children die from their injuries each year.

• Describes the prevalence of a specific illness in the population at a particular time.
• Includes: acute illness, chronic disease, and disability

Individuals who are joined together by marriage, blood, adoption or reside in the same household

Mom, Dad, and children

Mom, Dad and children from a previous marriage or adoption.

one or both parents, and another relative (usually grandparents). Could also be if a relative lives very close.

Mom, Dad, and children that belong to other families (step-children).

People living together, but involved in other families.

Two or more families living together (related or not)

Previous marriage or adoption

A married couple with no children

• Families with Infants
• -Integrates infants into family unit
• -Accommodate to new parenting and grand-parenting roles
• -Maintain marital bonds with increases stress.
• -Young families children < 3 y.o.

• Families with Preschoolers
• -Socialize children
• -Parents and children adjust to separation
• -Children usually 3-6 y.o.

• Families with School Agers
• -Children develop peer relations
• -Parents adjust to their children's peer and school influences
• -If the woman didn't work she would start back now.
• -Children 7-12 y.o.

• Families with Teenagers
• -Adolescents develop increasing autonomy
• -Parents refocus on midlife marital and career issues
• - Parents begin a shift toward concern for older generations (parents getting older)
• -Highest marital stres
• -Children 13-18 y.o.

• Launching-Giving children off
• -Children move out of the house and attend college
• -Marital satisfaction increases.

• Interdependence of family members
• Any change or stressor experienced by one or more members effects the entire family.
• OPEN-Family seeks information and resources to solve difficulties
• CLOSED- Family views support and resources as a threat
• These response effect "Family Adaptability"

• There are many stressors in a family
• -Positive (Birth)
• -Unexpected (Car Accident)
• -Negative (Financia, Illness)
• -Cumulative (Moving, Leukemia)
• -Come from Many sources
• Stressors can lead to a change as to how members interact.

• Social Competence-empathy and caring
• Competence in communication
• Ability to problem solve
• Flexibility but maintain commitment to family
• Sense of purpose and belief in a positive outcome
• Supportive relationships and connectedness with others outside of the family

• A-Adaptation
• P-Partnership
• G-Growth
• A-Affection
• R-Resolve (commitment)
• Higher score, Higher degree of satisfaction

• 1. The family at the center
• 2. Family-Professional collaboration
• 3. Family-Professional communication
• 4. Cultural Diversity of Families
• 5. coping Differences and supports
• 6. Family-Centered peer support
• 7. Specialized Service and Support Systems
• 8. Holistic Perspective of Family-Centered care

• Family of origin
• Family unit into which one is born

• Affinal-Family of Procreation
• Family of marital relationships

• *The family is the constant in the child's life
• *Family at the center in policy and Practice
• *Family-Proffessional Communication
• *Family-Professional Collaboration
• *Recognition and adaptation for cultural needs
• *Recognition and respect for coping differences
• *Facilitation of peer support
• *Specialized services and support systems for children and families
• *Meeting holistic needs of children and their families

• TRUST Vs. MISTRUST (Birth-1year)
• Trust in someone or something (needs get met shortly after cry)
• Mistrust develops when basic needs are not consistently met

• AUTONOMY Vs. SHAME AND DOUBT (1-3 y.o.)
• The focus is on the ability to control their bodies, themselves, and their environment ("NO", potty training)
• How do they accomplish this? ---Need encouragement

• INITIATIVE Vs. GUILT (3-6 y.o.)
• Begin to initiate activities
• Explore their worlds with their senses
• Develop a conscious
• can develop a sense of guilt
• Sexual Identity

• INDUSTRY Vs. INFERIORITY(6-12 y.o.)
• Like to engage in activities that they can complete (games & sports)
• Desire a sense of achievement
• Learn to compete and cooperate
• Can develop inferiority if they think the do not measure up to someone's expectations.

• IDENTITY Vs. ROLE CONFUSION (12-18 y.o)
• Dramatic physical changes
• very preoccupied with how they look and how they are perceived by others
• Can develop role confusion when they try to integrate many other roles into their lives

• Birth-2years
• Infants learn about the world by input obtained through the sense and by their motor activity
• Six substages

• Birth-1 month
• The infant begins life with a set of reflexes such as sucking, rooting, and grasping. By using these reflexes, the infant receives stimulation via touch, sound, smell, and vision. The reflexes thus pave the way for the first learning to occur.

• 1 to 4 months
• Once the infant responds reflexively, the pleasure grained from that response causes repetition of the behavior. For example, if a toy grasped reflexively makes noise and is interesting to watch, the infant will grasp it again.

• 4 to 8 months
• Awareness of the environment grows as the infant begins to connect cause and effect. The sounds of bottle preparation will lead to excited behavior. If an object is partial hidden, the infant will attempt to uncover and retrieve it.

• 8 to 12 months
• Intentional behavior is observed as the infant uses learned behavior to obtain objects, create sounds, or engage in other pleasurable activity.
• Object permanence (The knowledge that something continues to exist even when out of sight) begins when the infant remembers where a hidden object is likely to be found; it is no longer "out of sight, out of mind." This object permanence is not fully developed. Stranger anxiety is quite common.

• 12 to 18 months
• Curiosity, experimentation, and exploration predominate as the toddler tries out actions to learn results. Objects are turned in every direction, placed in the mouth, used for banging, and inserted in containers as their qualities and uses are explored.

• 18 to 24 Months
• Language provides a new tool for the toddler to use in understanding the world. Language enables the child to think about events and objects before or after they occur. Object permanence is now fully developed as the child actively searches for objects in various locations and out of view. The child who has had successful separations from the parents followed by return, such as hours spent in another's home or childcare center, begins to understand that the missing parent will return.

• 2-7 years
• The young child thinks by using words as symbols, but logic is not well developed. During the preconceptual stages (2-4) vocabulary and comprehension increases greatly, but the child shows egocentrism (an inability to see things from the perspective of another). In the intuitive substage (4-7) the child relies on transductive reasoning (drawing conclusions from one general fact to another) Cause-and-effect relationships are often unrealistic or result of magical thinking (the belief that events occur because of thoughts or wishes). Additional characteristics noted in the thought of preschoolers include centration, or the ability to consider only one aspect of a situation at a time, and animism, or ascribing to life to inanimate objects because they move, make noise, or have certain other qualities.

• 7-11 years
• transductive reasoning has given way to a more accurate understanding of cause and effect. The child can reason quite well if concrete objects are used in teaching or experimentation. The concept of conservation (that matter does not change when its form is altered) is learned at this age.

• 11years to adulthood
• Fully mature intellectual thought has now been attained. The adolescent can think abstactly about objects or concepts and consider different alternatives or outcomes.

• Stage I: Beginning families
• Stage II: Childbearing families
• Stage III: Families with preschool children
• Stage IV: families with school children
• Stave V: Families with Adolescents
• Stage VI: Families as launching centers
• Stage VII: Families in the middle years
• Stage VIII: Aging families

• Makes Jerky, quivering arm thrust
• Brings hands within range of eyes and mouth
• Moves head from side to side while lying on stomach
• Head flops backward if unsupported
• Keeps hands in tight fists
• Strong reflex movements

• Focuses 8-12 inches away
• eyes wander and occasionally cross
• Prefers black and white or high-contrast patterns
• Prefers the human face to all other patterns

• Hearing is fully mature
• recognizes some sounds
• May turn toward familiar sounds and voices

• Anterior: Soft and flat-2 adult fingers closes at 12-18 months
• Posterior: closes in 6 weeks, i finger size

• Prefers sweet smells
• Avoids bitter or acidic smells
• Recognizes the scent of his own mother's breastmilk
• Prefers soft to coarse sensations
• dislikes rough or abrupt handling
• should not be floppy

• Raises head and chest when lying on stomach
• supports upper body with arms when lying on stomach
• stretches legs out and kicks when lying on stomach or back
• Opens and shuts hands
• Pushes down on his legs when his feet are placed on a firm surface
• Brings hands to mouth
• Takes swipes at dangling objects with hands
• Grasps and shakes hand toys

• Watches faces intently
• follows moving objects
• Recognizes familiar objects and people at a distance
• Recognizes familiar objects and people at a distance
• Starts using hands and eyes in coordination

• Smiles at the sound of your voice
• begins to babble
• Begins to imitate some sounds
• Turns head toward direction of sound

• Begins to develop a social smile
• enjoys playing with other people, and may cry when playing stops
• Becomes more communicative and expressive with face and body
• Imitates some movement and facial expressions

• Rolls both ways (front to back, back to front)
• sits with, and then without support of her hands
• Supports her whole weight on her legs
• Reaches with one hand
• Transfers objects from hand to hand
• Uses raking grasps (not pincer)

• Develops full color vision
• Distance vision matures
• Ability to track moving objects matures

• Responds to own name
• Begins to respond to "no"
• distinguishes emotions by tone of voice
• responds to sound by making sounds
• uses voice to express joy and displeasure
• Babbles chains of consonants (d's & b's are common)

• Finds partially hidden objects
• Explores with hands and mouth
• Struggles to get objects that are out of reach

• Enjoys social play
• interested in mirror images
• responds to other people's expressions of emotion

• shy or anxious with strangers
• cries when mother or father leaves
• enjoys imitating people in his play
• shows specific preferences for certain people and toys
• tests parental responses to his actions during feedings (what do you do when he refuses a food?)
• Tests parental responses to his behavior. (What do you do if he cries after you leave the room?)
• May be fearful in some situations
• Prefers mother and/or regular caregiver over all others
• repeats sounds or gestures for attention
• finger-feeds himself
• extends arm or leg to help when being dressed

• explores objects in many different ways (shaking, banging, throwing, dropping)
• Finds hidden objects easily
• Looks at correct picture when the image is named
• Imitates gestures
• Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)

• pays increasing attention to speech
• responds to simple verbal requests
• responds to "no"
• uses simple gestures, such as shaking head for no
• babbles with inflection
• says "dada" and "mama"
• uses exclamations such as "oh-oh"
• tries to imitate words

• Reaches sitting position without assistance
• Crawls forward on belly
• assumes hands-and-knees position
• creeps on hands and knees
• gets from sitting to crawling or prone position
• pulls self up to stand
• walks holding on to furniture
• stands momentary without support
• may walk two or three steps without support

• Walks alone
• Pulls toys behind her while walking
• Carries large toy or several toys while walking
• begins to run
• Stands on tiptoe
• kicks a ball
• Climbs onto and down from furniture unassisted
• Walks up and down stairs holding on to support

• demonstrates increasing independence
• Begins to show defiant behavior
• episodes of separation anxiety increase toward midyear then fade (parents need to tell children they are leaving)

• Finds objects even when hidden under two or three covers
• Begins to sort by shapes and colors
• Begins make believe play

• points to objects or pictures when it's named for him
• recognizes names of familiar people, objects and body parts
• says several single words (by 15-18 months)
• Uses simple phrases (by 18-24 months)
• uses two-four word sentences
• follows simple instructions
• repeats words overheard in conversation

• imitates behavior of others, especially adults and older children
• Increasingly aware of herself as separate from others
• Increasingly enthusiastic about company of other children
• Play dates- they do not share!!

• scribbles spontaneously
• turns over container to pour out contents
• builds tower of four blocks or more
• might use one hand more frequently than the other

• climbs well
• walks up and down stairs, alternating feet
• kicks ball
• runs easily
• pedals tricycle
• bends over easily without falling

• makes vertical, horizontal, and circular strokes with pencil or crayon
• Turns book pages one at a time
• Builds a tower of more than six blocks
• holds a pencil in writing position
• Screws and unscrews jar lids, nuts and bolts
• Turns rotating handles

• expresses affection openly
• expresses a wide range of emotions
• by 3, separates easily from parents
• objects to major changes in routine

• makes mechanical toys work
• Matches an object in her hand or room to a picture in a book
• Plays make believe with dolls, animals and people
• sorts objects by shape and color
• completes puzzles with three or four pieces

• imitates adults and playmates
• spontaneously shows affection for familiar playmates
• can take turns in games
• understands concept of "mine" and "his/hers"

• Follows a two-three component command
• recognizes and identifies almost all common objects and pictures
• understands most sentences
• understands physical relationships (on, under, in)
• uses four-and five word sentences
• can say name, age, and sex
• uses pronouns (I, you, me, we, they) and some plurals (Cars, dogs, cats)
• strangers can understand most of her words

• Hops and stands on one foot up to five seconds
• goes upstairs and downstairs without support
• kicks ball forward
• throws ball overhand
• catches bounced ball most of the time
• moves forward and backward with agility

• Imagines that many unfamiliar images may be "monsters"
• view self as a whole person involving body, mind, and feelings
• often cannot distinguish between fantasy and reality

• stands on one foot for 10 seconds or longer
• hops, somersaults
• swings, climbs
• may be able to skip

• copies triangle and other geometric patterns
• draws person with body
• prints some letters
• dresses and undresses without assistance
• uses fork, spoon, and (sometimes) a table knife
• usually cares for own toilet needs

• Recalls part of a story
• Speaks sentences of more than five words
• uses future tense
• tells longer stories
• says name and address

• can count 10 or more objects
• correctly names at least four colors
• Better understands the concept of time
• knows about things used every day in the home (money, food, appliances)

• wants to please friends
• wants to be like her friends
• more likely to agree to rules
• likes to sing, dance, and act
• shows more independence and may even visit a next-door neighbor by herself

• Aware of sexuality
• able to distinguish fantasy from reality
• sometimes demanding, sometimes eagerly cooperative

• 5-6 y.o.
• smooth and strong motor skills
• writes neatly
• dress appropriately
• perform certain chores
• genetic background, nutrition, and exercise may influence growth
• may begin to develop secondary sex characteristics

• 5-6 y.o.
• simple but structurally complete sentences
• 6 y.o.s normally can follow a series of 3 commands in a row
• 10 y.o.s can follow 5 commands in a row

• frequent physical complaints (tummy hurts)
• peer acceptance becomes important
• friendships are primarily with the same sex
• may try lying, cheating, stealing
• 6 year-olds should be able to focus upon an appropriate task for at least 15 minutes
• 9 year olds should be able to focus for about an hour

• rapid gains in height and weight
• development of secondary sex characteristics
• continued brain development

• teens frequently sleep longer
• teens may be more clumsy because of growth spurts
• teenage girls may be overly sensitive about their weight
• teens may be concerned because they are not physically developing at the same rate as their peers
• teens may feel awkward about demonstrating affection to the opposite sex parent
• teens may ask more direct questions about sex.

• establishing an identity
• establishing autonomy
• establishing intimacy
• becoming comfortable with one's sexuality
• achievement

• Teens begin to spend more time with their friends than their families
• Teens may have more questions about sexuality
• Teens may begin to keep a journal
• Teens may begin to lock their bedroom doors
• Teens may become involved in multiple hobbies or clubs
• teens may become elusive about where they are going on with whom
• teens may become more argumentative
• teens may not want to be seen with parents in public
• Teens may begin to interact with parents as people

• Developing advanced reasoning skills
• Developing abstract thinking skills
• Developing the ability to think about thinking

• Teens demonstrate a heightened level of self-conciousness
• Teens tent to believe that no one else has ever experience similar feelings and emotions
• Teens tend to exhibit the "it can't happen to me" syndrome
• Teens tend to become very cause-oriented
• Teens tend to exhibit a "justice" orientation