NCM 107 Care of Child and Adolescence (Well Clients)

Module 1: Developmental Influences on Child Health and Promotion

This course focuses on human growth and development over the lifespan. This course is important because it gives
the student a background in human growth and development from before birth, through childhood, into adulthood,
and through death and grief. It gives the student perspective and highlights where people in the caring professions
are most needed. Students who take this course will come away with a broad understanding of all the careers that
help people from birth to death.

1. Discuss factors influencing growth and development.

2. Describe biophysical developmental theories.
3. Demonstrate knowledge of the physical, social/emotional, cognitive and language development of
children, both typical and atypical, in major developmental stages.

III.
VOCABULARY LIST

For your better understanding of the lesson , here is the list of words and their meanings. Read and understand them
carefully.

1. Growth: increase in structure – the physical changes in the anatomy of the child.
2. Development: increase in function
3. Maturation: is the process of the unfolding of the genetic or inherited tendencies within the child
4. Learning: is a “change of behavior”
5. Cephalocaudal: growth and development begin in the head and moved down toward the
feet
6. Proximodistal: motor development proceeds from the center of the body toward the exterminates
7. General to specific: Muscle development and control proceed form the mass to the specific – from
simple to complex
8. Prehension: is the effective use of the hand for picking up small objects or for grasping the
development of the ability to oppose the thumb to the fingers in picking up that object precedes
reaching, grasping
9. Locomotion: the ability to walk alone proceed after a sequence of development accomplishments
 10. Temperament: is defined as the manner of thinking, behaving, or reacting characteristics of an
individual
11. Onlooker Play: the child watches other children play but does not take part in any of the activities
12. Solitary Play children play alone and part with toys which are not being used by other children
13. Parallel Play: children play independently but among other children
14. Association Play: children play together and are engaged in a similar or even identical activity
15. Cooperative Play: this is organized play with groups of children which have discussed definite
purposes to the play and the end result

IV.
PRE - TEST
Direction:
1. Find all the Child Development terms with in the word search.
2. Create a complete sentence using each term in the appropriate context.
 Introduction to Pediatric
Nursing

Developmental Influences on Child Health

and Promotion

1. Growth: increase in structure – the physical changes in the anatomy of the child.
▪ implies a change in quantity
▪ increase in number and size of cells thus increasing the size and weight of the whole or any of the
parts
2. Development: increase in function
▪ changes occur in the physiological aspect of the child and they accompany growth
▪ Development also involves the changing from a lower to a more advanced stage of complexity
▪ Development is achieved through growth, maturation and learning

✔ Maturation: is the process of the unfolding of the genetic or inherited tendencies within the child
⮚ some children are “late” maturers while others are “rapid” maturers
⮚ all children mature at their own rate
⮚ it is described as an increase in competence and adaptability
⮚ there is a “qualitative” change

✔ Learning: is a “change of behavior”

⮚ it is the result of experience, experimentation, and training
⮚ the ability to learn is dependent upon the inborn capacity for mental development

Maturation and Learning are interrelated. No learning can take place unless the child is mature
enough to understand and the behavior is changed. The learning process can be hindered if the child
is not given the opportunity learn by experience and from others when the time is optimum.

V.
LEARNING ACTIVITIES
LEARNING ACTIVITY NO. 1: The Challenge: A Self Check

This time, you are about to jump to a new series of learning tasks. As you go on to the extensive and wider
scope of child development, you need to acquire the concepts about the GROWTH and DEVELOPMENT. In
order to do so, let me take you to the first task.

MECHANICS of the ACTIVITY

You are provided with a table having two columns namely “YES, I KNOW!” and “WHAT I WANT TO
KNOW!”
In the left column, write the things you already know about Growth and Development
In the right column, write the things you want to know about Growth and Development

YES, I NOW! WHAT I WANT TO NOW!

1. 1.

2. 2.

3. 3.

4. 4.

5. 5.

Stages of development and their respective age ranges

▪ Prenatal: conception to birth

▪ Neonatal: birth to 0 – 28 days
▪ Infancy: 1 - 12 months of age
▪ Toddler: 1 - 3 years
▪ Preschool: 3 - 6 years
▪ School Age: 6 -12 years
▪ Adolescent: 13 -18 years

Three basic patterns involved in directional trends:

a. Cephalocaudal: growth and development begin in the head and moved down toward the
feet
 b. Proximodistal: motor development proceeds from the center of the body toward the
exterminates

c. General to specific: Muscle development and control proceed form the mass to the specific – from
simple to complex

Five basic principles of growth and

development.

a. Growth and development occur in an orderly sequence.

▪ the sequence of development is the same for all children but the rate is different
▪ children creep before they stand and stand before they walk
▪ talk before they read and read before they write
▪ each stage of development is an outgrowth of the previous stage

b. Growth and development continue from conception to maturity.

▪ growth is never regular or even
▪ there are periods of faster and slower growth with spurts and growth is normally not
interrupted.

c. Differences in growth and development rates.

▪ all children are on their own schedules and are unique to themselves.

d. Variation of Growth Rates for Different Body Structures

▪ not all body parts mature at the same rate
▪ the brain is completely grown by age 7 but is not matured until years later.

e. Growth and Development is a Total Process

▪ the growth and development of a child is a PHYSICAL, MENTAL SOCIAL and

EMOTIONAL process
✓ The development of a “whole being”
▪ State the two forces which govern the growth and development of every child.
▪ The genetic and environmental factors control every aspect of all the child’s growth and
development by overlapping and intertwining their influence. There are controversies on both sides
 of the debate concerning which has more influence over the child. The battle of the “nature versus
nurture”.

Categories of growth and development

⮚ Physical Growth
▪ there are four well-defined periods of physical growth
✔ rapid growth during infancy
✔ slow, steady growth during childhood years
✔ growth spurt during puberty
✔ decreasing growth and attaining maximum height
✔ the nervous system grows rapidly during infancy then decelerates and the reproductive
✔ system grow slowly until puberty

⮚ Height – average length is 20 inches at birth

▪ 10 inches in the first year
▪ 5 inches during the second year
▪ 3 inches per year during the preschool years
▪ 2 inches per year from 6th to 10th years

⮚ Weight – average weight is 7.5 pounds

▪ the weight doubles by 5th month and triples by the first year
▪ the weight gain is slowed down and only 5 pounds per year during the preschool years

⮚ Body Proportions – at birth, the infant’s head is 1/4 the size of the body but as an adult it is 1/8 the size
of the body
▪ the infant’s trunk is shorter than the extremities

⮚ Bone Formation – there are changes in the texture, size and shape of bones as the child grows
▪ bone development occurs in a orderly sequence and completed by the 3rd decade when the
epiphyses and diaphyses fuse

⮚ Tooth Formation – at birth the primary teeth and the first permanent teeth are developing
▪ there is a wide variation when teeth will shed and erupt

⮚ Motor development:
▪ Prehension – is the effective use of the hand for picking up small objects or for grasping the
development of the ability to oppose the thumb to the fingers in picking up that object
precedes reaching, grasping
✔ this phenomenon is connected with the development of eye-hand coordination.

▪ Locomotion – the ability to walk alone proceed after a sequence of development

accomplishments

▪ Intellectual Development
✔ intelligence is defined as the ability to solve problems or achieve a goal or, another definition
can include the ability to adjust to new situations, to – intelligence strongly influences the
level of difficulty at which the child is able to function efficiently and the scope of his
activities
✔ one predictor of an infant’s intelligence is HABITUATION which is the period of time that
elapses between the infant’s initial response to a repeated stimulus and the cessation of
that response the shorter the habituation – the higher the intellectual potential

Temperament

✓ Temperament is defined as the manner of thinking, behaving, or reacting characteristics of an

individual
✓ it refers to how a person deals with life
✓ there are no implications of good or bad
✓ children can be placed into one of three categories:

1. The easy child: even-tempered with regular and predictable habits

● open and adaptable to change
● mild to moderate to intense mood
● 40% of children in this category

2. The difficult child: highly active, irritable, and irregular in their habits
● require a structured environment and withdraw more often
● adaptation is slow to new routines, people and situations
● negative moods
● temper tantrums, crying, frustrations
● 10% of the children
 3. The slow-to-warm-up child: react negatively and with mild intensity to new stimuli
● adapt slowly with repeated contact
● response with passive resistance
● inactive and moody
● 15% of the children

LEARNING ACTIVITY NO. 2:

MECHANICS of the ACTIVITY

Below are three circles with jumbled letters inside. The jumbled letters refer to some essential
terminologies related to TEMPERAMENT
Arrange these letters to come up with the correct answer.
If you think you got the correct term, write it in the space provided.
Think of a single word synonymous to the term you found.
Write the synonym in the box found below the line.

DLIHD
TLUCIFFID

____________________ ___________________ ____________________

A. Emotional Growth
✓ an emotion is a reaction that accompanies either the satisfaction or frustration of a basic need
or it can be defined as a psychologic reaction caused by internal or external stimuli
✓ emotions are related to basic drives which can be physical, social, intellectual or personal
 ✓ all emotions cause a physical response but we all react to emotions in a different way and the
manifestation of these changes due to emotions are different from one person to another

Factors which influence the physical and emotional development.

A. Heredity – in all cultures, attitudes and expectations are different with respect to the sex of the
child
▪ there is a direct correlation between parent and child with regard to physical characteristics
▪ even such traits as personality, activity level, responsiveness and even shyness can be
inherited.

B. Neuroendocrine Factors – many hormones come into play with all aspects of growth and
development from Human Growth Hormone to thyroid, sex hormones, androgens etc.

C. Nutrition – the single most important influence on growth

▪ malnutrition thus can be severely detrimental to the proper growth of the child
▪ malnutrition does not have to be undernourishment but could be related poor qualitative
food, stress and diseases.

D. Socioeconomic Level – discrepancies between all levels of the socioeconomic classes – factors
affecting growth and development could be eating, sleeping, and exercising.

E. Disease

F. Interpersonal Relationships – quality and quantity of contacts with other people is essential to the
emotional, intellectual, and personality development
▪ parents – siblings – and peers all play a role in the development of positive interpersonal
relationships.

G. Mass Media – one cannot ignore the influence of television, radio, movies, books and other
reading materials on the emotional development of the child
▪ children learn about their world and how to deal with this
▪ environment of objects, time, space, structure, and people
▪ play is considered work of the child
▪ patterns of children’s play can be categorized according to

The role of play in development of the child.

Content and Social Character

A. Content of Play

1. Social-Affective Play
✓ the infant takes pleasure in relationship with people
✓ the adults talking, fondling, nuzzling elicit responses in the infant

2. Sense-Pleasure Play
✓ nonsocial stimulating experiences that originates from outside the individual
✓ objects in the environment which attract the attention of the child
✓ pleasure is derived from handling material plus using all other senses with the object

3. Skill Play
✓ the ability of the infant to grasp and manipulate the object and persistently demonstrate
and exercise their new skill

4. Dramatic Play
✓ begins in toddler stage and is perfected in the preschooler
✓ “fantasizing and imagining” are very important
✓ their toys and articles become part of the real world as they pretend the various roles in
society

5. Unoccupied Play
✓ not play but focus their attention on anything which strikes their interest
✓ daydreaming, fiddling with objects, walking aimlessly

Social Character of Play

1. Onlooker Play: the child watches other children play but does not take part in any of the activities.

2. Solitary Play
✓ children play alone and part with toys which are not being used by other children
✓ their own activity is most important

3. Parallel Play
✓ children play independently but among other children
✓ they do not influence or are influenced by other children
✓ characteristic play of the toddler

4. Association Play
✓ children play together and are engaged in a similar or even identical activity
✓ but, there is not organization to the play
✓ there is no group goal but there may be a sharing of equipment
 5. Cooperative Play
✓ this is organized play with groups of children which have discussed definite purposes to the
play and the end result
✓ there is a definite sense of belonging to the group
✓ the leader-follower relationship is established

State the functions of play.

a) Sensorimotor development
b) Intellectual development
c) Socialization Creativity
d) Self-awareness
e) Therapeutic value
f) Moral value

State the ways parents can encourage their child’s toy play.
1. Play teaches skills and abilities that are the center of intelligence.
2. Play with your child or enroll them in play therapy several days per week.
3. Do not turn every play activity into an educational lesson.
4. Respect your child’s likes and dislikes.
5. Observe your child at play and get to know their favorite toys.

GUIDELINES FOR TOY SAFETY

State the purpose of the Denver Developmental Screening Test.

▪ The DDST is the most widely used screening test for assessing a young child’s development in order
to detect delays.

State the four major areas of development evaluated by the DDST.

▪ Personal-social
▪ Fine motor-adaptive
▪ Language
▪ Gross motor

VI.
PRACTICE TASKS

Practice Task 1: Test Your Knowledge!

 Identify the 3 basic classes of
temperament and briefly explain
each.

1. __________________________________________________________________________________________
__________________________________________________________________________________________

2. __________________________________________________________________________________________
__________________________________________________________________________________________

3. __________________________________________________________________________________________
__________________________________________________________________________________________

Define Temperament________________________________________________________________________________

________________________________________________________________________________

Practice Task 2: Understand your temperament!

➢ List the characteristic of a child according to temperament.

Easy (Flexible Difficult (Active) Slow to warm up (Cautious)

1. 1. 1.
2. 2. 2.
3. 3. 3.
4. 4. 5.
Practice Task 3: Photo Reflection!
The photos depict the different stages of growth and development of a CHILD.
By looking at these photos, construct a meaning, description or characteristics that you may directly
associate to them.
Your answers may be written in a bulleted outline, tabular, phrasal or sentence form. Write as many
as you can provided that you are able to explain your thoughts very well.
You may write your answers in the space provide.

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VII.
POST - TEST

Using 3 to 5 sentences, write a paragraph depicting your learning on this lesson. Write your answer
in a clean sheet of paper or in your data notebook.
 1. What factors impact the development of a child?
2. Explain how literate communities influence child development
3. Describe the role played by the surroundings in the development of a child

VIII.
ASSIGNMENT / ADDITIONAL ACTIVITIES

1. Learning Insights/Reflective Journaling

Well done!!! You did a great job.

Rest and relax a while then move on
to the next module. Good luck

References:

1. Gleason, K. and Devaskar, S. (2012). Avery’s Diseases of the Newborn. Philadelphia, PA: Saunders
2. Pillitteri, A. (2018). Maternal and Child Health Nursing: Care of the Childbearing and the Childrearing
Family. Philadelphia, PA: Lippincott Williams and Wilkins
3. Hockenberry,M. and Wilson, D (2013) Wong’s Essential of Pediatrics Nursing:Mosby
4. Delmar’s NCLEX-PN® Review, Second Edition (2013) Judith C. Miller, RN, MSN
5. Patricia A. Potter, RN, MSN, PhD, FAAN, Anne Griffin Perry, RN, EdD, FAAN Fundamentals of Nursing 9th
Edition