Developmental Influences on Child Health Promotion

1
Developmental Influences on Child Health Promotion

• Part 2 Psychosocial, Cognitive, Moral
  Development
• Ricci, chapters 25-29

2
GD Theories

• Piagetcognitivelearning to think, reason, make
  judgments
• Eriksonpsychosocialpersonality development
• Kohlbergmoraldevelopment of a sense of right
  and wrong

3
Piaget

• Sensorimotor phaselearning thru senses and motor
  skills. Object permanence is major task.
• Preoperational phaseegocentrisminability to see
  others point of view. Concrete thinking based
  on what is observed.
• Concrete operationsmostly concrete thinking with
  beginnings of abstract thought. Conservation and
  reversibility are major concepts
• Formal operationsabstract thinking. Develops a
  workable philosophy of life.

4
Erikson

• Trust vs. mistrust (0-1). Relationship to primary
  caregiver is essential to establishing trust.
• Autonomy vs. shame doubt (1-3). Need to do
  things for self. When stopped or made to feel
  wrong about it, feel shame and doubt.
• Initiative vs. guilt (3-6). Creating and starting
  things on ones own. Egocentrism causes guilt.
• Industry vs. inferiority (6-12). Need to feel
  worthwhile and important is crucial. Comparison
  to peers creates feelings of inferiority.
• Identity vs. role confusion (12-18). Striving for
  a sense of self and belonging and finding a
  direction are important. Demands on self and from
  others can create confusion.

5
Kohlberg

• Preconventional leveldoing what is right to
  avoid punishment or because it is in his own best
  interests and is fair
• Conventional leveltries to live up to others
  expectations what is right is whatever is
  societys rules
• Postconventional leveldoing good accd to what
  is best for greatest universal moral
  principles of justice, equal rights, and respect
  for human dignity

6
Developmental TasksInfant

• Trust
• Begins separateness
• Develops and desires affection
• Preverbal communication of needs
• Learns language
• Fine and gross motor skills
• Explores environment
• Develops object permanence

7
Toddler

• Egocentric
• Begins socially acceptable behavior
• Separateness
• Increased verbal communication skills
• Tolerates delayed gratification
• Controls body functions
• Begins self-care

8
Preschooler

• Sense of initiative
• Increased language skills
• Behaves in socially acceptable ways
• Develops conscience
• Identifies sex roles
• Develops readiness for school

9
School Age

• Active and cooperative member of group
• Learns rules/norms of society adapts to moral
  standards
• Increased psychomotor and cognitive skills
• Masters time, conservation, and reversibility
• Masters oral and written communication
• Wins approval from adults and peers
• Builds a sense of industry and self-concept
• Gives affection without expecting anything

10
Adolescence

• Develops group and self identity
• Gains independence from parents
• Develops value system
• Develops academic vocational skills
• Develops analytical skills
• Adjusts to rapid physical sexual changes
• Develops sexual identity
• Develops multicultural skills
• Considers and chooses career

11
Role of Play in Development

• Universal language of children
• Provides socialization
• Stimulates developmentphysical, emotional, and
  cognitive, moral
• Develops creativity
• Provides outlet for fears
• Helps develop self-awareness

12
Social Character of Play

• Solitary or onlooker playplays by self or enjoys
  watching others (infancy)
• Parallel playplays with same toy, but with no
  interaction (toddler)
• Associativeplays same thing as others in group,
  but no group plan or goal (preschool)
• Cooperativetogether with others, play is
  organized with group goal (school-age)

13
Developmental Assessment

• To identify children whose developmental level is
  below normal for chronologic age and who
  therefore require further investigation
• Remember, most are only screening tools, not
  diagnostic.

14
Risk Factors p. 1055

• LBW, prematurity
• CNS problems or neuromuscular issues
• Hyperbilirubinemia/kernicterus
• Congenital malformations (syndromes)
• Chronic OM
• Inborn error of metabolism (PKU)
• Perinatal infections
• Parental issuesdrugs, ETOH, low income, mental
  illness, etc

15
Warning Signs (p. 1056)

• No response to stimuli, does not interact with
  others
• No babbling
• Persistent primitive reflexes
• Abnormal posturinghead lag, fisting, arching,
  tiptoeing
• Failure to achieve gross and fine motor
  milestones
• Failure to achieve language milestones echolalia
• Extreme aggressiveness, fearfulness, sadness
• Easily distracted, cant concentrate
• Rarely engages in fantasy play
• Failure to achieve personal-social skills or
  self-help activities

16
Denver Developmental Screening Test II

• AKA Denver II or DDST
• Widely used, standardized measures
• Tests personal-social, language, fine, gross
  motor skills
• Examiners must be specifically trained and
  certified in use of the tools
• Have to have a kit with specific items to
  administer the test and follow instructions in
  the manual to ensure validity of the test.

17
Interpretation of Denver

• Dont use the word test with a parent, but tell
  them it is a guide
• If child fails skill, reevaluate in 1-4 weeks
• If still problems, do not freak parents out
  remind them this is screening only
• Refer to pediatrician or developmental testing
  center for further evaluation