Life Span Development • Each stage of the life span is unique and has certain distinguishable features. The goal of studying the life span is to enable the student to better understand and relate to individuals at various stages of development. • With the increasing older population, we must become more aware of the unique characteristics, needs, and problems of the older adult.
Health Promotion Across the Life Span • Life Expectancy • This is the average number of years an individual will probably live. • Life expectancy in the United States at the beginning of the twentieth century was 47.3 years. • Today, average life expectancy at birth in the United States is 77 years. • There are currently 18 countries that have a life expectancy greater than that of the United States. • Females outlive males by an average of 6 years.
Health Promotion Across the Life Span • Life Expectancy (continued) • Those in households with incomes of greater than $25,000 live 3 to 7 years longer depending on gender and race than do those in households with individual incomes of less than $10,000. • Infant Mortality • This is the number of deaths before the first year of life. • The infant mortality rate for African-American infants is more than double that of white infants.
Health Promotion Across the Life Span • Development • Begins at conception and ends with death • The study of life span development is the study of how and why persons change over time, as well as how they remain the same. • The eight stages of life span development • Infancy, toddler, preschool, school age, adolescence, early adulthood, middle adulthood, and late adulthood
Growth and Development • Growth • Refers to an increase in size of the whole or its parts • Development • Refers to function or the gradual process of change and differentiation from simple to complex • Cephalocaudal • Growth and development that proceed from the head toward the feet • Proximodistal • Growth and development that proceed from the center toward the outside
Growth and Development • Principles: • Growth and development proceed at a highly individualized rate that varies from person to person. • Growth and development are continuous processes characterized by spurts of growth and periods of rest • Growth and development proceed from the simple to the complex in a predictable sequence • Growth and development vary for specific structures at specific times • Growth and development are a total process that involves the whole person.
Growth and Development • Patterns of Growth • Growth patterns appear to be genetically controlled. • Nutrition, heredity, and environment play an important role in the patterns. • The blueprint for all inherited traits is contained in the chromosomes. • Chromosomes are threadlike structures in the nucleus of a cell that function in the transmission of genetic information • At conception, the individual is endowed with a complex set of biologic potentials involving characteristics such as height and skin, hair, and eye color.
Growth and Development • The Beginnings • Development begins with conception. • After fertilization, the zygote has 23 pairs of chromosomes, for a total of 46 chromosomes. • One of each pair has been contributed by the mother and one by the father. • Teratogen • Any substance, an agent, or a process that interferes with normal prenatal development, causing the formation of one or more developmental abnormalities in the fetus
The Family • The family is the basic unit of society. • Families are composed of two or more people who are united by marriage, blood, adoption, emotional bonds, and/or social roles. • The individuals of the family usually share ties that often last a lifetime. • Types of families • Nuclear, extended, single-parent, blended, social contract family and cohabitation, homosexual, adoptive, and foster
The Family • Family Patterns • Refers to the way in which family members relate to each other • Types of family patterns • Autocratic • Patriarchal • Matriarchal • Democratic
The Family • Stages of Family Development • Engagement/commitment stage • Begins when the couple acknowledges to themselves and others that they are considering marriage • Establishment stage • Extends from the wedding up until the birth of the first child • Expectant stage • Begins with conception and continues through pregnancy
The Family • Stages of Family Development • Parenthood stage • Begins at birth or adoption of the first child • Disengagement stage of parenthood • Period of family life when the grown children depart from the home • Senescence stage • Last stage of the life cycle, which requires the individual to cope with a large range of changes
The Family • Causes of Family Stress • Common Signs of Stress in Children • Mood swings • Acting out behavior • Change in eating or sleeping patterns • Frequent stomachaches, headaches, or other unexplained somatic complaints • Excessive clinging to parents • Thumb-sucking • Bed wetting • Return to behavior typical of an earlier stage of development
The Family • Causes of Family Stress • Chronic illness • Working mothers • Abuse • Divorce
Stages of Growth and Development • Infancy: 1 to 12 Months • Physical Characteristics • Gains about 1.5 lbs. per month until 5 months • Doubles birth weight by 4 to 6 months • By 1 year of age, birth weight triples • Vital Signs • At 2 months, the average apical rate is about 120 beats per minute. At 12 months, average resting respirations is about 30 breaths per minute and blood pressure will gradually increase to 90/60.
Stages of Growth and Development • Infancy: 1 to 12 Months • Motor Development • 2 months: holds up head • 4 months: holds head up steadily to a 90- degree angle. • 6 months: balances head • 7 months: sits up easily without support and crawls • 9 months: creeping • 8 to 15 months: standing with support and walking
Figure 8-2 (From Wong, D.L. . Whaley & Wong's nursing care of infants and children. [5th ed.]. St. Louis: Mosby.) Development of locomotion.
Stages of Growth and Development • Infancy: 1 to 12 Months • Dentition • Teething begins at about 5 to 6 months • Signs of teethingirritability, edematous red gums, excessive drooling, change in stools usually begin 3 to 4 weeks before appearance of tooth. • Oral hygiene consists of offering sips of clear water and wiping and massaging the infant’s gums. • Tooth brushing should begin after the first teeth appear.
Stages of Growth and Development • Infancy: 1 to 12 Months • Psychosocial Development • Basic trust versus mistrust • Cognitive and Intellectual Development • Infant uses senses to learn about self and the environment. • Infant learns through exploration of objects and events and through interaction. • Infants are in the sensorimotor stage of cognitive development; knowledge occurs primarily through sensory impressions and motor activities.
Figure 8-3 (From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. . Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.) Nine-month-old infant enjoying own image in a mirror.
Stages of Growth and Development • Infancy: 1 to 12 Months • Communication and Language • During infancy, the unique ability of the brain to sort out basic sounds and to extract from sentences becomes apparent. • Infants will not speak spontaneously; the environment must provide a means for them to acquire these skills. • The rate of speech development varies from child to child and is directly related to neurologic competence and intellectual development.
Stages of Growth and Development • Infancy: 1 to 12 Months • Nutrition • Both human breast milk and commercially prepared formula are available to meet the nutritional needs of the infant. • Foods that should be avoided in the first 6 months of life are citrus fruits, egg whites, wheat flour all frequently identified as allergy-producing substances. • Rules for solid foods: introduce only one new food at a time; introduce cereals first, then fruits and vegetables, and meat last.
Stages of Growth and Development • Infancy: 1 to 12 Months • Sleep, Play Activity, and Safety • Newborns and infants sleep 18 out of 24 hours. • Toward the end of the first 3 months, definite sleep patterns emerge. • By the end of the first year, the infant will sleep 12 hours at night and take one nap during the day. • Play is important for learning. • Accidents are the leading cause of injury and death in infants and young children.
Stages of Growth and Development • Infant Play: captures the pleasure of using the senses and motor abilities = sensorimotor play • Play style during infancy = solitary play • Allows adequate freedom of movement develop muscles and bones
Stages of Growth and Development • Toddler: 1 to 3 Years • Physical Characteristics • Rate of growth is slower in the toddler than in infancy. • In the beginning of this stage, the toddler’s body proportions result in a top-heavy appearance, but by the end they have a more proportionate body appearance. • Toddlers have an exaggerated lumbar lordosis and protruding abdomen. • By 2.5 years, all 20 deciduous teeth are present.
Stages of Growth and Development • Toddler: 1 to 3 Years • Vital Signs • Pulse: 90-100 beats per minute • Blood pressure: 100-80/64 • Temperature: 98-100º F • Respirations: 20-30 breaths per minute • Neuromuscular Development • Walking, climbing, hopping, running, pulling, holding on tight skills • Scribble and copy a circle
Stages of Growth and Development • Toddler: 1 to 3 Years • Toilet Training • Children do not reach the physiologic or psychological maturity necessary to be toilet trained until 18 to 24 months of age. • Nighttime control may be achieved after daytime control is established. • Success should be praised and accidents should be ignored.
Stages of Growth and Development • For successful toilet training: • 1. physical maturation for neuromuscular control • 2. cognitive ability to understand • 3. Language skills to express their needs • Success in bowel control is usually achieved first even though bowel and bladder training may start at the same time
Stages of Growth and Development • Toddler: 1 to 3 Years • Psychosocial Development • The toddler is an uninhibited, energetic little person always seeking attention, approval, and personal goals. • Autonomy versus shame and doubt • Use of the word “no” gives a sense of control. • Possessiveness and a desire to have things go their way are characteristic. • Ritualistic behavior and repetitive rituals self-consoling feeling of safety and security; decreases anxiety • Temper tantrums are common.
Stages of Growth and Development • Toddler: 1 to 3 Years • Cognitive and Intellectual Behavior • The period from 12 to 24 months is the last phase of the sensorimotor development. • Preoperational thought stage • The child focuses on the use of language as a tool to meet needs. • The child has the emerging ability to think mentally. • Toddlers are constantly absorbing new ideas, widening their cognitive world, and expanding their memory.
Stages of Growth and Development • Toddler: 1 to 3 Years • Communication and Language • Toddlers think about their actions and make their will known to their caregivers. • They identify objects by use. • At age 2.5, their vocabulary is about 450 words. • By age 3.5, the child can answer questions, use brief sentences, and recite television commercials.
Stages of Growth and Development • Toddler: 1 to 3 Years • Nutrition • One serving of meat, two or more servings of vegetables, at least two servings of fruit, cereal or bread • Twenty-four ounces of milk per day • Bite-size pieces, finger foods, and smaller portions
Figure 8-8 (From Mahan, L.K., Escott-Stump, S. . Krause’s food, nutrition, and diet therapy. [11th ed.]. Philadelphia: Saunders.) Milk and other dairy products supply the toddler with the calcium and vitamin D for growing bones.
Stages of Growth and Development • Toddler: 1 to 3 Years • Sleep, Play Activity, and Safety • Toddlers expend a high level of energy in daily growing, playing, and exploring. • They require 12 hours of sleep each night plus a daytime nap. • Parallel play: play alongside of, but not with, peers • Running, jumping, and climbing help develop their growing bones and muscles. • More than half of all childhood deaths are caused by accidents, many of which are motor vehicle accidents.
Figure 8-5 (From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. . Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.) Children are most likely to ingest substances that are on their level.
Figure 8-9 (From Hockenberry-Eaton, M.J., Wilson, D., Winkelstein, M.L., Kline, M.D. . Wong’s nursing care of infants and children. [7th ed.]. St. Louis: Mosby.) Parallel play.
Stages of Growth and Development • Preschooler: 3 to 5 Years • Physical Characteristics • Maturation of nervous system and mastery of skills • Growth slow and steady; taller and thinner. • Average weight gain less than 5 lbs. per year. • Linear growth about 2 to 2.5 inches per year. • Vital Signs • Heart rate: 70-110 beats per minutes • Respiratory rate: 23 breaths per minute • Blood pressure: 110/60 • Temperature: 97-99° F
Stages of Growth and Development • Preschooler: 3 to 5 Years • Psychosocial Development • First, learns to function independently • Then, begins to use imagination to explore • Initiative versus guilt • Pretends to be grown up by trying a variety of roles • Superego functions as a censor of behavior • Typical development includes gender identity • Strong sibling bonding established
Figure 8-12 Siblings establishing a bond.
Stages of Growth and Development • Preschooler: 3 to 5 Years • Cognitive and Intellectual Development • Uses symbols to represent objects • Trial and error to discover new traits and characteristics • Begins to think logically • Sees things as absolute; either good or bad • Time associated with weekly and seasonal events • Needs trust and guidance to distinguish truth from fantasy d/t magical thinking
Stages of Growth and Development • Preschooler: 3 to 5 Years • Communication and Language • By age 3 years, children can carry on a conversation; language becomes more adult-like. • Pronunciation problems continue. • Nutrition • They need high levels of proteins. • Calcium and phosphorus are important for bones and teeth. • Food habits, likes, dislikes, and appetites vary greatly from child to child.
Stages of Growth and Development • Preschooler: 3 to 5 Years • Sleep, Play Activity, and Safety • They need 11 to 12 hours of sleep at night. • The child begins to share, take turns, and interact with playmates. • Through dramatic play, the child tries different roles and identifies with adult models. • Child can learn to ride a bicycle with training wheels. • Discipline and limit setting are needed. • They learn to function independently and explore the imagination.
Figure 8-10 Trying out new roles.
Stages of Growth and Development • School Age: 6 to 12 Years • Physical Characteristics • Growth is usually gradual and subtle. • Most obvious change involves long bones of the extremities and development of the facial bones. • Height and weight increases by about 2 inches and 4.5 to 6.5 lbs. per year. • Vital Signs • Pulse rate: 55-90 beats per minute • Respiratory rate: 22-24 per minute • Blood pressure: 110/65
Stages of Growth and Development • School Age: 6 to 12 Years • Psychosocial Development • Become more aware of rules, socialization skills, and expectations • Beginning skills of compromise and competition • Industry versus inferiority • Learns to master skills that produce satisfaction as the result of work • Develop their own goals and direct their efforts toward mastery of these goals
Stages of Growth and Development • School Age: 6 to 12 Years • Cognitive and Intellectual Development • Thoughts become increasingly logical and coherent, so the child is able to classify, sort, and organize facts while still being incapable of generalizing or dealing with abstractions. [concrete operational phase, Piaget] • They view the world more realistically, and they are capable of understanding the views of others. • They begin to develop logical socialized thought. • Movement is away from fantasy • Realize that a physical cause is behind an event
Stages of Growth and Development • School Age: 6 to 12 Years • Communication and Language • Good command of sentence structure • Vocabulary becomes more extensive and includes slang and swear words • Printing becomes clearer and smaller • Nutrition • Dietary habits and food preferences are strongly established. • Childhood obesity is correlated with obesity in adult years; maintain weight within normal limits.
Stages of Growth and Development • School Age: 6 to 12 Years • Sleep, Play Activity, and Safety • Fatigue, irritability, inattention, and poor learning are often signs of inadequate sleep. • They need about 10-12 hours of sleep at night. • They need adequate exercise to enhance muscle development, coordination, balance, and strength. • Privacy and a place for their things are important. • They may become involved with competitive or team sports. • Accidents are the leading cause of death.
Stages of Growth and Development • Accidents are often due to impulsiveness, poor judgment, curiosity, and incomplete control over motor coordination. • TV influence – a frequent and potent model for aggressiveness and violence • Issue: preventing school violence