01.01 Theories of Growth and Development

Overview

1. While there are many different theories of growth and development in the pediatric patient, we will focus our studies on Erikson’s Theory as this is the most commonly studied, tested, and applied.

Nursing Points

General

1. Identifies 8 stages a healthy individual should pass through from infancy to adulthood
2. Each stage presents a crisis that, if overcome, allows the individual to progress

Assessment

1. 0-18 mo (Infant)
   1. Crisis: Trust vs Mistrust
   2. Significant Relationship: Mother
   3. The infant must form a first loving, trusting relationship with the caregiver, or develop a sense of mistrust.
2. 18mo-3yr (Toddler)
   1. Crisis: Autonomy vs Shame and Doubt
   2. Significant Relationship: Parents
   3. The child’s energies are directed toward the development of physical skills,including walking, grasping, and rectal sphincter control.
   4. The child learns control but may develop shame and doubt if not handled well.
3. 3-6 yr (Preschool, Early Childhood)
   1. Crisis: Initiative vs Guilt
   2. Significant Relationship: Family
   3. The child continues to become more assertive and to take more initiative, but may be too forceful, leading to guilt feelings.
4. 6-12yr (School-Age)
   1. Crisis: Industry vs Inferiority
   2. Significant Relationship: Neighbors, school
   3. The child must deal with demands to learn new skills or risk a sense of inferiority, failure and incompetence.
5. 12-20 yr (Adolescent)
   1. Crisis: Identity vs Role Confusion
   2. Significant Relationship: Peers, role model
   3. The adolescent must achieve a sense of identity in occupation, sex roles, politics, and religion.
6. 20-35 yr (Young Adult)
   1. Crisis: Intimacy vs Isolation
   2. Significant Relationship: Friends, partners
   3. The young adult must develop intimate relationships or suffer feelings of isolation.
7. 35-65 yr (Adult)
   1. Crisis: Generativity vs Stagnation
   2. Significant Relationship: Household, workmates
   3. Each adult must find some way to satisfy and support the next generation.
8. 65-death (Older Adult)
   1. Crisis: Integrity vs Despair
   2. Significant Relationship: Mankind
   3. The culmination is a sense of oneself as one is and of feeling fulfilled.