CENTRAL PHILIPPINE UNIVERSITY NURSING REVIEW CENTERIn Collaboration with A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY

PEDIATRIC NURSING(Normal Concepts)Prepared by: Alvin John H. Gustilo, RN

FETAL STAGE: Fetal Growth and Development

First Trimester : ___________________________________First Month FHT, CNS Develops, GIT and Respi Tract remains as single tube Differentiation of Primary Germ Layer Endoderm Thyroid ____________________________ Thymus ____________________________ Liver GIT Linings of Upper GI Tract Mesoderm Heart Musculoskeletal Reproductive Organ Kidney Ectoderm Brain CNS Skin 5 senses Hair, nails Anus Mouth4 weeks Gestational Age The human embryo, drawn here many times its actual size, is in fact about 1/100th of an inch long. The heart begins to form. Blood circulation begins.

Second Month Life span of corpus luteum ends All vital organs are formed Placenta is developed Sex organ is developed Meconium is present6 weeks Gestational Age _________________________________ By this time the head and upper body are well developed. The eyes have begun to form. Structures that will become arms and legs, called limb buds, begin to appear. The heart, now in a tubular form, begins to beat. The neural tube has formed which will give rise to the brain and spinal cord.8 weeks Gestational Age ____________________________________ The embryo now has a four chambered heart. The vertebral (spinal) column is developed and visible but is composed of cartilage at this stage. Electrical activity begins in the developing brain and nervous system. The fingers begin to develop.

Third Month Placenta is complete Kidneys are functional Fetus begins to swallow amniotic fluid Buds of milk appear Sex is distinguishable FHT audible via ___________________10 weeks Gestational Age ___________________________________________ During this period the embryo reaches a transition point. It is now called a fetus, a Latin word meaning young one or offspring. The head is about half the size of the fetus and the tail has disappeared. The fetus now has a distinct human appearance.12 weeks Gestational Age _____________________________________________ The eyelids fuse together. Fingernails are developing.

All major body organs are formed although they are not able to function outside of the uterus. The rest of the pregnancy is needed to allow these organs to grow and mature.____________________ any drug or irradiation, the exposure to which may cause damage to the fetus DRUGS Streptomycin anti TB (quinine) damage to the 8th cranial nerve poor learning and deafness/ ototoxic Tetracycline stoning the tooth enamel, inhibits long bone growth Vitamin K hemolysis, destruction of RBC, jaundice, hyperbilirubenemia Iodides enlargement of thyroid and goiter Thalidomides anti-emetics Amelia or Pocomelia absence of distal part of extremities Steroids cleft lip or palate and even abortion Lithium congenital maformation ALCOHOL LBW, fetal alcohol syndrome ( characterized by microcephaly) SMOKING LBW CAFFEINE LBW COCCAINE LBW, abruptio placenta TORCH group of infections that can cross the placenta or ascend through the birth canal and adversely effect fetal growth Toxoplasmosis cat lovers Others - Hepa AB, HIV, Syphillis Rubella Cytomegalo virus Herpes Simplex virus

Second Trimester: _____________________________________________Fourth Month Lanugo begins to appear Buds of permanent teeth appear FHT audible via Fetoscope @ __________________ 14 weeks Gestational Age The fetus is able to swallow and the kidneys are able to make urine. Blood begins to form in the bone marrow.16 weeks Gestational Age By this age it is possible to distinguish the sex of the fetus. The head is erect and the legs are developing.Fifth Month Quickening : 1st fetal movement Primi: ___________, Nulli - ________ Lanugo covers the body FHT audible via stethoscope or w/out instrument Actively swallow amniotic fluid Fetus : _________________ 18 weeks Gestational AgeThe body and facial features of the fetus are now recognizable.The fetus is able to respond to sound.The nose, lips and ears can be recognized at this stage.20 weeks Gestational AgeThe oil glands in the skin, called ________________, begin to work.The mother will be able to feel the fetus move, kick, and punch. The movements are sometimes described as feeling like movement of butterfly wings or bubbles. This is called quickening.Sixth Month Skin is red and wrinkled ___________________________ Eyelids open Exhibits startle reflex22 weeks Gestational Age Toenails have begun to develop. By 22 weeks the lower limbs are fully formed. Head and body hair called ___________ thickly covers the fetus. The fetus is about ____________ long and weighs about 1 pound.24 weeks Gestational AgeThe fetus begins to gain weight steadily, but still appears scrawny.The skin is typically wrinkled and red.The head is still quite large compared to the rest of the body.Eyebrows and eyelashes are recognizable.The fetus is about ______________________________________

3rd Trimester : ____________________________________________________Seventh Month _________________________ Male: ___________________________________ Female : _________________________________26 weeks Gestational Age The fetus can respond to sounds that occur both inside the mothers body and outside in the mothers surroundings.The fetus is now about 13 inches long and weighs about 2 pounds.The eyelids open and close.28 weeks Gestational AgeEyelashes and eyebrows are present.The fetus has a good head of hair.The thin, red, wrinkled skin of the fetus is covered with a white cheese-like substance called vernix caseosa that protects the skin from the drying action of the amniotic fluid.Eight Month Active moro reflex Lanugo begins to disappear Sub q fats deposits(______________), steady weight gain, nails to fingers30 weeks Gestational AgeThe lungs of the fetus become more mature with each week that is spent in the uterus. However, if the baby is born now it will still need expert medical help.32 weeks Gestational Age____________________ continues to form a thick coat on the skin.The fetus continues to grow and mature.Toenails are fully formed.Ninth Month Lanugos and vernix caseosa is evident in body fold Birth position assumed Amniotic fluid somewhat decrease Sole of the foot has ____ creases34 weeks Gestational AgeThe movements and kicks of the fetus are much stronger now. Sometimes this activity can be seen by watching the mothers abdomen.The fingernails reach the end of the fingertips.The skin is pink and smooth.36 weeks Gestational AgeLanugo disappears from the face but remains on the head.The fetus has fully-formed limbs with fingernails and toenails.Muscle tone is developed and the fetus can turn and lift its head.The fetus has soft earlobes with little cartilage.Tenth Month ________________ in the fetal skull Vernix caseosa is evident in body38 weeks Gestational AgeThe fetus can grasp firmly.Skin on the face and body becomes smooth.The head continues to be the largest body part.The body usually appears plump._________is left only on the shoulders and upper body.40 weeks Gestational AgeIn males, the testicles are fully descended into the scrotum.The chest is prominent; the breasts protrude.

Growth and Development:Definition and Concepts:The process of an individual organism growing organically; a purely biological unfolding of events involved in an organism changing gradually from a ________________________________ levelImportant characteristics of Human beingA process by which the fertilized ovum develops in to a mature adultMaturation occurs through successive changes in the both physical structure and functional ability

The Beginning of Life_________________________________________________________Total number of chromosomes: ______ (DIPLOID)Sex Determination: by ________________ XX- _____________ XY- ____________ Identical Twins ( Uniovular)- ________ovum Non- identical (Fraternal)- _______ovum

Two factors that affect GD __________________= nutrition, socioeconomic status, health, ordinal position in family, parent child relationship _________________= race, intelligence, sex, nationality

Growth Complex phenomenon of a structure or a whole Increase in physical size 2 parameters: _______________ Estrogen- _________________________________ Testosterone- __________________________________ Weight Changes _____- 5- 6 months _____- 1 year _____- 2- 2 year Height Changes 9 years old- male= female 12 years old- ___________ 13 years old- ____________

DEVELOPMENT- _______________________________________________ Increase in the skills or capacity to function __________________________ Measured by simply observing the child doing simple tasks

Learning ________________________IQ= mental age x 10Chronological age

IQDescription

140 plus

130-139

120-129

110-119

90- 109

80-89

70-79

50-69

49 below

Moron- ________________________________Idiot- ________________________________Imbecile- ________________________________

Principles of Growth and Development Growth and development is a continuous process Womb to tomb principle Asynchronous growth- ________________________________ Each child is ________________________________ Cephalocaudal- ( head to tail)- ________________________________ Proximo-distal- ________________________________ Symmetrical- ________________________________ Mass- specific- ________________________________ Sequential Trend- ________________________________ Secular Trend- ________________________________

Behavior ________________________________Play ________________________________ neonatal reflexes must be lost first before development can proceed

PATTERNS OF GROWTH AND DEVELOPMENT ________________________________ BRAIN- ________________________________ Rapid growth and development of the brain from ________________________________ Reproductive system- ________________________________

Rates of Growth and Development1. Fetal and Infancy- ________________________________1. Toddler- ________________________________1. Preschooler- ________________________________1. School- age- ________________________________1. Adolescent- ________________________________

General Principles Females were born with lesser weight than men Men were born with lesser length than men by 1 inch

Factors influencing Growth and Development Heredity Nutrition Illness and Disease Physical, emotional and social environment Age and gender Others- Birth order, Birth interval dependence and independence.

Assessment of GrowthGrowth can be measured in term of:Nutritional Anthropometry (Wt., Ht., Hc., Cc.)Assessment of Tissue growth (Muscle mass, Skin fold thickness)

Newborn loses weight of10% of Birth weight till early 7 days and regain by 10th Day Birth weight doubles by 6 months Triples by a year& 4 times by 2 years.

ASSESSMENT OF HEIGHT At Birth- 50cm 6 months- +12 cm 1 year- 75 cm 2 years- 85 cm 2-5 years- +6 to8cm/year 5 years - 5cm/year

HEAD CIRCUMFERENCEHC= ________________________________

CHEST CIRCUMFERENCEMeasured at the level of Nipple________________________________Equal to HC by 1 yearLesser then HC by 1.5year

Mid arm circumference:Applicable for 1-4 years being >13.5 is normal ________________________________ Arm spam:Distance between tips of the middle fingers with both arm held wide open(Spread apart)

DENTAL GROWTH Most infants have their first teeth erupt at age ________________________________of AgeTwo types of Tooth are Primary or Deciduous Secondary or Permanent Teeth

Neonatal Reflexes:

The sucking reflex ________________________________The Moro reflex, ________________________________stepping reflex ________________________________The tonic neck reflex ________________________________rooting reflex ________________________________The Babinski reflex ________________________________The newborn exhibits two grasp reflexes: palmargrasp and plantar grasp. ________________________________Blinking, sneezing, gagging, and coughing ________________________________The truncal incurvation reflex ________________________________The anocutaneous reflex (anal wink) ________________________________

DEVELOPMENTAL MILESTONE:________________________________

( 1 MONTH )PHYSICALWEIGHTGains about ________________________________weekly during the first 6 months of life.Birth weight doubles by ________________________________

HEIGHT

HEAD CIRCUMFERENCE/OCCIPITO-FRONTALCIRCUMFERENCE (OFC)________________________________.CHEST CIRCUMFERENCEMeasure chest circumference at the level ________________________________.FONTANELLEAt birth, anterior fontanelle measures about 2 inches (4-5 cm) at its widest part; closes at between ________________________________At birth, posterior fontanelle measures 0.5 inches (0.5-1cm) at its widest part; closes by ________________________________MOTORHolds the head parallel from the body when suspended in prone position.

Can turn head from side to side when prone; lifts head momentarily from bed.

Asymmetric posture dominates, such as tonic neck reflex.

Primitive reflexes still present.SENSORY

Eye movements coordinated most of the time; follows a light to midline.Visual acuity ________________________________SOCIALIZATION AND VOCALIZATIONWatches face intently while being spoken to.________________________________

( 2 3 MONTHS )PHYSICAL________________________________closed.MOTORHolds head erect for a short time and can raise chest supported on forearms.Bears some weight on legs when held in standing position.Actively holds rattle but will not reach for it.Grasp, tonic neck, and Moro reflexes are fading, step or dance reflex disappears.SENSORYFollows a light to the periphery.________________________________ (vertical and horizontal vision)Listen to sounds.SOCIALIZATIONSmiles in response to a person or object; cries less

( 4-5 MONTHS)PHYSICALBirth weight doubles.________________________________ because salivary glands are functioning but dont have sufficient coordination to swallow.MOTORCan sit when the back is supported; balances the head wellCan sustain a portion of weight when held in standing position.Reaches for and grasps an object with the whole hand but misjudges distance.Can carry hand or object to the mouth at will.Primitive reflexes(grasp, tonic neck and Moro) have disappeared. PHYSICALSENSORYRecognizes familiar objects and people.Accommodation is developing.

SOCIALIZATION AND VOCALIZATIONCoos and gurgles when talked to; enjoys social interaction.Vocalizes displeasure when an object is taken away.

( 6-7 MONTHS)PHYSICALWEIGHT________________________________HEIGHTGrows about 1.25 cm (1/2 inch) a month.

HEAD CIRCUMFERENCEGrows about 0.5 cm (1/5 inch) a month.Teething may begun eruption of two lower central incisors, followed by upper incisors.

MOTORCan turn equally well from stomach or backSits fairly well unsupported, esp. if placed in forward-leaning position.

SENSORYHas taste preferences; will spit out disliked foodBegins to recognize things are still present even though not seen.

SOCIALIZATION AND VOCALIZATIONBegins to differentiate between strange and familiar faces and shows Stranger Anxiety.Makes polysyllabic vowel sounds.Vocalizes ________________________________when crying; cries easily on slightest provocation but laughs just as quickly.

( 8-9 MONTHS )MOTORSits steadily alone; pulls self to standing position; stands holding onto furniture.Has a good ________________________________coordination.Developing pincer grasp, with preference for use of one hand over the other.Crawls, may go backward at first.SENSORYDepth perception is increasing.Displays interest in small objects.SOCIALIZATION AND VOCALIZATIONDefine social attachments is evident; shows anxiety with strangers.Responds to own name; is separating from mother by desire to act on own.Reacts to adult anger and cries when scolded.Has imitative and repetitive speech using vowels and consonants such as ________________________________No true as yet but comprehend words such as BYE-BYE

( 10-12 MONTHS )PHYSICALWEIGHTBirth weight triples.HEIGHTBirth length increases by 50%Head and chest circumference are equal.Upper and lower and lateral incisors usually have erupted for total of 6-8 teeth.Hemotocrit: 29-41%MOTORCreeps (abdomen off the floor)Stands alone for short times; walks with help; moves around by holding onto furniture.Can sit down from a standing position without help.SENSORYVisual acuity 20/50Discriminates simple geometric forms.SOCIALIZATION AND VOCALIZATIONShows emotions such as jealousy,affection and anger.Enjoys surroundings and will explore away from mother.Fearful in strange situations or strangers; clings to mother.May develop ________________________________ blanket.Can say two words besides DADA or MAMA with meaningUnderstands simple verbal requests (e.g. Give it to me.

( 15 MONTHS )MOTOR Walks well alone by 14 months with a wide-based gait; creeps upstairs.Builds tower of two blocks; enjoys throwing objects and picking them up.Drinks from a cup and can use a spoon.VOCALIZATION AND SOCIALIZATIONCan use ________________________________, including name.Has learned no which may be said while doing a requested demand.

( 18 MONTHS )PHYSICALGrowth has decreased and appetite lessened- ________________________________Anterior fontanel is usually closed.Abdomen protrudes, larger than chest circumferenceMOTORRuns clumsily; climbs stairs or up on furniture.Imitates strokes in drawing.Drinks well from cup; manages a spoon well.Builds tower of three to four cubesVOCALIZATIONSays ________________________________words.Has a new awareness of strangers.Begins to have temper tantrums.Very ritualistic, has a favorite toy or blanket, thumb sucking may be at peak.

( 2 YEARS )PHYSICALWEIGHTAbout 11-12 kg (26-28 lbs)HEIGHTAbout 80-82 cm (32-33 inches)TEETH16 temporary; begin visits to dentistMOTORGross motor skills quite refined.Can walk up and down stairs, both feet on one step at a time, holding onto rail.Builds tower of six to seven cubes or will make cubes into a train.SENSORY Accommodation well developed.Visual acuity 20/40VOCALIZATION AND SOCIALIZATIONVocabulary of about 300 words; uses short, two to three-word phrases, also pronouns.Obeys commands; shows signs of increasing autonomy and individuality; makes simple choices when possible.Still ________________________________, especially at bedtime.Can help undress self and pull on simple clothes.Does not share possessions, everything is mine.

( 30 MONTHS )PHYSICALFull set of 20 temporary teeth.Decreased need for naps.

MOTORWalks on tiptoe; stands on one foot momentarily.Builds tower of eight blocks.Copies horizontal or vertical line.May attend to own toilet needs.

VOCALIZATION AND SOCIALIZATIONBeginning to see self as a separate individual from reflected appraisal of significant others.Still sees other children as objects.Increasingly independent, ritualistic, and negativistic.

MAJOR LEARNING EVENTSSphincter control adequate when child can walk.Able to retain urine for ________________________________.Daytime bowel and bladder control: ________________________________Night control: ________________________________

PROCESS OF BOWEL TRAININGUsually begins with bowel then bladder.Accidents and regressions frequently occur

PARENTAL GUIDANCEChoose a specific word for the act.Have a specific time and place.Do not punish for the accidents.

DISCIPLINEBe consistent; set realistic limits.Reinforce desired behavior.Be constructive, geared to teach self-control.Punish immediately after wrongdoing; punish appropriately.

( 3 YEARS )

PHYSICALUsual weight gain 1.8 to 2.7 kg (4-6 lbs)Usual height gain 7.5 cm (3 inches)

MOTOR Jumps off bottom step; walks upstairs alternating feet.Rides a ________________________________.Constructs three-block bridge; builds tower of ________________________________Can unbutton front or side button; uses a spoon.Usually toilet trained at night.

SENSORYVisual acuity 20/30.

VOCALIZATION AND SOCIALIZATIONVocalization of about 900 words; uses three-to-four word sentences; uses plurals; may have hesitation in speech pattern.Begins to understand ideas of sharing and taking turns.

MENTAL ABILITIESBeginning understanding of the past, present and future, or any aspect of time.Stage of magical thinking.

( 4 YEARS )PHYSICAL Height and weight increases are similar to previous year. Length at birth is doubledMOTOR Skips and hops on one foot; walks up and down stairs like an adult. Can button buttons and lace shoes. Throws ball overhand; uses scissors to cut outline.VOCALIZATION AND SOCIALIZATION Vocabulary of 1500 words or more. May have an imaginary companion. Tends to be selfish and impatient but takes pride in accomplishments; ________________________________MENTAL ABILITIES Unable to conserve matter. Can repeat ________________________________and is learning number concept. Knows which is the longer of two lines; has poor space perception.

( 5 YEARS )PHYSICAL Height and weight increases are similar to previous year.MOTOR Gross motor abilities well developed; can balance on one foot for about 10 seconds; can jump rope, skip, and roller skate. Can draw a picture of a person; prints first name and other words as learned. Dresses and washes self; may be able to tie shoelaces.SENSORY ________________________________ is well established.VOCALIZATION AND SOCIALIZATION Vocabulary of about ________________________________; talks constantly; ask meaning of new words. Generally cooperative and sympathetic toward others. Basic personality structure is well established.MENTAL ABILITIES Beginning understanding of time in terms of days as part of a week. Has not mastered the concept that parts equal a whole regardless of their appearance; difficulty with abstract thought.

(6-12 YEARS )PHYSICAL GROWTH Permanent dentition, beginning with 6-year molars and central incisors at 7 or 8 years of age. Tends to look lanky because bone development precedes muscular development.MOTOR Refinement of coordination, balance, and control occurs Motor development necessary for competitive activity becomes important.SENSORYVisual acuity of 20/20.MENTAL ABILITIES Readiness for learning, especially in perceptual organization: names months of the year, knows right from left, can tall time, can follow several directions at once. Acquires use of reason and understanding of rules; needs consistency. Trial-and-error problem solving becomes more conceptual rather than action oriented. Reasoning ability allows greater understanding and use of language. Concrete operations (Piaget): ________________________________

(ADOLESCENCE)MENTAL ABILITIES ________________________________ - New level of social communication and understanding: can comprehend satire and double meanings; can say one thing and mean another. - Can conceptualize thought; more interested in exploring ideas than facts. - Can appreciate scientific thinking, problem solve, and theoretically explore alternatives. PERCEPTION - Can appreciate nonrepresentational art. - Can understand that the whole is more than the sum of its parts. LEARNING - Long attention span. - Learns through ________________________________ rather than ________________________________. - enjoys regressing in terms of language devt. by using jargon to suit changing moods.

FEEDING MILESTONESDURING INFANCYAt birth, the full-term infant has sucking, rooting and swallowing reflexes.Newborn feels hunger and indicates desire for food by crying; expresses satiety by falling asleep.At 1 month, has strong extrusion reflex.By 5-6 months, ________________________________By 6-7 months, ________________________________By 8-9 months, ________________________________By 9 months, ________________________________By 12 months, ________________________________

ACCIDENT PREVENTION

DURING INFANCY

NEWBORN INFANTDont ________________________________ around infants.Dont leave infant unattended in a ________________________________in a safety seat.Use ________________________________car safety seat.Make sure furniture is free of ________________________________paint.Crib slats should be no further than ________________________________inches; the mattress and bumper pads should be tight fitting.2 MONTHS Dont hold infant while smoking or drinking hot liquid. Set water heater at ________________________________; Test bath water with inner aspect of forearmthe wrist before immersing infant.4 MONTHS Keep small objects and small pieces of food out of infants reach. Dont use ________________________________- they may become small and obstruct airway.6 MONTHS Child-proof the home,esp. the ________________________________. Remove all dangerous items or place out of reach. Use syrup of ipecac in home for emergency use.Keep poison control number on phone; use as needed.9 MONTHS Use nonskid rugs, socks with nonskid strips, nonskid strips in bathroom. Keep wastebaskets covered or out of reach. ________________________________sharp edges of furniture. Never leave unattended near water or in bathtub. Dont use electrical appliances near ________________________________.1 3 YEARS OLD Dont use toys with small pieces. Hold childs hand when walking near the street. Encourage the child to sit down while eating. Turn pot handles toward the back of the stove.When 20 lbs use front-________________________________.

(3-5 YEARS) Use bicycle helmet; ride bicycle on right-hand side of the road or on sidewalk; make sure the bicycle is the correct size, feet should touch the ground when sitting on the bicycle seat. Teach child not to eat things from outside (e.g. mushrooms) until checked by parents. Look both ways before crossing street.Use safety restraints in cars.

(6-12 YEARS) Obey traffic signals while on bike; use ________________________________ on bike; wear light clothing. When playing group sports look for teams divided by size and maturation, not by age; use protective equipment.

( ADOLECENCE ) Use car safety restraint. Teach responsible behavior to reduce ________________________________. Suicide prevention. Handgun control and safety. Motorcycle helmet use. Smoke and carbon monoxide detector use.

(ELDERLY) At risk for injuries - Muscle weakness. - Changes in balance. - Gait abnormalities. - Slowed reaction time. - Use of medications. - Chronic medical conditions (Parkinsons disease) - Changes in vision, hearing, smell Remove throw rugs, door thresholds; make sure floors are smooth and non slip. Clear pathways of furniture. Use solid chairs with arm rests. Provide ________________________________with accessible switches; use ________________________________. Adapt kitchen and bathroom; use ________________________________ toilet seat, grab bars. Use ________________________________ phone.

DIFFERENT THEORIES RELATED TO GROWTH AND DEVELOPMENT

Freudians Psychoanalytic and Psychodynamic Framework/ Psychosexual Theory Intrapsychic process Personality expressed through behavior Personality is ________________________________e, complex and dynamic Personality is the ________________________________General Concepts: ________________________________ has meaning and not determined by chance All behavior is ________________________________ The ________________________________plays a role in determining behavior The ________________________________of life are extremely important in personality development

Structure of Personality Id- ________________________________- the unconsious - Primitive and biologic drives and urges ________________________________e Ego- ________________________________ ________________________________ ________________________________ of personality Partly ________________________________, partly ________________________________s - Reality principle Superego- ________________________________ the conscience A. ________________________________ B. ________________________________The rewarding and the punishing of the super-ego is based in the internalized standard of right and wrong and NOT on morality

Levels of Consciousness: Conscious- ________________________________ Subconscious/ Preconscious- ________________________________ Unconscious-________________________________

Freuds Psychosexual DevelopmentOral Stage (0-18 months) Pleasure through the ________________________________period of complete dependence Task: ________________________________ Primary narcissismAnal stage (18 months- 3 years) Pleasure through ________________________________ Holding on and letting go Power, punishment cleanliness and being dirty ________________________________ Toilet training achieved A. daytime bladder control- ________________________________old B. nighttime bladder control- ________________________________. old Phallic Stage (3-6 years old) Pleasure through ________________________________ ________________________________: Elektra Complex ________________________________: Oedipal Complex ________________________________of genitals ________________________________n complexLatency Stage (6- 12 years old) Energy focused on ________________________________ Sense of industry and mastery Acquires friend Peers of the ________________________________x Genital Stage (12- 20 years) Sexual pleasure through genitals Responsible to self Sexual identity, ability to love and work

Erick Ericksons Psychosocial Theory Trust vs. mistrust- (0-18 months)Autonomy vs. shame and doubt (18 months to 3 years) Obsessive- compulsive Negative: ________________________________

Initiative vs. guilt (3- 5 years) Development of conscience

Industry vs. Inferiority (6-12) How to do things well halfway outside then family and the teachers.

Identity vs. Role Confusion (12-20) Who you are and how you fit in the society Accepts and adjusts to different changes in the body

Intimacy vs. Isolation (18- 30 years) Close to others as lovers, friends

Generativity vs. Stagnation (25- 60 years) Concern for the next and future generations

Integrity vs. despair (60 yrs. - end of life) Accepts responsibility for what life has been

Cognitive Development/ Principles of Cognitive Development (Piaget) Focuses on ________________________________which include expectations, beliefs and memories and thinking patterns which influences behavior and feelings. Sensorimotor (0- 2 years)- senses and motor abilities ________________________________Pre- operational (2-7 yrs. Old) 2-4 y.o- ________________________________ 4-7 y.o ________________________________ Concrete Operations ( 7-12 y.o) ________________________________ Understand cause and effect ReversibilityFormal operations( 12 yrs- adulthood) Logical, Mathematical and scientific reasoning Solutions to all kinds of problems

Moral Development Theory (Kohlbergs)

Level 1 (Pre-Conventional)1. Obedience and punishment orientation________________________________2. Self-interest orientation________________________________)

Level 2 (Conventional)3. Interpersonal accord and conformity________________________________4. Authority and social-order maintaining orientation________________________________)Level 3 (Post-Conventional)5. Social contract orientation6. Universal ethical principles

Sullivans Interpersonal Theory Development results from interaction with significant others and that the child internalizes approval or disapproval by significant others3 Personifications GOOD ME- ________________________________ BAD ME- ________________________________ NOT ME- ________________________________Infancy ( 0-18 months)- ________________________________ Dependent on others Toddlerhood ( 18 months- 3 years) ________________________________ Sense of power Headstrong and negativistic Curious, active, mobile, prone to accidents Pre- Schooler ( 3- 6 years) Consensual validation-________________________________ Love to watch adults and imitate their behaviour Very imaginative Love ________________________________ words Questions about ________________________________Schooler Juvenile era ________________________________ Relate to peers Competition, compromise, and cooperation Peers of ________________________________ Pre- adolescence( 11-12 y.o)- Experience intimacy Chum relationship Leads to healthy ________________________________Adolescence (12- 18 y.o) relates to opposite sex Experience sexual urges ________________________________ Development of heterosexual relationship Young Adulthood ( 20-40 y.o)- Economically intellectually and self- sufficient

Trust in the Lord with all your Heart and lean not on your own understanding,. Acknowledge Him in all your ways and he shall make your path straight.

Proverbs 3:5-6

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