Growth & developmental Theories Introduction

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1 Growth & developmental Theories Introduction

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4 سيغيسموند شلومو فرويد يعرف اختصارًا بـسيغموند فرويد (6 مايو 1856—23 سبتمبر، 1939) هو طبيب نمساوي من أصل يهودي، اختص بدراسة الطب العصبي ومفكر حر] يعتبر مؤسس علم التحليل النفسي.[16] وهو طبيب الأعصاب النمساوي الذي أسس مدرسة التحليل النفسي وعلم النفس الحديث. اشتهر فرويد بنظريات العقل واللاواعي،[17]وآلية الدفاع عن القمع وخلق الممارسة السريرية في التحليل النفسي لعلاج الأمراض النفسية عن طريق الحوار بين المريض والمحلل النفسي. كما اشتهر بتقنية إعادة تحديد الرغبة الجنسية والطاقة التحفيزية الأولية للحياة البشرية، فضلا عن التقنيات العلاجية، بما في ذلك استخدام طريقة تكوين الجمعيات وحلقات العلاج النفسي، ونظريته من التحول في العلاقة العلاجية، وتفسير الأحلام كمصادر للنظرة الثاقبة عن رغبات اللاوعي.[18]

5 في حين أنه تم تجاوز الكثير من أفكار فرويد، أو قد تم تعديلها من قبل المحافظين الجدد و"الفرويديين" في نهاية القرن العشرين ومع التقدم في مجال علم النفس بدأت تظهر العديد من العيوب في كثير من نظرياته، ومع هذا تبقى أساليب وأفكار فرويد مهمة في تاريخ الطرق السريرية وديناميكية النفس وفي الأوساط الأكاديمية، وأفكاره لا تزال تؤثر في بعض العلوم الإنسانية والعلوم الاجتماعية.

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10 There are three major theories, list below, are important determinants of the individuals development, ad they all describe the developmental stages of the individual & the tasks that should be accomplished in each stage from the point of view theorists. Psychosexual analytic theory [ ] Cognitive theory [ ] Psychosocial theory

11 The theories help the pediatric nurse to know the developmental tasks that the child should accomplish in his/her development stage & assist him/her to accomplish them. Decrease accomplishment & development = mental Illness.

12 Freud's psychoanalytical theory
The Freud's theory focused on the importance of biology & unconscious thinking in different developmental and psychosexual stages. Its view the world as an organic. The theory discussed three forces, id, ego, & superego, which are fairly well balanced the personality function. If the balance is lost between the three conflicting forces, psychological problems will develop. Problems can also arise out on the different psychosexual stages of development when fixation occurs.

13 Fixation means that some part of the mind is sealed off from further development. Every fixation leaves the individual more like an infant & less like an adult. The basis of Freud's theory of development Is derived from that the sexual energy of the "id" finds different sources of satisfaction stages of psychosexual development: Oral stage birth _1 year. Anal stage 1-3 years. Phallic sage 3-6 years. Latency stage 6-11 years. Genital stage 11 adulthood.

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15 These stages must be satisfied enough, if satisfied the person will become emotionally mature, if not the person will find difficulty and unresolved conflicts at any stage than appears through dreams or thoughts and inappropriate emotions.

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17 السيرة الذاتية: ولد عام 1902 بالقرب من مدينة فرانكفورت بألمانيا   وقد ابتعد عن التعليم النظامي بسبب رغبته الشديدة في أن يصبح فنانا كان يعتقد أنه مرفوض من أقرانه لأنه كان يشبه سكان شمال أوربا ولأنه كان يهوديا وكان يعامل من اليهود على أنه غير يهودي لذا فقد أصبحت أزمة الهوية الهم الشاغل له في حياته وفي نظريته. لم ينهي دراسته وقضى فترة من حياته في التجول في البلدان الأوروبية لتعلم الرسم. ويعتبر ذلك مؤشرا لشعوره بالاغتراب واضطراب الهوية. تسنى له التعرف على “أنا فرويد Anna Freud ” التي انتدبته لتدريس الفن للأطفال الأمريكيين القادمين إلى فيينا لدراسة منهج فرويد 1927 فتعلم الكثير عن التحليل النفسي من تلاميذ فرويد. رحل إلى الولايات المتحدة ليشتغل معالجا نفسيا للأطفال وقام بالتدريس في أعرق الجامعات وتولى عدة مناصب في مؤسسات علاجية كبيرة رغم أنه لم يحصل على أي درجة جامعية وقام بعدد من البحوث التي أثمرت عن نظريته في التحليل النفسي. توفي عام 1994 عن عمر يناهز الواحد وتسعين سنة.

18 حياته العلمية: يمكن تلخيص حياة إريك إريكسون العلمية في النقاط التالية: قام بدراسة مشاكل المعارك لدى الجنود الأمريكيين في الحرب العالمية الثانية درس اللعب عند الأطفال الطبيعيين والمضطربين. قام بحوارات مع المراهقين المضطربين الذين يعانون من مشكلات تتعلق بالشخصية. درس السلوك الاجتماعي في الهند. كتب عن هذه البحوث في إصداراته مثل “الطفولة المعروفة والمجتمع ” و “الشخصية :الشباب والأزمات ” كتب عن بعض الموضوعات الهامة مثل الفجوة بين الأجيال والتعصبات العرقية ونزعة الصبيان إلى الجنوح وتغيير الأدوار الجنسية. ساهم أريكسون في ثلاث طرق لدراسة النمو: الملاحظة المباشرة، ومقارنة الثقافات، ومنهج الإحياء النفسي.

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20 Oral stage (birth -1 year):
Infant gets pleasure from sucking and swallowing and it takes one picture from the following: Oral receptive personality: When the child continues to seek the pleasure through the mouth by overeating and smoking.

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24 Oral aggressive personality:
Pleasure frustrated he seeks aggressive pleasure through the mouth by being verbally hostile to others.

25 Anal stage: (1-3 years): Toilet training children gets pleasure from expelling faces. It takes one picture from the following: Anal retentive: If the child has excessive punishment form failure during toilet training, the child gaining his satisfaction from holding back feces and show neatness. النظافة Anal expulsive: Child gains pleasure from expelling the body's waste products. If the child is over satisfied in this stage he will gives feces especially at in appropriate time and show messiness. الفوضى

26 Phallic stage: (3-6 years):
Satisfaction is focused on genitals and child begins to enjoy touching his/her genitals and develop sexual attraction to the parent of the opposite sex: Oedipus complex with mother. Electra complex with father.

27 Latency stage: (6-11 years):
In this stage, the sexual energy is sublimated and converted into socially valued activities in school work, riding bicycles and playing. The sexual interest is relatively inactive. Genital stage: (11 – adulthood): Sexual desires and interests are directed toward one's pears. Adolescent boy search for girl friend. Adolescent female search for boy friend.

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30 This is the beginning of mature adult sexuality sublimation, in this stage the person become more important as sexual and aggressive "id" motives become transformed into energy for marriage and occupation.

31 Cognitive / Piaget's theory (1896-1980)
Cognitive process: In Order to understand Piaget theory you should recognize on 4 major cognitive processes which are: Schemas:مخطط It is a method of dealing with the environment that can be generalized to many situations. Equilibrium: It is the achievement of balance between internal and external forces. Adaptation / assimilationالإستيعاب / accommodation: Refers to changes of internal forces to adapt with external environmental circumstances. Conservation: ability of child to conserve concept of numbers and quantities

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35 Sensory motor stage: (birth -2 years):
During this period infants learn through the senses (see, hear and touch) and motor abilities (grasping, kicking).الركل At the end of stage start symbolizing and playing. Pre operational stage (2-7): Thoughts become more symbolic can arrive at answers mentally instead of through physical attempt. Child is egocentric and unable to see the point of view of another.

36 Concrete operational stage (7-12 years):
Thoughts become increasingly logical and coherent. Children are able to classify, sort, and order. They conserve volume; weight and numbers. Thoughts become less self-centered and consider points of view of others. Own thinking has become socialized.

37 Formal or operational stage (12-18 years):
Adaptability and flexibility is characteristic of this stage. Adolescent can think in abstract thinking forms, use abstract symbols and draw logical conclusions from a set of observations and can make hypothesis and test them. Although they may confuse the ideal with the practical, they can deal with and resolve most contradictions in the world

38 (adolescence Adulthood)
Piaget's Cognitive Development Stages Formal Operational (adolescence Adulthood) Concrete Operational (7-11 years old) Preoperational (2-7 years old) Sensorimotor (birch – 2 years old) 1 2 3 4

39 Erik Erickson's Theory (psychosocial development)
Erickson's Theory includes eight general age groupings with a set of orderly, acquired behaviors for each stage from infancy to old age. Erickson sees each stage as a conflict between opposite values, with accomplishment of that stage being determined by a resolution of the conflict.

40 Progression through the earlier stages should be considered because is may have an impact on how the child develops. When the critical issues at each stage of life are resolved, the individual goes on to the next stage. When a critical issue remains unresolved, the individual ordinarily has difficulties in adjusting to the next stage in life. The individual change from stage to other stage by achieving developmental tasks of each stage.

41 Stages of growth and development according to Erickson's Theory
Trust versus mistrust (birth to 18 months): This is the stage, which forms the base of subsequent personality that the quality of the relationship between infant & primary caretaker (mother or other) is important. If a relationship between infant & his or her mother was good & warmth, this lead infant to trust mother and enter this stage perfectly, while if not pass this stage perfectly the infant will mistrust mother.

42 Autonomy versus Shame / Doubt (18 months to 4 years):
In this stage, with trust the infant can now discover his own behavior. The toddler becomes assertive and wants to explore himself & explore his environment. Without trust the infant cannot explore anything and may become schizoid that does not share in everything.

43 Initiative versus Guilty (4-6 years):
The language and good locomotion gives the child the ability to expand imagination. The development of conscience begins. If child cannot be initiative he becomes guilty one.

44 Industry versus Inferiority (6- 12 years):
This is the primary school age; the child begins to differentiate between work (especially school work) and play. He learns to enjoy his work for the pleasures. Identity versus Diffusion ( years): In this stage the adolescent is learning about himself, where he wants to go, and what he wishes to do with his life. He is putting it all together for adulthood.

45 Intimacyالألفة versus Isolation (18 – 40 years)
The young adult is concerned with establishing sexual intimacy, which is usually centered on marriage. Final career choices become important. If he failed to achieve that, he isolates from society.

46 Generatively versus Stagnation (40 -65 years):
In this stage, the concern in the middle adulthood is to contribute something of lasting value to youth and society. Adjusting to a change in sexual activity becomes important but if he can't make adjustment stagnation become the result.

47 Integrity versus Despair (65 year till death):
Accepting one's life for what it was and enjoying what has been promotes integrity. Feeling useful and enjoying respect is important.

48 Compassion of the Piagetian, Freudian &Eriksonian stages of development
Item Piaget' theory Freud's theory Erikson's theory Stage period Integrity ys. Despair 60 – death Generatively vs. stagnation 40-60y. Intimacy vs. Isolation 18-40y. Formal Stage 12-18 Genital Stage 11- adulthood Identity vs. diffusion 12-18y. Concrete operational Stage 7-12y. Latency Stage 6-11y. Industry vs. Inferiority 6-12y. Pre Operational Stage 2-7y. Phallic Stage 3-6y. Initiative vs. guilt 4-6y. Sensory Motor Stage Birth -2y. Anal Stage 1-3y. Autonomy vs. shame 18m. – 4y. Oral Stage 0-1y. Trust vs. mistrust 0-18m.

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61 Assessment of Growth Assessment of infant' growth is crucial during different stages of life because periodic assessment of infants and children permits early detection of growth deficiencies and deviations from normal standards. During assessment the nurse should take the following points in his/her consideration:

62 Physical growth assessment is usually carried out using tables and charts.
The measurements which are commonly done are weight, height, and head circumference. Newly chest circumference is done for newborns to assess fetal growth at birth. There is wide range of normal variation among infants and children of the same chronological age. These normal differences are described in terms or percentiles. Comparison of the child percentile with those of the previous examination of the same child can detect abnormalities in his growth.

63 Not all measurements of the same child necessarily fall into the same percentile, but each measurement should follow its own percentile in a healthy child.

64 Assessment of Development
Developmental pediatrics is referred to maturation of the structure and functioning of the organs from fetal viability to full growth. It's intimately related to the maturation of CNS. Developmental assessment includes 4 areas as the next:

65 Gross motor: the normal acquisition of motor skill depends on:
Loss of primitive reflexes. The development of postural control (Cephalocuodale direction). Increase ability to interpret the visual information as distance. The development of movement pattern which are adjustable to environmental circumstances.

66 Fine motor and vision Integration of visual input and motor output is necessary for development of accurate manipulative skills. Manipulative skills start from crude palm grasp and gradually developed till fine pincer grasp that reached at 12 months old.

67 Speech and hearing Speech, as a system of communication is an essential future of human life. Nurse should assess preferences of the baby for some human voices and face as parent. Personal-social Include assessment of child social reaction to other persons. Even neonates are socially active as they are able to elicit attention of their parents. During the second half of the first year, the baby starts to recognize the familiar adults and develop strong attachment to her/his care giver.

68 Assessment of maturity
The process of maturation is continuous throughout life; it begins at conception and ends at death. Maturational "events" include those aspects of maturation that occur once and provide an unambiguous signal that the individual has reached a particular level of maturity. For example, the exact age at which menarche (the first menstrual period) is experienced in girls or the exact the age of peak height velocity during the adolescent growth spurt. The maturity process of a child can be assessed at a single examination using three aspects:

69 Sexual maturity can be assessed from the development of public hair in each sex, the genitalia in males and the hearts in females. Usually, these assessments accomplished by with direct inspection. Skeletal maturity is assessed from radiographs of wrist and is recorded as a continuum of skeletal ages (years) that may range from birth to 18 years. Dental maturation is best assessed by taking panoramic radiographs of the mandible and maxilla and scoring the stages or formation and calcification of each tooth.

70 Catch-up growth Unusual acceleration of growth may follow the recovery of infant or the child from a disease. Catch-up growth (acceleration) is complete if the growth data for a child return to child's original percentile before the deficit occurred.

71 Catch-up growth is not always complete, however, and appears to depend on the timing, severity, and duration of the insult. This appears to be particular true in the treatment of hormone deficiencies. Complete catch-up is more common in infants than in older children but in may be delayed. Catch-up can occur in weight an any age, in stature until the time of epiphyseal fusion, and in head circumference until the sutures of the cranial vault interlock at about 5 years.

72 Growth velocity chart Growth velocity chart is used to assess a child's growth rate over several periods of time. Calculate you child's growth rate by recording his/her height at 2 points in time that are at least 150 days apart; then compare it with the normal growth rate of children the same age and sex.

73 Growth Chart Growth charts are the primary tools for the recognition of unusual growth. Consist of a set of smoothed curves for selected percentiles with accompanying tables of means and standard deviations. Some of these charts were developed from nationally representative samples to obtain estimates for total populations. The curves are usually for that 3rd, 5th. 10th. 25th, 50th, 75th, 90th, 95th, and 97th, percentiles. For example, when there are 100 children in an age group, the 3rd percentile value depends upon only the smallest three to four observations.

74 Children whose measurements fall within the 5th and 95th percentiles are generally considered within the normal growth range. Sudden or sustained changes in percentile may indicate a chronic disorder, emotional difficulty, or nutritional intake problem. These findings require further assessment or the physical status of the child as well as other types of evaluations such as dietary intake or serum laboratory measurements.