Pediatrics 1

Growth and Development

Definition of Terms
• Growth • ECOBIODEVELOPMENTAL MODEL
o Physically measurable like height and weight o Ecology of childhood: social and
• Development physical
o Increase in the complexity of factors o Biologic process
o Skill progression o Determine: outcomes, life trajectories
o Ability to adapt to new environment/ situation
o Developmental milestones
Importance of knowing the Normal Growth and social

Development
• Order to effectively monitor children’s progress
physical
• Identify delays or abnormalities in development
• Obtain needed services
child
• Counsel parents and caretakers

Models of Development
• BIOPSYCHOSOCIAL MODEL
o Patient’s symptoms are examined and
explained in the context of patient’s existence
o Used to understand health and both acute and
chronic illness
early influences affect health
(stress) and well-being
Ex: Type 1 DM

toxic levels of disrupted

stress (stress coping
molecule response) mechanisms
organelle
cell
tissue alteration in
modifies gene
organ structure and
expression
function

biosphere person
Factors influencing growth and development
a. Biological influence
— genetics
— in utero, exposure to teratogens
— long-term negative effects of low
culture family birthweight (neonatal morbidities)
society/ nation community
— postnatal illnesses
— exposure to hazardous substances
— maturation (attainment of skills)
b. Psychologic influences Transactional Model: Developmental Risk
— Attachment
o Predictive of behavioral and learning
problems
o Biologically determined tendency of Prematurely:
a young child to seek proximity to Depressed mother
 sleep
the parent during times of stress (post partum):
o Allows securely attached children to malnutrition
does not feed
use their parents to reestablish a developmental delay
sense of well being after a stressful
experience (adaptability)
— Contingency
o Adult: paying attention to verbal and
non-verbal cues of a child and
responding accordingly
*fosters autonomic self-regulation
timid, silent
5 y/o child
c. Social factors
— Family systems
o Critical importance of influences
outside of the mother- child dyad dysfunctional workaholic mother
mother-child needs of child not
*father, grandparents, significant others, relationship met
unrelated caregivers

Effect in children:
o denied with decision making: rebellious
o poorly defined parent- child boundaries:
carry responsibilities beyond their age peer pressure child distant and
secretive
o birth order: influence roles and pattern of drugs, alcohol
angry mother feels unloved
interaction
— Ecologic model
o Family system functions within the
larger systems of extended family,
subculture, culture, and society with Developmental Resilience
parent-child dyad at center

d. Unifying concepts: the transactional model, risk

and resilience
— Child’s status at any point in time is a Prematurely:
Supportive mother:
function of the interaction between  sleep
biologic and social influences feeding every 3 hours
(+) weight gain
attentive to baby's needs
(-) developmental delay

biologic factors:
social factor:
temperament
child- rearing
health status
THEORIES OF EMOTION AND COGNITION
1. Psychoanalytic Theory
a. Freudian Theory (Sigmund Freud)
— bodily centered (“sexual) drives
— emotional health of both child and the adult
depends on adequate resolution of these
conflicts
b. Erickson Theory (Erick Erickson)
— intrapersonal challenges facing children at
different ages in a way that facilitates
professional intervention
2. Cognitive Theory
a. Piaget Theory (Jean Piaget)
— cognition changes in quality, not just
quantity
— described how children actively construct
knowledge through:
o linked processes od assimilation (taking
in new experiences according to existing
schemata)
o accommodation (creating new patterns
of understanding to adapt new
information)
— children are continually and actively
reorganizing cognitive processes
3. Moral Development Theory
a. Kohlberg Theory
— children are guided by:
o basic precepts of moral behavior
o takes into account local standards
eg. dress code, classroom behavior,
dating expectations
Behavioral Theory
— sole focus is on observable behaviors and
measurable factors
— no stages are implied
— behaviors that are positively reinforced occur
more frequently; behaviors that are negatively
reinforced or ignored occur less frequently
— simple, widely applicable, and conducive to
science verification

Developmental Infancy Toddlerhood Preschool School Age Adolescence

Theories (0-1 YR) (2-3 YR) (3-6 YR) (6-12 YR) (12-20 YR)

Freud:
Oral Anal Phallic/ oedipal Latency Genital
psychosexual
Basic trust Autonomy Initiative Industry Identity
Erickson:
vs. vs. vs. vs. vs.
psychosocial
Mistrust Shame and Doubt Guilt Inferiority Role diffusion
Piaget: preoperational concrete formal operation
sensorimotor sensorimotor
cognitive (symbols) operations (logical thinking)
preconventional:
conventional: conventional:
Kohlberg: avoid punishment/ post conventional:
— conformity law and order
moral obtain rewards moral principles
(stage 3) (stage 4)
(stage 1 and 2)