Lec. 3 - Growth and development of preschoolers, school age and adolescents

Preschoolers

ages 3 to 6

Initiviative vs guit

preoperational

preschoolers - weight and height

weight - gain 4 ½ to 6 ½ lb per year

height - gain 2 ½ to 3 ½ inch per year

Preschoolers - physical appearance

• skull elongates

• evolve from protruding abd

• evovle from unsteady wide stance

• graceful, erect posture, physical stance

Preschoolers gross motor skills

• running, jumping, throwing more defined

• coordination improves

  • skipping and hopping on one foot

preschoolers fine motor skills

• more percise movements

• can use scissors, draw shapes

  • dress themselves with minimal assitance

preschoolers - growth or developmental delays

• early discovery is apparent

• annual well child visit

• parents know history best

preschoolers - developmental screenign tools

• informs parents of expected development

• identification leads to early discovery and resources

preschool psychosocial development

initiative vs guilt

• asserts themselves establishing initiative - criticism leads to guilt

• practical applications - provide boundaries that supports childs control, encourage participation in care, treat questions serious and answer in developmentally appropriate way

• play is now associative

Preschools cognitive development

• Preoperative - assimilation, accomodation, equilibrium

• Intuitive - ask why, irreversibility, egocentrism

• make judgements based on appearance - magical thinkers phasing out domestic mimicry, animism, centration, time

preschoolers - language develpment

rapid vocab expansion - 2100 words by 4yrs, 4 word sentences, endless talking/questions

literal interpretations - clear, age appropriate questions, especially important in hospital settings.

Preschoolers behaviors

• speech issues - grow out of

• aggression

• discipline

• body image

• sexuality

• behavioral problems

• preschool/kindergarten

preschoolers safety promotion

• car seat safety

• poisoning

• water safety - monitor in bathtub, gate around pool

• trampoline safety - spine injuries occur

• bicycle safety

preschooler - health promotion, disease prevention

• vaccines

• dental care - be able to brush by 6,

• nutrition

• sleep - 12 hrs

  • physical activity

preschooler unexpected findings

• child neglect

• child abuse

School age - physical development

weight - gain 4-7lbs in a year

height - grow 2-2 ½ inch in a year

• puberty at 10, source of physical and emotional problems, physical maturity doesnt equal mental meturity

School age physical development

• develop at varied paces

• loss of deciduous teeth (baby teeth)

• prepubesence and puberty - secondary sexual characteristics, rapid growth (girls), continued (boys), hair on body, mensturation occurs 2-3yrs after breast budding

school age gross motor skills - Early school age

• rides two wheeled bike

• skips fluidly

• maintain balance on 1 leg

• navigate monkey bars

• basic gymnastics

• accurate throwing

• team sports

school age gross motor sjills - late school age

• exhibits agility

• adult like coordination

• significatn endurance

• coordinates complex tracking

school age children - fine motor skills - early school age

• establish hand dominance

• ties shoes independently

• writes legebly

• cuts irregular shapes

school age children - fine motor skills - late school age

• refines handwriting control

• manipulates intricate objects

• use hand tools safely

• draws detailed illustrations

school age developmental delays

gross motor milestones - balance, coordination, endurance

fine motor milestones - dexterity, hand eye coordination

variation is normal

school age psychosocial development

industry vs inferiority

• develops interests, takes pride in accomplishments

play is cooperative

• enjoy structured play in groups

• at 6 - fantasy play alone or w/ same sex friends

• mix of structed/unstructred acitivities promote growth

school age psychosocial development and behaviors - self esteem development

influenced by academic achievment, parental support

• high self esteem = better adaptation skills

• satisfying relationships, improved academics, better mental/physical health

school age psychosocial development and behaviors - body image

experience physical and psychological chagnes - body image crucial

• positive image contributes to life long habits

• comments from peers, family, adults contribute

school age psychosocial development and behaviors - sexual identity

• oritation

• gender identity

• ideals about relationships and intimacy

• evolves over time

• encourage questions as nurse

school age psychosocial development and behaviors - discipline

crucial for positive behavior, character devlopment

• effective discipline impacts cognitive and mental health

  • physical force doesnt help manage difficult feelings or promote positive behavior

school age stress and fears

• pressure form various sources

• may not recognize stress - tachypnea, tachycardia, muscle tension, GI issues, HA

• behavioral signs - anxiety, new fears, clingy, angry, emotional instability, regression, activity avoidance, eating habits, sleep disturbances, nightmares, vague physical complaints

School age - bullying

• significant in this age group

• mental health concerns, behavioral issues

  • depression,anxiety, sleep distrubances, poor academics/attendance, dec. sense belonging,

  • prevention - understnad risk factors, violence reduction programs, community wide engagement crucial,

school age cognitive development - concrete operations

• transition from perceptual to conceptual thinking

• master ceoncept of conservation

• tells time

• process complex info

• sees perspective of others

• solves problems

  • most learning in school setting

school age cognitive development - langauge

delays cause frusturation

• ask about and note difficulrt expressing language

school age - communication and language development

• learns to read

• use complex grammatical forms

• develop metalingustic awareness - think about language, comment on properties, enjoy jokes

• begin understand metaphors

• experiment w/ profanity

• imitate family

school age - school health

• 6-8 hrs school each day

• chronic health conditions affect attendance - nurtrition, exercise, helathcare

• healthy students exhibit - higher lvl engagement, achieve better academics, experience improved health

school age learnign disabilites

disorders affecting acquisition, organization, retention comprehension, application of info

• globally - 5% affected, US - 10% affected

School age - ADHD

• age and severity - begins before 12, as early as 3

• mild to severe

treatment

• meds - stimulatns/nonstimulants

• behavior therapy - develop skills to control behavior

• counseling - assist emotional challenge, coping strats

• edu. services

School age - obesity

• 18.5% of pop.

• high risk for: diabetes, cardiac problems, obesity in adulthood, morbidity, premature death

• boy more likely age 6-11

• girls more likely age 12-19

adolescents - physical growth

boys: weight - gain 15 ½ to 65 lbs, height - grow 4 - 12in - muscle inc.

girls: weight - gain 15 ½ to 55lbs, height - grow 2-8in - fat deposits inc.

puberty

• estrogen inc in girls

• testosterone in boys

• breat tissue in girls,

• pubic hair in both

• male genital changes

respiratory - adolescents

greowth of laryngeal cartilag, larynx, pharynx, vocal cords, lungs produce voice changes

integumentary adolescents

inc. lvl testosterone in both sexes

• inc. sebum production = acne, oily hair

adolescent gross motor skills - early

• develop indurance

• concentration inc. follow complex instructions

• uneven growth spurts, negative effect coordination

adolescent gross motor skills - middle

• speed and accuracy

• coordiantion improves

• more competitive

adolescent gross motor skills - late

• narrows areas of interest

• concentrates on needed relevant skills

adolescents fine motor skills - early

• inc. ability manipulate products

• neat handwriting

• inc finger dexterity

adolescents fine motor skills - middle

refining dexterity skills

adolescents fine motor skills - late

• develop percise hand eye

• coordination and finger dexterity

adolescent psychosocial development

identity vs role confusion

• try diff. roles to develop sense of personal identity

• mood swings common early on

• introspection inc. in middle adolescents

• stabe emotions, anger management in later development

adolescent cognitive development - formal operations

• able to think through more than 2 categories of variables concurrently

• capable evaluate quality of own work

• maintain attention for long period

• highly imaginative, idealistic

• formal logic

• understnad how actions of one influences others

• abstract thinking

language development

• improved communication

• colloquial speech (slang) increases - communication with ppl other than peers becomes difficult

adolescent behaviors - self esteem

• influenced by peers, family relationships, physical appearance, social norms

  • support by giving positive feedback

adolescent behaviors - sexuality

• explore feelings, desires during puberty

• provide education and create safe space

• understna impact of social and cultural factors on sexuality

adolescent behaviors - social interactions

• vital for mental health, well being

• nurse encourages positive peer relationships, guidance to set boundaries and seek help

• active listening and comprehansion skills essential for social interactions

adolescent behavior - perspective on health

shapred by physical, emotional, social factors

adolescent behaviors - high risk

substnace use, unprotected sex, reckless driving

adolescent social development - importance of peers

changes within family systems in society, peer group plays significant role in socialization of adolescents

• peers have positive/negative influence

• peer role modeling and acceptance lead to formation of crew creates collective identity and gives sense of belonging

adolescent social development - sexuality

time when teens begin experimentation related to sexual identity, orientation and behavior

• experimentation part of process of sorting their sexuality, doesnt define identity

  • majority of sexual minoritized adolescents are well but other become depressed

adolescent social behavior - dating

teen dating ranges from group dating to single dating to serious relationships

• romantic relationships are essential to social life of middle and late adolescents

• dont automatically know what makes healthy relationships

adolescent health concerns

• HTN

• Penile disorder

• testicular torsion

• gynecomastia

• menstural disorders

• endometriosis

• premenstural syndrome

• vag infxn

• STI

adolescent behavioral concerns

• contraception

• pregnancy

• abortion/reproductive rights

• rape

• eating disorders

• anxiety

• depression

• substance abuse

• violence