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Review Article

Theories of growth and development in pediatrics: A review

Dayanand Belagavi

Assistant Professor, Dept. of Child Health Nursing, Sumandeep Nursing College, SumandeepVidyapeeth,Piparia, Waghodia, Gujarat, India

Abstract
Growth and development are the two important aspects for human life, especially among children these are fundamental requirement in
assessing the normality and abnormality during stages of childhood. Hence various experts expressed theories of growth and development
in which it can be referred for understanding the normal and abnormal findings of child. Moreover it is beneficial for appropriate, prompt
and preventive management of abnormal children accordingly.

Keywords:Beneficial for appropriate, Prompt and preventive management of abnormal children accordingly.

Introduction is consistent among adolescents. However, there may be a

Biological, psychosocial and cognitive changes that begin great deal of deviation in the age of onset, duration, and
during puberty and continue throughoutadolescence directly tempo of these events between and within individuals.
affect nutritional status and nutrient needs. Adolescents However, with increasing education needs, there is an
experience dramaticphysical growth and development increasing gap between physical maturation and the ability
during puberty. As children grow, their external dimensions to take on adult responsibilities.
increases, which in turn appreciably increases their Therefore, it is vital that health care providers who
requirements for energy, protein, and many vitamins and provide nutrition education and counseling have a thorough
minerals.Early adolescence can be described as a period of understanding of adolescent physical and psychosocial
life, in which youth undergo rapid physical, cognitive, and growth and development.
social transformation.
Adolescent patients present a unique set of challenges Theories of development
to pediatricians. A polite, compliant child can appear to 1. Psychosexual development- Freud’s theory
transform into a surly, rebellious teen before a doctor’s eyes. 2. Psychosocial development- Erikson’s theory
Adolescence can be a tumultuous time, even when it is 3. Cognitive/ intellectual development- Piaget’s theory
unfolding in a healthy manner. For this reason, and because 4. Moral development- Kohlberg’s theory
there is so much individual variation in adolescent 5. Spiritual development- Fowler’s theory
development, it is usually referred to as a unit, expressed as 6. Language development
the sum of the numerous changes that take place during the
lifetime of an individual. Psychosexual development:(Freud’s theory)
Growth- is an increase in number and size of cells as they 1. The Oral Stage(Birth to 1 Year): During this period,
divide and synthesize new proteins, results in increased size the sensory area of the mouth provides the highest
and weight of the whole or any of body part. Growth as a sensual satisfaction for an infant by doing sucking,
quantitative change. biting, chewing and vocalizing.
Development- is a gradual change and expansion of the 2. The Anal Stage(1to 3 Years):The toddler period, the
person. The all round expansion of the individual’s second and third years of life, the greatest amount of
capacities through growth, maturation and learning. sensual pleasure is obtained from the anal and urethral
Development as aqualitative change. areas by defecating. At this stage the climate
surrounding toilet training.
Normal physical growth and development 3. The Phallic Stage (3 to 6 Years):During this stage,
The beginning of biological growth and development during children become more interested about the genitalia and
adolescence is signified by the onset of puberty, which is sensitive area of the body. They recognize difference
often defined as the physical transformation of a child into between the sexes and become curious about
an adult. A myriad of biological changes occur during dissimilarities. The oedipal stage occurs in the later part
puberty including sexual maturation, increases in height and of phallic stage, during this time the child loves the
weight, completion of skeletal growth accompanied by a parent of opposite sex as the provider of satisfaction.
marked increase in skeletal mass, and changes in body 4. The Latency Stage(6 Years to Puberty):During this
composition. The succession of these events during puberty stage, children elaborate on previously acquired traits
*Corresponding Author: Dayanand Belagavi, Dept. of Child Health Nursing, Sumandeep Nursing College, Sumandeep Vidyapeeth,
Piparia, Waghodia, Gujarat, India
Email: dayabelagavi@gmail.com

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Dayanand Belagavi Theories of growth and development in pediatrics: A review

and skills and also form close relationship with others success to be recognized by adults and by peers.
of their own age and sex. The danger this period is the development of a
5. The Genital Stage(Puberty to Death):During puberty, sense of inferiority if the parents or the school
secondary characteristics appear in both sexes with expect a level of achievement that children are
maturation of the reproductive system and production unable to attain. The ego quality development from
of sex hormone. a sense of industry is competence.
5. Identity vsRole Confusion (12 to 18 Years):The
Psychosocial development (Erikson’s theory) sense of identity develops during adolescence.
Adolescents experience dramatic biological changes related Success in this period brings self-esteem, an
to puberty; these biological changes can significantly affect attitude towards the self. Inability to solve the core
psychosocial development. An increased awareness of conflict results in role confusion. The outcome of
sexuality and a heightened preoccupation with body image successful mastery is devotion and respect to others
are fundamental psychosocial tasks during adolescence. and to values.
Peer influence is a dominant psychosocial issue during
adolescence, especially during the early stages. Young teens Cognitive or intellectual development (Piaget’s theory)
are highly cognizant of their physical appearance and social The early stage of adolescence is a time of great cognitive
behaviors, seeking acceptance within a peer group. The development. At the beginning of adolescence, cognitive
desire to conform can influence food intakes among teens. abilities are dominated by concrete thinking, egocentrism,
The broad chronological age range during which biological and impulsive behavior. The ability to engage in abstract
growth and development begins and advances can become a reasoning is not highly developed in most young teens,
significant source of personal dissatisfaction for many limiting their capacity to comprehend nutrition and health
adolescents as they struggle to conform to their peers. relationships. Young adolescents also lack the skills
Erikson, apsychologist wrote on Emotional or necessary to problem solve in an effort to overcome barriers
personality development. He said in each stage of a child’s to behavior change and the ability to appreciate how current
emotional development, a central problem exists for which a behaviors can affect future health status. Much of modern
solution should be found. Erikson’s life span approach to thinking about cognitive development in adolescence has its
personality development relating to childhood included roots in the work of Jean Piaget (1896 to 1980). According
here; to Piaget, maturation and growth have certain signposts and
1. Trust vsMistrust (Birth to 1 Year): Infant learn adolescence marks a shift from the rule-bound, concrete
to trust the adults, usually the parents’ who care for methods of problem solving during the concrete operations
them and are sensitive to their needs. Loving care stage characteristic of younger children to the greater
by a mothering person is essential for development capacity for abstraction and flexible problem solving that
of trust and bonding relationship. ‘Mistrust’ characterizes formal operations. Children are born with
develops when trust promoting experience is inherited potentials for intellectual growth, but they must
deficient or lacking or when basic needs are develop that potential through interaction with the
inadequately met. The favorable outcomes are faith environment. Upon entering what he labeled the “formal
and optimism. operations stage,” early adolescents, Piaget believed,
2. Autonomy vsShame &Doubt (1 TO 3 developed the ability to think more scientifically; to design
Years):The development of autonomy during the and test multiple hypotheses; and to manipulate objects,
toddler period is centered on children’s increasing operations, and future outcomes in their minds without
ability to control their bodies, themselves and their having to actually interact with physical objects. This view
environment. If they do not succeed, they will of cognitive development in early adolescence has played a
doubt their own worth and that of others and will major role in the sequencing of curriculum in schools
have a sense of shyness, doubt and shame. The Four major stages of emotional development are;
good results are self-control and will power. 1. Sensorimotor (Birth to 2 Years):In which children are
3. Initiative vsGuilt (3TO 6 Years):At this age, primarily concerned with learning about physical
children want to learn what they can do for objects. Children progress from reflex activity through
themselves. They have active imaginations, simple repetitive behaviors to imitative behavior. They
imitating their parents, teachers and wanting to develop a sense of cause and effect as they direct
share in adult activities. During some activities behavior towards objects.
they are in conflict withparents it makes to feel that 2. Pre-operational (2 to 4 Years):The predominant
their activities or imaging are bad produces a sense characteristic of the preoperational stage of intellectual
of guilt. The lasting outcomes are direction and development is ego centrism, which in this sense
purpose. doesn’t mean selfishness the inability to put oneself in
4. Industry vsInferiority (6 to 12 Years):Children the place of another. Children are preoccupied with
in this age group have a strong sense of duty. They symbols in language, dreams and fantasy.
want to engage in tasks in their social world that 3. Intuitive phase (4to 7 Years):Children begin to
they can carry out successfully, and they want their elaborate concepts and to make simple associations
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Dayanand Belagavi Theories of growth and development in pediatrics: A review

between ideas. They are only beginning to deal with which children have no concept of right or wrong, no
problems of weight, length, size and time. Reasoning is beliefs and no convictions to guide their behavior.
also transductive because 2 events occur together, they 2. Stage ‘1’-Intuitive Projective:Toddlerhood is
cause each other or knowledge of one characteristic is primarily a time of imitating the behavior of others.
transferred to another. Children imitate the religious gestures and behavior of
4. Concrete operation(7 to 11 Years):In this, children others without comprehending any meaning or
move into the abstract world, mastering numbers and significance to the activities.
relationships. At this age thought becomes increasingly 3. Stage ‘2’-Mythical Literal:In this period, spiritual
logical and coherent. Children are able to classify sort, development parallels cognitive development and is
order, and otherwise organize facts about the world to closely related to children’s experiences and social
use in problem solving. interactions.Good behavior is awarded and bad
5. Formal operation (11 to 15 Years):In which they behavior is punished.
tackle purely logical thought, thinking about their own 4. Stage ‘3’-Synthetic Convention: As children approach
thinking as well as that of others. Formal operational adolescence, however they become increasingly aware
thought is characterized by adaptability and flexibility. of spiritual disappointment.they recognize that prayers
Adolescents can think in abstract terms, use abstract are not always answered and may begin to abandon or
symbols and draw logical conclusion from a set of modify some religious practices.
observations. 5. Stage ‘4’-Individuating Reflexive:Adolescence
becomes more aware of the emotion, personality,
Moral development (Kohlberg’s theory) patterns,behaviours, ideas, thoughts and experience of
The study of moral development is somewhat controversial self and others. They begin to compare the religious
because it places morality under a scientific lens, implying a standards of their parents.
social and biologic basis for moral behavior. Self-concept is how an individual describes himself
Moral development described by Kohlberg is based on or herself. The term self-concept includes all the
cognitive developmental theory. He observed, not every notions, beliefs and convictions that constitute an
individual reaches the same end. Kohlberg postulates 6 individual’s relationship with others.
stages of potential moral development which is organized in
3 levels: Language development
1. Pre-conventional Level:The pre-conventional level of 1. The ability to communicate is a significant factor in a
normal development parallels the preoperational level child’s intellectual, emotional and social development.
of cognitive development and intuitive thought. They Language is a complex system of grammatical and
avoid punishment and obey without question those who semantic properties. Children are able to understand
have the power to determine and enforce the rules and language before they are able to speak it.
labels. 2. The steps of prelingual speech are the same for all
2. Conventional Level:At the conventional stage children children.Reflex, vocalizations, babbling, imitation of
are concerned with conformity and loyalty. They value sounds and verbal utterance.
the maintenance of family, group or national 3. The child’s articulation or ability to pronounce words
expectation regardless of consequence. One earns correctly so that they are understood develops along
approval by being nice, obeying the rules and with language ability. Articulation skills require the co-
maintaining the social order are the correct behavior. ordination of the tongue and lower jaw.
This level is correlated with the stage of concrete 4. Vocabulary or semantic development, progresses from
operation in cognitive development. infancy throughout life. The most dramatic vocabulary
3. Post-conventional Level:At the post conventional development takes place between 18 months &3 years
level the individual has reached the cognitive stage of of age.
formal operation. Correct behavior tends to be defined 5. A single child develops language earlier than those with
in terms of general individual rights and standards that siblings. Girls learn language and speak earlier than
have been examined and agreed by the entire society. boys.

Spiritual development (Fowler’s theory) Conclusion

According to Fowler, faith is a human universal that is Adolescence is a complex developmental process that varies
expressed through beliefs, rituals and symbols specific to substantially, both individually and culturally and the
religious tradition. It is multidimensional and a way of divisions of development are arbitrary. They are
learning about life. Spirituality affects the whole person psychosocial, psychosexual, moral, cognitive and spiritual.
mind, body and spirit. The stages of development of faith They all usually progress together in the process of
are; maturation and learning. Knowledge of growth and
1. Stage ‘0’- Undifferentiated: This stage of development is important to the nurse to observe the
development encompasses the period of infancy during sequence of developmental behavior of each child and also
helps to plan better care to the baby. In addition, it is
IP Journal of Paediatrics and Nursing Science, July-September, 2019;2(3):63-66 65
Dayanand Belagavi Theories of growth and development in pediatrics: A review

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