PNP: Developmental Theories and Assessment.txt

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MBitting
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PNP: Developmental Theories and Assessment.txt
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2011-06-07 17:56:38
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Developmental Theories Assessments
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Developmental Theories and Assessments for Pediatric Nurse Practitioners
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  1. What is the Maturation Theory?
    • Derived from the embryology and developmental physiology and from thestudy of physical growth.
    • Child is seen as a developing Neurophysiological immature organism
    • Predictable patterns of behavior
    • Emphasis on process of maturationover time.
    • Model for understanding normal & delayed development
  2. What is Psychoanalytic Theory?
    • Freud’s contribution of the child’s affective and emotional development.
    • Model emphasizes importance of unconscious and conscious mental processes in the child’s concept of themselves as individuals and their place in society.
  3. What is NeoFreudianTheory (Erik Erickson)?
    • Erik Erickson advanced and broadened the psychoanalytic theory to formulate a structure to understand the stages ofemotional development through out the life cycle.
    • Each stage is characterized by negotiation of one central issue
    • Early stages are foundations for later development.
  4. Explain Erik Erickson Theory?
    • Development is a continual process that occurs in distinct stages.
    • Each stage has a developmental crisis that requires resolution.
    • Child may never completely finish all the developmental tasks in a given stage.
    • Some degree of mastery and comfort must be achieved before proceeding to next stage.
    • New Development rooted in prior experience.
  5. What are Erickson’s 5 Stages of Ego Development and when do they occur?
    • Trust versus mistrust (period of infancy)
    • Autonomy versus shame and doubt(early childhood)
    • Initiative versus guilt (preschool and early schoolyears)
    • Industry versus inferiority (Middle to latechildhood)
    • Identity versus identity diffusion (Adolescence)
  6. Who developed Learning Theories and describe what they entail?
    • Pavlov, Skinner, and Watson in 1927postulated the environment is a source of behavioral change.
    • The environment supplies patterns of reinforcement or regard that shapeand determine the child’s response
    • Example: Behavioral Modification techniques
  7. Who developed the Social Learning Theory and describe what it is?
    • Bandura, a Cognitive social learning theorist, postulated more elaborate learning milieu to explain social and object related development
    • Child learns to fit into a social organization family, school, soccer team, etc.
    • Child learns through observation of behavior and its consequences on those around him in these settings (Role Models)
  8. What is the Piagetian Theory?
    • Provides understanding of cognitive development
    • Child is an active participants in their life experiences, constantly incorporating experiences (assimilation) into their own mental and physical structures of action(schema).
    • When confronted with new events, child modifies behavior and mental structures to handle (accommodation).
    • Modification is dependent on a stagerelated level of competencies
  9. Describe the child's development in the Piagetian Theory?
    • Development of cognitive
    • Abilities occurs in a fixed sequence of qualitatively different stages
    • Child’s mind works differently in each stage
    • Schemes
    • Are thought patterns child develops to help understand the encounters with the environment and problems discovered
    • Is the action pattern and the mental basis for the action
    • Development occurs as schemes increase in scope and complexity
  10. How can the Piagetian Theory help parents understand a child's development?
    • Provides information to assist parent sunderstanding and coping with child’sbehavior
    • Parents are often distressed when the infant cries with separation and is afraid ofstrangers between 79 months offering information about the development of object permanence is helpful
    • Separation anxiety or protest results fromthe infant’s inability to remember that the parent exists even though not seen
  11. Describe how Piaget described cognitive development?
    • Piaget recognized that cognitive development was not always at the same chronological time, but that it did follow apredictable pattern.
    • The child does not advance to the next stage until he has completed his present stage.
    • Process of knowing
    • Perception - memory - j udgment - reasoning
  12. What are the Stages of Cognitive Development and when do they occur?
    • Sensorimotor Period: Birth - 2yrs. Object permanence, causality and symbolism
    • Preoperational: 2 - 7yrs. Magical thinkers unableto separate stories andfantasy from reality
    • Concrete Operations: 7-11yrs. Enables new skills but only with directly perceived information. Unable to perform abstract thinking. Able to classify objects by characteristics.
    • Formal Operations: 11yrs. to adolescence
  13. What is the Attachment Theory?
    • Is an affectional tie that one person forms between himself and another specific one that endures over time and space (Bowlby, 1969)
    • It is the prototype for all future attachments
  14. Who is at High Risk for Attachment Disorders?
    • Preterm infants,
    • Chronically ill children,
    • Children with Congenital defects
  15. Why do we study a child's temperment?
    Understanding temperament assists in tailoring anticipatory guidance about behavior issues or management plans for behavioral problems
  16. What instrument do we use to assess a child's temperment and at what age do we test it?
    Carey Infant Temperament Questionnaire assess 4 - 8 month olds
  17. The quantitative or measurable aspects of the individual’s size measures what?
    Growth
  18. The qualitative or observable aspects of changes in the individual measures what?
    Development
  19. What assesses development and compares results to the average standard?
    Developmental Screening Test
  20. When we examine the changes in function, including those influenced by the emotional and social environments, we are measuring what?
    Development
  21. Development is intimately related to maturation of what?
    the nervous system
  22. _____________ of development is the same in all children, but the ________of development varies from child to child.
    Sequence, rate
  23. Development occurs __________.
    cephalocaudal: neurological development that proceeds from the head downward
  24. What must be lost before the corresponding voluntary movement can be achieved?
    Certain primitive reflexes
  25. Development follows some normalpatterns of predictability within anindividual called ___________.
    milestones
  26. What are the 4 Developmental Assessment Areas?
    • Physical or Physiologic
    • Neurodevelopmental
    • Cognitive
    • Psychosocial
  27. Describe physical or physiologic development?
    • Domains, Physical size, Shape, Function
    • Tract changes over time
    • Assessed by plotting on charts
  28. Describe Neurodevelopmental maturation.
    • Changes in behavior over time
    • Examples: reflex activities, gross and fine motor skills
    • Assessment by observation
  29. Describe cognitive development.
    • Closely related to neurodevelopment
    • Physiologic and mental structures that permit
    • thought, learning, knowing, problem solving along with behaviors that support these structures
    • Assessed by observation and interaction
  30. Describe psychosocial development.
    • Interactions of the infant or child with the environment
    • Focus: emotional content and quality of the interpersonal relationships
    • Assessed: Observation, interaction, interview
  31. Integration of developmental process shows the uniqueness of each individual child including active interplay between:
    • Physical/physiologic development
    • Neurodevelopmental Maturation
    • Cognitive development
    • Psychosocial Development
    • Genetic & Temperament
    • Environment
  32. Neonatal Period is between _____________ ?
    birth to 1 month
  33. Infancy period is betweeen _____________ ?
    1 month to 1 year
  34. 3 examples of newborn assessment are?
    • Apgar Score
    • Dubowitz GestationalAge
    • Brazelton Neonatal Behavioral Assessment Scale assessment of reflexes and behavioral responses
  35. Describe Denver II and at what ages can one utilize it?
    • Age: 0 72months
    • Gross Motor, Fine motor, adaptive/language, and personal/social skills
    • Part of Well Child Evaluation
    • Improved assessment of language over Denver Development Assessment
  36. Describe Early Language Milestone (ELM) and at what age would you use it?
    • Focus: Speech and language screening
    • Important as it correlates best with cognitive development in the early years
    • Ages: Birth to 36 months
    • Visual, auditory receptive, and auditory expressive areas
    • Testing combines history, direct testing and observation
    • With a delay, a hearing deficit must be considered referto audiologist or speech pathologist
  37. Describe Denver Articulation ScreeningExam (DASE) and at what age would you use it?
    • Speech and language screening
    • Age: 2 to 6 years
    • Focus: word imitation to screen articulation and intelligibility ofspeech
    • Dysfluency stutteringis common in 3 - 4year olds. Unless sever, accompaniedby tics or unusual posturing, or occurs after age 4yrs., counsel parents
  38. Describe Developmental Profile II and at what age would you use it?
    • Developmental Screening
    • Age: Birth to 9.5 years
    • Focus: physical/motor, self help, social, academic and communication skills
    • Structured interview with parents
  39. Describe Minneapolis PreschoolScreening Instrument and at what age would you use it?
    • Preschool readiness
    • Age: 4 to 5 years
    • Focus: Addresses school related skills and maturation
  40. Describe Goodenough Harris Draw a Person Test and at what age would you use it?
    • Visual motorskills and problem solving abilities
    • Age: 3 adult
    • Instruct to”draw a person, draw the best person you can”.
    • Do not suggest specific, supplementation, or changes.
    • Observe how pictures are drawn inaddition to final product
    • Scoring: one point for each detail present
  41. Describe Gesell Figures and what age would you use it?
    • Focus: motor/ visual skills and problem solving abilities
    • Examples:
    • 15 months imitates scribble
    • 18 months scribble sspontaneously
    • 2 years imitates strokes
    • 3 years Draws a circle
    • 4 years Draws a cross
    • 41/2 years Draws a square
  42. Describe Bayley Scales of Infant Development and at what age would you use it?
    • Mild developmental delay
    • infants, toddlers 3- 24 months
    • Three scales: mental , motor, behavior
    • Mental: sensation, perception, object constancy, memory and learning, verbal abilities, higher order thinking, language, and computation
    • Motor: body control, coordination, recognition of objects by touch
    • Behavior: measures attention, orientation, emotional control
  43. Testing results depend on:
    • Temperament of child
    • Exposure to environmental stimuli
    • Opportunity
  44. When test results so insufficiency or defect:
    • Repeat results in 2 - 3weeks when failures are present
    • Use test results to assist with Anticipatory Guidance

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