Developmental Theories
By the end of this section, you should know about:
- The factors influencing growth and development.
- The biophysical developmental theories.
- The psycho analytical/psychosocial theories proposed by Freud and Erikson.
- Piaget’s theory of cognitive development.
- The developmental theories when planning interventions in the care of patients throughout the lifespan.
Let’s take a closer look at them.
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The factors influencing growth and development.
Several factors influence growth and development across the lifespan:
Genetic Factors: Inherited genetic traits determine many aspects of physical growth and developmental milestones, including height, intelligence, and vulnerability to certain diseases.
Environmental Factors: A child’s environment plays a crucial role in development. This includes access to safe housing, nutrition, healthcare, and early childhood experiences. A stimulating or neglectful environment can either enhance or hinder developmental progress.
Nutrition: Adequate nutrition is vital for physical growth, brain development, and immune system function. Malnutrition or nutrient deficiencies can stunt growth and cause cognitive delays.
Cultural and Socioeconomic Factors: Cultural beliefs and practices can shape developmental expectations and socialization. Socioeconomic status (SES) affects access to resources such as quality healthcare, education, and nutrition, which influence developmental outcomes.
Health Status: Chronic diseases, birth defects, or mental health conditions can delay or alter normal growth patterns. On the other hand, a healthy individual typically experiences smoother developmental progress.
Life Experiences: Both positive (supportive relationships, educational opportunities) and negative (trauma, abuse) experiences affect emotional, cognitive, and social development.
Growth and Development Across the Lifespan: Growth refers to measurable, quantifiable changes in an individual, such as an increase in height, weight, and other physical characteristics Nurses use this measure to compare an individual’s growth to comparison standards established about and any deviation from the expected growth pattern is detected.
Development: on the other hand, involves more qualitative changes that increase an individual’s abilities or skills. Not only do you get bigger physically, it’s more work and mentally demanding. For example, physical fitness, cognitive and social functioning improve throughout life.
The biophysical developmental theories.
Developmental theories provide a framework for understanding human growth. These principles help caregivers and especially nurses manage their response to illness and guide the delivery of appropriate care. Human development is a dynamic process influenced by various factors such as biological, emotional, psychological, and moral aspects. This summary covers key concepts of development including biophysical, psychoanalytic/psychosocial, cognitive, and moral development.
Biophysical developmental theories
Biophysical evolution focuses on physical growth and changes in the human body, especially at different stages of life. Gesell’s theory of development explains that each child has a unique growth pattern that is determined by genetics. Human growth follows two main stages:
• Cephalocaudal: Growth begins at the head and moves downward.
• Proximodistal: Growth begins in the middle of the body and extends towards the posterior end.
Although aging is largely determined by genes, environmental factors such as nutrition and disease can influence its expression.
Developmental Theories: Developmental theory provides a framework for understanding the processes of development and change within individuals. These principles help define a predictable developmental trajectory and provide a basis for assessing whether an individual is progressing or whether there are barriers that may require intervention. The principles also provide nurses with guidelines for assessing patients, understanding their responses, and identifying areas of growth or development delay or failure to progress as expected.
Biophysical Development Theory: This theory explores the biological underpinnings of growth and development. It looks at predictable changes in the sequence of individuals from conception to maturity across the lifespan, how environmental factors such as nutrition and exercise can affect growth and nurses measure these factors in care, recognizing that genetic environmental influences can affect a person’s physical and cognitive development.
The psychoanalytical/psychosocial developmental theories proposed by Freud and Erikson.
These theories explore personality, thinking, and behavior, often through unconscious processes. Sigmund Freud’s Psycho analytical Theory divides development into five stages based on pleasure-seeking behaviors focused on different parts of the body.
Freud’s Psychosexual Stages:
Oral Stage (Birth to 18 months): Focus on sucking and oral pleasure. Disruptions in caregiver availability can affect development.
Anal Stage (18 months to 3 years): Focus on toilet training and self-control.
Phallic Stage (3 to 6 years): Focus on the genitals; includes the Oedipus/Electra complex and identification with the same-sex parent.
Latency Stage (6 to 12 years): Sexual urges are repressed and channeled into socially acceptable activities.
Genital Stage (Puberty onward): Sexual urges reawaken, focusing on relationships outside the family.
Freud’s theory also emphasizes the development of the id (pleasure-seeking impulses), ego (reality-based decision-making), and superego (moral conscience).
Erik Erikson’s Psychosocial Development Theory
Erikson’s theory focuses on psychosocial conflicts that individuals must resolve at each stage of life. Success in resolving these conflicts allows progression to the next stage. Each stage has a central conflict that shapes personality and behavior.
Stages:
Trust vs. Mistrust (Birth to 1 year): Infants develop trust based on caregiver reliability.
Autonomy vs. Shame and Doubt (1 to 3 years): Toddlers develop independence and self-control through choices.
Initiative vs. Guilt (3 to 6 years): Preschoolers explore new roles and learn to balance initiative with responsibility.
Industry vs. Inferiority (6 to 11 years): School-age children develop competence through social interactions and achievements.
Identity vs. Role Confusion (Adolescence): Adolescents explore personal identity and establish a sense of direction.
Intimacy vs. Isolation (Young adulthood): Young adults seek close, meaningful relationships.
Generativity vs. Stagnation (Middle adulthood): Adults focus on contributing to future generations and community involvement.
Integrity vs. Despair (Old age): Older adults reflect on their lives, seeking satisfaction or regret.
Freud vs. Erikson
Freud’s theory focuses on sexual stages and unconscious impulses, while Erikson’s theory emphasizes social relationships and culture at each developmental stage. Erikson’s stages expand into adulthood and highlight the importance of resolving psychosocial conflicts to achieve psychological health.
Psychosocial Theories: Psychosocial theories, such as Erik Erikson’s theory of psychosocial development, focus on how personality, thinking, and behavior are influenced by a combination of internal biological processes and external social and cultural forces. These theories help nurses understand the emotional and social challenges that patients face at different stages of life, such as trust development in infancy or identity exploration in adolescence.
Piaget’s developmental theories of cognitive development.
Cognitive developmental theories focus on how people learn to think and make sense of the world. Jean Piaget was a pioneering figure in this area, particularly in the development of children’s intellectual organization. Piaget proposed that cognitive development progresses in four stages:
Sensorimotor Stage (Birth to 2 Years): During this stage, infants learn about their world primarily through physical interactions and motor activities. They develop object permanence, understanding that objects exist even when they cannot be seen or touched.
Preoperational Stage (2 to 7 Years): Children in this stage begin to use symbols and mental images but exhibit egocentrism, where they see the world only from their own perspective. Their thinking is dominated by fantasy and magical thinking, and they engage in animism, attributing lifelike qualities to inanimate objects.
Concrete Operational Stage (7 to 11 Years): In this stage, children gain the ability to perform mental operations and think logically about concrete events. They can understand conservation (the idea that quantity remains the same despite changes in shape or appearance) and seriation (the ability to order objects by size or other properties).
Formal Operational Stage (11 Years to Adulthood): Adolescents develop the ability to think abstractly and engage in hypothetical-deductive reasoning. They can consider possibilities and reason about theoretical concepts, which marks the transition to more advanced cognitive processes.
Piaget’s theory has been influential, although later research has shown that some cognitive abilities may emerge earlier than Piaget suggested, and others may develop later in life. Adults, for instance, may remain in concrete operational thinking in some areas but may also develop beyond the stages Piaget outlined.
Adult Cognitive Development
Recent research has highlighted that adults do not always reach a single solution to problems but often consider multiple possibilities. Adults tend to incorporate emotions, practicality, and flexibility in decision-making. This has led to the proposal of a fifth stage of cognitive development known as postformal thought, where individuals recognize that answers vary depending on context, and that sensible, practical solutions are often more important than abstract reasoning alone.
This understanding of postformal thought reflects the reality that adults’ thinking is more adaptable and flexible than the rigid stages Piaget proposed. The application of developmental theories, including those related to temperament, adult development, and cognitive growth, is crucial for health care providers to understand when offering age-appropriate interventions and guidance.
Application to Nursing Practice
In nursing practice, developmental theories can inform the care provided to individuals at different life stages. For example, the study of infant sleep patterns can help nurses educate parents about how their emotional involvement influences their baby’s sleep quality. Similarly, understanding cognitive development can help nurses provide age-appropriate education and support for patients, whether they are infants, children, or adults.
By integrating theories of temperament and cognitive development into practice, nurses can better support individuals and families in managing the challenges and opportunities associated with each developmental stage.
Moral Developmental Theories
Moral development concerns the changes in an individual’s understanding of right and wrong. Key theories in this area include those of Jean Piaget and Lawrence Kohlberg.
Lawrence Kohlberg’s Stages of Moral Development:
Kohlberg extended Piaget’s work and proposed a six-stage model divided into three levels:
Preconventional Level: Moral decisions are based on external consequences like rewards or punishments. For example, children in this stage may believe illness results from bad behavior (punishment).
Conventional Level: Individuals focus on conforming to social expectations and maintaining relationships. At this level, people care about approval from others and uphold laws to maintain social order.
Postconventional Level: Individuals base their moral decisions on abstract principles and universal ethics, such as justice and equality. At this stage, people may defy laws they see as unjust, as demonstrated by figures like Martin Luther King Jr.
Critics, however, argue that Kohlberg’s theory may be biased, especially since it was based primarily on male subjects from Western cultures. Carol Gilligan, a prominent critic, suggested that Kohlberg’s model overemphasized justice and ignored care-based moral reasoning, particularly from a gendered perspective. Some research has not supported gender differences in moral reasoning, though.
Practical Applications to Nursing
Understanding developmental and moral theories is essential for nurses in various aspects of patient care. Recognizing the different developmental stages and moral reasoning levels of patients can improve communication, support informed decision-making, and guide ethical practice. For example, in pediatric care, understanding a child’s level of moral reasoning can help nurses explain medical procedures in ways that are age-appropriate, reducing anxiety and fostering cooperation. Similarly, in end-of-life care, understanding the moral dilemmas faced by family members and respecting their differing moral viewpoints is crucial for providing compassionate care.
In all aspects of patient care, nurses should reflect on their own developmental and moral frameworks, ensuring they support patients through a holistic and empathetic approach that respects their developmental stage, cultural background, and moral views.
The Life Span Perspective of growth and development emphasizes that individuals continue to grow and develop throughout their entire life, not just during childhood and adolescence. This perspective acknowledges that development is multidimensional, encompassing various aspects such as physical, cognitive, emotional, and social development. These aspects are interrelated and change over time, influenced by both internal and external factors. As nurses, understanding these principles is essential for providing comprehensive care, as they guide how we assess, understand, and predict human behavior and responses across different developmental stages.
Cognitive Development: Cognitive development focuses on changes in the individual’s ability to think, reason, and solve problems. Theories of cognitive development, such as Piaget’s stages of Vygotsky’s theory, illustrate how individuals’ intellectual abilities evolve over time, from childhood to adulthood. Nurses must understand these cognitive milestones to assess a patient’s level of understanding, decision-making ability, and ability to learn.
Temperament: Temperament refers to a person’s inherent behavioral patterns and their typical responses to the environment, including how they interact with others. For instance, some individuals may be naturally more outgoing or easygoing, while others may be more reserved or reactive. Understanding a patient’s temperament allows nurses to adjust their approach to communication and care, ensuring it aligns with the individual’s personal characteristics.
The developmental theories when planning interventions in the care of patients throughout the lifespan.
Understanding developmental stages is crucial for nurses, especially when caring for patients in different age groups. Knowledge of Erikson’s stages allows nurses to provide age-appropriate care, helping patients address conflicts and facilitating their growth through health-related challenges. Nurses can use anticipatory guidance to assist parents of infants or help adolescents navigate their developmental challenges, such as identity formation and risk-taking behavior.
Nurses also play a key role in helping patients face challenges such as hospitalization, illness, or aging, while supporting their need for social interaction, intimacy, or generativity, depending on the stage of life.
Theories Related to Temperament
Temperament refers to the inherent behavioral style that influences an individual’s emotional interactions with others (Santrock, 2012a). It is closely related to personality and plays a significant role in shaping an individual’s emotional responses and interactions throughout life. The study of temperament is important for understanding how children react to their environments, which can inform how parents and caregivers respond to the child’s needs. By knowing about temperament, parents can better tailor their responses and interactions, fostering healthier relationships and development (Hockenberry & Wilson, 2015).
Stella Chess and Alexander Thomas conducted a seminal longitudinal study that identified three key temperament types in children:
- Easy Child: This child is characterized by a positive mood, adaptability to change, and a regular, predictable daily routine. Easy children are generally well-tempered, showing mild to moderate intensity in their emotions.
- Difficult Child: These children are often characterized by high activity levels, irritability, and irregular routines. They tend to resist changes and have intense negative emotions. They typically require a more structured environment.
- Slow-to-Warm-Up Child: Children in this category show mild negativity and resistance to new situations or changes but adapt over time with repeated exposure. They are more passive in their emotional responses.
The study of temperament remains essential in understanding how children develop their emotional and behavioral responses. When parents have this knowledge, they can approach parenting with strategies that cater to the temperament of their child, particularly when the child’s responses differ from expectations, such as when a second child is born.
Perspectives on Adult Development
Traditionally, scholars viewed aging as an inevitable decline, but contemporary theories focus on ongoing growth and adaptation throughout life. The life span perspective underscores that individuals continue to develop new abilities and adapt to changing environments even in adulthood. Two major approaches to studying adult development are the Stage-Crisis Theory and the Life Span Approach.
Stage-Crisis Theory (Robert Havinghurst)
Robert Havinghurst’s theory of human development focuses on developmental tasks that arise across different stages of life. These tasks can stem from biological maturation, personal values, or societal expectations. According to Havinghurst, successful resolution of these tasks is crucial for healthy development. He identified key stages such as:
Infancy and early childhood (birth to age 6)
Middle childhood (6 to 12 years)
Adolescence (13 to 18 years)
Early adulthood (19 to 30 years)
Middle adulthood (30 to 60 years)
Late adulthood (60 years and beyond)
In later years, Havinghurst proposed the Activity Theory in response to the stereotype of older adults withdrawing from society. His theory suggested that continued engagement in activities and social involvement leads to greater satisfaction in old age.
Life Span Approach (Paul Baltes)
The life span approach, championed by Paul Baltes, emphasizes that development is a lifelong process, multidimensional, and influenced by biological, sociocultural, and individual factors. In this view, development is plastic, meaning it is adaptable and changeable throughout life. The life span approach also stresses that age-related changes are context-dependent, varying by individual circumstances such as health, social support, and historical context. Research on successful aging within this framework highlights the importance of maintaining relationships and pursuing socially oriented goals for overall well-being.
Understanding developmental theories is essential for nurses as they care for patients at various life stages. These theories provide a framework for assessing and interpreting patient responses to illness, treatment, and life changes. By recognizing an individual’s developmental stage, nurses can tailor their care approach to suit the patient’s unique needs.
For instance, pediatric nurses use growth and development theories to assess children’s progress in areas like motor skills, language, and social functioning, while geriatric nurses apply biophysical and cognitive theories to address age-related changes, such as memory loss and physical decline.
Nurses also use moral development theory to understand the ethical challenges faced by patients and families and provide guidance in making decisions that align with the patient’s moral reasoning and values.
Developmental Tasks: Developmental tasks are age-related achievements that people are expected to complete as they age. Successfully achieving these tasks is associated with happiness and well-being, while failure to meet these tasks can lead to difficulty in later stages of development. For instance, in adolescence, a key task is establishing a sense of identity, while in adulthood, tasks might include career development and establishing intimate relationships. Nurses use this knowledge to recognize potential challenges or delays in meeting these tasks.
Developmental Crisis: A developmental crisis occurs when a person struggles to meet the tasks of their current developmental period. This could happen during periods of significant life change or stress, such as adolescence or midlife. Nurses need to recognize when a patient is experiencing a crisis and provide support, guidance, and interventions to help them navigate these challenges.
Moral Development Theory: Moral development explores how individuals develop moral reasoning and ethical decision-making abilities over time. Theories, such as Kohlberg’s stages of moral development, suggest that individuals evolve from focusing on external consequences to developing an internal sense of morality based on principles of justice and human rights. Nurses must be aware of the different stages of moral reasoning, especially when patients or families face complex ethical decisions, such as those encountered in end-of-life care.