Presentation on theme: "Pediatric Growth and Development"— Presentation transcript:
1Pediatric Growth and Development Ana H. Corona, DNP, FNP-BCNursing ProfessorRevised September 2013Resources: HCC 2007, UPHS 2006, PSY 501 Craig Cramer, Bernadette Flynn and Ann LaFave.1997
2Developmental Milestones Children will demonstrate certain physical and mental skills.These skills are called developmental milestones.
3Infant -- birth to 1 year Displays social smile Rolls over by self Able to sit alone, without supportBabblingPlays peek-a-booEruption of 1st toothPulls self to standing positionWalks while holding on to furniture or other supportSays mama and dada, using terms appropriatelyAble to drink from a cupUnderstands "NO" and will stop activity in responseWalks without support
4Toddler -- 1 to 3 years Masters walking Recognizes gender differences Uses more words and understands simple commandsAble to run, pivot, and walk backwardsUses spoon to feed selfCan name pictures of common objects and point to body partsAble to walk up and down stairsImitates speech of others, "echoing" word backBegins pedaling tricycleLearns to take turns (if directed) while playing with other childrenAble to feed self neatly, with minimal spillingAble to state first and last nameRecognizes and labels colors appropriatelyAble to draw a line (when shown one)Dresses self with only minimal helpLearns to share toys (without adult direction)
5Preschooler -- 3 to 6 years Rides tricycle wellAble to draw a circleAble to draw stick figures with 2 to 3 features for peopleHops on one footCatches a bounced ballUnderstands size conceptsEnjoys rhymes and word playAble to skipEnjoys doing most things independently, without helpBalances better, may begin to ride a bicycleUnderstands time conceptsBegins to recognize written words -- reading skills startStarts school
6School-age child -- 6 to 12 years Understands and able to follow sequential directionsBeginning skills for team sports (soccer, T-ball, etc.)Begins to lose "baby" teeth and erupt permanent teethRoutines important for daytime activitiesReading skills develop furtherPeer recognition begins to become importantGirls begin to show growth of armpit and pubic hair, breast developmentMenarche (1st menstrual period) may occur in girls
7Adolescent to 18 yearsBoys show growth of armpit, chest, and pubic hair; voice changes; and testicular/penile enlargementGirls show growth of armpit and pubic hair; breast development; menstrual periodsAdult height, weight, sexual maturityUnderstands abstract conceptsPeer acceptance and recognition is of vital importance
8Physical and motor-skill markers: 2 month old Closure of posterior fontanelle (soft spot at the back of the head)Several newborn reflexes, such as the dance reflex (baby appears to dance or step when placed upright on solid surface) and grasp reflex (grasping a finger), disappearLess head lagWhen on stomach, able to lift head almost 45 degreesLess flexing of the arms and legs while on stomach
9Sensory and cognitive markers: 2 month old Head turns from side to side with sound at the level of the earBeginning to look at close objectsCrying becomes differentiatedCoosVocal response to familiar voicesSmiles
10Play recommendations: 2 month old Toys and objects should be bright colorsThe room should be bright with pictures and mirrorsExpose the baby to sounds outside those of the homeTake the baby for rides in the car
11PHYSICAL AND MOTOR SKILLS: 4 month old Show a slowing of weight gain to approximately 20 grams per dayDemonstrate the fading of the infant reflexes (Moro reflex, asymmetric tonic neck reflex, rooting reflex, and Perez reflex)Have almost no head lag while in a sitting positionBe able to sit up straight if proppedRaise head 90 degrees when placed on stomachBe able to roll from front to backTry to reach objects with hands (may commonly overshoot)Play with rattle when it's placed in the hands, but won't be able to pick it up if droppedBe able to grasp rattle with both handsBe able to place objects in mouth
12SENSORY AND COGNITIVE SKILLS: 4 month old Have well-established close visionHave beginning eye-hand coordinationBe able to babble and cooBe able to laugh out loudAnticipate feeding when able to see a bottle (if bottle-fed)Begin to show memoryDemand attention by fussingRecognize parent voice or touch
13Play Recommendations: 4 month old Place the baby in front of a mirrorProvide bright-colored toys to holdRepeat sounds the infant makesHelp the infant roll overUse a swing or stroller
14Physical and motor-skill markers: 6 month old Should have doubled birth weight (birth weight often doubles by 4 months, and it would be concerning if it hasn't happened by 6 months)Able to lift chest and head while on stomach, bearing the weight on hands (often occurs by 4 months)Able to sit in a high chair with a straight backBeginning of teethingIncreased droolingAble to bear almost all weight when supported in a standing positionAble to roll from back to stomachAble to hold own bottle (but many babies won't do it, or do it only for short periods)Able to pick up a dropped object
15Sensory and cognitive markers: 6 month old Vision is between 20/60 and 20/40Can locate sounds not made directly at the ear levelPrefers more complex sound stimulationStarts to imitate soundsSounds resemble one-syllable wordsEnjoys hearing own voiceMakes sounds to mirror and toysBegins to fear strangersRecognizes parentsBegins to imitate actionsBegins to realize that if an object is dropped, it is still there and just needs to be picked up
16Play Recommendations: 6 month old Provide a mirror that is unbreakableProvide large, bright colored toys that make noise or have moving partsPlay peek-a-booProvide paper to tearSpeak clearlyImitate words such as "mama" to facilitate learning of languageStart naming parts of the body and the environmentUse the word "no" INFREQUENTLYUse body movements and actions to teach language
17PHYSICAL CHARACTERISTICS AND MOTOR SKILLS: 9 month old Gains weight at a slower rate -- approximately 15 grams per day, 1 pound per monthIncreases in length by 1.5 centimeters per monthBecomes more regulated in bowel and bladder systemsShows parachute reflex to protect self from fallingIs able to crawlRemains sitting for prolonged periodsPulls self to standing positionHas a pincer grasp between thumb and index fingerFeeds selfThrows or shakes objects
18SENSORY AND COGNITIVE SKILLS: 9 month old Is developing depth perceptionAchieves "object constancy", the understanding that objects continue to exist even when not seenResponds to simple commandsResponds to nameUnderstands the meaning of "no"Imitates speech soundsMay be afraid of being left alonePlays interactive games
19Play Recommendations: 9 month old Provide picture booksProvide different stimuli:Go to the mall (people)Go to the zoo (animals)Play ballBuild vocabulary by reading and naming people and objects in the environmentTeach hot and cold through playProvide large toys that can be pushed to encourage walking
20PHYSICAL AND MOTOR SKILLS: 12 month old Triple the birth weightGrow to a height of 50% over birth lengthHave a head circumference equal that of the chestHave teethHave a nearly-closed anterior fontanel (the front soft spot on the head)No longer have a Babinski reflexPull to stand and walk with help or aloneSit down without helpBang 2 blocks togetherTurn through pages of a book by flipping many at a timeHave a precise pincer grasp
21SENSORY AND COGNITIVE DEVELOPMENT: 12 month old Follows a fast moving objectHas control over response to soundsComprehends several wordsCan say mamma, papa, and at least 1-2 other wordsComprehends simple commandsTries to imitate animal soundsAssociates names with objectsSearches for objects that are hidden, but unable to consider alternative locationsPoints to objects with index fingerWaves byeMay develop attachment to a toy or objectExperiences separation anxiety and may cling to parentsMay make brief exploratory journeys away from parents in familiar settings
22Play Recommendations: 12 month old Provide the infant with picture booksProvide the infant with different stimuli, such as going to the mall or zooPlay ballBuild vocabulary by reading and naming people and objecting in the environmentTeach hot and cold through playProvide large toys that can be pushed to encourage walking
23PHYSICAL AND MOTOR SKILL MARKERS : 18 months Has a closed anterior fontanel (soft spot on the front of the head)Is growing at a slower rate and has less of an appetite compared to previous monthsIs physically able to control sphincter muscles, but may not be psychologically ready to use the toiletRuns with a lack of coordination and falls frequentlyJumps in placeIs able to get onto chairs without assistanceWalks up stairs while holding on with one handCan build a tower of blocksCan use a spoon and cup with helpImitates scribblingCan turn the pages of a book 2 or 3 at a time
24SENSORY AND COGNITIVE MARKERS: 18 month old Shows affectionListens to a story or looks at picturesCan say 10 or more words when askedIdentifies parts of the bodyUnderstands and is able to point to and identify common objectsFrequently imitatesFeeds selfIs able to take off some clothing items, such as gloves, shoes, and socksBegins to feel a sense of ownership identifying people and objects by saying "my"
25Play Recommendations: 18 month old Encourage and provide the necessary space for physical activityProvide safe replicas of adult tools and equipment for the child to play withAllow the child to help around the house and participate in the daily responsibilities of the familyEncourage play that involves building and creativityRead to the childControl the type and quantity of television viewingControl the type and quantity of games played
26Physical and motor-skill markers: 2 year old Should have the first 16 teeth (can be a wide variation of the actual number of teeth)The height is roughly half the total height the child will attain as an adultMay be psychologically ready for toilet trainingCan run with better coordination, while the stance may remain wideCan kick ball without losing balanceCan build a tower of 6 to 7 cubesCan browse through a book one page at a timeAble to turn a door knobCan pick up objects while standing, without losing balance (often occurs by 15 months, and would be concerning if you don't see it by 2 years)
27Sensory and cognitive markers: 2 year old Vision fully developedVocabulary has increased to about 50 to300 words (healthy children demonstrate wide variations)Can organize phrases of 2 to 3 wordsAble to communicate needs such as thirst, hunger, need to use the restroomIncreased attention spanAble to clothe self in simple clothes (frequently more adept at removing clothes than putting them on)
28Play Recommendations: 2 year old Encourage and provide the necessary space for physical activityProvide safe replicas of adult tools and equipmentAllow the child to help around the house and participate in the daily responsibilities of the familyEncourage play that involves building and creativityREAD TO THE CHILDTry to avoid watching television at this age (recommendation of the American Academy of Pediatrics)Parents should control both the content and quantity of television viewing. Limit television viewing to less than 3 hours per day, and preferably 1 hour or less. Avoid programming with violent content. Re-direct the child to reading or play activitiesControl the type and quantity of games played
29Physical and motor skills: 3-year-old: Gains about 5 poundsGrows about 3 inchesHas improved balanceHas improved visionMay have daytime control over bowel and bladder functions (may have nighttime control as well)Can briefly balance on one footMay walk up the stairs with alternating feetCan construct a block tower of more than 9 cubesCan easily place small objects in a small opening
30In sensory and cognitive skills, a child: 3 year old Has a vocabulary of many hundreds of wordsComposes sentences of 3 to 4 wordsFrequently asks questionsCan dress self, only requiring assistance with laces, buttons, and other fasteners in awkward placesHas longer attention spanFeeds self without difficultyActs out social encounters through play activitiesHas some decrease in separation anxiety for short periods of timeAt age 3, nearly all of a child's speech should be understandable.
31Play Recommendations: 3 year old Provide a safe play environment and constant supervision.Encourage and provide the necessary space for physical activity.Instruct the child how to participate in and learn the rules of sporting activities.Encourage play with other children to help develop social skills.Encourage creative play.Read together.Limit both the time and the content of television viewing.Expose your child to different stimuli by visiting local areas of interest.Encourage your child to learn by answering questions and providing activities related to the child's particular interests.Encourage your child to learn simple chore such as picking up their toys or room. Welcome their help in small household tasks.
32Physical and Motor Skills: 4 year old Gains weight at the rate of about six grams per dayGrows to a height that is double the length at birthShows improved balanceHops on one foot without losing balanceThrows a ball overhand with coordinationCan cut out a picture using scissorsMay not be able to tie shoelacesMay still wet the bed (normal)
33SENSORY AND COGNITIVE: 4 year old Has a vocabulary of over 1500 wordsEasily composes sentences of four or five wordsCan use the past tenseCan count to fourWill ask the most questions of any ageMay use words that aren't fully understoodMay begin using vulgar terms, depending on their exposureLearns and sings simple songsTries to be very independentMay show increased aggressive behaviorTalks about personal family matters to othersCommonly has imaginary playmatesHas an increased comprehension of timeIs able to distinguish between two objects based on simple criteria such as size and weightLacks moral concepts of right and wrongIs rebellious if expectations are excessive
34Play Recommendation: 4 year old Encourage and provide the necessary space for physical activityInstruct the child how to participate in, and follow the rules of sporting activitiesEncourage play and sharing with other childrenEncourage creative playTeach children to do small chores, such as setting the tableRead togetherMonitor both the time and content of television viewing (preferably less than 1.5 hours of TV, no more than 3 hours maximum)Expose the child to different stimuli by visiting local areas of interest
35Physical and motor skills milestones: a 5-year-old Erupting the first permanent teeth (the majority of children do not get their first permanent teeth until age 6)Developing increased coordinationSkipping, jumping, and skating with good balanceMaintaining balance while standing on one foot with eyes closedTying own shoelacesShowing increased skill with simple tools and writing utensils
36Sensory and cognitive milestones include: 5 year old Increasing vocabulary to over 2100 wordsComposing sentences of six to eight words, and with all parts of speechIdentifying coinsProperly naming the primary colors and possibly many moreQuestioning more deeply, addressing meaning and purposeBehaving more responsiblyDecreasing aggressive behaviorOutgrowing earlier childhood fearsAccepting the validity of other points of view (while possibly not understanding them)Demonstrating increased mathematical skillQuestioning others, including parentsStrongly identifying with the parent of the same sex
37Play Recommendations: 5 year old Reading togetherProviding the necessary space for physical activityInstructing the child to participate in -- and learn the rules of -- sporting activitiesEncouraging the child to play with other children, which helps develop social skillsPlaying creatively with the childMonitoring both the time and content of television viewingVisiting local areas of interestEncourage the child to take responsibility for small household chores such as helping set the tableHave the child pick up his or her toys after playing
38PHYSICAL DEVELOPMENT: preschooler Gross motor development in the 3- to 6-year-old should include:Becoming more skilled at running, jumping, early throwing and kickingThe ability to catch a bounced ballThe ability (at 3 years) to pedal a tricycle but perhaps not steer well becoming able to steer well around age 4The ability (at around 4) to hop on 1 foot, followed with balancing on 1 foot for up to 5 secondsThe ability to perform a heel-to-toe walk
39Fine motor development milestones should include: preschooler The ability to draw a circle upon request at about 3 yearsDrawing a person with 3 partsBeginning use of children's blunt-nose scissorsSelf-dressing (with supervision)The ability to draw a square by age 4The use of scissors progressing to cutting a straight lineThe ability to put clothes on properlyManaging spoon and fork neatly while eatingSpreading with a knife by about age 5The ability to draw a triangle
40Language DevelopmentThe 3-year-old uses pronouns and prepositions appropriatelyThe 4-year-old begins to understand size relationshipsThe child enjoys rhymes and word playThe 5-year-old shows early understanding of time conceptsThe child is able to follow 3 simple commands
41LanguageStuttering may commonly occur in the normal language development of toddlers years of age. It occurs because ideas come to mind faster than the child is able to express them. It more commonly occurs if the toddler is stressed or excited.When the child is speaking, give your full, prompt attention, and do not comment on the stuttering. If the stuttering is accompanied with other signs, such as tics, grimacing, extreme self-consciousness, or if the stuttering persists longer than 6 months, consider having the child evaluated by speech pathologist.
42Behavior: the preschooler The child's ability to cooperate with a larger number of peers increases. Although 4- to 5-year-olds may be able to start participating in games that have rules, the rules are apt to change frequently at the whim of the more dominant child.Small group of preschoolers may see a dominant child emerge who tends to boss the others around without much resistance from the other children.It is normal for preschoolers to test their limits in terms of physical abilities, behaviors, expressions of emotion, and thinking abilities. Having a safe, structured environment within which to explore and face new challenges is important, but well-defined limits must be included.Early morality develops as egocentrism gives way to the desire to please parents and others of importance. This is commonly known as the "good boy" or "good girl" stage.Elaborate story-telling may progress into lying, a behavior that -- if not addressed during the preschool years -- may continue into the adult years. Mouthing-off or backtalk in the preschooler is usually a means of getting attention and attempting to elicit a reaction from the adult it is directed toward.
43Safety is extremely important for preschoolers. The preschooler is highly mobile and able to quickly get into dangerous situations.Car safety is critical. The preschooler should ALWAYS be in a seatbelt when riding in the car.Falls are a major cause of injury for the preschooler. Climbing to new and adventurous heights, the preschooler may fall off playground equipment, bikes, down stairs, from trees, out windows, and off roofs. Lock doors that access dangerous areas (such as roofs, attic windows, and steep staircases) and provide strict rules for the preschooler to understand areas that are off limits.Kitchens are a prime area for a preschooler to incur burns, either trying to help cook or coming in contact with appliances left to cool off. Encourage the child to help cook or learn cooking skills with safe, cool recipes.Keep all household products and medicines safely locked out of the reach of preschoolers.
44Introduction to Erikson's 8 Stages Erikson's theory consist of eight stages of development.Each stage is characterized by a different conflict that must be resolved by the individual.When the environment makes new demands on people, the conflicts arise."The person is faced with a choice between two ways of coping with each crisis, an adaptive, or maladaptive way.Only when each crisis is resolved, which involves a change in the personality, does the person have sufficient strength to deal with the next stages of development“ (Schultz and Schultz, 1987).If a person is unable to resolve a conflict at a particular stage, they will confront and struggle with it later in life.
45Stage 1: Oral-Sensory Age: Infancy -- Birth to 1 year Conflict: Trust vs. MistrustImportant Event: FeedingDescription:The important event in this stage is feeding. According to Erikson, the infant will develop a sense of trust only if the parent or caregiver is responsive and consistent with the basic needs being meet. The need for care and food must be met with comforting regularity. The infant must first form a trusting relationship with the parent or caregiver, otherwise a sense of mistrust will develop.
46Stage 1 Elements for a positive outcome: The infant's need for care, familiarity, comfort and nourishment are met. Parental consistency and responsiveness is essential for the sense of trust to develop.Elements for a negative outcome:Babies who are not securely attached to their mothers are less cooperative and more aggressive in their interactions with their mothers. As they grow older, they become less competent and sympathetic with peers. They also explore their environment with less enthusiasm and persistence.Examples:Babies will begin to understand that objects and people exist even when they cannot see them. This is where trust becomes important.
47Stage 2: Muscular-Anal Age: Toddler period -- 1 to 2 years Conflict: Autonomy vs. DoubtImportant Event: Toilet TrainingDescription:According to Erikson, self control and self confidence begin to develop at this stage. Children can do more on their own. Toilet training is the most important event at this stage. They also begin to feed and dress themselves. This is how the toddler strives for autonomy. It is essential for parents not to be overprotective at this stage. A parent's level of protectiveness will influence the child's ability to achieve autonomy. If a parent is not reinforcing, the child will feel shameful and will learn to doubt his or her abilities. "Erikson believes that children who experience too much doubt at this stage will lack confidence in their powers later in life"(Woolfolk, 1987).
48Stage 2 Elements for a positive outcome: The child must take more responsibility for his or her own feeding, toileting, and dressing. Parents must be reassuring yet avoid overprotection.Elements for a negative outcome:If parents do not maintain a reassuring, confident attitude and do not reinforce the child's efforts to master basic motor and cognitive skills, children may begin to feel shame; they may learn to doubt their abilities to manage the world on their own terms. Children who experience too much doubt at this stage will lack confidence in their own powers throughout life.Examples:In this stage children begin to assume important responsibilities for self-care like feeding, toileting, and dressing.
49Stage 3: Locomotor Age: Early Childhood -- 2 to 6 years Conflict: Initiative vs. GuiltImportant Event: IndependenceDescription:The most important event at this stage is independence. The child continues to be assertive and to take the initiative. Playing and hero worshipping are an important form of initiative for children. Children in this stage are eager for responsibility. It is essential for adults to confirm that the child's initiative is accepted no matter how small it may be. If the child is not given a chance to be responsible and do things on their own, a sense of guilt may develop. The child will come to believe that what they want to do is always wrong.
50Stage 3 Elements for a positive outcome: In order for a positive outcome in this stage, the child must learn to accept without guilt, that there are certain things not allowed. Children must be guilt free when using imagination. They must be reassured that it is okay to play certain adult roles.Elements for a negative outcome:If children are not allowed to do things on their own, a sense of guilt may develop and they may come to believe that what they want to do is always wrong.Examples:A four year old passing tools to a parent who is fixing a bicycle. Children at this stage will worship heroes. Pretend games are also common.
51Stage 4: Latency Age elementary and middle school years. 6 – 12 years Conflict: Industry vs InferiorityImportant event: SchoolDescription: in this stage children are learning to see the relationship between perseverance and the pleasure of job completed. Important event at this stage is school attendance. Children have the need to be productive and do work on their own. Interaction with peers at school plays an imperative role of child development in this stage.
52Stage 4 Elements for a positive outcome It is essential for the child at this stage to discover pleasure in being productive and succeed.The child’s relationship with peers becomes increasingly important.Elements of Negative Outcomes:Difficulty with the child’s ability to move between the world at home and the world of peers could lead to feelings of inferiority.Examples: in this stage children want to do productive work on their own. Students are able to water class plants, collect and distribute materials for the teacher, and keep records or forms for the teacher.
53Stage 5: Adolescence Age: Adolescence --12 to 18 years Conflict: Identity vs. Role ConfusionImportant Event: Peer relationshipsDescription:At this stage, adolescents are in search of an identity that will lead them to adulthood. Adolescents make a strong effort to answer the question "Who am I?" Erikson notes the healthy resolution of earlier conflicts can now serve as a foundation for the search for an identity. If the child over comes earlier conflicts they are prepared to search for identity. Did they develop the basic sense of trust? Do they have a strong sense of industry to believe in them selves?
54Stage 5 Elements for a positive outcome: The adolescent must make a conscious search for identity. This is built on the outcome and resolution to conflict in earlier stages.Elements for a negative outcome:If the adolescent can not make deliberate decisions and choices, especially about vocation, sexual orientation, and life in general, role confusion becomes a threat.Examples:Adolescents attempt to establish their own identities and see themselves as separate from their parents.
55Stage 6: Young Adulthood Age: Young Adulthood to 40 yearsConflict: Intimacy vs. IsolationImportant Event: Love relationshipsDescription:In this stage, the most important events are love relationships. Intimacy refers to one's ability to relate to another human being on a deep, personal level. An individual who has not developed a sense of identity usually will fear a committed relationship and may retreat into isolation. It is important to mention that having a sexual relationship does not indicate intimacy. People can be sexually intimate without being committed and open with another. True intimacy requires personal commitment. However, mutual satisfaction will increase the closeness of people in a true intimate relationship.
56Stage 6 Elements for a positive outcome: The young adult must develop intimate relationships with others. Not resolving this conflict leaves the young adult feeling isolated. The young adult must be willing to be open and committed to another individual.Elements for a negative outcome:An individual may retreat into isolation if a sense of identity is not developed and will fear a committed relationship.Examples:Giving and sharing with an individual without asking what will be received in return.
57Stage 7: Middle Adulthood Age: Middle adulthood to 65 yearsConflict: Generativity vs. StagnationImportant Event: ParentingDescription:In this stage Generativity refers to the adult's ability to care for another person. The most important event in this stage is parenting. Does the adult have the ability to care and guide the next generation? Generativity has a broader meaning then just having children. Each adult must have some way to satisfy and support the next generation. According to Erikson, "A person does best at this time to put aside thoughts of death and balance its certainty with the only happiness that is lasting: to increase, by whatever is yours to give, the goodwill and higher order in your sector of the world "(Erikson, 1974).
58Stage 7 Elements for a positive outcome: To have and nurture children and/or become involved with future generations.Elements for a negative outcome:An individual must deal with issues they are concerned with or it can lead to stagnation in later life.Examples:In this stage an adult will be concerned with issues such as: the future of the environment, what kind of world will we leave the next generation, equality for all people, etc.
59Stage 8: Maturity Age: Late Adulthood -- 65 years to death Conflict: Integrity vs. DespairImportant Event: Reflection on and acceptance of one's lifeDescription:The most important event at this stage is coming to accept one's whole life and reflecting on that life in a positive manner. According to Erikson, achieving a sense of integrity means fully accepting oneself and coming to terms with the death. Accepting responsibility for your life and being able to undo the past and achieve satisfaction with self is essential. The inability to do this results in a feeling of despair.
60Stage 8 Elements for a positive outcome: The adult feels a sense of fulfillment about life and accepts death as an unavoidable reality.Elements for a negative outcome:Individuals who are unable to obtain a feeling of fulfillment and completeness will despair and fear death.Examples:An aged person may find it necessary to reflect and analyze what they have accumulated throughout life and decide what offspring will receive from them upon death.
61Autonomy vs. Shame/Doubt Toilet Training StageAgeBasic conflictImportant EventSummaryOral Sensory0-12 to 18 monthsTrust vs. MistrustFeedingInfant must develop a sense of trustMuscular Anal18 mths to 3 yrsAutonomy vs. Shame/DoubtToilet Trainingmaster physical environment while maintaining self-esteemLocomotor3 to 6 yearsInitiative vs. GuiltIndependenceBegins to initiate not imitate develops conscience and sexual identityLatency6 to 12 yearsIndustry vs. InferioritySchooldevelop a sense of self-worth by refining skillsAdolescence12 to 18 yearsIdentity vs Role ConfusionPeer Relationshipsself-image under role model and peer pressureYoung Adulthood19 to 40 yearsIntimacy vs. IsolationLove Relationshipspersonal commitment to another as spouse, parent or partnerMiddle Adulthood40 to 65 yearsGenerativity vs. StagnationParentingsatisfaction through productivity in career, family, and civic interestsMaturity65 years to deathEgo Integrity vs. DespairReflection on and acceptance of one's lifeReviews life accomplishments, deals with loss and preparation for death
62Psychoanalyst Erik Erikson Psychoanalyst Erik Erikson describes the physical, emotional and psychological stages of development and relates specific issues, or developmental work or tasks, to each stage.If an infant's physical and emotional needs are met sufficiently, the infant completes his/her task -- developing the ability to trust others.A person who is stymied in an attempt at task mastery may go on to the next state but carries with him or her the remnants of the unfinished task.If a toddler is not allowed to learn by doing, the toddler develops a sense of doubt in his or her abilities, which may complicate later attempts at independence.A preschooler who is made to feel that the activities he or she initiates are bad may develop a sense of guilt that inhibits the person later in life.
63Summary:Infant Trust vs Mistrust Needs maximum comfort with minimal uncertainty to trust himself/herself, others, and the environmentToddler Autonomy vs Shame and Doubt Works to master physical environment while maintaining self-esteem
64SummaryPreschooler Initiative vs Guilt Begins to initiate, not imitate, activities; develops conscience and sexual identitySchool-Age Child Industry vs Inferiority Tries to develop a sense of self-worth by refining skills
65SummaryAdolescent Identity vs Role Confusion Tries integrating many roles (child, sibling, student, athlete, worker) into a self-image under role model and peer pressureYoung Adult Intimacy vs Isolation Learns to make personal commitment to another as spouse, parent or partner
66SummaryMiddle-Age Adult Generativity vs Stagnation Seeks satisfaction through productivity in career, family, and civic interestsOlder Adult Integrity vs Despair Reviews life accomplishments, deals with loss and preparation for death