The complex and interrelated elements that contribute to human growth and development involve not only biophysical factors but also factors of personality development. These paper summarizes few well known theories and its theorists in relation to growth and development. Among of these theories and theorist are the following: Sigmund Freud’s Five Stages of Development, Erick Erickson’s Eight Stages of Development, Jean Piaget’s Cognitive Theory, Lawrence Kohlberg’s Stages of Moral Development and James Fowler’s Stages of Spiritual Development. The theories summarized in this paper help us understand cognitive psychosocial, moral and spiritual development. To understand the whole person, we must need to evaluate all the components of growth and development to understand certain life events or concerns.
Although theories offer a great deal of insight into the processes of human growth and development, they do have some limitations. When planning holistic nursing care for patients with diverse needs, backgrounds and ages, we should therefore assess the patient as an individual and use interventions based on rationales from multiple developmental theories to provide comprehensive health promotion.
The needs of humans quickly change as a person grows and passes through life. These needs are unique for each person but include certain similarities at specific period. Especially when we talk about the child development. The theories is a great help for us because, we are observing the child’s development and what to expect on that specific age. Sometimes, these theories are become a basis for parents to relate what developmental age of their child is so that appropriate care can be given to these child.
A Close Look to Growth and Development: It’s Associated Theories and Theorists
There are many theorists who contributed to the growth and development of human. Among of these theories, really significant to the lives of every people. In this paper, we will identify and compare each selected theories that had a great impact on the growth and development of human. Among these theories and its theorists are the following: Sigmund Freud’s Five Stages of Development, Erick Erickson’s Eight Stages of Development, Jean Piaget’s Cognitive Theory, Lawrence Kohlberg’s Stages of Moral Development and James Fowler’s Stages of Spiritual Development.
Humans grow and develop throughout life. Growth is an increase in body size or changes in body cell, structure, function and complexity. Development is an orderly pattern of changes in structure, thoughts, feelings or behaviors resulting from maturation, experience and learning. Development is a dynamic and continuous process as one proceeds through life, characterized by a series of ascents, plateaus and declines. The human processes of growth and development result from the interrelated effects of heredity and environment. Humans simultaneously grow and develop in physical, cognitive, psychosocial, moral and spiritual dimensions, with each dimension being an essential part of the whole person. Growth and development are independent, interrelated process. For example, an infant’s ,muscles, bones, nervous system must grow to a certain point before the infants can sit up or walk. Growth generally takes place during the first 20 years of life, development continues after that. All humans experience the same growth patterns and developmental levels, but, because these patterns and levels are individualized, a wide variation in biologic and behavioral changes is considered normal. Within each developmental level, certain milestone can be identified; for example, the time the infant roll over, crawls, walks, or says his or her first words. Although growth and development occur in individual ways for different people, certain generalization can be made about the nature of human development for everyone (Thies, & Travers, 2001).
Moral development, a complex process not fully understood, involves learning what ought to be and what ought not to be done. It is more than imprinting parents’ rules and virtues or values on children. The terms moral means “relating to right and wrong.” The term morality, moral behavior and moral development need to be distinguished. Morality refers to the requirements necessary for people to live together in society; moral behavior is the way a person perceives those requirements and responds to them; moral development is the pattern of change in moral behavior with age.
Lawrence Kohlberg’s theory specifically addresses moral development in children and adults. The morality of an individual’s decision was not Kohlberg’s concern; rather, he focused on the reasons an individual makes a decision. According to Kohlberg, moral development progresses through three level and six stage. Levels and stages are not always linked to a certain developmental stage, because some people progress to a higher level of moral development than others
Kohlberg recognized that a person’s moral development is influenced by cultural effects on one’s perceptions of justice in interpersonal relationships. A child’s beginnings in moral development result from caregiver and child communications during the early childhood years, as the young child tries to please his or her parents. The concept of morality emerges as a subset of a person’s beliefs or values and governs choices made throughout life. Rules and regulations established by society are eventually challenged and evaluated as a person either accepts societal rules into his or her own internal set of values or rejects them. The level of moral development include the pre-conventional, conventional and post conventional. Each level is further divided into separate stages this includes:
(1) Punishment and Obedient Orientation
(2) Instrumental Relativist Orientation
(3) Interpersonal Concordance Orientation
(4) Law-and-Order Orientation
(5) Social Contract Legalistic Orientation, and
(6) Universal Ethical Principle Orientation.
At the Kohlberg’s first level, called the Pre-moral or Pre-conventional level, the children are responsive to cultural rules and labels of good and bad, right and wrong. This is based on the external control as the child learns to conform to rules imposed by the authority figures. At stage 1, punishment and obedience orientation, the motivation for choices of action is fear of physical consequences of authority’s disapproval. As a result of the consequences, perception of goodness and badness develops. At stage 2, instrumental relativist orientation, the thought of receiving a reward overcomes fear of punishment, so actions that satisfy this desire are selected.
At the second level, the Conventional level, the individual is concerned about maintaining the expectations of the family, group or nation and sees this as right. In stage 3, “good boy-good girl” orientation, the person is strives for approval in an attempt to be viewed as “good.” At stage 4, “law and order” orientation, behavior follows social or religious rules from a respect for authority. In his later work, Kohlberg maintained that many adults are at this stage because they think abstractly and view themselves as members of society.
Level three is called the Post Conventional, Autonomous or Principled level. At this level, people make an effort to definite valid values and principles without regard to outside authority or to the expectations of others. At stage 5, social contract and utilitarian orientation, correct behavior is defined in terms of society’s laws. Laws can be changed, however, to meet society’s needs, while maintaining respect for itself and others. Stage 6, universal ethical principle orientation, represents the person’s concern for equality for all human beings, guided by personal values and standards, regardless of those set by society or laws. Justice might be internalized at an even higher level than society. Few adults ever reach this stage of development (Kohlberg, 1969).
Psychosocial development refers to the development of the personality. Personality is a complex concept that is difficult to define. It can be considered as the outward (interpersonal) expression of the inner (intrapersonal) self. It encompasses a person’s temperament, feelings, character traits, independence, self esteem, self concept, behavior, ability to interact with others, and ability to adopt to life changes. Many theorists attempt to account for psychosocial development in humans. Many of these theories explain the development of person’s personality and the cause of behavior.
Sigmund Freud introduced a number of concepts about development that are still used today. The concepts of the unconscious mind, defense mechanism, and the id, ego and superego are Freud’s. The unconscious mind is the part of a person’s mental life that the person is unaware of. This concept of life unconscious is one of Freud’s major contributions to the field of psychiatry:
(1) The unconscious mind
The unconscious mind contains memories, motives, fantasies and fears that are not accessible to recall but directly affect behavior. The id is part of the mind concerned with self-gratification by the easiest and quickest available means. Defense mechanism are means of unconscious coping to reduce stress in the conscious mind when the id’s impulses cannot be satisfied. Id is normally develops at birth and resides in the unconscious and, operating on the pleasure principle, seeks immediate pleasure and gratification (Thomas, 2001). The ego, is the conscious part of the mind which operates on the reality principle, it balances the gratification demands of the id with the limitations of social and physical circumstances. The methods the ego uses to fulfill the needs of the id in a socially acceptable manner are called defense mechanism or adaptive mechanism as they are more commonly called today, as the result of conflicts between the id’s impulses and the anxiety that attends these conflicts due to environment restrictions. The Ego includes one’s intelligence, memory, problem solving, separation of reality from fantasy, and incorporation of experiences and learning into future behavior. Development of the ego allows the infant, by 6 months of age, to view self as separate from others and to begin to alter behaviors in response to cues. Ego development continues throughout life. The third aspect of the personality, according to Freud, is the superego. The superego contains the conscience and the ego idea. The conscience consists of society’s “don’ts” usually as a result of parental and cultural expectations. The ego ideal comprises the standards of perfection toward which the individual strives (Green & Piel, 2002, p. 49). Normally, superego is develop during first year of life, as the child learns praise versus punishment for actions. In addition, superego represents the internalization of rules and values so that socially acceptable behavior is practiced. Freud proposes that the underlying motivation to human development is a dynamic, psychic energy, which he calls libido.
According to Freud’s theory of psychosexual development, the personality is develops in five overlapping stages from birth to adulthood. The libido changes its location of emphasis within the body from one stage to another. Therefore, a particular body area has special significance to a client at particular stage. The first three stages (oral, anal, and phallic) are called pre-genital stage. The culminating stage is the genital stages. If the individual does not achieve a satisfactory progression at each stage, the personality becomes fixated at the stage. Fixation is immobilization or the inability of the personality to proceed to the next stage because of anxiety. For example, an individual can assist an infant’s development by making feeding a pleasurable experience and by making toilet training a positive experience, thereby enhancing the child’s feeling of self control. Freud also emphasizes the importance of infant-parent interaction. Therefore, the nurse as a caregiver should provide a warm, caring atmosphere for an infant and assist parents do when the infants returns to heir care. Ideally, an individual progresses through the tack of each stage and balance is achieved between the id, ego and superego. Conflict or stress, however, can delay or prolong progression through a stage or cause a person to regress to previous stage.
During the oral stage, the infant uses his or her mouth as the major source of gratification and exploration. Pleasure is experienced from eating, biting, chewing and sucking. The infant’s primary need is for security. A major conflict occur with weaning. Normally at this stage, the play of this stage is a solitary play, meaning we could incorporate toys that are suited for his or her age, we must also note that the toys should not have small pieces that might the infant swallow, because as said in these stage. Their gratification is towards the oral, meaning all the things that these infants may see, he will swallow it.. And its fear is stranger anxiety making it very hard for other people to touch or hold these baby, because he or she is frightened about the strangers. The Anal stage begins with the development of neuromascular control to allow control of the anal sphincter. Toilet training is a crucial issue, requiring delayed gratification as the child comprises between enjoyment of bowel function and limits set by social expectations. Appropriate play for this stage is parallel play. This means the toddlers engages in an independent activity that is similar to but not influenced by or shared with the others. The child under the phallic stage has increased interest in gender differences, his or her own gender and conflict and resolution of that conflict with the parent of the same sex (Oedipus and Electra complexes). Oedipus complex refers to the male child’s attraction for his mother and hostile attitudes toward his father, while Electra complex refers to the female’s attraction for her father and hostile attitudes toward her mother. Curiosity about the genitals and masturbation increase during this stage. Its play at this stage is associative/ cooperative play like of kitchen set. At these stage also they view death as reversible or temporary only. During the latent stage, it marks the transition to the genital stage during adolescence. Increase sex-role identification with the parent of the same sex prepares the child for adult roles and relationships. Play: Competitive play like of scrabble and chess. They are mostly had fear on the ghost and dark. And they view death as a final account for human. And lastly. The genital stage, sexual interest can be expressed in overt sexual roles and relationships . Sexual pressures and conflicts typically cause turmoil as the adolescent makes adjustments in relationships. Play: competitive or team play. Their fears is rejection of peers and views death as universal to all humans (Freud, 1961).
Erick H. Erickson adapted and expanded Freud’s theory of development to include the entire lifespan, believing that people continue to develop throughout life. He describes eight stage of development that progress from birth to old age and death, envisions life as a sequence of levels of achievement. His psychosocial theory is based on four major organizing concepts: (1) stages of development, (2) developmental goals or tasks, (psychosocial crises), (4) the process of coping. Each stage signals a task that must be achieved. The resolution of the tack can be complete, partial or unsuccessful. Erickson believes that the greater task achievement, the healthier the personality of the person; failure to achieve a task influences the person’s ability to achieve the nest task. These developmental task can be viewed as series of crises and successful resolution of these crises is supportive to the person’s ego. Failure to resolve the crises is damaging to the ego. Erickson’s eight stage reflect both positive and negative aspects of the critical life periods. The resolution of the conflicts at each stage enables the person to function effectively in society. Each phase has its own developmental task, and individual must find a balance between, for example, trust versus mistrust (stage 1).
When using Erickson’s developmental framework, we must be aware of indicator of positive and negative resolution of each stage. It is also important to be aware that the environment id highly influential in development, according to Erickson. We can enhance a client’s development by being aware of the person’s developmental stage and by helping the person develop coping skills relative to stressors experienced at the level. We can strengthen a client’s positive resolution of a developmental task by providing the individual with appropriate opportunities and encouragement. For example, a 10-year-old child can be encourage to be creative, to finish schoolwork and to learn how to accomplish these task within the limitations imposed by the health. Erickson emphasizes that people must change and adapt their behavior to maintain control over their lives. In his view, no stage in personality development can be bypassed, but people can become fixated at one stage or regress to a previous stage under anxious or stressful conditions. For example, a middle-aged women who has never satisfactorily accomplished the task of resolving identity versus role confusion might regress to an earlier stage when stressed by an illness with which she cannot cope.
Cognitive development refers to the manner in which people learn to think, reason, and use language. It involves a person’s intelligence, perceptual ability, and ability to process information. Cognitive development represents a progression of mental abilities from illogical to logical thinking, from simple to complex problem solving and from understanding concrete ideas to understanding abstract concepts. The most widely known cognitive theorist is Jean Piaget. His theory of cognitive development has contributed to other theories, such as Kohlberg’s theory of developmental and Fowler’s theory of the development of faith.
According to Piaget (1966), cognitive development is an orderly, sequential process in which a variety of new experiences (stimuli) must exist before intellectual abilities can develop. Piaget’s cognitive developmental process is divided into five major phases: (1) the sensorimotor phase, (2) the preconceptual phase, (3) the intuitive thought phase, (4) the concrete operations phase and (5) the formal operations phase.
A person develops through each of these phases; each phase has its own unique characteristics. In each phase, the person uses three primary abilities: assimilation, accommodation and adaptation. Assimilation is the process through which humans encounter and react to new situations by using the mechanisms they already possess. In this way, people acquire knowledge and skills as well as insights into the world around them. Accommodation is a process of change whereby cognitive process mature sufficiently to allow the person to solve problems that were unsolved before. This adjustment is possible chiefly because new knowledge has been assimilated. Adaptation, or coping behavior, is the ability to handle the demands made by the environment. We can employ Piaget’s theory of cognitive development when developing teaching strategies. For example, we can expect a toddler to be egocentric and literal; therefore explanations to the toddler should focus on the needs of the toddler rather than on the needs of others. A 13 year-old- can be expected to use rational thinking and to reason; therefore, when explaining the need for a medication a nurse can outline the consequences of taking and not taking the medication, enabling the adolescent to make a rational decision. We must remember, however, that the range of cognitive development is broad, despite the ages arbitrarily associated with each level. When teaching adults, we must be aware that some adults are more comfortable with concrete thought and slower to acquire and apply new information that are other adults.
The Spiritual Component of growth and development refers to individuals’ understanding of their relationship with the universe and their perceptions about the direction and meaning of life. James Fowler describes the development of faith as a force that gives meaning to a person’s life. He uses the term faith as a form of knowing, a way of being in relation to “an ultimate environment.” To Fowler, “faith is a relational phenomenon; it is an active ‘mode-of-being-in relation’ to another or other in which we invest commitment, belief, love, risk and hope” (Fowler & Keen, 1985, p. 85).
Fowler’s theory and developmental stages influenced by the work of Piaget, Kohlberg, and Erickson. Fowler believes that the development of faith is an interactive process between the person and the environment. In each of Fowler’s stages, new patterns of thought, values and beliefs are added to those already held by the individual; therefore the stages must follow in sequence. Faith stages, are separate from the cognitive stages of Piaget: they evolve from the combination of knowledge and values.
Different theories explain one or more aspect of an individual’s growth and development. Typically, theorists examine only one aspect of an individual’s development, such as the cognitive, moral, or physical aspect. Each of these theorist agreed in some aspect of life, that is the stages and its development. On the table below. I summarizes all the theorists and its corresponding theories.
Key Point of Developmental Theories
Infancy to Toddlerhood
Oral stage; anal stage
Trust vs. mistrust; autonomy vs. shame and doubt
§ Basic reflexes
§ Coordinates more than one thought at a time
§ Begins to reason and anticipate events
§ Centers on relationship with primary caregiver
§ Oriented to obedience and punishment
Preschool to early school years
Initiative vs. guilt
§ Learning sex differences
§ Forming concepts
§ Getting ready to read
§ Imitates religious behaviors of others
§ Defines acts satisfying to self and some satisfying to others as right
Industry vs. inferiority
§ Develops logical thinking
§ Incorporates others perspectives
§ uses abstract thinking and deductive reasoning
§ tests beliefs to establish vales
§ Accepts existence of deity
§ Stories define religious and moral beliefs
§ Morality of maintaining good relations and approval of others; aware of need to respect authority
Adolescent to adult years
Intimacy vs. generation
§ Achieving gender-specific social role
§ Achieving independence
§ Acquiring a set of values and an ethical system to guide behavior
§ Selects principles to follow
§ Concern for the rights and needs of others
Middle adult years
Generativity vs. stagnation
§ Achieving social and civic responsibility
§ Accepting and adjusting to physical changes
§ Integrates others’ viewpoints into own understanding of truth
Later adult years
Ego intergrity vs. despair
§ Adjusting to decreasing physical changes
§ Values absolute love and justice of all
§ Believes in the existence of the future
Freud’s Five Stages of Development
Birth to 1 ½ year
§ Mouth is the center of pleasure (Major source of gratification and exploration).
§ Major conflict: Weaning
§ Feeding produce pleasure and sense of comfort and safety.
§ Feeding should be pleasurable and provided when required.
1 ½ to 3 years
§ Anus and Bladder are the sources of pleasure (sensual satisfaction, self control).
§ Major conflict: Toilet training
§ Controlling and expelling feces provide pleasure and sense of control.
§ Toilet training should be pleasurable experience
4 to 6 years
§ The child’s genitals are the center of pleasurable. Masturbation offers pleasure. Other activities can include fantasy, experimentation with peers and questioning of adults about sexual topics.
§ Major conflict: The Oedipus or Electra complex, which resolves when the child identifies with parent of the same sex.
§ Oedipus complex refers to the male child’s attraction for his mother and hostile attitudes toward his father.
§ Electra complex refers to the female’s attraction for her father and hostile attitudes toward her mother.
§ The child identifies with the parent of the opposite sex and later takes on a love relationship outside the family.
§ Encourage identity.
6 to puberty
§ Energy is directed to physical and intellectual activities.
§ Sexual impulses tend to be repressed.
§ Develop relationships between peers of the same sex.
§ Encourage child with physical and intellectual pursuits.
§ Encourage sports and other activities with same sex peers.
Puberty and after
§ Energy is directed toward full sexual maturity and function and development of skills needed to cope with the environment.
§ Encourage separation from parents, achievement of independence, and decision making.
Fowler’s Stages of spiritual Development
1 to 3 years
§ Infants unable to formulate concepts about self or the environment
4 to 6 years
§ A combination of images and beliefs given by trusted others, mixed with the child’s own experience and imagination
7 to 12 years
§ Private world of fantasy and wonder; symbols refer to something specific; dramatic stories and myth used to communicate spiritual meanings
Adolescent or adult
§ World and ultimate environment structured by the expectations and judgments of others; interpersonal focus
After 18 years
§ Constructing one’s own explicit system; high degree of self-consciousness
After 30 years
§ Awareness of truth from a variety of viewpoints
§ Becoming in carnation of the principles of love and justice
Erickson’s Eight Stages of Development
Indicators of positive Resolution
Indicators of negative resolution
Birth to 18 months
Trust vs. mistrust
§ Learning to trust others
§ Mistrust, withdrawal, estrangement
18 months to 3 years
Autonomy vs. shame and doubt
§ Self-control without loss of self-esteem
§ Ability to cooperate and to express oneself
§ Compulsive self-restraint or compliance.
§ Willfulness and defiance
3 to 5 years
Initiative vs. guilt
§ Learning the degree to which assertiveness and purpose influence the environment
§ Beginning ability to evaluate one’s own behavior
§ Lack of self-confidence. Pessimism, fear of wrongdoing
§ Over-control and over-restriction of own activity
6 to 12 years
Industry vs. inferiority
§ Beginning to create, develop, and manipulate
§ Developing sense of competence and perseverance
§ Loss of hope, sense of being mediocre.
§ Withdrawal from school and peers.
12 to 20 years
Identity vs. role confusion
§ Coherent sense of self.
§ Plans to actualize one’s abilities
§ Feelings of confusion, indecisiveness and possible antisocial behavior
18 to 25 years
Intimacy vs. isolation
§ Intimate relationship with other person
§ Commitment to work and relationships
§ Impersonal relationships
§ Avoidance of relationship, career, or lifestyle commitments
25 to 65 years
Generativity vs. stagnation
§ Creativity, productivity, concern for others
§ Self-indulgence, self-concern, lack of interests and commitments
65 to death
Integrity vs. despair
§ Acceptance of worth and uniqueness of one’s own life.
§ Acceptance of death
§ Sense of loss, contempt for others
Piaget’s Phases of Cognitive Development
Phases and Stages
Birth to 2 years
Stage 1: Use of reflexes
Birth to 1 month
Most action is reflexive
Stage 2: Primary Circular reaction
1 month to 4 months
Perception of events is centered on the body. Object are extension of self.
Stage 3: Secondary circular reaction
4 to 8 months
Acknowledge the external environment. Actively makes changes in the environment.
Stage 4: Coordination of secondary schemata
8 to 12 months
Can distinguish a goal from a means of attaining it
Stage 5: Tertiary circular reaction
12 to 18 months
Tries and discover new goals and ways to attain goals. Rituals are important.
Stage 6: Inventions of new means
18 to 24 months
Interprets the environment by mental image. Uses make believe and pretend play.
2 to 4 years
Uses an egocentric approach to accommodate the demands of an environment . Everything is significant and relates to “me.” Explores the environment. Language development is rapid. Associates words with objects.
Intuitive thought phase
4 to 7 years
Egocentric thinking diminishes. Thinks of one idea at time. Includes others in the environment. Words express thoughts.
Concrete operations phase
7 to 11 years
Solves concrete problems. Begins to understand relationships such as size. Understands right and left. Cognizant of viewpoints.
Formal operations phase
11 to 15 years
Uses rational thinking. Reasoning is deductive and futuristic.
Kohlberg’s Stages of Moral Development
Person is responsive to cultural rules of labels of good and bad, right or wrong. Externally established rules and determine right or wrong actions. Person reasons in terms of punishment, reward or exchange of favors.
1. Punishment and Obedient Orientation
Fear of punishment, not respect for authority, is the reason for decisions, behavior and conformity
2. Instrumental relativist Orientation
Conformity is based on egocentricity and narcissistic needs. There is no feeling of justice, loyalty or gratitude. “ill do something if l get something for it or because it pleases you”
Toddler to 7 years
Preschool through school age
Person is concerned with maintaining expectations and rules of the family, group, nation or society. A sense of guilt has developed and affects behavior. The person values conformity, loyalty and active maintenance of social order and control. Conformity means good behavior or what pleases or helps another and is approved
3. Interpersonal Concordance Orientation
Decision and behavior are based on concerns about other’s reactions; the person wants other’s approval or a reward.
An emphatic response, based on understanding of how another person feels, is a determinant for decisions and behavior. (“I can put my self in you shoes.”)
4. Law-and-Order Orientation
The person wants established rules from authorities, and the reason for decisions and behavior is that social and sexual rules and traditions demand the response. (“I’ll do something because it’s the law and my duty)
School age through Adulthood
Adolescence and adulthood
The person lives autonomously and defines moral values and principles that are distinct from personal identification with group values. He or she lives according to principles that are universally agreed on and that the person considers appropriate for life.
5. Social Contract Legalistic Orientation
The social rules are not the sole basis for decisions and behavior because the person believes a higher moral principle applies such as equality, justice or due process.
6. Universal Ethical Principle Orientation
Decisions and behaviors are based on internalized rules, on conscience rather than social laws, and one self-chosen ethical abstract principles that are universal, comprehensive and consistent.
Middle-age or older adult
Middle-age or older adult
Freud, S. (1961). The Ego and the Id and other works. Strachey, J., translator. London: Hogarth Press and Institute of Psychoanalysis. Vol. 9
Fowler, J., and Keen, S. (1985). Life maps: Conversations in the journey of faith. Waco, TX: Word Books.
Green, M., and Piel J. A., (2002), Theories of Human Development. A comparative approach. Boston: Ally & Bacon
Kohlberg, L. (1969). Stage and sequence: The cognitive developmental approach to socialization. Chicago: Rand Mcnally
Thies, K., and Travers, J. (2001). Human growth and Development through lifespan. Thorofare, NJ: Slack Inc.
Thomas, R. M., (2001). Recent theories of human development, Thousand oaks, CA: Sage Publications