Chapter 4
Developmental
Assessment
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Competencies
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Identify the defining concepts and principles
of major developmental theories.
Assess patients’ developmental levels by
applying the major developmental theories.
Incorporate appropriate developmental tasks
associated with each life stage into a
patient’s assessment.
Select appropriate developmental
assessment tools for use in screening a
patient for developmental difficulties.
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Developmental
Theories
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Ages and stages
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Developmental stage
Developmental tasks
Life event/transitional
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Ages and Stages
Developmental
Theories
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Piaget’s theory of cognitive
development (1952)
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Stages
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Sensorimotor
Preoperational
Concrete operations
Formal operational
(continues)
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Ages and Stages
Developmental
Theories
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Freud’s psychoanalytic theory of
personality development (1946)
Personality
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Ego
Superego
(continues)
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Ages and Stages
Developmental
Theories
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Psychosexual stages
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Oral
Anal
Phallic
Latency
Genital
(continues)
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Ages and Stages
Developmental
Theories
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Erikson’s Epigenic theory of
personality (1974)
Stages
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Trust vs. Mistrust
Autonomy vs. Shame and doubt
Initiative vs. Guilt
Industry vs. Inferiority
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(continues)
Ages and Stages
Developmental
Theories
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Stages in Erikson's Epigenic theory
(cont.)
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Identity vs. Role confusion
Intimacy vs. Isolation
Generativity vs. Stagnation
Ego integrity vs. Despair
(continues)
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Ages and Stages
Developmental
Theories
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Kohlberg’s theory of moral
development (1981)
Levels
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Preconventional
Conventional
Postconventional
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Developmental Stages,
Tasks, and Life Events
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Stages
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Infancy (birth to 1 year)
Toddler (1 to 3 years)
Preschool (3 to 6 years)
School-age (6 to 12 years)
Adolescent (12 to 18 years)
Young adult (18 to 30 years)
Early middle age (30 to 50 years)
Late middle age (50 to 70 years)
Late adulthood (70 years to death)
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Stage 1: Infancy
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Rapid physical, motor, cognitive,
emotional, and social growth
Major task is weaning
Sensorimotor (Piaget)
Oral (Freud)
Trust vs. Mistrust (Erikson)
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Growth and
Development During
Infancy
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Gross motor
Fine motor
Language
Sensory
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Stage 2: Toddler
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Steadily increasing motor
development and control
Intense activity and discovery
Rapid language development
Increasingly independent behaviors
Marked personality development
(continues)
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Stage 2: Toddler
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Gross motor
Fine motor
Language
Sensory
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Developmental
Theories During
Toddlerhood
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Sensorimotor to preoperational
(Piaget)
Anal (Freud)
Autonomy vs. Shame and doubt
(Erikson)
Preconventional level—moral stage
(Kohlberg)
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Stage 3: Preschool
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Focused on developing initiative
and purpose
Preoperational (Piaget)
Phallic (Freud)
Initiative vs. Guilt (Erikson)
Individualism, instrumental purpose,
and exchange (Kohlberg)
(continues)
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Stage 3: Preschool
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Fine motor
Gross motor
Language
Sensory
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Stage 4: School-age
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Reduce dependency on family for
socialization, begins to socialize with peers
Preoperational to concrete operations
(Piaget)
Latency (Freud)
Industry vs. Inferiority (Erikson)
Conventional level—mutual expectations,
relationships, and conformity (Kohlberg)
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(continues)
Stage 4: School-age
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Fine motor
Gross motor
Language
Sensory
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Stage 5: Adolescent
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Period of struggle and turmoil
Formal operations (Piaget)
Genital (Freud)
Identify vs. Role confusion
(Erikson)
Conventional level—social system
and conscience (Kohlberg)
(continues)
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Stage 5: Adolescent
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Fine motor
Gross motor
Language
Sensory
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Stage 6: Young Adult
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Time of separation and independence from
the family
Marked by new commitments,
accountability, responsibilities
Key developmental tasks
Formal operations (Piaget)
Intimacy vs. Isolation (Erikson)
Postconventional level—social contract or
utility and individual rights (Kohlberg)
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Stage 7: Early Middle
Age
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Settle into career, lifestyle, relationships
Develop political, civic, social,
professional, religious affiliations
Key developmental tasks
Generativity vs. Stagnation (Erikson)
Postconventional level—social contract
or utility (Kohlberg)
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Stage 8: Late Middle
Age
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Development of chronic disease
Changes in relationships, affiliations
Key developmental tasks
Generativity vs. Stagnation
(Erikson)
Universal ethical principles stage
(Kohlberg)
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Stage 9: Late Adulthood
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Time for adjustments
Changes in health, relationships,
affiliations
Key developmental tasks
Ego integrity vs. Despair (Erikson)
Universal ethical principles stage
continues (Kohlberg)
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Stages of the Family
Life Cycle
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Leaving home
Joining of families
Families with young children
Families with adolescents
Launching children
Families in later life
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Developmental
Assessment Tools
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Infants to young school-age children
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Brazelton Neonatal Behavioral
Assessment (BNBAS)
Denver II
Revised Prescreening Developmental
Questionnaire (R-PDQ)
Early Language Milestones Scale
(ELM)
(continues)
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Developmental
Assessment Tools
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Carey Infant and Child Temperament
Questionnaire
Washington Guide to Promoting
Development in the Young Child
Stress Scale for Children
Adolescents
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HEADSS (home, education, activities,
drugs, sex, and suicide) adolescent risk
profile
(continues)
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Developmental
Assessment Tools
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Children with disabilities
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NGAGED (now, growth and
development, activities of daily living,
general health, environment, and
documentation)
Adults
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Recent Life Changes Questionnaire
Life Experiences Survey
(continues)
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Developmental
Assessment Tools
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Everyday Hassles Scale (EHS)
Stress Audit
Sense of coherence (SOC)
Beck Depression Inventory (BDI)
Older adults
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Functional Activities Questionnaire (FAQ)
Folstein Mini-Mental Status Examination
(MMSE)
(continues)
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Developmental
Assessment Tools
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Nursing home residents
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Functional Assessment Screening in the
Elderly (FASE)
Minimum Data Set for Nursing Facility
Resident Assessment and Care Screening
Families
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Calgary Family Assessment Model (CFAM)
Friedman Family Assessment Model (FFAM)
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