Life-Span Development

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Infancy

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

The younger the child, the more rapid the pulse and respirations.

Blood pressure is related to age and weight.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Weight

Normal birth weight is 3.0

–3.5 kg.

Weight drops within first week due to excretion of extracellular fluid.

First month infants grow approximately 30 grams per day.

Infant’s head is equal to 25% of the total body weight.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Infants double their weight by 4 to 6 months old and triple it by 9 to 12 months.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Cardiovascular System

Several changes occur to transition the infant from fetal to pulmonary circulation: – The ductus venosus constricts.

– The foramen ovale closes.

– The ductus arteriosus constricts.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Pulmonary System

Infant’s airway is shorter, narrower, less stable, and more easily obstructed than at any other time.

Infants are obligate nose breathers.

Lung tissue is fragile.

Accessory muscles are immature.

Chest wall is less rigid; ribs are horizontal, causing diaphragmatic breathing.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Renal System

Kidneys are unable to produce concentrated urine, so infants are much more easily dehydrated.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Immune System

The fetus acquires some of the mother’s immunity which may remain active for six months to a year after birth.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Nervous System

(1 of 2) Infants lack ability to localize pain.

Infants have several reflexes that disappear over time: – Moro reflex (startle) – Palmar grasp – Rooting reflex – Sucking reflex Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Nervous System

(2 of 2) Fontanelles allow for compression of head during childbirth and allow for rapid growth of brain.

Newborns sleep 16 –18 hours daily, evenly distributed over a 24-hour period.

Sleep decreases to 14 –16 hours, with a 9 –10 hour period at night.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Musculoskeletal System

Extremities grow from growth plates.

Epiphyseal plates are secondary growth centers.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Other Characteristics

(1 of 3) Two Months Three Months Four Months Five Months Recognizes familiar faces and objects Moves objects to mouth, displays primary emotion Reaches out to people Sleeps through the night, differentiates between family and strangers Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Other Characteristics

(2 of 3) Six Months Seven Months Sits upright, makes single syllable sounds Exhibits fear of strangers Eight Months Responds to the word "no," sits alone, plays "peek-a-boo" Nine Months Pulls up to standing position, explores objects by mouthing, sucking, chewing, and biting them Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Other Characteristics

(3 of 3) Ten Months Eleven Months Twelve Months Pays attention to name, crawls well Attempts to walk without assistance, shows frustration about restrictions Can walk without help, knows name Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Family Processes and Reciprocal Socialization

Crying Attachment Trust vs. mistrust Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Crying

Crying is an infant’s only means of communication.

Mothers quickly learn to distinguish the differences between cries.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Attachment

Secure attachment – Infant learns that caregivers will be responsive and helpful when needed.

Anxious resistant attachment – Infant learns to be uncertain about whether or not caregivers will be responsive.

Anxious avoidant attachment – Infant learns that caregivers will not be responsive or helpful when needed.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Trust vs. Mistrust

Infant wants the world to be an orderly place where causes and effects can be anticipated.

Infant develops trust when he or she can count on consistent parental care.

Mistrust develops if he or she cannot count on parental care.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Temperament

Easy child: – Regular body functions – Low or moderate intensity of reactions – Accepts new situations Difficult child: – Irregular body functions – Intense reactions – Withdrawal from new situations Slow-to-warm-up child: – Low intensity of reactions and somewhat negative mood Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Parental Separation Stages

Protest Despair Detachment or withdrawal Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Toddler and Preschool Age

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

A toddler beginning to stand and walk on his own

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Body System Changes

(1 of 3) Cardiovascular: – Capillary beds better developed and assist in thermoregulation.

– Hemoglobin levels approach normal adult levels.

Pulmonary: – Alveoli increase in number.

– Chest muscles still immature.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Body System Changes

(2 of 3) Renal: – Kidneys well developed.

– Urine characteristics similar to adult.

Immune: – Passivity immunity is lost and child is susceptible to minor respiratory and GI infections.

Nervous: – Brain at 90% of adult weight.

– Myelination has increased.

– Fine motor skills developing.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Body System Changes

(3 of 3) Musculoskeletal: – Muscle mass and bone density increase.

Dental: – All primary teeth have erupted by the age of 36 months.

Senses: – Visual acuity is 20/30 during toddler years.

– Hearing reaches maturity at 3 to 4 years old.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

In the preschool-age child, exploratory behavior accelerates.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

(1 of 2) Cognition: – Starts to grasp meaning of words at 1 year.

– By 3 or 4, has mastered basics of language.

– Between 18 and 24 months, begins to understand cause and effect.

– By 24 to 36 months, develops magical thinking and engages in play-acting.

Play: – Able to play simple games and follow basic rules.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

(2 of 2) Sibling relationships: – Sibling rivalry may occur.

Peer group functions: – Provide source of information about other families and the outside world.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Television and Modeling

Television: – TV violence increases aggression.

– Increases passive acceptance of use of aggression by others.

Modeling: – Begin to recognize sexual differences and begin to incorporate gender-specific behaviors of parents, siblings, and peers.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

School Age

Ages 6 to 12 Years Old Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

School-age children are allowed more self regulation and independence as they grow older.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

Average child gains 3 kg per year.

Vital signs reach adult levels.

Lymph tissues are proportionately larger than those of an adult.

Brain function increases in both hemispheres.

Primary teeth are being replaced by permanent ones.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

Development of self-concept.

Begin to develop self-esteem.

Moral development begins: – Pre-conventional reasoning – Conventional reasoning – Post-conventional reasoning Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Adolescence

Ages 12 to 18 Years Old Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Children reach reproductive maturity during adolescence.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

Usually experience a rapid two- to three-year growth spurt.

Both males and females reach reproductive maturity.

Muscle mass and bone growth are complete.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

Family conflict may occur as the adolescent strives for autonomy and parents strive for continued control.

Privacy and modesty become important.

There is a need to be treated as an adult.

There is increased idealism, which leads to disappointment.

Depression and suicide are more common at this age than any other.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Ethical Development

Development of logical, analytical, and abstract thinking occurs.

A personal code of ethics develops.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Early Adulthood

Ages 20 to 40 Years Old Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Peak physical conditions occur in early adulthood.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

(1 of 2) The body begins its slowing process.

Spinal discs settle, leading to decreased height.

Fatty tissue increases, leading to weight gain.

Childbirth is common in this stage.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

(2 of 2) Muscle strength decreases.

Accidents are the leading cause of death.

The highest levels of job stress occur.

Love develops.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Middle Adulthood

Ages 41 to 60 Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

People in middle adulthood still function at a high level.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

(1 of 2) Hearing and visual changes occur.

Cardiac output decreases and cholesterol levels increase.

Cancer often strikes this age group.

Weight control is more difficult.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Physiological Development

(2 of 2) For women in their late 40s and early 50s, menopause commences.

Offspring have left home, and “empty nest syndrome” may occur.

Often there are financial commitments to elderly parents and young adult children.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Late Adulthood

Ages 61 and Older Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

The ability to learn and adjust continues throughout life.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Cardiovascular System

Vessel walls thicken.

Increased peripheral vascular resistance, and reduced blood flow to organs.

Decreased baroreceptor sensitivity.

Decreased vessel elasticity.

Heart starts showing disease.

Functional blood volume decreases, as well as red blood cells.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Respiratory System

Trachea and large airways increase in diameter.

Decreased surface area of lungs as well as decreased elasticity in the lungs.

Coughing is less effective due to weakened chest wall and bone structures.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Endocrine System

Glucose metabolism and insulin production decrease.

The thyroid shows diminished triiodothyronine production.

Cortisol is diminished by 25%.

The pituitary is 20% less effective.

The reproductive organs atrophy in women.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Gastrointestinal System

(1 of 2) Tooth loss can lead to dietary changes, increased chance of malnutrition, vitamin and mineral deficiency.

The swallowing mechanism changes.

Peristalsis is decreased and the gastric sphincter is less effective.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Gastrointestinal System

(2 of 2) Stomach secretions decrease.

Intestines atrophy.

Metabolism and absorption change.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Renal System

Reduced kidney function leads to decreased clearance of some drugs and decreased elimination.

The kidneys’ hormonal response to dehydration is reduced.

The kidneys are less able to modify vitamin D to a more active form.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

The Senses

Taste buds diminish.

Smell declines, and parts of the brain involved in smell degenerate.

Response to pain is diminished.

Ability to sense movement diminishes.

Visual acuity decreases, and reaction times increase.

Hearing decreases.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

The Nervous System

Neurotransmitters are decreased.

Loss of coordination and memory.

Sleep problems may occur.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Psychosocial Development

The terminal drop hypothesis states that death is preceded by a five-year period of decreasing cognitive function.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Challenges

Housing becomes a challenge.

Maintaining a sense of self-worth becomes a problem as it is harder to care for themselves.

Finances become stressful with retirement and the decreased ability to work.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Dying Companions or Death

Because of the death or impending death of companions, fear and grief are present.

People must go through the stages of the grieving process.

Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Summary

Characteristics of the following life stages: Infancy Toddler Preschooler School age Adolescent Early Adult Middle-aged Adult Late-aged Adult Bledsoe et al.,

Paramedic Care Principles & Practice Volume 1: Introduction

© 2006 by Pearson Education, Inc. Upper Saddle River, NJ