Theories of Development

Sensorimotor (0–2 yrs)

• Learning through movement, touch, sight, sound
• Gradually learn object permanence
• Use distraction for procedures
• Infant may cry when parent leaves
• Allow comfort objects

Preoperational (2–7 yrs)

• Big imagination and pretend play
• Thinking is still very child-centred
• May believe they caused their illness
• Use simple, concrete explanations
• Demonstrate on a teddy or doll
• Reassure it is not their fault

Concrete Op. (7–11 yrs)

• More logical thinking about real things
• Can follow clear cause and effect
• Understands another person's view better
• Include child in discussions
• Give logical explanations
• They can learn about their condition

Formal Op. (12+ yrs)

• Can think about ideas and "what if"
• Future consequences make sense now
• Involve them in care decisions
• Discuss longer-term implications
• Consider Gillick competence

Trust vs Mistrust (0–1 yr)

• "Can I trust the world?"
• Keep routines consistent
• Involve parents throughout
• Respond to cries promptly

Autonomy vs Shame (1–3 yrs)

• "Me do it!"
• Offer simple choices
• Allow some control
• Be patient with attempts

Initiative vs Guilt (3–6 yrs)

• "Am I good or bad?"
• Encourage questions
• Use play for procedures
• Praise appropriate curiosity

Identity vs Confusion (12–18)

• "Who am I?"
• Respect autonomy
• Address body image concerns
• Involve in care decisions

Secure

• Uses caregiver as safe base
• Distressed when separated
• Easily comforted on reunion
• Develops from consistent, responsive care

Insecure–Avoidant

• Avoids caregiver
• Little distress at separation
• Ignores on reunion
• Often from emotionally unavailable parenting

Insecure–Resistant

• Very distressed at separation
• Hard to comfort on reunion
• From inconsistent caregiving
• Also called ambivalent attachment

Disorganised

• No clear pattern
• Confused or contradictory behaviours
• Often linked to abuse or neglect
• Highest risk for later difficulties

Zone of Proximal Dev.

• The "almost but not quite alone" zone
• Gap between solo ability and guided ability
• Where real learning happens

Scaffolding

• Temporary support to help succeed
• Reduce support as confidence grows
• Think of it like training wheels

More Knowledgeable Other

• Parent, teacher, nurse, sibling, or peer
• Anyone who knows a bit more
• Guides the learner through ZPD

Clinical Application

• Guide self-care step by step at first
• Step back as confidence grows
• Peer support helps — children learn from others
• E.g., inhaler technique teaching

Pre-Conventional

• Stage 1: Avoid punishment (~2–6 yrs)
• "It's wrong because I'll get in trouble"
• Stage 2: Self-interest (~6–9 yrs)
• "What's in it for me? Fair exchange"

Conventional

• Stage 3: Good boy/girl (adolescence)
• Want approval; relationships matter
• Stage 4: Law and order (adulthood)
• Rules and authority are important

Post-Conventional

• Stage 5: Social contract (some adults)
• Rules can be changed for greater good
• Stage 6: Universal principles (few adults)
• Personal ethics may override law

Clinical Application

• Young children — link to concrete consequences
• Older children — rules and fairness matter
• Adolescents — discuss reasoning openly
• More effective than simply telling them

Bandura

• Social Learning Theory
• Children learn by observing and imitating
• Explains modelling of behaviour
• Model healthy behaviours in practice
• Be aware children may copy staff

Bronfenbrenner

• Ecological Systems Theory
• Family (microsystem)
• School/community (mesosystem)
• Parental work (exosystem)
• Culture (macrosystem)
• Consider the whole context of a child's life

Freud

• Psychosexual Development
• Five stages: oral, anal, phallic, latent, genital
• Concepts like defence mechanisms still relevant
• Denial and regression are common coping strategies

Clinical Applications

• Model healthy behaviours (Bandura)
• Consider family, community, culture (Bronfenbrenner)
• Understand behaviour may have unconscious roots (Freud)
• Defence mechanisms are normal coping