Self-esteem development during middle childhood

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I need this essay to be rewritten; however, same format. The Child Development Assessment Revised 3 (4). docx

Child’s initials: A. J., male, caucasian

Age: 11

Born: December 21st

57 inches tall, 78 lbs

3 siblings: 23 year old half brother, 21 year old half sister, 13 year old brother (biological)

Father is a Lieutenant Commander in the military. Father works 5 days a week, leaves at 6 in the morning, returns after 6pm. Father has strict rules, authoritarian household

Mother is a hairstylist. Works part-time. Arrives home to meet children at the bus.

Parent DO NOT SMOKE. The only strain on growth development is the parenting style: authoritarian.

Autocratic Leadership (Authoritarian) Leadership: Autocratic leaders make independent decisions without communicating, collaborating and consulting with others. These leaders state what has to be accomplished, when it must be done, and how it should be done. Families who use an autocratic or authoritarian parenting are typically strict and the leader has control and authority over the other family members. Some families that use the autocratic or authoritarian parenting style are considered patriarchal, with the father as the leader, and others are considered matriarchal with the mother as the person with the power and control over other members of the family.

Family dysfunction, as defined by the North American Nursing Diagnosis Association (NANDA), is the “psychosocial, spiritual, and physiological functions of the family unit are chronically disorganized , which leads to conflict, denial, of problems, resistance to change, ineffective problem solving, and a series of self perpetuating crises”.

Some of the many stressors and crises that can impact on the family unit include poverty, homelessness, abuse, neglect, substance related abuse including alcoholism, divorce, separation, psychological illness, maturational and developmental crises such as the birth of a new baby, role changes, power shifts, and physical illnesses.

Assessment Focus

  • Communication
  • Emotional
  • Coping
  • Roles/relationship

Expected Outcomes Family Members Will

  • Not experience physical, verbal, emotional, or sexual abuse.
  • Communicate clearly, honestly, consistently, and directly.
  • Establish clearly defined roles and equitable responsibilities.
  • Express understanding of rules and expectations.
  • Report the methods of problem solving and resolving conflicts have improved.
  • Report a decrease in the number and intensity of family crises
  • Seek ongoing treatment.

Suggested Noc Outcomes

Family Coping; Family Functioning; Family Normalization; Social Interaction Skills; Substance Addiction Consequences

Intervention And Rationales

Determine: Assess family’s developmental stage, roles, rules, socioeco-nomic status, health history, history of substance abuse; history of sex-ual abuse of spouse or children, problem-solving and decision-making 131 skills, and patterns of communication. Assessment information will provide development of appropriate interventions.Perform: Meet with family members to establish levels of authority and responsibility in the family. Understanding the family dynamics provides information about the kinds of support the family needs to work with the patient’s issues.Create an environment in which family members can expres themselves openly and honestly to build trust and self-esteem.Establish rules for communication during meetings with the family to assist family members to take responsibility for their own behavior.Inform: Teach family members basic communication skills to enable them to discuss issues in a positive way. Have them role-play with one another numerous times to demonstrate what has been learned.Involve the family in exercises to reduce stress and deal with anger.Attend: Hold adults accountable for their alcohol or substance abuse and have them sign a “Use contract” to decrease denial, increase trust, and promote positive change.Involve patient in planning and decision making. Having the ability to participate will encourage greater compliance with the plan.Assist family to set limits on abusive behaviors and have them sign “Abuse contracts” to foster feelings of safety and trust.Manage: Refer to case manager/social worker to ensure that a home assessment is done.Refer to support groups that deal with substance abuse, domestic violence, or sexual abuse depending on the needs of the patient and/or family to enhance interpersonal skills and strengthen the family unit.Provide all appropriate phone numbers so that the family members can initiate whatever follow-up is needed.

Suggested Nic Interventions

Coping Enhancement; Family Integrity Promotion; Family Process Maintenance; Family Support; Normalization Promotion; Substance Use Prevention; Substance Use Treatment


Yonaka, L., et al. (2007, January–February). Barriers to screening for domestic violence in the emergency department. Journal of Continuing Education for Nursing, 38(1), 37–45.

Theorists: Eric Erickson

Psychosocial Development of Middle Childhood

Erikson’s theory of industry versus inferiority explains the psychosocial development of middle childhood.

The energy of children during middle childhood development is directed towards creativity and productivity. They strive to accomplish competence at useful skills and tasks to attain social recognition among the adults and children in their environment.

Self-esteem development during middle childhood

Self-esteem is based on how children perceive themselves in the areas that are important to them.

Healthy self-esteem is built on positive self-concept, which gets pronounced during middle childhood years.

From age 6 to10 are the early school years, when children establish their own identity. Individuality and independence is first experienced by children during this phase of development.

Self-esteem of middle childhood children is very high

They have high self-esteem; respect themselves and the family to which their own identity is linked. They begin to mark their own social stand in appearance, behavior and capabilities in comparison to those around them.

Their capabilities and social status influence their self-concept and consequently their self-esteem. At this stage of childhood development children judge themselves according to their ability to produce socially valued outputs.

Building healthy self-esteem is a continuous process. It starts in child’s own mind as a part of psychosocial development of middle childhood.

As children advance through school years, they associate their self-esteem in three separate facets; academic, social and body image.

Low self-esteem impairs school performance & social relationships

The danger of inadequate self-esteem development arises in children whose personality development has been hampered by early childhood trauma.

These children are usually poor achievers; they lack their basic self-esteem essential to build overall confident personality. They are likely to suffer from inferiority complex unless intervened early by positive reinforcement by parents and teachers.

Psychosocial development and parent-child relationship

The desire for independence and growing individuality move children into the world that is a little distant from that of their parents. They assert their will, defy authority and resist parental interference. This is often misinterpreted as disrespectful behavior.

Children however recognize the need for the parents’ support. They respect parents’ knowledge and skills and strive to seek parents’ acceptance. Emotional deprivement leaves them lonely and in pain. Co-regulation prevents social and emotional disharmony in children.

Emotional Deprivement Leaves Children Lonely & In Pain3Save


Co-regulation implies that parent to child communication need to be a bilateral dynamic process rather than simple exchange of information. This form of child parenting is also known as democratic parenting.

Here the words and the tone of conversation are adjusted based on perceptions, facial expressions and body language of the child.

Since children get the liberty to express their views, they do not resist sharing information or avoid participating in a discussion.

Co-regulation helps parents to hold oversight and gives children the desired independence and the responsibility.

Coping with sibling rivalry

Sibling rivalry is a normal phenomena of psychosocial development of childhood. It is the reflection of competitive attitude of children to achieve recognition among the adults and children in their environment: Essential process for healthy self-esteem and personality development.

Siblings are companions, who help and comfort each other through difficult tasks and difficult times. Elder sibling usually attains higher IQ and better school grades as a result of parental expectation of mature behavior. The younger gains more peer popularity attributed to development of better negotiating and compromising capabilities.


Comparison of siblings’ traits, abilities, and accomplishments by the parents leads to an increase in sibling rivalry and may even perpetuate jealousy between them.

When siblings are close in age and of the same sex, parental comparisons take place more frequently, which results in more quarrelling and antagonism among the siblings.

Building peer group relationships

Psychosocial development of middle childhood focuses on peer relationship. Children at this age conform readily to the peer group norms in order to win social acceptance. They seek acceptance both from elders and peer group by their ability to produce socially valued outputs.

Peer group provides a context in which children practice cooperation, leadership and followership, and develop a sense of loyalty to collective goals.

During middle childhood, friendships are fairly stable. Friends chosen tend to be of the same age, sex, and ethnicity.



Piaget – Concrete operations
Transitions from perceptual to conceptual thinking

Masters the concept of conservation

Conservation of mass is understood first, followed by weight, and then volume

Learns to tell time

Classifies more complex information

Able to see the perspective of others

Able to solve problems

Age appropriate activities for an 11 year old:

Competitive and cooperative play is predominant

simple board games and number games
jump rope
collections (rocks, stamps, cards, coins, or stuffed animals)
ride bikes
build simple models
join organized sports ( for skill building)

Age-appropriate activities for 9-12 years

make crafts
build models
collect things/ engage in hobbies
solve jigsaw puzzles
play board games and card games
join organized competitive sports

A.J. participates in Tae Kwon Do, he is a blue belt. He also plays soccer for recreations. He also loves anything related to automobiles.

Safety Concerns: guns are located inside the household. Bleach and harmful cleaning chemicals in accessible location. Recommend to lock guns in secure location and keep chemicals out of reach or stored in a locked compartment, or outside in the garage.

Information that can remain the same:

food diary, ADHD, nutrition

Factors that facilitate/inhibit G&D and Discussion of Identified Problems and pediatric home environment (except for smoking and drinking)

Discussion of identified problems

Discussion of identified problems

Child’s Home Environment


Unformatted Attachment Preview

2 to 20 years: Boys Stature-for-age and Weight-for-age percentiles Mother’s Stature Date Father’s Stature Age Weight Stature BMI* NAME RECORD # 12 13 14 15 16 17 18 19 20 cm AGE (YEARS) 95 90 75 50 25 in 62 S T A T U R E 60 58 56 54 52 50 48 46 44 42 40 38 cm 3 4 5 6 7 8 9 10 11 10 5 190 185 180 175 170 165 160 160 155 155 150 150 74 72 70 68 66 64 62 60 140 105 230 135 100 220 130 95 125 90 95 210 90 200 120 85 115 80 75 75 110 105 50 100 25 95 10 5 190 180 170 160 70 150 W 65 140 E I 60 130 G 36 90 34 85 50 110 32 80 45 100 40 90 35 35 30 30 25 25 20 20 15 15 10 kg 10 kg 80 70 60 50 40 30 lb S T A T U R E 145 30 W E I G H T in 76 AGE (YEARS) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Published May 30, 2000 (modified 11/21/00). SOURCE: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion (2000). 55 120 80 70 60 50 40 30 lb H T Running head: CHILD DEVELOPMENT ASSESSMENT PAPER 1 Child Development Assessment Paper Student’s name Institution affiliation Date CHILD DEVELOPMENT ASSESSMENT PAPER 2 Introduction This paper presents an in-depth assessment of the growth and development of a child aged 10 years. This assessment focuses on the Child’s physical as well as psychological growth and development. I will analyze the data collected from the home visit to determine the factors that facilitate or inhibit the child’s growth and also provide interventions and recommendations to promote or maintain their welfare. Child Home Visit CK is a Caucasian 10 years old boy who was born on 12 June 2008. CK’s family consists of the father (55years); the mother (49years) and 2 siblings aged 9years and 3years respectively. All the family members live together in a three-bedroom apartment. While CK’s father works as an accountant in a bank in Maryland, his mother stays at home to care of the three children. I visited the family in June to collect data for my assessment and they were welcoming and very hospitable. Assessment To determine CK’s developmental status throughout his lifetime and determining his health status, I collected both subjective and objective data for physical parameters such as stature, weight, and BMI for every age. After collecting the data, I used the Center for Disease Control (CDC), 2-20 years 3rd-97th percentile forms to plot the stature for age, weight for age and the BMI for age growth charts since CK is more than 2 years of age. Growth charts According to Hockenberry & Wilson (2014), “Growth charts use a series of percentile curves to demonstrate the distribution of body measurements in children.” (p. 110). • Stature for Age Growth Chart CHILD DEVELOPMENT ASSESSMENT PAPER 3 “The term height (or stature) refers to the measurement taken when a child is standing upright” (Hockenberry & Wilson, 2014, p.113). In preparation for the measurement of his height, CK removed his shoes and stood before a wall with his heels, buttocks and the back of his shoulders touching the wall. I used a tape measure to measure his height and recorded it to the nearest 1 millimeter. I then plotted his height in the CDC’s 2-20 years 3rd-97th percentile form of stature for age, see Appendix 1. • Weight For Age Growth Chart I used a weighing balance to measure CK’s weight and recorded it in Kilograms. While measuring his weight, I ensured that he wore minimal clothing to avoid getting the wrong measurements. I then plotted his weight in the CDC’s 2-20 years 3rd-97th percentile form of weight for age, see Appendix 2. • BMI For Age Growth Chart “With the increasing number of overweight children in the United States, the BMI charts are a critical component of children’s physical assessment” (Hockenberry & Wilson, 2014: p.117). BMI is calculated to determine if a child is overweight or underweight as well as evaluating whether they stand a risk of being overweight or underweight. I calculated CK’s BMI value by dividing his weight (in kilograms) with his height (in meters squared). I then plotted his BMI value in the CDC’s 2-20 years 3rd-97th percentile form of BMI for age, see Appendix 3. Nutritional Status (24-hour food diary) “Each day in a seven-day meal plan should include a balance of foods to ensure adequate nutrient intake” (Cespedes, 2017: p.1). For CK’s case, daily nutrition comprises of three main meals, i.e., breakfast, lunch, and dinner. CHILD DEVELOPMENT ASSESSMENT PAPER 4 For breakfast, CK eats a variety of foods such as oatmeal, whole-grain toast, berries and milk, pancakes, low-fat yogurt, milk and low sugar cereals. For lunch, CK eats foods like vegetables with low sodium, roast beef or turkey, whole bread with peanut butter and bananas, carrot and celery sticks, etc. For a snack, he takes grapes, salted almonds or low-fat yogurt. During dinner, CK prefers to take grilled chicken served with mild salsa and baked potato, a pizza topped with veggies and low-fat cheese or flank steak in a tortilla with backed chips and avocado dip on the side. Family Assessment CK’s parents believe in authoritative discipline, and this has worked well with CK and his siblings. The power to make decisions in the family lies with the father and they always consult him even when he is not at home. In regards to communication, every member of the family seemed to respect the opinion of others. No abusive word was used during the interview, and despite being away at work, the father frequently calls home to find out how everybody is doing. Unfortunately both of CK’s parents smoke inside their house, and this poses serious health problems for their children. Additionally, CK’s father drinks a lot of alcohol during his off days and weekends, and this affect the family psychologically as well as financially. The family also eats out severally and hence consumes unhealthy foods risking being overweight or obese. Pediatric Home Environment According to Conlon et al. (2015), “the home environment, which includes parenting practices, is an important setting in which children develop their health behaviors.” CK’s home offers him an ideal environment for playing with sibling and friends since it’s spacious and has a well-trimmed lawn. The home is a three bedroom house with a basement which is out of bounds CHILD DEVELOPMENT ASSESSMENT PAPER 5 for the children. The living room is the largest space in the house where the children mostly play. The house is well ventilated and heated for cold seasons. CK and his siblings share a room that has good beds and beddings. The only indoor hazard is when parents smoke cigarettes inside the house terming the children as secondary smokers. Also, there are harmful chemicals in the house such as pesticides and OTC drugs. Analysis of Data Child’s Growth and Development From the data collected, it is evident that CK has a normal rate of development in both physical parameters and psychological attributes. In regards to the stature, CK stood 33 inches tall which falls in the 25th percentile and is within the normal range of height for children of his age (50-60 inches). See appendix 1. CK’s weight was at 30 kilograms which fall in the 50th percentile and was on the normal ranges of 26-40 kilograms for children of his age (See appendix 2). After calculating the BMI of CK, I obtained a value of 15kg/m2 which is in the 5th percentile indicating that he is of healthy weight (See appendix 2). From these findings, I can conclude that CK is growing at a standard rate and is healthy at the moment. Various theorists explain the phenomena of child’s psychological and cognitive attributes growth and development. According to Erikson’s stages of psychosocial development, CK is at the concrete stage whereby he is becoming aware of himself more. According to Eccles (1999), “during these years, children make strides toward adulthood by becoming competent, independent, self-aware, and involved in the world beyond their families. Biological and cognitive changes transform children’s bodies and minds.” CK shows interests in learning and completing complex activities such as reading a book, telling time correctly and grooming with CHILD DEVELOPMENT ASSESSMENT PAPER 6 minimal supervision. In this stage, children begin recognizing their unique gifts and this evident since CK has a special liking for musical instruments. According to the theory of cognitive development by Jean Piaget, CK is currently in the concrete operational stage which is characterized by the proper use of logic. According to Fischer (1980), the theory “attempts to explain a large part of this psychological transformation. It focuses primarily on cognition and intelligence, and it deals with aspects of learning and problem solving” (p. 477). Unlike in his earlier years, CK can now rearrange patterns, symbols or images to form a logical thought. A good example is when CK reverses an action by simply doing the opposite of his presiding action. Child’s Home Environment From the information gathered regarding CK’s home, the environment is right for his growth and development. The house environment is ambient due to the good ventilation and heating system provides fresh air and suitable temperatures. Additionally, the available space is ample for him to play with siblings and friends. Moreover, CK’s sleeping space is clean and comfortable hence impacting his growth especially since sleep is associated with a child’s growth and development. However, when CK’s parents smoke cigarettes inside the house, he is at risk of inhaling the nicotine fumes which would affect his respiratory system and also risk getting lung cancer. Additionally, pesticides among other hazardous chemical are at his reach. In regards to nutrition, CK’s family provides healthy food for him, apart from when they eat outside, and this puts him at risk of becoming overweight. Factors that facilitate/inhibit G&D For the assessment, I identified several factors that facilitate or inhibit CK’s growth and development. One element that facilitates his growth is a supportive family and community. CK CHILD DEVELOPMENT ASSESSMENT PAPER 7 has a mother near him every time to take care of him; sibling and friends to play with hence boost his overall growth. Additionally, taking at least three balanced-diet means a day provides adequate nutrition for his growth. On the other hand, in-utero-exposure to drugs through his mother’s smoking habits, as well as being a secondary smoker pose serious health problems that would inhibit his growth. Discussion of identified problems Through the assessment I identified several problems that face CK and his family. CK has been experiencing constant coughs and colds. On several occasions, CK’s parents admitted to have taken him to the hospital where he was diagnosed with pneumonia and middle ear disease. According to Hockenberry & Wilson (2014), “maternal smoking and passive smoking by household members have been correlated with higher rates of SIDS, respiratory tract illnesses” (p.409). It is hence due to the parents smoking habits that CK has been experiencing these ailments. Another problem identified is that CK has symptoms of Attention Deficit Hyperactivity Disorder (ADHD). He has a very short concentration retention time and is distracted before completing tasks. He has difficulty remembering things after getting instructions and makes careless mistakes. Hockenberry & Wilson (2014) notes that “It has been shown that cigarette smoking has detrimental effects beyond the neonatal period, with deficits in growth, intellectual and emotional development, and behavior” (p.409). Through this information, it is evident that the symptoms of ADHD are due to the smoking behaviors of his parents. Goals and Interventions/Recommendations For Child 1. To improve CK’s attention concentration time CHILD DEVELOPMENT ASSESSMENT PAPER 8 2. To treat CK’s constant cough and cold For Family 1. To reduce smoking and especially in the house 2. To minimize eating unhealthy foods when they go out Maintenance of current Health Practices I recommend that the family maintains the daily diet for CK since it provides essential nutrients that facilitate his growth and development. Additionally, the family needs to maintain the good home environment that provides ample playing space, fresh air, favorable temperature and a clean sleeping space. However, as CK grows to adolescence stage of his life, I recommend that his parents consider moving him to a separate individual bedroom since he will need some privacy as he transitions into adulthood. Finally, I recommend that the family members maintain the strong communication and respect they have towards each other. According to LaFortune, (2014), “If a child feels safe, secure, and loved in their family, it helps with the formation of their self-esteem and well-being” (p. 1) Promotion of health, growth & development CK’s parents need to stop smoking inside the house especially in the presence of their children. Consequently, Smith (2017) warns “nicotine withdrawal may give you headaches, affect your mood, or sap your energy. Nicotine replacement therapy can curb these urges.” (p. 3). I recommend CK’s parent to use nicotine gums, patches and lozenges to minimize withdrawal side effects. Additionally, CK’s father should avoid alcohol and other triggers to succeed in the quitsmoking program. Additionally, I would recommend that the parents find a safer place to store pesticides and OTC drugs out of reach of the children. Toxic chemicals pose a risk of poisoning as the CHILD DEVELOPMENT ASSESSMENT PAPER 9 children would choose to play with the containers oblivious of the dangers that they may face. Finally, I recommend home-based interventions for CK’s inattentiveness. The intervention may comprise of simple, basic and straightforward instructions. The parents could obtain CK’s attention by using command language and calling out his name before directing him. CHILD DEVELOPMENT ASSESSMENT PAPER 10 References LaFortune, A. (2014). What Is the Family Impact on Early Childhood Development?. Retrieved from Cespedes, A. (2017). A 7-Day Meal Plan for Healthy Kids. Retrieved from Conlon, B. A., McGinn, A. P., Lounsbury, D. W., Diamantis, P. M., Groisman-Perelstein, A. E., Wylie-Rosett, J., & Isasi, C. R. (2015). The role of parenting practices in the home environment among underserved youth. Childhood obesity, 11(4), 394-405. Eccles, J. S. (1999). The development of children ages 6 to 14. The future of children, 30-44. Fischer, K. W. (1980). A theory of cognitive development: The control and construction of hierarchies of skills. Psychological review, 87(6), 477. Hockenberry, M. J., & Wilson, D. (2014). Wong’s nursing care of infants and children-E-book. Elsevier Health Sciences. Smith, M. (2017). 13 Best Quit-Smoking Tips Ever. Retrieved from CHILD DEVELOPMENT ASSESSMENT PAPER 11 Appendices Appendix 1: CK’s 3rd-97th Statute-For-Age Percentiles Appendix 2: CK’s 3rd-97th Weight-For-Age Percentiles CHILD DEVELOPMENT ASSESSMENT PAPER 12 Appendix 3: CK’s 3rd-97th BMI -For-Age Percentiles …
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