Childhood Learning Abilities and Nursing Education

Childhood Learning Abilities and Role of Nursing Educators

What are Childhood Developmental Stages,Developmental Aspects In Childhood,Toodlerhood and Teaching Strategies in Children.

What are Childhood Developmental Stages

    Pedagogy is the art and science of helping children to learn (Knowles, 1990, Knowles, Holton, & Swanson, 2015). The different stages of child-hood are divided according to what develop mental theorists and educational psychologists define as specific patterns of behavior seen in definitive phases of growth and development. One common attribute observed throughout all phases of childhood is that learning is subject centered. 

    This section reviews the developmental characteristics in the four stages of childhood and the teaching strategies to be used in relation to the physical, cognitive, and psycho social maturational levels indicative of learner readiness. Infancy (First 12 Months of Life) and Toddlerhood (1-2 Years of Age)

    The field of growth and development is highly complex, and at no other time is physical, cognitive, and psycho social maturation so changeable as during the very early years of childhood. Because of the dependency of members of this age group, the focus of instruction for health maintenance of children is geared toward the parents, who are considered the primary learners rather than the very young child (Callans, Bleiler, Flanagan, & Carroll. 2016; Crandell et al. 2012: Santrock, 2017). However, the older toddler should not be excluded from healthcare teaching and can participate to some extent in the education process.

Developmental Aspects In Childhood 

    At no other time in life is physical maturation as rapid as during the period of development from infancy to toddlerhood (London et al. 2017). Exploration of self and the environment becomes paramount and stimulates further physical development (Crandell et al., 2012; Kail & Cavanaugh, 2015). 

    Patient education must focus on teaching the parents of very young children the importance of stimulation, nutrition, the practice of safety measures to prevent illness and injury, and health promotion (Polan & Taylor, 2015). Piaget (1951, 1952, 1976) a noted expert in defining the key milestones in the cognitive development of children labels the stage from infancy to toddlerhood as the sensorimotor period. 

    This period refers to the coordination and integration of motor activities with sensory perceptions. As children mature from infancy to toddlerhood, learning is enhanced through sensory experiences and through movement and manipulation of objects in the environment. Toward the end of the second year of life, the very young child begins to develop recognition of object permanence that is, that objects and events exist even when they cannot be seen, heard, or touched (Santrock, 2017). 

    Motor activities promote toddlers' understanding of the world and an awareness of themselves as well as others' reactions in response to their own actions. Encouraging parents to create a safe environment can allow their child to develop with a decreased risk for injury.

    The toddler has the rudimentary capacity for basic reasoning, understands object permanence, has the beginnings of memory, and begins to develop an elementary concept of causality, which refers to the ability to grasp a cause and effect relationship between two paired, successive events. (Crandell et al., 2012). 

    With limited ability to recall past happenings or anticipate future events, the toddler is oriented primarily to the here and now and has little tolerance for delayed gratification. The child who has lived with strict routines and plenty of structure has more of a grasp of time than the child who lives in an unstructured environment.

    Children at this stage have short attention spans, are easily distracted, are egocentric in their thinking, and are not amenable to correcting their own ideas. Unquestionably, they believe their own perceptions to be reality. Asking questions is the hallmark of this age group, and curiosity abounds as they explore places and things. They can respond to simple, step-by-step commands and obey such directives as “give Grandpa a kiss” or “go get your teddy bear” (Santrock, 2017). 

    Language skills are acquired rapidly during this period, and parents should be encouraged to foster this aspect of development by talking with and listening to their child. As they progress through this phase, children begin to engage in fantasizing and make-believe play. Because they are unable to distinguish fact from fiction and have limited cognitive capacity for understanding cause and effect, the disruption in their routine during illness or hospitalizations, along with the need to separate from parents, is very stressful for the toddler (London et al. , 2017). 

    Routines give these children a sense of security, and they gravitate toward ritualistic ceremonial like exercises when carrying out activities of daily living. Separation anxiety is also characteristic of this stage of development and is particularly apparent when children feel insecure in an unfamiliar environment. This anxiety is often compounded when they are subjected to medical procedures and other healthcare interventions performed by people who are strangers to them (London et al., 2017).

    According to Erikson (1963), the noted authority on psychosocial development, the period of childhood is one of trust versus mistrust. During this time, children must work through their first major dilemma of developing a sense of trust with their primary caretaker. As the infant matures into toddlerhood, autonomy versus shame and doubt emerges as the central issue During this period of psychosocial growth, toddlers must learn to balance feelings of love and hate and learn to cooperate and control willful desires (TABLE 5-2).

    Children progress sequentially through accomplishing the tasks of developing basic trust in their environment to reach increasing levels of independence and self-assertion. Their newly discovered sense of independence is often expressed by demonstrations of negativism. Children may have difficulty in making up their minds, and, aggravated by personal and external limits, they may express their level of frustration and feelings of ambivalence in words and behaviors, such as by engaging in temper tantrums to release tensions (Falvo, 2011). 

    With peers. play is a parallel activity, and it is not unusual for them to end up in tears because they have not yet learned about tact, fairness, or rules of sharing (Miller & Stoeckel, 2016; Polan & Taylor, 2015).

Toodlerhood and Teaching Strategies in Children

Patient education for childhood through toddler hood needs not to be illness related. Usually, less time is devoted to teaching parents about illness care, and considerably more time is spent teaching aspects of normal development, safety, health promotion, and disease prevention. When the child becomes ill or injured, the first priority for teaching interventions would be to assess the parents' and child's anxiety levels and to help them cope with their feelings of stress related to uncertainty and guilt about the cause of the illness or injury. 

    Although teaching activities are primarily directed to the main caregiver(s), children at this developmental stage in life have a great capacity for learning. Toddlers are capable of some degree of understanding procedures and interventions that they may experience. Because of the young child's natural tendency to be intimidated by unfamiliar people, it is imperative that a primary nurse is assigned and time is taken to establish a relationship with the child and parents. 

    This approach not only provides consistency in the teaching learning process but also helps to reduce the child's fear of strangers. Parents should be present whenever possible during formal and informal teaching and learning activities to allay stress, which could be compounded by separation anxiety (London et al., 2017).

    Ideally, health teaching should take place in an environment familiar to the child, such as the home or daycare center. When the child is hospitalized, the environment selected for teaching and learning sessions should be as safe and secure as possible, such as the child's bed or the playroom, to increase the child's sense of feeling protected.

    Movement is an important mechanism by which toddlers communicate. Immobility resulting from illness, hospital confinement, or disability tends to increase children's anxiety by restricting activity. Nursing interventions that promote children's use of gross motor abilities and that stimulate their visual, auditory, and tactile senses should be chosen whenever possible.

    Developing rapport with children through simple teaching helps to elicit their cooperation and active involvement. The approach to children should be warm, honest, calm, accepting, and matter of fact. A smile, a warm tone of voice, a gesture of encouragement, or a word of praise goes a long way in attracting children's attention and helping them adjust to new circumstances. Fundamental to the child's response is how the parents respond to healthcare personnel and medical interventions.

    The following teaching strategies are suggested to convey information to members of this age group. These strategies feed into children's natural tendency for play and their need for active participation and sensory experiences.

 For Short Term Learning

• Read simple stories from books with lots of pictures.
• Use dolls and puppets to act out feelings and behaviors.
• Use simple audiotapes with music and videotapes with cartoon characters.
• Role play to bring the child's imagination closer to reality.
• Give simple, concrete, nonthreatening explanations to accompany visual and tactile experiences. Perform procedures on a teddy bear or doll first to help the child anticipate what an experience will be like.
• Allow the child something to do-squeeze your hand, hold a Band-Aid, sing a song, cry if it hurts to channel his or her response to an unpleasant experience.
• Keep teaching sessions brief (no longer than about 5 minutes each) because of the child's short attention span.
• Cluster teaching sessions close together so that children can remember what they learned from one instructional encounter to another. 
• Avoid analogies and explain things in straight forward and simple terms because children take their world literally and concretely. Individualize the pace of teaching according to the child's responses and level of attention.

For Long Term Learning

• Focus on rituals, imitation, and repetition of information in the form of words and actions to hold the child's attention. For example, practice washing hands before and after eating and toileting.
• Use reinforcement as an opportunity for children to achieve permanence of learning through practice.
• Employ the teaching methods of gaming and modeling as a means by which children can learn about the world and test their ideas over time.
• Encourage parents to act as role models, be- cause their values and beliefs serve to reinforce healthy behaviors and significantly influence the child's development of attitudes and behaviors.