1. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Chapter 12 Life-Span Development

2. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Topics Infancy Toddler Preschooler School age Adolescent Early Adult Middle-aged Adult Late-aged Adult Characteristics of the following life stages:

3. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

4. Normal Vital Signs

5. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Infancy

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. 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

14. 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.

15. 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.

16. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Other Characteristics (1 of 3)

17. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Other Characteristics (2 of 3)

18. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Other Characteristics (3 of 3)

19. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Psychosocial Development

20. 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

21. 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.

22. 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.

23. 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.

24. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Scaffolding is a teaching/learning method whereby the infant builds on what he or she already knows.

25. 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

26. 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

27. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Toddler and Preschool Age

28. 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

29. 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.

30. 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.

31. 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.

32. 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.

33. 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.

34. 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.

35. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Parenting Styles Authoritarian parents are demanding and desire instant obedience. Authoritative parents believe both they and the children have rights and try to maintain a balance. Permissive parents take a tolerant, accepting view of a child’s behavior.

36. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Divorce and Child Development Children express feelings of shock, depression, and fear that their parents no longer love them. May feel abandoned. Cannot see the divorce from the parent’s perspective.

37. 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.

38. 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

39. 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.

40. 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.

41. 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

42. 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

43. 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.

44. 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.

45. 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.

46. 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.

47. 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

48. 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.

49. 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.

50. 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.

51. 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

52. 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.

53. 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.

54. 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.

55. 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

56. 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.

57. 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.

58. 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.

59. 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.

60. 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.

61. 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.

62. 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.

63. 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.

64. 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.

65. 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.

66. 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.

67. 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.

68. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Summary Infancy Toddler Preschooler School age Adolescent Early Adult Middle-aged Adult Late-aged Adult Characteristics of the following life stages: