Key Takeaways
- Erikson's stages describe psychosocial development from infancy through older adulthood
- Piaget's theory covers cognitive development from sensorimotor (birth-2) through formal operations (12+)
- Each developmental stage has specific tasks that must be mastered for healthy progression
- The LPN/LVN adapts care approaches based on the patient's developmental stage
- Failure to complete developmental tasks can affect progression through subsequent stages
Last updated: January 2026
Developmental Stages Across the Lifespan
Understanding how humans develop physically, cognitively, and psychosocially helps the LPN/LVN provide appropriate care for patients of all ages. The NCLEX-PN tests knowledge of developmental theories and their application to nursing care.
Erikson's Psychosocial Development
Erik Erikson described eight stages of psychosocial development, each with a central conflict that must be resolved.
| Stage | Age | Crisis | Positive Outcome |
|---|---|---|---|
| Trust vs. Mistrust | Birth-18 months | Can I trust the world? | Hope, security |
| Autonomy vs. Shame/Doubt | 18 months-3 years | Can I do things myself? | Will, independence |
| Initiative vs. Guilt | 3-6 years | Is it okay to do things? | Purpose, initiative |
| Industry vs. Inferiority | 6-12 years | Can I succeed? | Competence, achievement |
| Identity vs. Role Confusion | 12-18 years | Who am I? | Fidelity, identity |
| Intimacy vs. Isolation | Young adult | Can I love and be loved? | Love, relationships |
| Generativity vs. Stagnation | Middle adult | Will I contribute? | Care, productivity |
| Integrity vs. Despair | Older adult | Was my life meaningful? | Wisdom, acceptance |
Piaget's Cognitive Development
Jean Piaget described how children's thinking develops through four stages.
| Stage | Age | Characteristics |
|---|---|---|
| Sensorimotor | Birth-2 years | Learns through senses and movement; develops object permanence |
| Preoperational | 2-7 years | Uses symbols, language; egocentric thinking; magical thinking |
| Concrete Operations | 7-11 years | Logical thinking about concrete objects; conservation |
| Formal Operations | 12+ years | Abstract thinking; hypothetical reasoning |
Infant Development (Birth-12 Months)
Physical Milestones:
| Age | Motor Skills |
|---|---|
| 2-3 months | Lifts head, social smile |
| 4-5 months | Rolls over, grasps objects |
| 6-7 months | Sits with support, transfers objects |
| 8-9 months | Crawls, pulls to stand |
| 10-12 months | Walks with support, pincer grasp |
Nursing Considerations:
- Maintain safe environment (choking hazards, falls)
- Encourage parent-infant bonding
- Teach parents about developmental expectations
- Provide sensory stimulation appropriate to age
Toddler Development (1-3 Years)
Key Characteristics:
- Rapid language development
- Parallel play (plays alongside, not with others)
- "No" and temper tantrums are normal
- Ritualistic behaviors provide security
- Beginning toilet training
Nursing Considerations:
- Allow choices to support autonomy
- Maintain routines
- Use simple explanations
- Provide safe environment for exploration
- Expect regression during illness
Preschool Development (3-6 Years)
Key Characteristics:
- Magical thinking (may think illness is punishment)
- Developing initiative and imagination
- Associative play (plays with others)
- Fear of bodily harm
- Developing conscience
Nursing Considerations:
- Use simple, concrete explanations
- Allow therapeutic play
- Address fears directly and honestly
- Prepare for procedures with demonstrations
- Praise accomplishments
School-Age Development (6-12 Years)
Key Characteristics:
- Cooperative play
- Developing competence and self-esteem
- Concrete thinking, curious
- Peer relationships become important
- Understands cause and effect
Nursing Considerations:
- Provide clear explanations with rationale
- Allow participation in care decisions
- Maintain school and peer connections
- Address body image concerns
- Use games and activities for learning
Adolescent Development (12-18 Years)
Key Characteristics:
- Identity formation
- Abstract thinking develops
- Peer influence is strongest
- Risk-taking behaviors
- Developing independence from family
Nursing Considerations:
- Maintain confidentiality appropriately
- Provide privacy and respect
- Include in care decisions
- Address body image and sexuality concerns
- Be non-judgmental about behaviors
Older Adult Development (65+ Years)
Key Characteristics:
- Life review and seeking meaning
- Adapting to physical changes
- Dealing with losses
- Maintaining independence
- Wisdom sharing
Nursing Considerations:
- Allow time for processing information
- Respect experience and wisdom
- Support independence
- Assess for depression related to losses
- Provide safety measures for physical changes
Applying Development to Care
| Age Group | Communication | Care Approach |
|---|---|---|
| Infant | Talk to parent, comfort infant | Involve parent, minimize separation |
| Toddler | Simple words, choices | Allow rituals, expect protests |
| Preschool | Concrete terms, demonstration | Therapeutic play, address fears |
| School-age | Clear explanations, answer questions | Encourage participation |
| Adolescent | Private conversations, listen | Respect autonomy, maintain limits |
| Older adult | Clear speech, allow time | Support independence, show respect |
On the NCLEX-PN
Expect questions about:
- Appropriate nursing interventions for each developmental stage
- Communication approaches for different age groups
- Normal developmental milestones
- Addressing developmental needs during illness
Test Your Knowledge
A 4-year-old child tells the LPN, "I got sick because I was bad." This statement reflects:
A
B
C
D
Test Your Knowledge
According to Erikson, what is the primary developmental task of adolescence?
A
B
C
D
Test Your Knowledge
When caring for a 2-year-old who is hospitalized, which nursing action best supports the child's developmental needs?
A
B
C
D