H.

Developmental History Eriksons Psychosocial Theory of Development Stage Central Task Trust vs. Mistrust Actual Finding and Interpretation When asked if J.D. was breastfed, the parents negated it explaining how Mrs. J.D. was unable to accommodate breastfeeding due to her need to work. The patients primary caregiver were his father, aunt and eldest half- sister as Mrs. J.D. left Mindanao for Manila to earn a living. The father, Mr. R.D. narrated how his son never gave him a problem during his infancy period as he rarely cries and had not exhibited fear of stranger despite having been cared by a lot of his relatives. Further, the father narrated how his son easily changed from bottled milk to cup claiming it the reasons behind J.D.s healthy set of teeth. Interpretation During the interview the patient was observed to act irritably refusing to answer most of the questions. He would furrow his brows and looked away even after the student nurses introduced themselves and had attempted to establish rapport. Although the father claimed that his son had not exhibited fear of stranger, J.D. evoked signs of mistrust to strangers. While fear or nurses wearing white uniform could be a factor, when Erikson stated in his theory regarding mistrust when needs during infancy was not met could not be overlooked. The absence of the mother and the replacement of her eldest daughter in her first wedding could contribute to this lack of trust to strangers. Actual Finding

Infancy Birth to 18 months

Learning to trust others when needs are met while becoming mistrustful and exhibiting sense of withdrawal and estrangement if otherwise An important role lies in the primary caretaker who can be assumed by the parents, siblings, grandparents or caretaker who will feed the need of infants such as bonding. (Pillitteri, 2003)

Early

Autonomy vs. Shame and Doubt

Childhood 1 years to 3 years

J.D.s father narrated how his son had stopped wearing diaper even before reaching two years. He said that among his children, J.D. was one of the earliest who had mastered toilet training at a younger age. He said that the patients half-sister was bent and strict in implementing early toilet training claiming that caring for 3 toddlers was messy enough that they need to be responsible soon enough. Before age 2 R.D. learned how to defecate in the toilet. When asked if the eldest half-sister reinforced punishment when their children failed to comply, J.D.s parents did not deny this and even verbalized their support to this type of discipline claiming that this contributed to fast learning. Autonomy which means selfgovernment or independence builds on childrens new motor and mental abilities. Children take pride in new accomplishments and want to do everything independently Crucial positive development of sense of control is triggered when parents recognize the toddlers need to do what they are capable of doing at their own pace and in their own time. On the other hand, impatient caregivers lead the children to develop a sense of doubt and shame Interpretation Erikson emphasized how early and strict toilet training could trigger an inner conflict to the child that could be manifested when he grew up. At this stage, the toddler realizes that he is a separate person with his own desires and abilities. He wants to do things for himself without help or hindrance from other people. This push for autonomy is enhanced by muscular maturation as toddlers try to use their developing muscles to explore their environment. Potentially, toddlers can get into dangerous situations. Therefore, parents have to balance the opposing virtues of encouragement and restraint. If a toddler's efforts to do things on his own were frustrated by over-protective parents then he may not have many opportunities to develop autonomy. On the other hand, if a toddler was harshly

Late Childhood Initiative vs. Guilt 3 to 5 years

criticized then he may develop doubt about his own abilities to tackle new challenges. This reflected to the childs withdrawal from school during the succeeding stage. Actual Finding When asked if J.D. had spent his late childhood playing outside, his father admitted that their eldest half-sister did not allow them to play outside as she was trying to protect them. The younger J.D. would prefer to play with his brothers so as not to aggravate his older sister. Upon reaching 5, they enrolled J.D. to barangay day care center. His father admitted how his son excelled academically even finishing the term with honors. He stated how enthusiastic his son was at school. At home, his aunt and older sister would teach and help them in their homework. Interpretation The sense of overprotection was observed in prohibiting the patient to play outside. While ensuring a safe playing environment is healthy to the childrens development, being overly strict could hamper the childs sense of assertiveness. While it did not become apparent during this stage as compensated by the childs achievement at school, patient would eventually withdraw from school when the parents least expected it. Actual Finding When the child was transferred from Mindanao to GMA, Cavite, his eldest half-sister was also left in Mindanao having had a family of her own. J.D. was then observed to have an increased appetite to play unceasingly, playing after he had his breakfast and would only

Positive indicator of development is marked by the degree of learning to which assertiveness and purpose influence the environment Negative indicator is marked by lack of self-confidence, pessimism, fear of wrongdoing, over control and over restriction of own activity (Kozier, et al, 2004)

School Age 6 to 12 years

Industry vs. Inferiority

return home before dinner. During his first grade, the teachers child reported the childs explicit disinterest to listen. J.D. would cover his ears during class discussion and eventually decided to leave school for a year. When asked why his parents heed to their sons request, the father said that they could not really force him to do something he does not want to do. When asked if he had problem academically, the father negated it claiming that his son was actually smart. He also had no problem adjustment at his new school since they had always used Tagalog as they vernacular even when they were in Mindanao. Interpretation Conflict was manifested by the childs withdrawal from school. The compounding problem during his preceding developmental stage had triggered a sense of being mediocre at school that he chose not to listen anymore to his lessons contrary to most of the children his age. The freedom from strict and firm mode of disciplining could also trigger this change of behavior or could have created an opportunity to do what he really wanted to play with his friends.

Positive indicator is marked by beginning to create, develop, and manipulate and a development a sense of competence and perseverance According to Erikson, in contrast to what was mentioned above, manifestations than conflict arises include loss of hope, sense of being mediocre and withdrawal from school and peers