In this lesson, we’re going to focus on Piaget’s theory of cognitive development.

So I’m sure you guys are saying well what the heck is cognitive development?

Well cognitive development is the study of how someone grows and develops over time. And it’s really based on Jean Piaget’s work, who focused a lot of his time on childhood development. He created some really interesting research that focused on how children think, interact and see the world around them.

This doesn’t exclude adult patients, but it does offer some insight into how they’ve developed and it can also help us to predict patterns for our patients respond to care.

Piaget’s work really was focused on the four periods or stages that we’re going to cover in this lesson so let’s get started.

The first period that we’re going to cover something called sensorimotor development. It starts from birth and goes all the way to Age 2. The important thing that you need to know about this is it covers the development of reflexes overtime. This is really about the development of reflexes and motor skills.

The other thing that’s really interesting about this stage is Piaget develop the idea of something called a circular reaction, which is really foundational to Piaget’s work. A circular reaction is this idea that the patient experiences something by accident, and then they try to replicate it. It’s all about learning and growing. You’ve probably seen the cute little videos of a kid doing something by accident, and an adult starts laughing. Well the baby will try to do that again and again and again, to elicit the same type of response. It was really about figuring out patterns and trying to figure out ways to achieve goals through time

Sensorimotor development is a really complex aspect of Piaget’s work, and can be extremely complicated. But the thing that you really need to understand is that it’s an early development of the way that babies and infants see the world, and it’s how they start to explore that world and realize that things inside of it respond to them and to their actions.

When we talk about the preoperational stage what we’re really talking about is the age of development from about 2 to 7 years old.

This stage can really be broken up into an early a late pre-operational stage.

In the early pre-operational stage which is ages 2 to 4, patients really only see things from their point of view. Patients in this stage need instant gratification.. That’s why they call it the terrible twos, because kids in that developmental stage really need things right then and there. You’ll also see an increase in playing and pretending and using symbols or toys to represent other things. This is kind of the stage where their imagination begins to go wild and they really spend a lot of time playing. They also lack concrete knowledge in this phase.

In the late pre-operational stage this is the time in their life or they going to start to ask you why why why why why? They really want to know everything and this is the time when they really start to develop primitive reasoning. So this is where they begin to develop logical reasoning, but it’s still very early.

In the concrete operational stage you’re going to see a lot more development in areas of logical reasoning, and many patients begin to use rationale and where they begin to critically analyze things around them.

Patient will begin to see other people as independent objects, and they’ll also begin to see themselves in relation to those other people. During this phase will also start to organize and classify things and they start to really use those processes and learning where they fit into society or their roles.

In this last stage, called the formal operational stage, this is the time from about age 11 through adulthood.

This is where the patient begins to really use abstract thought. Patients can become goal-oriented, meaning that they can envision things like world peace or or they start to contemplate the meaning of life. I said begin to experience life, those life experiences contribute to development and higher-level learning, and it helps them to form more concrete reasoning and logic. For instance, in earlier stages patient may use things like trial-and-error to really figure out if things were and how they were. But in this stage, patients can really think about these processes to be more efficient and to yield higher level results from whatever task they’re doing. Because they develop such a higher level of thinking and the use of logic and abstract thought they can really focus their results to be more efficient and on point.

Just like with all of these other developmental theories, we have to think about our role as the nurse.

And I can talk all day until I’m blue in the face about all of these different types of theories and areas of development, but what you need to understand is that if you have a good solid foundation of some of these concepts, and especially with childhood development. This can help guide you in anticipating what you should expect from your patient. For instance if you have a toddler, who has no concrete logical reasoning, you can’t expect them to have things like abstract thought because they haven’t gotten that far developing. This will really help you in developing your education styles, and catering how you speak to patients and how you speak to the patient’s families while you’re taking care of them.

The other thing that’s important about Piaget’s work is that a gives insight into Kohlberg’s model of morality. Since Kohlberg used a lot of Piaget’s developmental theories, it really helps you to meld what you learned from different theories and idealogies. If you haven’t check out our other lessons on other developmental theories be sure to do so. And then, you can think about your patient as this multi complex being that’s just not some mannequin in a lab. All of our patients have different levels of development and we have to keep those things in mind. So as you go forward think about what you’ve learned About development and think about how you can apply them. For instance PJ would be extremely helpful in Pediatrics because that’s where all of his research was founded.

As you’ve gone through out Piaget’s theory of cognitive development we focused our nursing concepts on human development, cognition, and health promotion.

So let’s recap.

Piaget focused his work on childhood development, so be sure to refer back to this when you’re working with your pediatric patients.

In the sensorimotor phase, patients under the age of 2 use tactile sensation and reactions to learn about the world around them.

In the preoperational stage, patience really focus on pretending and playing, and as they grow older begin to ask “why?” to learn about everything.

When you talk about the concrete operational stage, understand that your patient is going to begin to use logical reasoning and improve their organization.

And finally in the formal operational stage, this is where your patients are going to have abstract thought, be goal-oriented, and begin to really understand reasoning.

And that’s our lesson on Piaget and his theory of cognitive development. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!