Many parents encounter different developmental challenges while bringing up their infants. Some of the problems they face are looking for the right method in ensuring their children grow properly and develop physically and mentally at the right time. Some parents choose to put their kids in childcare for various reasons like work, the parent's mental and physical state, and developmental purposes. There is a case where the mothers of a four-month-old baby want to place her in a childcare program. They would like to know the best placement that would guarantee normal development. As a primary care NP, one can offer the appropriate strategies those guardians can use to assess their baby's progress. Piaget's theory would be the best formula to determine the child's development as it offers a detailed explanation of how each stage occurs.
Piaget’s Theory of Development
Jean Piaget formulated five stages a person undergoes in overall development, depending on the age. According to him, there are certain traits that each level presents to show a normal developmental process. In the given case, the child is a four-month-old baby who falls under the sensorimotor stage and must portray certain features. They include cognitive, physical, social, and emotional development. Each one is explained below in details.
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Cognitive Development
Piaget acknowledges cognitive development as the overall development of the brain and its function. It also involves how a person identifies with the surroundings and the type of response he/she gives. The child in the case given falls under the sensorimotor stage of cognitive development. The kid is aged four months, thus can perform various cognitive functions (Craig, 1983) . The first significant progress for this age is the ability to maintain a close vision. She will also recognize specific objects and people while following each movement. Therefore, the parent should place the child in a childcare facility that contains the appropriate visual aids. Those items will sharpen the visual skill of the child. The second part of cognitive development for a four-month-old child is the ability to coordinate hands and eyes. The baby should recognize particular objects before making bodily contact with them. Another cognitive development of a four-month-old baby is the ability to repeat actions that give the desired outcomes. At this age, the child can distinguish between the right or wrong move based on his/her short-term memory (McAlister & Peterson, 2007) . Therefore, the parent should place the kid in a childcare facility with qualified personnel who understand those cognitive components. He should also be able to monitor the type of care the child receives closely and whether it correlates with the required cognitive development.
Physical Development
A four-month-old baby undergoes a various physical transformation that a parent or a guardian can quickly identify. The first change that occurs during this age is the child proliferates in weight and body size; thus, this development becomes one of the most recognizable. The parent can regularly take measurements like the child's general weight to determine how much the kid has gained. This type of development dramatically depends on the nutrition the child receives. It is recommended worldwide that a child at this age should entirely rely on the mother's milk as a source of nutritional value. Therefore, the mother should put the kid in a nearest childcare facility to reach with ease whenever the need to suckle arises. The second most noticeable physical development in a child is holding the head upright without drooping (Jonsson & Von Hofsten, 1998) . This growth ensures that the child maintains the right posture while not affecting other parts. For the mother wishing to put her kid in a childcare program, she must ensure that the selected setting contains the necessary facilities to support this development. Beds and cots in such places must offer the child the required comfort to prevent him/her from drooping or head injury. Another most recognizable part of physical development in toddlers is the ability to hold and release objects. The mother can dangle particular objects in front of the child and see how he/she grasps it.
Social Development
The child should portray specific social components at the age of four months. Those factors generally translate to how the kid interacts with people around him/her. They could be parents, siblings, caregivers, and fellow children. First, the child should respond to the right cues like tickles and smiles another person offers. This feature shows that the kid can recognize different social changes and respond appropriately. From such actions, the child develops a particular bond with other people based on their interaction with him/her. The second social development at four months involves babbling and cooing. At this age, the child can talk continuously, although in an incomprehensible way. This action signifies the start of the child's development of speech. He/she can respond to certain sounds by producing a related voice. Third, the child can self-soothe by taking specific actions to express something (de Haan & Maurer, 1996) . For instance, the baby at this stage suckles a fist to indicate hunger. The parent or the caregiver should take such cues to provide whatever the child needs. Lastly, the baby, at this age, expresses excitement whenever a caregiver approaches. This action will depend on the relationship such a person has with the child. Contrary, he/she might cry to express displeasure for a specific individual. Therefore, the parent needs to note such responses to determine the relationship that particular caregivers or nannies have with the child. If the child expresses displeasure towards a specific, it would be advisable to remove the person as one of the caregivers or discontinue the facility's whole program. The caregivers should also have proof of the necessary skills to handle the social and emotional development in this age bracket.
Consideration of the Family Constellation and Parent’s Concerns
Family constellation is a form of psychological therapy where individual family members act as representatives of others and a network of relationships formed. In this way, the therapist visualizes the bond between various family members and comes up with solutions to their problems. In the case of two mothers desiring to place their kid to childcare facilities, there might be problems resulting from this process (Yasgur, 2013) . First, the family might be undergoing specific challenges like generational mental and social ills. As a primary care NP, one needs to investigate the underlying factors that might have prompted the mothers to place them under childcare. This action will help establish which placement fits her and remove the doubt mothers have. By determining the generational mental and social ills, the therapist can also ascertain whether putting the kid in childcare can affect her future life. If the action has a future problem, it would be better to advise the mothers against it.
The second consideration for the family constellation in the case presented is the family’s morphogenic field. This factor is a position that contains the specific energy of a family or a community. The primary care NP can use the morphogenic area to gather knowledge about a particular group, thus coming up with the right solution to a specific problem. In the case of the mothers who want to place their child in childcare, the family’s energy will provide information about the issue and help formulate the appropriate solution. Therefore, the therapist will advise the mothers on the best placement for their child. The third important consideration for the family constellation is the order of love. This factor involves the right to belong, and each person occupying a specific position in a family. The primary care NP should determine the relationship the child has with the parents or guardians. The reason for the mothers putting the child at that tender age in a childcare facility might be a lack of enough love for her. Therefore, the primary care NP can offer the appropriate therapy that would help foster the mothers' relationship with the child. They might reconsider their decision to place the kid under the childcare program. Lastly, the therapist can check the history of excluded family members. The child might be undergoing this problem where the parents have decided to disassociate with her. The primary care NP should also try to establish the reason why those mothers might have taken this action. Some of the possible factors which might have led to this exclusion include the unhealthy relationship between parents, drug abuse, and emotional struggles.
The Piaget theory of development will be the best formula to assess a child's growth as it gives detailed information about each stage. For the case of a child to be placed in a childcare program, the parents can look for certain features to determine the best placement. They include cognitive, physical, social, and emotional components. From such information, parents can decide which facility fits their child. The primary care NP can also use family constellation to address parents' concerns in the above case. He/she can consider generational ills, morphogenic fields, and exclusion of individual family members. Using those consideration, the primary care NP can develop the best therapy to the guardians intending to place their child in a childcare facility.
References
Craig, R. (1983). Piaget: Experience and Cognitive Development. Educational Considerations , 10 (3). doi: 10.4148/0146-9282.1787
de Haan, M., & Maurer, D. (1996). Perception of symmetry by 4-month-old infants. Infant Behavior And Development , 19 , 418. doi: 10.1016/s0163-6383(96)90472-5
Jonsson, B., & Von Hofsten, C. (1998). Predictive head movements in 6 -month old infants. Infant Behavior And Development , 21 , 491. doi: 10.1016/s0163-6383(98)91704-0
McAlister, A., & Peterson, C. (2007). A longitudinal study of child siblings and theory of mind development. Cognitive Development , 22 (2), 258-270. doi: 10.1016/j.cogdev.2006.10.009
Yasgur, J. (2013). Family Constellation Therapy. EXPLORE , 9 (1), 9. doi: 10.1016/j.explore.2012.11.008
