Nursing Informatics

Jean Piaget’s Theory of Cognitive Development (Reading & Sharing)

Piaget’s theory of cognitive development includes four periods that are related to age and demonstrate specific categories of knowing and understanding.

  • Sensorimotor (birth to 2): the infant develops the schema or action pattern for dealing with the environment
    • 0-1 month: reflexes (sucking, rooting, grasping, crying) are primary
    • 1-4 months: reflexive behavior is replaced by voluntary behavior, recognizing a stimulus and a response (primary circular reactions)
    • 4-8 months: there is an intensification, with children developing a sense of causality, time, and personal separateness. They begin to imitate and show different affects. They develop a sense of object permanence between 6 and 8 months (secondary circular reactions)
    • 9-12 months: this is a transitional stage with further intellectual development, including understanding that a hidden object is not gone. Children begin to behave with intention, to associate words and symbols (bye-bye) with events, and attempt to climb over obstacles
    • 13-18 months: Newly acquired motor skills allow children to experiment and demonstrate the beginning of rational judgement and reasoning. Children further differentiate themselves from objects, understand cause and effect, but have little transfer ability. Children gain spatial awareness (tertiary circular reactions)
    • 18-24 months: preparation for more complex intellectual activities. Children understand object permanence, begin to use language, and engage in domestic mimicry and sex-role behavior. They have some sense of time, but time is exaggerated.

  • Preoperational (2-7):
    • This is a time when children learn to think with the use of symbols and mental images
    • Egocentric: children see objects and persons from only one point of view, their own. Children believe that everyone experiences the world exactly as they do.
    • Play becomes a primary means by which children foster their cognitive development and learn about the world.
    • Children can now communicate about events with others. As the language fits into a logic form, it mirrors the thinking process at the time.


  • Concrete Operations (7-11): Cause and effect is better understood, and children understand concrete objects and the concept of conservation
    • Children now achieve the ability to perform mental operations, such as think about an action before performed physically
    • Children now able to describe a process without actually performing it
    • Reversibility: Children mentally reverse the direction of their thoughts
    • Children can now mentally classify objects according to their quantitative dimensions, known as seriation.
    • Conservation: the ability to see objects or quantities as remaining the same despite a change in their physical appearance


  • Formal Operations (11 to adulthood): Children exhibit mature thought processes and the ability to think abstractly. Children and young adults can evaluate different possibilities and outcomes
    • Adolescents and young adults begin thinking about such subjects as achieving world peace, finding justice, and seeking meaning in life.
    • Adolescents are able to organize their thoughts in their minds.
    • They have the capacity to reason with respect to possibilities.


Piaget’s theory actively selects and interprets environmental information in the construction of one’s own knowledge. While paying attention to and taking account of the structure of the environment during knowledge seeking, one reconstructs and reinterprets the environment according to one’s own mental framework. This process neither copies the world, rather creating a private mental conception. This is an active self-directed way of cognitive development.



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