Gordon's helpful Wellbeing Designs provide an organized system for assessing the development and growth patterns of young children. In 1987, Marjory Gordon developed Gordon's set of 11 functional health patterns for nurses to use in the nursing process to ensure that a more complete nursing assessment of patients is performed.
In each pattern, nurses ask questions to obtain more details that the patient may not have provided during the initial assessment and/or problems that may have arisen during nursing care. Health patterns include:
1. Health Perception-Health Management Pattern
2. Nutrition and metabolic pattern
3. Elimination Health Pattern
4. Activity-exercise pattern
5. Cognitive-perceptual pattern
6. Sleep-rest health pattern
7. Self-perception – Self-concept
8. Role Relationship Health Pattern
9. Reproductive Sexuality
10. Stress tolerance
11. Pattern of beliefs in values.
When comparing a 12-month-old and a 24-month-old, notable formative contrasts can be observed within this system.
1- Health Perception- Health Management Pattern:
A 12-month-old girl is completely dependent on her caregivers to manage her well-being, her safety, administration of vaccines, follow-up checkups with her pediatrician, and well-child checkups. They need to understand the concepts of well-being (Gordon, 1987). In contrast, a 24-month-old child begins to pay attention to essential cleaning tasks, such as handwashing, regularly imitating adults, but still very subordinate to caregivers when it comes to health-related decisions.
2- Nutrition and metabolic pattern
By 12 months, babies transition from breastfeeding or diet to strong foods, explore different surfaces and flavors, and typically spend little on dinner guests (Hockenberry & Wilson, 2018). At 24 months, they eat more family-style food.
3- Elimination health pattern
The process of removing a 12-month-old baby's diaper is usually sporadic and caregivers closely monitor diaper changes. At 24 months, many young children begin to seek latrine preparation, recognizing the stimulus to go and stay dry for longer periods (Hockenberry & Wilson, 2018).
4- Activity-exercise pattern
Physical movement essentially increases from 12 to 24 months. A 12-month-old child regularly slides or begins to walk, developing fine motor skills (Gordon, 1987). By 24 months, toddlers are more mobile, running, climbing, and engaging in complex play, which helps with muscle development and coordination.
5- Cognitive-perceptual pattern
Cognitive abilities expand rapidly. At 12 months, a toddler concentrates on solving fundamental problems, recognizes recognizable individuals, and reacts to simple lighting. By 24 months, language skills are more developed, with a vocabulary of several hundred words and the ability to create two-word phrases (Hockenberry & Wilson, 2018). They also show advances in memory and can follow more complex instructions.
6- Sleep – pattern of health rest
The sleep pattern also progresses in a unique way. A 12-month-old baby usually rests twice a day and rests between 11 and 14 hours in total. By 24 months, toddlers can transition to resting once a day and can endure more hours of sleep, requiring a consistent sleep schedule to ensure satisfactory rest (Gordon, 1987).
7- Self-perception and self-concept.
Self-awareness begins to develop around 12 months, when toddlers recognize themselves in mirrors. Over the course of 24 months, they have a clearer sense of independence, regularly use individual pronouns, and seem to gravitate toward exercises and objects.
8- Role relationships Health pattern
The child with 12-month-old baby forms strong connections with her essential caregivers and may show separation anxiety. At 24 months, toddlers begin to develop social skills, play close to other children (parallel play), and acquire familiar parts (Hockenberry & Wilson, 2018).
9- Reproductive Sexuality
This design is not entirely relevant for young children, but body research is common. Both 12- and 24-month-old children show interest in their bodies, which is normal for their growth.
10- Stress tolerance
Adaptive tools progress from crying and touching at 12 months to using more modern strategies such as verbal communication and searching for comforting objects at 24 months.
11- Pattern of beliefs in values
At 12 months, toddlers begin to learn essential rules through caregiver reinforcement. By 24 months, they begin to understand the concept of right and wrong and can follow simple rules with updates (Hockenberry & Wilson, 2018).
In summary, while both age groups are intensely dependent on caregivers, the 24-month-old child appears to have greater autonomy and more advanced physical, cognitive, and social improvement compared to the 12-month-old child. This development is well captured through the different aspects of well-being that Gordon used in his theory.
References
Gordon, M. (1987). Functional health patterns: The next generation. Nursing Science Quarterly, 1(3), 191-199.
Hockenberry, M. J., & Wilson, D. (2018). Wong's nursing care of infants and children (11th ed.). Elsevier.