The basic mechanisms of learning appear to be essentially the same at all ages.At present, psychologists generally consider that there are 3 distinct mechanisms by which behavioral responses are learned}
EMOTIONAL DEVELOPMENTbased on Sigmund Freud’s psychoanalytic theory of personality development.greatly extended by Eric Erickson.His “eight stages of man” illustrate a progression through a series of personality development stages.
Erickson’s stages of emotional development Development of basic Trust (birth to 18 months) a basic trust or lack of trust – in the environment is developed. Successful development of trust depends on a caring and consistent mother or mother -substitute, who meets both the physiologic and emotional needs of the infants. This bond must be maintained to allow the child to develop basic trust in the world.
The syndrome of maternal deprivation, in which a child receives inadequate maternal support is well recognized through fortunately rare. Such infants fail to gain weight and are retarded in their physical as well as emotional growth. fig 2.48) Unstable mothering that produces to apparent physical effects.
The syndrome of maternal deprivation - inadequate maternal support.infants fail to gain weight , retarded in their physical as well as emotional growth. fig
Development of Autonomy (18 months –3 years): Children around the age of 2 often are said to be undergoing the terrible two’s. uncooperative and frequently obnoxious behavior. the child is moving away from the mother and developing a sense of individual identify or autonomy.
He or she varies between being a little devil who says no to every wish of the parents and insist on having his own way and being a little angel who retreats to the parents in moments of dependence.
Failure to develop a proper sense of autonomy results in the development of doubts in the child’s mind about his ability to stand alone, and this in turn produces doubt and shame.
A key toward obtaining co-operation with treatment from a child at this stage is that It is all right to open your mouth if you wants to, one way around this is to offer the child reasonable choices whenever possible. Allowing the parents to be present during treatment may be needed for even the simplest procedures.
Complex dental treatment at this stage is quite challenging and may require extra- ordinary behavior management procedures as sedation or general anesthesia.
The tight bond between parent and child at this early stage of emotional development is reflected in a strong sense of “separation anxiety’ in the child when separated from the parent. If it is necessary to provide dental treatment at this stage, parents should be present and if possible child is being held by the of the parents.
Development of initiative (3-6 years):In this stage, the child continues to develop greater autonomy; the initiative is shown by physical activity and motion, extreme curiosity and questioning and aggressive talking. At this stage, child is inherently teachable.
The opposite of initiative is guilt resulting from goals that are contemplated but not attained, from acts initiated but not completed, or from acts rebuked by persons the child respects
In Erickson’s view, the child’s ultimate ability to initiate new ideas or activities depends on how well he or the is able at this stage to express new thought and do new things without being made to feel guilty about expressing a bad idea or failing to achieve what was expected.
For most children, the first visit to the dentist comes during this stage of initiative.
Mastery of Skills (7-11 years):At this stage the child is working to acquire the academic and social skills and will allow him or her to compete in an environment.
The influence of parents as role models decrease and the influence of the peer group increases. The negative side can be the acquisition of a sense of inferiority. orthodontictreatment often begins during this stage.
Development of Personal identity (age 12-17 yr): Adolescence, a period of intense physical development. also the stage in psychosocial development in which a unique personal identity is acquired. extremely complex stage many new opportunities arise. Emerging sexuality complicates relationships with others.
physical ability changesacademic responsibilities increase, and career possibilities being to be defined.Members of the peer group become important role modelsvalues and taste of parents are likely to be rejected.
Most of the dental treatment including orthodontic is carried out during the adolescent years, and behavioral management of adolescent can be extremely challenging. At this stage, treatment should be carried out only if the patient wants it not just to please the parents.
Motivation for seeking treatment can be defined as internal or external.External motivation is from pressure from others internal motivation is provided by individual’s own desire for treatment
Development of Intimacy Young Adult):Begin with the attainment of intimate relationship with other. Successful development depends on a willingness to compromise and even to sacrifice to maintain a relationship.
. A Person at this stage feels that a change in their appearance will facilitate attainment of intimate relationship.
Guidance of the Next generation (Adults) A major responsibility of a mature adult is the establishment and guidance of the next generation. Becoming a successful and supportive parent is obviously a major part of this. Opposite is stagnation, characterized by self – indulgence and self centered behavior.
Attainment of integrity (Late adult): The final stage in psychosocial development The feeling of integrity is best summed up as a feeling that one has made the best of this life’s situation and has made peace with it . opposite to this is despair.
The term cognitive means knowing or understating, and when we speak of cognitive development we are referring to mental development in the broadest sense, including not only intelligence but also such complementary or component process as perceiving, Jean Piaget, an eminent Swiss epistemologist concentrated upon the development of thought in the child.
Every individual in Piaget’s view, adaptation occurs through two complementary process, assimilation and accommodation.
For example, a child who has just learned the word “bird” tend to assimilate all flying objects into his idea of bird, when he has sees a bee, he will probably say, look, bird!”
Intelligence develops as interplay between assimilation and accommodation. From the perspective of cognitive development theory, life can be divided into four major stages:
The sensorimotor period : from birth to 2 years of age; The preoperational period : from 2 to 7 yrs Period of Concrete Operations : 6-12 years The period of formal operations : 11- 15 yrs (from adolescence through adulthood).
Sensorimotor Period. During the first 2 years of life, a child develops from a newborn infant who is almost totally dependent on reflex activities to an individual who can develop new behavior to copy with new situations. Communication between a child at this stage and an adult is extremely limited because of the child’s simple concepts and lack of language capabilities.
According to Piaget, young children often do not think to the sense that older ones do. Piaget called this intelligence “practical intelligence”. Specifically, he called this stage of cognitive development the sensorimotor period because the child merely senses things and acts upon them.
Lack of Symbols Infants do not seen to carry around in their heads the symbols or image of objects; they have no representational ability.
Achieving Objects Permanence This understanding of the object as a permanent, independent entity marks the end of the sensorimotor period. Children can carry images of rattles, balls, and others things in their heads, which is perhaps the beginning of thinking.
Preoperational Period. Because children above the age of 2 begin to use language in ways similar to adults, it appears that their through processes are more like those of adults than is the case. Children in the preoperational period understand the world in the way they sense it through the five primary senses.
Concepts that cannot be seen, head, smelled, tasted, or felt for example, time and health – are very difficult for preoperational children to grasp. They are not able worlds more than the literal meaning of idioms.
Egocentrism, meaning that the child is incapable of assuming another person’s point of view. Still another characteristic of through processes at this stage is animism investing inanimate objects with life. Essentially everything is seen as being alive by a young child
animism can be used to the dental team’s advantage by giving dental instruments and equipment life-like names and qualities. For example, the headpiece can be called “Whistling Willie” who is happy while he works at polishing the child’s teeth. A preoperational child is much more likely to understand:
“Brushing makes your teeth feel clean and smooth,” and, “Toothpaste makes your mouth taste good,”
Children learn to use language to communicate ideas to others. During this stage, called the preoperational period, the child still does not understand the use of symbols and basic operations. The child is preoperational throughout most of the preschool years, from age 18 or 24 months to age six or seven years.
Concept of Egocentrism Preoperational though is characterized as egocentric thought because the child is unaware of other perspectives. For example, in perceptual egocentrism preschoolers do not realize that other people see things from a viewpoint different from theirs.
A young girl, playing hide-and-seek, shuts her eyes and says “Ha, ha! Can’t see me!” cognitive egocentrism, in which children find it different to understand that other people do not know their thoughts.
Concept of Centration Preoperational thought also focuses on a single, striking feature of an object or event, a tendency called centration.
Child is Scientist In a normal environment, the child because a little scientist or explorer, seizing opportunities for twisting and pulling, picking and dropping, poking and rubbing, shaking and breaking, striving to understand himself or herself and the surroundings.
Period of Concrete Operations. As a child moves into this stage, typically after a year or so of preschool and first grade activity, an improved ability to reason emerges. By this stage, the ability to see another point of view develops, while animism declines. The child begins to master the conservation problem around age six.
Understanding Operations At the close of this stage, the child can solve problems that require classification, ordering, and sequencing. The child can arrange a series of sticks from tallest to shortest without making errors.
Period of Formal Operations. Formal operations, which is the capacity for reasoning apart from concrete situations. It is abstract reasoning, Piaget’s final level of cognitive development.
For most children, the ability to deal with abstract concepts and abstract reasoning develops by about age 11. at this stage, the child’s through process has become similar to that of an adult, and the child is capable of understanding concepts like health, disease, and preventive treatment.
Adolescents assume that others are as concerned with their bodies, actions, and are constantly “on stage,” being observed and criticized by those around them. This phenomenon has been called the “imaginary audience” by Elkind.
The notion that “others really care about my appearance and feelings as much as I do” leads adolescents to think they are quite unique, special individual. If this were not so, why would others be so interested in them? As a result of this thought a second phenomenon emerges, which Elkind called the “personal fable.”
The personal fable is a powerful motivator that allows us to cope in a dangerous world. It is the job of the dentist to carefully evaluate the development of the child, and adapt his or her language so that concepts are presented in a way that the patient can understand them. The adage “different strokes for different folks” applies strongly to children.
Forming and Testing Hypotheses In the concrete operations stage, the child was able to classify, enumerate, and place objects and event in time and space, but at the sage of formal operations she can imagine the possibilities inherent in a problem. The adolescent generates hypotheses and tests them to find which one seems most valid, and she can even leave reality altogether, reasoning entirely in abstract terms.
Nelson:The Newborn Behavioral States. The organization of infant behavior into discrete behavioral states may reflect an infants inborn ability to regulate arousal. Six states have been described: quiet sleep, active sleep, drowsy, alert, fussy, and crying.
In the alert state, infants visually fixate on objects or faces and follow them horizontally and (within a month) vertically; they stimulated, they may calm themselves by booking away, yawning, or sucking on their lips or hands, thereby increasing parasympathetic activity and reducing sympathetic nervous activity.
Age 0-2 Months Cognitive Development. Care taking activities provide visual, tactile, olfactory, and auditory stimuli; all of these support the development of cognition. They can recognize facial expressions smiles) as similar, even when they appear on different faces. They also can match abstract properties of stimuli, such as contour, intensity, or temporal pattern across sensory modalities.
Emotional Development. Basic trust, the first of Eriksons psychosocial stages, develops as infants learn that their urgent needs are met regularly. Infants who are consistently picked up and held in response to distress cry less at 1 year and show less aggressive behavior at 2 year.
The emotional significance of any experience depends on an individual childs temperament as well as the parents responses. Hunger generates increasing tension; as the urgency peaks, the infant cries, the parent arrives with a bottle or breast, and the tension dissipates. Infants fed "on demand" consistently experience this link between their distress, the arrival of the parent, and the relief from hunger.
Most infants fed on a fixed schedule quickly adapt their hunger cycle to the schedule. Those who cannot because they are temperamentally prone to irregular biologic rhythms experience periods of unrelieved hunger as well as unwanted feedings when they already feel full.
Similarly, infants fed at the parentss hunger cues nor a fixed schedule may not consistently experience feeding as the pleasurable reduction of tension. These infants often show increased irritability and physiologic instability (spitting, diarrhea, poor weight gain) as well as later behavioral problems.
AGE 2-6 MONTHS At about 2 mo, the emergence of voluntary (social) smiles and increasing eye contact mark a change in the parent-child relationship, heightening the parents sense of being loved back.
Cognitive Development. Four-month-old infants are described as "hatching" socially, becoming interested in a wider world. During feeding, infants no longer focus exclusively on the mother but become distracted.
Infants at this age also explore their own bodies, staring intently at their hands, vocalizing, blowing bubbles, and touching their ears, cheeks, and genitals. These have a role in the emergence of a sense of self.
For example, the proprioceptive feeling of holding up the hand and wiggling the fingers always accompanies the sight of the fingers moving. Such the sound, smell, and feel of mother sometimes appears promptly in response to crying but sometimes does not.
Emotional Development and Communication. The primary emotions of anger, joy, interest, fear, disgust, and surprise appear in appropriate contexts as distinct facial expressions. Infants of depressed parents show a different pattern, spending less time in coordinated movement with their parents and they show sadness and a loss of energy when the parents continue to be unavailable.
AGE 6-12 MONTHS Months 6-12 bring increase mobility ad exploration of the inanimate world, advances in cognitive understanding and communicative competence, and new tensions around the themes of attachment and separation
Cognitive Development. At first, everything goes into the mouth in time, novel objects are picked up, inspected, passed from hand to hand, banged, dropped, and then mouthed. The pleasure, persistence, and energy with which infants tackle these challengers suggest the existence of and intrinsic drive or mastery motivation. Mastery behavior occurs when infants feel secure; those with less secure attachments show limited experimentation and less competence.
A major milestone is the achievement (about 9 mo) of object constancy, the understanding that objects continue to exist even has seen. At 4-7 mo, infants look down for a yarn ball that has been dropped but quickly give up if it is not seen. With object constancy, infants persist in searching, finding objects hidden under a cloth or behind the examiners back.
Emotional Development. The advent of object constancy corresponds with qualitative changes in social and communicative development. Separations often become more difficult. Infants who have been sleeping through the night for months begin to awaken regularly and cry, as though remembering that parents are in the next room.
At the same time, a new demand for autonomy emerges. Infants no longer consent to be fed but turn away as the spoon approaches or insist on holding it themselves. Self-feeding with finger foods allows infants to exercise newly acquired fine.
Cognitive Development. As toddlers master reaching, grasping, and releasing, and greater mobility gives them access to more and more object, exploration increases. Playthings are also more likely to be used for their intended purposes (combs for hair, cups for drinking). Imitation of parents and older children is an important mode of learning
Emotional Development. Infants developmentally approaching the milestone of their steps may be irritable. Once they start walking, their predominant mood changes markedly. Toddlers are described as "intoxicated" with their new ability and with the power to control the distance between themselves and their parents.