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Child psychology /certified fixed orthodontic courses by Indian dental academy


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Child psychology /certified fixed orthodontic courses by Indian dental academy

  1. 1. CHILD PSYCHOLOGY INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. Structure of the presentation • Introduction • Theories of Emotional Development • Emotional Development and Its Relation to cooperation in Treatment • Patient compliance • Behaviour management of child
  3. 3. CHILD PSYCHOLOGY The part of developmental psychology which traces the changes in behaviour occuring during the early years of life.
  4. 4. Stone and Church’s classification • Infant : till 15 months • Toddler :5 months to 2 years of age • Preschooler : 2 to 6 years of age • Middle year child : 6 to 12 years of age • Adolescent : 12 years till maturity.
  5. 5. Theories of Emotional Development  Stanely Hall{1846-1924} : founder of Emotional development and Psychology.  "Theories are nothing but more than a set of Concepts and Propositions that allow the Theorist to describe and explain some aspects of experience".
  6. 6. • Jean Piaget (1896 - 1980)
  7. 7. Intellectual Growth Intellectual growth involves three fundamental processes: • assimilation, • accommodation, • and equilibration
  8. 8. ASSIMILATION ACCOMODATION Modification of one’s environment to fit into an already developed cognitive structure. Modification of one’s cognitive structure to fit in with characteristics of the environment
  9. 9. • This dual process, assimilation- accommodation, enables the child to build-up various hierarchies of related behavior, which Piaget called Schemata. • Equilibration: involves the person striking a balance between them-self and the environment, between assimilation and accommodation.
  10. 10. Piaget's theory delinates four phases of cognitive growth and the processes by which children progress through them. The four stages are: • Sensorimotor stage • Preoperational stage • Concrete operational stage • Formal operational stage
  11. 11. SENSORIMOTOR STAGE • The period between birth to 2 years was labelled as “Sensorimotor stage” by Sir Jean Piaget. Characterized by: development of object permanence.
  12. 12. Object Permanence. • A child’s realization that objects continue to exist even when they are hidden from view.
  13. 13. PRE-OPERATIONAL STAGE • The period between about the ages 2-7 years was labelled as “pre-operational stage” by Sir Jean Piaget. • Characterised by: Egocentrism Animism/ representational thoughts Identity concept Transductive reasoning
  14. 14. Egocentrism • Inability to adopt another person’s point of view. • Because of this the child can only manage his own perspective and assumes another’s view is simply beyond his mental capabilities.
  15. 15. egocentrism altruism sympathetic
  16. 16. Altruism • Giving and sharing objects, time, or goods with others with no obvious self-gain.
  17. 17. Animism • A child’s belief that all things are living and have feelings and intentions just as we (humans) do.
  18. 18. Representational thoughts • Capacity to form mental symbols which stands for objects or events that are not actually present. • Manifestations ….
  19. 19. APPLICATIONS OF PRE-OPERATIONAL STAGE • There is also no point talking to a 4 year old about how much better his tooth will look in the future if he stops thumsucking. • At the same time it would not be useful to point out to the child how proud his father would be if he stopped thumsucking, since the child would think his fathers attitude was same as the child (Egocentrism). • Telling him that the teeth will feel better now or talking about how bad his thumb tastes.
  20. 20. CONCRETE-OPERATIONAL STAGE • The period between about the ages 7-11 years was labelled as “concrete-operational stage” by Sir Jean Piaget. • Characterised by: Conservation Coordination of 2-dimensions Seriation Sequencing Reversibility
  21. 21.
  22. 22. Seriation, centering • Centering : paying attention on the single most striking feature and ignoring it’s all other features.
  23. 23. FORMAL-OPERATIONAL STAGE • The period between about the ages 11years to adults was labelled as “formal- operational stage” by Sir Jean Piaget.
  24. 24. Major works • Introduction to Genetic Epistemology (1950) • Play, Dreams, & Imitation (1951) • Origins of Intelligence (1952) • Constructions of Reality (1954)
  25. 25. SIGMUND FREUD 1856-1939 “I was the only worker in a new field.” .
  26. 26. Born in Freiburg in Moravia View of Freiburg
  27. 27. psychoanalytic theory Theory of personality structure Theory of personality dynamics Psychosexual theory of cognitive development
  28. 28. Freud’s Psychosexual Stages • STAGE Oral (0-18 months) Anal (18-36 months) Phallic (3-6 years) Latency (6 to puberty) Genital (puberty on) • FOCUS Pleasure centers on the mouth-sucking, chewing, biting Pleasure focuses on bowel and bladder elimination; coping with demands for control Pleasure zone is the genitals; coping with incestuous sexual feelings Dormant sexual feeling Maturation of sexual interest
  29. 29. Important Psychosexual Stage Theory Vocabulary • Anal personality- overemphasis by adults on toilet training results in compulsion obstinate and perfectionist behaviour in later life which is called Anal personality • Electra complex: affectional responces by a girl toward her father accompained by jealousy of her mother. • Oedipus complex-a boy’s sexual desires toward his mother and feelings of jealousy and hatred for the rival father(penis envy).
  30. 30. • Fixation-a lingering focus of pleasure-seeking energies at an earlier psychosexual stage, where conflicts were unresolved.(Portion of libido is stuck in 1 stage because of excessive frustration or gratification) • Identification-the process by which, children incorporate their parents’ values into their developing superegos.
  31. 31. Drawbacks of Psychosexual theory • Overemphasis on sexuality. • Role of society is completely ignored. • Female psychology is not taken into account (KAREN HORNEY, feminine psychology 1967)
  32. 32. Major works • Studies on Hysteria (with Josef Breuer) (Studien über Hysterie, 1895) • The Interpretation of Dreams (Die Traumdeutung, 1899) • The Psychopathology of Everyday Life (Zur Psychopathologie des Alltagslebens, 1901) • Three Essays on the Theory of Sexuality (Drei Abhandlungen zur Sexualtheorie, 1905) • Totem and Taboo (Totem und Tabu, 1913) • On Narcissism (Zur Einführung der Narzißmus, 1914) • Beyond the Pleasure Principle (Jenseits des Lustprinzips, 1920) • The Ego and the Id (Das Ich und das Es, 1923) • The Future of an Illusion (Die Zukunft einer Illusion, 1927) • Civilization and Its Discontents (Das Unbehagen in der Kultur, 1929) • Moses and Monotheism (Der Mann Moses und die Monotheistische Religion, 1939) • An Outline of Psycho-Analysis (Abriß der Psychoanalyse, 1940)
  33. 33. Eric Erickson’s view
  34. 34. Eric Erickson • Trust versus mistrust • Autonomy versus shame • Initiative verses guilt • Industry verses inferiority • Identity versus role- confusion
  35. 35. Trust versus mistrust Development of the basic Trust depends on caring and consistent mother or mother substitute, who meets both the physiologic and emotional needs for the infants. The strong bond between mother and child is necessary for the child to develop a Basic trust in the world.
  36. 36. Maternal Deprivation Syndrome When the child receives inadequate maternal support, it will fail to gain weight and are retarded in both physical and emotional growth. This is seen in children of broken families or who lived in a series of foster homes.
  37. 37. Autonomy versus shame • Autonomy : confidence in oneself.
  38. 38. Autonomy versus shame • Shame: a feeling of having all ones shortcoming exposed. e.g Bowel control
  39. 39. TERRIBLE TWOS Little devil Little angel He says NO to every wish of parents and insists on having his own way. He retreats to parents in moments of dependence.
  40. 40. Initiative verses guilt • Initiative : to plan, to start-up and to perform a task.
  41. 41. Initiative verses guilt • Guilt: feeling of fear that ones activities might not be acceptable
  42. 42. • Features of this age are: Extreme curiosity and questioning, aggressive talking, physical activity. • A major task for parents and teacher at this stage is to channel the activity into manageable tasks, arranging things so that child is able to succeed, and preventing him or her from undertaking tasks where success is not possible.
  43. 43. Industry verses inferiority • Industriousness : to learn about the rules by which the world is organized and to acquire the academic and social skills that allow him to compete in the environment
  44. 44. Identity versus role- confusion/ identity diffusion • Identity : searching for continuity and sameness in oneself. • During this period, they rebel against the set-rules and norms.
  45. 45. TURMOIL OF ADOLESCENCE security and comfort of childhood. privilege and responsibilities of adulthood
  46. 46. Psycho-orthodontic theory This theory was put forwarded by El-Mangoury. Motivation is a very broad psychological term which describes a hypothetical construct which aims to explain the reason for the stream of a goal-directed behavior driven by specific or nonspecific forces.
  47. 47. • A) Achievement motivation : the motivation characterized by striving for success in any situation in which standards of excellence apply. • B) Attribution motivation : the motivation for perceiving the causes of success and failure, either internally (that is, to the self) or externally (that is, outside the self).
  48. 48. C) Affiliation motivation of orthodontic patients was defined as a hypothetical construct of seeking orthodontic care for the purpose of improving the dento facial esthetics in order to facilitate the connection or association of oneself with other people for obtaining, maintaining, and/or restoring close interpersonal relationships.
  49. 49. Emotional Development and Its Relation to cooperation in Treatment Patients usually expect improved dental facial appearance as an outcome of the treatment, but factors like co-operation play a major role.  AJO 1992 Nanda showed female adolescent patients showed more cooperation than male patients.  Adolescence Shows less cooperation because of the establishment of social and developmental issues, personal values and goals. Thus the relative strength of peers and parental influences are changing during adolescence maturation.
  50. 50.  AJO 1985 Gross reported adolescence have negative perception of orthodontic treatment and parental support is critical to treatment success  EJO 1990 Kegeles reported children whose parent encouraged treatment were generally cooperative. Cooperation was still higher for adolescent patient whose parents express positive attitudes towards orthodontic treatment.
  52. 52. • Rivera and Hatch SEM in orthodontics 2000 evaluated emotional status of the patient before and after orthodontic and orthognathic surgery patients and concluded; • BEFORE TREATMENT :  Individuals with mild facial disfigurement was affected more than severe deviation.  60% believed self confidence,social acceptance,communication and body image will improve after treatment.
  53. 53. IMMEDIATELY AFTER SURGERY: Immediately after surgery negative mood last for 4-6 weeks because of pain, numbness and oral function problems but it was recovered within 3 months.
  54. 54. AFTER ORTHOGNATHIC SURGERY : Patient after orthognathic surgery showed more positive benefits with increased self judgement self esteem, self confidence and body image when compared with orthodontic alone treated patients.  Social potency, social responsiveness social interaction, and behavior improved after surgery.
  55. 55. PATIENT COMPLIANCE • The success of orthodontic therapy frequently depends on patient compliance. • EGOLF and others described a compliant patient as one who practices good oral hygiene, wears appliances as instructed without abusing them, follows an appropriate diet, and keeps appointments.
  56. 56. ACHIEVING PATIENT COMPLIANCE • ROSEN provided a practical patient-oriented approach to creating a compliant patient. • Health care providers should develop a compliance model that is patient-centered rather than clinician-centered.
  57. 57. PERSONALITY TESTING AND COMPLIANCE • Major orthodontic treatment decisions are based on an anticipated level of patient compliance. • PERSONALITY TEST: • SOUTHARD et al • “The Millon Adolescent personality inventory” (MAPI) (MILLON, GREEN, and MEAGHER-1982) • To predict the behavior of adolescent patients in an orthodontic practice.
  58. 58. Methods of improving patient compliance (A.O. 1998 No. 2, T. Mehra, R.S. Nanda, P.K Sinha.) Verbally praising the patient, Discussing treatment goals and poor patient cooperation with the patient and parent. Educating the parent about the use of orthodontic appliances, and about the consequences of poor compliance.
  59. 59. Methods of improving patient compliance • JCO 1996 Sep MELVIN MAYERSON, R.G “WICK” ALEXANDER • Patient Education • Patient Motivation • Office Environment • Communication Techniques • Monitoring Progress
  60. 60. ORTHODONTIST AND PATIENT COMMUNICATION • KLAGES, SERGL, and BURUCKER – found strong relationships between clinician’s encouraging behavior and patient communication cooperation, and concluded that the orthodontist's behavior may be relevant for patient verbal cooperation. • The doctor-patient interaction is the best predictor of how well a patient could be expected to comply with the doctor’s instructions.
  61. 61. Communication Techniques An effective communication technique is to look in their eyes before you look in their mouths. • "Horizontal communication": Dr. J. Moody Alexander looking in patient's eyes before looking in the mouth. • Good communication should be honest as well as two-way, the orthodontist should be “askable”.
  62. 62. Patient Motivation • WILLIAM JAMES “The most important discovery of the 20th century is that the attitudes of an individual can change”. • The only truly motivational technique is self- motivation
  63. 63. BEHAVIOUR MANAGEMENT OF CHILD 1. Non-pharmacological (psychological approach) 2. Pharmacological • Non- pharmacological: 1. Communication 2. Behavior shaping (modification) • Desensitization • Modelling • Contingency management
  64. 64. BEHAVIOUR MANAGEMENT OF CHILD 3. Behavior management • Audio analgesia • Biofeed back • Voice control • Hypnosis • Humor • Coping • Relaxation • Implosion therapy • Aversive
  65. 65. BEHAVIOUR MANAGEMENT OF CHILD • Pharmacological: 1. Pre-medication • Sedatives And Hypnotics • Anti-anxiety Drugs • Anti-histamines 2. Conscious sedation 3. General anesthesia.
  66. 66. CONCLUSION • Books only superficially touches the psychology of a child, the best way to learn child psychology is through child- interaction.
  67. 67. Sources • Bakken, L.; Thompson, J.; Clark, F. L.; Johnson, N.; Dwyer, K. (2001). Making • conservationists and classifiers of preoperational fifth-grade children. Journal • of Educational Research, 95, 56-57. • Cairns, T. (2001). How acquiring basic skills should be part of everyday life. Adults • Learning, 13, 20-22. • Gale. (2001). Cognitive development. Encyclopedia of Psychology (2nd ed.). New York. • Weiten, W. (2001). The growth of thought: cognitive development. Psychology • Themes and Variations (5th ed.). 336-340. • Kalat, J. W. (1996). Introduction to psychology. Pacific Grove, CA: Brooks/Cole. • Baillargeon, R. (1994). How do infants learn about the physical world? Current • Directions in Psychological Science,
  68. 68. Thank you For more details please visit