This document provides an overview of child psychology and its theories and applications. It discusses: - Definitions of psychology and child psychology. - The importance of understanding child psychology for dental care. - Major theories of child psychology including psychodynamic theories by Freud and Erickson, learning theories by Pavlov, Skinner and Piaget. - Key concepts in each theory like the psychosexual stages, psychosocial stages, classical and operant conditioning, cognitive development stages. - Applications of these theories in understanding child behavior and development and providing effective dental care.

1. CHILD PSYCHOLOGY
Dr. Parkhi Bhatnagar

2. Definitions
 Psychology: It is the science dealing with
human nature, function, and phenomenon
of his soul in the main.
 Child Psychology: It is science and study
of Child’s mind and how it functions. It is
also the science that deals with mental
power or an interaction between the
conscious and sub-conscious elements in a
child.

3. Importance of Child Psychology
 To understand the child better.
 To know the problem of psychological origin.
 To deliver the dental services in a meaningful
and effective manner.
 To establish effective communication with the
child and the parent.
 To gain confidence of the child and of the
parent.

4.  To help the child overcome fear and
anxiety of dental treatment.
 To have a better treatment planning
and interaction with other discipline.
 To produce a comfortable environment
for the dental team to work on the
patient.
 To teach the child and the parents
importance of primary and preventive
care.

5. Theories of Child Psychology
 Psychodynamic
theories
1. Psychosexual theory-
Sigmund Freud
2. Psychosocial theory-
Eric Erickson
3. Hierarchy of needs-
Abraham Maslow
 Behavior Learning
Theories
1.Cognitive theory-Jean
Piaget
2.Social learning
theory-Albert
Bandura
3.Classical conditioning
theory-Ivan Pavlov
4.Operant conditioning
theory-Skinner

6. Psychosexual Theory
 Sigmund Freud (1905) analyzed three
structures in the understanding of
personality development and intra psychic
processes.
 Psychic structure is composed of three
parts:1)Id
2)Ego
3)Super ego

7. Psychic Structure
 The Id and the Superego
are opposites; the Id wants
to do what it wants, right
now, while the Superego
wants to do what is right. If
you think of the cartoon with
a devil on one shoulder and
the angel on the other,
trying to convince you to do
something, that's like the Id
and the Superego. The
person in the middle, trying
to negotiate between the
two, is the Ego

8. Id
 Basic structure of personality which
serves as a reservoir of instincts or
their mental representative.
 Present at birth,impulse ridden and
strives for immediate pleasure and
gratification-Pleasure principle.
 Represents the subconscious
instinctive urge to gain pleasure.

9. Ego
 Develops out of Id in the 2nd to 6th month
of life when the infant begins to
distinguish between itself and the outside
world.
 It is the mediation between Id and Super
ego.
 It is governed by the Reality Principle.
 Ego perceives learns,remembers and
reasons.

10. Super Ego
 Is the prohibition learned from
environment or more from parents and
authorities and can be termed as
conscience.
 Is determined by regulations and
restrictions imposed on the child by
parents,society and culture(ethics and
morals).
 The child develops an internal feeling of
good/bad,love/faith,reward/punishment.

11. Psychosexual Stages
 Oral Stage-From birth to 18 months.
 Anal Stage-18 months to 3 years.
 Urethral stage – transitional stage
 Phallic Stage-3 years to 5 years.
 Latency Stage-5 years to 11years.
 Genital Stage-11years to adulthood.

12. Oral Stage
 First year of life.
 Baby gains pleasure from sucking,nursing
and mouthing.
 The oral zone is the area of primary
interest.
 If the infants are deprived of adequate
mothering,the baby’s behavior reveals its
distress - shallow breathing,exaggerated
cry,muscle rigidity is seen.

13. Oral Stage
 When mothering becomes adequate,these
symptoms disappear.If mothering is still
absent,the child may end up in Infantile
autism.
 If child’s needs are not adequately met in
this stage,Excessive
optimism,Narcissism,Pessimism,Demanding
ness,Envy,Jealousy develop.

14. Anal Stage
 Baby derives pleasure from the
process of elimination in the first 6
months and holding in next 6 months.
 Anus and surrounding areas-areas of
main interest.
 If properly trained they acquire
sphincter control thereby gaining
mastery over self control.

15. Urethral stage
 Transition between anal and phallic stage.
 Control over urinary sphincter
 Loss of urethra control results in shame
 Ambition

16. Phallic Stage
 The child’s libidal energy is directed
to genital activities.
 The child discovers the anatomical
differences between the male and
female.
 The male child develops Oedipus
Complex and the female child
develops the Electra Complex

17. Oedipus Complex
 Young boys have a natural tendency to be
attached to their mother and to consider
their father as enemy.Hence they strive
to imitate their father to gain the
affection of the mother.
 The name Oedipus comes from Greek
mythology.Oedipus,King of Thebe killed his
father and married his mother.

18. Electra Complex
 The girlchild develops attachment to
father and resents mother being
close to father.
 In Greek mythology,Electra helped
her brother to kill the lover of their
father,Agenennon in order to build
father’s love.

19. Latency Period
 From 7-11 years.
 Boys play with boys and girls only
with girls.
 They put their energy to achieve
cognitive skills.They turn their
attention to school and play.

20. Genital Stage
 At the onset of puberty,the child
matures physically and heterosexual
interest reemerges.
 In Freud’s view,the failure to satisfy
the needs of the earlier stages
leaves the individual partially fixed
at those levels.Such fixation is shown
in adulthood as immature behavior.

21. Psychosocial Theory
 Eric Erickson (1963) modified Freud’s
theory by superimposing psychosocial and
psychosexual factors.
 He says that the society responds to the
child’s basic needs and developmental
tasks in each specific period of life and
states that by doing so,the society
assures not only the child’s healthy
growth,but also the passage of culture and
tradition.

22. Infancy
Basic Trust /Mistrust(upto1yr)
 Erickson described this as a time for
achieving a sense of basic trust when
the child’s oral needs are met.Failure
to achieve satisfaction or mothering
leads to a sense of mistrust.
 The infant forms the first trusting
relationship with the caregiver.

23. Toddler Stage
Autonomy/Shame and doubt (1-3yr).
 This stage is a time for gaining mastery
over issues beyond the bowel and bladder
control.A successful control leads to
autonomy and failure leads to shame and
doubt.If a child is not encouraged to
perform independent tasks by himself and
is humiliated by his
parents/caretakers,then he develops a
sense of shame and doubt.

24. Preschool Stage
initiative/guilt(3-6 yrs)
 The child begins to explore his
environment and thereby develops a
sense of initiative.A child who is
constantly prohibited in doing so will
develop a feeling of guilt.
 Curiosity of anatomic differences is
common and if the child is humiliated
about this,it may lead to guilt.

25. School Stage
Industry/inferiority(6-12 yr)
 The child moves out of the home,a parent
centered world into the society of school
and peer centered world.Here the child
learns mastery over academic skills.If they
are successful,competent, then they
develop a sense of industry.
 The kind of support provided by
parents,teachers in achieving these skills
plays an important role.If they aren’t able
to complete the given task,they develop a
sense of inferiority.

26. Adolescence Stage
Identity/Role confusion(13-19yrs)
 The teenager tries to identify himself as a
person in society.They want to be
independent from their parents and are
greatly influenced from their
peers(friends) and yearns for peer
acceptance.
 They search for a role model and imitate
them.Successful consolidation of self
leads to a sense of identity or it might
lead to role confusion.

27. Young adult
-intimacy/isolation (19-25yrs)
 Successful development of intimacy
leads to the establishment of a
proper relationship between partners
of opposite sex.Failure leads to
isolation and is accompanied by
strong prejudices against the
opposite sex to keep others away.

28. Adult stage
generativity/stagnation (26-50yrs)
 The adult rears children or performs
creative act failing which stagnation
occurs.
 It is the responsibility of the mature
adult to provide guidance and support to
the next generation.Another aspect of
this is service to the group,community or
nation leading to generativity,if not the
person becomes self centered and reaches
phase of stagnation.

29. Late adult stage
ego integrity/despair (above 50yrs)
 The feeling of integrity is explained
as the feeling that one has made the
best use of his life and has made
peace with it.The opposite character
is despair which is expressed as
disgust.Unhappiness in
life,accompanied by a fear of death.

30. Classical Conditioning Theory
 Ivan Pavlov,(1927),a Russian
psychologist studied the conditioning
of reflexes.Conditioning is the paired
relation between a conditioned
stimulus and a unconditioned
stimulus.The more frequent the
pairing of the conditioned and
unconditioned stimulus the stronger
is the conditioning effect.

31. Classical Conditioning Theory
The principles involved in this process are:
1)Acquisition : learning a new response from the
environment by conditioning.
2) Generalization
3)extinction.
4)discrimination.
Generalization: occurs when the response is produced
after the pairing of 2 events and is repeated.The child
comes for a first dental visit.The child sees a doctor in
white coat with a syringe and has a painful
experience.This when repeated twice or thrice only the
sight of the white coat is sufficient to produce a
response.

33. Classical Conditioning Theory
 Extinction: of the conditioned behavior
results if the association between the
conditioned and unconditioned response is
not reinforced, it results in extinction of
that behavior.
 Discrimination:here the child is exposed
to 2 clinical settings,one with painful
experience and other with pleasant
experience.The child will be able to
discriminate between the two and even
the generalized response to any office will
be extinguished.

34. Applications- classical conditioning
theory
 Developing good habits.
 Breaking habits and elimination of
conditioned fear.
 Psychotherapy,to decondition
emotional fear.
 Developing positive attitudes.
 Teaching alphabets.

35. Theory of Operant Conditioning
 Skinner(1928)
 It is an extension of Classical
conditioning
RESPONSE STIMULUS
CONSEQUENCE

36. Theory of Operant Conditioning
 The consequence of behavior will alter the
probability of that response occurring
again in similar situation.
 Consequence-
pleasant/unpleasant,depending on that
response.
 4 types of consequence:positive
reinforcement,negative
reinforcement,omission,punishment.

37. Theory of Operant Conditioning
 Positive reinforcement: occurs if a
pleasant consequence follows the
response.For example:if the child is
rewarded for good behavior.
 Negative reinforcement:involves removal
of unpleasant stimulus following a
response.For example when the parent
listens to the temper-tantrum thrown by
the child,then the bad behavior is
reinforced or repeated.

38. Theory of Operant Conditioning
 Omission: removal of the pleasant stimulus
after a particular response.For example:if
the child misbehaves,then its favorite toy
is taken away.
 Punishment:is introduction of a aversive
stimulus (Voice control).It can be of
different types.In a dental setup only
positive and negative reinforcement can
be ideally used.

39. Theory of Hierarchy of Needs
 Masler(1954) believed in the self-
actualization theory that is the need to
understand the totality of a person.
 The needs are arranged in a hierarchy and
as one general type of need will
emerge.The desires from most basic
biologic needs to the more psychological
ones become important only after basic
needs have been satisfied.

41. Cognitive theory-Jean Piaget(1952)
 Child development according to Piaget
proceeds from an egocentric position
through a predictable stepwise expansion
and incorporation of learned experiences.
 Piaget’s theory explained that the children
think and acquire knowledge from
environment by a process of assimilation
and accommodation collectively termed as
adaptation.

42. Cognitive Theory
 Assimilation describes the ability of a
child to deal with a new problem ,for
example-learning a special skill,child falls
and tries to get up
 Accommodation enables him to adapt and
change his way of dealing/handling a
situation,child avoids falling.
 Through this dual processes,the child
develops a pattern of behavior called
schemata.

43. Cognitive Theory
 Piaget has explained 4 major periods of
cognitive growth characterized by
different type of thinking.
A.Sensorimotor period(birth to 18 months).
B.Pre-operational period-1)pre-conceptual
period-(18months-4yrs).
2)Intuitive period(4-7yrs).
C.Period of concrete operations(7-12yrs).
D.Period of formal operations(above 12yrs).

44. Sensorimotor Period
 During the first 2 years of life the
child develops from a newborn infant
who is almost totally dependant on
reflex activities to an individual who
can develop new behavior.

45. Pre-conceptual Period
 This stage marks the start of
symbolic activity.
 The child’s reactions are based not
simply on the physical nature of the
stimulus but on its meaning.

46. Intuitive Period
 Prelogical reasoning appears based on
preconceptual appearances
unhampered by reversibility.

47. Period of Concrete Operations
 This corresponds to elementary
school age of the child.The child’s
intelligence develops enormously due
to academic guidance.
 He classifies objects around him
according to shape,size etc.

48. Period of Formal Operations
 This is not an age related factor but due
to increased knowledge in the academic
level which gives them the ability for
abstract thinking and logical and
hypothetical reasoning.
 The person tries to use his knowledge and
find a solution for his problems and
predict the outcome for future events.

49. Applications of Piaget’s Theory
 CONSTRUCTIVISM
 COGNITIVE EQUILIBRIUM
 ANIMISM
 CENTERING
 EGOCENTRISM

50. Application of Piaget’s Theory
 Constructivism: Piaget theorized that a
child’s acquisition of reality is
accomplished by touching,exploring and
observing.The child in the dental setting
constructs his/her knowledge about the
unknown world of dentistry through
activities such as handling and working
with dental instruments,observing and
touching appliances and smelling various
materials

51. Application of Piaget’s Theory
 Cognitive equilibrium:knowledge acquired
by the child produces a state of balance
called cognitive equilibrium.
 This can be utilized by the dentist by
encouraging the child to acquire knowledge
about the dental instruments and
techniques.
 The dentist must use the curiosity of the
child to gain knowledge in developing a
positive dental attitude.

52. Application of Piaget’s Theory
 Animism: using Piaget’s principles,dental
instruments and materials may be given
life like names,example:a handpiece could
be referred as whistling barney.
 The principle of physiognomic properties
is a state wherein the child perceives that
inanimate objects take on the form and
emotions of human beings.This
phenomenon can be
effectively used because fantasy,play and
language when used repeatedly help the
child to become more comfortable.

53. ANIMISM
EUPHEMISMS ACTUAL WORD
Mr Whistle Hand piece
Mosquito bite Needle prick
Rain coat Rubber dam
Clip or button Rubber dam clamp
Tooth paint Sealant
Cavity Fighter Fluoride
Sleepy Juice Local Anesthetic
Vacuum cleaner Suction
Pudding Alginate

54. Application of Piaget’s Theory
 Centering:Piaget believed that a child
focuses on the most important
characteristics of what he/she sees
excluding everything else.
 During treatment the child can be given a
mouth mirror to look in.The child should
be directed to focus attention in the
mirror,watch the treatment and
concentrate on what is happening.

55. Application of Piaget’s Theory
 Egocentrism:Piaget believed that
children view the world in a self
centric manner.A child believes that
his/her point is the only right one.
 This can be put to practical purpose
in the dental clinic by making the
child feel more important.

56. Social Learning Theory
 Albert Bandura(1963).
 Learning of behaviour is affected by
four principle elements :
• Attention process
• Retention process
• Motoric reproduction
• Reinforcement and motivation

57. Application
 Children are capable of acquiring almost
any behaviour that they observe closely
and are too complex for them to perform at
the level of physical development.
 Observational learning is an important tool
in management of dental treatment.

58. Mahler’s Theory (1933)
 This theory categorizes the early childhood object
relations to understand personality development.
 the period of childhood is thus divided into : -
- Normal Autistic phase (0-1yr)
- Normal Symbiotic Phase (3-4wk t0 4-5
months)
- Separation-Individualisation Process (5 to 36
months)

59. CONCLUSION
The pediatric dentist is a
parent surrogate and can
discharge certain aspects
of the parent care to the
child as do the physician
and the teacher.
Therefore he needs to
understand several
dimensions of child
psychology and apply it to
the dental situation for
successful management
of the child in the dental
clinic.

60. THANK YOU

61. References
 Shobha Tandon – Textbook of Pedodontics, 2nd
Edition
 Child Taming : How To Manage Children in
Dental Practice - Barbara L Chadwick and
Marie Therese Hosey
 Nikhil Marwah- Textbook of Pediatric
Dentistry, 2nd Edition