This document discusses cognitive, emotional, and social development from childhood through adulthood based on theories from Freud, Erickson, and Piaget. It describes key stages of development including trust vs mistrust in infancy, autonomy vs shame and doubt in toddlers, initiative vs guilt in preschoolers, industry vs inferiority in school-aged children, identity vs role confusion in adolescence, intimacy vs isolation in young adults, and integrity vs despair in late adulthood. It also outlines Piaget's stages of cognitive development from sensorimotor to concrete to formal operational thought. Dental considerations are discussed for each developmental period.

1. COGNITIVE,
EMOTIONAL
&
SOCIAL
DEVELOPMENT OF
CHILD

2. LEARNING
&
DEVELOPMENT OF
BEHAVIOR

3. 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}

4. Classical conditioning
Operant conditioning
Observational learning

5. EMOTIONAL
&
COGNITIVE
DEVELOPEMNT

6. EMOTIONAL DEVELOPMENT
based 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.

7. 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.

8.  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.

9. The syndrome of maternal
deprivation - inadequate
maternal support.
infants fail to gain weight ,
retarded in their physical as
well as emotional growth. fig

10.  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.

11. 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.

12. 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.

13.  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.

14.  Complex dental treatment at
this stage is quite challenging
and may require extra-
ordinary behavior
management procedures as
sedation or general
anesthesia.

15.  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.

16. 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.

17. 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

18. 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.

19. For most children, the first visit to
the dentist comes during this stage
of initiative.

20. 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.

21. 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.

22.  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.

23. physical ability changes
academic responsibilities increase,
and career possibilities being to be
defined.
Members of the peer group
become important role models
values and taste of parents are
likely to be rejected.

24.  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.

25. 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

26. 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.

27. . A Person at this stage feels that a
change in their appearance will
facilitate attainment of intimate
relationship.

28.  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.

29.  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.

30. COGNITIVE
DEVELOPMENT

31.  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.

32.  Every individual in Piaget’s view,
adaptation occurs through two
complementary process, assimilation and
accommodation.

33.  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!”

34.  Intelligence develops as interplay between
assimilation and accommodation. From the
perspective of cognitive development
theory, life can be divided into four major
stages:

35.  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).

36.  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.

37.  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.

38.  Lack of Symbols
 Infants do not seen to carry around in
their heads the symbols or image of objects;
they have no representational ability.

39.  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.

40.  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.

41.  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.

42.  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

43.  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:

44.  “Brushing makes your teeth feel clean and
smooth,” and, “Toothpaste makes your
mouth taste good,”

45.  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.

46.  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.

47.  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.

48.  Concept of Centration
 Preoperational thought also focuses on a
single, striking feature of an object or event,
a tendency called centration.

49.  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.

50.  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.

51.  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.

52.  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.

53.  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.

54.  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.

55.  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.”

56.  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.

57.  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.

58. Nelson:
The Newborn
 Behavioral States. The organization of
infant behavior into discrete behavioral
states may reflect an infant's inborn ability
to regulate arousal. Six states have been
described: quiet sleep, active sleep, drowsy,
alert, fussy, and crying.

59.  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.

60.  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.

61.  Emotional Development. Basic trust, the
first of Erikson's 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.

62.  The emotional significance of any experience
depends on an individual child's temperament as
well as the parent's 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.

63.  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.

64.  Similarly, infants fed at the parents's 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.

65.  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.

66.  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.

67.  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.

68.  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.

69.  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.

70.  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

71.  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.

72.  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 examiner's back.

73.  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.

74.  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.

75.  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
parent's and older children is an important
mode of learning

76.  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.
