very well explained theories along with appropriate images. Hope it will be helpfull to you all.

1. PSYCHOLOGICAL
DEVELOPMENT OF CHILD
UPTO ADOLESCENCE
Dr. Rupali M Athawale
IInd MDS

2. DEFINITIONS Psychology = study of the soul
“Psyche” meaning “soul”
“Logos” meaning “Discourse”
WILLIAM JAMES : “It is the description & explanation of state of
consciousness as such”
WILLIAM WUNDT & his disciple EDWARD BRADFORD TITCHENER :
psychology as “the science of consciousness”
WILLIAM Mc DOUGALL : “ the science which aims to give us better
understanding and control of the behavior of the organism as a whole”
WALTER BOWERS PILLSBURY : Psychology as “the science of human
behavior”
MORGAN et al : “the systematic & scientific study of human and animal
behavior, including the application of the science to human problems

3. CHILD/ DEVELOPMENTAL PSYCHOLOGY
• It is a branch of Psychology, which deals with developmental
processes of Persons from conception onwards. It emphasizes
on processes of pre- postnatal growth & Maturation of behavior
• It is the science or study of child’s mind and how it functions. It is
also the science that deals with mental power or an interaction
between conscious and subconscious elements in a child (Shobha
Tandon)
• It is the science that deals with the mental power or an
interaction through conscious & subconscious element in a child
(Nikhil marwah)

4. 4 MAJOR PERSPECTIVES ON CHILD DEVELOPMENT
1. THE MECHANISTIC
2. THE ORGANISMIC
3. THE PSYCHOANALYTIC
4. THE HUMANISTIC

5. THE MECHANISTIC PERSPECTIVE
“ MECHANICAL MIRROR MODEL”
• It equates people with machines
• According to this humans react to what the environment makes
of them
• Change is seen as quantitative and development as continuous
• It focuses on how early experiences affect later behavior
• This view is held by Social Learning Theorists and Behaviorists

6. THE ORGANISMIC PERSPECTIVE
“ORGANIC LAMP MODEL”
• According to this humans initiate acts, change is inherent part of
life which is internal rather than external
• Change is qualititative and discontinuous
• Most prominent advocate of the organism world view is JEAN
PIAGET

7. THE PSYCHOANALYTIC PERSPECTIVE
• First developed by SIGMUND FREUD
• According to this people are neither active nor passive but
always in flux between the two states, always in conflict between
their natural instincts & constraints imposed upon them by
society
• Psychoanalytic theory of SIGMUND FREUD & ERIC ERIKSON
come under this

8. THE HUMANISTIC PERSPECTIVE
• This perspective sees people as having ability to take charge of
their lives and to foster their own development
• It emphasizes the individuals abilities to do this in healthy
positive ways through the distinctive human qualities of choice,
creativity, valuation and self-realization

9. THEORIES ON CHILD’S PSYCHOLOGICAL
DEVELOPMENT
PSYCHODYNAMIC THEORIES
THEORY OF COGNITIVE
DEVELOPMENT –
JEAN PIAGET
PSYCHOSEXUAL THEORY-
SIGMUND FREUD
PSYCHOSOCIAL THEORY-
ERIC ERIKSON
BEHAVIOURAL THEORIES
CLASSICAL CONDITIONING THEORY-
IVAN PAVLOV
OPERANT CONDITIONING THOERY-
B.F. SKINNER
SOCIAL LEARNING THEORY-
ALBERT BANDURA
HIERARCHY OF NEEDS-
MASLOW

10. JEAN PIAGET’S THEORY OF
COGNITIVE DEVELOPMENT
(1952)

11. JEAN PIAGET’S THEORY OF COGNITIVE
DEVELOPMENT (1952)
→actively construct their own cognitive words
→adapt thinking to include new ideas, because additional
information furthers understanding
• PIAGET explains many aspects of children’s thought and behavior
by considering them as going through definite stages
• Each stage represents a qualitative change from one type of
thought/behavior to another

12. • At each stage of development, individuals personal
representation of the world –Scheme- will become more
complex, more abstract and realistic
• 2 processes underline the individual’s construction of the world
 Organization
 Adaptation
PIAGET believed that we adapt in 2 ways:
ASSIMILATION: occurs when individual incorporate new information
into their existing knowledge (schemas)
ACCOMODATION :occurs when individuals adjust to new information

13. • Equilibration: The process by which people balance assimilation
and accommodation to create stable understanding

17. Piaget’s marked four stages of cognitive growth each
characterized by different type of thinking & each child relies
more upon internal stimuli
FORMAL OPERATIONAL STAGE (11-15 YRS)
CONCRETE OPERATIONAL STAGE ( 7-11 YRS)
PREOPERATIONAL STAGE (2-7 YRS)
SENSORIMOTOR STAGE (BIRTH-2 YRS)

18. SENSORIMOTOR STAGE (BIRTH-2 YRS)
• Infant changes from a creature who responds primarily through
reflexes to one who can organize his/her activities in relation to
the environment
• Sensori + motor = sensation + action
• Beginning  little more than reflexive
patterns with which to work
• End  2 year olds have complex sensorimotor patterns & begin to
operate with primitive symbols

19. Substages of sensorimotor stage
Stage 1 : use of reflexes (birth-1 month)
• Sucking, grasping, looking
Stage 2 : primary circular reactions(1-4 months)
• Thumb sucking
• Own body is center of attention
OBJECT PERMANANCE:
• In stages 1 & 2, a baby is constantly encountering, losing contact with
& re encountering objects
• But when something disappears, baby does not look for it
• It has ceased to exist when it cannot be seen, felt, heard, smelled or
tasted
• No sense that an object is permanent even when body doesnot
perceive it

20. Stage three: secondary circular reactions(4-8 months)
• Beginning of intentional actions
OBJECT PERMANANCE : Has partial object permanence, searches
for an object that is partly hidden and not fully hidden
Stage 4 : coordination of secondary circular schemes and their
application to new situation (8-11months)
• Coordination of schemes & intentionality
Stage 5 : tertiary circular reactions (12-18 months)
• Discovery of new means through active experimentation
• First stage to be concerned with novelty
OBJECT PERMANANCE: Infant has a scheme of permanent object
and follow a sequence of object displacements

21. Stage 6 : invention of new schemes through mental combination
(18-24months)
• Mental functioning shifts from a purely sensorimotor plane to a
symbolic plane
OBJECT PERMANANCE: Fully developed. Infant can now
understand visible and invisible displacements
DENTAL APPLICATION
Child begins to interact with
the environment and can be
given toys while sitting on
dental chair in his/her hand

22. PREOPERATIONAL STAGE (2-7YEARS)
• Transition period
• Represent world with words,
images & drawings
• Lack ability to perform “operations”
(Internalized mental actions that allow children
to do mentally what they previously did
physically)
• Highly egocentric & their thought lacks
generality
• Their reasoning is transductive &
illogical

23. "Three Mountain Task”
• A model of 3 mountains that have landmarks placed among them
• A child sits at one location in relation to the mountains, and a doll
sits at another location
• The experimenter then asks the child to describe what the doll
would see from its location
• Preschool children typically describe scene as they view it from
their own location
• Further, when given photographs depicting the views from each
location around the table, children select the photos showing view
from their own locations, not the doll’s
• In other words, children select views based on their own personal
& intuitive experience with scene
• They don’t yet take into account logical necessity that someone
viewing scene from a different place will have a different
perspective

25. • Preconceptual stage (2-4 yrs) : Symbolic activity
• Intuitive stage (4-7 yrs) : Prelogical reasoning appears based on
preconceptual appearances unhampered by reversibility

27. DENTAL APPLICATION
Constructivism : Child likes to explore
things & make own observations. Eg. child
surveys dental chair, airway syringe
Cognitive equilibrium : Child is explained
about equipment or instrument & allowed
to deal with it
Animism : Child correlates with other
objects which they are used to or
accustomed. Eg. Radiograph as tooth picture

28. CONCRETE OPERATIONAL STAGE (7-11 YEARS)
• Grasps concept of reversing & expands
beyond centering & egocentricity
• Conservation, i.e. objects are not altered
in number, volume or size simply because they are reshaped or
rearranged

29. DENTAL APPLICATION
• Concrete instructions like this is
retainer, brush like this etc
• Abstract instructions like wear
retainer every night & keep clean
• Centering : allowed to hold mirror to
see what is being done on his teeth
• Ego-centrism : Child has achieved
level of understanding & gets involved
in treatment Eg. Holds suction tip by
himself

30. FORMAL OPERATIONAL STAGE
(11-15 YEARS)
• Child becomes capable of
solving complex & abstract
problems
• Formulate & test hypotheses
within the laws of scientific
method
DENTAL APPLICATION
• Esthetic & corrective dental
treatment , orthodontic appliances
& braces

31. Two major changes occur in this stage :
• Develop ability to use hypothetico-deductive reasoning
• They extend their logical thinking to concepts that are abstract (no
longer solely to materials that are concrete and tangible)
 Hypothetico-deductive reasoning :
• Use of deductive reasoning (reasoning from general principles to
particular conclusions) to systematically manipulate several
variables, test their effects in a systematic way & reach correct
conclusions
• In his famous pendulum problem, children & adolescents of
different ages were given a set of weights & strings of different
lengths

32. • Weights could be hung from the strings and swung like pendulums

33. • Adolescents using formal operations, however, start by
considering all of the variables and all of their possible
combinations, reasoning that any one factor could be responsible
for the pendulum’s rate of oscillation
• They then systematically test each factor one at a time, holding
the other factors constant, until they arrive at the correct solution
• The adolescent shows hypothetico-deductive reasoning, or
formal scientific reasoning—the ability to plan systematic tests to
explore multiple variables

34. • Abstract thought
• Thought about things that are not real or tangible, or things that
are only possibilities
• When solving problem, adolescents took as their starting point all
possible solutions; this allowed them to reach an accurate solution
efficiently
• Leads adolescents to spend extraordinary amounts of time
speculating on all possible outcomes of seemingly simple actions
• Adolescent also learns to think logically about such abstract
concepts as truth, justice, fairness, and morality

35. • Although adolescents are learning formal logical thought &
abstract reasoning, Piaget observed that adolescents still show a
level of immaturity
• ADOLESCENT EGOCENTRISM - young person’s inability to
distinguish between his or her own abstract reasoning & thoughts
and those of other
A cognitive immaturity seen in adolescents—their inability to
distinguish between their own abstract reasoning and thoughts
and those of others

36. • 2 particular forms of adolescent egocentrism
1) Imaginary audience
• Adolescents believe that other people are just as concerned
with their behavior, feelings, and thoughts as they are
themselves -- > leads to a sometimes excruciating degree of self-
consciousness
• Many adolescents feel “on stage,” as if everyone else were
noticing every embarrassing thing they do
2) Facet of personal fable
• Adolescents tend to believe that they & their newly abstract
thoughts are unique, invulnerable
• Often they believe that no one has ever thought about issues in
same way they do, and that no one else (especially parents!)
could ever understand the way they feel

37. • With achievement of hypothetico-deductive reasoning & abstract
though, with eventual decline of adolescent egocentrism, young
adults gradually attain what Piaget considered mature cognition
• They become able to reason about anything, real or imagined,
and have capability to use scientific reasoning to solve complex
problems
• On the contrary, Piaget claimed that we never reach a permanent
state of equilibrium
• He believed that we are forever adapting & reorganizing our
cognitive structures and working “toward better equilibrium

39. THE PSYCHOSEXUAL THEORY /
PSYCHOANALYTIC THEORY -
SIGMUND FREUD (1905)

40. THE PSYCHOSEXUAL THEORY / PSYCHOANALYTIC
THEORY -SIGMUND FREUD
Sigmund Freud (father of psychodynamic theories & founder of
psychoanalysis)
 Topographic Model
• Conscious mind
• Preconscious mind
• Unconscious/
subconscious mind

41.  Psychic Model/ triad
1) The id (birth)
- Strives for immediate
pleasure & gratification
2) The ego (2-6 months)
- delays, modifies & control
id impulses on a realistic
level
3) The super ego
- prohibition learned from
environment
- internalized control which
produces feeling of shame
& guilt

45. • Ego deals with demands of reality, id and superego
• But when anxiety becomes overwhleming, ego must defend
itself
• It does so by unconsciously blocking impulses or distorting
them into more acceptable, less threatening form
• These techniques are known as EGO- DEFENCE
MECHANISMS

47. ORAL STAGE
• Age : 0-1.5 yrs
• Erogenous zone in focus : mouth
• Gratifying activities : nursing, eating,
mouth movements such as sucking,
biting, swallowing
Interaction with environment :
• For infant, mother’s breast not only is the source of food & drink but
also represents her love
• As child’s personality is controlled by ID, they demand immediate
gratification
• Responsive nurturing is the key
• Both insufficient & forcefull feeding result in fixation
Symptoms of oral fixation : Smoking, nail bititng, drinking, sarcasm

48. ANAL STAGE
• Age : 1.5 – 3 yrs
• Erogenous zone in focus : Anus
• Gratifying activities : Bowel movement
& withholding of such movement
Interaction with environment :
• Toilet training, a process through which children are taught when,
where & how excretion is deemed appropriate by society
• Start to notice pleasure & displeasure associated with bowel
movements through toilet training
• By exrecising control over retention & expulsion of feces a child
can choose to either grant or refuse parent’s wishes

49. Symptoms of anal fixation
Anal- expulsive personality :
• If parents fail to instill society’s rule about bowel movement
control, child will derive pleasure & succes from expulsion
• Individuals with a fixation on this mode of gratification are
excessively sloppy, disorganized, reckless, careless, defiant
Anal – retentive persoanlity :
• If a child receives excessive pressure & punishment from
psrents during toilet training, he will experience anxiety during
bowel movements & hence withhold such functions
• Individuals with such fixation are clean, orderly, intolerant to
those who are not clean

50. URETHRAL STAGE
• Age : 3-4 yrs
• Erogenous zones : Transitional stage between anal & phallic
• Gratifying activities : Pleasure in urination
Interaction with environment :
• Urethral erotism – pleasure in urination, as well as pleasure in
urethral retention analogus to anal retention
• Predominant urethral trait is that of competitiveness & ambition,
prbably related to compenation for shame due to loss of urethral
control

51. PHALLIC STAGE
• Age : 4-5 yrs
• Erogenous zone in focus : Genitals
• Gratifying activities : Genital fondling
Interaction with environment :
• Key event is the child’s feeling towards the parent of opposite sex
together with envy & fear of same sex parent
Symptoms of phallic fixation :
Men : anxiety & guilty feelings about sex fear of castration &
narcissistic personality
Women : It is implied that women never progress past this stage
fully & will always maintain sense of envy & inferiority but there
are no possible fixations resulting from this stage

52. Oedipus complex
Greek mythology : Oedipus (king of
thebe) unwitingly slew his father &
married his mother
Electra complex
Greek mythology : Electra helped her
brother slay the lover of their father
Agamemnon, in order to win father’s love
PHALLIC STAGE

54. LATENCY STAGE
• Age : 5yrs – puberty
• Erogenous zone in focus : None
Interaction with environment :
• In this period, sexual feelings are supressed to allow children to
focus their energy on other aspects of life
• Much of child’s energy chanelled into developing new skills &
acquiring new knowledge, play becomes largely confined to other
children of same gender
• Fixation : Demonstrates sexual sublimation & repression

55. GENITAL STAGE
• Age : Puberty onwards
• Erogenous zone in focus : Genitals
• Gratifying activities : Heterosexual relationships
Interaction with environment :
• 3 major sorces of sexual arousals during this period:
 Memories & sensations from earlier childhood periods
 Physical manipulation of genitals
 Hormonal secretions
• In particular, targets of sexual arousal lie outside tiny circle of
self & family

56. PSYCHOSOCIAL THEORY – ERIC
ERIKSON (1963)

57. PSYCHOSOCIAL THEORY – ERIC ERIKSON (1963)
• Eric Erickson extended the Freudian concept of ego
• Development functions by EPIGENETIC principle
we develop through a predetermined unfolding of our personalities
in 8 stages, each of which depends on successful resolution of a
turning point or crisis
Freud and Erikson – assumptions :
• Development depends on child’s instincts & responses around him
• Unresolved issues from early stages of life affect person’s ability to
deal with subsequent stages
• Erikson elaborated Freud's genital stage into adolescence plus 3
stages of adulthood
• Describes emotional development across the life span

59. STAGE I (0-1 YEARS) : TRUST Vs MISTRUST (HOPE)
ORAL SENSORY STAGE

60. DENTAL APPLICATION
• Separation anxiety
• To provide dental t/t, it is preferable to do with parent
present & preferably with parent holding the child
• All stages of life, ration between two should be maintained
• Once the child loses basic trust with world, it is very difficult
to gain confidence of child & require special efforts to
establish support with dentist and staff
TASK : To develop trust without completely eliminating the capacity
for mistrust

61. STAGE II (2-3 YEARS): AUTONOMY Vs SHAME & DOUBT (WILL)
Autonomy vs Shame & doubt
If parents permit child to explore & manipulate his or her environment --
autonomy /independence
 Parents should not discourage child, but neither should they push. "firm
but tolerant"
Selfcontrol and self-esteem
If parents give unrestricted freedom & no sense of limits, or if you try to
help children do what they should learn to do for themselves, you will
also give them impression that they are not good for much
preserve
be
ANAL-MUSCULAR STAGE

62. TASK: To achieve a degree of autonomy while minimizing shame
& doubt
DENTAL APPLICATION
• Child is running away from mother, but still he will retreat to
her in threatening situations
• Parent’s presence is essential in dental clinic
• Child takes pleasure in doing tasks by himself
• Dentist must obtain cooperation from him by making him
believe that t/t is his choice ot of dentist/ parent

63. STAGE III (3-6 YEARS): INITIATIVE Vs GUILT (PURPOSE)
GENITAL-LOCOMOTOR STAGE

64. TASK : To learn initiative without too much guilt
• Extreme form of ruthlessness = SOCIOPATHY
• Erickson also includes the oedipal experience in this stage
• On the sexual , oedipal side, the inhibited person may be
impotent or frigid
DENTAL APPLICATION
• Child can be encouraged to view this visit as a new adventure &
encouraged to genuine success in it
• If this visit fails it can lead to sense of guilt in child
• He is inherently teachable at this stage & so can be taught about
various things in dental setup
• Independence has to be reinforced rather than dependence

65. STAGE IV (7-12YEARS): INDUSTRY Vs INFERIORITY
Hard working,
sacrifying play for work
Ridiculed or punished
for lack of ability

66. TASK : To develop a capacity for industry while avoiding an excessive
sense of inferiority
• If allowed too little success, because of harsh teachers or
rejecting peers then a sense of Inferiority or Incompetence
• Additional sources of Inferiority- Racism, Sexism and other forms
of Discrimination
• Balance of industry with just a touch of inferiority to keep us
sensibly humble  COMPETENCY

67. DENTAL APPLICATION
• Child drive for sense of industry & accomplishment,
cooperation with t/t can be obtained
Cooperation depends on
• whether she/he understands what is needed to please
dentists/ parents
• whether peer group is supportive
• whether desired behaviour is reinforced by dentist

68. STAGE V (12-18 YEARS): IDENTITY Vs ROLE CONFUSION (LOYALTY)
Lack of Identity
Knowing “who you are and how you fit in to the rest of society”
 It requires to take all that has been learnt about life & one-self be
molded into unified self image, one that the community finds meaningful
• An uncertainty about one’s place in society world
• When an Adolescent is confronted by Role confusion, he is suffering
from Identity Crisis

69. TASK: To achieve ego identity and avoid role confusion
• Too much Ego identity  Fanatism (person is so involved in a
particular role in a particular society or subculture that there is no
room for tolerance)
DENTAL APPLICATION
• Behavior management is challenging
• Any orthodontic t/t should be carried out if child wants it & not
the parents as at this stage parental authority is being rejected
• Approval of peer group is very important

70. STAGE VI (the 20’s): INTIMACY Vs ISOLATION

71. TASK : To achieve some degree of intimacy as opposed to remaining in
isolation
DENTAL APPLICATION
• External appearances are very important as it helps in
attainment of intimate relation
• These young adults seek orthodontic t/t to correct their
dental appearances, characterized as internal motivation
• But alteration of appearances can also interfere with
previously established relations, so t/t options must be fully
explained & discussed with young adults

72. STAGE VII (Mid 20’s & Late Fifties) GENERATIVITY Vs STAGNATION
Establishing & guiding
next generations
Dissatisfaction with lack
of personal productivity

73. STAGE VIII (50’s & beyond) INTEGRITY Vs DESPAIR
I’ve had a successful life When old people become
preoccupied with past
experiences

74. • Last stage, late adulthood or maturity or less delicately as old age
• In Erickson’s theory, reaching this stage is a good thing & not
reaching it suggests that earlier problems have retarded development
TASK: To develop ego integrity with a minimal amount of despair
1. Detachment from society, from a sense of usefulness for most
people
2. There is a sense of biological uselessness, as the body no longer
does everything it used to
3. Along with illnesses come concerns of death
• Erickson calls it a gift to children, because “healthy children will not
fear life if their elders have integrity enough to fear death”

76. TO BE CONTINUED ….

77. BEHAVIORAL
THEORIES

78. CLASSICAL CONDITIONING
THEORY-
IVAN PAVLOV

79. Learning is a relatively permanent change in an organism’s
behavior as the result of experience
• New information (for exams)
• New skills – Sports – Vocational
• Hobbies and Interests – Gambling
• Fears
• Rituals, behavioral predispositions (personality?)
• Beliefs
• Values
• Social behavior (how to behave among others)
• Attitudes, stereotypes, prejudices

80. • We learn by association
• Simple process of Association of one stimulus with another
• Our minds naturally connect events that occur in sequence
• 2000 years ago, Aristotle suggested this law of association. Then
200 years ago Locke and Hume reiterated this law
• Conditioning process involves presenting neutral stimulus &
unconditional stimulus at same time & repeating this many
times. More the repetitions, stronger the conditioning

81. Neutral Stimulus : A stimulus that before conditioning has no effect
on desired response

84. • A review of Dental Literature reveals that uncooperative
behavior in dental setting is most typically attributed to
Behavioral manifestation of Anxiety & Fear
• Association b/w Medical-Dental atmospheres & anxiety can be
explained acc to principles of Classical Conditioning
• Each time child encounters a new stimulus, a surprise reaction
called Orienting Reflex will take place
• Orienting Response: Alerting response, indicates that the baby is
paying attention to some stimulus
• Another important influence is State. Babies are Conditioned
more easily when they are sleeping quietly than when they are
restless

86. PRINCIPLES INVOLVED IN CLASSICAL CONDITIONING
1) Generalization :
• Wherein process of conditioning is evoked by band of stimuli
centered around a specific conditioned stimulus
Eg. Child who had painfull experience with doctor in white coat
will always associate with any doctor in white coat with pain
• Treatment that might produce pain should be avoided if at all
possible in the first visit
2) Acquisition :
• Learning a new response from environment by conditioning

87. 3) Extinction :
• If the association b/w conditioned & unconditioned stimulus is
not reinforced, the association b/w them will become less
strong & eventually conditioned response will no longer occur
Eg. In a fearful child, subsequnt visits to doctor without any
unpleasant experience results in extinction of fear
4) Discrimination :
• Opposite of Generalization
• If a child is taken into a dental office where painful injections are
not necessary, discrimination b/w the two types of office will
soon develop and generalized response to any office as place
where painful things occur will be extinguished

88. DENTAL APPLICATION
FIRST VISIT WHITE COAT → PAIN OF INJECTION
(Neutral stimulus) (Unconditioned Stimulus)
PAIN OF INJECTION → FEAR & CRYING
(Unconditioned Stimulus) (Response)
SECOND VISIT SIGHT OF WHITE COAT PAIN OF INJECTION
(Conditioned Stimulus) (Unconditioned Stimulus)
PAIN OF INJECTION FEAR & CRYING
Sound of Handpiece & sight of dentist
If individuals in white coats (neutral stimulus) give painful
injections (unconditioned stimulus) that cause crying (response),
then the sight of an individual in white coat (now a conditioned
stimulus) will provoke crying despite absence of painful procedures

89. OPERANT CONDITIONING
THEORY
–B.F.SKINNER

90. • Significant extension of Classical Conditioning
• Most complex human behaviors can be explained by OPERANT
CONDITIONING
OPERANT CONDITIONING relies on 3 main principles:
1. Operant Behaviors are the behaviors that are voluntary & not
reflexive
2. Consequence of a behavior is itself a stimulus that affects future
Behavior
3. Behaviors not expressed by subject can be taught –
Behavior Shaping
Building a response by reinforcing its components in a step-by-step manner

91. 1. Positive
Reinforcement
2. Negative
Reinforcement
3. Omission
4. Punishment

92. 1.Positive Reinforcement
If a pleasant consequence follows
a response, response has been
positively reinforced
Behavior that led to this pleasant
consequence becomes more likely
in future
EXAMPLE: If a child is given a reward such as toy for behaving
well during her first visit, she is more likely to behave well
during future dental visits; her behavior was positively reinforced

93. 2.Negative Reinforcement
Involves withdrawal of an unpleasant
stimulus after a response
EXAMPLE: If behavior considered unacceptable by dentist
succeeds in allowing child to escape from dental treatment,
that behavior has been negatively reinforced & is more
likely to occur next time when child is in dental office

94. 4. Punishment3. Omission/ time out
Involves removal of
pleasant stimulus after
a particular response
EXAMPLE: If a child who throws a
temper tantrum has his favorite
toy taken away for a short time or
sending mother out of operatory
as a consequence of this behavior,
probability of similar misbehavior
is decreased
Example: Use of palatal
rake in correction of
Tongue Thrusting habit,
Voice control
Involves introduction of
an aversive stimulus into
a situation to decrease
the undesirable behavior

97. • In Dental practice only desired behavior should be reinforced &
undesirable behavior should be avoided
Types of Reinforcers
1) Unlearned Reinforcers : Behavioral consequences which perform
exactly as one might expect them to do (Eg.food, candy & toys)
2) Token Reinforcers : Items which can be collected & later
exchanged for a desired event (Eg. Points, stars etc)
• Some dentists have used token reinforcers in habit therapy. This
approach can be successful if parents are reliable in acting as
assistants in monitoring the frequency of habit occurrence. As
frequency decreases, some form of token is given to child. At
predetermined levels of improvement, the child can trade his
tokens for a previously agreed upon reinforcement

98. 3) Activities : Which the child enjoys can also be used as reinforcers
i.e. if the child does as desired then he may do what he desires
• Historically parents universally have used this kind of bartering
systems reinforcement
EXAMPLE: “Finish your homework and then you may play”
4) Social Reinforcers : Involves personal behavior toward child
EXAMPLE: Giving attention, words of praise, smiling
• These reinforcers are readily available & they are powerful

99. Clinical Implications
• Positive & Negative reinforcement - motivating orthodontic
patients who must cooperate at home even more than in
dental office
• Older children - susceptible to Positive reinforcements
• Negative reinforcement, more difficult to utilize as a
behavioral management tool in dental office, but it can be
used effectively if circumstances permit
Example: Treatment which requires long bonding & banding
appointments may go more efficiently and smoothly if the
child understands that his helpful behavior has shortened
procedure & reduced possibility that procedure will need to
be redone

100. • Omission & Punishment must be used sparingly. Since a
positive stimulus is removed, the child may react with
anger, frustration
• Punishment can lead to classically conditioned fear
response
• “Voice Control” is a mild of punishment. Firm voice to
gain child’s attention should be used with care & child
should be immediately rewarded for improvement in his
behavior

102. SOCIAL LEARNING THEORY-
ALBERT BANDURA (1963)
• Emphasizes the importance of observing and modeling behaviors,
attitudes, emotional reactions of others
• Most human behavior is learned observationally through
modeling : from observing others one forms an idea of how new
behaviors are performed, & on later occasions this coded
information serves as a guide for action
• Observational Learning is also known as Imitation/Modeling

107. Attention :
• First component of observational
learning
• Individuals cannot learn much by
observation unless they perceive &
attend to significant features of
modeled behavior
Retention
• To reproduce modeled behavior,
individuals must code information
into long term memory
• Simple verbal description of what
model performed would be known as
Retention
• Memory is an important cognitive
process that helps observer code &
retrieve information

108. Motor Reproduction
• Observer must learn & posses
physical capabilities of
modeled behavior
Motivation
• Final Process in observational
learning
• Observer expects to receive
positive reinforcement for
modeled behavior

109. Effects of Modeling on Behavior
• Teaches new behavior
• Influences frequency of previously learned behaviors
• May encourage previously forbidden behavior
• As a behavior shaping technique, basic Modeling procedure
involves allowing a patient to observe 1/more individuals who
demonstrate appropriate behaviors in a particular situation
• Patient will frequently imitate model’s behavior when placed in a
similar situation

110. DENTAL APPLICATION
Whether a child will actually perform an acquired behavior
depends on several factors:
1. Characteristics of Role Model
• If the model is liked or respected, the child is more likely to
imitate him/her. For this reason, a parent or older sibling is
often the subject of imitation
2. Expected consequences of Behavior
• If the child sees that his older sibling is being rewarded for his
behavior he is more likely to imitate him
3. Motor ability to reproduce the Model’s behavior
• Research has demonstrated that one of the best predictors of
how anxious a child will be during dental treatment is how
anxious the mother is

111. HIERARCHY OF NEEDS
- ABRAHAM MASLOW
(1943)

113. • As long as these needs are satisfied, we are moving towards
growth & self-actualization. Blocking gratification makes us sick or
evil
Physiological Needs
• Basic needs - air, water, food, sleep etc
• If not satisfied  irritation, pain, discomfort etc
• These feelings motivate us to alleviate them as soon as possible
to establish homeostasis
• A lack of one of these will affect the stability, growth, and ability
of an individual
• Once satisfied, focus changes to other things

114. Safety Needs
• Protection, stability, pain avoidance, etc
• Establishing stability and consistency in a chaotic world. These
are Psychological in nature
• If unsatisfied, the person gets stuck to this level
Love Needs
• Humans need to feel loved by others and to be accepted by
others
• Looked at negatively, an individual becomes increasing
susceptible to loneliness and social anxieties

115. Esteem Needs : Two types
• Self Esteem: results from competence or mastery of a task
• Attention & Recognition
• Love & esteem - needed for the maintenance of health
• Motivation - constantly required and is a never ending, fluctuating
complex present in almost all organisms
• Pain avoidance, tension reduction & pleasure act as sources of
motivating behavior
• The negative version of these needs is low self-esteem and
inferiority complexes

116. • Preceding 4 levels Maslow  DEFICIT NEEDS OR D-NEEDS
• If you don’t have enough of something -- i.e. you have a deficit --
you feel the need
• But if an individual obtains all he/she needs in these four areas,
they feel nothing at all
• In other words, they cease to be motivating
• These needs are no longer motivational or “salient needs

117. • Homeostasis is the principle by which your furnace thermostat
operates : When it gets too cold, it switches the heat on
• When it gets too hot, it switches the heat off
• For individuals, if their body develops a hunger for it & gets enough
of it, then hunger stops
• Extends homeostatic principle to needs : safety, belonging, esteem
• When you are managing individuals, you have to realize that for
every action there will be a reaction by involved individual
• Under stressful conditions, or when survival is threatened,
individuals “regress” to a lower need levels
• When an individual you are managing has their career fall flat, they
will seek out a little attention. Give them the help & support that
they need

118. SUMMARY
• PSYCHODYNAMIC THEORIEs
1) THEORY OF COGNITIVE
DEVELOPMENT – JEAN PIAGET
• Environment does not shape
child behavior but the child &
adult actively seek to understand
environment
• Assimilation + accomodation +
equilibration

119. 2) PSYCHOSEXUAL THEORY-
SIGMUND FREUD
• Attempted to explain
personality & psychological
disorders in an individual by
understanding mind at
different levels
• Personality is to originate as a
result of satisfaction of set of
instinct out of which sexual
instinct was most important

120. 3) PSYCHOSOCIAL THEORY -
ERIC ERIKSON
• Described 8 stages of lifecycle
which are marked by internal
crisis defined as turning
points/ periods
• Each stage demands
resolution before next stage
can be satisfactorily
negotiated

121. BEHAVIOURAL THEORIES
1) CLASSICAL
CONDITIONING
THEORY- IVAN PAVLOV
• Demonstrated how
learned associations
were formed by various
events in an organism’s
environment
• These learned
associations form the
basic building blocks of
entire learning process

122. 2) OPERANT CONDITIONING
THOERY- B.F. SKINNER
• Individual’s response is
changed as a result of
reinforcement or
extinction of previous
responses
• Hence, satisfactory
outcome will be repeated
while unsatisfactory
outcomes will diminish in
frequency

123. 3) SOCIAL LEARNING THEORY-
ALBERT BANDURA
• Most human behavior is
learned observationally
through modeling : from
observing others one
forms an idea of how new
behaviors are performed,
& on later occasions this
coded information serves
as a guide for action
• Attention + retention +
reproduction + motivation

124. 4) HIERARCHY OF NEEDS-
MASLOW
• Based on totality of
personality development
• Needs are arranged in
hierarchy
• Desires from most basic
biologic needs to more
psychological ones become
important only after basic
needs have been satisfied

125. The importance of Child psychology
• Know the child patients better
• Understand the behavior problem psychologically
• Deliver dental services in a meaningful and effective way
• Establish effective communication and gain confidence of the child
and the parent
• Produce a comfortable environment for the dental team to work on
the patient
• Teach the parent and the child, the importance of primary and
preventive care

126. CONCLUSION
“The dentist who fails to attend to the psychological needs of a child will
soon deal with an uncooperative patient”
- David C Johnsen
• Children should not be studied as embryonic adults, but in their essential
child nature so as to understand their capacities and know how to deal with
them
• A basic knowledge of child management is of importance to the dentist not
only in solving acute treatment problems, but also in developing the adult
patient of tomorrow. The child’s early dental experiences will often be
reflected in his adult attitude towards dentistry
• Hence every dentist should know the emotional with social behaviour to
expect from children in different age groups with also be able to
communicate on a level consistent with the child’s view of the world for the
successful management of the child in the dental clinic

127. THANK YOU