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Child psychology 5

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Child psychology 5

  1. 1. Good morning
  2. 2. TOPIC PSYCHOLOGICAL DEVELOPMENT FROM BIRTH TO ADOLESCENT INCLUDING PSYCHOLOGICAL DISORDERS AND CHILD ABUSE AND NEGLECT Dr. SNEHARAJ. N P. G. STUDENT
  3. 3. CONTENT • Introduction • Importance of studying child psychology • Classification Of Theories Of Psychology • Psychoanalytic theory or psychosexual theory by Sigmund Freud • Psychosocial theory or Erikson’s model of Personality development Cognitive development theory by Jean Piaget • Classical conditioning by Ivan Pavlov • Operant conditioning by B.F. Skinner • Social or Observational learning by Albert Bandura
  4. 4. Other relevant theories o Separation-Individuation theory by Margaret S Mahler o Theory of Hierarchy of Needs by Abraham Maslow • Psychological development from birth to adolescent • Psychological disorders • Child abuse and neglect
  5. 5. INTRODUCTION • In the 19th century the worth of Darwin on the principle of natural evolution focused the scientists interest on human development • Darwin emphasized the importance of adjustment to the continuing survival of an organism • Thus laid the ground work for the concept of psychological adjustment
  6. 6. DEFINITIONS • Psychology – a branch of science dealing with human and animal behavior and related mental processes • Child psychology – is the science that deals with the mental power or an interaction through the conscious and sub conscious element in child
  7. 7. AIMS OF CHILD PSYCHOLOGY • Understanding the child and deal with them more effectively and efficiently • Better planning and interaction between treatment plan • To identify problems of psychosomatic origin • To train child so that he understands his own oral hygiene • Helps modify child developmental process
  8. 8. Psychoanalytic theory & psychosexual theory by Sigmund Freud
  9. 9. 3 parts 1) Theory of structure of personality Id, Ego, Superego 2) Theory of personality dynamics Conscious, Unconscious and ego defence mechanism 3) Theory of psycho sexual development Motives- Child at different stages of growth
  10. 10. Psychic triad Das Es Das Ich Das uber-Ich The It The I Over I
  11. 11. ID • Primitive part • Pleasure principle • Bridled by ego
  12. 12. EGO • Reality principle • Thinking skills • Socially acceptable way
  13. 13. Super ego • Conscience • Right & wrong • Moral principle
  14. 14. Personality dynamics
  15. 15. • Eg: Fraulein Elisabeth Von R
  16. 16. Defense Mechanism Includes • Denial • Repression • Regression • Displacement • Sublimation • Projection • Intellectualization • Rationalization • Reaction formation
  17. 17. DENIALDENIAL I FEEL SO GOOD! Denying to existence of the threatening situation.
  18. 18. • Motivating to forget • Burying the threatening situation
  19. 19. REGRESSION • Baby talk • In face of threat one may retreat to an earlier pettern of adaptation, possibly childish behavoiur
  20. 20. DISPLACEMENT It is the redirection of an impulse onto a substitute target
  21. 21. SUBLIMATION It consists of a redirection of sexual impulses to socially valued activities and goals
  22. 22. PROJECTION Blaming others or It is a way of coping with one,s unwanted motives by shifting them to someone else.
  23. 23. Intellectualization • Similar to rationalization, involves reasoning. • Intensity of anxiety is reduced by a retreat into detached, unemotional, abstract language
  24. 24. RATIONALIZATION • Substitutes an acceptible conscious motive for an unacceptable unconscious one • We make excuses, giving a reason different from the real one for what we are doing • Its not lying
  25. 25. Reaction formation • Reversal of motives is another method by which people attempt to cope with conflict • A motive that would arouse unbearable anxiety if it were recognized is converted into its opposite.
  26. 26. Defense Mechanisms
  27. 27. PSYCHOSEXUAL STAGE
  28. 28. THE ORAL STAGE (0 - 1½ Y)
  29. 29. Anal expulsive personality Anal retentive personality
  30. 30. THE PHALLIC STAGE (3-6Y)
  31. 31. THE LATENCY STAGE (8-13Y)
  32. 32. THE GENITAL STAGE ( 11-13Y)
  33. 33. ERIK HOMBURGER ERIKSON (1902-1994)
  34. 34. What does Psychosocial Means? Stages of a person’s life from birth to death are formed by social interaction with a physically and psychologically maturing organism “Mutual fit between individual and environment” First 4 stages are seen during infancy and childhood 5th stage during adolescence Last 3 stages during adult years up to and including old age
  35. 35. DEVELOPMENT OF BASIC TRUST (BIRTH – 18 MONTHS) hope• Oral stage of Freud’s psychoanalytical theory • Trust Vs. Mistrust • Maternal deprivation syndrome • Separation anxiety • Extremely frightened and uncooperative Developed through consistent love and support
  36. 36. Autonomy Vs Doubt ( 18 month to 3 yr) will power • Terrible two’s • Individual identity • Being little Angel and devil • Toilet training • General anesthesia Independence fostered by support and encouragement
  37. 37. Initiative Vs Guilt ( 4-5 yrs) purpose The child becomes curious and moves around into new spaces to explore The child learns to play with others A child who is not allowed to take initiative will feel guilty and fearful Developed by exploring and accepting challenges
  38. 38. Industry vs inferiority • Competency A child develops a need to do things well, work, and to provide in the future. School and peers are important in assisting the child in his or her mastery over tasks. If a child fails to achieve a sense of mastery, he or she will feel inferior and incompetent. Mastery comes from success and recognition
  39. 39. Identity Vs Role confusion (12-17 yrs) fidelity An adolescent begins to create his or her own identity and integrate the various components of him or herself into a whole person. An adolescent who is unable to integrate will experience role confusion. Exploration of different paths to attain a healthy identity
  40. 40. Intimacy vs isolation • love The individual learns to build reciprocal relationships with others socially, sexually, and occupationally. Individuals who do not build these relationships will feel isolated Form positive, close relationships with others
  41. 41. Generativity vs stagnation • care The individual develops the capacity to care and nurture. An individual who fails at this stage will focus only on caring for him or herself Transmitting something positive to the next generation
  42. 42. Ego integrity vs despair • Wisdom • Life review and retrospective evaluation of one’s past The individual learns to accept his or her own life achievements and those of significant others. If the individual fails at this, he or she will experience despair.
  43. 43. FREUD v/s ERIKSON May 6, 1856- 23 Sep, 1939 15 Jun, 1902- 12 May, 1994
  44. 44. Approximate Ages Freud's Stages of Psychosexual Development Erikson's Stages of Psychosocial Development Birth to 1 year Oral Stage A child's primary source of pleasure is through the mouth, via sucking, eating and tasting. Trust vs Mistrust Children learn to either trust or mistrust their caregivers.
  45. 45. 1-3 years Anal Stage Children gain a sense of mastery and competence by controlling bladder and bowel movements. Autonomy vs. Doubt Children develop self- sufficiency by controlling activities such as eating, toilet training and talking
  46. 46. 3-6 years Phallic Stage The libido's energy is focused on the genitals. Children begin to identify with their same-sex parent. Initiative vs. Guilt Children begin to take more control over their environment.
  47. 47. 7-11 years Latent Period The libido's energy is suppressed and children are focused on other activities such as school, friends and hobbies. Industry vs Inferiority Children develop a sense of competence by mastering new skills.
  48. 48. Adolescence Genital Stage Children begin to explore romantic relationships. Identity vs Role Confusion Children develop a personal identify and sense of self.
  49. 49. Adulthood According to Freud, the genital stage lasts throughout adulthood. He believed the goal is to develop a balance between all areas of life. Intimacy vs Isolation Young adults seek out romantic love and companionship. Generativity vs Stagnation Middle-aged adults nurture others and contribute to society. Integrity vs Despair Older adults reflect on their lives, looking back with a sense of fulfillment or bitterness.
  50. 50. Cognitive development theory
  51. 51. PIAGET’S VIEW OF COGNITIVE DEVELOPMENT • Schemes • Adaptation • Accomodation • Assimilation • Equilibration.
  52. 52. STAGES OF COGNITIVE DEVELOPMENT
  53. 53. Stage 1: Sensorimotor Though (birth-2 years) Babies are stuck in the HERE AND NOW world they “know the world only in terms of their own sensory input (what they see, smell, taste, touch, and hear) and their physical or motor actions on it (e.g. sucking, reaching, grasping)
  54. 54. www.indiandentalacademy.com
  55. 55. Preoperational Period: • During the preoperational stage, the capacity develops to form mental symbols representing things and events not present, and children learn to use words to symbolize these absent objects. For Eg: • To an adult, the word “coat” refers to a whole family of external garments that may be long or short, heavy or light, and so on. • To a preoperational child, however, the word “coat” is initially associated with only the one he or she wears, and the garment that daddy wears would require another word.
  56. 56. • Concrete nature of the process and hence, the concrete or literal nature of their language. • children understand the world in the way they sense it through five primary senses. • Concepts that can not be seen heard smelt, tasted or felt for example time and health. • Children use and understand language in a literal sense.
  57. 57. Egocentrism • At this stage his own perspective is all that he can manage Animism • Dental team’s advantage:- giving dental instrument and equipment lifelike names and qualities • Handpiece :- “Whistling Willie”
  58. 58. Mountain Study
  59. 59. Period of Concrete Operations • An improved ability to reason emerges. • 8 year old could watch the water being poured from one glass to another, imagine the reverse of that process, and conclude that the amount of water remains the same no matter what size the container is • The child’s thinking is still strongly tied to concrete situations, and the ability to reason on an abstract level is limited.
  60. 60. Period of Formal Operations • Ability to deal with abstract concepts and abstract reasoning develops by about age 11 • Intellectually the child can and should be treated as an adult • Successful communication, in other words, requires a feel for the child’s stage of intellectual development.
  61. 61. • Aware that others think • Experiencing tremendous biologic changes in growth and sexual development • They feel as though they are constantly “on stage”, being observed and criticized by those around them • “Imaginary Audiences” by Elkind
  62. 62. • The imaginary audience is a powerful influence on young adolescents • The reaction of the imaginary audience to braces on the teeth, of course, is an important consideration to a teenage patient • “Others really care about my appearance and feelings as much as I do” • “Personal fable
  63. 63. Personal Fable • “Because I am unique, I am not subject to the consequences others will experience”. • Imaginary audience and the personal fable have useful functions in helping us develop social awareness and allowing us to cope in a dangerous environment.
  64. 64. Ivan Petrovich Pavlov (September 14, 1849 – February 27, 1936) Physiologist, Psychologist, and Physician Awarded the Nobel Prize in Physiology in 1904 CLASSICAL CONDITIONING
  65. 65. • Unconditioned stimulus (UCS) – It is the stimulus that elicits a particular response without any prior learning. • Unconditioned response (UCR) – It is an unlearned response elicited by an unconditioned stimulus that occurs without previous conditioning. • Conditioned response (CR) – It is a learned response to stimulus that was not originally capable of producing the response. • Conditioned stimulus (CS) – It is an initially neutral stimulus that comes to elicit a particular response after being paired with a UCS that always elicits the response Terminology
  66. 66. Clinical Application: Dental • Occurs readily with young children and can have a considerable impact on a young child’s behavior on the first visit to a dental office • Children’s early experiences with a pediatrician involved needles for immunization
  67. 67. White coat No Pain (Neutral Stimulus) (No response) 78
  68. 68. White coat + Injection Pain + Fear &Crying (NS) (UCS) (UCR) 79
  69. 69. White coat Pain + Fear & Crying (CS) (CR) 80
  70. 70. Operant Conditioning Theory By B.F. Skinner •Also called as instrumental learning •Extension of classical conditioning •Consequence of a behaviour is in itself a stimulus that affects future behaviour •Behaviour that controls or operates environment is called as operant •Reinforcement is critical factor in learning and development of personality.
  71. 71. 4 basic types of operant conditioning (distinguished by the nature of the consequence) Positive reinforcement Negative reinforcement Omission punishment
  72. 72. Positive reinforcement •A pleasant consequence follows a response •A child is given a reward such as a toy for behaving well during her first dental visit.
  73. 73. Negative reinforcement • Involves the withdrawal of an unpleasant stimulus after a response. • Leads to the removal of an undesirable stimulus. • Child shows temper tantrum to go to clinic. • If thif behaviour suceeds , likely to occur the next time a visit to the clnic is proposed. • So in dental office, it is important to reinforce only desired behaviour.
  74. 74. Omission (also called time-out) •Involves removal of a pleasant stimulus after a particular response. •Favourite toy taken away for a short time (sending the mother out of the operatory) as a consequence of this behaviour, the probability of similar misbehaviour is decreased.
  75. 75. Punishment •Occurs when an unpleasant stimulus is presented after a response. This is also decreases the probability that the behaviour. •Effective at all ages, not just with children •Firm voice control •Use of tongue crib for correction of tongue thrusting habit.
  76. 76. HIERARCHY OF NEEDS
  77. 77. PSYCHOLOGICAL DEVELOPMENT FROM BIRTH TO ADOLESCENT INCLUDING PSYCHOLOGICAL DISORDERS • Infancy – early steps in the march to maturity a) The neonate b) Motor development c) Cognitive development d) Social development e) Emotional development f) Adjusting problems in infancy Stubborness & temper Down syndrome Infantile autism
  78. 78. Motor Development
  79. 79. Early childhood: play, pre-school, and pre-operations • Cognitive development • Language development • Social development Socialization parent-child relationship-baumarind study Sex roles Peers and play Aggression • Adjustment problem in early childhood
  80. 80. Linguistic Development Age Linguistic Achievement 3 months Cooing 4 months Babbling 10 months First word 18 months About 20 words One word utterances 24 months About 250 words Two word utterances 30 months About 500 words Three plus word utterances
  81. 81. Baumrind’s Parenting Styles Authoritarian Parents are restrictive and punitive. Children tend to be socially incompetent, anxious, and exhibit poor communication skills. Indulgent Parents are highly involved but set few restrictions. Children have poor self-control. Neglectful Parents are uninvolved. Children have poor self- control, don’t handle independence well, and low achievement motivation. Authoritative Parents are nurturing and supportive, yet set limits. Children are self-reliant, get along with peers, and have high self-esteem.
  82. 82. Later childhood: cognitive tools, social- rules, schools • Cognitive development • Social development Friendship Groups Peer vs adult influence • Social achievement • Adjustment problem in later childhood
  83. 83. The Changing Family Working parents  Nature of parents’work matters Children in divorced families  The quality of parental relationships, timing of divorce, use of support systems, type of custody, SES, and quality schooling all affect children.  Elementary school children did best when the parent and the school environment were authoritative. Children in stepfamilies  Show more adjustment problems than children in intact families, especially during adolescence
  84. 84. Ethnic and Socioeconomic Variations in Families Minority students  Families tend to be larger; depend more on the extended family for support  Single parents are more common  Less educated; lower income Low-income parents  Tend to value external characteristics such as obedience and neatness  See education as the teachers’job
  85. 85. Ethnic and Socioeconomic Variations in Families Middle-class families  Often place high value on internal characteristics such as self-control and delayed gratification  See education as a mutual responsibility
  86. 86. Adolescence:storm and stress or smooth sailing? • Biological development &puberty • Cognitive • Moral judgment • Achieving identity • Social development • Adjustment problem
  87. 87. Pshycological disorder • Defined as, Patterns of abnormal behaviour, emotions or thought that significantly interfere with an individuals adaptation to important life demands and often cause distress in the individual or in others.
  88. 88. CLASSIFICATION • Infantile autism • Bulemia- an eating disorder • Schizophrenic disorder • Paranoid disorder • Disorder of affect Major depression & bipolar disorder • Anxiety disorder Phobic disorder Obsessive- compulsive disorder • Personality disorder Histrionic personality disorder Antisocial personality disorder
  89. 89. DSM-III (APA,1980) CLINICAL SYNDROME • Schizophrenic disordores • Paranoid • Affective • Anxiety • Dissociative PERSONALITY DISORDER • Histrionic • Narcissitic • Antisocial • compulsive
  90. 90. DSM 5(APA 2013) • Neurodevelopment disorder Intellectual disabilities Communication Autism spectrum disorder Attention deficit/ hyperactivity disorder Speech learning disorder Motor disorder • Schizophrenic disorder • Bipolar & related disorder • Depressive disorder • Anxiety disorder • Obsessive compulsive disorder • Dissociative disorder • Eating & feeding disorder • Elimination disorder • Sleep- wake disorder • Sexual dysfunction • Neurocognitie disorder Personality • Other mental disorder
  91. 91. AUTISM • First estimated to occur in 4 to 5 per 10,000 children, the incidence of autism is now 1 per 110 in the United States, and 1 per 64 in the United Kingdom, with similar incidences throughout the world. Autism disorder (AD) was first described in 1943 by the American child psychologist, Leo Kanner. He presented 11 children whose behaviours were obviously different from those of others. Kanner suspected that they had an inborn feature which had prevented their regular social contacts. Autism Disorder is sometimes referred to as early infantile autism, childhood autism, or Kanner’s autism.
  92. 92. • Autism Society of America (ASA)- A complex developmental disability that typically appears during the first 3 years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. • The National Institute of Child Health and Human Development defined Autism Disorder (AD) as: “A complex biological disorder that generally lasts throughout a person’s life, as it starts before age three, in the developmental period, and causes delay or problems in many different ways in which a person develops or grows.”
  93. 93. Diagnostic criteria
  94. 94. CHILD ABUSE and NEGLECT • Child abuse • Neglect • Types of child abuse • Physical • Sexual • Neglect • Emotional
  95. 95. Contributing Factors to Child Abuse • Drug and alcohol abuse • Stress • Lack of support network • Domestic violence • “Learned behaviors” - many abusers are, themselves, victims of child abuse
  96. 96. Possible Indicators of Child Abuse • Patterns – Bruises, welts, bite marks, tattoos – Lacerations or abrasions – Burns • Fractures • Head injuries (Kellogg el at., 2005)
  97. 97. Warning Signs Repeated injuries (multiple bruises) Inappropriate behavior Neglected appearance Strict, super-critical parents Extremely isolated families
  98. 98. Behavior Indicators of Abuse No eye contact Suicide attempts Running away Aggressiveness Withdrawn Dramatic mood changes Wary of parents Fear of touch INDICATORS (National Clearinghouse on Child Abuse and Neglect et al., 2003)
  99. 99. Clinical Protocol • General physical assessment • Behavior assessment • Patient history • Oral examination • Documentation • Consultation (Kenney et al., 2006)
  100. 100. Patient Histories • Obtain histories from child and parent. Do they match? • Is the injury consistent with the history? • History of similar injuries in the past? (Moudan & Smedstad et al., 2002)
  101. 101. Signs of Oral Trauma in Abuse • Avulsed teeth • Non-vital teeth • Lip lacerations • Tongue injuries • Frenum injuries • Jaw fractures (Kellogg et al., 2005)
  102. 102. Identification of Dental Neglect • Willful failure of a parent or guardian to seek and follow with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection • Untreated, rampant caries • Untreated pain, infection, bleeding or trauma • Lack of continuity of care once informed that above conditions exist (American Academy of Pediatric Dentistry Oral Health Policies and Guidelines, 2003)
  103. 103. The Need For Education • 87% of dental professionals surveyed say they need more education about child maltreatment (Littel et al., 2004) • With education, dental professionals are five times more likely to report(Littel et al., 2004)
  104. 104. "A mother understands what a child does not say.“ THANK YOU

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