OUTLINE OF CHILD and Adolescent DEVELOPMENT

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OUTLINE OF CHILD and Adolescent DEVELOPMENT

• Dr. Khalid Bazaid, MBBS, FRCPC
• Assistant Professor Consultant
• Child Adolescent Psychiatrist
• Department of Psychiatry
• College of Medicine
• King Saud University

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Introduction

• Development ? changes in a persons long-term
  growth, feelings and pattern of thinking and
  behavior.
• Some developmental changes are relatively
  specific. Others are more general.

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• Why Study Development?
• It can give you realistic expectations for
  children and adolescents.
• Knowledge of development can help you respond
  appropriately to childrens actual behavior.
• Knowledge of development can help you recognize
  when departures from normal are truly
  significant.
• Studying development can help you understand
  yourself.
• Studying development can make you better advocate
  for the need rights of children.

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2 Months
5 Days
28 Years
1 Year
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Conventional Stages of Development

• Embryo conception to 8 weeks
• Fetus 8 weeks to birth
• Infancy birth to 15 months
• Toddler 15 months to 2 ½ years
• Preschool 2 ½ to 6 years
• Middle years 6 to 12 years
• Adolescence 12 to 19 years
• Adulthood 20 to 65
• Late adulthood old age

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• Factors Influencing Child Development
• Genetic Influences
• The whole process of normal brain formation and
  development is under the control of genetic
  mechanisms.
• However, the expression of the genetic endowment
  will depend on many environmental constraints.
• Physical characteristics have a clear genetic
  basis and some of these may directly or
  indirectly affect behavior.
• General personality dimensions may have a genetic
  basis, however, individual cognition, behavior
  and interpersonal relationship develop from
  actual experiences.

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• Prenatal Influences
• Mothers age
• Diet
• Mental and physical health of the mother
• External factors such as drugs and environmental
  toxins
• Neonatal Influences
• Complications during the process of delivery can
  affect the physical and psychological well-being
  of the baby.

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• Nutrition
• Malnutrition appears to have its greatest
  effects during the later stages of pregnancy and
  the 1st few months of life when a great deal of
  brain development occurs.
• Environmental Chemicals
• Some of the chemical products of modern industry
  and war consequences appear to have a potential
  harmful effect on the development of the brain
  mechanisms.

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Maternal Health

• Maternal stress correlates with high levels of
  stress hormones (epinephrine, norepinephrine, and
  adrenocorticotropic hormone) .
• Mothers with high levels of anxiety are more
  likely to have babies who are hyperactive,
  irritable, and of low birth weight and who have
  problems feeding and sleeping
• Smoking during pregnancy is associated with both
  premature births and below-average infant
  birthweight
• Alcohol use in pregnancy is a major cause of
  serious physical and mental birth defects in
  children (Fetal alcohol syndrome)

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Biological versus Environmental Influences
Nature vs. Nurture

• Most psychologists now tend to be
  interactionists E.g., there are interactions
  between the child's genetic tendencies toward
  aggression and the child's being exposed to
  violence on TV.
• Violent TV has a greater effect on children who
  are genetically inclined toward aggression.

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• 6. Physical handicaps and brain injury
• These can have lasting influences on
  psychological development. These effects can be
  direct or indirect.
• Critical Periods
• Attachment
• Temperamental patterns

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Developmental landmarks

• Reflexes and survival systems at birth
• Language and Cognitive Development
• Emotional and Social Development

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Child Development

• The Newborn
• - Many important capacities are present at a
  very early stage.
• - Great difficulty in studying psychological
  processes in babies.
• - Newborns have considerable learning
  abilities e.g. buzzer stimulus.
• - Perceptual abilities are more than
  imagined e.g. turning eyes appropriately.
• - Social behavior is present in the earliest
  days of babyhood. e.g. imitate simple facial
  gesture.
• - Making body movement which are coordinated
  with the speech pattern of adults who talk to
  them (non-verbal communication).

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• Motor development
• - It starts before birth and is effectively
  completed in infancy.
• - Motor skills are a prerequisite to effective
  control of the environment and result from a
  complex interactions between genetic potential,
  opportunity and personal attributes such as
  motivation and organizational skills.
• - Tables exist which list the average age at
  which certain motor skills are obtained.
• - The sequence and timing of motor development
  is largely genetically preprogrammed. However,
  fine motor development is more sensitive to
  social influence and opportunities.

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• Perceptual Development
• - Even in very young babies, perception is an
  active process.
• - Compared with adults, children tend to cover
  less of the object and to fixate on details.
• - Selective attention is markedly improved
  between ages of 5 and 7 years.
• - There is strong preference for looking at
  faces from birth but appears about the 4th or 5th
  month.

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Piagets Periods of Cognitive Development Piagets Periods of Cognitive Development Piagets Periods of Cognitive Development Piagets Periods of Cognitive Development
Birth to 2 years Sensori-motor Uses senses and motor skills, items known by use Object permanence learned
2-6 yrs Pre-operational Symbolic thinking, language used egocentric thinking Imagination/ experience grow, child de-centers
7-11 yrs Concrete operational Logic applied, has objective/rational interpretations Conservation, numbers, ideas, classifications
12 yrs to adulthood Formal operational Thinks abstractly, hypothetical ideas (broader issues) Ethics, politics, social/moral issues explored
Focus on organization and adaptation
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• Cognitive Development
• - There are 4 key concepts in Piagets theory
  and these help describe the way children process
  information and deal with the world
• 1. The schemata are the inferred cognitive
  structure or internal processes that the child
  uses in conceptualizing experiences.
• 2. Assimilation describes the way in which
  the child deals with new information.
• 3. Accommodation occurs when an existing
  schema modified to incorporate new information.
• 4. Equilibrium exist when the two processes
  are in a state of relative balance.

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• Children tend to pass through 4 broad stages
• Sensorimotor stage it lasts for the 1st 2 years
  infant construct sensorimotor schemata based on
  his or her interactions with the environment ?
  object permanence.
• Pre-operational thought between 2 7 years.
  The child begins to use an internal
  representation of his or her external world. ?
  conservational problem.
• Concrete operations between 7 11 years.
  Children apply logical reasoning to concrete
  objects and problems.
• Formal operations it begins at about 11 years.
• - full adults thinking ability.
• - abstract reasoning skills.

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• Language Development
• - Language comprises the sum of skills
  necessary for the process of communication.
• - It consists of the ability to understand and
  utilize communications, verbal and non-verbal and
  to make such communications to others with
  meaning.
• - The newborn shows a remarkable ability to
  distinguish among speech sound e.g. his mothers
  voice.
• - Speech production lags behind the capacity
  for recognizing and responding to speech.
• - By 3 4 months early bubbling usually
  occurs.

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• Mother and baby can be observed to be involved in
  turn-taking conversation.
• At about 12 months the 1st words with meaning
  usually occur.
• By 18 months the child is usually generating
  combinations of words.
• By age of 5, the child not only accumulates a
  large vocabulary but also learns the rules for
  producing grammatically correct utterances.
• Influences on normal language development
• Genetic factors
• Physical factors
• Social class
• Family size
• Multiple births
• Gender
• Quality of stimulation
• Bilingual households

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• Social development
• - During the 1st few months attachment will be
  established.
• - At age of 8 months, infants begin to show a
  definite fear of strangers and not long after
  this, they will show fear of separation from
  their caretakers.
• - During the preschool years, new behaviors
  attitudes develop as children increasingly
  interact with their social environment as part of
  a process called socialization.
• - One area of behavior during this phase is the
  gender roles is mediated through
  identification.
• - Moral constraints on behavior is learned in
  part through identification with parents.

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Fetal Behavior

• Women usually detect fetal movements 16 to 20
  weeks into the pregnancy
• The fetus may be able to hear by the 18th week,
  and it responds to loud noises with muscle
  contractions, movements, and an increased heart
  rate.
• The retinal structures begin to function at that
  time. Eyelids open at 7 months.
• Smell and taste are also developed at this time,
  and the fetus responds to substances that may be
  injected into the amniotic sac, such as contrast
  medium.

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Infancy period

• Reflexes are present at birth.
• Survival systems breathing, sucking, swallowing,
  and circulatory and temperature homeostasis are
  relatively functional at birth, but the sensory
  organs are incompletely developed.
• The newborn infant is awake for only a short
  period each day.
• Infants 1 day old can detect the smell of their
  mother's milk, and those 3 days old distinguish
  their mother's voice.
• Guttural or babbling sounds occur spontaneously,
  especially in response to the mother.
• Infants imitate the facial movements of adult
  caregivers by age 3 weeks.

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Infant Care Attachment

• John Bowlby describes attachment as a complex
  two-way process in which the child becomes
  emotionally linked to members of his or her
  family, usually the mother, father, and sibs.
• It is an adaptive, biological process serving the
  needs of the child for protection and nurture.
• Early separation of infants from their mothers
  had severe negative effects on children's
  emotional and intellectual development
• Stranger anxiety
• Separation anxiety

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• Although it is genetically determined, the
  behavior of those around the child will influence
  the security of the attachment.
• Failure to establish such close relationship
  would result in different type of difficulties in
  personality, relationship and emotional
  disorders.
• Attachment of family members
• As the child has been born, most of the family
  members especially the mother will show positive
  warm feelings towards him. They are likely to
  show
• - strong protective feelings.
• - a need for proximity to the child.
• - exclusion of other relationship.
• - empathic feelings with the child.

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• Attachment of the Child is governed by the
  childs level of perceptual and other abilities.
• Evidences for attachment include
• - Recognition of other family members as special
  people.
• - Expression of especially intense feelings
  towards family members.
• - Expectation that the family members will meet
  all needs.
• - Empathy with the feelings of other family
  members.

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• Attachment interaction between child and family
  members.
• - Mutually satisfactory biological rhythms.
• - Bodily interplay.
• - Communication interplay.

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Factors affecting the development of attachment

• Factors within the child.
• Developmental maturity of the child.
• Temperament.
• Presence of sensory defects.
• Factors within family members, especially
  parents.
• The wish for the child.
• Parental personality, physical and mental
  health.
• Behavior of older brothers and sisters.
• Quality of family relationships.
• Living conditions.
• Early environment and language.
• Early environmental stimulation is
  important for language development.

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In
fant Care Contd

• Temperamental Differences
• Goodness of fit
• Parental Fit
• Good-Enough Mothering

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Toddler Period

• The second year of life is marked by accelerated
  motor and intellectual development.
• Toddlers' negativism is vital to the development
  of independence.
• Learning language is a crucial task.
• The child looks to parents and others for
  emotional cues about how to respond to novel
  events.
• Gender identity, the unshakable conviction of
  being male or female, begins to manifest at 18
  months.
• Sphincter Control and Sleep.

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Preschool period

• Characterized by marked physical and emotional
  growth.
• They have mastered the tasks of primary
  socialization
• Control their bowels and urine
• Dress and feed themselves
• Control their tears and temper outbursts
• Children's use of language expands, and they use
  sentences.
• Children between are aware of their bodies, of
  the genitalia, and of differences between the
  sexes
• Children's play behavior reflects their level of
  social development.
• Thinking is egocentric.

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Middle Years

• Children enter elementary school.
• Logical exploration tends to dominate fantasy.
• Children are now capable of increased
  independence, learning, and socialization.
• In the middle years, both girls and boys make new
  identifications with other adults e.g. teachers.
• Interest in relationships outside the family
  takes precedence over those within the family,
  and prefer to interact with children of the same
  sex.
• Emotions about sexual differences begin to emerge
  as either excitement or shyness with the opposite
  sex.
• Sex play and curiosity are common.
• School Refusal

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Adolescence

• The period between the end of childhood and
  beginning of adulthood (12-20 ).
• It is a time of great biological, psychological
• and social changes.
• Puberty is established with characteristic
  Physical changes.
• It is the time for establishing personal
  identity.

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Adolescence cont.

• Cognitive and physical changes will give rise to
  self-awareness.
• Peer influence is considerably increased.
• Fighting authority control is an important issue.
• Oversensitivity to criticism, moodiness and
  easily provocation are common.
• By the end, they will establish personal
  identity, independence and workable relationship
  with peers.

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Adolescence

• works in progress? characterized by
• increasing ability for mastery over complex
  challenges of academic, interpersonal, and
  emotional tasks,
• While searching for new interests, talents, and
  social identities.

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Adolescence cont.

• 75 of youth, adolescence is a period of
  successful adaptation to physical, cognitive, and
  emotional changes, largely continuous with their
  previous functioning.
• 20 of the adolescent population experience
  psychological maladjustment, self-loathing,
  disturbance of conduct, substance abuse,
  affective disorders, and other impairing
  psychiatric disorders emerge.
• Erik Erikson characterizes the normative task of
  adolescence as identity versus role confusion.

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Components of Adolescence

• Physical development
• Puberty is the process by which adolescents
  develop physical and sexual maturity, along with
  reproductive ability.
• Cognitive maturation
• Transition from concrete thinking to more
  abstract thinking.
• An increased ability to draw logical conclusions
  in scientific pursuits, with peer interactions
  and in social situations.
• New abilities for self-observation and
  self-regulation.
• Socialization
• Ability to find acceptance in peer relationships
• The development of more mature social cognition.
• Peer influences are powerful.
• Moral development
• set of values and beliefs about codes of
  behavior that conform to those shared by others
  in society.

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Stages of Adolescence

• Early Adolescence
• From 12 to 14 years of age
• Physical changes
• Criticize usual family habit
• Insist on spending time with peers
• Awareness of style and appearance
• Increase in opposite sex
• Experiment with cigarettes, alcohol, and
  marijuana

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Stages of Adolescence

• Middle Adolescence
• Between the ages of 14 and 16
• Independent
• Abilities to combine abstract reasoning with
  realistic decision-making
• Sexual behavior intensifies
• Identify with a group of peers
• Conflict with families

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Stages of Adolescence

• Late Adolescence
• Between the ages of 17 and 19
• Self and a sense of belonging to certain groups
  or subcultures within mainstream society.
• Well-adjusted adolescents can be comfortable with
  current choices of activities, tastes, hobbies,
  and friendships, yet remain aware that their
  identities? will continue to be refined during
  young adulthood

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Components of Adolescence cont.

• Self-Esteem
• one's sense of self-worth based on perceived
  success and achievements, as well as a perception
  of how much one is valued by peers, family
  members, teachers, and society in general.
• Good SE correlates
• ve physical appearance
• Academic achievement

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Environmental Influences and Adolescence

• Adolescent Sexual Behavior
• By high school, most male adolescents report
  experience with masturbation, and more than half
  of adolescent girls report masturbation
• Close to four of ten girls who had first
  intercourse at 13 or 14 years of age report it
  was either not voluntary or unwanted. Three of
  four girls and over half of boys report that
  girls who have sex do so because their boyfriends
  want them to.
• In general, adolescents who initiate sexual
  intercourse at younger ages are also more likely
  to have a greater number of sexual partners.
• In 2003, 47 percent of 9th to 12th grade students
  reported having sexual intercourse, a decline
  from 53 percent in 1993

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Environmental Influences and Adolescence

• Nearly four of ten teen pregnancies end in
  abortion
• The average adolescent mother who cannot care for
  her child, has the child either placed in foster
  care or raised by the teenager's already
  overburdened parents or other relatives.
• Few teenage mothers marry the fathers of their
  children the fathers, usually teenagers, cannot
  care for themselves, much less the mothers of
  their children. If the two do marry, they usually
  divorce. Many are more likely to end up on
  welfare.
• The additive effects of more highly educated
  families, social and religious youth groups, and
  school-based educational programs can be credited
  with a decline in high-risk sexual behavior among
  adolescents.
• Responsible sexual behavior among adolescents has
  been determined as one of the ten leading health
  indicators for the next decade.
• Abortion Nearly four of ten teen pregnancies end
  in abortion

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Risk-Taking Behavior

• Alcohol
• Nicotine
• Cannabis
• Violence
• Bullying
• Prostitution
• Tattoos and Body Piercing

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Thank you