Paeds: Child Development Flashcards
What skills develop in childhood?
1) Motor
2) Perceptual
3) Language
4) Cognitive
5) Social
What biological factors influence development (nature)?
1) Genetics
2) Prenatal - health status and health related behaviours of mother, what happens in uterus
3) Neonatal - birth complications
4) Childhood illness
What are social/environmental influences on development (nurture)?
1) Pollution e.g. impact on developing lungs, asthma and other respiratory conditions are difficult to manage
2) This can lead to loss of time at school/with friends, less time outside playing and gaining motor skills and access to environments that prompt development
3) If living somewhere where worried about crime might not let child out the child centres or outside
4) Primary caregiver might not be there a lot to allow child to develop fully
Why is the interaction between biological and environmental factors (nature and nurture) complicated?
Because environmental factors can directly influence biological growth e.g. brain growth and genetic factors can influence the child’s environment e.g. a sociable child producing different reactions from others than an antisocial child
What are critical periods?
Defined periods where appropriate stimulation is required to ensure development e.g. development of language skills or emotional attachments (rooted in early childhood) - but evidence of plasticity
What are cohort effects?
Group specific changes influenced by historical/cultural factors
What are the 4 domains of child development?
1) Gross motor
2) Fine motor (and vision)
3) Speech and language (and hearing)
4) Social (and emotional)
What is each development domain characterised by?
The acquisition of more complex skills (in a typical manner)
What are the 4 stages of child development?
1) Infancy (0-2)
2) Early childhood (2-6)
3) Middle childhood (6-12)
4) Adolescence (12-18)
What are the features of infancy?
1) Attachement
2) Maturation of sensory, perceptual and motor functions
3) Understanding objects through senses
What are the features of early childhood?
1) Locomotion
2) Fantasy play
3) Language development
4) Sex role identification
5) Group play
What are the features of middle childhood?
1) Friendship
2) Skill learning
3) Self-evaluation
4) Team play
5) Understand cause, effect and conservation
What are the features of adolescence?
1) Physical maturation
2) Emotional development
3) Peer group and sexual relationships
4) Understand abstract thinking
What are the six gross motor milestones in order?
1) Sitting without support (4-9 months)
2) Standing with assistance (5-11.5 months)
3) Hands and knees crawling (5-13.5 months)
4) Walking with assistance (6-14 months)
5) Standing alone (7-17 months)
6) Walking alone (8-18 months)
What is the progression in head and trunk control from newborn to 6 months?
1) Newborn - head lag
2) 2 months - some head control but no trunk control
3) 6 months - can pull up head and trunk
What is the progression of fine motor skills from newborn to 24 months?
1) Newborn - palmar reflex
2) 6 weeks - hands to midline and into mouth
3) 3 months - holds rattle
4) 15 months - palmar grasp, draws to-fro scribbling
5) 18 months - transitional grasp, circular scribble
6) 24 months - tripod grasp, copies vertical lines
What are the 5 stages of language development?
1) Preverbal communication
2) Phonological development
3) Semantic development
4) Syntax and grammar development
5) Pragmatics development - hidden meaning in words that have been used
Describe the progression of language development from newborn to 1 year
1) Newborn - responsive to language (interactional synchrony)
2) Early months - universal babbling
3) Pre-verbal communication - pointing
4) Towards end of first year - narrower range of sounds
5) At approx. 1 year - first words
Describe the stages of rate of word learning from 9 months to 6 years
1) 9-13 months - first words
2) 12-18 months - learn about 3 new words a month
3) 18 months - know ~ 22 words
4) Naming explosion - learn 10-20 new works a week
5) 6 years - know 10,000 words, 5 new words a day
What are two features of perception in infants?
1) Babies are able to fixate their gaze, focussing on areas of contrast
2) Evidence of active not passive - information seeking
Describe the progression of perceptual development
1) At 4-5 months babies demonstrate a preference for faces
2) Move onto scanning the environment
3) At 6 years they develop appropriate selective attention - learn which environmental cues warrant perceptual attention
What are the three ways that babies learn?
1) Conditioning - classical and operant
2) Habituation and dishabituation
3) Schematic learning - organising learning into expectancies of “known” combinations
What is social learning?
- When behaviours are acquired by observing significant others carrying them out
- Imitation - reproduction of learning through observation
- Modelling involves learning by observation and imitation of others e.g. aggression
- Learning can occur in the absence of reinforcement
What is Piaget’s theory about development of cognitive skills?
- Children go through the same kinds of sequential discoveries about the world at similar ages and make the same mistakes
- 4 main stages and 4 key concepts
What are the 4 main stages of cognitive development?
1) Sensorimotor (0-2 years)
2) Pre-operational (2-6/7 years)
3) Concrete operations (6/7-11/12 years)
4) Formal operations (11/12 years +)
Describe the sensorimotor stage of cognitive development
- Initial reflexes via sensory motor schema
- Child interacts with environment and manipulates objects
- Understanding of object permanence
Describe the pre-operational stage of cognitive development
- Internal representation of concrete objects and situations
- Child uses symbolic schemes like language
- Ego centric
- Reasoning dominated by perception
Describe the concrete operations stage of cognitive development
- Reasoning involves more than one salient feature (conservation)
- Logical reasoning can only be applied to objects that are real or can be seen
Describe the formal operations stage of cognitive development
- Can think logically about potential events or abstract ideas
- Can test hypotheses about hypothetical events
Describe the progression of social development?
1) Early social responsiveness e.g. non-specific smiling
2) After first few months specificity of smiling towards main caretakers
3) 8 months - develop separation anxiety and fear of stranger
4) 10 months - social referencing
What is attachment?
- Process of proximity seeking to identified attachment figure in situations of distress or alarm for purpose of survival
- Brain begins by developing areas needed for basic survival
- Attachment to primary carer - basic necessity for survival, along with food and water
- A biological system for coping with threat, not active when no threat is perceived
- Attachment behaviour allows the infant to draw other towards them at moments of need or distress
- Critical periods = 6 months - 2 years
What are the 8 stages of social development illustrated by attachment?
1) 0-2 months → warming up the bond
2) 2-6 months → getting to know who mum is
3) 6-11 months → the first real signs of attachment behaviour
4) 11-18 (24) months → the peak of the attachment period
5) 2-4 years → the need for physical proximity slowly lessens
6) 4-5 years → attachment behaviour still surfaces now and then
7) 6-7 years → mum’s availability is enough
8) 7-11 years → a good dose of mum now and then will do
What are the 4 key concepts of cognitive development?
1) Scheme - internal cognitive structure which provides procedure to use in specific circumstances - where information gathered sits
2) Assimilation - process of using scheme to make sense of event or experience
3) Accommodation - changing scheme as result of new information
4) Equilibration - process of balancing assimilation and accommodation to create schemes that fit environment
Why is it important to understand how children learn and develop?
- Contributes to understanding their behaviours at different stages
- Underpins how we assess development and counsel parents/caregivers
What are the attachment aims in a child?
A reasonably firm expectation of feeling protected and safe, a habit of seeking and being able to take comfort when under threat, which in turn allows them to explore their world more confidently
How can you assess attachment?
- Degree of responsiveness to separation
- How easy the child is to comfort when reunified with carer
What are the two attachment behaviours either side of the normal ‘secure’?
1) Resistant - child is resistant to comfort from carer, linked to emotionally repressive way of managing emotions
2) Avoidant - not linked to anxiety surprisingly, child accepts comfort but doesn’t benefit them
- Both children have a schema in their mind (conditioned by parenting) of how to react to comfort
What is disorganised attachment?
- If parenting hasn’t been reliable enough to form a habit of mind (schema) this can lead to disorganised attachment
- Associated with neglect and abuse
- It is an indicator of the impact of abuse
What is the link between attachment security and later life?
- Attachment security may condition later response to stress and set pattern for relationships
- But not linked to a diagnosable disorder
- Don’t really know the important outside the ages of 0-2
- Attachment security as part of a formulation with other factors - multifaceted
What are two disorders linked to attachment problems?
1) Reactive attachment disorder (RAD)
2) Disinhibited social engagement disorder (DSED)
What is reactive attachment disorder?
- Lack of attachment behaviours
- Extreme maltreatment/neglect
- Rare
- Leads to physical brain changes incl. atrophy
What is disinhibited social engagement disorder?
- Lack of inhibition
- Decreasing link to maltreatment
- Neurodevelopmental
- Rare
What are the problems with attachment thinking?
- Inappropriate therapies
- Blame
- Tunnel vision
- Missed diagnosis
- Therapeutic nihilism
What are further skills required for behavioural development?
1) Social interaction and communication
2) Self-control
3) Executive function - ability to get to a goal, being flexible about planning and memory
4) Rationalisation of emotion - and talk about emotion
5) Resilience and self-image
Describe social interaction and communication in people with autism?
Autistic people have a different form of social interaction and communication than neurotypical world - like being in foreign country
How are skills for behavioural development learnt?
1) Genetic potential/physical ability
2) Motivation (reward, perception of benefit)
3) Opportunity for practice - child can explore in safe environment
4) Feedback and guidance
What are features of ADHD?
- Problems with self-control
- Disruptive in class
- Avoids school work
- Fights in the playground
- Refuses to go to bed
Why do the ‘terrible twos’ happen?
Children realise that other people and themselves have autonomy (can say no), cognitive explosion of awareness
What are the features of classical conditioning?
- Behaviours acquired through the process of associative learning between two stimuli
- Pavlov’s dogs
- Naturally occurring stimuli that are important for survival - food, water, opportunities for sexual reproduction, threats to survival
- Innate (unlearned and automatic) responses - salivation, thirst, arousal (fear/sexual), escape
- A range of external stimuli e.g. pub, coffee shop and internal stimuli e.g. mood
- Allows the learning of new stimulus - response relationships
What are the features of operant conditioning?
- Behaviours acquired through the process of positive reinforcement, negative reinforcement or punishment
- Behaviours have consequences
- How does reinforcement and punishment influence behaviour?
- Skinner’s rats
What are the effects of positive reinforcement?
1) Strengthens a behaviour (more probable)
2) Reinforcement is pleasurable
3) Child receives a gold start for good behaviour
What are the effects of negative reinforcement?
1) Strengthens a behaviour (more probable)
2) Removal or avoidance of an aversive event/state
3) Child told they must behave well or they won’t get a present
What are the effects of punishment?
1) Weakens behaviours (less probable)
2) Presentation of an aversive stimulus
3) Child is smacked when behaving badly
