Social and Behavioral Development

Question 1

What are the 3 conditioning categories?

Answer 1

• Classical
• Operant
• Observational learning

Question 2

• Pavlov’s dogs- Salivated at the sound of a bell b/c food was always served in association with the ringing bell.
• occurs readily in children
• White coat syndrome
• Take home:
• Make the office look and feel as little like a pediatrician’s office or hospital as possible – develop discrimination
• Make the first visit/visits “happy visits” especially if there has already been a negative experience. (May need to convince parents to make multiple appointments)

Answer 2

Classical conditioning

Question 3

• Extension of Classical conditioning
• Consequence of a behavior is itself a stimulus that can influence future behavior.
• Reinforcement increases likelihood of behavior.
• Punishment decrease likelihood of behavior

Answer 3

Operant Conditioning

Question 4

• Desired behavior is rewarded (likelihood of behavior increased)
• Toy given to a child for good behavior.
• Giving praise or compliment for good behavior
• Noticing and complimenting improved hygiene.

Answer 4

Positive Reinforcement

Question 5

•Unpleasant stimulus is removed as result of behavior (likelihood of behavior increased).
•Can go two ways.
1.Tantrum gets you out of the situation- throw a bigger one next time.
2.Appointment time shortened due to good behavior.
a. May need to help patient recognize the association.

Answer 5

Negative reinforcement

Question 6

• Something is taken away as a result of the behavior
• Toy is taken away after a tantrum.
• The punishment is the removal of a pleasant stimulus.

Answer 6

Negative punishment (omission/timeout)

Question 7

• Behavior results in an unpleasant stimulus being presented.
• Speeding ticket

Answer 7

Positive Punishment

Question 8

What 2 forms of operant conditioning are most appropriate for the dental office?

Answer 8

Positive and negative reinforcement

Question 9

• Acquisition of behavior by imitation.
• 2 stages
• Acquisition
• Performance
• Behavior moves from acquisition to performance if the model is liked/respected/trusted.
• Take home:
• Let younger siblings see older siblings behaving and being rewarded
• Open treatment areas.

Answer 9

Observational Learning (Modeling)

Question 10

: 8 ages of man
•Presented by Erik Erikson.
•Associated with chronological age but more important and constant is the sequence.

Answer 10

Emotional Development

Question 11

Emotional Development is Associated with chronological age but more important and constant is the _________.

Answer 11

sequence

Question 12

•Basic trust or lack of trust is developed.
•Child is usually very attached to parent at this stage.
•If patient hasn’t developed basic trust, they may be fearful and uncooperative.
Take home:
•Best to treat patient with parent, knee to knee is a good option.
•Be patient with children. Try to find clues about parental relationship.

Answer 12

Step 1: Development of basic trust (mistrust)

0- 18 months

Question 13

• Terrible Twos
• Child is finding independence and ability to choose.
• If it’s not their idea, it likely won’t happen.
• Take home:
• Give choices
• Yellow or green napkin,
• Two kinds of sunglasses
• Still good to have parent present
• Complex treatment best done under sedation of general anesthesia.

Answer 13

Step 2: Autonomy (or shame)

18 months to 3 years old

Question 14

• Physical activity and motion
• Tons of questions, very curious.
• Important to succeed- perceived failure is detrimental. •Take home:
• First dental visit is usually in this period of development
• A successful visit will produce a sense of accomplishment for the patient.
• Consider an exploratory visit with little treatment done.
• Usually better to treat away from parent to reinforce independence.

Answer 14

STEP 3: Development of Initiative (or Guilt)

3- 6 years old

Question 15

•Acquiring academic and social skills which allow them to compete in an environment where those who produce are recognized.
•Necessity of working together is realized
•Peers becoming more important.
•Realistic goals should be set and met.
Take home:
•Compliance depend on child understanding what is needed to please parents, dentist and peers.
•Not motivated by abstract things like “a better bite.”

Answer 15

Step 4: Industry/mastery of skills (or inferiority)

7- 11years old

Question 16

• Adolescence
• Realizing one can exist outside the family
• Rejecting parental authority, peer group extremely important.
• Motivation is internal or external
• Internal- Desire to improve appearance-sometimes as a result of bullying.
• External- “to get mom off my back.”
• Take home
• It is very important that a patient in this age group has an internal desire to undergo any prolonged or involved treatment such as orthodontic treatment. •Teenage boy with grandma vs Teenage girl with anterior crossbite.

Answer 16

Step 5: Development of Identity (or Role confusion)

12 -17 years old

Question 17

• Creating close meaningful relationships.
• Ability to sacrifice and compromise for a relationship. •Take home:
• Some seek esthetic treatment for improved chance at relationships.
• Drastic changes in appearance (new look) can possibly interfere with existing relationship as the partner may view the change as altering the relationship.

Answer 17

Step 6: Development of Intimacy ( or Isolation)

Young Adult

Question 18

What are the 8 stages of psychosocial development?

Answer 18

1. Trust/Mistrust
2. Autonomy/Shame and Doubt
3. Initiative/Guilt
4. Industry/Inferiority
5. Identity/ Role
6. Intimacy/Isolation
7. Generativity/Stagnation
8. Integrity/Despair

Question 19

• Development of intellectual capabilities.
• Via assimilation and accommodation.
• Related to age.
• Intelligence develops as assimilation and accommodation build on one another.

Answer 19

Cognitive Development

Question 20

• Incorporating events within the environment into mental categories.
• Child sees something fly ->learns it’s a bird-> everything that flies is a bird

Answer 20

Assimilation

Question 21

• Child changes mental categories to better represent the environment
• Learning to distinguish a bird from a fly

Answer 21

Accommodation

Question 22

• Discover reality of objects- they don’t disappear when not being looked at.
• Limited ability to project forward or backward.
• Usually aren’t treating patients in this age group but can have patients with disabilities that could fall into any stage of development.

Answer 22

Sensorimotor development

0- 2 years old

Question 23

• They use words like adults, they appear to think more like adults than they really do.
• Limited association- My daughter will say “I’m not pretty, I’m Maddisyn.”
• Understand the world through 5 senses.
• If it’s not touched, tasted, seen, heard, or smelled, it’s hard to understand•Incapable of seeing another person’s point of view (egocentrism).
• Apply life to inanimate objects (Animism).
• Take home:
• Talk to 4-year-old about Mr. Thumb being a problem when he wants to get into the mouth.
• Focus on senses: Brushing makes your teeth feel clean and smooth and makes your mouth taste good.

Answer 23

2. Preoperational Period

2- 7 years old

Question 24

• Develops ability to see another’s point of view
• Limited but increasing ability to think about abstract things.
• Take home:
• Present concrete directions.
• GOOD: “This is your retainer. Put it in your mouth like this. Take it out like this., Brush it like this…”
• Bad: “ Here’s your retainer. Wear it regularly to keep your teeth straight.”

Answer 24

3. Period of Concrete Operations

7- 11 years old

Question 25

• Can think about thinking.
• Adolescents think that others are thinking about them (imaginary audience)
• Self conscious because “others are thinking about what I’m wearing, doing, etc.
• Adolescents see themselves as unique leading to the “ personal fable.”
• Personal fable-I’m unique. Everyone cares about what I’m doing. Nothing bad will happen me…
• In working with teenagers don’t try to change their reality of the imaginary audience and personal fable. Rather help them better see reality.•If a teenager is reluctant to wear a certain appliance or device, telling them that many of their peers are wearing them too will not help.
• See if they will give the appliance a try and if they get the response from their peers that they anticipate, then the appliance can be removed. Usually, the response isn’t what they think it will be.
• Once a teenager realized that others think their flipper is “cool,” they may be more ok with wearing it. Not because “everyone else is wearing one”, but because the response isn’t what the patient may perceive it to be.
• Take home:
• Provide guidance toward a more accurate evaluation of the attitude of the audience. Not by telling them, but rather giving them a chance to see for themselves.

Answer 25

4. Period of Formal Operations

- 11 years old to adulthood