Week 6 - Child Development and Communication

Question 1

Describe the concept of attachment in child development

Answer 1

• Bowlby described attachment as a biologically based system that functions to maintain proximity to the infant’s care-giver
  — Infants are predisposed to exhibit:
  • Proximity seeking behaviour
  • Contact maintaining behaviours
• The infant forms first ‘mental model’ of relationship based on interactions with their primary care giver
• Secure attachment:
  — Worthy of love and care
  — Others will be available to them in times of need
  — Influences brain development
  — Infant will have better social competence, peer relations, self reliance, physical and emotional health
• The critical period for first attachment is during the first year
  — Problems may result if separated during first 4 years

Question 2

What are the stages of social development in infancy?

Answer 2

• Newborns show preference for human faces to inaminate objects
• – First ‘social smile’ at about 6 weeks
• Approx. 3 months = distinguish strangers from non-strangers
• – Show preference for non-strangers
• – Will allow any caring adult to handle them without becoming unduly upset
• 7-8 months = specific attachments formed
• – Child will miss key people and show signs of distress in their absence
• – Wary of strangers picking them up or touching them, even with key people present

Question 3

What are the different attachment styles?

Answer 3

• Secure
• – Carer is sensitive to child’s signals
• – Rapid, appropriate response emitted consistently
• – Interactive synchrony with carer
• – Carer accepts role of parent/carer
• – Carer has higher self-esteem
• Insecure:
• – Avoidant (little/no comfort from mother when upset)
• – Ambivalent (clingy – inconsistent comforting from mother)
• – Disorganised

Question 4

What are the effects on the infant if the attachment figure is absent?

Answer 4

• Behavioural changes:
• – Separation anxiety
• – Increased aggression
• – Clinging behaviour
• – Bed wetting
• – Detachment
• Physical impact (seen with primates):
• – Depression
• – Slower movement
• – Less play
• – Less sleep
• – Changes in heart rate
• – Body temperature changes

Question 5

What are some criticisms of the attachment theory?

Answer 5

• Too simplistic
• Overly focused on mothers; fathers are marginalised
• Multiple attachment figures may be formed, this was not explored initially
• Quality of substitute care not considered

Question 6

What are the implications of separation for a hospitalised child?

Answer 6

Predictable pattern of behaviour following 3 phases:
- Protest:
— Distressed
— Look for mother
— May cling to substitute
— Can last hours or even days
- Despair
— Signs of helplessness
— Withdrawn
— Cry only intermittently
- Detachment
— More interested in surroundings
— May smile and be sociable, but when carer returns they are remote and apathetic
The second 2 phases are often mistaken for recovery
Separation of children from carers distressing for both and can have negative short and long term psychological and physical consequences

Question 7

At what age does a child experience the most distress due to separation and why?

Answer 7

Children aged 6 months – 3 years

• Lack ability to keep image of carer in mind
• Limited language (e.g. don’t understand ‘tomorrow’)
• Lack ability to understand abstract concepts
• Often feel abandoned and may attribute it to their own failing (e.g. she’s gone because I was naughty) and see being left as punishment

Question 8

What are some implications of separation on health outcomes?

Answer 8

• Adherence to treatment may be adversely affected, and this in turn may impede recovery
• Patients experience of pain may be worse if anxiety levels high
• Patients may suffer from adverse effects of stress on health

Question 9

What are some examples of good practice in the organisation of hospital care for children?

Answer 9

• Allow parental/carer access
• Allow attachment objects
• Reassure that child not being punished or abandoned
• Environment more like home
• Stimulating toys and activities
• High quality substitute care, specialist nurses
• Continuity of staff

Question 10

Describe Piaget’s 4 stages of childhood cognitive development

Answer 10

• Sensorimotor (0-2 years)
• – Babies experience world through senses
• – Develop motor co-ordination
• – No abstract concepts
• – Develop body schema – awareness of where they ‘end’ and the world starts
• – Develop understand permanence around 8 months – understand continuing existence of objects even when they are out of site
• Preoperational (2-7)
• – Language development, symbolic thought, able to imagine things
• – Egocentricism (difficulty seeing things from other’s point of view, believe everyone experiences the world the way they do)
• – Lack concept of conversation
• – Classification by single feature
• Concrete operational (7-12)
• – Think logically but concrete rather than abstract
• – Achieve conservation of number, mass and weight
• – Classification by multiple features
• – Able to see things from others’ perspectives
• Formal operational (12+)
• – Abstract logic
• – Hypothetic deductive reasoning

Question 11

What is a criticism of Piaget’s 4 stages

Answer 11

• Tends to focus on what child cannot do, not what they can achieve
• – If child deemed too young to appreciate a given concept no point in trying to inform them

Question 12

What is Vygotsky’s theory of social development?

Answer 12

• Cognitive development requires social interaction
• Child as an ‘apprentice’, learns through shared problem solving
• With ‘able instruction’ child can achieve some increase in understanding
• – But with support, they can perform better cognitively