Chapter 12
Lecture #8
Guest Lecturer:
Dr. R. Pillai Riddell, PhD, CPsych

–Guest lecture to be evaluated as part of my tenure and promotion process at the university
–Ask Questions (Section
Breaks)
–Brief Evaluation over break

My Background
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Assistant Professor, Clin-Dev Psychology, York
Associate Scientist, Infant Psychiatry, Sick Kids
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Faculty, York/Sick Kids Infant Mental Health
Certificate Program
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Area of Research Focus: Infant Pain and the influence of caregivers
– Understanding Chronic Pain in Infancy
– The Development of Pain Reactivity over the
First Year of Life: Caregiver Influences
– Improving Distraction as an Infant Pain
Management Strategy

How would you try to understand this infant’s social-emotional behaviour?
Johnny is an 18-month old child whom you have been following for a year because mother is in a teen parenting program. His mother is 19 years old and had behavioral difficulties as a teenager. She moved from Afghanistan when she was 12 and has been estranged from her nuclear family since the baby was born. She reports that Johnny becomes fussy and oppositional very easily, is very active, and throws “mean” tantrums –especially when he is sick. You note that Johnny looks like he has a cold and is making repeated attempts to nuzzle his head in is mother’s chest while she is attempting to dress him to leave. She says under her breath that she needs to get back home quickly as her shift at the restaurant begins in an hour, and she is already late.
Johnny is focused on trying to get close to her. The mother is focused on getting his arm into his winter coat. Johnny
Immediately explodes in tears and begins shrieking. She looks at you and says, “See what I mean”.

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Never attempt to understand an infant in isolation
Potential Spheres of Influence
– Infant characteristics (e.g. Temperament)
– Parent characteristics (e.g. Caregiving Style)
– Dyadic characteristics (e.g. Attachment Status)
– Familial characteristics (e.g. Nuclear Family?)
– Community characteristics (e.g. SES?)
– Cultural characteristics (e.g. Individualistic vs
Collectivist?)

General: To provide a more in-depth understanding of topics covered by Chapter
12.
Specific:
1.
Theories of Early Social Development
2.
3.
4.
Temperament
– Goodness of Fit Exercise
Attachment
– Video “A Simple Gift”
Unrelieved Pain: Potential Breach of the
Attachment Relationship?

1.
2.
3.
4.
Theories of Early
Social Development
Temperament
– Goodness of Fit
Exercise
Attachment
– Video “A Simple Gift”
Unrelieved Pain:
Potential Breach of the Attachment
Relationship

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“Chicken and Egg”
Transactional
Humans are social creatures that need and give care
Theories-
1

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Evolutionary and Biological Approaches
– Focus on innate behaviours and species survival
– Innate signalling behaviours (Attachment Behavioural
Control System)
– Innate response to “large heads, round faces and chubby legs” (Caregiving Behavioural Control System)
– Johnny’s crying is a pre-programmed behaviour
Theories-
2

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Environmental/Learning
– Focus on socialization as a result of learning processes (reinforcement, punishment, observational learning)
– Johnny’s crying is reinforced by maternal attention
Cognitive-Developmental
– Focus on how infants and parents understand their social context
(working models, schemas)
– Johnny’s immediate jump to high distress is based on his belief that attention
Sociocultural
– Focus on socialization in a cultural context
– Johnny’s intense crying is related to his mother’s stress levels due to her isolation from family, financial stress and cultural isolation Theories-
3

1.
2.
3.
4.
Theories of Early
Social Development
Temperament
– Goodness of Fit
Exercise
Attachment
– Video “A Simple Gift”
Unrelieved Pain:
Potential Breach of the Attachment
Relationship

Temperament is the how of behaviour and not the why or the what of behaviour.
Temperament is about individual
differences in behaviour and behavioural style.
The importance of temperament has become more recognized as there is a growing understanding about the child’s unique contribution to developmental outcomes.

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No universal definition
General agreement
– Various dimensions
– Biological, innate predispositions and significant degree of stability
– Can be either protective or risk factor depending on social context  Goodness of
Fit crucial to well-being

(NYLS) (Thomas, Chess, & Birch, 1968)
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Began in 1956 and extended for three decades
Assessed 133 3-month-old infants until early adulthood
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Followed the infants into adulthood
On basis of clusters of the dimensions identified 3 types of children: “easy”,
“difficult”, and “slow-to-warm-up”.

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Characteristics tended to remain constant over time.
Not all the “difficult” children ended up with behaviour or emotional problems.
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Outcome influenced by “goodness of fit” particularly with parents.

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Activity Level
– Level of motor activity (active to inactive)
Regularity/Rhythmicity
– Predictability of biological functions
– Hunger, sleep, toileting
Approach/withdrawal/first reaction
– How child accepts new things
– People, foods, places, clothes

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Adaptability
– Longer term responses to change/novelty
– Degree to which reactions can be modifiable
Sensory Threshold/Sensitivity
– Responses to differences in sensations (e.g. taste, texture, sound, temperature)
– Particular interest for pain
Intensity of Reaction
– Energy level of response (regardless of pole)

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Mood
– Amount of positive mood
Distractibility
– How interfering are outside stimuli to ongoing behaviour
Persistence/Attention Span
– Amount of time activity is pursued without interruption
– Continuation in the face of obstacles

The easy child (40%)
1. Is regular and has predictable routines
2. Readily approaches new things
3. Easily adapts to new situations
4. Shows a mild degree of reaction
5. Positive in mood

The slow-to-warm-up or shy child (5-
15%)
1. Withdraws in new situations
2. Slow to adapt
3. Low in activity level and intensity
4. Displays a lot of negative mood

The difficult child (10%)
1. Is irregular and has unpredictable routines
2. Low in approach, withdrawing from novelty
3. Slow to adapt
4. Intense in reactions
5. Displays a lot of negative mood
Note: About 35-40% of children combine these qualities and have been called intermediate or mixed. Based on the New York
Longitudinal Study (NYLS) (Thomas, Chess, & Birch, 1968).

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“Goodness of fit” occurs when there is
compatibility between the capacities and characteristics of the individual and the demands and expectations of the environment.
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When there is “poorness of fit” there is the risk of the development of a behaviour problem or disorder.

… She reports that Johnny becomes fussy and oppositional very easily, is very active, and throws “mean” tantrums especially when he is sick…. His mother is focused on getting his arm into his winter coat. Johnny immediately explodes in tears and begins shrieking...
His mother sighs and states that Johnny hates this coat because he is very sensitive to the roughness of the fabric.
Both Johnny’s social worker and mother agree that his reactions in your office were quite typical. You note that when he first started coming in with his mother, he was often irritable because he had to miss his nap and his mother explained it really upsets him when his routines are disrupted and he has to meet new people. You note that things are better but that it has taken almost three months for him to get used to coming for appointments.
1. How would you classify Johnny?
2. What type of parent would be a good fit for Johnny?

1. Is irregular and has unpredictable routines X
2. Low in approach, withdrawing from novelty

3. Slow to adapt

4. Intense in reactions

5. Displays a lot of negative mood


1. Activity level: Are you always on the move or do you prefer to be still
1…………………………………………………..5
Still Active
2. Regularity: How regular do you like to be about eating, sleeping and other bodily functions?
1…………………………………………………..5
Regular Irregular
3. Approach/First Reactions: How do you react to new ideas, activities, places or people?
1…………………………………………………..5
Reject at first Jump right in
4. Adaptability: How quickly do you adapt to new situations, changes in routines
1…………………………………………………..5
Quickly Slowly
5. Sensory Thresholds/Sensitivity: How sensitive are you to noises, bright lights, temperatures, tastes, smells, textures?
1…………………………………………………..5
Very Sensitive Not sensitive

6.
Intensity of Reaction: How intense are your emotional reactions?
1…………………………………………………..5
Mild Reactions Intense Reactions
7. Mood: How much of the time do you feel happy and content compared to discontented and unhappy?
1…………………………………………………..5
Usually positive Usually Negative
8. Distractibility: How aware are you of things going on around you? Do you often get distracted by external stimuli
1…………………………………………………..5
Not distractible Very Distractible
9. Persistence/Attention Span
Do you generally persist with an activity regardless of interest/difficulty?
1…………………………………………………..5
Very persistent give up easily

1.
2.
3.
4.
Theories of Early
Social Development
Temperament
– Goodness of Fit
Exercise
Attachment
– Video “A Simple Gift”
Unrelieved Pain:
Potential Breach of the Attachment
Relationship

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Freud- secondary drive/dependency theory
Karl Lorenz’s geese (1935)
Bowlby’s leadership on WHO project on mental health of homeless children (1951)
James Robertson’s “A two year old goes to the hospital” (1952)
Harlow’s monkeys challenge (1962)
Bowlby’s Attachment and Loss (1969, 1973,
1980)
Ainsworth operationalizes attachment
(Strange Situation Paradigm) and a strong empirical tradition is born (1978)

Bowlby’s Ethological Theory of Attachment
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Different basic biobehavioural systems control our behaviour
The Attachment System
– Proximity seeking is the ultimate goal of the
attachment system
– Some triggers = pain, fatigue, fear
– When proximity is achieved  attachment system deactivates
– Works with the Exploratory Behavioural Control
System
– Both systems are crucial to Social, Emotional and
Cognitive Development
Reliably measured after 12 months of age

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(Ainsworth et al., 1978)*
Page 470 in text
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Introduction
Parent and infant alone
Stranger enters, parent leaves
First separation episode
First reunion episode
Second separation episode
Continuation of second separation episode
Second reunion episode
Approximately 20-25 minutes in total

Secure 55%
(explore, distress, relief)
Insecure-Avoidant 23%
(explore, little distress, avoid)
Insecure-Resistant 8%
(limited exploring, lots of distress, relief/anger)
Disorganized 15% (greater in high risk groups)
(maybe explore but unpredictable, odd behaviours to separation and reunion)
(Benoit, 2000)

(cont.)
Parent Attachment-
Adult Attachment Inventory
Autonomous parent
Infant Attachment- SSP
Secure
Dismissive parent Avoidant
Preoccupied parent Ambivalent/ resistant
Unresolved/
Disorganized Disorganized

VIDEO: A Simple Gift
1. Which 2 types of parents are exemplified in the video?
2. Any Ideas why they picked those two to highlight to parents?

1.
2.
3.
4.
Theories of Early
Social Development
Temperament
– Goodness of Fit
Exercise
Attachment
– Video “A Simple Gift”
Unrelieved Pain:
Potential Breach of the Attachment
Relationship?

The Socio-
Communication Model of Infant Pain
Craig & Pillai Riddell,
2003
Painful Event
Cultural
Context
Community
Context
Familial
Context
Pain Experience
Pain Expression
Child
Cultural
Community
Context
Context
Familial
Context
Assessment of pain
Intervention
Caregiver

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Research has suggested a positive relationship between inappropriate parental behaviours and physiological stress responses (Field 1994; Lueken &
Lemery 2004).
Pain experience and expression is altered after significant, prolonged exposure to pain in medical environments (Grunau et al
1994; Taddio et al 1997).
Using principles of operant conditioning a few possible scenarios developing over time…

(Pillai Riddell & Chambers, 2007)
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Sensitive assessment and management of physical and psychological dimensions of pain
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Over time, the infant trusts the caregiver will respond to the their pain. Thus, although the infant still gets upset from pain, caregiver soothing is quite effective.

(Pillai Riddell & Chambers, 2007)
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Low sensitivity  less vigorous signaling to a caregiver (e.g.,
Sweet et al 1999)
Inconsistent sensitivity  most intense pain behaviours would be positively reinforced and less intense reactions would be extinguished


(Pillai Riddell & Chambers, 2007)
Parent consistently exacerbates the infant’s pain experience by heightening fear/anxiety
(e.g Hysterical when the infant cries, Unreassuring reassurance, Shaking the infant ) a) b) high level of behavioural reactivity
(inconsolability) to an objectively mild pain stimulus low/no level of reactivity (‘spacing out’) to a highly painful stimulus (e.g. our NICU babies?)

Which Infant-Caregiver Description is based on which attachment style?
Optimal (sensitive to infant cues, child’s pain is attended to consistently, infant is soothed)?
Secure
Low Sensitivity (doesn’t attend to infant cues; reinforces low emotional expressivity in infant)?
Avoidant
Inconsistent Sensitivity (if responds, tends to respond only when infant is at peak reactivity; infant not sure whether caregiver will respond or not; infant quite upset even when caregiver tries)?
Ambivalent/Resistant
Significant Insensitivity (scares infant, expects infant to caretake, heightens infant fear/anxiety; odd infant reactions) ?
Disorganized

“ Developmental Psychology Lecture
November 8, 2007 ”