19/02/2015
The Agenda
CHILD DEVELOPMENT
Child Matters
Ages and Stages
Theorists
Stress Response
Auckland
Adolescence
February 2015
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Father
Family
What we bring...
Father
Mother
Caregiver
Whanau
Kathryn Berkett
Grandparent
Kathryn Berkett
MEdPsych
MEdPsych
When entering situation Consider:
• Child
• Connection / Relationship
• Parent
• Your effect on situation
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
1
19/02/2015
In Utero
Insults
• Cell development
• Migration
• Differentiation
• Alcohol
• Other drugs
• High Stress
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Possible Effects
First 18 Months
• Growth of Brain
• Cell connections
• Anxiety
• Behaviour Issues
• Developmental delay
• Myelination
• Templates
• Trust vs Mistrust
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Brain Growth
Cell Body
Axon
Nucleus
Synapse
Dendrites
Newborn
Reference:
1 year
3 years
Adult
Dekaban (1978)
2
19/02/2015
Kathryn Berkett
MEdPsych
Theorists
Trust vs Mistrust
•Sigmund Freud
• Theory of Psychosexual Development
• Oral Phase (Freud)
•Erik Erikson
• Theory of Psychosocial Development
• “Dance of Attunement”
• Attachment
•Bowlby / Ainsworth
• Attachment Theory
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Freud’s Theory of Psychosexual
Development
Erikson’s Theory of Psychosocial
Development
• Oral Stage:
birth – 18 months
1.
Trust vs Mistrust
• Anal Stage:
18 months – 3 years
2.
Autonomy vs Shame and Doubt
• Phallic Stage:
3 – 6 years
• Latent Period:
6 years - puberty
• Genital Stage:
[Birth – 18 months]
[18m – 3years]
3.
Initiative vs Guilt
[3 – 5 years]
4. Industry vs Inferiority
puberty +
[6 – 12 years]
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
3
19/02/2015
cont...
5.
Identity vs Confusion [12 – 18 years]
6.
Intimacy (and Solidarity) vs Isolation
Attachment Theory
• Bowlby & Ainsworth
[18 – 35ys]
7.
• 1930’s
Generativity vs Stagnation
• “Strange Situation” Test
[35 – 55/65 years]
8.
Integrity vs Despair
[55/65 – death]
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Key Concepts
Attachment Styles
• Safe Haven
• Secure
• Secure Base
• Ambivalent – Insecure
• Proximity Maintenance
• Avoidant – Insecure
• Separation Distress
• Disorganised – Insecure
(Main & Soloman, 1986)
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
18 Months – 3 Years
Autonomy vs Shame & Doubt
• Autonomy vs Shame & Doubt
• Emotional Development
• Anal Phase (Freud)
• Theory of Mind
• Sense of Control
• Piaget
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
4
19/02/2015
The Terrific Twos
Cortex
Limbic
Midbrain
Brainstem
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Cortex
Cortex
Limbic
Limbic
Rational, Abstract,
Creative, Futuristic…..
Empathic
Midbrain
Midbrain
SURVIVAL
Brainstem
Brainstem
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Theory of Mind
Piaget’s Theory of Cognitive
Development
• Sensorimotor Stage:
• Pre-operational Stage:
Birth – 2 years
2 – 6 years
• Concrete Operational Stage:
7 – 11 years
• Formal Operational Stage: 12 years +
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
5
19/02/2015
4 Years – 6 Years
Initiative vs Guilt
• Initiative vs Guilt
• “No”
• Sexual Identity
• Of self
• Oedipus / Electra Complex
• Phallic (Freud)
• Confidence to try
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
7 Years – Puberty
• Industry vs Inferiority
Sexual Development
• Moral Development
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Industry vs Inferiority
Kohlberg’s Theory of Moral Development
Heinz Steals the Drug
• Latent Stage (Freud)
• Courage to try…
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
6
19/02/2015
In Europe, a woman was near death from a special kind of
cancer. There was one drug that the doctors thought
might save her. It was a form of radium that a druggist in
the same town had recently discovered. The drug was
expensive to make, but the druggist was charging ten
times what the drug cost him to make. He paid $200 for
the radium and charged $2,000 for a small dose of the
drug.
The sick woman's husband, Heinz, went to everyone he
knew to borrow the money, but he could only get
together about $ 1,000 which is half of what it cost. He
told the druggist that his wife was dying and asked him to
sell it cheaper or let him pay later. But the druggist said:
"No, I discovered the drug and I'm going to make money
from it." So Heinz got desperate and broke into the man's
store to steal the drug-for his wife. Should the husband
have done that? (Kohlberg, 1963)."
Kathryn Berkett
LEVEL 1: Preconventional Morality
• Stage 1. Obedience and Punishment
• Stage 2. Individualism and Exchange
LEVEL 2: Conventional Morality
• Stage 3. Interpersonal Relationships
• Stage 4. Maintaining Social Order
LEVEL 3: Postconventional Morality
• Stage 5. Social Contract and Individual Rights
• Stage 6. Universal Principles
MEdPsych
Adolescent Development
• Identify vs Confusion
Kathryn Berkett
MEdPsych
•Survival
•Procreation
•Protection
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Physical Development
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
7
19/02/2015
1 – 4 Months
4 – 8 Months
• Teeth may begin to appear (teething behaviour)
• Infant will instinctively protect self with arms thrown out if lowered suddenly
• Sit alone without support
•
Eyes moving together in unison
• Holds a bottle
•
Startle reflex (until 4/5 months)
•
• Pulls into crawling position, may rock, but generally not moving
Grasp with entire hand
•
• Roll over from back to stomach
Not strong enough to hold items
•
Raise head and upper body when in prone position
•
Reaches for objects
• Plays ‘peek-a-boo’
• Understands “no” or “danger”
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
8 – 12 Months
12 – 24 Months
• Weight approx three times birth weight
• Can see objects 4-6m away and points at them
• Rapid eruption of teeth
• Reaches with one hand to grasp object
• Crawls skilfully and quickly
• Begins to use pincer grasp
• Releases object by dropping/throwing. Can’t deliberately put things down
• Begin to pull into standing position / may stand alone
• Gets to feet unaided / stands alone
• May still ‘drop’ to floor to sit, or fall forward
• Enjoys scribbling, uses whole arm movement
• Follows simple instructions
• Holds spoon, still not accurate, spills etc
• Repeatedly and intentionally drops objects
• Helps turn pages of book
• Watches people, takes interest in immediate environment
• If you hide an object and child sees, they will always look in same place for object. Later in
period will look in other places
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
12 – 24 months cont...
Two Year Old
• Develops functional relationships (spoon in bowl. cars drive)
• Puts items in container then dumps out
• Uses lots of ‘jargon’ talk, imitates speech patterns / rules
• Follows simple directions
• 25-50 words usually about food, animals, toys
• Recognises self in mirror
• Asserts independence – tantrum to resist getting dressed, shoes on etc... Doesn’t want help.
• Enjoys peers, but doesn’t play co-operatively
•
15 baby teeth almost finished growing out
•
Balances on one foot, jumps up and down but may still fall
•
May achieve toilet training – expect accidents
•
Throws large ball underarm
•
Scribbles holding crayon with full fist
•
Puts objects together / takes them apart
•
Simple classification (cars / dolls separate)
•
Concentration periods increase
•
Understands cause and effect – tip cup = spill
•
Object permanence begins
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
8
19/02/2015
Two Year Old cont...
Year Old
• Can jump from low step, jumps onThree
spot
• 50 – 300 different words
• Can kick big ball shaped object
• Receptive speech more advanced than expressive
• Throws ball overhand – aim and distance limited
• Repeatedly asks ‘what's that?’
• Draws horizontal, vertical and circular strokes with more control
• Shows signs of empathy and caring (often ‘cure’ is what they would want)
• Catches large ball with both arms extended
• May still be aggressive when angry or frustrated
• Enjoys swinging on swing – not too high
• Temper tantrums peak this year
• Can carry liquid without spilling too much
• May begin bossing parents and others
• Pours from one container to another
• Still playing solitary, though may imitate others
• Enjoys books, pretends to read, interacts with story, Can turn pages
• Shouting ‘no’ becomes automatic at times
• Speech is understandable most of the time
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Four Year Old
Four Year Old cont...
•
Can follow and recognise simple sequence of activities
• Can walk a straight line
•
Rote count to 20 or more (may not have concept)
• Hops on one foot
•
Recites simple songs and rhymes
• Climbs ladders, trees etc
•
Moods change rapidly and unpredictably
• Jumps and lands with both feet together
•
Has imaginary playmate
• Starts to use a tripod grasp when drawing
•
Exaggerates, boasts. May push boundaries with ‘naughty’ words and subjects
• Recognises when words are similar
•
Participates with group activities, cooperates with others
• Identify 18 – 20 letters, may write some letters and their name
•
Shows pride in achievements
• Understands tallest, smallest, same, more...
•
Still may be selfish, unable to take turns
•
Enjoys role-playing and make believe
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
Five Year Old
Five Year Old cont...
• Can walk backwards, toe to heel
• Learns to skip
• Catches a ball
• Balances well on either foot for ten seconds
• Can reproduce three dimensional structure with blocks from a picture or model
• Knows lots of shapes, letters
• Good control with drawing
• Cuts on line with scissors, (not straight)
• Understands concept of same shape, same size
•
Recognises numerals from 1-10
•
Still asking lots of what, why, when questions
•
1,500 + words
•
Recalls a story from a book while reading it
•
Knows 4 – 8 colours
•
May have one or two good friends
•
Can play co-operatively for a while, but may still exclude / play solitary
•
Generally subservient to parents / adults
•
Less emotional swings
•
Likes making people laugh, cares for people in pain
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
9
19/02/2015
Six Year Old
•
Has trouble staying still
•
Understands time of day
•
Enjoys challenges of puzzles, sorting games etc
•
May be reading
•
May reverse some letters b/d p/g etc
•
Can tie laces
•
Can identify left and right hands fairly consistently
•
Begins to understand death and dying
•
Can’t handle things not going their way
•
May be fearful of the unknown ie. dark
Observations
• Facts not opinions
• Be aware, sensitive and respectful
Kathryn Berkett
Kathryn Berkett
MEdPsych
MEdPsych
10