Eighteen to
Twenty-Four
Months
Fogel
Chapter 10
Created by Ilse DeKoeyer-Laros, Ph.D.
Overview Chapter 10
• Motor & Cognitive Development
• Emotional Development
• Social and Language Development
• Family and Society
Experiential Exercises
Between 18 and 24 months, toddlers
• walk & start to run
• feed themselves
• start to dress themselves
• are likely to start toilet learning
(between 18 & 36 months)
• still nap in the afternoon; it is
not uncommon for them to
wake occasionally at night
Picture from: http://jackandjillnursery.co.uk/wb/pages/oxton-nursery.php
Motor & Cognitive Development
Cognitive Development
Sensorimotor Stage VI (18 to 24 months) –
the invention of new means through
mental combinations
– children can think about the possible paths to
a goal, eliminate the most improbable ones,
and only then act
– they now have clear object permanence
Motor & Cognitive Development
Cognitive Development: Symbolic Play
Symbol – a representation of a thing or
event that is conventionally shared among
the members of a community
• in Stage VI, the symbol
becomes detached from its
original context
• it becomes something that can
be manipulated and explored
Picture from: www.doh.state.fl.us/.../module4/lesson1_4.html
Motor & Cognitive Development
Cognitive Development: Symbolic Play
Between 18 and 24 months, toddlers
develop the ability to execute complex
play sequences that require multiple
symbols & advance planning
Pictures from: www.dalianmitmita.com
Motor & Cognitive Development
The Ability to Categorize Objects
By 18 months, infants learn to categorize
by sequential order, or by cause and
effect
• they remember better if items & events are
organized into a sequence
– e.g., a teddy bear is undressed, put into the tub,
washed, and then dried
• they can remember sequences up to 2
weeks later (whether familiar or unfamiliar)
Motor & Cognitive Development
The Ability to Categorize Objects
Script – an organization of concepts and
memories in terms of how the events are
related to each other in time
– become increasingly important to represent
reality & remember action sequences
– 2-year-olds cannot memorize long lists of new
words or concepts, but they can execute
complex sequences of related actions
Motor & Cognitive Development
Favorite Toys
Between 18 and 24 months, children love
• pegboards in which they can fit objects of
different shapes in the corresponding holes
• containers (and putting things in them)
• nesting-cup toys, in which smaller cups are
placed inside successively larger cups
Pictures from: http://mae12.wordpress.com/
simplebounty.wordpress.com/2008/01/
Motor & Cognitive Development
Smart Toys, TV, & the Internet
Between 18 and 24 months, infants become more
interested in TV and ‘smart toys’
– about 40% of 3-month-olds in the US regularly watch
TV, DVDs, or videos
– babies under age 1 watch on average 1 hr/day; at
age 2, this is 1.5 hours per day
– about 75% of parents report that their infants under
age 2 watches TV; 1 in 5 watches at least 2 hrs/day
– reasons for using these media:
• entertainment, babysitting, and education
Motor & Cognitive Development
Smart Toys, TV, & the Internet
One study showed that smart toys are
neither beneficial nor harmful
– if infants engage with the world at their own
level, it makes little difference what kind of toy
is available so long as it is interesting
– parents can encourage development with
inexpensive low-tech toys as easily as with
expensive ones
Motor & Cognitive Development
Smart Toys, TV, & the Internet
TV, DVD, and video viewing has been
shown to have harmful effects on
cognition and brain development for
children under the age of 3
Picture from: parentzing.wordpress.com
Motor & Cognitive Development
Smart Toys, TV, & the Internet
• Regardless of other risk factors, more hours of
TV, DVD or video at ages 1 and 3 were related to
— more aggression at age 4
— attention & hyperactivity at age 7
• For every hour of TV watched per day, 2-yearolds knew 6-8 fewer words
Motor & Cognitive Development
Smart Toys, TV, & the Internet
Parents should carefully monitor children’s TV
viewing & limit the amount of time children are
allowed to watch (max. 15-30 minutes per day)
— infants learn best by acting
and not by simply observing
— pots and pans will make a
baby just as smart as an
expensive toy
Picture from: hubpages.com/hub/The-Importance-of-Play
Motor & Cognitive Development
Smart Toys, TV, & the Internet
In the US, children spend an average of only 30
minutes of unstructured outdoor time per week
— outdoor play and other nature experiences have
been shown to lower depression, improve attention
and concentration, and increase self-discipline
Picture from: gennasuspapillons.blogspot.com
Emotional Development
Between 18 and 24 months, emotional
expressions continue to become more complex
& more related to communicative situations
Picture from: camdennguyen.blogspot.com/
Emotional Development
Positive Emotions
After 18 months, infants are
more likely
– to smile during joint activity &
attention with their mothers
– to smile when they experience
periods of affective sharing
– to initiate positive emotions in
their communications with the
parent
Emotional Development
Positive Emotions
In the 2nd year, laughter
• takes on specific meaning within the motherinfant communication system
• serves to get attention
• mother-infant dyads develop their own styles of
laughing together
– one mother would frame an opportunity for infant
laughter by providing all the facial features of a
laugh, and waiting until the infant provided the actual
laugh before she laughed in unison
Emotional Development
Symbolic Thought & Emotional Experience
• After 18 months, fear can be evoked by a
symbolic mental image
– children develop fears of the dark and of things that
might lurk behind doors, refrigerators, and other
unseen places
• Dreams can also be a source of fears
— but nightmares do not appear until after the second
birthday
Emotional Development
Symbolic Thought & Emotional Experience
By 20 months, about one-third of all children will
talk about one or more of the following states:
– sleep/fatigue (“tired”)
– pain (“ouch”)
– distress (“sad”)
– disgust (“yuck”)
– affection (“love Mommy”)
– value (“good,” “bad”)
Emotional Development
Symbolic Thought & Emotional Experience
• By 24 months, toddlers
— engage in conversations about their feelings
— talk about the causes of their feelings
— play games with siblings in which they pretend to
have certain kinds of feelings
• The verbal expression of internal experience is
one of the major characteristics of the
existential self
Emotional Development
Self-Conscious Emotions
• Toddlers recognize themselves in a mirror &
tend to show embarrassment when they do
– embarrassment (or shame) is a self-conscious
emotion
– one has to realize that others are different from the
self & that the self is exposed, separate, and likely to
be evaluated by others
• Other self-conscious emotions
emerge around the 2nd birthday
– guilt, jealousy, and pride
Picture from: raisingchildren.net.au/.../context/752
Emotional Development
Self-Conscious Emotions
Pride
• the result of meeting their
own standards
• awareness of having
accomplished a personal
goal in the eyes of another
person
Picture from: www.cremedelacreme.com/programs/toddlers.asp
Emotional Development
Self-Conscious Emotions
Pride & shame develop within the context of
communication about success or failure in
meeting standards, rules, & achievements
in one study, children were more likely to show guilt, when
their parents responded more positively to the child’s
achievements
Picture from: http://thankgoodnesschildcare.com/Toddlers.html
Emotional Development
Self-Conscious Emotions
Feelings related to anger
• defiance, negativism, and aggression, due to
– a growing sense of independence
– a feeling that the self is separate from others
• Erik Erikson:
– two emotional poles of this phase are autonomy
(pride, defiance) & shame (doubt, disappointment)
Emotional Development
Coping with Stress
Teddy bears & favorite blankets are used to selfcomfort in stressful situations & when parents
are not around
toddlers can become attached to these objects:
they constantly want them close & show signs of
anxiety & distress when separated from them
Picture from: reviews.ebay.com
Emotional Development
Coping with Stress
• A blanket seems to be an effective substitute for
the mother, at least for brief periods
– blankets are soft and cuddly
– they carry familiar smells that may remind the child
of home & impart an sense of security
• Attachment objects have been called
transitional objects
– seem to serve as a bridge between a child’s total
reliance on the mother & the development of
individuation
Emotional Development
Coping with Stress
There seems to be little need for
transitional objects when
children have continued access
to physical contact
– 4.9% of rural Italian children had
transitional objects, vs. 31.1% of
children in Rome
– only 38% of Japanese infants had
an object attachment compared to
62% of US infants
Picture from: www.abibitumikasa.com
Emotional Development
Coping with Stress
• In one study, infants were exposed to a variety
of frustrating situations
– some children showed distress by screaming,
hitting, kicking, or banging
– more distressed children were less able to selfcomfort (e.g., distracting themselves)
• Mothers of more distressed children were more
likely to try to help rather than letting the
children solve the problem themselves
Emotional Development
Coping with Stress
Parents play a crucial role in the
development of emotion regulation skills
children are better regulated if mothers have
talked with them about children’s feelings
Picture from: http://www.parents-in-a-pickle.com
Emotional Development
Coping with Stress
• Early deficits in neurological development that
may also play a role in emotion regulation
– children whose mothers smoked prenatally are more
disruptive & less able to self-calm than other infants
• Emotion regulation difficulties were more likely
by the end of the 2nd year if infants had been
less able to establish joint attention with parents
in the 1st year
Emotional Development
Coping with Stress
Children adopt the emotional regulation
styles found in their families
• For example,
– 2-year-olds tended to seek comfort & assistance from
preschool caregivers with a family history similar to
that of their mothers
• Adults typically choose partners who have
similar family histories & attachment styles
Emotional Development
Coping with Stress
Children develop internal working models –
expectations for particular kinds of
attachment styles
• they continue to replicate those even
when it is not in their best interest
• breaking out of the cycle of difficult
interpersonal relationships often
requires individual, couple, or family
psychotherapy
Picture from: www.bostonmarriagetherapy.com/
Emotional Development
Coping with Stress
In sum,
• the parent-infant relationship & the active role of
adults are crucial for emotion regulation
• transitional objects are useful but can’t replace
an adult
• even though toddlers begin to acquire
language, most emotion regulation is nonverbal
– this may help explain the lasting effect on the
formation of later interpersonal relationships
Emotional Development
Separations from Primary Caregivers
By the end of the 2nd year, toddlers understand
that parents will return after a separation
In one study (in a public park), boys left parents more often
than girls, but they did not wander off further or longer
Emotional Development
Separations from Primary Caregivers
Infants separate more easily
• if the parent prepares the child & gives instructions
for what to do during separation
• if dropped off at a familiar setting
• if the caregiver stays at a distances shortly before
departure
• if dropped of by father rather than mother (mothers
took longer to leave the children)
Social & Language Development
Important changes in language between 18
and 24 months:
1. a dramatic increase in vocabulary
2. the beginning of multiword sentences
Picture from: http://amazingtrips.blogspot.com/2007_02_01_archive.html
Social & Language Development
The Vocabulary Spurt
Vocabulary spurt: rapid increase in
vocabulary around 18 months
– children begin to acquire 5 or more words
per week (primarily object names)
– it is as if they discover that objects have
names and become obsessed with naming
things & asking for object names – the
naming insight
Social & Language Development
The Vocabulary Spurt
Age
Average Vocabulary
18 months
90 words
24 months
6 years
high school
graduate
320 words
14,000 words
60,000 words
From 2 to 18 years, children learn 9-10 words per
day: most language is acquired after the infancy
period
Social & Language Development
The Vocabulary Spurt
• Nouns predominate in all languages
• Toddlers of this age also acquire:
– verbs (play, kiss)
– adjectives (hot, yucky)
– adverbs (up, more)
• They can use words to make comments
– on objects (gone, dirty)
– on their own actions and feelings (uh-oh, tired)
Social & Language Development
The Vocabulary Spurt
Just before the acquisition of multiword speech,
infants use single words in more complex ways
that suggest a subject and a predicate
– after 18 months, infants may point to a shoe and say
“dirty” or “Mommy”
– this could be interpreted as
“the shoe is dirty” or
“this is Mommy’s shoe”
Social & Language Development
Multiword Speech
Around 20 months, sentences
emerge & children begin to
– pursue objects after multiple
hidings
– use tools in deliberate ways
– engage in symbolic play
Social & Language Development
Multiword Speech
Cognitive abilities guide language learning
• Children
– combine symbolic objects &
gestures in novel ways
– classify objects by sorting
– solve complex problems
mentally without trial-and-error behavior
Picture from: compassionatesolutions.ca
Social & Language Development
Multiword Speech
• Prior to using 2-word sentences, children may
combine a gesture & a word
– seeing a sleeping bird, the child might point at the bird
and say “nap”
– a month later, the child can say “bird nap” to mean
the same thing: the bird is taking a nap
• Toddlers discover they can create new
meanings simply by changing the word order
• The first 2-word combinations are idiosyncratic
usages that only later become conventional
Social & Language Development
Multiword Speech
• Toddlers discover they can create new
meanings simply by changing the word order
• The first 2-word combinations are idiosyncratic
usages that only later become conventional
– this is similar to the early idiosyncratic use of
communication gestures that gradually develops into
conventional communication signs
Social & Language Development
Multiword Speech
Telegraphic speech leaves out small words such
as prepositions and word endings such as -ing, s sounds, and -ed,
– these add additional refinements to the meaning of
words and sentences
– simpler endings such as -ing, the plural -s, and the
possessive -’s are acquired first
– next, the more difficult use of the verb “to be” with all
its tenses, auxiliaries, and contractions
Social & Language Development
Two Types of Speech Style
Young children show two distinct styles of
vocabulary acquisition
– referential speech
– expressive speech
Social & Language Development
Two Types of Speech Style
Referential Speech
Expressive Speech
Object names
Nouns
Single words
Large vocabulary
Social routines
Pronouns
Phrases
Small
Substantive content
Original production
Clear articulation
Relational
Imitative
Mumbled
Referential
As in reading books
Interpersonal
As in free social play
Table 10.8
Social & Language Development
Two Types of Speech Style
These styles of language acquisition
• are used by most children in different contexts
• may reflect the speech spoken to them
– if a caregiver clearly labels objects, the child may
focus more on individual words (referential)
– if the caregiver uses social language like “D’ya wanna
go out” or “I dunno where it is,” the child is likely to
hear these as whole phrases (expressive)
Social & Language Development
Language & the Social Environment
• Adults increasingly rely on verbal suggestions
and commands
– requests: asking for information through “what” and
“where” questions (“Where’s the doggie?”)
– comments are responses to the children’s utterances
or attempts to initiate a conversation (“Yes, that’s an
apple”; “This is the same car we saw the other day”)
• After children’s mispronunciation, mothers
simply repeated the correct pronunciation
Social & Language Development
Language & the Social Environment
The child develops greater linguistic
competence when the adult
– uses speech that is more
responsive to the child’s
focus of interest
– uses the child’s interest to
achieve a joint focus of
attention before talking
– uses clear speech
Picture from: http://www.toddler-activities-at-home.com
Social & Language Development
Guided Participation
Guided participation – the active role that
children take in observing & participating
in the organized activities of the family &
society
– from the adult’s perspective, the child is
merely “playing games” or “playing at”
cooking or taking care of a doll
– from the child’s perspective, the child is
actually doing the task as an active participant
Social & Language Development
Guided Participation
Guided Participation
•
establish coordinated joint
attention based on the
child’s initiatives
•
the adult must also constrain
the child’s participation (e.g., for safety)
•
the adult transfers responsibility for larger
segments of the task to the child
Picture from: www.cyfernet.org/local_spotlight/04-08.htm
Social & Language Development
Guided Participation
Cultural differences
• Mothers from the U.S. were compared with
Maya Indian mothers from Guatemala on how
they helped their 20-month-olds use a set of
nesting dolls
– the U.S. mothers acted more like peers, wanting to
take turns in combining dolls and commenting on the
process
– the Maya mothers retained more of an adult-child
status differential
Social & Language Development
Guided Participation
When adults participate in children’s spontaneous
actions, children can achieve higher levels of
language, play, and cognitive development
– they develop higher levels of symbolic
play when mothers give more options
that stimulate creativity
– coordinated joint attention is less likely if
mothers are depressed or have a low
sense of self-efficacy
Picture from: www.littlebundles.ca
Social & Language Development
Guided Participation
Individual differences
• sharing and mutuality vary
with the task or situation
– shared pretend play evokes
more sharing
• children with difficult temperament or attachment
problems receive more explicit instructions
(more by fathers than mothers)
Picture from: www.discoverytoyslink.com
Social & Language Development
Guided Participation
Functions of parent-child pretend play
• just for fun
• to meta-communicate about conflicts or
disagreements
– mothers may engage in pretend play to give the child
something to do, to redirect an otherwise undesirable
activity, or to make light of a negative emotion
• for guidance, such as teaching proper conduct
– more likely in Taiwanese than in North American
families
Social & Language Development
Discipline & Compliance
Authoritative parents combine empathy &
firmness
They
– use firm demands
– express their own anger or distress appropriately
– do not use power to control the child
Picture from: www.whattoexpect.com
Social & Language Development
Discipline & Compliance
Children of authoritative parents
• show purposive, independent
behavior
• are cooperative with adults
• show friendliness to peers
• are more likely to imitate their
mothers
• are likely to become upset after
violating standards of conduct
Picture from: http://www.njkidfit.com/childrensprograms.nxg
Social & Language Development
Discipline & Compliance
By this age, the father begins to
play a substantial role in family
processes
more sensitive & involved fathers
have children who are more
socially competent and less
defiant
Pictures from: www.fathers.com & www.camh.net
Social & Language Development
Discipline & Compliance
Parental proactive behavior – any action that has
the goal of a positive outcome for the child
– e.g., joining the infant’s play and then try to make the
child do something else
– avoiding problems by proactively controlling, or
regulating access to, the environment
– preventive measures
• e.g., talking to the child & giving something to eat while
shopping to avoid tantrums
Social & Language Development
Discipline & Compliance
Coercive & controlling discipline
• in one study, mothers & fathers in “troubled”
families were more likely to use control instead
of guidance & authoritative approaches
– children in these families showed the most defiance
and the most negative emotion
• teenage mothers
– are more coercive (on average)
– tend to infer more anger & defiance in
infants’ emotion expressions
Picture from: www.squidoo.com
Social & Language Development
Discipline & Compliance
• Corporal punishment – using physical force that
causes pain to the child but not injury
• A review of 88 studies (n=36,309) found that
corporal punishment in the early years related to
– poor self control
– poor relationship with parents throughout childhood
– more criminal or antisocial behavior
– abuse of children’s own children or spouse in
adulthood
Social & Language Development
Discipline & Compliance
Some suggest that occasional spanking may be
used in serious offenses (e.g., running into the
street), especially if the spanking is later
accompanied by
– explanations
– recognition of the child’s feelings
– expressions of love
Picture from: www.parentlineplus.org.uk
Social & Language Development
Discipline & Compliance
Ethnic differences
• Caucasian-American children who were
spanked were at 5 times greater risk for later
behavior problems
• for African-American and Hispanic-American
families, there was no relationship
– spanking is viewed as a normal parental behavior and
is rarely done impulsively or in anger
Social & Language Development
Discipline & Compliance
• In general,
– focus on praise, proactive parenting, respect for the
child’s point of view, and mild sanctions
– toddler defiance is often a way for children to express
their feelings, assert their budding self-awareness, &
experiment with taking initiative and taking charge
• Defiance that is aggressive or violent is typically
a sign of an emerging vicious cycle implicating
parental coercion and aggression
Social & Language Development
Peer Interactions
• Toddler-peer play is different in quality from
toddler-parent play
• When given a choice,
toddlers almost always
choose a peer over their
mothers to play with
– they spend more time with the peer and make fewer
bids for their mother’s attention when a peer is
present
Picture from: student.britannica.com
Social & Language Development
Peer Interactions
Between 18 and 24 months, peer play
begins to take on a more game-like quality
– children take simple turns
• e.g., offering & accepting, throwing & catching, or
simple verbal exchange
– words are used, but not at the same level of
elaboration as in adult-infant games
– there is little cooperation & collaboration
Social & Language Development
Peer Interactions
Relationship – a continuing pattern of
communication between two or more
people in which past encounters provide a
historical background for future encounters
it is not until the end of the 2nd
year that children can form
lasting relationships with other
children
Picture from: www.bigelowcoop.org
Social & Language Development
Peer Interactions
Differences in peer relationships
• compatible friends – direct mostly positive
behaviors toward each other & refrain from
conflicts
• enemies or fighting friends – tend to engage in
conflicts most of the time
• other children tend not to interact with each
other (ignoring), either positively or negatively
Social & Language Development
Peer Interactions
• The types of toys used in peer play influence the
types of interactions between the children
• In one study, researchers found
– more sophisticated interaction between 18-montholds & a greater expression of positive emotion with
large play equipment (ladders, slides, boxes)
– with small portable toys, more conflict & negative
emotion was expressed
– children were most creative in the no-toy situation
Social & Language Development
The Sense of an Existential Self
The existential self: 18-month-olds begin to create
a whole picture of themselves as someone who
can be recognized & distinguished
They
– recognize themselves in
a mirror
– categorize & remember
familiar sequences of
events (scripts)
Picture from: www.parentingtoddlers.net
Social & Language Development
The Sense of an Existential Self
Use of personal pronouns begins around the
same time as mirror self-recognition
– expressing intended actions
(“I do it,” “I hold it”)
– making requests or
proposals (“I wanna play with
that one”)
– stating propositions (“I have
the crayon”)
Social & Language Development
The Sense of an Existential Self
After 18 months, infants are also beginning
to reason about other people’s desires
• In one study, 14- and 18-month-olds watched
while adults ate either crackers or broccoli
– 14-month-olds offered the adult only crackers,
assuming that the adult would like what the child
liked, regardless of the adult’s expressed preferences
– 18-month-olds, offered whichever food the adult
seemed to prefer
Social & Language Development
The Sense of an Existential Self
Infants who are more self- and other-aware
• are more securely attached to their
mothers & fathers
• show more concern for other’s
distress
• can coordinate mirror image imitation
• are more competent with peers
Social & Language Development
Infantile Autism
• Autism – a developmental psychopathology that
may be reliably diagnosed during this age period
– impaired ability to interact socially
– speech and language deficits
– unusual movements of the body
• 6 to 13 out of every 1,000 individuals
– affects 2 to 4 times more males than females
Picture from: www.bukisa.com
Social & Language Development
Infantile Autism
Difficulty with coordinated joint attention &
intersubjectivity
– don’t use social referencing or affective sharing
– don’t respond appropriately to the desires or distress
of others
– less distressed at separation from mothers
– less likely to imitate others
– don’t pretend
– unlikely to initiate social interaction
– don’t talk, or only in monologues
Social & Language Development
Infantile Autism
Many children with autism never develop a sense
of an existential self & other
– do not show embarrassment in
front of a mirror or when getting
a photo taken
– do not seem to have a sense of guilt
• suggests that they cannot see themselves in the eyes of
others
– are less likely to use personal pronouns or to refer to
themselves in conversations
Picture from: www.redbookmag.com
Social & Language Development
Infantile Autism
They can
• develop secure attachments with their mothers
– although they are more likely than others to develop
disorganized attachment relationships
• point & use gestures to ask for what they want
• be advanced in some perceptual and objectrelated skills
• imitate object-related tasks better than typically
developing children
Social & Language Development
Infantile Autism
• Play is less likely to be symbolic & more likely to
be aggressive or self-stimulatory
– less likely to initiate social play with peers
– tend to use toys in ways different from their
appropriate functions (e.g., banging a toy telephone
rather than pretending to talk)
• These children can acquire
pretend play when adults use
guided participation
Picture from: characteristicsofautism.net
Social & Language Development
Infantile Autism
• A small number of children with autism show
exceptional skills in one area
– some are gifted artists but draw only one subject,
such as public buildings and monuments
• High-functioning autistics may be able to hold
jobs & create a life for themselves
• Most children with autism will change little and
acquire only minimal social skills & self-care
Social & Language Development
Infantile Autism
Causes
• believed to have origins in early infancy &
prenatal development
• genetic & chromosomal abnormalities
• possibly brain & other physiological problems
that emerge during early development
– abnormalities in the limbic system (e.g., amygdale)
– abnormalities in the auditory region of the brain stem
– myelin pathologies
Social & Language Development
Infantile Autism
• Autism originates in early infancy, but typically
isn’t diagnosed until age 4 or 5
• One study found that at 18 months, children later
diagnosed with autism showed a lack of
– pointing, showing objects,
looking at others, and orienting
to their name
Picture from: sfari.org
Social & Language Development
Infantile Autism
Another study found that 2 or more of the following
at 18 months predicted autism at 30 months:
– a lack of pretend play
– a lack of pointing
– a lack of interest in social relationships
– an absence of social play
– an inability to establish joint attention with the
caregiver
Social & Language Development
Infantile Autism
Treatments for young children
• Most focus on improving the ability to engage
with another person & to develop coordinated
joint attention
• Early intervention may have more lasting effects
• Studies of sensorimotor deficits may lead to new
treatments for infants that might positively affect
brain development
Family & Society
Informal Support Systems
Parents, particularly mothers, who receive more
support
–
–
–
–
–
–
are less likely to be punitive
are more likely to play & be affectionate
respond more quickly to babies’ cries
have more secure attachments
are more nurturant
have more positive attitudes
about child rearing
– abuse their infants less
Picture from: www.drinktoglow.com
Family & Society
Informal Support Systems
A larger & more complex support network is
related to better-quality support and to
parental competence in child rearing
Two main sources of support
• spouses
• maternal grandmothers
Picture from: familyplayandlearn.com/JuneActivities.html
Family & Society
Informal Support Systems
Social support is less likely to occur when
• infants have special needs (e.g.,
preterm)
• parents are abusive and/or have
poor interpersonal skills
• parents distrust sources of support
– e.g., due to cultural reasons
Picture from: www.ehponline.org
Family & Society
Informal Support Systems
Social networks are more supportive when
• the psychological stress of the parents is
relatively low
• the family is experiencing an expected or
understandable life transition (e.g., a temporary
job loss, a death in the family)
• the source of stress is a single event rather than
a long-term problem
Family & Society
Formal Support Systems
• Formal support systems offer services including
– childbirth education well-baby care, parent training
programs, early childhood education for
disadvantaged toddlers
• Educational interventions
for parents can be enormously
effective
– especially when combined with
health care & income support
Picture from: www.stmark-elca.org
Family & Society
Formal Support Systems
• For families at risk, a comprehensive effort
is most effective
• Successful programs combine
– preschool education
– a nurse–home visitor
– an effort to link parents up with other formal
and informal community supports
• education, job training and placement, recreational
facilities, etc.
Family & Society
Formal Support Systems
• Multisite, multimethod intervention programs
have been shown to
– decrease reliance on welfare
– reduce parental substance abuse
– lower the incidence of criminal acts when the infants
become adolescents
• Neither parent education alone nor child care
alone is as effective as the two are in
combination
Family & Society
Formal Support Systems
Head Start
• Participating children 15 years later:
– had fewer teen pregnancies
– had a higher high school graduation rate
– were more likely to be employed
– were less likely to have been arrested
• Head Start children have a more enriched early
childhood and do better in preschool &
elementary school than controls
Family & Society
Formal Support Systems
Experimental programs include:
• including children under age 3
• family service centers
• transition to elementary school programs
• comprehensive child developmental centers
• family child-care projects
– these efforts combine services for the developing
child with attempts to lift the family from poverty
Picture from: blog.mlive.com
Family & Society
Infant-Parent Mental Health (IPMH)
Infant-Parent Mental Health (IPMH)
• an emerging multi-disciplinary
specialization
• focuses on the relational context of
the development of young children
• commitment to trans-disciplinary integration and to the
treatment of developmental, relational, and emotional
distress from a whole-child-in-relationship perspective
Picture from: www.cimhd.org
Family & Society
Infant-Parent Mental Health
(IPMH)
Clinical Practice in IPMH
• the caregiver-child relationship is the “client”
• intervention with parents can break the cycle of
intergenerational transmission of pathology
• IPMH is ultimately a preventative approach,
responding to difficulties in the infant-parent
relationship before they become major problems
Picture from: cehd.umn.edu
Family & Society
Infant-Parent Mental Health (IPMH)
Assessment & Diagnosis: DC: 0-3R (2005)
• a diagnostic manual specifically for disorders of
children under the age of 3 years
• categories for “individual” problems
– e.g., problems with sleeping, feeding, depression
• categories for different types of parent-infant
relationship that may be problematic
– e.g., parents who are under- or over-involved with
infants who are anxious or tense; abuse, neglect
Family & Society
Infant-Parent Mental Health (IPMH)
Interventions
• Programs such as “A Home Within” and the
“Circle of Security” project
• Video-based interventions
– parents watch videotaped parent-child interactions
together with the therapist
• Home Visits
– provide important opportunities for support,
education, referral, and information
Experiential Exercises:
Words & Feelings
This exercise centers around the experience infants
have when they begin to use symbolic language
and thought.
• Lying on the floor, relax: notice your breathing, your
heartbeat, pressure on your body, your eyes blinking. Notice
your thoughts coming and going.
• Your partner now slowly reads you a list of words (see p.
523), using appropriate accents and intonations. Notice how
your thoughts change with each word & notice the pictures
and images that run through your mind.
• Think about the experience a young child might have when
they heard these words. What would go through a young
child’s mind after having attempted to form some of these
words on his or her own?
Experiential Exercises:
Mirror self-recognition
The purpose of this exercise is to evoke the experience of
seeing oneself in a mirror for the very first time, and thus
imagine the sense of otherness or foreignness of the mirror
image, sense of shame or pride, etc.
• Sit at a desk or table with a mirror, a blank piece of paper and a pencil.
• Close your eyes for 2-3 minutes and relax.
• Open your eyes & examine your face in the mirror. As you study your
face, remain aware of your sensations and emotions.
• Write down your experience, then close your eyes once more and relax
for another 2-3 minutes.
Experiential Exercises:
Mirror self-recognition
• Open your eyes & cover one eye with your hand.
• Study your face for second time using the uncovered eye.
Notice your feelings and experience during this portion of the
exercise. Do you see yourself differently than before? Write
down your experience
• Close your eyes for another 2 minutes and repeat this
portion of the exercise with the opposite eye uncovered.
• Compare your three experiences. Imagine the different ways
in which an infant may see himself when looking into a mirror
for the first time. What do you imagine would go through an
infant’s mind?