Development :

Birth & Childhood

Dr Omar I Almodayfer
MD, FRCPC, ABAPDip
Head of Mental health
KAMC, Riyadh
modayfero@ngha.med.sa
 :Objectives
 To understand the complexity of
development.
 To know the basic theories of development.
 To be able to understand the influence of
development on health related issues.
 To be able to assess this influence at an
appropriate level.
What is the normal
?development
 Think
 A child 1 yr old his mother could not train him
to be dry during the day.
 A neglected 6yrs old child id wetting his bed
daily at the family home.
 Development is a very
complicated process where every
.aspect affect the other ones
 Pathways
 Motor :
 Gross.
 Fine.

 Speech and language.

 Social development.
 Moral development.
 Pathways2
 Psychological:
 Psychosexual: Freud.
 Psychosocial : Erickson.
 Cognitive development. Piaget.
 Separation individuation: Mahler.
 Attachment theory, Bowlby.
 Temperamental theory: Thomas and chess.
 Freud's theory
 3 important concepts :
 topographical view
 Id
 In Freudian theory, the part of the psyche
that is totally unconscious and serves as the
source of instinctual impulses and demands
for immediate satisfaction of primitive needs.
 Ego
 the ego is the largely unconscious part of
personality that mediates the demands of the
id, the superego and reality. The ego prevents
us from acting on our basic urges (created by
the id), but also works to achieve a balance
with our moral and idealistic standards
(created by the superego)...
 Super ego
 the superego is the component of personality
composed of our internalized ideals that we
have acquired from our parents and from
society. The superego works to suppress the
urges of the id and tries to make the ego
behave morally, rather than realistically.
 Consciousness
 It may involve thoughts, sensations,
perceptions, moods, emotions, dreams, and
an awareness of self, although not
necessarily any particular one or combination
of these.
 Preconscious
 preconscious is applied to thoughts which
are unconscious at the particular moment in
question, but which are not repressed and
are therefore available for recall and easily
capable of becoming conscious.
 Unconscious
 unconscious refers to that part of mental
functioning of which subjects make
themselves unaware.
 Drive theory
 Libido.
 Aggression.
 Phases
 Oral 0-1
 Anal 1-3
 Phallic 3-5
 Latency 5-11
 Genital 11-18
 Practical points
 Unconscious can affect behavior and
feelings.
 The society plays a significant role in helping
the child moderating his drives and the ego
develop as a result of this.
 Our childhood experiences affect our mental
health significantly.
 Psychosocial development
 8 stages man.
 Epigenetic principles.
 Different varieties of outcome.
 Stage 1
 Basic trust vs. mistrust.
 0- 1 yrs old.
 Practical applications:
 Stage 2
 Autonomy vs. shame.
 1-3 yrs old.
 Practical points:
 Stage 3
 Initiative vs. guilt.
 3-5 yrs.
 Stage 4
 Industry vs. inferiority.
 5-11 yrs.
 Practical points:
 Stage 5
 Ego identity vs. role diffusion.
 11-21 yrs
 Practical points:
 Stage 6
 Intimacy vs. isolation.
 21-40.
 Stage 7
 Generativity vs. stagnation.
 40-60 yrs.
 Practical points:
 Stage 8
 Ego integrity vs. despair.
 Above 60 yrs.
 Practical points:
 Cognitive development
 Piagets theory.
 Stages of cognitive and intellect
development.
 Stages are dependant on each other.
 These development are a result of :
 Maturation of CNS.
 Life experience.
 Paiget's theory
 Sensory motor 0-2yrs
 Pre operational 2-7yrs.
 Concrete operational 7-11yrs
 Formal operational 11-18
 Other concepts
 Assimilation:
 Accommodation:
 Attachment theory
 A warm, intimate, and continues relationship
with the mother in which both find satisfaction
and enjoyment.
 Secure base.
 Attachment stages
 Pre attachment 0-10 weeks.
 Attachment in the making 8wks- 6 months.
 Clear cut attachment after 6 months.
 Strange person experiment
 A laboratory procedure used to assess infant attachment style. The procedure
consists of the following eight episodes (Connell & Goldsmith, 1982; Ainsworth,
Blehar, Waters, & Wall, 1978).
 Parent and infant are introduced to the experimental room.
 Parent and infant are alone. Parent does not participate while infant explores.
 Stranger enters, converses with parent, then approaches infant. Parent leaves
inconspicuously.
 First separation episode: Stranger's behavior is geared to that of infant.
 First reunion episode: Parent greets and comforts infant, then leaves again.
 Second separation episode: Infant is alone.
 Continuation of second separation episode: Stranger enters and gears behavior
to that of infant.
 Second reunion episode: Parent enters, greets infant, and picks up infant;
stranger leaves inconspicuously.
 The infant's behavior upon the parent's return is the basis for classifying the
infant into one of three attachment categories.
 Temperament theory
 NYLS.
 Lasted for more than 40 yrs.
 Thomas and chess.
 behavioral dimensions of 9
)temperament ( stable
 Activity level.
 Rhythmicity.
 Approach or withdrawal.
 Adaptability.
 Intensity of reaction.
 Cont
 Threshold of response.
 Quality of mood.
 Distractibility.
 Attention span and persistence.
 groups 3
 Easy Children 40%.
 Regularity, Positive approach to stimuli,
Adaptable, Mild mood intensity.
 Difficult Children 10%.
 Irregularity, Withdrawal response, Slow
Adaptation, Intense mood.
 Slow to Warm Up 15%.
 Not Classified 35%.
 http://www.youtube.com/watch?
v=mgXwCqzh9B8