Lecture 7.1: Child Development and Communication

Question 1

Principles of Development (5)

Answer 1

• Influenced by both heredity and
  environment
• It takes place at different rates for
  different parts of the organism
• Development is continuous rather
  than discrete
• There is a great deal of variability
  amongst individuals
• Breaks in the continuity of
  development will generally be due
  to environmental factors

Question 2

What is Attachment?

Answer 2

An affectional bond that a person feels for another

Question 3

Types of Attachment

Answer 3

• Secure
• Insecure: Anxious & Avoidant

Question 4

Multiple Attachment Model

Answer 4

• All attachments are important, not
  just the primary attachment

Question 5

Temperament Hypothesis

Answer 5

• Personality influences the type of
  attachment

Question 6

Attachment Theory

Answer 6

• Attachment theory is a
  psychological, evolutionary and
  ethological theory concerning
  relationships between humans
• The most important tenet is that
  young children need to develop a
  relationship with at least one
  primary caregiver for normal social
  and emotional development

Question 7

Stage Theory of Cognitive Development (4)

Answer 7

• Sensory motor stage (birth–2 yrs)
• Pre-operational stage (2–7)
• Concrete operational stage (7–12)
• Formal operational stage (12+)

Question 8

Stage Theory of Cognitive Development: Sensory Motor Stage (4)

Answer 8

• Sensory and motor skills used to
  explore the environment
• Experience is limited to the
  immediate environment
• Coordination and intentionality of
  movement
• Object permanence

Question 9

Stage Theory of Cognitive Development: Pre-Operational Stage (6)

Answer 9

• Symbolic thinking
• Egocentricism
• Reasoning is not yet logical or
  abstract
• Mainly concrete and intuitive
• Classification is based on single
  features
• Difficulty in understanding
  conservation

Question 10

Stage Theory of Cognitive Development: Concrete Operational Stage (5)

Answer 10

• Logical reasoning ability
• Reasoning remains concrete rather
  than abstract
• Classification is based on multiple
  features
• Development of empathy
• Mastery of conservation

Question 11

Stage Theory of Cognitive Development: Formal Operational Stage (3)

Answer 11

• Metacognition
• Introspection abilities
• Reasoning becomes abstract,
  hypothetical, multi-dimensional and
  systematic

Question 12

Limitations of Standardising Children’s Development (4)

Answer 12

• Children’s abilities are
  underestimated
• Progress depends on factors other
  than chronological age
• Individual differences are not
  considered
• Understanding in some domains
  may be more advanced than others

Question 13

Through the Eyes of the Child: Pre-Operational Stage in regards to Illness (5)

Answer 13

• Explanations of illness are
  egocentric, magical, circular and
  phenomenological
• Illness is perceived as a
  punishment for real or imaginary
  rule transgression
• Children can hate clinicians
  inflicting pain
• Cannot see link between treatment
  and relief of symptoms
• Practitioners should provide
  reassurance that illnesses or pains
  are not punishments

Question 14

Through the Eyes of the Child: Concrete Operational in regards to Illness (4)

Answer 14

• Increased awareness of body and
  internal organs
• Fear of total annihilation (body
  destruction and death)
• Illnesses are caused by
  contamination or internalisation
• Reassurance regarding fears of
  bodily annihilation should be
  provided

Question 15

Through the Eyes of the Child: Formal Operational
Understanding in regards to Illness (3)

Answer 15

• Understanding of illnesses of
  varying degrees
• Have proportionate reaction to the
  diagnosed illness
• Ability to comprehend treatment

Question 16

Language Development in Children (5 Stages)

Answer 16

• 6 months: Babbling
• 12 months: First Words
• 2 years: Incomplete Sentences
• 3 years: Complete Sentences
• 5 years: Complex Sentences

Question 17

Theories of Language Development (3)

Answer 17

• Nativism/Nature (innate language
  acquisition device)
• Behaviourism/Nurture
  (reinforcement, social learning and
  observational)
• Interactionism/Nature&Nurture (a
  combination of innate and.
  environmental factors)

Question 18

Theory of Mind (ToM)

Answer 18

• The ability to attribute mental states
  to oneself and others
• Understanding that others can have
  different mental states to our own

Question 19

Different ToM Levels: Zero-Order

Answer 19

• No theory about the mental states
  of others

Question 20

Different ToM Levels: First-Order

Answer 20

• A theory about the mental states of
  another person

Question 21

Different ToM Levels: Second-Order

Answer 21

• A theory about what one person
  thinks about the mental states of
  another person
• A theory about what other people
  think about our mental states

Question 22

What is Psychosocial Development?

Answer 22

• “Psycho” relating to the mind and
  “social” relating to relationships and
  the environment
• Describes the impact of social
  experience across the lifespan
• A psychosocial crisis occurs at
  each stage

Question 23

How many stages of Psychosocial Development are there?

Answer 23

8

Question 24

Psychosocial Development: Stage 1 Infancy (birth to 18
months)

Answer 24

• Psychosocial Crisis: Trust vs
  Mistrust
• Infants must learn to trust the care
  and affection of their parents.
• Important event: feeding.
• Maladaptive crisis resolution results
  in distrust of parents and viewing
  the world as inconsistent and
  unpredictable

Question 25

Psychosocial Development: Stage 2 Early Childhood (18 months to 3 years)

Answer 25

* Psychosocial crisis: Autonomy vs. Shame and Doubt * Children need to develop a sense of control and independence * Important event: toilet training. * Maladaptive crisis resolution results in feeling ashamed and doubt about ability to do things independently

Question 26

Psychosocial Development: Stage 3 Preschool Age (3-5 years)

Answer 26

* Psychosocial crisis: Initiative vs. Guilt * Children should use their own initiative in planning or carrying out actions * Important event: exploration * Maladaptive crisis resolution results in developing a sense of guilt over misbehaviour

Question 27

Psychosocial Development: Stage 4 School Age (5-11 years)

Answer 27

* Psychosocial crisis: Industry vs. Inferiority * Children are required to follow the rules imposed by teachers at school or parents at home * Important event: school. * Maladaptive crisis resolution results in beliefs of being inferior to others

Question 28

Psychosocial Development: Stage 5 Adolescence (11-18 years)

Answer 28

* Psychosocial crisis: Identity vs. Role confusion * Adolescents need to acquire a sense of identity * Important event: social relationships * Maladaptive crisis resolution results in confusion about role in life

Question 29

Is Early Puberty Onset worse for Boys or Girls?

Answer 29

Girls

Question 30

Is Late Puberty Onset worse for Boys or Girls?

Answer 30

Boys

Question 31

Issues in Communicating with Children (5)

Answer 31

* Triadic (or more!) rather than dyadic consultation * Parents often interrupt during medical interviews * Often highly anxious and overly concerned * Younger children are naturally fearful of new environments and strangers * Younger children have a limited. understanding

Question 32

Recommendations for Communicating with Children (11)

Answer 32

* Establish rapport * Eye contact with child and parent * Be at the child’s eye level * Ensure child-friendly environment * Observe, wait, listen (OWL) * Use simple language and explain medical concepts appropriately * Offer choice * Reading books to children about their illness can aid understanding * Do mock examinations on a toy or the parent * Start by examining non-threatening areas first to build trust * Give rewards and acknowledge cooperative behaviours

Question 33

Issues in Communicating with Adolescents (3)

Answer 33

* Adolescents can be “private” and self- conscious * They may not want their parents to be involved * Desire for independence includes non- adherence to treatment

Question 34

Recommendations for Communicating with Adolescents

Answer 34

* Negotiate times to see adolescents separately from parents * Stress confidentiality of information * Be respectful and understanding * Take concerns seriously * Show a positive attitude and interest in their point of view * Use their terminology and explain any medical terminology * Don’t ‘get down with the kids’

Question 35

Issues in Communicating with Disabled Children and Adolescents

Answer 35

* May be unable to ask questions or understand explanations * Reasoning ability should be considered

Question 36

Recommendations for Communicating with Disabled Children and Adolescents (8)

Answer 36

* Ask about strategies the patient uses to communicate * Ensure enough time to communicate * Use diagrams and writing * Check and clarify understanding * Maintain eye contact when speaking * Speak louder than normal if required * Verbalisation of any actions * Ensure supporters do not speak for the patient unless requested

Question 37

Parental Communication Styles and the corresponding Coping Strategies

Answer 37

* Optimism: Unrealistic Optimism * Realism: Realistic Optimism * Pessimism: Pessimism * Factual: Neutral