Flashcards in The Beginning of Life: Pregnancy Through Preschool Deck (100):
How many children are born each year in the US?
What percentage of births is by cesarean section?
Give the definitions of premature and very premature births.
Premature --> Gestation less than 37 weeks.
Very premature --> Gestation less than 32 weeks.
What are the risks associated with premature birth?
1. Greater risk for dying in the 1st year of life.
2. Emotional, learning, behavioral problems.
3. Physical disability
4. Mental retardation
What is the target group of premature births and with what conditions is it associated?
1. Low income
2. Maternal illness or malnutrition
3. Young maternal age
--> Twice as many in non-Hispanic African American than in non-Hispanic white infants.
Mention a political reason about the high mortality rates of infants in the US?
In part, because there is no system of health care for all citizens paid for by the government through taxes.
What is the Apgar score?
Quantifies physical functioning in premature and full-term newborns and can be used to predict the likelihood of immediate survival.
The Apgar score is named after Dr. Virginia Apgar. What is the useful mnemonic?
A --> Appearance (color)
P --> Pulse (heartbeat)
G --> Grimace (reflex irritability)
A --> Activity (muscle tone)
R --> Respiration (breathing regularity)
At what times is the infant evaluated for the Apgar score?
1 minute and 5 (or 10) minutes after birth.
Discuss the measures of the Apgar score?
0, 1, 2 --> Highest = 10.
>7 --> no imminent survival threat.
imminent survival threat.
What is the baby blues (postpartum blues)?
Many women experience a typical emotional reaction called baby blues lasting up to 2 weeks after childbirth.
What is the country with the lowest infant mortality rate?
Sweden --> 2.4 per 1000 live births.
What does the zero in Apgar score mean for the 5 categories?
Color --> Both body + extremities are pale or blue.
Heartbeat --> Absent
Reflexes --> No response
Muscle tone --> Flaccid, limb
Respiration --> Absent
What does the 1 in Apgar score mean?
Color --> Pink body + Blue extremities.
Heartbeat --> Slow ( Grimace
Muscle tone --> Weak, inactive.
Respiration --> Irregular, slow.
What does the 2 in Apgar score mean?
Color --> Pink body + pink extremities.
Heartbeat --> Rapid (>100/min).
Reflexes --> Foot withdrawal, cry, sneeze, cough.
Muscle tone --> Strong, active.
Respiration --> Good, crying.
What factors lead to the baby blues?
Psychological factors (emotional stress of childbirth, the feelings of added responsibility).
Physiological factors --> changes in hormone levels + fatigue.
What does the management of baby blues involve?
Emotional support from the physician as well as practical suggestions for child care.
Mention 2 more serious reactions than postpartum blues?
1. Major depression
2. Brief psychotic disorder with postpartum onset.
--> Give antidepressants and antipsychotics.
What enhances bonding between the caregiver and the infant?
What may adversely effect the bonding?
1. Child is of low birth weight or ill leading to separation from the mother after delivery.
2. Problems in the mother-father relationship.
What is the incidence of postpartum blues, major depressive episode, and brief psychotic disorder (post partum onset)?
Postpartum blues --> 33-50%.
Major depressive episode --> 5-10%.
Brief psychotic disorder (post partum onset) --> 0.1-0.2%.
When is the onset of symptoms of the 3 psychological sequelae after childbirth?
Baby blues --> Within a few days after delivery.
Major depressive episode --> Within 4 weeks after delivery.
Brief psychotic disorder --> Within 4 weeks after delivery.
Compare the duration of symptoms of the 3 different sequelae after childbirth.
Baby blues --> Up to 2 weeks after delivery.
Major depressive disorder --> Up to 1yr without treatment - 3-6 wks with treatment.
Brief psychotic disorder --> Up to 1 month.
What are the characteristics of baby blues?
1. Exaggerated emotionality and tearfulness.
2. Interacting well with friends and family.
3. Good grooming.
What are the characteristics of major depressive disorder?
1. Feelings of hopelessness and helplessness.
2. Lack of pleasure or interest in usual activities.
3. Poor self-care
4. May include psychotic symptoms ("mood disorder with psychotic features").
5. Mother may harm infant.
What are the characteristics of brief psychotic disorder?
1. Psychotic symptoms not better accounted for by mood disorder with psychotic features.
2. Mother may harm infant.
What is the principal psychological task of infancy?
The formation of an intimate attachment to the primary caregiver, usually the mother.
What happens toward the end of the 1st year of life between the infant and the primary caregiver?
Separation from the primary caregiver leads to initial loud protests from the infant (typical "separation anxiety").
What may depressed infants exhibit?
Poor health and slowed physical growth.
What is the diagnostic and statistical manual of mental disorders, 4th Ed., Text revision (DSM-IV-TR) term for disturbances in otherwise typical children owing to grossly pathological care?
Reactive attachment disorder of infancy or early childhood.
What are the 2 types of reactive attachment disorder of infancy or early childhood?
Inhibited and disinhibited.
What happens in inhibited type of reactive attachment disorder of infancy or early childhood?
Children are withdrawn and uresponsive.
What happens in the disinhibited type of reactive attachment disorder of infancy or early childhood?
Children approach and attach indiscriminately to strangers as though the strangers were familiar to them.
What has Harry Harlow demonstrated about infant monkeys reared in relative isolation by surrogate artificial mothers?
Do not develop typical mating, maternal, and social behaviors as adults.
Males or females are affected more by such isolation?
Is the length of time of isolation important?
Yes --> Young monkeys isolated for less than 6 months can be rehabilitated by playing with typical young monkeys.
What has Rene Spitz documented?
Children without proper mothering (those in orphanages) show:
1. Severe developmental retardation
2. Poor health
3. Higher death rates
("Hospitalism") despite the adequate physical care.
What is the foster care system?
Foster families are those that have been approved and funded by the state of residence to take care of a child in their homes.
What are the major reflexes of reflexive behavior of the infant?
1. Sucking reflex
2. Startle reflex (Moro reflex)
3. Palmar grasp reflex
4. Babinski reflex
5. Rooting reflex.
ALL these reflexes DISAPPEAR within the 1st year of life.
What is one of the 1st markers of the infant's responsiveness to another individual?
The social smile - not the reflexive smile present at birth.
What is called "stranger anxiety"?
Crying and withdrawing in the presence of an unfamiliar person.
When does stranger anxiety normally begin?
At about 7 months of age.
What does stranger anxiety indicate?
That the infant has developed a specific attachment to the mother and is able to distinguish her from a stranger.
True or false? Infants exposed to many caregivers are less likely to show stranger anxiety than those exposed to few caregivers.
What is the object permanence?
At about 1yr the child can maintain the mental image of an object or of the mother without seeing it or her.
What is the palmar grasp reflex and when does it disappear?
The child's fingers grasp objects placed in the palm.
When does the sucking reflex disappear?
What is the Moro reflex?
When the child is startled, the arms and legs extend.
When does the Moro reflex disappear?
What is the Babinski reflex?
Dorsiflexion of the largest toe when the plantar surface of the child's foot is stroked.
When does the Babinski reflex disappear?
What is the tracking reflex?
Child visually follows a human face.
When does the tracking reflex disappear?
What motor development do we see in 1-3mos?
Lift head when lying prone.
What motor development do we see in 4-6mos?
1. Turns over (5mos)
2. Sits unassisted (6mos)
3. Reaches for objects
4. Grasps with entire hand ("raking grasp")
What motor development do we see in 7-11mos?
1. Crawls on hands and knees.
2. Pulls self up to stand.
3. Transfers toys from hand to hand (10mos).
4. Picks up toys and food using "pincer" (thumb and forefinger) grasp.
What is the motor development in 12-15mos?
What is the social development in 1-3 mos?
Smiles in response to a human face (the "social smile").
What is the social development in 4-6mos?
1.Forms an attachment to primary caregiver.
2. Recognizes familial people.
What is the social development in 7-11mos?
1. Shows stranger anxiety
2. Plays social games such as peek-a-boo
3. Waves "bye-bye"
What is the social development in 12-15mos?
Shows separation anxiety.
What is the verbal and cognitive development in 1-3mos?
Coos or gurgles in response to human attention.
What is the verbal and cognitive development in 4-6mos?
Babbles (repeat single sounds over and over).
What is the verbal and cognitive development in 7-11mos?
1. Imitates sounds
2. Uses gestures
3. Responds to own name
4. Responds to simple interactions
What is the verbal and cognitive development in 12-15mos?
1. Says first words
2. Show object permanence
What have Chess and Thomas showed about the temperaments of infants?
There are endogenous differences that remain quite stable for the first 25 years of life.
What are the three categories of children?
1. Easy children --> Adaptable to change, show regular eating and sleeping patterns, and have a positive mood.
2. Difficult children --> Show traits opposite to easy children.
3. Slow-to-warm up children --> Difficult children at first but then improve and adapt with increased contact with others.
How does Freud describe development?
In terms of parts of the body from which the most pleasure is derived at each stage of development (e.g. the oral stage occurs during the 1st year of life).
How does Erik Erikson describe development?
In terms of critical periods for the achievement of social goals - if a specific goal is not achieved at a specific age, the individual will have difficulty achieving the goal in the future.
--> Erikson's stage of basic trust vs mistrust --> children must learn to trust others during the 1st year of life or they will have trouble forming close relationships as adults.
How does Piaget describe development?
In terms of learning capabilities of the child at each age.
How does Margaret Mahler describe development?
Early development as a sequential process of separation of the child from the mother or primary caregiver.
What is the major theme of the 2nd year of life?
To separate from the mother or the primary caregiver, a process that is complete by about age 3.
Is there compelling evidence that daily separation from working parents in a good day care setting has short- or long-term negative consequences for children?
What is the motor development in 1.5yr?
1. Throws a ball
2. Stacks 3 blocks
3. Climbs stairs one foot at a time
4. Scribbles on paper
What is the motor development in 2yrs?
1. Kicks a ball
2. Balances on one foot for 1 sec
3. Stacks 6 blocks
4. Feeds self with spoon
What is the motor development in 3yrs?
1. Rides a tricycle
2. Undresses and partially dresses without help
3. Climbs stairs using alternating feet
4. Stacks 9 blocks
5. Copies a circle
What is the motor development in 4yr?
1. Catches a ball with arms
2. Dresses independently using buttons and zippers
3. Grooms self (e.g. brushes teeth)
4. Hops on one foot
5. Draws a person
6. Copies a cross
What is the motor development in 5yrs?
1. Catches a ball with 2 hands
2. Draws a person in detail (e.g. with arms, hair, eyes)
3. Skips using alternating feet
4. Copies a square
What is the motor development in 6yr?
1. Ties shoelaces
2. Rides a two-wheeled bicycle
3. Prints letters
4. Copies a triangle
What is the social development in 1.5yr?
Moves away from and then returns to the mother for reassurance (rapprochement).
What is the social development in 2yrs?
1. Shows negativity (e.g. the favorite word is "no")
2. Plays alongside but not with another child (parallel play: 2-4yrs)
What is the social development in 3yr?
1. Has a sense of self as male or female (gender identity)
2. Usually achieves bladder and bowel control (encopresis and enuresis cannot be diagnosed until 4 or 5yrs, respectively)
3. Comfortably spends part of the day away from mother.
What is the social development in 4yr?
1. Begins to play cooperatively with other children.
2. Engages in role playing
3. May have imaginary companions
4. Curious about sex differences (plays "doctor" with other children)
5. Has nightmares and transient phobias (e.g. monsters)
What is the social development in 5yrs?
1. Has romantic feelings about the opposite sex parent (the oedipal phase) at 4-5yrs.
2. Overconcerned about physical injury at 4-5yrs.
What is the social development in 6yrs?
1. Begins to develop an internalized moral sense of right or wrong.
2. Begins to understand the finality of death
What is the verbal and cognitive development in 1.5yr?
1. Uses about 10 individual words.
2. Says own name
What is the verbal and cognitive development in 2 yrs?
1. Uses 250 words
2. Speaks in two-word sentences and uses pronouns (e.g. me do)
3. Names body parts and objects
What is the cognitive and verbal development in 3yrs?
1. Uses about 900 words in speech.
2. Understands about 3.500 words.
3. Identifies some colors.
4. Speaks in complete sentences (I can do it myself)
5. Strangers can now understand her.
What is the verbal and cognitive development in 4yrs?
1. Shows good verbal self-expression (e.g. can tell detailed stories).
2. Comprehends and uses prepositions (e.g. under above).
What is the verbal and cognitive development in 5yrs?
Shows further improvement in verbal and cognitive skills.
What is the verbal and cognitive development in 6yrs?
1. Begins to think logically
2. Begins to read
When does a child experiencing separation anxiety disorder?
When it cannot separate from his mother after age of 3.
Do preschool children understand that death is permanent?
No - they expect that a dead relative (or pet) will come back to life.
When does toilet training typically occur?
At age 3.
What is a typical reaction of children to life stress? (divorce, birth of sibling)?
Regression --> behave baby-like again.
What are typically preschool children?
Active --> rarely sit still for long.
When does the child understand that death is permanent?
When does the child understand that it also can die?
When does the superego (sense of morality) begin to develop?