Module I: Introduction to Lifespan Development

Descriptors/Topics
Life Span Development: Definition, Concept, Issues
Principles of Development
Influence of Culture and Diversity
Research and Anthropometric measures in Development

Development: The pattern of change that begins at conception and continues through the life
span. Most development involves growth, although it also includes decline brought on by
aging and dying.
life-span perspective: The perspective that development is lifelong, multidimensional,
multidirectional, plastic, multidisciplinary, and contextual; involves growth, maintenance,
and regulation; and is constructed through biological, sociocultural, and individual factors
working together.
 What is life span development?
Life span as defined by the Britannica dictionary is the ‘period of time between the life and
death of an organism’.
• Life span development is an important field of Developmental Psychology which is
concerned with various developmental changes occurring in an individual from
conception till death. It is a diversified and a growing field concerned with
application. It studies various aspects of human development including physical,
intellectual, emotional and social. (extra: Physiological development encompasses:
genetics, body growth, hormonal changes, and the impact of physical deformities,
diseases and illnesses.
• Cognitive development involves changes and achieving milestones of: language,
memory, and intelligence.
• Emotional development involves changes in the way people learn to recognize and
react to their own emotions, and identify and respond to those of others. Mental health
disorders usually influence both cognitive and emotional development.
• Social development refers to changes’shumans go through and experiences they have
in relationship to others.
• First social interactions are primarily with family, and every family is distinctly
influenced by culture and demographics.
 • As people grow, their social influences expand to include friends and communities.
Social interactions are influenced at every stage by authority figures and technological
evolution.)
Life span development is a field of study that takes a scientific approach and examines
patterns of growth, change and stability in behaviour that occur throughout the lifespan. Life
span development focuses on human development.
 It seeks to understand universal principles of development.

 To know how cultural, racial and ethnic differences affect development.

 To understand the traits and characteristics that differentiates one person from
another.
 The limit of ‘life span’sof each species is dependent on the heredity of that species.
The exact duration of human life is unknown, although there is presumably a maximum life
span for the human race established in the genetic material.
It should be remembered that human development is a continuous process which lasts
throughout one’s life. Developmental Psychologists are not only interested in changes that
take place as we develop, but they are also interested in stability. They are interested in
knowing when and how human behaviour reveals consistency and continuity with prior
behaviour.
[ LIFE EXPECTANCE – if asked
• Life expectancy as defined by the Oxford dictionary is ‘the average period that a
person may expect to live’
• Though in recent years the life expectancy of a human has increased but the life span
has not changed although research suggests that life expectancy also changes as one
grows older and is susceptible to more risks.
The ‘life expectancy’son the other hand can be affected by:
• Socio-economic status (employment/ income/ expense etc.)
• Quality and level of Education
• Quality of healthcare facilities and access to healthcare
• Unhealthy behaviors such as excessive consumption of tobacco, alcohol, drugs, food
etc.
• Poor Nutrition, house overcrowding, lack of sanitization, no clean drinking water etc.]
Importance/ why Life Span Development?
 1. life-span development is intriguing and filled with information about who we are,
how we came to be this way, and where our future will take us. Developmental
psychologists study how people grow, develop and adapt at different life stages. They
conduct research designed to help people reach their full potential.

2. Most development involves growth, but it also includes decline. In exploring

development, we will examine the life span from the point of conception until the
time when life ends.

3. For ease of studying life span development, we speak of stages from infancy through
old age, but in reality, people develop in a continuous fashion throughout life. Even
periods marked by specific biological changes, such as puberty and menopause in
women, occur in a gradual fashion. We will learn about how your experiences today
will influence your development through the remainder of your adult years.

4. Developmental psychologists develop theories about development and use

methodical, scientific techniques to validate the accuracy of their assumptions
systematically.

5. Some seek to understand universal principles of development, while others focus on

how cultural, racial, and ethnic differences affect development.

6. While studying change developmental psychologists also consider stability. They ask
in which areas, and in what periods, people show change and growth, and when and
how their behavior reveals consistency and continuity with prior behavior.

7. Life span development covers several diverse areas like physical development,
cognitive development, emotional development and social development.

Issues in development:

Life span development is a long journey of many decades which often raises many questions
for developmental psychologists. Few important issues in lifespan development are as
follows:
1. Continuity v/s Discontinuity in Development: The continuity-discontinuity issue
focuses on the degree to which development involves either gradual, cumulative
change (continuity) or distinct stages (discontinuity). Continuous change refers
to changes that are gradual, subtle with achievement at one level building on those of
 previous levels. Continuous change is quantitative. The underlying development
process remains the same over the lifespan. Development is also viewed as
discontinuous. Discontinuous change occurs in distinct stages. Each stage brings
about behaviour that is assumed to be qualitatively different from behaviour at earlier
stages. Example- In terms of continuity, as the oak grows from seedling to giant oak,
it becomes more of an oak— its development is continuous. Similarly, a child’s first
word, though seemingly an abrupt, discontinuous event, is actually the result of
weeks and months of growth and practice. Puberty might seem abrupt, but it is a
gradual process that occurs over several years. In terms of discontinuity, as an insect
grows from a caterpillar to a chrysalis to a butterfly, it passes through a sequence of
stages in which change is qualitatively rather than quantitatively different. Similarly,
at some point a child moves from not being able to think abstractly about the world to
being able to do so. This is a qualitative, discontinuous change in development rather
than a quantitative, continuous change.
2. The Importance of Critical and Sensitive Period: critical period is a specific time
during development when a particular event has its greater consequences. Critical
periods occur when the presence of certain kinds of environmental stimuli are
necessary for development to proceed normally. Critical period is more important for
physical development rather than social or personality development. In sensitive
period, organisms are particularly susceptible to certain kinds of stimuli in their
environments. In contrast to a critical period, however, the absence of those stimuli
during a sensitive period does not always produce irreversible consequences.
3. Nature v/s Nurture: The nature-nurture issue involves the extent to which
development is influenced by nature and by nurture. Nature refers to an organism’s
biological inheritance, nurture to its environmental experiences. The nature v/s
nurture controversy has led to heated debates in psychology and social sciences
especially with respect to intelligence. Some believe that an evolutionary and genetic
foundation produces commonalities in growth and development (Freedman, 2017;
Starr, Evers, & Starr, 2018). By contrast, other psychologists emphasize the
importance of nurture, or environmental experiences, in development (Almy &
Cicchetti, 2018; Nicolaisen & Thorsen, 2017; Rubin & Barstead, 2018). However,
chances are, we can see the ways in which both heredity and environmental factors
(such as lifestyle, diet, and so on) have contributed to these features. It is difficult to
isolate the root of any single behavior as a result solely of nature or nurture.
 4. Active vs passive: Some theorists see humans as playing a much more active role in
their own development. Piaget, for instance believed that children actively explore
their world and construct new ways of thinking to explain the things they experience.
In contrast, many behaviourists view humans as being more passive in the
developmental process
5. Stability vs change: The stability-change issue involves the degree to which early
traits and characteristics persist through life or change. Many developmentalists who
emphasize stability in development argue that stability is the result of heredity and
possibly early experiences. Developmentalists who emphasize change, take the more
optimistic view that later experiences can produce change. Experts such as Paul
Baltes (2003) argue that older adults often show less capacity for learning new things
than younger adults do. However, many older adults continue to be good at
practicing what they have learned earlier in life.
The roles of early and later experience are an aspect of the stability-change issue that
has long been hotly debated (Chen & others, 2018; Roisman & Cicchetti, 2017).
Some theorists argue that the personality traits of adults are rooted in the behavioral
and emotional tendencies of the infant and young child. Others disagree, and believe
that these initial tendencies are modified by social and cultural forces over time.
Principles of Development
German psychologist Paul Baltes, a leading expert on lifespan development and aging,
developed one of the approaches to studying development called the lifespan perspective.
This approach was based on several key principles which state that development is:

1. Lifelong: Development occurs across one’s entire life, or is lifelong.

2. Multidisciplinary: Development is multidisciplinary.

3. Multidirectional: Development is multidirectional and results in gains and losses

throughout life.
4. Multidimensional: Development is multidimensional, meaning it involves
the dynamic interaction of factors like physical, emotional, and psychosocial
development.

5. Plastic: Development is plastic, meaning that characteristics are malleable or

changeable
 6. Contextual: Development is influenced by contextual and socio-cultural influences.
(Other Contextual Influences on Development: Cohort, Socioeconomic Status, and
Culture. A cohort is a group of people who are born at roughly the same period in a
particular society. These people travel through life often experiencing similar
circumstances.)

Influence of Culture and Diversity:

Many variables influence one‘s development. One such variable is culture. Different
cultures and subcultures have their own views of appropriate and inappropriate child
rearing, depending upon the goals for children that they have. The Oxford dictionary
defines ‘culture’sas “the ideas, customs, and social behavior of a particular people or
society”. Culture is an extremely important context for human development and
understanding development requires being able to identify which features of development
are culturally based. Culture is often referred to as a blueprint or guideline shared by a
group of people that specifies how to live. It includes ideas about what is right and wrong,
what to strive for, what to eat, how to speak, what is valued, as well as what kinds of
emotions are called for in certain situations. Culture is learned from parents, schools,
media, friends and others. The kinds of traditions and values that evolve in a particular
culture serve to help members function in their own society and to value their own
society. We tend to believe that our own culture’s practices and expectations are the right
ones. This belief that our own culture is superior is called ‘ethnocentrism’. There is still
much that is unknown when comparing development across cultures, so much of what
developmental theorists have described in the past has been culturally bound and difficult
to apply to various cultural contexts.

Understanding Human Diversity: In order to understand human development, one need

to take into consideration the issue of human diversity. Development psychologists have
acquired greater understanding about the universal principles of development and have
been able to distinguish it from culturally determined differences by scientifically
assessing and studying similarities and differences among various ethnic, cultural and
racial groups.

Research and Anthropometric measures in Development:

Developmental Psychologists use wide variety of research methods. Some important topics
included under research methods are:

1. Experiments: Experiments involve significant control over extraneous variables and

manipulation of the independent variable. As such, experimental research allows
developmental psychologists to make causal statements about certain variables that
are important for the developmental process. Because experimental research must
occur in a controlled environment, researchers must be cautious about whether
behaviors observed in the laboratory translate to an individual’s natural environment.
2. Correlational Research: This type of research seeks to identify whether an association
or relationship exists between two factors. Correlational research cannot tell us whether
one factor causes changes in the other. Piaget and Vygotsky used correlational research.
3. Observational studies: Scientific observation requires an important set of skills. For
observations to be effective, they have to be systematic. When we observe
scientifically, we often need to control certain factors that determine behavior but are
not the focus of our inquiry (Leary, 2017). For this reason, some research on life-span
development is conducted in a laboratory, a controlled setting where many of the
complex factors of the “real world” are absent (artificial observation). Naturalistic
observations involve observing behavior in its natural context. Naturalistic
observation provides insights that sometimes cannot be attained in the laboratory
(Babbie, 2017). A developmental psychologist might observe how children behave
on a playground, at a daycare center, or in the child’s own home. While this research
approach provides a glimpse into how children behave in their natural settings,
researchers have very little control over the types and/or frequencies of displayed
behaviour.
4. Survey method: The survey method asks individuals to self-report important
information about their thoughts, experiences, and beliefs. This particular method can
provide large amounts of information in relatively short amounts of time; however,
validity of data collected in this way relies on honest self-reporting, and the data is
relatively shallow when compared to the depth of information collected in a case
study.
5. Standardized Test: A standardized test has uniform procedures for administration
and scoring. Many standardized tests allow a person’s performance to be compared
 with that of other individuals; thus, they provide information about individual
differences among people (Kaplan & Saccuzzo, 2018).
6. Case study: A case study is an in-depth look at a single individual. A case study
provides information about one person’s experiences; it may focus on nearly any
aspect of the subject’s life that helps the researcher understand the person’s mind,
behavior, or other attributes (Yin, 2012). A researcher may gather information for a
case study from interviews and medical records. A case study can provide a dramatic,
in-depth portrayal of an individual’s life, but we must be cautious when generalizing
from this information.
7. Physiological Measures: Researchers are increasingly using physiological measures
when they study development at different points in the life span (Bell & others, 2018).
Hormone levels are increasingly used in developmental research. These methods
focus on relationship between physiological processes and behaviour. For example, a
researcher might study the relationship between blood flow in the brain and problem-
solving ability. The three most frequently used psychophysiological measures are as
follows:
 Electroencephalogram (EEG).
 Computerised Axial Tomography (CAT).
 Functional Magnetic Resonance Imaging (fMRI).
Anthropometric measures:

• Anthropometry is the scientific study of the measurements and proportions of the

human body.

• It is the most common technique used to assess the presence and degree of protein-
energy malnutrition.

• Anthropometry is the measurement of body parameters to indicate nutritional status.

• Anthropometry can be used to measure an individual to determine if he or she needs

nutrition intervention or it can be used to measure many individuals to determine if
malnutrition is a problem in a population.

• Some common anthropometric measurements include:

 Height or length
  Weight

 Mid-upper arm circumference (MUAC)

 Demi-span or arm span

 Knee height

 Sitting height

 Skin fold thickness

 Head circumference

 Body Mass Index (BMI) - BMI is a calculation based on the relationship of height to
weight used to screen for adiposity in individuals 2 years and older

 Height (or length) and weight are the most common anthropometric measures used to
indicate protein-energy nutritional status in emergencies.

Module II: Pre Natal-Development and Birth

Descriptors/Topics:

Pre Natal-Development Stages: Conception to Birth

Genetics vs Environmental Interactions
Teratogens
Birth Stages
APGAR Scale
Newborn Reflexes

Pre Natal-Development Stages: Conception to Birth:

The interplay of biological, cognitive, and socioemotional processes produces the periods of
the human life span. A developmental period refers to a time frame in a person’s life that is
characterized by certain features. For the purposes of organization and understanding, we
commonly describe development in terms of these periods.
The prenatal period is the time from conception to birth. It involves tremendous growth—
from a single cell to an organism complete with brain and behavioural capabilities—and
takes place in approximately a 9-month period.

In the process of fertilization, a sperm cell from the male and the ovum (egg) of the female
join in the female’s fallopian tube in conception. The prenatal development which occurs
during the 38 weeks of pregnancy is typically separated into three periods:

(1) the germinal period (the period of the zygote)

(2) the embryonic period (the period of the embryo)

(3) the foetal period (the period of the fetus).

GERMINAL PERIOD:

Within several hours of conception, half of the 23 chromosomes from the egg and half of the
23 chromosomes from the sperm fuse together, creating a zygote — a fertilized ovum.
The germinal stage begins at conception when the sperm and egg cell unite in one of the two
fallopian tubes. Just a few hours after conception, the single-celled zygote begins making a
journey down the fallopian tube to the uterus. (fewer than half of zygotes survive beyond this
earliest stage of life.)

Cell division begins approximately 24 to 36 hours after conception. Through the process of
mitosis, the zygote first divides into two cells, then into four, eight, sixteen, and so on. The
process of cell division continues till the original cell becomes 800 billion or more cells. As
the cells multiply, they will also separate into two distinctive masses: the outer cells will
eventually become the placenta, (Placenta protects baby from infections of all types. It also
produces hormones that support pregnancy. It prepares mother for lactation. Placenta is a fluid
filled sac that protects baby and gives a place for moving around. ) while the inner cells form the
embryo. Cell division continues at a rapid rate during the approximately week-long journey
from fallopian tube to uterus wall. The cells develop into what is known as a blastocyst. The
blastocyst is made up of three layers, each of which develops into different structures in the
body.

1. Ectoderm: Skin and nervous system

2. Endoderm: Digestive and respiratory systems
3. Mesoderm: Muscle and skeletal systems
Finally, the blastocyst arrives at the uterus and attaches to the uterine wall, a process known
as implantation. Implantation occurs when the cells nestle into the uterine lining and rupture
tiny blood vessels. The connective web of blood vessels and membranes that form between
them will provide nourishment for the developing being for the next nine months.

EMBRYONIC PERIOD:

Once the zygote attaches to the wall of the uterus, it is known as the embryo. During the
embryonic phase, which will last for the next six weeks, the major internal and external
organs are formed, each beginning at the microscopic level, with only a few cells. The
changes in the embryo’s appearance will continue rapidly from this point until birth.

During this period the three layers of the cell are differentiated. The outer layer or ectoderm
develops into sensory cell skin and nervous system. The middle layer or the mesoderm
becomes the excretory system, muscles and blood. The inner layer the endoderm develops
into glands, digestive system, liver, pancreas and respiratory system. By the end of third week
of development, the nervous system is formed rapidly and heart starts breathing. After the
fourth weeks legs of the baby can be seen. After two months of pregnancy all the vital parts
of the body cells and kidneys start moving the waste products. The facial features become
clear and distinct by this time. The head is half of the body size now. The fingers and toes are
blunt, ribs start appearing under the skin. Approximately four weeks after conception, the
neural tube also forms. This tube will later develop into the central nervous system including
the spinal cord and brain.

This environment consists of three major structures: The amniotic sac is the fluid-filled
reservoir in which the embryo (soon to be known as a fetus) will live until birth, and which
acts as both a cushion against outside pressure and as a temperature regulator. The outer
membrane, called the chorion, develops into two organs, the placenta and the umbilical cord.
[The placenta is an organ that allows the exchange of nutrients between the embryo and the
mother, while at the same time filtering out harmful material. The placenta, is fully developed
by about 4 weeks of gestation, is a platelike mass of cells that lies against the wall of the uterus. It
serves as the liver and kidneys for the embryo until the embryo’s own organs begin to function. It also
provides the embryo with oxygen and removes carbon dioxide from its blood. Finally, the umbilical
cord links the embryo directly to the placenta and transfers all material to the fetus. Thus, the
placenta and the umbilical cord protect the fetus from many foreign agents in the mother’s
system that might otherwise pose a threat.]
THE FOETAL PERIOD:

The Fetal Stage Once organogenesis is complete, the developing organism is known as a
fetus and the final phase of prenatal development, the fetal stage, begins (lasting from
approximately 8 weeks until birth). This stage is marked by amazing change and growth. The
early body systems and structures established in the embryonic stage continue to develop.
The fetus continues to grow in both weight and length. Fetal period of development is an
important period as nervous system become mature and starts functioning. The fetus with
lower weights, such as three to four pounds, have less chance of survival than the heavier
ones.

Milestones of the Fetal Period

• Weeks 9–12: Fingerprints; grasping reflex; facial expressions; swallowing and

rhythmic “breathing” of amniotic fluid, urination; genitalia appear; alternating periods
of physical activity and rest.

• Weeks 13–16: Hair follicles; responses to mother’s voice and loud noises; 8–10
inches long; weighs 6 ounces

• Weeks 17–20: Fetal movements felt by mother; heartbeat detectable with

stethoscope; lanugo (hair) covers body; eyes respond to light introduced into the
womb; eyebrows; fingernails; 12 inches long

• Weeks 21–24: Vernix (oily substance) protects skin; lungs produce surfactant (vital
to respiratory function); viability becomes possible.

• Weeks 25–28: Recognition of mother’s voice; regular periods of rest and activity;
14–15 inches long; weighs 2 pounds; good chance of survival if born now

• Weeks 29–32: Very rapid growth; antibodies acquired from mother; fat deposited
under skin; 16–17 inches long; weighs 4 pounds; excellent chance of survival of
delivered now

• Weeks 33–36: Movement to head-down position for birth; lungs mature; 18 inches
long; weighs 5–6 pounds; virtually 100% chance of survival if delivered

• Weeks 37+: Full-term status; 19–21 inches long; weighs 6–9 pounds
Teratogens:

Despite this protection, the environment can affect the embryo or fetus in many well-
documented ways. A teratogen is any agent that can potentially cause a birth defect or
negatively alter cognitive and behavioural outcomes. The field of study that investigates the
causes of birth defects is called teratology (Boschen & others, 2018; Cassina & others, 2017).
Some exposures to teratogens do not cause physical birth defects but can alter the developing
brain and influence cognitive and behavioral functioning.

The dose, genetic susceptibility, and the time of exposure to a particular teratogen influence
both the severity of the damage to an embryo or fetus and the type of defect:

• Dose. The dose effect is rather obvious—the greater the dose of an agent, such as a drug,
the greater the effect.

• Genetic susceptibility. The type or severity of abnormalities caused by a teratogen is linked

to the genotype of the pregnant woman and the genotype of the embryo or fetus (Lin &
others, 2017). The extent to which an embryo or fetus is vulnerable to a teratogen may also
depend on its genotype (Middleton & others, 2017). Also, for unknown reasons, male fetuses
are far more likely to be affected by teratogens than female fetuses.

• Time of exposure. Exposure to teratogens does more damage when it occurs at some points
in development than at others (Feldkamp & others, 2017). Damage during the germinal
period may even prevent implantation. In general, the embryonic period is more vulnerable
than the fetal period.

Following are key teratogens and few of their effects:

Prescription and Non-prescription Drugs: Prescription drugs that can function as
teratogens include antibiotics, such as streptomycin and tetracycline; some antidepressants;
certain hormones, such as progestin, and Accutane. Among the birth defects caused by
Accutane are heart defects, eye and ear abnormalities, and brain malformation. Non-
prescription drugs that can be harmful include diet pills and high dosages of aspirin (Cadavid,
2017). Research indicates that low doses of aspirin pose no harm for the fetus but that high
doses can contribute to maternal and fetal bleeding (Osikoya & others, 2017).
Psychoactive Drugs Psychoactive drugs act on the nervous system to alter states of
consciousness, modify perceptions, and change moods. Examples include caffeine, alcohol,
and nicotine, as well as illicit drugs such as cocaine, marijuana, and heroin.
Caffeine- People often consume caffeine when they drink coffee, tea, or cola, or when they
eat chocolate. Somewhat mixed results have been found for the extent to which maternal
caffeine intake influences an offspring’s development. The U.S. Food and Drug
Administration recommends that pregnant women either not consume caffeine or consume it
only sparingly.
Alcohol- Heavy drinking by pregnant women can be devastating to their offspring (Jacobson
& others, 2017). Fetal alcohol spectrum disorders (FASD) are a cluster of abnormalities and
problems that appear in the offspring of mothers who drink alcohol heavily during pregnancy
(Del Campo & Jones, 2017; Helgesson & others, 2018).
Nicotine -Cigarette smoking by pregnant women can also adversely influence prenatal
development, birth, and postnatal development (Shisler & others, 2017). Preterm births and
low birth weights, fetal and neonatal deaths, respiratory problems, and sudden infant death
syndrome (SIDS, also known as crib death) are all more common among the offspring of
mothers who smoked during pregnancy (Zhang & others, 2017).
Cocaine- The most consistent finding is that cocaine exposure during prenatal development is
associated with reduced birth weight, length, and head circumference (Gouin & others, 2011).
Also, in other studies, prenatal cocaine exposure has been linked to impaired connectivity of
the thalamus and prefrontal cortex in new-borns.
Marijuana- An increasing number of studies find that marijuana use by pregnant women
also has negative outcomes for offspring. To state a few, researchers found that prenatal
marijuana exposure was related to lower intelligence in children (Goldschmidt & others,
2008). Research reviews concluded that marijuana use during pregnancy alters brain
functioning in the fetus (Calvigioni & others, 2014; Jaques & others, 2014).
Heroin- It is well documented that infants whose mothers are addicted to heroin show several
behavioral difficulties at birth (Angelotta & Appelbaum, 2017). The difficulties include
withdrawal symptoms, such as tremors, irritability, abnormal crying, disturbed sleep, and
impaired motor control.
Incompatible Blood Types: Incompatibility between the mother’s and father’s blood types
poses another risk to prenatal development (Yogev-Lifshitz & others, 2016). Blood types are
created by differences in the surface structure of red blood cells. The differences can result in
any number of problems, including miscarriage or stillbirth, anemia, jaundice, heart defects,
brain damage, or death soon after birth (Fasano, 2017).
Environmental Hazards: Many aspects of our modern industrial world can endanger the
embryo or fetus. Some specific hazards to the embryo or fetus include radiation, toxic wastes,
and other chemical pollutants (Jeong & others, 2018; Sreetharan & others, 2017). X-ray
radiation can affect the developing embryo or fetus, especially in the first several weeks
after conception, when women do not yet know they are pregnant. Environmental
pollutants and toxic wastes are also sources of danger to unborn children. Among the
dangerous pollutants are carbon monoxide, mercury, and lead, as well as certain fertilizers
and pesticides (Wang & others, 2017).

Maternal Diseases: Maternal diseases and infections can produce defects in offspring by
crossing the placental barrier, or they can cause damage during birth (Cuffe & others, 2017;
Koren & Ornoy, 2018).

Rubella (German measles) is one disease that can cause prenatal defects. A recent study
found that cardiac defects, pulmonary problems, and microcephaly (a condition in which the
baby’s head is significantly smaller then normal) were among the most common fetal and
neonatal outcomes when pregnant women have rubella (Yazigi & others, 2017).

Syphilis (a sexually transmitted infection) is more damaging later in prenatal development—

four months or more after conception. Damage to offspring includes stillbirth, eye lesions
(which can cause blindness), skin lesions, and congenital syphilis (Braccio, Sharland, &
Ladhani, 2016).

Another infection that has received widespread attention is genital herpes. New-borns
contract this virus when they are delivered through the birth canal of a mother with genital
herpes (Sampath, Maduro, & Schillinger, 2017). About one-third of babies delivered through
an infected birth canal die; another one-fourth become brain damaged.

AIDS is a sexually transmitted infection that is caused by the human immunodeficiency virus
(HIV), which destroys the body’s immune system (Taylor & others, 2017).

Other Parental Factors:

 Maternal Diet and Nutrition- A developing embryo or fetus depends completely on its
mother for nutrition, which comes from the mother’s blood (Kominiarek & Peaceman, 2017).
Children born to malnourished mothers are more likely than other children to be malformed.

Maternal Age When possible harmful effects on the fetus and infant are considered, two
maternal age groups are of special interest: adolescents and women 35 years and older
(Gockley & others, 2016; Kingsbury, Plotnikova, & Najman, 2018). The mortality rate of
infants born to adolescent mothers is double that of infants born to mothers in their twenties.
Maternal age is also linked to risk for adverse pregnancy outcomes. When a pregnant woman
is older than 35, there is an increased risk that her child will have Down syndrome
(Jaruratanasirikul & others, 2017).

Emotional States and Stress When a pregnant woman experiences intense fears, anxieties,
and other emotions or negative mood states, physiological changes occur that may affect her
fetus (Fatima, Srivastav, & Mondal, 2017). A mother’s stress may also influence the fetus
indirectly by increasing the likelihood that the mother will engage in unhealthy behaviors
such as taking drugs and receiving poor prenatal care.

However, it should be noted that Men’s exposure to lead, radiation, certain pesticides, and
petrochemicals may cause abnormalities in sperm that lead to miscarriage or to diseases such
as childhood cancer (Cordier, 2008). The father’s smoking during the mother’s pregnancy
also can cause problems for the offspring (Han & others, 2015). All the other factors
discussed can also affect men and cause defects. Another way that the father can influence
prenatal and birth outcomes is through his relationship with the mother. By being supportive,
helping with chores, and having a positive attitude toward the pregnancy, the father can
improve the physical and psychological well-being of the mother. Conversely, a conflictual
relationship with the mother is likely to bring adverse outcomes (Molgora & others, 2018).

Birth stages:

Stages of Birth The birth process occurs in three stages.

The first stage is the longest of the three. Uterine contractions are 15 to 20 minutes apart at
the beginning and last up to a minute. These contractions cause the woman’s cervix to stretch
and open. As the first stage progresses, the contractions come closer together, appearing
every two to five minutes. Their intensity increases. By the end of the first birth stage,
contractions dilate the cervix to an opening of about 10 centimeters (4 inches), so that the
baby can move from the uterus to the birth canal. For a woman having her first child, the first
stage lasts an average of 6 to 12 hours; for subsequent children, this stage typically is much
shorter.

The second birth stage begins when the baby’s head starts to move through the cervix and
the birth canal. It terminates when the baby completely emerges from the mother’s body.
With each contraction, the mother bears down hard to push the baby out of her body. By the
time the baby’s head is out of the mother’s body, the contractions come almost every minute
and last for about a minute. This stage typically lasts approximately 45 minutes to an hour.

Afterbirth is the third stage, at which time the placenta, umbilical cord, and other
membranes are detached and expelled. This final stage is the shortest of the three birth stages,
lasting only minutes.

Methods of Childbirth U.S. hospitals often allow the mother and her obstetrician a range of
options regarding the method of delivery.
1. Medication: Three basic kinds of drugs that are used for labor are analgesia,
anesthesia, and oxytocin/Pitocin.
Analgesia is used to relieve pain. Analgesics include tranquilizers, barbiturates, and
narcotics (such as Demerol).
Anesthesia is used in late first-stage labor and during delivery to block sensation in
an area of the body or to block consciousness.
Oxytocin is a hormone that promotes uterine contractions; a synthetic form called
Pitocin is widely used to decrease the duration of the first stage of labor.
2. Natural childbirth and prepared childbirth: is the method that aims to reduce the
mother’s pain by decreasing her fear by providing information about childbirth and
teaching her and her partner to use breathing methods and relaxation techniques
during delivery (Bacon & Tomich, 2017; London & others, 2017). One type of natural
childbirth that is used today is the Bradley Method, which involves husbands as
coaches, relaxation for easier birth, and prenatal nutrition and exercise. French
obstetrician Ferdinand Lamaze developed a method similar to natural childbirth that is
known as prepared childbirth, or the Lamaze method. It includes a special breathing
technique to control pushing in the final stages of labor, as well as more detailed
education about anatomy and physiology. The pregnant woman’s partner usually
 serves as a coach who attends childbirth classes with her and helps with her breathing
and relaxation during deliver.
3. Cesarean Delivery In a cesarean delivery, the baby is removed from the mother’s
uterus through an incision made in her abdomen. Cesarean deliveries are performed if
the baby is lying crosswise in the uterus, if the baby’s head is too large to pass
through the mother’s pelvis, if the baby develops complications, or if the mother is
bleeding vaginally.
[ What are some of the specific reasons why physicians do a cesarean delivery? The most
common reasons are failure to progress through labor (hindered by epidurals, for example)
and fetal distress. Normally, the baby’s head comes through the vagina first. But if the baby
is in a breech position, the baby’s buttocks are the first part to emerge from the vagina. In 1
of every 25 deliveries, the baby’s head is still in the uterus when the rest of the body is out.
Breech births can cause respiratory problems. As a result, if the baby is in a breech position,
a cesarean delivery is usually performed (Glavind & Uldbjerg, 2015).]

Genetics vs Environmental Interactions:

Behaviour genetics is the field that seeks to discover the influence of heredity and
environment on individual differences in human traits and development (Charney 2017 et al).
Behavior geneticists try to figure out what is responsible for the differences among people—
that is, to what extent people vary because of differences in genes, environment, or a
combination of these factors (Finkel, Sternang, & Wahlin, 2017; Meier & others, 2018; Rana
& others, 2018; Wu & others, 2017). Epigenetics: the study of changes in organisms caused
by modification of gene expression rather than alteration of the genetic code itself.

Studies conducted so far has made it clear that behaviour is a product of interaction of
heredity and environment e.g., temperament. Temperament refers to patterns of arousal and
emotionality, and it happens to be enduring characteristics of individual’s personality. Studies
suggest that some children are born with unusual physical activity as compared to other
children. Still further, the difference is caused by the opportunities provided by parents that
may encourage some children to overcome their shyness. Children raised in a stressful
environment, where there is marital discord or prolonged illness in the family, may continue
to remain shy. (Kagar & Snidman, 1991, McCrae et al 2000).

Traits determined by combination of genetic and environmental factors reflect multi-factorial

transmission. In multi-factorial transmission genotype provides the range within which
phenotype vary. Hence, genotype refers to underlying genetic combination that a child
receives from parents. Phenotype refers to actual observable characteristics that are due to
interaction of genetic and environmental conditions, e.g., People may have a genotype of
average intelligence, but their intelligence differs depending upon the exposure received by
them. In such cases, environment determines how a particular genotype will be expressed, as
a phenotype.

It is also like that not all the behaviours and traits are influenced by environmental conditions.
It is not possible to say that a specific behiviour is caused only by environment or by
hereditary factors.

Nature vs nurture: the following methods are used for studying the relative influence of
hereditary and environmental factors.

In the most common twin study, the behavioral similarity of identical twins (who are
genetically identical) is compared with the behavioral similarity of fraternal twins. Thus, by
comparing groups of identical and fraternal twins, behavior geneticists capitalize on the basic
knowledge that identical twins are more similar genetically than are fraternal twins
(Inderkum & Tarokh,; Li & others, 2016; Rosenstrom & others, 2018; Wertz & others, 2018).

In an adoption study, investigators seek to discover whether the behavior and psychological
characteristics of adopted children are more like those of their adoptive parents, who have
provided a home environment, or more like those of their biological parents, who have
contributed their DNA (McAdams & others, 2015; Salvatore & others, 2018). Another form
of the adoption study compares adoptive and biological siblings (Kendler & others, 2016).

Animal study is one of other methods of studying relative influence of heredity and
environment. For studying the impact of the environmental factors, animals similar in genetic
makeup are breed together, in this way it is often possible to study the effect of different
environmental settings, e.g., genetically similar animals can be raised in stimulating
environmental settings and others in relatively impoverished environmental settings.
Similarly, researchers can examine the role of genetic factors by exposing genetically
dissimilar animals to identical environment. Animal studies offer sufficient evidence for
drawing inferences, but the question remains how far these findings can be stretched for
human beings.
Family studies is another approach, in which people who are totally unrelated, but share
similar environment are studied, e.g. family that adopts two young unrelated children usually
provide them with similar environment.

Heredity and environment correlates:

The difficulties that researchers encounter when they interpret the results of twin studies and
adoption studies reflect the complexities of heredity-environment interaction. Some of these
interactions are heredity-environment correlations, which means that individuals’sgenes may
be systematically related to the types of environments to which they are exposed (Jaffee,
2016). Behavior geneticist Sandra Scarr (1993) described three ways that heredity and
environment can be correlated

passive genotype-environment correlations: Correlations that exist when the natural

parents, who are genetically related to the child, provide a rearing environment for the child.

evocative genotype-environment correlations: Correlations that exist when the child’s

genetically influenced characteristics elicit certain types of environments.

active (niche-picking) genotype-environment correlations: Correlations that exist when

children seek out environments, they find compatible and stimulating.

APGAR Scale:
The Apgar score is a method to quickly summarize the health of newborn children
against infant mortality. Virginia Apgar, an anesthesiologist at New York–Presbyterian
Hospital, developed the score in 1952 to quantify the effects of obstetric anesthesia on babies.
[3]
The Apgar score is a test given to new-borns soon after birth. The Apgar Scale evaluates an
infant’s heart rate, respiratory effort, muscle tone, body color, and reflex irritability. An
obstetrician or a nurse does the evaluation and gives the new born a score, or reading, of 0, 1,
or 2 on each of these five health signs. A total score of 7 to 10 indicates that the new-born’s
condition is good. A score of 5 indicates there may be developmental difficulties. A score of
3 or below signals an emergency and indicates that the baby might not survive.
The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth.
Sometimes, if there are concerns about the baby's condition, the test may be given again. In
the test, five things are used to check a baby's health:

• Appearance (skin color)

• Pulse (heart rate)
• Grimace response (reflexes)
• Activity (muscle tone)
• Respiration (breathing rate and effort)
Doctors, midwives, or nurses add up these five factors for the Apgar score. Scores are
between 10 and 0. Ten is the highest score possible, but few babies get it. That's because
most babies’shands and feet remain blue until they have warmed up.
A lower score does not mean that your baby is unhealthy. It means that your baby may need
some immediate medical care, such as suctioning of the airways or oxygen to help him or her
breathe better. Perfectly healthy babies sometimes have a lower-than-usual score, especially
in the first few minutes after birth

EXTRA INFORMATION:
Various conditions that pose threats for new-borns have been given different labels. We will
examine these conditions and discuss interventions for improving outcomes of preterm
infants.
Preterm and Small for Date Infants: Three related conditions pose threats to many new-
borns: low birth weight, being born preterm, and being small for date:
• Low birth weight infants weigh less than 5 pounds 8 ounces at birth. Very low birth weight
new-borns weigh less than 3 pounds 4 ounces, and extremely low birth weight new-borns
weigh less than 2 pounds.
• Preterm infants are those born three weeks or more before the pregnancy has reached its full
term—in other words, before the completion of 37 weeks of gestation (the time between
fertilization and birth).
• Small for date infants (also called small for gestational age infants) are those whose birth
weight is below normal when the length of the pregnancy is considered. They weigh less than
90 percent of all babies of the same gestational age. Small for date infants may be preterm or
full term. One study found that small for date infants had more than a fourfold increased risk
of death (Regev & others, 2003).

Newborn Reflexes:

Many of your baby's movements in their first weeks are done by reflex. Reflexes are
involuntary movements or actions. Some movements are spontaneous, occurring as part of
the baby's usual activity. Others are responses to certain actions. Some reflexes remain with
newborns for months, while others go away in weeks.

1. Root Reflex
• This reflex begins when the corner of the baby's mouth is stroked or touched. The
baby will turn his or her head and open his or her mouth to follow and "root" in the
direction of the stroking.

• This helps the baby find the breast or bottle to begin feeding.

• This reflex lasts about four months.

2. Suck Reflex
• Rooting helps the baby become ready to suck. When the roof of the baby's mouth is
touched, the baby will begin to suck. This reflex does not begin until about the 32nd
week of pregnancy and is not fully developed until about 36 weeks.

• Premature babies may have a weak or immature sucking ability because of this.
• Babies also have a hand-to-mouth reflex that goes with rooting and sucking and may
suck on fingers or hands.
• Rooting, sucking, and bringing his hand to his mouth are considered feeding cues in
the first weeks after birth. Later on, after breastfeeding is well established, your baby
will start to use these movements to console himself, and may also be comforted by a
pacifier or when you help him find his thumb or fingers.
3. Tonic neck reflex or "fencing" posture
• When a baby's head is turned to one side, the arm on that side stretches out and
the opposite arm bends up at the elbow. This is often called the "fencing" position.
This reflex lasts until the baby is about 5 to 6 months old.
4. Moro or “startle” Reflex
• The Moro reflex is often called a startle reflex because it usually occurs when a
baby is startled by a loud sound or movement.

• In response to the sound, the baby throws back his or her head, extends out the
arms and legs, cries, then pulls the arms and legs back in.

• A baby's own cry can startle him or her and trigger this reflex.

• This reflex lasts until the baby is about 5 to 6 months old.

5. Grasp Reflex
• Stroking the palm of a baby's hand causes the baby to close his or her fingers in a
grasp. The grasp reflex lasts until the baby is about 5 to 6 months old.

• Palmer and plantar.

6. Babinski Reflex
• When the sole of the foot is firmly stroked, the big toe bends back toward the top
of the foot and the other toes fan out. This normal reflex lasts until the child is
about 2 years of age.

7. Step Reflex
• This reflex is also called the walking or dance reflex because a baby appears to
take steps or dance when held upright with his or her feet touching a solid surface.
This reflex lasts about two months.
8. The crawling reflexes
 • If your baby is placed on their stomach, they will pull their legs under their body
and kick them out in a crawling motion. In fact, when newborn babies are placed
on their mother’s stomachs, they are able to crawl up to their mother’s breast and
start suckling. The crawling reflex disappears after just a few weeks.

Module III: Infancy and Early Childhood

Descriptors/Topics:
Infants: Physical and Motor Development
Cognitive Development: Sensorimotor Stages
Early Childhood: Gross and Fine Motor Skills (page 120)
Cognitive Development: Importance of Play in Infancy and Early Childhood,
Stages of Attachment
Language Development in Infancy and Early Childhood
Emergence of Moral Development in Early Childhood

Infants: Physical and Motor Development

Cognitive Development: Sensorimotor Stages (Piaget’s developmental
stages)

Infancy:
• Infancy is the first phase of development of the postnatal period. It begins at birth and
continues till first year. (0-1 year)
• The focus is on physical development of the infant. The major points of emphasis are
on the growth and stability, motor development and the development of the sensory
system of the infant.
• Physical development during infancy is characterized by growth in height, weight and
changes in the facial appearance of the newborn.
• Infancy is defined as the first year of life after birth. For the first month after birth, an
infant is called a newborn. A newborn has a distinctive appearance. New-
borns’sheads are quite large in comparison with the rest of their bodies. They have
little strength in their necks and cannot hold their heads up, but they have some basic
reflexes. In the span of 12 months, infants become capable of sitting anywhere,
 standing, stooping, climbing, and usually walking. During the second year, growth
decelerates, but rapid increases in such activities as running and climbing take place.
• Many newborns still have lanugo on some areas of their body, but this usually
disappears within a few weeks after birth. Head hair can vary from almost no hair to a
full head of hair. The stub of the umbilical cord remains for a few weeks until it dries
up and falls off, forming the navel.
Principles of growth: There are individual differences in the physical development of the
infant. The following are the principles that govern physical development during infancy.
There are four principles that are related to physical development:
1. Cephalocaudal principle: Sequence in which greatest growth occurs at top (head),
working its way to neck, shoulders, middle trunk, so on... This principle describes the
direction of growth and development. The head region starts growth at first, following
by which other organs starts developing. The child gains control of the headfirst, then
the arms and then the legs. Infants develop control of the head and face movements at
first two months. In next few months they are able to lift themselves up by using their
arms. Next gain control over leg and able to crawl, stand, walk, run, jump, climb, day
by day.

2. Proximodistal principle: Sequence in which growth starts at center of body and moves
toward extremities. The directional sequence of development during both prenatal and
postnatal stages may either be (i) from head to foot, or (ii) from the central axis to the
extremities of the body. The spinal cord develops before outer parts of the body. The
child’s arms develop before the hands, the hands and feet develop before the fingers
and toes. Fingers and toe muscles are the last to develop in physical development.

3. Principle of hierarchical integration: This principle states that, complex skills follow
simple skills. For example, an infant first develops the control of fingers and then only
he/she is able to integrate and perform the more complex action of grasping an object.
Children use their cognitive and language skills to reason and solve problems.
Children at first are able hold the big things by using both arms. In the next part able
to hold things in a single hand, then only able to pick small objects like peas, cereals
etc. Children when able to hold pencil, first starts draw circles then squares then only
letters after that the words.
 4. Principle of the independence of the system: This principle suggests that, different
systems follow different rates of growth. For example, development of nervous
system, body size and sexual characteristics develop at different rates.
Development of brain and nervous system:

The following discussion will encompass some of the important aspects of brain development
that includes, synaptic pruning and myelination with other aspects.

Synaptic pruning:
Synaptic pruning is the systematic sculpting of the unused neurons or neural networks. In the
process of brain development many neurons and neural networks are formed further, some
gets stimulation from environment and experiences are survived and some do not receive
stimulation and remain unused, these are removed i.e., pruned out of the system.

Myelination:
Myelin sheath is located on the axon of the neuron cell. As the neurons are formed and
located at their predetermined locations, the process of myelination begins. The best
illustration of the importance of myelination is the degenerative disorders like multiple
sclerosis, where the myelin sheath degenerate and result in disturbances of motor behaviour.
Though the development is genetically determined, but, it is also susceptible to
environmental influences. Plasticity, which is a tendency of the brain to modify according to
the experiences, plays a significant role in brain development.
Integrating the bodily systems: the life cycles of infancy:
Soon after the birth the various systems like sleep cycles which are noticeable and some
systems which are subtle like breathing are regularised.
Rhythms and States:
Behaviour becomes integrated through development of various rhythms. Rhythms are
repetitive, cyclic patterns of behaviour. As the neurons of the nervous system become more
and more integrated the pattern of rhythms becomes more regular.
States:
An infant's state is a major body rhythm, which is a degree of awareness that infant shows to
the inner and outer stimulation. These states range from awake states to sleep states.

Motor development
At the time of birth, the infant is not very proportionately developed. His head is bigger and
heavy to lift. His limbs are shorter. Bones and skeleton muscles are underdeveloped.
However, the infant is still able to have some behavioural repertoires that are called as
reflexes.

REFLEXES:
The new-born is not completely helpless. Among other things, it has some basic reflexes.
Reflexes are unlearned, organised, involuntary responses to the stimuli; they govern the new-
born’s movements. Reflexes are genetically carried survival mechanisms. They allow infants
to respond adaptively to their environment before they have had the opportunity to learn like
swimming reflex of an infant. Eye-blinking reflexes to protect any damage to eye. However,
all reflexes do not remain life-long. Swimming reflex extinguishes after some years but eye-
blinking reflex remains throughout the life. The reason behind it is understood as; the reflexes
those disappear become part of the more controlled voluntary motor behaviour.

“The diving reflex” is the first of these natural responses. Known properly as the
“bradycardic response,” this is a natural reflex common to many mammals, including
humans. When a baby is submerged in water, the natural survival reflex is to hold their breath
and open their eyes. The rooting reflex occurs when the infant’s cheek is stroked or the side
of the mouth is touched. In response, the infant turns its head toward the side that was
touched in an apparent effort to find something to suck. The sucking reflex occurs when
new-borns automatically suck an object placed in their mouth. Another example is the Moro
reflex, which occurs in response to a sudden, intense noise or movement. The movements of
some reflexes eventually become incorporated into more complex, voluntary actions. One
important example is the grasping reflex, which occurs when something touches the infant’s
palms.

The landmarks in physical achievement can be divided in to two types: one is gross motor
skills and second is fine motor skills.

Gross motor skills: Infant in the beginning is not able to make movement due to the lack of
muscular development and strength. It can be observed that the infant struggles to make
hand and leg movements. When placed on his stomach he will try to lift his head and as the
strength grows he could make backward and forward movements. Approximately after three
month he could roll over independently. Close to six months could sit with some support and
latter could manage to sit without support. By eight to ten months can start crawling. Then
walking with support and without support emerges later, which enables the infant to explore
the world around him.

Fine motor skills:

Along with the gross motor skills the infant is also developing the fine motor skills. These
skills help him to hold certain objects and explore his/her environment. In the beginning
it appears very difficult for the infant to coordinate the vision, hands approach and hold an
object. However, with development of the nervous system this motor skill also became
more and more sophisticated. By three-month, infant can open hands prominently and
is able to grasp certain objects such as toys and round shapes like ball. By the eight
months he/she is able to coordinate with his thumb and fingers. Further, his sophistication
in visual-perception and visual-motor- perception helps to develop his skills.

THE DEVELOPMENT OF THE SENSES: (only if specified elaborate)

Sensation occurs when information interacts with sensory receptors—the eyes, ears, tongue,
nostrils, and skin. Perception is the interpretation of what is sensed.

i) Visual perception: At the time of birth and for next six months the visual acuity of the
infant is 1/10 to 1/3rd of the adult. Near six month of age the infant develops vision of adult
level.

ii) Depth perception: Depth perception is an ability to acknowledge height and avoid falls.
It is seen that infants of six to fourteen months have developed the ability to perceive the
depth.

iii) Visual preferences: Visual preference is the tendency to prefer certain visual stimuli
since birth. In this regard it is seen that infants prefer more complex stimuli than simple
stimuli.

iv) Auditory perception: Development of health auditory perception is very important for
language development. The auditory perception is developed even before birth. At the time of
birth infants are more sensitive to very high and very low frequencies than adults. They are
also less insensitive to middle-frequency. The sound, localization is an important ability of
pinpointing the direction of sound. It become difficult for the infant initially to point out the
correct direction of the sound. However, by one year this ability is well developed among
them.

v) Smell and taste perception: Early in their infancy infants learn to identify smell. They
respond differently to the variations in the smell. It is observed that infants could identify
their mothers by their smell. In context of taste also infants are found to be as sensitive as
adults. They smile when sweeter liquid is placed on their tongue and show disgust when they
find the taste bad. Smell and taste are sensitive because it has evolutionarily survival value.

vi) Touch and pain perception: Experiencing pain in infants is well developed. Infants do
communicate through the expression of pain to any discomfort. It is observed that infant
changes their tone and intensity of crying to express pain. As the nervous system is in
development process the reaction to pain is also seen to be little late. The information
processing is very slow during infancy hence the response to pain is little late.

vii) Multimodal perception: Multimodal perception suggests integration and coordination

of stimuli from various sensory modalities. There exist two views on this issue. One suggests
that infant's sensations are integrated and another view suggests that initially infant's
sensations are separate and latter became sophisticated with the overall development.
However, this multimodal perception is dependent on the development of the concept of
affordance, which is a characteristic of the situation or stimuli; for example, walking on the
steep slope has affordance value of falling down while walking on it.

COGNITIVE DEVELOPMENT in infancy and early childhood– SENSORIMOTOR

STAGES

Many theorists believe that infancy is the most critical period of life when it comes to
cognitive development. The theorization about cognitive development has started with the
pioneering efforts of Jean Piaget. Jean Piaget (1896-1980), a Swiss psychologist,
theorized cognitive development of infants assuming that they carry out experiments with
environment to learn.

According to Piaget’s infants knowledge is equal to their actions. He argued that

knowledge is obtained through motor behavior carried out by infants. Piaget’s theory of
cognitive development follows stage approach to cognitive development. Stage approach
believes that, from birth through adolescence, children pass through a series of four stages
in the same order. The change from one stage to another occurs as a result of maturational
processes and availability of environmental stimulation. The important concepts in
Piaget’s theory are schema, accommodation, assimilation, organization and equilibrium.

• Schema:

As the infant or child seeks to construct an understanding of the world, said Piaget
(1954), the developing brain creates schemes. These are actions or mental representations
that organize knowledge.The infants have organized sensory-motor patterns. In addition
to sucking, chewing, they try to reach out for an object, hold them, drop them, etc. These
are simple skills, but they direct the ways in which the infant explore their environment.
These schemas determine how infants gains more information of the world. Schemas can
contribute to stereotypes and make it difficult to retain new information that does not
conform to our established ideas about the world.

• Assimilation:

Refers to assimilating new information into an existing schema. They understand new
experience in the present structure of cognitive development. They use current cognitive
system to make sense of the stimulus. For example, the children have a schema of how to
hold new object and mouth it. So, if it sees a new object say a new toy, the child will grab
it and try to chew it.

• Accommodation:

As opposed to assimilation, accommodation refers to the schema changes for the new
object. The thinking or understanding changes as a result of confronting a new stimulus is
accommodation. The kids starting distinguishing between the objects they can mouth and
do not chew everything. Assimilation occurs when children use their existing schemes to
deal with new information or experiences. Accommodation occurs when children adjust
their schemes to take new information and experiences into account.

 Organisation:
To make sense out of their world, said Piaget, children cognitively organize their
experiences. Organization in Piaget’s theory is the grouping of isolated behaviors and
thoughts into a higher-order system.

• Equilibrium:
 It is an ideal state of balance required for making sense of the world. The accommodation
and assimilation takes place in order to maintain the state of equilibrium. Equilibrium
maintained by making sense of world in terms of existing schemas is assimilation. When
assimilation cannot explain the world then the equilibrium is maintained by the process of
accommodation. A state of mind is brought to a level of congruence with the external
world. There is considerable movement between states of cognitive equilibrium and
disequilibrium as assimilation and accommodation work in concert to produce cognitive
change. Equilibration is the name Piaget gave to this mechanism by which children shift
from one stage of thought to the next.

The result of these processes, according to Piaget, is that individuals go through four stages
of development. A different way of understanding the world makes one stage more advanced
than another. Cognition is qualitatively different in one stage compared with another. In other
words, the way children reason at one stage is different from the way they reason at another
stage. The four stages are:

 Sensorimotor stage: birth to 2 years

 Preoperational stage: ages 2 to 7

 Concrete operational stage: ages 7 to 11

 Formal operational stage: ages 12 and up

Piaget believed that children take an active role in the learning process, acting much like little
scientists as they perform experiments, make observations, and learn about the world. As kids
interact with the world around them, they continually add new knowledge, build upon
existing knowledge, and adapt previously held ideas to accommodate new information. The
sensorimotor stage lasts from birth to about 2 years of age. During this stage of cognitive
development, infants construct an understanding of the world by coordinating sensory
experiences (such as seeing and hearing) with physical, motoric actions—hence the term
“sensorimotor.” At the beginning of this stage, newborns have little more than reflexes with
which to work. At the end of the sensorimotor stage, 2-year-olds can produce complex
sensorimotor patterns and use primitive symbols.

Piaget divided the sensorimotor stage into six substages: (1) simple reflexes;
(2) first habits and primary circular reactions; (3) secondary circular reactions; (4)
coordination

of secondary circular reactions; (5) tertiary circular reactions, novelty, and curiosity; and

(6) internalization of schemes.

1) Simple reflexes, the first sensorimotor substage, corresponds to the first month after birth.
In this substage, sensation and action are coordinated primarily through reflexive behaviors
such as rooting and sucking. Soon the infant produces behaviors that resemble reflexes in the
absence of the usual stimulus for the reflex. For example, a newborn will suck a nipple or
bottle only when it is placed directly in the baby’s mouth or touched to the lips. But soon the
infant might suck when a bottle or nipple is only nearby. Even in the first month of life, the
infant is initiating action and actively structuring experiences.

2) First habits and primary circular reactions is the second sensorimotor substage, which
develops between 1 and 4 months of age. In this substage, the infant coordinates sensation
and two types of schemes: habits and primary circular reactions. A habit is a scheme based
on a reflex that has become completely separated from its eliciting stimulus. For example,
infants in substage 1 suck when bottles are put to their lips or when they see a bottle. Infants
in substage 2 might suck even when no bottle is present. A circular reaction is a repetitive
action.

A primary circular reaction is a scheme based on the attempt to reproduce an event that
initially occurred by chance. For example, suppose an infant accidentally sucks his fingers
when they are placed near his mouth. Later, he searches for his fingers to suck them again,
but the fingers do not cooperate because the infant cannot coordinate visual and manual
actions.

Habits and circular reactions are stereotyped—that is, the infant repeats them the same way
each time. During this substage, the infant’s own body continues to be the center of
attention. There is no outward pull by environmental events.

3) Secondary circular reactions is the third sensorimotor substage, which develops between
4 and 8 months of age. In this substage, the infant becomes more object-oriented, moving
beyond preoccupation with the self. The infant’s schemes are not intentional or goal directed,
but they are repeated because of their consequences. By chance, an infant might shake a
rattle. The infant repeats this action for the sake of its fascination. This is a secondary
circular reaction: an action repeated because of its consequences. The infant also imitates
some simple actions, such as the baby talk or burbling of adults, and some physical gestures.
However, the baby imitates only actions that he or she is already able to produce.

4) Coordination of secondary circular reactions is Piaget’s fourth sensorimotor substage,

which develops between 8 and 12 months of age. To progress into this substage the infant
must coordinate vision and touch, eye and hand. Actions become more outwardly directed.
Significant changes during this substage involve the coordination of schemes and
intentionality. Infants readily combine and recombine previously learned schemes in a
coordinated way. They might look at an object and grasp it simultaneously, or they might
visually inspect a toy, such as a rattle, and finger it simultaneously, exploring it tactilely.
Actions are even more outwardly directed than before. Related to this coordination is the
second achievement—the presence of intentionality. For example, infants might manipulate a
stick in order to bring a desired toy within reach, or they might knock over one block to reach
and play with another one.

5) Tertiary circular reactions, novelty, and curiosity is Piaget’s fifth sensorimotor substage,
which develops between 12 and 18 months of age. In this substage, infants become intrigued
by the many properties of objects and by the many things that they can make happen to
objects. A block can be made to fall, spin, hit another object, and slide across the ground.
Tertiary circular reactions are schemes in which the infant purposely explores new
possibilities with objects, continually doing new things to them and exploring the results.
Piaget says that this stage marks the starting point for human curiosity and interest in novelty.

6) Internalization of schemes is Piaget’s sixth and final sensorimotor substage, which

develops between 18 and 24 months of age. In this substage, the infant develops the ability to
use primitive symbols. For Piaget, a symbol is an internalized sensory image or word that
represents an event. Primitive symbols permit the infant to think about concrete events
without directly acting them out or perceiving them. Moreover, symbols allow the infant to
manipulate and transform the represented events in simple ways. The infant also develops a
symbolic representation of the events related to memory, thoughts, ideas, that can be called as
symbolic thought. Indeed they can have mental representation of imaginary objects as well.
This gets reflected in their behavior.

By the end of the sensorimotor period, objects are both separate from the self and permanent.
Object permanence is the understanding that objects continue to exist even when they
cannot be seen, heard, or touched. Acquiring the sense of object permanence is one of the
infant’s most important accomplishments, according to Piaget.

Stages of Attachment:

Attachment is a close emotional bond between two people.

The ethological perspective of British psychiatrist John Bowlby (1969, 1989) stresses
the importance of attachment in the first year of life and the responsiveness of the caregiver.
Bowlby maintains that both infants and their primary caregivers are biologically predisposed
to form attachments. He argues that the new-born is biologically equipped to elicit attachment
behavior. The baby cries, clings, coos, and smiles. Later, the infant crawls, walks, and
follows the mother. The immediate result is to keep the primary caregiver nearby; the long-
term effect is to increase the infant’s chances of survival.
Attachment does not emerge suddenly but rather develops in a series of phases, moving from
a baby’s general preference for human beings to a partnership with primary caregivers.
Following are four such phases based on Bowlby’s conceptualization of attachment
(Schaffer, 1996):
• Phase 1: From birth to 2 months. Infants instinctively direct their attachment to human
figures. Strangers, siblings, and parents are equally likely to elicit smiling or crying from the
infant.
• Phase 2: From 2 to 7 months. Attachment becomes focused on one figure, usually the
primary caregiver, as the baby gradually learns to distinguish familiar from unfamiliar
people.
• Phase 3: From 7 to 24 months. Specific attachments develop. With increased locomotor
skills, babies actively seek contact with regular caregivers, such as the mother or father.
• Phase 4: From 24 months on. Children become aware of others’sfeelings, goals, and plans
and begin to take these into account in forming their own actions.

Bowlby argued that infants develop an internal working model of attachment, a simple model
of the caregiver, their relationship, and the self as deserving of nurturant care. The infant’s
internal working model of attachment with the caregiver influences the infant’s and later the
child’s subsequent responses to other people (Cassidy, 2016; Hoffman & others, 2017). The
internal model of attachment also has played a pivotal role in the discovery of links between
attachment and subsequent emotional understanding, conscience development, and self-
concept (Bretherton & Munholland, 2016; Vacaru, Sterkenburg, & Schuengel, 2018).
Theory:
Bowlby considered the importance of the child’s relationship with their mother in terms of
their social, emotional and cognitive development. Specifically, it shaped his belief about the
link between early infant separations with the mother and later maladjustment, and led
Bowlby to formulate his attachment theory. The central theme of attachment theory is that
primary caregivers who are available and responsive to an infant's needs allow the child to
develop a sense of security. Attachment theory, developed by John Bowlby, focuses on the
close, intimate, emotionally meaningful relationship that develops between infants and their
mothers or primary caregivers. This ―attachment‖ is described as a biological system that
evolved to ensure the survival of the infant. Attachment behavior is evoked whenever the
person is threatened or stressed and involves actions to move toward the person(s) who create
a sense of physical, emotional, and psychological safety for the individual. Infants securely
attached to their parents or a parent are later found to be more curious, have better problem-
solving ability, are socially competent in preschool and are generally more resilient.
Unfortunately, there are situations that inhibit a child from forming attachments. Some babies
are raised without the stimulation and attention of a regular caregiver, or locked away under
conditions of abuse or extreme neglect. The possible short-term effects of this deprivation are
anger, despair, detachment, and temporary delay in intellectual development. Long-term
effects include increased aggression, clinging behavior, detachment, psychosomatic
disorders, and an increased risk of depression as an adult. Attachment is the close bond
between infants and their caregivers. Researchers used to think that infants attach to people
who feed them and keep them warm. However, researchers Margaret and Harry Harlow
showed that attachment could not occur without contact comfort. Contact comfort is
comfort derived from physical closeness with a caregiver.
The Harlows’sBaby Monkeys: The Harlows raised orphaned baby rhesus monkeys and
studied their behavior. In place of its real mother, each baby monkey had two substitute or
surrogate mothers. One ―mother‖ had a head attached to a wire frame, warming lights, and a
feeding bottle. The other ―mother‖ had the same construction except that foam rubber and
terry cloth covered its wire frame. The Harlows found that although both mothers provided
milk and warmth, the baby monkeys greatly preferred the cloth mother. They clung to the
cloth mother even between feedings and went to it for comfort when they felt afraid. This
demonstrated the role of contact comfort in the development of attachment bonds and also
laid the foundation for understanding the specific functions of attachments in young primates.
Bowlby - Also developed a theory of human attachment. He found that:
a) Attached children exhibit less distress when the object of their attachment leaves,
especially if they are in an unfamiliar environment,
b) Attached children exhibit pleasure when reunited with that person,
c) Attached children exhibit displeasure when approached by a stranger unless comforted by
the object of their attachment,
d) Attached children are more likely to explore an unfamiliar environment if the object of
their attachment is present.
EXTRA: [ He observed that children experienced intense distress when separated from their
mothers. Even when such children were fed by other caregivers, this did not diminish the
child’s anxiety. They found three progressive stages of distress:
• Protest: The child cries, screams and protests angrily when the parent leaves. They
will try to cling on to the parent to stop them leaving.

• Despair: The child’s protesting begins to stop, and they appear to be calmer although
still upset. The child refuses others’sattempts for comfort and often seems withdrawn
and uninterested in anything.

• Detachment: If separation continues the child will start to engage with other people
again. They will reject the caregiver on their return and show strong signs of anger.]

Bowlby believed that there are four distinguishing characteristics of attachment:

• Proximity maintenance: The desire to be near the people we are attached to.

• Safe haven: Returning to the attachment figure for comfort and safety in the face of a
fear or threat.

• Secure base: The attachment figure acts as a base of security from which the child
can explore the surrounding environment.

• Separation distress: Anxiety that occurs in the absence of the attachment figure.

Psychologist Mary Ainsworth further expanded upon Bowlby's groundbreaking work.

Ainsworth created the Strange Situation, an observational measure of infant attachment that
requires the infant to move through a series of introductions, separations, and reunions with
the caregiver and an adult stranger in a prescribed order, based on how babies respond in the
Strange Situation, Ainsworth concluded that there were three major styles of attachment:
secure attachment, ambivalent/anxious-insecure attachment, and avoidant-insecure
attachment. Researchers Main and Solomon added a fourth attachment style known as
disorganized-insecure attachment.

• Secure attachment: It happens when parents or other caregivers are: available,

sensitive, responsive, accepting. In relationships with secure attachment, parents let
their children go out and about but are there for them when they come back for
security and comfort. These parents pick up their child, play with them, and reassure
them when needed. So, the child learns they can express negative emotions and
someone will help them. When the caregiver departs, securely attached infants might
protest mildly, and when the caregiver returns these infants reestablish positive
interaction with her. Children who develop secure attachment learn how to trust and
have healthy self-esteem.

• Anxious-insecure attachment: This type of attachment happens when parents

respond to their child’s needs sporadically. Care and protection are sometimes there
and sometimes not. In anxious-insecure attachment, the child can’t rely on their
parents to be there when needed. Because of this, the child fails to develop any
feelings of security from the attachment figure. And since the child can’t rely on their
parent to be there if they feel threatened, they won’t easily move away from the parent
to explore. The child becomes more demanding and even clingy, hoping that their
exaggerated distress will force the parent to react. In anxious-insecure attachment, the
lack of predictability means that the child eventually becomes needy, angry, and
distrustful.

• Avoidant-insecure attachment: Sometimes, a parent has trouble accepting and

responding sensitively to their child’s needs. Instead of comforting the child, the
parent: minimizes their feelings, rejects their demands, doesn’t help with difficult
tasks. This leads to avoidant-insecure attachment. In addition, the child may be
expected to help the parent with their own needs. The child learns that it’s best to
avoid bringing the parent into the picture. After all, the parent doesn’t respond in a

helpful manner. In avoidant-insecure attachment, the child learns that their best bet is

to shut down their feelings and become self-reliant. Ainsworth showed that children
 with an avoidant-insecure attachment won’t turn to the parent when they’re distressed
and try to minimize showing negative emotions.

• Disorganized-insecure attachment: parents show atypical behavior: They reject,

ridicule, and frighten their child. Parents who display these behaviors often have a
past that includes unresolved trauma. Tragically, when the child approaches the
parent, they feel fear and increased anxiety instead of care and protection. The first
three attachment styles are sometimes referred to as “organized.” That’s because the
child learns how they have to behave and organizes their strategy accordingly. This
fourth attachment style is considered “disorganized” because the child’s strategy is
disorganized — and so is their resulting behavior. Eventually, the child starts to
develop behaviors that help them feel somewhat safe. For example, the child may:
become aggressive toward the parent refuse care from the parent simply become super
self-reliant.

Importance of play in Infancy and Early Childhood

An extensive amount of peer interaction during childhood involves play, but social play is
only one type of play. Play is a pleasurable activity in which children engage for its own
sake, and its functions and forms vary (Hirsh-Pasek & Golinkoff, 2014).

Play’s Functions: Play is an important aspect of children’s development (Bergen, 2015;

Clark, 2016; Johnson & others, 2015; Taggart, Eisen, & Lillard, 2018). Theorists have
focused on different aspects of play and highlighted a long list of functions (Henricks, 2015a,
b).

 According to Freud and Erikson, play helps children master anxieties and conflicts
(Demanchick, 2015). Because tensions are relieved in play, children can cope more
effectively with life’s problems.
 Play also is an important context for cognitive development (Taggart, Eisen, & Lillard,
2018). Both Jean Piaget and Lev Vygotsky concluded that play is a child’s work.
Piaget (1962) maintained that play advances children’s cognitive development. At the
same time, he said, children’s cognitive development constrains the way they play.
 Vygotsky (1962) also considered play to be an excellent setting for cognitive
development. He was especially interested in the symbolic and make-believe aspects
 of play, as when a child substitutes a stick for a horse and rides the stick as if it were a
horse.

Types pf play:

Sensorimotor play: is behavior by infants that lets them derive pleasure from exercising
their sensorimotor schemes. The development of sensorimotor play follows Piaget’s
description of sensorimotor thought. Infants initially engage in exploratory and playful visual
and motor transactions in the second quarter of the first year of life. At about 9 months of
age, infants begin to select novel objects for exploration and play, especially responsive
objects such as toys that make noise or bounce.

Practice play: involves the repetition of behavior when new skills are being learned or when
physical or mental mastery and coordination of skills are required for games or sports.
Sensorimotor play, which often involves practice play, is primarily confined to infancy,
whereas practice play can be engaged in throughout life. During the preschool years, children
often engage in practice play.

Pretense/symbolic play: occurs when the child transforms the physical environment into a
symbol (Taggart, Eisen, & Lillard, 2018). Between 9 and 30 months of age, children increase
their use of objects in symbolic play. They learn to transform objects—substituting them for
other objects and acting toward them as if they were those other objects. For example, a
preschool child treats a table as if it were a car and says, “I’m fixing the car,” as he grabs a
leg of the table.

Functional Play: It refers to play that involves simple repetitive activities typical of three-
year-old child. Activities which are a part of this play include:

 Pushing cars on the floor.

 Skipping.
 Jumping, etc.
Functional play involves doing something to be active rather than to create something new.
Constructive Play: By the age of 04 years children become involved in a more sophisticated
form of play called as constructive play. In this type of play children manipulate objects to
produce or build something. Building a house of blocks is one type of constructive play.
Constructive play gives children a chance to practice their physical and cognitive skills and
fine muscle movements. Through constructive play children gain experience in solving
problems about the ways and the sequences in which things fit together, they also learn to
cooperate with others.

Social play involves interaction with peers. Social play increases dramatically during the
preschool years. For many children, social play is the main context for young children’s
social interactions with peers (Solovieva & Quintanar, 2017).

a) Parallel Play: It is a type of play in which children play with similar toys, in a similar
manner, but do not interact with each other.

b) Onlooker Play: It is one type of highly passive play in which children simply watch
others at play, but do not actually participate themselves.

c) Associative Play: This form of play involves interaction on the part of the children, in
which children interact with one another by sharing or borrowing toys or materials.

d) Cooperative Play: In this form of play children genuinely play with one another, taking
turns, playing games or devising contests.

e) Pretend Play: It is a make-believe play in which children may pretend to listen to a radio
by using a plastic radio or by using a cardboard box. According to Lev Vygotsky Pretend
Play is an important means for expanding preschool age children‘s cognitive skills. Through
such types of play children are able to ―practice‖ activities that are a part of their particular
culture and broaden their understanding of the ways in which the world functions.

[Preschooler’s Theory of Mind:

Understanding What Others are Thinking: Preschool children increasingly see the world
from other‘s perspectives. Children as young as 02 years old are able to understand that
others have emotions. By the age of three or four years they can imagine something that is
not physically present, such as a dog. They can also pretend that something has happened and
react as if it really has occurred, a skill that becomes a part of imaginative play. Preschool
children also develop insight about other‘s motives and behavior. They begin to understand
that their mother is angry. By the age of 04 years children develop an understanding that
people can be fooled by magic tricks. This helps them to become socially skilled and gain
insight in to other‘s thoughts.]

Bronfenbrenner’s Ecological Systems:

 Bronfenbrenner's ecological systems theory views child development as a complex

system of relationships affected by multiple levels of the surrounding environment,
from immediate settings of family and school to broad cultural values, laws, and
customs.
 To study a child's development then, we must look not only at the child and her
immediate environment, but also at the interaction of the larger environment as well.
 Bronfenbrenner divided the person's environment into five different systems: the
microsystem, the mesosystem, the exosystem, the macrosystem, and the
chronosystem.
 The microsystem is the most influential level of the ecological systems theory. This is
the most immediate environmental settings containing the developing child, such as
family and school.

The microsystem is the first level of Bronfenbrenner's theory, and are the things that have
direct contact with the child in their immediate environment, such as parents, siblings,
teachers and school peers. Relationships in a microsystem are bi-directional, meaning the
child can be influenced by other people in their environment and is also capable of changing
the beliefs and actions of other people too. Furthermore, the reactions of the child to
individuals in their microsystem can influence how they treat them in return. The interactions
within microsystems are often very personal and are crucial for fostering and supporting the
child’s development. If a child has a strong nurturing relationship with their parents, this is
said to have a positive effect on the child. Whereas, distant and unaffectionate parents will
have a negative effect on the child.

The Mesosystem: The mesosystem encompasses the interactions between the child’s
microsystems, such as the interactions between the child’s parents and teachers, or between
school peers and siblings. The mesosystem is where a person's individual microsystems do
not function independently but are interconnected and assert influence upon one another. If
the child’s parents and teachers get along and have a good relationship, this should have
positive effects on the child’s development, compared to negative effects on development if
the teachers and parents do not get along.

The Exosystem: It incorporates other formal and informal social structures, which do not
themselves contain the child, but indirectly influence them as they affect one of the
microsystems. Exosystems include the neighborhood, parent’s workplaces, parent’s friends
and the mass media. These are environments in which the child is not involved, and are
external to their experience, but nonetheless affects them anyway. Eg: Parent’s economic
troubles, Tiff with boss etc.

The Macrosystem: focuses on how cultural elements affect a child's development, such as
socioeconomic status, wealth, poverty, and ethnicity. Thus, culture that individuals are
immersed within may influence their beliefs and perceptions about events that transpire in
life. For example, a child living in a third world country would experience a different
development than a child living in a wealthier country.

The Chronosystem: This consists of all of the environmental changes that occur over the
lifetime which influence development, including major life transitions, and historical events.
These can include normal life transitions such as starting school but can also include non-
normative life transitions such as parents getting a divorce or having to move to a new house.

Language Development in Infancy and Early Childhood – 1st sem notes.

Emergence of Moral Development in Early Childhood

Moral development involves thoughts, feelings, and behaviors regarding rules and
conventions about what people should do in their interactions with other people. Major
developmental theories have focused on different aspects of moral development (Gray &
Graham, 2018; Hoover & others, 2018; Killen & Dahl, 2018; Narváez, 2017a, b, 2018; Turiel
& Gingo, 2017).

Moral Feelings: Feelings of anxiety and guilt are central to the account of moral
development provided by Sigmund Freud’s psychoanalytic theory. According to Freud,
children attempt to reduce anxiety, avoid punishment, and maintain parental affection by
identifying with parents and internalizing their standards of right and wrong, thus forming the
superego—the moral element of personality.

[Moral Reasoning: Interest in how children think about moral issues was stimulated by
Piaget (1932), who extensively observed and interviewed children between the ages of 4 and
12. Piaget watched children play marbles to learn how they applied and thought about the
game’s rules. He also asked children about ethical issues—theft, lies, punishment, and
justice, for example. Piaget concluded that children go through two distinct stages in how
they think about morality.

 From about 4 to 7 years of age, children display heteronomous morality, the first
stage of moral development in Piaget’s theory. Children think of justice and rules as
unchangeable properties of the world, removed from the control of people.
 From 7 to 10 years of age, children are in a transition showing some features of the
first stage of moral reasoning and some stages of the second stage, autonomous
morality.
 At about 10 years of age and older, children show autonomous morality. They
become aware that rules and laws are created by people, and in judging an action they
consider the actor’s intentions as well as the consequences.
Because young children are heteronomous moralists, they judge the rightness or goodness of
behavior by considering its consequences, not the intentions of the actor. For example, to the
heteronomous moralist, breaking 12 cups accidentally is worse than breaking one cup
intentionally. As children develop into moral autonomists, intentions become more important
than consequences.
The heteronomous thinker also believes that rules are unchangeable and are handed down by
all-powerful authorities. When Piaget suggested to young children that they use new rules in
a game of marbles, they resisted. By contrast, older children—moral autonomists—accept
change and recognize that rules are merely convenient conventions, subject to change.
The heteronomous thinker also believes in immanent justice, the concept that if a rule is
broken, punishment will be meted out immediately. The young child believes that a violation
is connected automatically to its punishment. Immanent justice also implies that if something
unfortunate happens to someone, the person must have transgressed earlier. Older children,
who are moral autonomists, recognize that punishment occurs only if someone witnesses the
wrongdoing and that even then, punishment is not inevitable.]
Kohlberg's Theory of Moral Development:

Kohlberg's theory proposes that there are three levels of moral development, with each
level split into two stages.

Kohlberg's theory of moral development is a theory that focuses on how children develop
morality and moral reasoning.

Kohlberg suggested that people move through these stages in a fixed order, and that
moral understanding is linked to cognitive development.

His work modified and expanded upon Jean Piaget's previous work but was more
centered on explaining how children develop moral reasoning.

By using children's responses to a series of moral dilemmas, Kohlberg established that the
reasoning behind the decision was a greater indication of moral development than the
actual answer.

Level 1. Preconventional Morality

Preconventional morality is the earliest period of moral development. It lasts until around the
age of 9. At this age, children's decisions are primarily shaped by the expectations of adults
and the consequences for breaking the rules. There are two stages within this level:

 Stage 1 (Obedience and Punishment): The earliest stages of moral development,

obedience and punishment are especially common in young children, but adults are
also capable of expressing this type of reasoning. According to Kohlberg, people at
this stage see rules as fixed and absolute. 7 Obeying the rules is important because it is
a way to avoid punishment.

 Stage 2 (Individualism and Exchange/ instrumental orientation): At the

individualism and exchange stage of moral development, children account for
individual points of view and judge actions based on how they serve individual
needs. Reciprocity is possible at this point in moral development, but only if it serves
one's own interests.

“what’s in it for me?” - Right behavior is defined by whatever the individual believes
to be in their best interest.
Level 2. Conventional Morality

The next period of moral development is marked by the acceptance of social rules regarding
what is good and moral. During this time, adolescents and adults internalize the moral
standards they have learned from their role models and from society.

This period also focuses on the acceptance of authority and conforming to the norms of the
group. There are two stages at this level of morality:

 Stage 3 (Developing Good Interpersonal Relationships): Often referred to as the

"good boy-good girl" orientation, this stage of the interpersonal relationship of moral
development is focused on living up to social expectations and roles.7 There is an
emphasis on conformity, being "nice," and consideration of how choices influence
relationships.

 Stage 4 (Maintaining Social Order): This stage is focused on ensuring that social
order is maintained. At this stage of moral development, people begin to consider
society as a whole when making judgments. The focus is on maintaining law and
order by following the rules, doing one’s duty, and respecting authority.

Level 3. Postconventional Morality

At this level of moral development, people develop an understanding of abstract principles of

morality. The two stages at this level are:

 Stage 5 (Social Contract and Individual Rights): The ideas of a social contract and
individual rights cause people in the next stage to begin to account for the differing
values, opinions, and beliefs of other people.7 Rules of law are important for
maintaining a society, but members of the society should agree upon these standards.

 Stage 6 (Universal Principles): Kohlberg’s final level of moral reasoning is based on

universal ethical principles and abstract reasoning. At this stage, people follow these
internalized principles of justice, even if they conflict with laws and rules.

Criticism:

Kohlberg's theory played an important role in the development of moral psychology. While
the theory has been highly influential, aspects of the theory have been critiqued for a number
of reasons:
  Moral reasoning does not equal moral behavior: Kohlberg's theory is concerned
with moral thinking, but there is a big difference between knowing what we ought to
do versus our actual actions. Moral reasoning, therefore, may not lead to moral
behavior.

 Overemphasizes justice: Critics have pointed out that Kohlberg's theory of moral
development overemphasizes the concept of justice when making moral choices.
Factors such as compassion, caring, and other interpersonal feelings may play an
important part in moral reasoning.9

 Cultural bias: Individualist cultures emphasize personal rights, while collectivist

cultures stress the importance of society and community. Eastern, collectivist cultures
may have different moral outlooks that Kohlberg's theory does not take into account.

 Age bias: Most of his subjects were children under the age of 16 who obviously had
no experience with marriage. The Heinz dilemma may have been too abstract for
these children to understand, and a scenario more applicable to their everyday
concerns might have led to different results.

 Gender bias: Kohlberg's critics, including Carol Gilligan, have suggested that
Kohlberg's theory was gender-biased since all of the subjects in his sample were
male.Kohlberg believed that women tended to remain at the third level of moral
development because they place a stronger emphasis on things such as social
relationships and the welfare of others.

Erikson’s psychosocial development:

Our personality traits come in opposites. We think of ourselves as optimistic or pessimistic,

independent or dependent, emotional or unemotional, adventurous or cautious, leader or
follower, aggressive or passive. Many of these are inborn temperament traits, but other
characteristics, such as feeling either competent or inferior, appear to be learned, based on the
challenges and support we receive in growing up. The man who did a great deal to explore
this concept is Erik Erikson. Although he was influenced by Freud, he believed that the ego
exists from birth and that behavior is not totally defensive. Based in part on his study of
Sioux Indians on a reservation, Erikson became aware of the massive influence of culture on
behavior and placed more emphasis on the external world, such as depression and wars. He
felt the course of development is determined by the interaction of the body (genetic biological
programming), mind (psychological), and cultural (ethos) influences. Erikson‘s view is that
the social environment combined with biological maturation provides each individual with a
set of ―crises that must be resolved. The individual is provided with a ―sensitive period in
which to successfully resolve each crisis before a new crisis is presented. The results of the
resolution, whether successful or not, are carried forward to the next crisis and provide the
foundation for its resolution. This is different from other theories such as Piaget‘s theory of
cognitive development or Maslow‘s theory of human needs where the level must be
satisfactorily addressed before one can move on to the next level. He organised life into eight
stages that extend from birth to death (many developmental theories only cover childhood).

Infancy Trust vs. Mistrust: Erikson ‘s first critical developmental stage is the crisis of trust
vs mistrust in infancy.

He referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put
everything in her mouth) where the major emphasis is on the mother ‘s positive and loving
care for the child, with a big emphasis on visual contact and touch. If we pass successfully
through this period of life, we will learn to trust that life is basically okay and have basic
confidence in the future. If we fail to experience trust and are constantly frustrated because
our needs are not met, we may end up with a deep-seated feeling of worthlessness and a
mistrust of the world in general. Incidentally, many studies of suicides and suicide attempts
point to the importance of the early years in developing the basic belief that the world is
trustworthy and that every individual has a right to be here. Not surprisingly, the most
significant relationship is with the maternal parent, or whoever is our most significant and
constant caregiver. According to Erikson responsive, sensitive parenting contributes to
infants ‘sense of trust.

Erik Erikson's Stages of Psychosocial Development:

Self-concept can be defined as thinking about self. It refers to their identity or their set of
beliefs about what they are like as individuals. Self-concept during preschool years is not
accurate.

Preschooler's sense of self leads to psychosocial development which includes changes in

individual’s understanding of themselves and of other ‘s behaviour.
Preschool children typically overestimate their skills and knowledge across all domains of
expertise. They generally have rosy pictures about themselves, are optimistic and they expect
to do well in the future even when they have experienced failure.

Erik Erikson developed a theory of psychosocial development in which he viewed people

passing through eight distinct stages of development. Each stage of development is
characterized by a crisis or conflict that the person must resolve. The experiences that we
gain in resolving these conflicts leads us to develop ideas about ourselves that can last for the
rest of our lives. The eight stages of psychosocial development are as follows:

Stage 1: Trust vs. Mistrust

The first stage of Erikson's theory of psychosocial development occurs between birth and 1
year of age and is the most fundamental stage in life. Because an infant is utterly dependent,
developing trust is based on the dependability and quality of the child's caregivers.

At this point in development, the child is utterly dependent upon adult caregivers for
everything they need to survive including food, love, warmth, safety, and nurturing. If a
caregiver fails to provide adequate care and love, the child will come to feel that they cannot
trust or depend upon the adults in their life.

If a child successfully develops trust, the child will feel safe and secure in the world and will
lead to virtue of hope. Caregivers who are inconsistent, emotionally unavailable, or rejecting
contribute to feelings of mistrust in the children under their care. Failure to develop trust will
result in fear and a belief that the world is inconsistent and unpredictable.

Stage 2: Autonomy vs. Shame and Doubt

The second stage of Erikson's theory of psychosocial development takes place during early
childhood (2-3 years) and is focused on children developing a greater sense of personal
control. At this point in development, children are just starting to gain a little independence.

They are starting to perform basic actions on their own and making simple decisions about
what they prefer. By allowing kids to make choices and gain control, parents and caregivers
can help children develop a sense of autonomy. The essential theme of this stage is that
children need to develop a sense of personal control over physical skills and a sense of
independence. Potty training plays an important role in helping children develop this sense of
autonomy.
Children who struggle and who are shamed for their accidents may be left without a sense of
personal control. Success during this stage of psychosocial development leads to feelings of
autonomy; failure results in feelings of shame and doubt. Children who successfully complete
this stage feel secure and confident, while those who do not are left with a sense of
inadequacy and self-doubt. Erikson believed that achieving a balance between autonomy and
shame and doubt would lead to will, which is the belief that children can act with intention,
within reason and limits.

Stage 3: Initiative vs. Guilt

The third stage of psychosocial development takes place during the preschool years(3-5
years). At this point in psychosocial development, children begin to assert their power and
control over the world through directing play and other social interactions.

Children who are successful at this stage feel capable and able to lead others. Those who fail
to acquire these skills are left with a sense of guilt, self-doubt, and lack of initiative.

The major theme of the third stage of psychosocial development is that children need to begin
asserting control and power over the environment. Success in this stage leads to a sense of
purpose. Children who try to exert too much power experience disapproval, resulting in a
sense of guilt. When an ideal balance of individual initiative and a willingness to work with
others is achieved, the ego quality known as purpose emerges.

Stage 4: Industry vs. Inferiority

The fourth psychosocial stage takes place during the early school years from approximately
ages 5 to 11. Through social interactions, children begin to develop a sense of pride in their
accomplishments and abilities.

Children need to cope with new social and academic demands. Success leads to a sense of
competence, while failure results in feelings of inferiority.

Children who are encouraged and commended by parents and teachers develop a feeling of
competence and belief in their skills. Those who receive little or no encouragement from
parents, teachers, or peers will doubt their abilities to be successful. Successfully finding a
balance at this stage of psychosocial development leads to the strength known as competence,
in which children develop a belief in their abilities to handle the tasks set before them.
Stage 5: Identity vs. Confusion

The fifth psychosocial stage takes place during the often-turbulent teenage years (12-18
years). This stage plays an essential role in developing a sense of personal identity which will
continue to influence behavior and development for the rest of a person's life. Teens need to
develop a sense of self and personal identity. Success leads to an ability to stay true to
yourself, while failure leads to role confusion and a weak sense of self.

During adolescence, children explore their independence and develop a sense of self. Those
who receive proper encouragement and reinforcement through personal exploration will
emerge from this stage with a strong sense of self and feelings of independence and control.
Those who remain unsure of their beliefs and desires will feel insecure and confused about
themselves and the future. Completing this stage successfully leads to fidelity, which Erikson
described as an ability to live by society's standards and expectations.

Our personal identity gives each of us an integrated and cohesive sense of self that endures
through our lives. Our sense of personal identity is shaped by our experiences and
interactions with others, and it is this identity that helps guide our actions, beliefs, and
behaviors as we age.

Stage 6: Intimacy vs. Isolation

Young adults need to form intimate, loving relationships with other people. Success leads to
strong relationships, while failure results in loneliness and isolation. This stage covers the
period of early adulthood (19-40 years) when people are exploring personal relationships.

Erikson believed it was vital that people develop close, committed relationships with other
people. Those who are successful at this step will form relationships that are enduring and
secure. Erikson believed that a strong sense of personal identity was important for developing
intimate relationships. Studies have demonstrated that those with a poor sense of self tend to
have less committed relationships and are more likely to struggler with emotional isolation,
loneliness, and depression.

Successful resolution of this stage results in the virtue known as love. It is marked by the
ability to form lasting, meaningful relationships with other people.

Stage 7: Generativity vs. Stagnation

Adults need to create or nurture things that will outlast them, often by having children or
creating a positive change that benefits other people. Success leads to feelings of usefulness
and accomplishment, while failure results in shallow involvement in the world.

During adulthood, we continue to build our lives, focusing on our career and family. Those
who are successful during this phase will feel that they are contributing to the world by being
active in their home and community. Those who fail to attain this skill will feel unproductive
and uninvolved in the world. Care is the virtue achieved when this stage is handled
successfully. Being proud of your accomplishments, watching your children grow into adults,
and developing a sense of unity with your life partner are important accomplishments of this
stage.

Stage 8: Integrity vs. Despair

According to the final psychosocial stage occurs during old age and is focused on reflecting
back on life. At this point in development, people look back on the events of their lives and
determine if they are happy with the life that they lived or if they regret the things they did or
didn't do.

Erikson's theory differed from many others because it addressed development throughout the
entire lifespan, including old age. Older adults need to look back on life and feel a sense of
fulfilment. Success at this stage leads to feelings of wisdom, while failure results in regret,
bitterness, and despair.

At this stage, people reflect back on the events of their lives and take stock. Those who look
back on a life they feel was well-lived will feel satisfied and ready to face the end of their
lives with a sense of peace. Those who look back and only feel regret will instead feel fearful
that their lives will end without accomplishing the things they feel they should have.

Those who are unsuccessful during this stage will feel that their life has been wasted and may
experience many regrets. The person will be left with feelings of bitterness and despair.

Those who feel proud of their accomplishments will feel a sense of integrity. Successfully
completing this phase means looking back with few regrets and a general feeling of
satisfaction. These individuals will attain wisdom, even when confronting death.

Module IV: Middle Childhood and Adolescence

 Descriptors/Topics
Physical and Cognitive Development in Middle Childhood- piaget’s theory (concrete
operational stage)
Social Development in Middle Childhood: Development of friendships, social
interactions- ecological system and Erikson (psychosocial development)
Importance of Play in Middle Childhood
Adolescence: Puberty
Cognitive Development in adolescence- formal operational stage
Development of identity in Adolescence- erikson
Moral Development in Middle Childhood and Adolescence- Kohlberg and Erikson

Physical changes, importance of play, adolescence: Puberty and development of identity

Physical changes in preschool:

During the preschool years, children experience rapid advances in their physical abilities.
There is a dramatic change in their size, shape and physical abilities. Economic factors
considerably influence one‘s physical development.

Changes in Body Shape and Structure:

The period of middle and late childhood involves slow, consistent growth (Hockenberry,
Wilson, & Rodgers, 2017). This is a period of calm before the rapid growth spurt of
adolescence. During the elementary school years, children grow an average of 2 to 3 inches a
year until, at the age of 11, the average girl is 4 feet, 10 inches tall, and the average boy is 4
feet, 9 inches tall. During the middle and late childhood years, children gain about 5 to 7
pounds a year. The weight increase is due mainly to increases in the size of the skeletal and
muscular systems, as well as the size of some body organs. Proportional changes are among
the most pronounced physical changes in middle and late childhood. Head circumference and
waist circumference decrease in relation to body height (Kliegman & others, 2016; Perry &
others, 2018). A less noticeable physical change is that bones continue to ossify during
middle and late childhood but yield to pressure and pull more than mature bones.

The brain:
Total brain volume stabilizes by the end of late childhood, but significant changes in various
structures and regions of the brain continue to occur. In particular, the brain pathways and
circuitry involving the prefrontal cortex, the highest level in the brain, continue to increase
during middle and late childhood. These advances in the prefrontal cortex are linked to
children’s improved attention, reasoning, and cognitive control (de Haan & Johnson, 2016;
Wendelken & others, 2016, 2017).

Neuroscientists have attempted to understand how brain growth is related to cognitive

development. It has been observed that during childhood brain shows unnatural growth spurts
which are linked to development of cognitive abilities. Research studies have revealed that
preschoolers growing cognitive capabilities are linked to increase in Myelin in the brain. It
has also been observed that by the age of five years Myelination of the reticular formation, an
area of brain associated with attention and concentration is completed. Myelination also leads
to improvement in memory during preschool years. It is also completed in the hippocampus
during preschool years.

There is also a significant growth in the nerves connecting cerebellum to the cerebral cortex.
Cerebellum is a part of the brain that controls balance and movement. Cereberal cortex is a
structure that is responsible for sophisticated information processing. Growth of nerve cells in
these structures leads to significant advances in motor skills and cognitive processing during
the preschool years.

MOTOR DEVELOPMENT

During middle and late childhood, children’s motor skills become much smoother and more
coordinated than they were in early childhood (Hockenberry, Wilson, & Rodgers, 2017). For
example, only one child in a thousand can hit a tennis ball over the net at the age of 3, yet by
the age of 10 or 11 most children can learn to play the sport. Running, climbing, skipping
rope, swimming, bicycle riding, and skating are just a few of the many physical skills
elementary school children can master. In gross motor skills involving large muscle activity,
boys usually outperform girls. Increased myelination of the central nervous system is
reflected in the improvement of fine motor skills during middle and late childhood. Children
can more adroitly use their hands as tools. Six-yearolds can hammer, paste, tie shoes, and
fasten clothes. By 7 years of age, children’s hands have become steadier. At this age, children
prefer a pencil to a crayon for printing, and reversal of letters is less common. Printing
becomes smaller. At 8 to 10 years of age, the hands can be used independently with more
ease and precision. Fine motor coordination develops to the point at which children can write
rather than print words. Cursive letter size becomes smaller and more even. At 10 to 12 years
of age, children begin to show manipulative skills similar to the abilities of adults. They can
master the complex, intricate, and rapid movements needed to produce fine-quality crafts or
to play a difficult piece on a musical instrument. Girls usually outperform boys in their use of
fine motor skills.

Cognitive Development in Middle Childhood- piaget’s theory (concrete operational stage):

According to Jean Piaget (1952), the preschool child’s thought is preoperational. Preschool
children can form stable concepts, and they have begun to reason, but their thinking is flawed
by egocentrism and magical belief systems. Some researchers argue that under the right
conditions, young children may display abilities that are characteristic of Piaget’s next stage
of cognitive development, the stage of concrete operational thought (Gelman, 1969).

The Concrete Operational Stage Piaget proposed that the concrete operational stage lasts
from approximately 7 to 11 years of age. In this stage, children can perform concrete
operations, and they can reason logically as long as reasoning can be applied to specific or
concrete examples. Remember that operations are mental actions that are reversible, and
concrete operations are operations that are applied to real, concrete objects. In this, Children
gain the abilities of conservation (number, area, volume, orientation), reversibility, seriation,
transitivity and class inclusion. However, although children can solve problems in a logical
fashion, they are typically not able to think abstractly or hypothetically.

The conservation task (Conservation is the understanding that something stays the same in
quantity even though its appearance changes. To be more technical conservation is the ability
to understand that redistributing material does not affect its mass, number, volume or length.)
involving conservation of matter, the child is presented with two identical balls of clay. The
experimenter rolls one ball into a long, thin shape; the other remains in its original ball shape.
The child is then asked if there is more clay in the ball or in the long, thin piece of clay. By
the time children reach the age of 7 or 8, most answer that the amount of clay is the same. To
answer this problem correctly, children have to imagine the clay rolling back into a ball. This
type of imagination involves a reversible mental action applied to a real, concrete object.
Concrete operations allow the child to consider several characteristics rather than focusing on
a single property of an object (decentration). In the clay example, the preoperational child is
likely to focus on height or width. The concrete operational child coordinates information
about both dimensions.

Other abilities of children who have reached the concrete operational stage are the ability to
classify or divide things into different sets or subsets and to consider their interrelationships.

Children who have reached the concrete operational stage are also capable of seriation,
which is the ability to order stimuli along a quantitative dimension (such as length). Now
children can sort from the tallest to the shortest, or the thinnest to the widest.

Another aspect of reasoning about the relations between classes is transitivity, which is the
ability to logically combine relations to understand certain conclusions.

The Development of Friendship:

Friendship is an important aspect of children’s development (Bagwell & Bukowski, 2018;

Rubin & Barstead, 2018; Smetana & Ball, 2018).

Healthy friendships are very important to child‘s development. The likelihood that children‘s
close friendships are with members of the same sex rises to near certainty during middle
childhood. This period also brings about marked changes in the understanding of friendship.
Children‘s concept of friendship also becomes more complex and psychologically based.
Making friends is one of the most important missions of middle childhood between 5 to 12
years. This forms a social skill that will endure throughout out their life. These children share
pleasure and frustration of life. In middle childhood, children have more select group of
friends and a smaller number of ―best‖ friends. Although best friends are from same sex,
boys and girls are certainly not segregated altogether during middle childhood years. Contact
in schools and neighbourhoods may often be in groups of same sex friends.

Middle Childhood (9-11 years): Child ‘s growing independence from the family and interest
in friends might be obvious by now. Peer pressure can be strong during this time. Children
who feel good about themselves are more able to resist negative peer pressure. They make
better friendship choices. Children gain sense of responsibility along with growing
independence. During this period child might: - Form stronger, more complex friendships and
peer relations. It is emotionally important to have friends, especially of the same sex.
Experience more peer pressure. Become more independent from the family. Become more
aware of his or her body as puberty approaches. Face more academic challenges at school. In
middle childhood 30% of child ‘s social interactions involve peers. Children ‘s behaviour in
the peer group was proven to be a stable indicator of their social competence. In school these
children construct understanding of others. They interact competently with their peers and
sustain friendship over a time. Children ‘s concern about acceptance in the peer group often
rise during middle childhood. By ages 10 to 11 years, most children demonstrate
―normative‖ friendship. During this period, they recognise that friends are supposed to be
loyal to each other. Research studies have shown that boys after conflicts renew the
friendship in one day, but girls took two weeks. to get back with their friends.

Choosing friends:

Many factors are involved in selecting friends. If a child is loved and respected within family,
he is more likely to make good choices of friends. If the child has caring and supportive
relationships with his brothers and sisters, he would have seen and experienced positive
examples of how people can relate. This impression he may transfer it to his own friendships.
On the other hand if the family experiences have not been supportive and confidence
boosting, he is likely to select out peers who have similar troubles. Parents have to take time
and help child understand the need for choosing. A healthy friendship is one in which both
children are on an equal footing. Neither child will dominate. They should share and make an
effort to please each other. Their approach should be that of problem solving. Language skills
are essential for solidifying good friendship relation. In middle childhood, some children
concentrate on their social activity on a single friend.

Negative peer influence: Dealing with negative peer influence is a challenge. There are
solutions. Some parents demand their child to stop spending time with bad influence ‘.
Instead of demanding it is better to reinforce positive friendships with other children whose
behaviour and values meet yours. Encourage these children to come home and spent time
with your children, to build up a healthy relationship. This approach will help your child to
think logically.

Friendship and Social Development: Friendships are important for social development.
Friendship processes are linked to social developmental outcomes also called social
provisions. In the interpersonal theory of psychiatry developed by Harry Stack Sullivan
argued that friends fulfill social needs called communal needs. This includes companion’s
acceptance and intimacy (Buhrmester 1996). This formulation is similar to Maslow ‘s need
for belonging. Friendship relationship satisfies following needs.
1) Communal needs — Interpersonal needs for affection, nurturance, enjoyment, support,
companionship, intimacy.

2) Survival needs – physical needs for safety, food, shelter, and health.

3) Agentic needs – Individual needs for competency achievement, status, power, identity and
self-esteem.

The social concerns of school age children focus on communal needs of acceptance by peers
and avoidance of rejection. Shyness and adjustment problems matters in the relationships of
friends during middle childhood. Before the age of three, children‘s social interaction is very
minimal. As they grow, children develop real friendships. Peers are viewed as having special
qualities and rewards.

Willard Hartup (1983, 1996, 2009) has studied peer relations and friendship for more than
three decades. He concludes that friends provide cognitive and emotional resources from
childhood through old age, such as fostering self-esteem and a sense of well-being. More
specifically, children’s friendships can serve six functions (Gottman & Parker, 1987):
• Companionship. Friendship provides children with a familiar partner and playmate,
someone who is willing to spend time with them and join in collaborative activities.
• Stimulation. Friendship provides children with interesting information, excitement, and
amusement.
• Physical support. Friendship provides resources and assistance.
• Ego support. Friendship provides the expectation of support, encouragement, and feedback,
which helps children maintain an impression of themselves as competent, attractive, and
worthwhile individuals.
• Social comparison. Friendship provides information about where the child stands vis-a-vis
others and whether the child is doing okay.
• Affection and intimacy. Friendship provides children with a warm, close, trusting
relationship with another individual. Intimacy in friendships is characterized by self-
disclosure and the sharing of private thoughts. Research suggests that intimate friendships
may not appear until early adolescence (Berndt & Perry, 1990).
Add theory of ecological systems for social interaction

IMPORTANCE OF PLAY IN MIDDLE CHILDHOOD:

Play is important to the optimum development of children during their middle childhood
years. Playtime is an excellent opportunity to build the relationship with child. Children like
to play both cooperative and competitive game. It creates a bond between child and family
members or between child and his peer group. Play time help children in various ways, some
of which are;
 physical development.
 developing high self-esteem.
 developing confidence.
 for emotional cognitive social and physical development and creativity.
 help parents to be behind their children.
 help in developing natural self-esteem.
 help in developing self-regulation, the second core strength child needs to be humane
and protect himself from violence.
 help to be self-reliant, to work through problems and re-charge.

Research studies show that middle childhood is marked by the fear of diminished playtime
and play space. Encourage children to collect things like shells, stamps, coins flowers, etc., as
learning experience, which should be done as part of playtime work. Also running, hopping,
skipping climbing and dancing are also enjoyed by this middle childhood. While playing
together children should be encouraged to talk about their feelings. When young adults are
asked to recall their most salient play experiences, they give joyous experience of their play
during 8 to 12 years. (Bergen and Williams 2008). These young adults believed that their
middle childhood play helped them learn social skills, hobbies ‘and often career decisions’
that influenced their adult experiences later. In middle childhood the play interest of boys and
girls grow in different directions. Boys prefer vigorous competitive games like football,
running and jumping. Girls prefer indoor games. They cannot sit still. Running is more than
walking during this period. They are always wanting to do something. Always engaged in
large variety of activities and various games. In late middle childhood children prefer gangs
in play groups. They show loyalty to their gangs. On their road to self-reliance and
independence, they need a helping hand to develop from adults. Average weight during
middle childhood increases 3 kg a year. Average height increases 2 to 3 inches. Muscle mass
increases. Legs become longer. Strength increases due to heredity and exercise. Boys are
found to be stronger than girls. During this period, coordinated motor skills are much
developed as they are able to master running skipping, bicycle riding and skating.
Eric Erickson characterised middle childhood as the stage when children are most challenged
by the issues of mastery and competence. This time of life coincides with the child‘s
increasing experience in the social arena. Middle childhood is marked by the transition from
the world of the family to the world of peers and school. With children‘s increased exposure
to others, they encounter new comparisons and judgments. This combination of factors leads
to the development of a critical self with self-esteem. Family and experience shape certain
values and attitude. In many ways middle childhood is an age of enlightenment.

Adolescence: Puberty

Adolescence is the stage of transition between childhood and adulthood. It is the most
difficult stage of human life. The term adolescence comes from the Latin word adolescere,
meaning ―to grow or ―to grow to maturity. Adolescence is considered as a period of
‗storm and stress ‘– a period of heightened emotional tension resulting from rapid physical
changes. This phase lasts for about a decade, from the age of 12 or 13 until the late teens to
early twenties

Puberty is not the same as adolescence. For most of us, puberty ends long before adolescence
does, although puberty is the most important marker of the beginning of adolescence. Puberty
is a brain-neuroendocrine process occurring primarily in early adolescence that provides
stimulation for the rapid physical changes that take place during this period of development
(Berenbaum, Beltz, & Corley, 2015; Shalitin & Kiess, 2017; Susman & Dorn, 2013).

Growth during Adolescence: The Rapid Pace of Physical and Sexual Maturation:
Adolescence is considered to begin with puberty, the process that leads to sexual maturity or
fertility – the ability to reproduce. The adolescent growth spurt, a rapid increase in height and
weight, generally begins in girls around age 10 and in boys around age 12. The growth spurt
typically lasts for about 2 years and thus girls tend to be taller than boys in this 2-year period.

Puberty: The Start of Sexual Maturation: Puberty begins at the age of 11 or 12 for girls
and 13 or 14 for boys (like the growth spurt), with the hormone signals from the brain to
gonads (the ovaries and the testes). The pituitary gland sends a message to the gonads to
begin producing the sex hormones, androgens (male hormones) or estrogens (female
hormones). Males and females produce both types of hormones but males have higher levels
of androgens while females have higher levels of estrogens. The hormone leptin is thought to
play a key role in the onset of puberty. The pituitary gland also signals the body to produce
more growth hormones. The interaction between the growth hormones and the sex hormones
causes the growth spurt and puberty.

Puberty in Girls:

In females, menarche, the onset of menstruation, a monthly shedding of the lining of the
uterus, is the principal sign of sexual maturity. Environmental and cultural factors play a role
in determining when puberty begins. In developing (poorer) countries, menstruation begins
later as compared to developed countries. Also, girls who are nourished and healthy tend to
start menstruating earlier than those suffering from malnourishment or chronic illness. Some
studies have shown that the amount of body fat may play an important role in the onset of
menstruation. Other factors such as environmental stress from parental divorce or family
conflicts can lead to an early onset (Hulanicka, 1999; Kim & Smith, 1999).

Menstruation is one of the signs of puberty related to the development of primary and
secondary sexual characteristics. The primary sexual characteristics are the organs
necessary for reproduction. In girls, the sex organs are the ovaries, the uterus and the vagina.
Secondary sexual characteristics are the physiological signs of sexual maturation that do
not directly involve the sex organs. This includes the development of breasts, pubic and
armpit hair. The breasts begin to grow around the age of 10. Pubic hair appears at about age
11 while underarm hair about 2 years later. On an average, menarche occurs about 2 years
after the breasts and uterus have begun to develop.

Puberty in Boys:

In males, the principal sign of sexual maturity is the production of sperm. A boy‘s first
ejaculation, known as spermache usually occurs around the age of 13, about a year after the
body begins producing sperm. The primary sexual characteristics include the growth of the
penis, testes and scrotum (accelerates around age 12 and reaches adult size about 3 to 4 years
later), prostate gland and seminal vesicles, which produce semen (the fluid that carries
semen).

The secondary sexual characteristics include growth of pubic hair, which begins around
age 12, followed by the growth of underarm and facial hair. In boys, the voice deepens
because the vocal cords become longer and the larynx larger. Rapid mood swings are
common among adolescents because of high hormones levels – boys tend to have feelings of
anger and annoyance while girls experience depression and anger.

[EXTRA:

The Timing of Puberty: The Consequences of Early and Late Maturation: Early
maturation: Early maturation is advantageous to the boys. Early-maturers tend to be
successful athletes probably because of their larger size and are more popular among peers
and elders, which enhances the self concept. However, on the downside, boys who mature
early are more likely to face difficulties in school, and tend to get involved in delinquency
and substance abuse. They seem to get along better with older boys and thus engage in age-
inappropriate activities. Early maturing boys are conformists and lack humour, but turn out to
be more responsible and cooperative in adulthood (Taga et al., 2006; Costello et al., 2007).
Early maturation comes at a very young age for girls because, in general, they mature earlier
than boys. Changes in the body (such as development of breasts) may make them feel
embarrassed and different from their peers. Less mature classmates may make fun of them
(William & Curie, 2000). On the positive side, early maturing girls are often sought as dates
and their popularity may enhance their self concept. However, early-maturers may not be
socially ready for the one-on-one dating situation and may feel anxious, unhappy and
depressed. Cultural factors play a significant role in determining how early maturation will be
perceived by girls. In the United States, an evident display of sexuality is likely to be seen
negatively, while in more liberal countries like Germany, early maturers are likely to have
better self - esteem. Late Maturation: Late maturation can be disadvantageous to boys –
small and lighter boys are perceived as unattractive, they may be at a disadvantage in sports
and may suffer socially as they are expected to be taller. This can negatively influence their
self concept and its effect may extend into adulthood.

However, on the positive side, late maturers tend to grow up to be assertive, insightful and
creatively playful as compared to early maturers (Kaltiala-Heino et al., 2003). Late maturing
girls have some advantages – they have fewer emotional difficulties and tend to fit into the
society‘s ideal of ‗slender‘ body type longer than their early maturing peers who look
relatively heavier (Simmons & Blythe, 1987). The reactions to early and late maturation are
complex and are influenced by various factors like changes in peer group, family situation,
school or other environmental factors more than the age of maturation or the impact of
puberty in general (Dorn et al., 2003).]
Development of identity in Adolescence:

―Who am I?, ―What is my role?, ―Where do I belong to? are some fundamental questions
for an adolescent. These issues come up primarily because the intellectual capacities of an
adolescent to an extent match those of adults. They realize that they are an individual entity -
different from everyone else around. In addition to the cognitive advancements, their bodies
are growing rapidly and others are responding to them in new ways. Thus, there is a drastic
change in the self concept and self esteem of adolescents.

Self-concept: What Am I Like?

In childhood, the one‘s views are not very different from those around. However, in
adolescence, one describes who one is, by taking into account others‘ as well as one‘s own
views (Harter, 1990; Cole et al., 2001; Updegraff et al., 2004). This wider perspective of
oneself is one aspect of the adolescents‘ growing sense of identity. As they can acknowledge
several characteristics of their self simultaneously, their perception of themselves becomes
more organized and consistent. They come to view themselves as psychological beings – as
abstraction rather than concrete entities (Adams, Montemayor, & Gullotta, 1996).

This broad multi-dimensional self-concept of adolescents‘ can create difficulties for them
because of its complexity, especially in the early years. Younger adolescents‘ may want to be
perceived in a certain way (―I am friendly and I like to be with people), and may worry
because their actions contradict that view (sometimes I can‘t stand being with my friends and
just want to be alone). However, by the end of adolescence, teenagers realize that behaviours
and feelings change from situation to situation (Trzesniewski et al., 2003, Hitlin et al., 2006).

Self-Esteem: How Do I Like Myself? Adolescents constantly seek to understand who they
are (their self-concept) but do not necessarily like themselves (their self-esteem). They are
able to view themselves fully due to an increasingly accurate self-concept. These perceptions
of self determine their self-esteem. The cognitive advancements that enable them
acknowledge several aspects of their self, also help them to assess those in various ways
(Chan, 1997; Cohen,J., 1999). An adolescent may have high self-esteem in one area (for
example, academics) but poor self-esteem in another (communication).

Gender differences in Self-Esteem:

Studies show that girls tend to have poor self-esteem and are more vulnerable, as compared to
boys, especially in the initial years (Watkins et al., 1997; Byrne, 2000; Miyamoto et al., 2000;
Ah-Kion, 2006).

Girls tend to be concerned about physical appearance, social success and academic
achievement, more than boys. Boys do care about these but tend to be quite casual about the
same. Boys tend to have higher self-esteem but gender stereotypes may make them believe
that they should be thoroughly competent, confident and tough. Those facing difficulties like
not being selected for a sport or being rejected for a date, may feel miserable about it and
come to see oneself as incompetent males (Pollack, 1999; Pollack et al., 2001).

Erikson’s View: It was Erik Erikson (1950, 1968) who first understood how central
questions about identity are to understanding adolescent development. Recall that Erikson’s
fifth developmental stage, which individuals experience during adolescence, is identity
versus identity confusion. During this time, said Erikson, adolescents are faced with
deciding who they are, what they are all about, and where they are going in life. The search
for an identity during adolescence is aided by a psychosocial moratorium, which is Erikson’s
term for the gap between childhood security and adult autonomy. During this period, society
leaves adolescents relatively free of responsibilities and able to try out different identities.
Adolescents experiment with different roles and personalities. They may want to pursue one
career one month (lawyer, for example) and another career the next month (doctor, actor,
teacher, social worker, or astronaut, for example). They may dress neatly one day, sloppily
the next. This experimentation is a deliberate effort on the part of adolescents to find out
where they fit in the world. Most adolescents eventually discard undesirable roles.

Youth who successfully cope with conflicting identities emerge with a new sense of self that
is both refreshing and acceptable. Adolescents who do not successfully resolve this identity
crisis suffer what Erikson calls identity confusion. The confusion takes one of two courses:
Individuals either withdraw, isolating themselves from peers and family, or they immerse
themselves in the world of peers and lose their identity in the crowd.

Psychological Moratorium: This refers to a period when adolescents take some time off to
assess various roles and alternatives. According to Erikson, due to the pressures of the
identity-versus-identity-confusion period, some adolescents may take a semester or a year off
travel, work to explore some other option. Many adolescents can not afford a psychological
moratorium to assess various identities. Some have to take up part-time jobs after school or
immediately after high school for economic reasons, leaving them with little opportunity to
explore. However, studying and doing a job simultaneously may provide the student with
psychological benefits that the psychological moratorium doesn‘t.

[Societal Pressures and Reliance on Friends and Peers:

The adolescent experiences societal pressures during this stage. There is pressure from
parents and friends to decide whether one will continue with studies or work after 193

high school is over and if one chooses to work, what will be the nature of the job. The
societal expectations influence the educational lives of adolescents till the end of high school.
After that one has to make the difficult choice of which path to take up (Kidwell et al., 1995).
During this phase, adolescent depend less on adults and friends become an important source
of information. This reliance on peers helps form close relationships and compare themselves
with others to define one‘s own identity. Erikson believed that this dependence on friends for
clarifying one‘s identity and learning to form close relationships connects this stage to the
next level of psychosocial development in Erikson‘s theory – intimacy versus isolation.
Erikson suggested that there is a difference in the way males and females pass the identity-
versus-identity-confusion period – males are more likely to follow the series of stages of
psychosocial development mentioned in the table of summary of Erikson‘s stages, and form
an established identity before forming intimate relationships. Females on the other hand tend
to seek intimate relationships first and then develop a sense of identity through these
relationships. However Erikson‘s views reflect the social scenario that was prevalent when he
was writing, when females tended get married early rather than study after high school and
have their own careers. In today‘s times, males and females more or less follow a similar
pattern during the identity-versus-identity-confusion period]

Cognitive Development in adolescence- formal operational stage:

Jean Piaget proposed that around 7 years of age children enter the concrete operational stage
of cognitive development. They can reason logically about concrete events and objects, and
they make gains in their ability to classify objects and to reason about the relationships
between
classes of objects. Around age 11, according to Piaget, the fourth and final stage of cognitive
development—the formal operational stage—begins.
The Formal Operational Stage:
Formal operational thought is more abstract than concrete operational thought. Adolescents
are no longer limited to actual, concrete experiences as anchors for thought. They can conjure
up make-believe situations, abstract propositions, and events that are purely hypothetical, and
can try to reason logically about them.
The abstract quality of thinking during the formal operational stage is evident in the
adolescent’s verbal problem-solving ability. Whereas the concrete operational thinker needs
to see the concrete elements A, B, and C to be able to make the logical inference that if A = B
and B = C, then A = C, the formal operational thinker can solve this problem merely through
verbal presentation. Another indication of the abstract quality of adolescents’ thought is their
increased tendency to think about thought itself.
Accompanying the abstract nature of formal operational thought is thought full of idealism
and possibilities, especially during the beginning of the formal operational stage, when
assimilation dominates. Adolescents engage in extended speculation about ideal
characteristics—qualities they desire in themselves and in others. Such thoughts often lead
adolescents to compare themselves with others in regard to such ideal standards. And their
thoughts are often fantasy flights into future possibilities.

At the same time that adolescents think more abstractly and idealistically, they also think
more logically. Children are likely to solve problems through trial and error; adolescents
begin to think more as a scientist thinks, devising plans to solve problems and systematically
testing solutions. This type of problem solving requires hypothetical-deductive reasoning,
which involves creating a hypothesis and deducing its implications, steps that provide ways
to test the hypothesis. Thus, formal operational thinkers develop hypotheses about ways to
solve problems and then systematically deduce the best path to follow to solve the problem.

[During preschool years children question ―who am I? which leads to developments of self.

Resolving Conflicts: Preschoolers sense of self leads to psychosocial development which

includes changes in individual’s understanding of themselves and of other‘s behaviour. Erik
Erikson developed a theory of psychosocial development in which he viewed people passing
through eight distinct stages of development. Each stage of development is characterized by a
crisis or conflict that the person must resolve. The experiences that we gain in resolving these
conflicts lead us to develop ideas about ourselves that can last for the rest of our lives. The
eight stages of psychosocial development are as follows: (write the theory)]

[Self-concept and self-esteem in the Preschool Years: not needed

High self-esteem and a positive self-concept are important characteristics of children’s well-
being (Baumeister, 2013; Miller & Cho, 2018;Oberle, 2018). Self-esteem refers to global
evaluations of the self; it is also called selfworth or self-image. For example, a child may
perceive that she is not merely a person but a good person. Self-concept refers to domain-
specific evaluations of the self. Children can make self-evaluations in many domains of their
lives—academic, athletic, appearance, and so on. The foundations of self-esteem and self-
concept emerge from the quality of parent-child interaction in infancy and early childhood
(Miller & Cho, 2018). Self-concept during preschool years is not accurate. Preschool children
typically overestimate their skills and knowledge across all domains of expertise. They
generally have rosy pictures about themselves, are optimistic and they expect to do well in
the future even when they have experienced failure. Preschooler‘s view of themselves reflects
their cultural beliefs. Children coming from collectivist culture tend to regard themselves as
parts of a larger social network in which they are interconnected with and responsible to
others. Where as children coming from individualistic orientation emphasise personal identity
and uniqueness. They view themselves as self-contained and autonomous. Preschooler‘s
cultural attitudes towards various racial and ethnic groups considerably influence their self-
concept. One‘s racial and ethnic identity also impact their self-concept.]

Module V: Adulthood and Ageing

Descriptors/Topics
Developmental Tasks of Young Adulthood and Adjustment
Stresses in Middle Adulthood-Empty nest syndrome
Ageing: Physical and Social Development
Psychopathology in Old Age
Death and dying: Kubler Ross Stages of Dying
Positive Ageing: Concept and Application

Middle adulthood lasts from the mid-30s to the mid-60s. During this stage of life, many
people raise a family and strive to attain career goals. They start showing physical signs of
aging, such as wrinkles and gray hair. Typically, vision, strength and reaction time start
declining. Diseases such as diabetes, cardiovascular or heart disease, and cancer are often
diagnosed during this stage of life. These diseases are also the chief causes of death in middle
adulthood.

Developmental Tasks of Young Adulthood and Adjustment

The term “developmental task” was introduced by Robert Havinghurst in the 1950’s. A
developmental task is one that arises predictably and consistently at or about a certain period
in the life of the individual (Havighurst, 1948 and 1953). He believed that learning is basic to
life and that people continue to learn throughout life. According to him a developmental task
is a task which an individual has to and wants to solve in a particular life-period. He
writes, “A developmental-task is the midway between an individual need and a social
demand. It assumes an active learner interacting with an active social environment”. Thus, it
is also an early and significant contributor to the emerging field of lifelong human
development.
Successful achievement of these tasks leads to the person’s happiness, and increases the
probability of competence in the following tasks, while failure leads to unhappiness in the
individual, disapproval by society and difficulty in later tasks. The concept of developmental
tasks assumes that human development in modern societies is characterised by a long series
of tasks. Some of these tasks are located in childhood and adolescence, whereas others arise
during adulthood and old age.

Characteristics of Developmental Task

Havighurst considered the many different aspects of a person’s life that influence a person’s
development viz., the biological development and physical structures of the individual; the
society in which the person lives, and the resultant cultural influences, as well as the
individual’s personal characteristics, values and goals. This view of development takes into
account the role of physical maturation and the role that society plays in determining the
skills that need to be learned at a certain age. According to Havighurst, there are sensitive
periods which he called teachable moments, when an individual is mature enough to learn
the developmental tasks. These tasks may be physical like walking, cognitive like learning to
read, or social where the person develops significant relationships. Once the critical period of
development is over, learning may still occur. Language skills for example, continue to
develop as one learns more complex ways of using language. Some tasks are the same for
everyone, regardless of where you live, as they are about human biology.
Havighurst identified the following six major stages in human life:
 Infancy & early childhood (Birth till 6)
 Middle childhood (6-12)
 Adolescence (13-18)
  Early Adulthood (19-30):
In young adulthood, developmental tasks are mainly located in family, work, and social life.
Family-related developmental tasks are described as finding a mate, learning to live with a
marriage partner, having and rearing children, and managing the family and one’s home. A
developmental task that takes an enormous amount of time of young adults relates to the
achievement of an occupational career. Family and work-related tasks may represent a
potential conflict, given that the individual’s time and energy are limited resources. Thus,
young adults may postpone one task in order to secure the achievement of another. With
respect to their social life, young adults are also confronted with establishing new friendships
outside of the marriage and assuming responsibility in the larger community.

 Middle Age (30-60):

Developmental tasks during midlife relate to:

• 1) Achieving adult civic and social responsibility

• 2) Establishing and maintaining an economic standard of living

• 3) Assisting teen-age children to become responsible and happy adults

• 4) Developing adult leisure, time activities

• 5) Relating oneself to one’s spouse as a person

• 6) Accepting and adjusting to the physiological changes of middle age

• 7) Adjusting to ageing parents.

Also, this is the time children group up and proceed to do their courses out of town and thus
leave their homes. The parents have to adjust to their leaving. During the middle years the
biological changes of ageing become prominent. Especially for the woman, the latter years of
middle age are full of profound physiologically based psychological change.

 Later maturity (60 and over):

The period of old age begins at the age of sixty. At this age most individuals retire from their
jobs formally. They begin to develop some concern and occasional anxiety over their
physical and psychological health. In our society, the elderly are typically perceived as not so
active, deteriorating intellectually, becoming narrowminded and attaching new significance
to religion and so on. Many of the old people lose their spouses and because of which they
may suffer from emotional insecurity. The developmental tasks of later maturity differ in
only one fundamental respect from those of other ages. They involve more of a defensive
strategy that is of holding on the life rather than of seizing more of it.

Havighurst forward the following developmental tasks for this view.

• 1) Adjusting to decreasing physical strength and health
• 2) Adjusting to retirement and reduced income
• 3) Adjusting to death of spouse
• 4)Establishing an explicit affiliation with one’s age group
• 5) Meeting social and civic obligations
• 6)Establishing satisfactory physical living arrangements

Stresses in Middle Adulthood-Empty nest syndrome:

Empty nest syndrome isn't a clinical diagnosis. Instead, empty nest syndrome is a
phenomenon in which parents experience feelings of sadness and loss when the last child
leaves home. (ENS) has been a term used in psychology to denote the psychological
symptoms that arise when the youngest child leaves the family for work or further studies
causing a void in the family leaving the aged parents behind termed as the empty nest. Τhe
empty-nest syndrome is a transitional stage, when middle-aged parents are in the process of
encouraging their children to take up their obligations as adults. It is a psychological
condition that affects both parents, who experience feelings of grief, loss, fear, inability,
difficulty in adjusting roles, and change of parental relationships, when children leave
the parental home. Researchers have found that while parents do feel a sense of loss when
their nests empty, they are also finding that this period can be one of increased satisfaction
and improved relationships. And some findings even challenge the notion that an empty nest
is hardest on women--if anything, research suggests, it may be men who don't fare so well
when children leave home.

Feelings of loss, sadness, anxiety, grief, and fear are common among parents experiencing
empty nest syndrome, and the condition affects both men and women. Here are the five most
common signs of this syndrome.

Loss of purpose: This feeling is common for parents whose children have recently left the
nest. Letting go of the active, day-to-day duties of parenting can be a tough transition to
make, especially if you largely defined yourself by your parenting role while your child lived
at home.

Lack of control: The lack of control over when your child is attending class, going to
work, going on a date, or hanging out with friends can be frustrating. You might also feel a
bit left out when you don't know the details of your child's day-to-day schedule.

Emotional distress: Becoming an empty nester can stir up a variety of emotions. You may be
feeling:

 Sad that your child has grown up

 Angry at yourself for not being more available to them in the past

 Nervous about the state of your marriage

 Scared that you're growing older

 Frustrated that you're not where you imagined you'd be at this phase in your life

Marital stress: In the process of raising a child, many couples set their relationship aside and
make the family revolve around the kids. If you've spent years neglecting your marriage, you
might find your relationship needs some work once the kids are gone.

Anxiety about your children: Whether your child has gone to college or simply moved into
their own place, it’s normal to worry about how they are faring after they've left the nest.
What isn’t normal, however, is to feel constant anxiety about how your child is getting by.

Ageing: Physical and Social Development:

4 Principles of Adult development and Ageing:
1)Continuity: Individuals remain the same even though they change. Can’t look at the
present without considering the past.
2) Survival: People who live till their old age managed to survive events that could have
caused their deaths. Survivors are more likely to care for their health and not engage in risky
behaviors.
3)Principle of Individuality: As people age, they become different from each other. Not
everyone ages in the same manner.
4) Normal ageing is different from disease: Intrinsic ageing process if different from
illness.
Theories of ageing:
1. ‘Activity Theory’ (1961) - Robert J. Havighurst:

• Is theory that describes the psychosocial ageing process.

• Activity theory emphasises the importance of ongoing social activity.
• This theory suggests that a person's self-concept is related to the roles held by that
person i.e. retiring may not be so harmful if the person actively maintains other
roles, such as familial roles, recreational roles, volunteer & community roles.
• To maintain a positive sense of self the person must substitute new roles for those
that are lost because of age. And studies show that the type of activity does
matter, just as it does with younger people.

2. ‘Disengagement Theory’ (1961) - Elaine Cumming & Warren Earl Henry:

• Refers to an inevitable process in which many of the relationships between a

person and other members of society are severed & those remaining are altered in
quality.
• Withdrawal may be initiated by the ageing person or by society, and may be
partial or total.
• It was observed that older people are less involved with life than they were as
younger adults.
• As people age they experience greater distance from society & they develop new
types of relationships with society.
• In America there is evidence that society forces withdrawal on older people
whether or not they want it.
• Some suggest that this theory does not consider the large number of older people
who do not withdraw from society.
• This theory is recognised as the first formal theory that attempted to explain the
process of growing older.

3. ‘Continuity Theory’ (1968) - George L. Maddox & Robert Atchley:

Continuity Theory holds that, in making adaptive choices, middle-aged and older adults
attempt to preserve and maintain existing internal and external structures; and they prefer
to accomplish this objective by using strategies tied to their past experiences of
 themselves and their social world. Change is linked to the person's perceived past,
producing continuity in inner psychological characteristics as well as in social behavior
and in social circumstances. Continuity is thus a grand adaptive strategy that is promoted
by both individual preference and social approval.
4. ‘Exchange Theory’ (1975) - James Dowd
The exchange theory of aging, proposed by James Dowd in 1975, is a social theory that
addresses a perceived loss of status and power associated with aging. It proposes that
social behavior is the result of an exchange process. Derived from the Social Exchange
theory of Economics it states that the purpose of this exchange is to maximize benefits
and minimize costs. People weigh the potential benefits and risks of social relationships.
When the risks outweigh the rewards, people will terminate or abandon that relationship.
Essentially older people view their social status to have diminished as the benefits
linked to being associated with them would also diminish with ageing.

Psychopathology in Old Age:

Geropsychiatry is a branch of psychiatry which focuses on the mental disorders of elderly
people. Also known as psychiatry of old age, geriatric psychiatry or psychogeriatrics, this
discipline provides people of retirement age with the psychological, somatic and social care
which their health requires.
Psychopathology was first introduced by Karl Jaspers, a German/Swiss philosopher and
psychiatrist 1913. Signs of psychopathology vary depending on the nature of the condition.
Some of the signs that a person might be experiencing some form of psychopathology
include:
• Changes in eating habits
• Changes in mood
• Excessive worry, anxiety, or fear
• Feelings of distress
• Inability to concentrate
• Irritability or anger
• Low energy or feelings of fatigue
• Sleep disruptions
• Thoughts of self-harm or suicide
• Trouble coping with daily life
• Withdrawal from activities and friends
Diagnostic and Statistical Manual of Mental Disorders (DSM) is created by the American
Psychiatric Association (APA) as an assessment system for mental illness.
DISORDERS:
• Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2 weeks
period & represent a change from previous functioning; at least one the symptoms is either 1)
depressed mood or 2) loss of interest or pleasure.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective
report (eg; feels sad, empty, or hopeless) or observation made by other (eg; appears
sad/tearful)
2. Markedly diminished interest or pleasure in all, or almost all activities most of the
day, nearly every day as indicated by either subjective account or observation)
3. Significant weight loss when not dieting or weight gain ( eg’ a change of more than
5% of the body weight in a month) or decrease or increase in appetite nearly every
day.
4. insomnia or hypersomnia.
5. Psychomotor agitation or retardation nearly every day (observable by others and not
merely subjective feelings of restlessness or being slowed down)
6. Fatigue or loss of energy nearly everyday
7. Feelings of worthlessness or excessive inappropriate guilt (guilt which may be
delusional) nearly every day (not merely self- reproach).
8. Diminished ability to think or concentrate or indecisiveness nearly everyday (either
by subjective account or by observation)
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social,
occupational and other important areas of functioning.

C. The episode is not attributable to the physiological effects of a substance use, drugs or
any other medical condition.

• Note: Criteria A-C constitute a major depressive episode. MDE are common in
bipolar I disorder but are not required for the diagnosis of bipolar I disorder.
 • Delirium:

• A. Disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift
attention) and awareness (reduced orientation to the environment).

• B. The disturbance develops over a short period of time (usually hours to a few
days), represents an acute change from baseline attention and awareness, and tends
to fluctuate in severity during the course of a day.

• C. An additional disturbance in cognition (e.g.memory deficit, disorientation,

language, visuospatial ability, or perception).

• D. The disturbances in Criteria A and C are not better explained by a pre-existing,

established or evolving neurocognitive disorder and do not occur in the context of a
severely reduced level of arousal such as coma.

• E. There is evidence from the history, physical examination or laboratory findings

that the disturbance is a direct physiological consequence of another medical
condition, substance intoxication or withdrawal (i.e. due to a drug of abuse or to a
medication), or exposure to a toxin, or is due to multiple etiologies.

Major Neurocognitive Disorder/ Dementia:

A. Evidence of significant cognitive decline in one or more cognitive domains (Complex
attention, executive function, learning, memory, language, perceptual motor or socio
cognition) based on:
1. Concern about significant decline, expressed by individual or reliable informant, or
observed by clinician.
2. Substantial impairment, documented by objective cognitive assessment.
B. The cognitive deficits interfere with independence in everyday activities (eg: at a
minimum requiring assistance with complex instrumental activities of daily living such as
paying bills or taking medication)

C. The cognitive deficits do not occur exclusively during delirium.

D. The cognitive deficits are not better explained by another mental disorder (depression,
schizophrenia)

E. Specify one or more etiologic subtypes, “due to”:

 • Alzheimer’s disease

• Cerebrovascular disease (Vascular Neurocognitive Disorder)

• Frontotemporal Lobar Degeneration (Frontotemporal Neurocognitive Disorder)

• Dementia with Lewy Bodies (Neurocognitive Disorder with Lewy Bodies)

• Parkinson’s disease

• Huntington’s disease

• Traumatic Brain Injury

• HIV Infection

• Prion Disease

• Another medical condition

• Multiple etiologies

Death and dying: Kubler Ross Stages of Dying:

Elisabeth Kübler- Ross (1969) divided the behavior and thinking of dying persons into five
stages: denial and isolation, anger, bargaining, depression, and acceptance.
Kubler-Ross's Five Stages of Dying (DABDA)
• Denial: is Kübler-Ross’ first stage of dying, in which the person denies that death is
really going to take place. it is a common defense mechanism used to protect oneself
from the hardship of considering an upsetting reality. While persistent denial may be
deleterious, a period of denial is quite normal in the context of terminal illness.
However, denial is usually only a temporary defense. It is eventually replaced with
increased awareness when the person is confronted with such matters as financial
considerations, unfinished business, and worry about the well-being of surviving
family members.
• Anger is commonly experienced and expressed by people as they concede to the
reality of a death/ terminal illness. At this point, the person becomes increasingly
difficult to care for as anger may become displaced and projected onto physicians,
nurses, family members, and even God. The realization of loss is great, and those who
 symbolize life, energy, and competent functioning are especially salient targets of the
dying person’s resentment and jealousy.
• Bargaining third stage of dying, in which the person develops the hope that death can
somehow be postponed or delayed. Some persons enter into a bargaining or
negotiation—often with God—as they try to delay their death. Psychologically, the
person is saying, “Yes, me, but . . .” In exchange for a few more days, weeks, or
months of life, the person promises to lead a reformed life dedicated to God or to the
service of others. The bargain offered could be rational, such as a commitment to
adhere to treatment etc. or magical hope.
• Depression is perhaps the most immediately understandable of Kubler-Ross's stages,
and patients experience it with unsurprising symptoms such as sadness, fatigue, and
anhedonia. Spending time in the first three stages is potentially an unconscious effort
to protect oneself from this emotional pain.
• Acceptance come from recognizing the reality of a difficult diagnosis/ death while no
longer protesting or struggling against it. People may choose to focus on enjoying the
time they have left and reflecting on their memories. They may begin to prepare for
death practically by planning their funeral, providing for loved ones etc. the person
develops a sense of peace, an acceptance of his or her fate, and in many cases, a desire
to be left alone. In this stage, feelings and physical pain may be virtually absent.
Kübler-Ross describes this fifth stage as the end of the dying struggle, the final resting
stage before death.

Positive Ageing: Concept and Application:

WHO defines healthy ageing as “the process of developing and maintaining the
functional ability that enables wellbeing in older age.” Functional ability is about having
the capabilities that enable all people to be and do what they have reason to value. This
includes a person’s ability to:
• meet their basic needs
• learn, grow and make decisions
• be mobile
• build and maintain relationships
• contribute to society.
Rowe and Kahn’s model (1997) is the best known and widely applied model of Successful
ageing which views “better than average” ageing as a combination of three components:
 • avoiding disease and disability
• high cognitive and physical function
• and engagement with life.

“The process of maintaining a positive attitude, feeling good about yourself, keeping fit
and healthy, and engaging fully in life as you age”. – Positive Psychology Institute,
Australia
Positive ageing is a way of living rather than a state of being, a new approach to later life. It
is an approach which recognizes how negative mental states (beliefs, thoughts, ideas,
attitudes) can have an impact on physical and emotional wellbeing as we age. It is a practical
way of improving the chances of having better life as we age. It understands that the ‘mind’
can have a significant impact on our physical and emotional wellbeing.
A positive ageing approach advocates: -
• A realistic understanding of ageing which fully recognizes its positive aspects as well
as the more challenging ones.
• An understanding that many major life events will happen in later life. We can’t
control or prevent them – but we do have some control over how we respond to them
• The realization that how we think and feel about ageing can have a significant impact
on our health and well-being in old age. Negative ideas can greatly increase the
likelihood of ill health and depression.
• Developing a more positive outlook – a ‘glass half full’ perspective to produce a
better quality of later life
• Using techniques from which can be learned and applied as preventative measures
during the ageing process to produce much better outcomes.
Martin Seligman- the founder of positive psychology gave the theory of “learned
helplessness” which states that - humans and animals can learn to become helpless and feel
they have lost control over what happens to them.
• Positive psychology focuses on the positive events and influences in life, including:
• Positive experiences (like happiness, joy, inspiration, and love).
• Positive states and traits (like gratitude, resilience, and compassion)
• character strengths, optimism, life satisfaction, happiness, wellbeing, gratitude,
compassion (as well as self-compassion), self-esteem and self-confidence, hope, and
elevation.
• Positive psychologists assume that valued subjective experience can help people of
old age optimize their well-being.
• It is suggested that older people may learn to change their personal focus by learning
new strategies of how to become more accepting.
• A person may be helped to shift their expectations according to their changed
abilities. The older person may learn not to expect that he/she can still drive to the
shops and back by themselves (Hill, 2010). Accepting declining functioning does not
mean that older people should not try to change what can be changed. Controlling
symptoms of disease or preserving physical fitness are clearly endorsed by positive
ageing proponents.