Child psychology khush

CHILD PSYCHOLOGY

1. CHILD PSYCHOLOGY Presented by: Khushbu Agrawal

2. CONTENT Introduction Theories of child psychology Classification of child’s behavior Factors affecting child’s behavior Behavior management Conclusion References 2

3. I ntroduction What is Psychology ? Science dealing with human nature, function and phenomenon of his soul in the main What is Child P sychology ?? Science or study of child’s mind and how it functions 3 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

4. Importance of Child Psychology: To better understand the child To know the problem of psychological origin To deliver dental sciences in a meaningful and effective manner To establish effective communication with the child To gain confidence of child and parents To teach child and parent importance of primary and preventive care To have a better Rx planning and interaction To produce a comfortable environment for dental team to work on the patient 4 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

5. THEORIES OF CHILD PSYCHOLOGY A] Psychodynamic theories 1.Psychosexual/Psychoanalytic theory – Sigmund Freud (1905) 2.Cognitive theory – Jean Piaget (1952) 3.Psychosocial theory – Erik Erickson (1963) 5 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

6. B] Theories of learning and behavior development Classical conditioning – Pavlov (1927) Operant conditioning – Skinner (1938) Hierarchy of needs – Maslow (1954) Social learning theory – Bandura (1963 ) C] Margaret Mahler’s theory of development (1933) 6 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

7. Psychoanalytic theory By Sigmund Freud in 1905 Personality to originate from biological roots , as a result of satisfaction of asset of instincts of which sexual instinct being most important C ategorized into 5 psychosexual stages At each stage sexual energy is invested in a particular part called erogenous zone 7 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

8. 8 Psychoanalytic theory…

9. a ] T opographic model There are 3 levels of consciousness: Conscious - a part of personality which is aware of thoughts and feelings for basic activities Preconscious - a part of personality of which the individual is not aware of at the moment however able to recollect into awareness without great difficulty. Subconscious/unconscious - part of personality of which individual is unaware, which generally cannot bring into awareness without help of assistant 9 Psychoanalytic theory…

10. Mental iceberg concept by Sigmund Freud 10 Psychoanalytic theory…

11. b] Psychic model/Psychic triad 11 Psychoanalytic theory…

12. 1) ID Basic structure of personality, reservoir of instincts Based on pleasure principle Features of id Present at birth Impulse ridden (instinctual) Strive for immediate pleasure and gratification Selfish and c annot withstand pain If retained – aggressive personality 12 Psychoanalytic theory…

13. 2 ) EGO Mediator between ID and Super ego Develops out of ID in the 2 nd to 6 th month of life Based on reality principle It modifies the ID and form the executive part of the personality Concerned with memory and judgment Seat of consciousness It is the actual reality we experience 13 Psychoanalytic theory…

14. 2 ) EGO Mediator between ID and Super ego Develops out of ID in the 2 nd to 6 th month of life Based on reality principle It modifies the ID and form the executive part of the personality Concerned with memory and judgment Seat of consciousness. It is the actual reality we experience 14

15. Functions of ego: Defense mechanism – prevents the instinctual impulses from the ID and reduces the level of anxiety. As a positive function in that the individual is able to avoid crisis. As a negative function in that they cause self deception and prevent the individuals from accepting the realities of life. 15 Psychoanalytic theory…

16. E GO DEFENCE MECHANISMS PROJECTION: Individual projects, personal feelings of inadequacy onto someone in order to feel more comfortable. DENIAL: Inability to accept the psychological impact of a potentially stressful event . DISPLACEMENT: The transfer of hostile and aggressive feelings from a original source to another, usually a less important one. 16 Psychoanalytic theory…

17. IDENTIFICATION: assumption of qualities of some one else to vent frustration or create fantasy (imitation) REACTION FORMATION: Transfer of hostile or more aggressive impulses into their opposite or more socially desirable form. RATIONALISATION: A strategy developed to excuse or minimize the psychological consequences of an event. REPRESSION: The process of unconscious forgetting which allows the suppression, painful experiences into subconscious mind . 17

18. 3) SUPEREGO Acts as a censor for acceptability of thoughts, feelings and behavior It is determined by the restrictions imposed by the parents, society and culture, i.e . morals and ethics It is developed by initial reward and punishment. Proper parenting is important. 18

19. Freud’s stages of development 19

20. Stage 1: Ora l stage (0-1 year) Perioral region is the area of pleasure and gratification – erogenous zone Adequate and regular feeding is very important Dependent stage Satisfaction of this stage helps in the development of trust and in later years it result in successful achievements of needs If child’s needs are not met properly at this stage: excessive optimism, pessimism, demandingness, envy, jealousy 20

21. Stage 2: Anal stage (2-3 year) Anal region - the zone of pleasure Ego centric or self centered behavior Maturation of his neuromuscular control Child become more independent and develops personal autonomy. Over emphasis of toilet training causes compulsive, obstinate, and perfectionist behavior in later life ANAL PERSONALITY: Characterized by disorderliness abstinence, stubbornness, willfulness, frugality 21

22. Stage 3: Phallic stage (3-5 year) Child becomes increasingly aware of his or her genitals, he can differentiate the sexes . Characteristics:- Oedipus complex : boys become attached to his mother . Resolution of this crisis for boys is to identify with his father and use him as a role model. 22

23. Electra complex :opposite of Oedipus complex. Girls get attached to father Sense of shame and guilt Emergence of jealous and competitive feelings towards peers and siblings 23 Psychoanalytic theory…

24. Stage 4: Latency stage (5-12 year) Period of consolidation More importance is on peer development and character formation Greater degree of control over instinctual impulses Lack of resolution of this stage can lead to immature behavior and decreased development of skills Males tend to act as females and females tends to act as males (tom boy) 24 Psychoanalytic theory…

25. Stage 5: Genital stage (12-18 year) Spurt in sexual activity Hormonal and physiological changes increase the interest in sexual matters Sense of identity develops Personality matures Helps to separate from dependence of parents Their acceptance of adult role, functions with social expectations and cultural values 25

26. Most important stage that shapes the future of a child are oral and phallic stages A successful resolution of oral stages give the foundation of close trusting relationship while unresolved phallic stage leads to confusion over sexual role and behavior 26 Psychoanalytic theory…

27. By Jean Piaget in 1952 Survival of the fittest and the most adaptable is the driving force for development. Cognitive development is the interaction between the individual and the environment cognitive theory 27 Textbook of Pedodontics Shobha Tondon 2 nd E di. 2008

28. FOUR MAJOR ASPECTS OF COGNITIVE DEVELOPMENT Progressive neurological development Child has the opportunity to practice newly acquired skills The opportunity for social interaction Internal psychological mechanism or structures emerge that allows the child to construct successively more complex cognitive models based on maturation and experience. 28

29. Two types of cognitive structure 29 Cognitive theory…

30. ADAPTATION OF COGNITIVE STRUCTURE By two process Assimilation: Refers to incorporation of new objects, thoughts, and behavior into existing structures. Accommodation : Is the change of existing structures in response to novel experiences Equilibration : Is the means by which the individual balances the competing forces of assimilation and accommodation. 30 Cognitive theory… Contemporary orthodontics by William Profitt 5 th Edi. 2008

31. PIAGETS STAGES OF COGNITIVE DEVELOPMENT 31 Cognitive theory… Contemporary orthodontics by William Profitt 5 th Edi. 2008

32. 32 Cognitive theory…

33. A] Sensorimotor stage (birth to 2yrs) Child born with certain basic characters for interacting with the environment. This primitive strategies mark the beginning of the thinking process. Child does not yet have the capacity to represent object (or) people to himself mentally. 33 Cognitive theory…

34. As maturation progresses the simple reflexes begin to be coordinated. E.g. arm is moved, eyes keep on watching it By l0th month, variety of elementary schemes develop. Permanent relating of object develops in course of coordinating actions with repeated contacts with environment 34 Cognitive theory…

35. Dental application: Child begins to interact with the environment and can be given toys while sitting on a dental chair in his hand 35

36. B] Preoperational stage (2 to 6yrs) Primitive strategies changes as the child assimilates new experiences and accommodates original strategies. The child uses symbols in language with play. Learns to classify things. S olves problems as a result of intuitive thinking but cannot explain why Concept of egocentrism Unaware of others perspective 36 Cognitive theory…

37. Egocentrism – unable to look from others perspective 37 Cognitive theory…

38. Immediate sensory impressions 38 Cognitive theory…

39. Dental application: Constructivism Cognitive equilibrium Animism 39 Cognitive theory…

40. C ] Concrete operation stage (6 to 12yrs ) The thinking process becomes logical Ability to use complex mental operations such as addition and subtraction. Child is able to understand others point of view. Development based on the level of understanding achieved so far 40 Cognitive theory…

41. 41 Cognitive theory… Changing the appearance or arrangement of objects does not change their key properties

42. Dental application: Concrete instructions like this is a retainer, brush like this Abstract instructions like wear the retainer every night and keep clean Centering – allowed to hold the mirror to see what is being done on his teeth Egocentrism – achieved level of understanding and gets involved in the treatment 42 Cognitive theory…

43. D ] Formal operation stage (11 to 15yrs ) Development of reasoning capacity Child able to think more abstractly Can imagine possibilities inherent in a problem Uses inductive (or) deductive logic to make decisions to solve problems Thinks of ideas and has developed a vast imagination 43 Cognitive theory…

44. Dental application: Peer influence and abstract thinking increases Play important role in orthodontic appliances and braces Imaginary audience (by Elkind ) Personal fable 44 Cognitive theory… Contemporary orthodontics by William Profitt 5 th Edi. 2008

45. 45 Cognitive theory…

46. MERITS AND DEMERITS Research works have failed to demonstrate the existence of cognitive structures . Children are consistently inconsistent in their approach to problem solving despite using the same cognitive structures . Lately it has been suggested that this inadequacy in problem solving are related to memory power of the child rather than cognitive ability . Piaget was better at describing processes than explaining how they operate. 46 Cognitive theory…

47. By Ivan Pavlov in 1927 Based on stimulus reflex response (an involuntary response to an external stimuli) When two events ,observed to occur together (proximity in time and space),will tend to be associated or paired together by the observer(pairing of initial and neutral stimuli). 47 CLASSICAL CONDITIONING

48. Generalization Process of conditioning is evoked by a band of stimuli centered around a specific conditioned stimulus. Thus a test stimulus similar to training stimulus results in response. Extinction If reinforcement does not occur results in extinction of the fear. Discrimination It is opposite of generalization. If the child is exposed to clinical setting which are different, child learns to discriminate between the two clinics and even the generalized response to any office will extinguish. 48

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51. Skinner in 1938 The consequence of behavior itself acts as a stimulus and affect future behavior Operant: behavior that operates or controls the environment 51 OPERANT CONDITIONING

52. 1. Positive reinforcement Occurs if a pleasant consequence follows the response e.g., a child rewarded for good behavior following dental treatment. 2. Negative reinforcement Involves removal of unpleasant stimulus following a response, e.g., if the parent gives into the temper tantrums thrown by the child, he reinforces this behavior. 52

53. 3 . Omission Refer to removal of the pleasant response after a particular response e.g., if the child misbehaves during dental procedure. If it’s favorite toy is taken away for short time resulting in the omission of the undesirable behavior. 4. Punishment Involves introduction of an aversive stimulus into a situation to decrease the undesirable behavior, e.g., use of parental rake in correction of tongue thrusting habit. 53

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55. Benjamin theory ( 1960) He says, “Thumb sucking arises from the rooting (or) placing reflex seen in all mammalian infants. Rooting reflex is the movement of the infant’s head and tongue towards an object touching his cheek. The object is usually the mother’s breast but may also be a finger (or) a pacifier. This rooting reflex disappears in normal infants around 7-8 months 55

56. Dunlop Beta hypothesis He states that best way to break a habit is by its conscious, purposeful repetition. He suggests that the child should be asked to suck his thumb observing himself as he indulges in the habit. This procedure is very effective if the child is asked to do the same at a time when he is involved in an enjoyable activity. 56

57. Classification of child’s behavior A] Wilson (1933) 57

58. B] Frankel’s behavior rating scale 58

59. C ] Wright (1975) 59

60. Factors affecting child’s behavior A] Under control of the dentist 60

61. B] Out of control of the dentist 61

62. C ] Under the control of the parents 62

63. behavior management 63

64. 64 Behavior management (Wright 1975) Means by which the dental health team effectively and efficiently performs dental treatment and thereby instills a positive dental attitude Behavior shaping Procedure which slowly develops behavior by reinforcing a successive approximation of the desired until the desired behavior comes into being

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66. Communicative Management Used in both cooperative and uncooperative child (Chambers in 1976 ) Basis for establishing a relationship with the child The communication should always be established from the first entry i.e . to the reception area

67. Types of communication: Verbal Nonverbal Body language Smiling Eye contact Expression of feeling Showing concern By touching the child Giving him a pat Giving a hug Using both 67

68. Behavior shaping 1] Desensitization Joseph Wolpe (1975) It is accompanied by teaching the child a competing response such as relaxing and then introducing a threatening stimuli 68

69. Tell Do Show (TDS) Addleston in 1959 Continuously and in grades the procedure should be moved from the least fear promoting object to more fearful ones. Indication for TSD: 1st visit. Subsequent visits when introducing new procedure Fearful child. Apprehensive child because of information received by peers or parents 69

70. 2] Modeling Bandura in 1969 Social learning principle Modelling can be done by Live models – siblings, parents of child etc., Filmed models Posters Audio - visual aids. 70

71. 3] Contingency management Method of modifying the behavior by presentation or withdrawal of reinforcers A +ve reinforcers: Henry W Fields in 1984. In this the contingent presentation increases the frequency of behavior. B –ve rein forcers: Stokes and Kennedy in 1980. In this, the contingent withdrawal increases the frequency of behavior this is generally a termination of an aversive stimulus. E.g . withdrawal of the mother.

72. Behaviour Management

73. Conclusion The dentist's message must be presented in terms that correspond to the stage of cognitive and psychosocial development that a particular child has reached. It is the job of the dentist to carefully evaluate the development of the child, and adapt his or her language so that concepts are represented in a way that the patient can understand them. 73