Child Development: An Overview for MDTs

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Child Development An Overview for MDTs

• Alicia Benedetto, Ph.D.
• Licensed Clinical Psychologist
• Assessment Resource Center (ARC)
• Columbia, SC

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There are two infancies

• Infancy of childhood
• Infancy of adulthood
• We will review benchmarks of development from 2 ½
  - 18 years
• Physical
• Linguistic
• Cognitive
• Social / Emotional
• Sexual

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TODDLERS
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Toddler 18 months3 yearsPhysical Skills

• Gross Motor
• clumsy runner at 18 months
• runs fairly well at two years (wide stance)
• jumps with both feet by 30 months
• can stand on one foot by 3 years
• rides a tricycle at 3

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Toddler 18 months3 yearsPhysical Skills

• Fine Motor
• progressive skills such as page-turning
• stacking and lining
• feeding self
• dressing self

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Toddler 18 months3 yearsLanguage Cognitive
Development

• Receptive language superior to expressive
  language
• Knows 300 words at 2 1,000 at 3
• Egocentric assumes you know what (s)he knows
• Concrete

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Toddler 18 months3 yearsLanguage Cognitive
Development

• Focuses on one central aspect of a situation
• Cant classify / order (stronger, taller, first)
• Symbolic representation complex play
• Lacks symbolic representation of self
• Concept of gender identity, but not fixed

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Toddler 18 months3 yearsSocial Emotional
Development

• Seeks adult approval
• Separation from caregiver is difficult,
  especially in novel settings
• Asserts more independence concept of I
• Displays affection

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Toddler 18 months3 yearsGenital/Sexual Behavior

• Interested in potty behavior
• Touches / rubs own genitals (exploratory)
• Imitative play (doctor, parent)
• Watches / pokes
• Touches breasts
• Uninhibited

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Toddler 18 months3 yearsAssessment
Considerations

• Able to separate from caregiver?
• Verbal? How verbal?
• Intelligible?
• Attention span?
• What activities will be rapport-building?
• What media will / wont be useful?

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Toddler 18 months3 yearsInterview Issues

• Hewitts Stage 1 interview
• Actions and words give clues to possible abuse,
  but emphasis on the assessor to anchor and
  structure this information within the childs
  status and history

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PRE-SCHOOLERS
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Preschool 3-4 yearsPhysical Skills

• Gross Motor
• as balance improves, skills improve
• tricycle riding
• jumping with both feet from elevations
• alternate footing up, then down stairs
• dancing
• skipping
• throwing overhand and catching

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Preschool 3-4 yearsPhysical Skills

• Fine Motor
• drawing improves circle, cross, face at 3
• to square, tracing, and stick figure at 4
• begins to use scissors
• may lace shoes, but cant tie them

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Preschool 34 yearsLanguage Cognitive
Development

• Gets prepositions, works on colors and counting
• Superficial, erroneous causal links
• Cant shift perspective
• Fantasy/reality blurred
• Egocentric
• Basic concept of right/wrong, works on truth/lie

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Preschool 34 yearsLanguage Cognitive
Development

• Poor source monitoring / source attribution
• Begins to classify, still faulty
• Time poorly understood
• Symbolic representation of self emerges between
  3 and 4
• Can remember events for years

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Preschool 34 years Social Emotional
Development

• Responds well to praise encouragement
• Sees family as central
• All or nothing feelings / opinions
• Identifies with parents and likes to imitate
  them
• Tends to be protective of parents

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Preschool 34 years Social Emotional
Development

• Growing social network, more relationships
• Displays independence
• World view is applied modified
• Gender identity grows in importance
• More suggestible than other people

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Preschool 34 years Genital/Sexual Behavior

• Touches/rubs own genitals (specific)
• Watches/asks about body functions
• Still touches breasts
• Disinhibited/inhibited
• Mimics / plays house
• Kissing / holding hands
• Private parts are serious . . . and funny

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Preschool 3-4 yearsAssessment Considerations

• Will separation from caregiver be an issue?
• Narrative ability?
• Attention span?
• How assertive / compliant?
• Competency?
• Representational Shift?
• What techniques can I employ?

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Preschool 34 years Interview Issues

• Hewitts Stage 2 interview for 3 - 4 year
  olds
• Period of transitioning skills. Carefully
  evaluate the current status of these childrens
  capabilities to ensure that the best match
  between interview style and the skills of the
  child is offered.

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EARLY SCHOOL
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Early School 5 - 6 yearsPhysical Skills

• Motor
• more coordinated (skips, hops, throws, catches,
  skates)
• balances on alternate feet with eyes closed
• more dexterous
• drawing, painting
• tying shoe laces
• vision reaches maturity

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Early School 56 yearsLanguage Cognitive
Development

• Gender identity is made permanent (4-5)
• Gets colors, counting
• Better with classifying/hierarchies
• Still egocentric

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Early School 56 yearsLanguage Cognitive
Development

• Superficial, erroneous causal links
• Symbolic representation of self
• Complex symbolic play
• Gets truth/lie wants to play by the rules

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Early School 56 yearsLanguage Cognitive
Development

• Improved source monitoring / source attribution
• Fantasy/reality less blurred
• Time still poorly understood

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Early School 56 years Social Emotional
Development

• Responds well to praise encouragement
• Sees family as central
• Identifies with parents and likes to imitate
  them
• Tends to be protective of parents

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Early School 56 years Social Emotional
Development

• Wider social network, more relationships
• Displays independence
• World view is applied modified
• All or nothing feelings

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Early School 56 years Genital/Sexual Behavior

• Touches / rubs own genitals (specific)
• Watches / asks
• Uninhibited / inhibited
• Mimics / plays house
• Kissing / holding hands
• Private parts are still serious and funny

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Early School 56 years Assessment Considerations

• Source monitoring?
• Narrative ability?
• Sequencing ability?
• What techniques / media can I employ?

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Early School 56 yearsInterview Issues

• Hewitts Stage 3" interview for 5-6 year olds
• Most of these children are able to respond to
  standardized interview formats however, there
  are still important interview abilities they do
  not possess (e.g., time)

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ELEMENTARY SCHOOL
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Elementary School 7 - 11 yearsPhysical Skills

• Working on mastery through practice
• Lots of energy
• Movements become more fluid
• Limber (bones grow faster than ligaments)

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Elementary School 711 yearsLanguage
Cognitive Development

• Understands expresses more abstract concepts
  
• Able to separate fantasy from reality
• Strong likes / dislikes opinionated
• Self-view more important

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Elementary School 7 - 11 years Language
Cognitive Development

• Much moral development
• Comprehends complex relationships
• Improved sequencing of events
• Sense of time improves, but still is problematic

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Elementary School 7 - 11years Social
Emotional Development

• Independence / dependence
• Teachers / peers gain importance
• Strong sense of fairness
• Family important, but conflicts emerge between
  family peer values
• Can express mixed emotions

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Elementary School 7 - 11 years Genital/Sexual
Behavior

• Masturbates with hand
• Looks at nude pictures
• Repulsed by/interested in opposite sex
• Exhibition/inhibition
• Tries to look at people undressing
• May still undress in front of care givers
• Kissing/dating

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Elementary School 7-11 yearsAssessment
Considerations

• External barriers to disclosure?
• Internal barriers to disclosure?
• What techniques can I employ?

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ADOLESCENCE
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Physical Development The new equipments here!

• Rapid body changes
• Secondary sex characteristics
• Girls
• growth spurt peaks 13 15 years
• breasts / hips grow for several more years
• Boys
• growth spurt peaks 16 19

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Cognitive Development

• Thinking becomes more self-conscious, idealistic,
  and critical
• Able to reason, generalize, form hypotheses and
  test them
• Events can be viewed from many perspectives
• By 14, decision-making process is same as for
  adults
• So why do they make so many bad decisions?

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Cognitive Development

• Dont consider all the consequences of words or
  acts
• Limited life experience
• Brain still under construction
• Frontal / Prefrontal lobes responsible for
  reasoning goal and priority setting impulse
  inhibition emotional control determining
  right from wrong determining cause and effect
  relationships

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Cognitive Development

• Frontal / Prefrontal lobes still under
  construction until 20 - something
• Pruning
• Myelination
• Adolescents rely on emotional decision-making
  driven by another part of the brain (amygdala)
• Reactive (juvenile) vs. Reflective (adult)

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Cognitive Development

• Later Adolescence (16 19)
• Symbolic reasoning and use of formal logic
  improves
• Fluid intelligence is reached by the end of
  this period ability to cope with new problems
  and situations

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Language Development

• Can often communicate like an adult
• May not ask for clarification or disclose when
  (s)he doesnt understand language
• Slang may have more meaning than formal language
• Trouble with double negatives
• Lose track of long, complex questions

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Social / Emotional Development These are heady
times

• Identity issues
• Idealistic about relationships, values
• Concerned with meaningful interpersonal
  relationships
• Feels misunderstood
• Rapid mood changes

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Social / Emotional Development

• Often doesnt trust adults strong sense of peer
  identity
• Concerned with personal morality code over social
  morality code
• Friendships have greater emphasis on intimacy and
  loyalty
• Concerned with the present

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Social / Emotional Development

• Early Adolescence (13 15)
• Conformity to peer pressure
• Independence v. dependence
• Challenging authority
• Increase in parent-child conflicts
• Later Adolescence (16 -19)
• Cliques / peer pressure decline in importance
• Increased assertiveness / launching
• Continued conflict with parents
• Internalization of external rules

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Risk-Taking

• Natural part of identity development,
  individuation
• Early adolescence is a time of particular
  vulnerability

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Sexual Behavior

• Masturbation becomes goal-directed
• Full range of sexual behavior / experimentation
  possible
• Ambivalence / discomfort with body
• Preoccupied with sexual issues
• Sexual orientation issues come to forefront

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Sexual Behavior 12-14 year olds

• 19 are sexually active
• 13-15 of the girls become pregnant
• 13 of the girls describe the sex as involuntary
• 24 of the relationships involve a partner two or
  more years older
• 12 involve a partner three or more years older

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Sexual Behavior 12-14 year olds

• Sexual activity highly correlated with AD,
  engaging in other delinquent acts
• Parents say they are talking to their kids about
  sex a lot more than the kids say that they are
• 34 of boys think its okay to pressure girls for
  sex
• 14 of girls think its okay to be pressured

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Teens and Sex

• Nearly 1 in 10 kids lose virginity by 13.
• 1 in 4 sexually active teens will contract an
  STD.
• 20 of sexually active girls 15 to 19 get
  pregnant each year.
• 1/2 of teens 13-19 have had oral sex.
• U.S. News World Report, May 27, 2002

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Teens and Sex

• 16 of high school sophomores have had 4 or more
  sexual partners.
• 2/3 of teens are sexually active by the end of
  high school.
• U.S. News World Report, May 27, 2002

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We didnt have sex.

• Adolescents may maintaining technical virginity
• But they still may engage in
• oral sex
• anal sex
• U.S. News World Report, May 27, 2002

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Quotable

• We do not interview children we interview one
  child at a time.
• Anne Graffam Walker
• When I was a boy of fourteen, my father was so
  ignorant I could hardly stand to have him
  around. But when I got to be twenty-one, I was
  astonished at how much he had learned in seven
  years.
• Mark Twain

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• This presentation was originally prepared and
  presented by Allison DeFelice, Ph.D. of the
  Assessment Resource Center (ARC) in Columbia,
  S.C.