Cognitive and Psychosocial Growth and Development

Theories of Cognitive and Psychosocial G&D

• Maturational: dev is genetically driven and depends on neurological and physiological maturation

• Psychoanalytic: emotional life has influence on behavior: emotions, dreams, feelings, frustrations, parents

  • Erikson’s psychosocial theory: personality is influenced by society and develops through a series of crises

• Behaviorism: The environment controls behavior (operant and classical conditioning)

  • Bandura: children learn by imitating and observing within a social context that rpovides feedback and influences behavior

• Social Learning Theory: development occurs through interaction a developing person and the surrounding systems of influences

• Cognitive: Changes occur between infancy and adolescence, the person is an active initiator of development

  • Jean Paget: children think differently than adults

Define Cognition

Development of intellectual processes and schemas for comprehending the physical environment

• Thinking

• Knowing

• Remembering

• Judging

• Problem solving

Life Stage and ways of thinking

• Infancy and toddlerhood: sensorimotor

  • Direct sensations to explore the environment

• 2-7: Pre-opertational (intuitive)

  • Memory and imagination

• 7-11: Concrete operations

  • Think logically, concrete reasoning, cause and effect

• >12: Formal Operation

  • Think about thinking

  • Systematic and abstract reasoning

  • Love, politics, justice

Dentists treating children should be familiar with:

• Age-appropriate language skills

• Language’s sequential process

• Hearing and understanding milestones

Infant

• Cognitive:

  • Facial relationships

  • Movement and color

  • Can categorize and group things together

  • Gestures

  • Recall past events even by 6 months

• Psychosocial

  • Engage in social interactions

  • Separation anxiety and stranger danger

  • Strong and secure attachment to nurtutring and caring adults

  • Temperament

Temperament

• Biologically based and consistent

  • Easy, Difficult, Slow-to-warm-up

• Can’t be changed but can be influenced

• Shy kids tend to be more prone to dental fear

Communication with the pediatric patient (infant)

• Primarily through parents

• Soft calm speech

• Avoid staring

• Child may respond positively or negatively

Toddler

Cognitive development

• Begin to experiment with behaviors to see what happens

• Think ab actions before taking them

• Now, mine

• Investigate touch and taste

• Routine

Psychosocial

• Possessive and self-centered

• Easily frustrated and distracted

Communication with toddler-2 year old

• show me your…

• Can make gramatically incorrect sentences

• Knows name

• Can follow simple commands

Early Childhood

3 YEAR OLD

Cognitive:

• Here and now age

• Why, who, where, what

• Talkative, lively imagination

• Understands “its time to”

• More skilled in words and symbols

Psychosocial

• Wears personality where it can be seen

• Avid me tooer, begins sharing

• Aggression and sympathy coexist

  • Jealous

  • Easily approached children are more cooperative in dental setting

• Adopts behavior of familiae individuals

4 YEAR OLD

Cognitive:

• Greets people

• Concepts of life and death

• Pays attention to simple stories and simple questions

• Talks and solves conflicts

Psychosocial:

• Dominates-bossy

• Explosive and destructive

• Resistant and tests limits

• Nonsense-loving, silly

5 YEAR OLD

Cognitive:

• Curious

• Boasts new knowkedge

• Same grammar as rest of family

• Confidence

Communication with Pediatric pt 3-5 year olds

• 75% nonverbal

• Speech should be soft, calm and reassuring

• Simple language and instructions

• Avoid baby talk

• Active and intense 5 year olds tend to cry more

Middle Childhood

• Reaching out for independent identity

• Lots of fears

• Emotionalism and confusion

• Joining others of his/her own gender

• Intuitive Stage (5-7): child understands only what they have seen

• Concrete Operational Stage (7-12): conversation, reflects and reasons, easier to accept dental treatment

Communication with 7-11 yo (Middle childhood)

• Appeal to pride and maturity

• Respect their feelings and be supportive

• Encourage conversation

Adolescence

• Changes emotionally

• Self-awareness intensifies and results in push for independence

• Own dialect

• More peer groups than family, alcohol, sex

• Still welcomes adult intervention into problems over which he or she has questionable control

• Most dental pt usually respond in an appreciative manner

• Sensitive, moody, requires attention and patience