Toddlerhood (Ages 2 to 4 Years)

Self-Control in Toddlerhood

Social prompts that foster self-control help children manage impulses.
Caregivers use talking about emotions to help young children gain impulse control.
- Articulating family/cultural rules about emotional expression.
  - Messages give an idea about acceptable levels of impulses/emotional intensity.
  - Also gives an idea of the types of emotions that need to be regulated.
- Modifying the intensity of emotions through reassuring/distracting talk.
- Giving children ideas for ways to manage impulses.
  - Suggesting activities like counting, thinking of pleasant times, or singing.
- Children listen to and imitate adults talking about their own strong emotions and impulses.
  - Parents' outlook on emotional expression permeates the home environment, creating a safe space for expressing emotions.
Toddlers who can talk to themselves may control fears, modify anger, and soften disappointments by repeating parents’ comforting words or developing verbal strategies for reducing pain/suffering.
Symbolic fantasy allows children to create imaginary situations for expressing and resolving disturbing problems.
- Through fantasy play, toddlers can control situations beyond their real-world capacities.
- Children use pretense to manage strong feelings and preserve emotional control.
- Verbal strategies, like self-talk and singing, help resist temptation.

Self-Directed Goal Attainment

Toddlers feel they can direct their own and others' behavior to achieve intended outcomes.
Infants become aware of themselves as causal agents; toddlers become assertive about initiating actions, persisting in activities, and determining when activities should stop.
Toddlers want to participate in decisions and direct others' behavior (e.g., showing, sharing, reading).
Confidence in handling difficult tasks isn't modified by realistic assessment.
Opportunities to do new/complex things and succeed give confidence.
Toddlers feel valuable as family members when contributing to routine household tasks.

The Role of Language in Self-Directed Goal Attainment

Toddlers use egocentric speech (Piaget) to accompany behavior, without concern for others understanding.
Vygotsky proposed a different developmental pathway:
- Social speech -> egocentric speech -> inner speech.
- Speech begins in social interactions, with the primary function being social.
- Egocentric speech transforms social speech inward to guide behaviors.
- Speech is a problem-solving tool.
- $Vygotsky (1978a, p. 26)$ : “Children solve practical tasks with the help of their speech, as well as their eyes and hands.”
- Egocentric speech dwindles into inner speech.
Adult guidance turns into children's self-guidance, adult's talk guides young children and then the children use it to guide their own behaviors.
Vygotsky: internalization of social speech.
Self-directed goal attainment depends on taking in spoken, practical advice from adults/peers.
Adults use inner talk/self-talk to organize tasks, encourage persistence, or review/revise.
Inner speech gives freedom, flexibility, and control in approaching tasks.
Children use private speech to focus attention and manage emotions.
They plan steps toward goals and repeat them to guide actions.
Words like "slowly," "be careful," or "hold tight" control behavior.
Inner speech helps regulate emotions or clarify communication even in social communication.
Language skills and self-control inhibit negative emotions and disruptive behavior during frustration.
Self-control links to delay of gratification from psychoanalytic concept (Freud).
Self-directed goal attainment (agency) accounts for competence through investigation and problem-solving.
Self-determination theory: children desire to explore, extend skills, and achieve mastery.
Autonomy supported by sensitive parenting (Deci & Ryan, 2000).
Autonomy-supportive parents foster goals, interests, and choices, give hints/suggestions, and offer encouragement.
Toddlers need to control feelings/impulses and decisions/tasks to function effectively.
As toddlers tolerate stress, express/withhold anger, approach difficult tasks, they gain selfhood.
The more toddlers do alone, the more confidence they have controlling outcomes and achieving goals.
Self-control during toddlerhood integrates into adult capacities to overcome obstacles and engage in generosity/kindness.

Autonomy Versus Shame and Doubt

Toddlerhood is the period when children become aware of their separateness.
Children discover parents don't always know what they want or understand their feelings.
Early toddlerhood: primitive devices to explore independence, saying "no" to everything, being demanding.

Autonomy

Positive pole of the psychosocial crisis.
Autonomy: ability to behave independently and perform actions on one’s own.
Children insist on doing things themselves, struggling until mastered.
Expectations for autonomy are expressed as encouragement for daily tasks.
Pressures for autonomy are often expressed in early expectations for skill acquisition and verbal expressiveness within U.S. society . Families in the U.S. are enthusiastic about fostering autonomy via early weaning, separate sleeping arrangements and toys that encourage independent movement.
Non-Western cultures value interdependence rather than independence.
Expectations for autonomy emphasize demanding less of the mother, being sensitive to others' needs, and functioning cooperatively with peers.
Establishing autonomy requires effort from the child and patience/support from parents.
Autonomy-supportive parenting includes:
1. Providing rationale and explanation for behavioral requests
2. Recognizing the feelings and perspective of the child
3. Offering choices and encouraging initiative
4. Minimizing the use of controlling techniques.
Autonomy-supportive parenting fosters self-regulation and internal motivation.
Predictive of higher self-regulation and social competence in toddlerhood, school achievement, and socioemotional development.
Toddlers may go through rigid, ritualized nay-saying.
Older toddlers are characterized by "I can do it myself."
New accomplishments give great pride.
Doing things independently leads to positive results, the sense of autonomy grows.
Toddlers create an image of themselves as competent and able to satisfy own needs.
Children allowed to experience autonomy have a strong foundation of self-confidence and delight in behaving independently.

Shame and Doubt

Some children fail to emerge from toddlerhood with a sense of autonomy leading to an overwhelming sense of shame and self-doubt.
Shame: intense negative emotion focusing on a negative evaluation of the self.
Accompanied by a sense of having been exposed/ridiculed and made to feel inferior.
Observed behaviors: physical tension, avoided eye contact, reluctance to talk.
Shame involves an imagined notion of how behavior might look to others.
One source of shame is social ridicule or criticism, often linked to toilet training.
Originates in interpersonal interaction where the child is made to feel embarrassed/ridiculed for acting stupidly, thoughtlessly, or clumsily.
When shamed, you feel small, humiliated, and helpless.
Some cultures rely on shame/restitution for social control due to how behaviors might reflect on their family or cause disruption in the social bond with their community.
Quality of early attachment relationships can also contribute to experiences of shame.
Attachment theory: children form an internal working model of self and other; rejecting, indifferent, or unpredictable models link to a sense of self as unworthy or unlovable.
Children whose earlier attachments were insecure are more likely to form negative representation of the self.
Children feel shame when their behavior doesn’t meet their ideal standards, even without breaking a rule.
Shame: feelings that the whole self is bad/worthless, making one want to disappear.
Children frequently shamed are likely to exhibit early signs of depression.
Shame prevents new activities, slows skill acquisition, and replaces confidence with doubt.
Children with pervasive doubt feel comfortable only in structured, familiar situations.
Shame/doubt often motivate denial, defensiveness, anger, and aggression and also predict risky and illegal behaviors in young adulthood.
Toddlers exhibit ambivalent dependency alternating with unrealistic self-assurance as they seek independence.
Successful outcome requires flexibility and warmth from caregivers who accept the emerging self while building support for self-control.

The Central Process and Adaptive Ego Quality/Core Pathology

Central Process: Imitation

Imitation is an efficient mechanism for learning, supporting cultural transmission over generations.
Each generation benefits from observing skilled behaviors of the previous generation.
Imitation plays a role in skill learning and social cognition.
Outcome: a shift of the action from the model to the imitator.
Toddlers are driven to imitate, evidenced by vocabulary expansion and interest in activities.
Imitative behavior is a vehicle for learning.
Acts become their own, even inspired by others.
Two motives for imitation:
- Drive for mastery and skill learning.
- Drive to feel connected to the social group.
Imitation is a means of participating in and sustaining social interactions, and advancing social cognition
Before verbal communication, toddlers use imitation to connect and coordinate.
Imitation advances empathy allowing for insight into others' experiences and emotional states.
It can reestablish belonging after exclusion or rejection and increases feelings of liking, closeness, and trust in the target.
Highlights the role of culture at this period of life.
Adults orient young children toward important tasks, expecting them to watch and learn.
Daily events provide models and reflect family/community culture.
Toddlers accumulate the vocabulary of speech/action belonging to their cultural group.
Imitation is supported by mirror neuron system, coordinated network of three areas:
- Gathers visual information.
- Recognizes/processes motor components.
- Processes the goal of the action.
The system supports sensory/motor integration during observation, imitation, and being imitated.
Neurons show activity during observation and greater activity during imitation.
Mirror neurons are sensitive to the intention of the action, key to empathy and understanding others through imitation of facial expressions, body posture, and gestures.
Disruptions in the mirror neuron system correlate with social deficits associated with autism.

Will vs. Compulsion

The resolution of autonomy versus shame and doubt results in the prime adaptive ego quality of will or the core pathology of compulsion.
Will: a sense of control over thoughts and actions, vital to self-expression, self-direction, and self-fulfillment.
Compulsion: reflects pervasive anxiety, unbidden impulses take will hostage.

The Ego Quality of Will

The capacity of the mind to direct and control action.
Inner voice focusing attention, encouraging, and urging one on, especially facing obstacles.
Provides psychological energy for competition, surpassing achievements, and reaching for goals.
Urges one to make peace with loss and focus on alternate goals or look for new solutions and prevent giving up hope during crises.
Inner determination and purpose permits a person to set goals freely and make persistent efforts to achieve them.
Term willpower is the ability to sustain effort and delay gratification to achieve a long-term goal (Mischel & Ayduk, 2011).
Will leads to a positive belief in oneself as someone who can make things happen.

Compulsion

Repetitive behavior motivated by impulse or restrictions on expression.
Non-spontaneous and unchanging.
Related to ritualization in toddlerhood.
Children devise rituals around transitions and insist they be followed.
Efforts to bring control and order to the environment.
Associated with fears.
Provide feelings of sameness and continuity during changes.
Benjamin's Bedtime Rituals:
Being read to.
Having music-box wound up.
Sleeping on the stomach.
Toddlers’ rituals don't repeat adult ways; they bring order/mastery to the unknown/unpredictable.
Compulsions must be carried out again and again, never resolving anxiety.
Obsessive-compulsive disorder (OCD) is a clinical diagnosis of anxiety disorder.
Obsessions: persistent, repetitive thoughts that focus anxiety.
Compulsions: repetitive, ritualized actions.
Can begin as young as 4 years old.
In a sense, people with obsessions and compulsions have a damaged will losing their ability to direct their thoughts and actions.
Compulsions represent the ego’s attempts to provide some structure to reality, but they do not work to promote further development because they are not meaningful (Erikson, 1982).
Experience of doubt-filled, shame-ridden person is continuously unpleasant, uncertain, and tortuous leading to meaningless, compulsive behaviors.

The Impact of Poverty on Psychosocial Development in Toddlerhood

Approximately 47 percent of U.S. children under 6 live in low-income families (family income is up to 200 percent above the poverty threshold). Approximately 24 percent (5.5 million children) lived in poor families (the family income is at the poverty threshold or below) in 2014.
In 2014, the federal poverty level for a family of three with one child was $19,055$ or less.
The National Center for Children in Poverty estimates that a family of three would need roughly twice this amount to meet basic needs to meet basic needs, an amount that varies by regions of the country as well as urban, suburban, and rural communities (Jiang, Ekono, & Skinner, 2016).
The United States has the highest percentage of children at 21.1% living in poverty compared to 20 rich countries around the world.

Poverty and Brain Development

Poverty is associated with conditions disruptive to optimal development, including food insecurity, poor nutrition/healthcare, limited parental education, child abuse/neglect, lack of stimulating parent/child interactions, and harsh punishment.
Early malnutrition, iron deficiency, exposure to environmental toxins, lack of stimulation, and harsh/neglectful parenting can impact brain development, including reactivity to stress, ability to regulate anxiety, executive control, memory, and attention.
Living in poverty is associated with high rates of cognitive challenges, particularly difficulties with inhibitory control and attention regulation (Lempinen, 2012).

Poverty and Health

Many children from low-income families have no regular source of health care and have not been immunized for measles and other infectious diseases.
The combination of malnutrition and illness has multiple consequences, including the possibility of structural brain damage, lethargy, delayed physical growth, and, consequently, minimal exploration of the environment leading to psychomotor and cognitive development delays.
Poor health in childhood has a lasting impact on adult health.

Poverty Impacts the Parenting Environment

Families in poverty are a diverse group, characterized by a range of conditions that could present challenges to optimal development.
Love, caring, warmth, and responsiveness can produce children who emerge from impoverished conditions with great strengths.
Mothers’ educational attainment is strongly associated with their children’s vocabulary and school achievement.
Maternal depression is a different risk factor, associated with the child’s social skills. Children whose mothers are depressed are less cooperative, less compliant, and show more evidence of oppositional or defiant behaviors in preschool (Perry & Fantuzzo, 2010).

Poverty and Academic Outcomes

Early exposure to poverty can have lasting consequences for adult outcomes, especially those related to academic achievement and cognitive abilities.
A combination of factors tied to family poverty, including exposure to harsh parenting, disruptions in emotional regulation, and the absence of positive interactions with adults, results in a lack of school readiness and a trajectory of lower academic motivation and subsequent disengagement from school.
Preschool enrollment contributes to school readiness, positive attitudes toward schooling, and a reduced risk of dropping out of school.
There is a combination of factors tied to family poverty, including exposure to harsh parenting, disruptions in emotional regulation, and the absence of positive interactions with adults, results in a lack of school readiness and a trajectory of lower academic motivation and subsequent disengagement from school.
A clear connection was found between exposure to poverty in the first 5 years of life and reduced income and hours of work after age 25 (Duncan, Ziol-Guest, & Kalil, 2010).
A model for explaining the poverty-academic outcome link focuses on the likelihood that extreme poverty brings with it exposure to toxic stress, intense and frequent traumatic events that persistently activate the stress response.
Toxic stress in childhood is associated with disruptions in the neurobiological systems that contribute to learning, memory, cognitive and emotional control leading to difficulties in academic performance, heightened risks of mental health disorders associated with anxiety and depression, and maladaptive coping strategies that impact health such as substance abuse and overeating in the absence of energy needs (Hill et al. 2016).
Childhood exposure to toxic stress results in reduced educational attainment, mental health and physical health problems, and impaired cognitive functioning, limiting occupational opportunities and forcing the young person to remain in the impoverished community where continued exposure to toxic stress is likely (Shern, Blanch, & Steverman, 2016).

Poverty Worldwide

Worldwide over 200 million children under 5 are exposed to extreme poverty conditions, malnutrition, and neglectful care that make them critically at risk for disrupted developmental outcomes causing inadequate food, poor sanitation, increased infections/illness, and growth retardation.
The mothers of these children have had limited education, and the home environment is barren and unstimulating.
Poor families live in high-risk neighborhoods where children are likely to be exposed to toxic stress and chaotic conditions causing increased disruptions in basic services, violence, and family instability
Investment in the nurturance, safety, education, health, and nutrition of young children worldwide is critical in order to alter the trajectory of an intergenerational pattern of lost developmental potential.

Child Care: A Psychosocial analysis

Every person who expects to combine parenting and employment or schooling must give some thought to how to provide child care arrangements.
Child care in the United States is covered by minimal federal and state regulations.
Children are in the care of a wide range of caregivers with varying types of education and training, from no specific background and training at all to bachelor’s and master’s degrees.
Quality child care for the children of working parents is important, as well as meeting the health, nutrition, and safety needs of the children of poor parents.

Child Care Arrangements

In 2011, 61 percent of children under the age of 5 were in some type of child care arrangement that were used at least once a week.
The remaining 39 percent of children had no regular arrangement.
Child care providers are classified as relatives or nonrelatives of children.
Relatives include mothers, fathers, siblings, grandparents, aunts, uncles, and cousins.
Nonrelatives include in-home babysitters, neighbors, friends, nonrelatives providing care in either the child’s or the provider’s home, and family day care providers.
Organized child care facilities include:
day care or child care centers.
nursery schools.
preschools, and Head Start programs.
kindergarten/grade school
The largest group at 42 percent was in care with a relative; 23.5 percent in some type of organized center-based care; and 11 percent in some form of nonrelative care. Eighteen percent were in multiple arrangements on a regular weekly basis.
Fathers and grandparents were especially important sources of care for young children, particularly for those whose mothers are employed full time.

The Philosophies of Organized Child Care Facilities

Organized child care facilities reflect a variety of philosophies about the care of young children, wide differences in curriculum, and a wide range of physical settings.
The U.S. approach to the care of infants and toddlers is highly variable.
There are markers of quality care that impact on children’s daily experiences and their long-term cognitive, emotional, and social development.
These markers include:
Advanced training in the field of child development and early childhood education for the caregivers
A small caregiver-to-child ratio and smaller group size
A safe, clean environment
Sensitive, developmentally appropriate interactions between caregivers and children
Strong, respectful, positive relationships with children’s families . (Honig, 2012; Watson, Koehn, & Desrochers, 2012)
Factors to Consider When Evaluating the Quality of Child Care:
The definition of quality and how is it measured?
What is the child’s exposure to this care? (How many months are the children in care?)
Who are the children in question? ( How old are the children/ Do they come from low income families?)
What specific outcomes are being measured?
Assessments of child care’s effects on young children generally focus on :
Intellectual abilities
Socioemotional development
Peer relations
Research has tended to emphasize the impact of child care on the children of families living in poverty because they are at a higher risk for school failure, illiteracy, minimal employment or unemployment, even though they are less likely to be enrolled in center-based care than families with more resources.
Many studies focus on Head Start which has a mission that includes education, health, mental health, and family support, leading to public and private differential child care.
Approximately 18 percent of young children experience a combination of care arrangements
Experiences with multiple care arrangements and frequent changes in arrangements have been found to be associated with behavioral difficulties even when the settings are of good quality (Morrissey, 2009).
It is best to think of studies that evaluate the impact of early child care arrangements as associational rather than causal.

The Impact of Child Care on Intelligence, Cognition, and Academic Achievement

Research suggests that the effect of quality child care on toddlers’ cognitive development is positive but modest (Auger et al., 2014; Ludwig & Phillips, 2007).
Data from model programs show that quality child care contributes greatly to intellectual achievement, particularly higher IQ scores, during the preschool years and during the first grade (Burchinal et al., 2000).
Studies have focused on more specific competencies such as language ability, pre-reading and pre-writing skills, vocabulary, cognitive problem solving, and motivation for school and school achievement as evidence of the long-term impact of child care on intellectual development (Love, Chazan-Cohen, Raikes, & Brooks-Gunn, 2013).
Studies of participation in Head Start or Early Head Start (a program for infants to age 3) find initial cognitive benefits in vocabulary, reading, math, and general school readiness.
Certain subgroups of children may benefit more from participation in high quality Head Start programs, especially those whose mothers are recent immigrants, where English is not their primary language spoken at home, and whose mothers have not had much education prior to immigration
Children who attended center-based care in pre-kindergarten were less likely to be chronically absent in kindergarten showing school engagement, school completion, attitudes toward learning, and health.

The National Institute of Child Health and Human Development 1991 Research Findings

Family variables were more important predictors of a child’s development than the quality of child care in infancy, toddlerhood, and even in middle school.
“Higher levels of parenting quality predicted greater levels of tested reading, math, and vocabulary achievement in fifth grade, and lower levels of teacher-rated externalizing problems and conflict and high levels of social skills, social-emotional functioning, and work habits in the sixth grade” (Belsky et al., 2007, p. 693). *After all the family factors were taken into account:
- The quality of language stimulation directed to the child in the child care setting made a significant additional contribution to children’s language and cognitive competence.
- Children in higher quality care had higher scores on measures of cognitive development, language, and school readiness.
Findings suggest long-term consequences of exposure to early child care: By the sixth grade:
- a positive relationship was observed between experiences in quality care and measured vocabulary (Belsky et al., 2007).
  By age 15:
- there was continued evidence of a benefit to high-quality care as measured in adolescents’ academic performance (Vandell et al., 2010).
For children from low-income families, experiences in high-quality child care can partially offset the negative associations between poverty and subsequent math and reading skills.
High-quality child care proved to be a benefit with regard to school readiness at age 3, which was then strongly associated with higher scores in measures of math, reading, applied problem solving, and language skills in grades 5 and 6 (Dearing, McCartney, & Taylor, 2009).
*Children in some type of setting are typically more physically active while they are at their center or preschool than when they are at home (Hesketh, Griffin, Simon, & van Sluijs, 2015).

Perry Preschool Project Research:

Those who had attended the quality preschool were 30 percent more likely to have graduated from high school or received their GED.
They were four times more likely to be earning $2,000$ or more per month, and three times more likely to own their own homes (High/Scope, 2003).

The Impact of Child Care on Social Competence

Quality care is associated with higher levels of social competence, self-esteem, and empathy.
Children who interact positively with adults in their child care settings are more likely to interact positively and comfortably with their teachers and classmates in the elementary grades.
Frequent positive interactions with care providers at ages 2 and 3 are better able to focus their attention and regulate their emotions when they are in early elementary school.
Frequent positive interactions with care providers over longer periods of time are associated with fewer behavioral problems in the elementary grades.
*The study conducted by NICHD helps explain these findings. The more time children spent in nonmaternal care:
The less responsive mothers were to their children at 15 and 36 months, and the less affectionate the child was to the mother at 24 and 36 months (NICHD Early Child Care Research Network, 2002).
by age 15, the more hours a child spent in nonfamily care as a toddler, the more likely they were to have difficulties controlling their impulses as an adolescent
children in child care benefit from opportunities to interact with a variety of peers where adults are readily available to help them make choices and resolve differences
BenefitsAssociatedWithHeadStart
Head Start is more comprehensive than most preschool or child care programs and has expanded the requirements to provide these children and the family with comprehensive services in health and nutrition. These services include:
A direct response to young children’s physical needs when their parents may not be aware of emerging problems or are unsure how to address them.
Health Benefits Head Start Offers
Mortality rates for 5- to 9-year-old children who had attended Head Start are 33 to 50 percent lower than the rates for comparable children who were not enrolled in Head Start
(Ludwig & Miller, 2007).
Head Start children are more likely to receive dental checkups and have healthy eating patterns than nonparticipants
(Lee et al., 2013).
Head Start children have lower Body Mass Index (BMI) scores and are less likely to be overweight compared to children in nonparental care. (Lee et al., 2013).

Long-Term Benefits:

Improve adult health status for graduates; they are 7 percent less likely to be in poor health as adults than their siblings who did not attend. (Deming, 2009; Johnson, 2010).
Reduce health costs, that savings are equal to 36 percent to-141 percent of the program costs.

Future Directions of Child Care in the United States

In 2013 President Obama proposed creating a universal pre-kindergarten program with additional investment in the Early Head Start programs and a proposal to partner with states for subsidized preschool based on income.
Prekindergarten would not be required for all children, but it would be accessible and affordable for all. The probability of any immediate action on this proposal is low.