CONTENTS

1.

Introduction

2.

Definition

3.

Importance of child psychology

4.

Theories of child psychology

Psychodynamic theories
Psychosexual theory by freud
Psychosocial theory by ericerikson
Cognitive theory by piaget

Behavior learning theories

Classical conditiong theory by ivan pavlow
Operant conditioning theory by bf skinner
Social learning theory by albert bandura
Hierarchy of needs by maslow

5.

Other theories

6.

Conclusion

7.

References

INTRODUCTION
Children were often viewed simply as a small version of adults and little attention was
paid to the many advances in cognitive abilities, language usage and physical growth.
Psychological development is a dynamic process which begins at birth and proceeds
in an ascending order through a series of sequential stages. These stages are governed
by genetic, familial, cultural, interpersonal, and inter psychic factors.
The professional dentist, who deals with children and takes the responsibilities of
their health care, is a parent surrogate and can discharge certain aspects of parent care
to the child, as do the physician and the teachers.
The clinician should know what emotional and social behavior to expect from
children in different age groups and should also be able to communicate on a level
consistent with the childs view of the world.

DEFINITION
PSYCHOLOGY It is a science dealing with human nature, function and
phenomenon of his soul is the main.
EMOTION An effective state of consciousness in which joy, sorrow, fear, hate or
the likes are expressed.
CHILD PSYCHOLOGY Study of childs mind and how its function.
It is the science deals with the mental power or an interaction between the conscious
and subconscious element in a child.
BEHAVIOR It is any change observed in the functioning of the organism.

IMPORTANCE OF CHILD PSYCHOLOGY

Knowledge of child psychology will help us to

Understand the child better and therefore deal with him more
effectively and efficiently.

Better planning and interaction between treatment plan.

To identify the problem of psychosomatic origin.

To trained the child so that he understand his own oral hygiene.

Helps modify childs developmental process.

THEORIES
1) PSYCHODYNAMIC THEORIES
a) Psychosexual /psychoanalytic theory by SIGMUND FREUD (1905)
b) Psychosocial theory /Model of personality development By ERIK ERIKSON
(1963)
c) Cognitive theory By JEAN PIAGET (1952)
2) BEHAVIORAL THEORIES
a) Classical conditioning By IVAN PAVLOV (1927)
b) Operant conditioning By BF SKINNER (1938)
c) Hierarchy of needs By ABRAHAM MASLOW (1963)
d) Social learning theory By ALBERT BANDURA (1954)

A)

PSYCHOANALYTICAL THEORY/PSYCHOSEXUAL THEORY

(Dr.Sigmund Freud) in 1905.

This theory was given in 1905 by SIGMUND FREUD an Australian

physician and FATHER OF MODERN DAY PSYCHIATRY.

FREUD`S interest in development arose from his desire to explain the

disorders of personality in adults.

He said that a body has two types of neuronsPhi neuron- concerned with condition of emotion.
Psi neuron- concerned with storage of emotion.
When these emotions reach a certain level a discharge is sparked off and this
over display of emotions is called ARCHAIC DISCHARGE.

He described five psychosexual stages .At each stage a sexual energy is

invested in a particular part called an EROGENOUS ZONE.

He attempted to explain a personality and psychological disorders in an

individual by understanding the mind at its different levels , its motivation and
conflicts.

He described human mind with the help of models

Topographic model

Psychic model / psychic triad.

Defense mechanism.

Psychosexual stages of development.

TOPOGRAPHIC MODEL

FREUD compare the human mind to an ice berg. Small part

shows above the surface of water (10%) is CONSCIOUS experiences the much
larger base below water level represents the UNCONSCIOUS (90%) store
house of impulses, passion and inaccessible memories that affect thoughts and
behaviors.

According to this model , human mind consist of

Conscious
Pre conscious
Sub conscious

CONSCIOUS everything we are aware of at any particular

moment.
It includes only our current thinking.

PRE CONSCIOUSAnything that can be easily made

conscious like the memories that we are not at the moment thinking about but
can readily bring to mind.

UNCONSCIOUS/

SUBCONSCIOUSThoughts,

feeling,

memories, wishes, that are extremely difficult to bring awareness, may appear in
disguised form in dreams.
PSYCHIC TRIAD/PSYCHIC MODEL

FREUD in 1923 made the tripartite structure model of ID, EGO and SUPER
EGO.

FREUD`S general nation that our behavior is influenced by biological drives

(ID), social rules (SUPEREGO), and mediating thought processes (EGO).

ID It is the most primitive part of a personality.

It is the basic structure of personality, which serves as a reservoir of
instincts or their mental representative.

It is present at birth, impulse ridden, and strives for immediate pleasure

and gratification.

Operating under the guidance of primary process, the ID lacks the

capacity to modify the drive.
Eg. I want it now. Child wants food irrespective of the external circumstances.

It is based on PLEASURE PRINCIPLE.

EGOIt develops out of ID in the 2nd to 6th months of life, when the infants
begins to distinguish between itself and the outside world.

Governed by REALITY PRINCIPLE.

It is the mediation between ID and SUPEREGO.

It is concerned with memory and judgement.

EGO is concerned with a state in which an adequate expression of ID

can occur within the constraints of reality and demands and restriction of
superego.
EGO says I need to do a bit of planning to get it.

E.g. Hunger must wait until food is given.

The EGO spans all three topographic dimensions of conscious,

preconscious, and unconscious.

Some of the functions of EGO are-

Control and Regulation of instinctual drives.

Relation to Reality.

Object relationship.

Judgment.

SUPEREGOIt is the prohibition learned from environment.

Ruled by the MORAL PRINCIPLE.

It acts as a sensor of acceptability of thoughts, feelings and behavior.

Culture and family restrictions.

It is the internalized control which produces the feeling of shame and

guilt.

SUPEREGO says- you cannot have it, its not right.

DEFENSE MECHANISM
Protects the EGO against the painful and threatening impulses arising from the ID we
distort the reality, the process that distort the reality for the EGO are called DEFENSE
MECHANISM.
a)

DISPLACEMENT- It is the transfer of desires or impulses onto a substitute,

person or object.

E.g. If a student is scolded by the teacher, he/she may take it out on a less
dangerous substitute, i.e. shouting at juniors, slamming a door or stamping feet.
b)

PROJECTION- Desire that are unacceptable to a persons EGO are projected

onto someone else to feel more comfortable.
E.g. A bad workman will be blamed on his tools.

c)

REACTION FORMATION- Person displays behavior that is the exactly

opposite of an impulse that she/he dare not express or acknowledge.
E.g. when you are not able to control your temper ,you start laughing to prevent
anxiety.

d)

REGRESSION- It is the age inappropriate response, as a result to avoid

current anxiety producing situation.
E.g. A child with a history of nail biting may resort to the same after growing up
as well, in times of danger.

e)

REPRESSION- it can take two forms;

The expulsion of thought and memories that might provoke anxiety from the
conscious mind. (PRIMARY REPRESSION).

The process by which hidden ID impulses are blocked from ever reaching
consciousness. (PRIMAL REPRESSION).

E.g. If a child had a painful dental experience in the past, in the future visits
he/she may avoid thinking about that painful event in order to repress
anxiousness.

f)

RATIONALIZATION- An attempt to explain our behavior to ourselves and

others, in ways that are seen as rational and socially acceptable, instead of
irrational and unacceptable.
E.g. After poor performance in exam, student may try to rationalize the same by
blaming the teachers of doing strict marking.

g)

DENIAL- Person may deny some aspect of personality.

E.g. A patient with a big ulcer in mouth diagnosed as carcinoma may not be able
to tackle to situation and he may consult another doctor for denial of the
diagnosis.

h)

IDENTIFICATIONincorporating an external object into ones own

personality, making them part of ones self i.e. one may come to think, and feel
like someone else.

PSYCHOSEXUAL STAGES OF DEVELOPMENT

The expression of discomfort as a result of conflict between the three components of
the psychic structure is defined as anxiety.
SIGMUND FREUD described six stages of psychosexual development, at each stages
different areas dominate source of sexual arousal and differences in satisfying the
sexual urges at each stage will lead to differences in adult personalities.
a)

ORAL STAGE (0-1.5yrs)

EROGENOUS ZONE IN FOCUS: mouth
GRATIFYING ACTIVITIES: Nursing, eating, mouth movement including
sucking, biting and swallowing.
INTERACTION WITH THE ENVIRONMENT: to the infant mothers breast
not only is the source of food and drink but also represent her love, because the
childs personality is controlled by the ID.
SYMPTOMS OF ORAL FIXATION: smoking, nail biting, drinking and
sarcasm.

B)

ANAL STAGE (1.5-3 yrs)

EROGENOUS ZONE IN FOCUS: anus
GRATIFYING ACTIVITIES: bowel movement and the withholding of such
movements.
INTERACTION WITH THE ENVIRONMENT: children at this stage starts to
notice the pleasure and displeasure associated with bowel movements through
toilet training. By exercising control over the retention and expulsion of feces a
child can choose either grant or refuse parents wishes.
SYMPTOMS OF ANAL FIXATION : Anal expulsive personality; if the parents
are too lenient and fails to instill the societys rules about bowel movement
control, the child will drive pleasure and success from the expulsion.
Individual of this mode are excessively sloppy, disorganized, reckless, careless,
and defiant.

Anal retentive personality: If a child receives excessive pressure and punishment

from parents during toilet training, he will experience anxiety during movements
and hence will with hold such functions.
Individual with such fixation are clean, orderly, and intolerant to those who are
not cleaned.
C)

URETHRAL STAGE (3-4 yrs)

EROGENOUS ZONE IN FOCUS- it is the transitional stage between anal and
phallic stages an has characteristics of both.
GRATIFYING ACTIVITIES: pleasure in urination.
INTERACTION WITH ENVIRONMENT; The child realizes the increasing
voluntary control, which provides him with the sense of independence and
autonomy.
SYMPTOMS OF URETHRAL FIXATION: Loss of urethral control results in
shame, competitiveness, ambition.

D)

PHALLIC STAGE(4-5yrs)
EROGENOUS ZONE IN FOCUS-genitals
GRATIFYING ACITIVITIES Genital fondling
INTERACTION WITH THE ENVIRONMENT- this is the most challenging
stage in a person`s psychosexual development.

According to FREUD, is the child feeling of attraction towards the

parent of the opposite sex together with envy and fear of the same sex parent, In
boys this situation is called the OEDIPUS COMLPEX and in girls this type of
attraction is called the ELECTRA COMPLEX.
OEDIPUS COMPLEX- named after the young man in a Greek myth who killed
his father and married his mother. The little boy adopt his father`s manners, his
attitude and interests thinking that by becoming like this his father he can win
his mother`s sexual love.
ELECTRA COPMLEX- young girl develop an attraction towards their father
and they resent the mother being close to the father. In Greek mythology, Electra
help her brother slay the lover of his father Agamemnon, in order to win her
fathers love.
SYMPTOMS OF PHALLIC FIXATION-

For men- anxiety and guilty feeling about sex, fear of castration and narassistic
personality.
For women- women always maintain a sense of envy and inferiority but there
are no possible fixations resulting from this stage.

E)

LATENCY STAGE (5yrs-puberty)

EROGENOUS ZONE IN FOCUS- None
INTERACTION WITH THE ENVIRONMENT; Maturation of ego takes place.
This is the period during which sexual feelings are suppressed to allow children
to focus their energy on other aspect of life. This is the time of adjusting to the
social environment outside of home, absorbing the culture forming beliefs and
values, developing same sex friendship, engaging in sports etc.
SYMPTOMS OF LATENCY FIXATION- Demonstrates sexual- sublimation
and repression.

F)

GENITAL STAGE (from puberty onwards)

EROGENOUS ZONE IN FOCUS- genital
GRATIFYING ACTIVITIES- heterosexual relation-ships.
INTERACTION WITH ENVIRONMENT- This stage is marked by renewed
sexual interest and desire and the pursuit of relationship.
SYMPTOMS OF GENITAL FIXATION- This stage does not cause any
fixation. According to FREUD if people experience difficulties at this stage the
damage was done in earlier oral, anal and phallic stages. These people come into
this last stage of development with fixations from earlier stages.
E.g. Attractions to the opposite sex can be a source of anxiety at this stage if the
person has not successfully resolved the oedipal or Electra conflict.

MERITS OF FREUD`S THEORY

One of the earliest and the most comprehensive theories of life long

psychological development.
DEMARITS OF FREUD`S THEORY
FREUD formulated this theory by his extensive studies on adult

psychological patients and hence its extrapolations to children are not very
justified.

This theory is based on obsessed observations of the psychologist.

PSYCHOSOCIAL THEORY/MODEL OF PERSONALITY

DEVELOPMENT by ERIC ERIKSON (1963)
This theory was given by ERIC.H.ERIKSON in 1963 in his book childhood and
society.

ERIKSON was a close friend and student of FREUD and he elaborated and
modified FREUD theory by superimposition of psychological and psychosexual
factors simultaneously contributing to personality development.

This theory postulates that society responds to a childs basic needs or

development task in a specific period of life and is doing so society ensures
childs healthy growth and survival in culture and traditions.

According to ERIKSON each individual passes through eight developmental

stages. Which are marked by internal crises defined as the turning points. Each
stage demands resolution before the next stage can be satisfactorily negotiated:
o

Basic trust Vs basic mistrust(hope)

Autonomy Vs shame(will)

Initiative Vs guilt ( purpose)

Industry Vs inferiority (competence)

Identity Vs role confusion( fidelity)

Intimacy Vs isolation( love)

Generativity Vs stagnation( care)

Integrity Vs Despair(wisdom)

STAGE 1 : INFANCY-Age 0-1 year.

CRISIS- trust v/s mistrust
DESCRIPTION- The infant forms the first trusting relationship with the caregiver.
The child if , well handled, natured and loved, develops trust and security and a basic
optimism. Badly handled, he becomes insecure and mistrustful.

DENATL APPLICATIONS: This stage identifies with development of separation,

anxiety in the child. so, if necessary to provide dental treatment at this early age, it is
preferable to do with the parent present and preferably with parent holding the child.

STAGE 2: TODDLER- Age 1 -2yrs.

CRISIS- Autonomy v/s Shame (will)
DESCRIPTION- TODDLERS learn to walk, talk, use toilets and do thinks for
themselves. Their self control and self confidence begins to develop at this stage.
Positive outcome- self sufficiency if exploration is encouraged.
Negative outcome- doubts about self, lack of independence.
DENTAL APPLICATIONS- Child is moving away from mother, but still will retreat
to her in threatening situations. So, parents presence is essential in dental clinic.
At this stage as the child takes pleasure in doing task by himself; dentist must obtain
co-operation from him by making him believe that the treatment is his choice not of
the dentist/parent.
STAGE 3: EARLY CHILDHOOD- (Age 2-6 yrs)
CRISIS- Initiative v/s guilt (purpose).
DESCRIPTION- Children have new found power at this stage as they have developed
motor skills and become more engaged in social interaction with people around them.
They now must learn to achieve a balance between eagerness for more adventure and
more responsibility and learning to control impulses and childish fantasies.
Positive outcome- Discovery of ways to initiate actions.
Negative outcome- Guilt from actions and thoughts.
DENTAL APPLICATIONS:
A child at this stage will be intensely curious about the dentists office and eager to
learn about the things out of there. An exploratory visit with little work is often a good
way to start the dental experiences.
STAGE 4: ELEMENTARY AND MIDDLE SCHOOL YEARS Age 6-12 yrs.
CRISIS- Industry V/S inferiority (competence)
DESCRIPTION-School is the important event at this stage. Children learn to make
things, use tools and acquire the skills to be a worker and a potential provider and
they do all these while making the transition from the world of home into the world of
peers. The influence of parents as a role model decreases and the influence of peers
group increases.

Positive outcome Development of sense of competence.

Negative outcome- feelings of inferiority, no sense of mastery.
DENTAL APPLICATIONS
Children at this age are trying to learn the skills and rules that define success in any
situation, and that includes the dental office.
The childs drive for a sense of industry and accomplishment, cooperation with
treatment can be obtained. Children at this stage still are not likely to be motivated by
abstract concepts rather they can be motivated by improved acceptance or status from
the peer group. This means that emphasizing how the teeth will look better as the
child co operates is more likely to be a motivating factors than emphasizing a better
dental occlusion.
STAGE 5: ADOLESCENCE- Age 12-18yrs
CRISIS- Identity v/s role confusion( fidelity)
DESCRIPTION- The child now an adolescent learns how to answer satisfactorily and
happily the question of who m I? and what he shall become. But even the best
adjusted of adolescents experiences some role confusion.
Positive outcome- Awareness of uniqueness of self.
Negative outcome- inability to identify appropriate roles in life.
DENTAL APPLICATION
Behavior management of adolescent can be challenging. Any orthodontic treatment
should be carried out if child wants it and not parents as at this stage, parental
authority is being rejected.
STAGE 6: YOUNG ADULTHOOD- Age 19-40 yrs.
CRISIS- Intimacy v/s Isolation( love)
DESCRIPTION The successful young adult, for the first time, can experience true
intimacy- the sort of intimacy that makes possible good marriage or a genuine and
enduring friendship.

In this stage the most important events are love relationship.

Positive outcome- development of loving, sexual relationships and same sex
friendships.
Negative outcome- Fear of relationship with others.
DENTAL APPLICATION- At this stage, external appearances are very important as
it helps in attainment of intimate relation. These young adults seek endodontic
treatment to correct their dental appearances and this is characterized as internal
motivation.
STAGE 7: MIDDLE ADULTHOOD- Age 40-65yrs.
CRISIS- Generatively v/s stagnation
DESCRIPTION- By generatively ERIKSON refers to the adults ability to look
outside oneself and care for others through parenting. The next generation is guided in
short not only by nurturing and influencing ones own children but also by supporting
the network of social services needed to ensure the next generations success. The
opposite personality trait in adult is stagnation, characterized by self- indulgence and
self-centered behavior.
Positive outcome- people can solve this crisis by having and nurturing children or
helping the next generation in other ways.
Negative outcome- person will remain self-centered and experiences stagnation later
in life.
STAGE 8: LATE ADULTHOOD- Age 65 to death.
CRISIS- Integrity v/s Despair (wisdom)
DESCRIPTION- Old age is a time for reflecting upon ones own life and seeing it
filled with pleasure and satisfaction or disappointments and failures.
Positive outcome- if the other seven psychological crisis have been successfully
resolved, the mature adult develops the peak of adjustment; integrity. If the adult has
achieved a sense of fulfillment about life and a sense of unity within himself and with
others he will accept death with a sense of integrity just as healthy child will not fear
life.
Negative outcome- the opposite of this is despair- this is often expressed ass disgust
and unhappiness on a broad scale, frequently accompanied by a fear that death will
occur before a life change that might lead to integrity can be accomplished.

MERITS OF ERIK-ERIKSON`S THEORY

Based on age wise classification of an individual, hence easy to apply at any

stage of development.

Simple and comprehensive to understand.

DEMERITS OF ERIK-ERIKSON`S THEORY

Based on the extreme ends of personality.

COGNITIVE THEORY BY JEAN PIAGET (1952)

JEAN PIAGET worlds leading theorist in the field of cognitive development
proposed this theory in 1952.
PIAGET formulated his theory on how children and adolescent think and acquire
knowledge. He derived his theories from direct observation of children by questioning
them about their thinking. According to PIAGET, the environment does not shape
child behavior, but the child and adult actively seek to understand the environment.
This process of adaptation is made up of following functional variantsOperation- An action, which the child performs, mentally and which has the added
property of being reversible.
Schemata- Represent a dynamic process of differentiation and recognization of
knowledge with the resultant evolution of behavior and cognitive functioning
apparatus for the age of child.
Assimilation- Concern with observing, recognizing, taking up an object and relating it
with earlier experiences.
Accommodation- an individuals tendency to modify action to fit into a new
situations.
Equilibrium- refers to changing basic assumptions following adjustments in
assimilated knowledge so that the facts fit better.
E.g. the child who has just learned the word bird will tend to assimilate all flying
objects in his idea of bird when he see a helicopter he will probably say look bird
.However for intelligence to develop the child must also have the complementary
process by accommodation.
STAGES OF DEVELOPMENT :
PIAGET`S marked four stages of cognitive growth each characterized by a different
types of thinking and in each child relies more upon internal stimuli.
1)

Sensori motor period (birth to 2 yrs of age).

2)

Pre operational period (2 to 7 yrs of age) .

Preconceptual period (2- 4yrs of age)
Intuitive period (4-7 yrs of age)

3)

Concrete operational stage (7 to 12 yrs of age)

4)

Formal operational stage ( beyond 12 yrs of age).

SENSORIMOTOR PERIODIt is a stage of practical intelligence.

Sensori+ motor = sensation + action.

This is from birth to 2yrs of age. During the first 2 yrs of life a child develops
from a newborn infant who is almost totally dependent on reflex activities to an
individual who can develop new behavior.

During this stage, child develop basic concept of object including the idea
that object in the environment are permanent and do not disappear when the
child is not looking at them.

Simple mode of thought that are the foundation of language develop during
this time but communication between a child and an adult at this stage is
extremely limited because of the childs simple concepts and lack of language
capability.

DENTAL APPLICATION
Child begins to interact with the environment and can be given toys while sitting on
the dental chair in his/her hand.
This stage can be sub divided into 6 stagesFirst Stage- (Birth to 2 Months)Schemata- Automatic inborn reflexes of infants.
Coordinated reflexes Uses inborn motor and sensory reflexes( sucking, grasping ,
looking) to interact and accommodate to the external world.
Second Stage (2-5 Months)Schemata- coordination of reflexes improves.
Coordinated reflexes- Primary circular reaction- coordinates activities of own body
and five senses (eg. Sucking thumb); reality remains subjective does not seek stimuli
outside of its visual field, displays curiosity.

Third Stage (5-9 Months)Schemata- infants try to perceive and maintain interesting experiences.
Coordinated reflexes- secondary circular reaction seeks out new stimuli in the
environment, starts both to anticipate consequences of own behavior and to act
purposefully to change the environment; beginning of intentional behavior.
Fourth Stage (9 Months1 yrs)
Schemata- coordinates sensorimotor scheme.
Coordinated reflexes- shows preliminary signs of object performance, has a vague
concept that objects exist apart from itself; plays peekaboo, imitates novel behaviors.
Fifth Stage (1 yr to 18 Months)
Schemata- new sensorimotor schemes are invited.
Coordinated reflexes- tertiary circular reaction- seeks out new experiences; produces
novel behaviors.
Sixth Stage (18 Months -2 yrs)
Schemata- invent new schemes through mental exploration in which they imagine
certain events and outcomes.
Coordinated reflexes- symbolic though- uses symbolic representations of events and
object; shows signs of reasoning.
E.g. uses one toys to reach for and get another, attains object performance.
2)

PRE-OPERATIONAL STAGES

It is also called as TRANSITIONAL PERIOD. Manipulation of symbols or words is a

characteristic feature of this stage.
It is divided into two stagesa)

Pre-conceptual stage (2-4yrs)

Child uses symbols in language and play.
He learns to classify things.
During this stage a stimulus begins to take on meaning and the child can use a
stimulus to represent other objects.

b)

Intuitive stage(4-7yrs)
Child solves problems as result of intuitive thinking but can not explain why?
Concept of egocentrism.
Child is unaware of others perspective.
Concept of centration- focuses attention on how things appear.

DENTAL APPLICATIONConstructivism- the child likes to explore things and make own observations.
E.g. Child survey the dental chair, airway syringe.
Cognitive equilibrium- child is explained about the equipment or instrument and
allowed to deal with it.
E.g. Airway syringe.
Animism- child correlates things with other objects to which they are more used to or
accustomed.
E.g. Explaining about radiograph as tooth picture.
3)

CONCRETE OPERATION STAGE (6-12 yrs)

The thinking process becomes logical.

He develops the ability to use complex mental operations such as additions and
subtractions.
The child is able to understand other point of view.
DENTAL APPLICATION- concrete instruction like this is a retainer, brush like this
etc.
Abstract instruction like wear the retainer every night and keep clean.
Centering- allowed to hold the mirror to see what is being done on his teeth.
EGO-centrism- child has achieved the level of understanding and gets involved in the
treatment.
E.g. Hold the suction tip by himself.
4)

FORMAL OPERATIONAL STAGE-

Development of reasoning capacity.

The child now a teenager is able to think still more abstractly.
Child can imagine possibilities inherent in a problem.

DENTAL APPLICATION- Peer influence and abstract thinking increases. This can
play an important role in orthodontic appliances and braces. Acceptance from peers
can be used for motivation for dental treatment.
MERITS FOR PIAGET`S THEORY

Most comprehensive theory of cognitive development.

This theory propagated that we can learn as much about

childrens intellectual development from examining their incorrect answers to
test items as from examining their correct answers.

DEMERITS OF PIAGET`S THEORY

Underestimates childrens abilities.

Overestimates age differences in thinking.

Vagueness about the process of change.

Underestimates the role of the social environment.

BEHAVIORAL THEORIES
A)

CLASSICAL CCONDITIONING by IVAN PAVLOV (1927).

Russian psychologist, IVAN petrovich PAVLOV was one of the first to

study conditioned reflexes experimentally on dogs. He discovered during his
studies of reflexes that apparently unassociated stimuli could produce the
reflective behavior.

PAVLOV classical experiment involved the presentation of food to a

hungry animal along with some of the other stimulus for example the ringing
bell.

In this famous experiment involved the presentation of food to a

hungry animal along with some of the other stimulus. Eg. The ringing bell.

In this famous experiment with dog he showed that the sight and smell
of food produced an unconditional response of salivation in the animal. He then
presented the food together with ringing bell. The sound of the bell is called
NEUTRAL STIMULUS because it does not produce any response by itself. But
the two events occurring together also lead to the unconditioned response of
salivation and later the ringing of the bell alone brought about conditional
response of salivation.

Classical conditioning is most often applied to responses mediated by

autonomic nervous system.

The more frequent the pairing of the conditioned and unconditioned

stimulus, the stronger is the conditioning.

The principles involved in the process

Acquisition- learning a new response from the environment by conditioning.

Generalization- It describes a process whereby a conditioned response is

transferred from one stimulus to another.
Eg. A child who has had a painful experience with a doctor in a white coat
always associates any doctor in white coat with pain.

Extinction- occurs when the conditioned stimulus is constantly repeated without

the unconditioned stimulus is constantly until the response evoked by the
conditioned stimulus gradually weakens and eventually disappears.
Eg. Subsequent visit to the doctor without any unpleasant experiences result in
extinction of the fear.
Discrimination- is the opposite of generalization. If the child is exposed to clinic
setting which are different to those associated with the painful experiences the
child learns to discriminate between the two clinics and even the generalized
response to any office will be extinguished.
Principles of classical conditioning

Developing good habits.

Breaking habits and elimination of conditioned fear.

Psychotherapy, to de-condition emotion fear.

Developing positive attitudes.

Teaching alphabets.

DENTAL APPLICATIONS- sound of headpiece and site of dentist.

MERITS OF CLASSICAL CONDITIONING
B)

Simple to understand and very applicable on a child in dental clinic.

OPERANT CONDITIONING BY BF SKINNER IN 1938.
The principle of operant conditioning arises from the experimental
work of SKINNER. It has been considered as an extinction of previous
responses. Hence satisfactory outcome will be repeated while unsatisfactory
outcome will diminish in frequency.

According to this theory, the consequence of behavior itself acts as

a stimulus and affects future behavior.

Behavior that operates or control the environment is called

OPERANT. It stresses that reinforcement is the critical factors for learning and
therefore for development of personality.

The relationship between operant and consequences that follows

them is called CONTINGENCY.

SKINNER described four basic types of operant conditioning

distinguished by the types of consequences.
Positive reinforcementNegative reinforcement
Omission
Punishment

Positive reinforcementIf a pleasant consequence follows the response. Eg. A child rewarded for a good
behavior following dental treatment.
Negative reinforcementInvolves removal of unpleasant stimuli following a response.
Eg. If the parent gives in to the temper tantrums thrown by the child, he reinforces this
behavior.
OmissionRemoval of the pleasant response after a particular response. Eg.If a child misbehaves
during the dental procedure his favorite toy is taken away for a short time resulting in
the omission of the undesirable behavior.
PunishmentIntroduction of an aversive stimulus into a situation to decrease the undesirable
behavior.
Where an unpleasant stimulus is presented after a response.
Punishment is effective at all ages result of adding negative outcomes or removing
positive ones thus weakening the response.
E.g. Use of palatal rake in correction of tongue thrusting habit.
Procedure- A behavior is followed by a consequence of reinforcement or punishment.
Results- the behavior increases or decreases in frequency.
E.g. A rat will press a bar 20 times per hour to achieve a reward or avoid punishment.
MERITS OF OPERANT CONDITIONING
Applicable on children who are difficult to manage.
Useful in instillation of life long positive behavior in a child dental patient.

DEMERIT OF OPERANT CONDITIONINGOveremphasis on use of negative reinforces and punishment in dental clinic.

Hierarchy of needs by MASLOW (1954)

This was given in 1943 by ABRAHAM MASLOW in his paper. A theory developed a
classification of the individual priority needs and motivations during personality
development. A five level triangular hierarchy of these needs from the most basic and
important to the most elaborate shows a trend from instinctive motives to more
rational intellectual ones.

Level of Hierarchy of NeedsLevel 1) PSYCHOLOGIC NEEDSThese are basic needs, such as food and water along with air, sleep, clothing etc. and
must be satisfied before other needs. If they are not fulfilled, people will direct all
their energy and resources towards satisfying them. Biological necessities such as
food, water, oxygen, sleep, sex etc. are the important needs because a person would
feel sickness, irritation, pain, discomfort etc. or may even die if they were not
fulfilled.
Level 2) SAFETY NEEDSBoth physical and psychological safety is necessary to meet these needs. These are
protection, stability, pain avoidance etc. MASLOW believed that children need safety
more than adults when they feel afraid, safety needs are mostly psychological in
nature which can be safety and security of a home and family.
Level 3) LOVE AND BELONGING NEEDSThese needs are also termed as social needs that include affection, acceptance and
inclusion in integrated groups. The need for affection from parents, peers and other
loved ones. This is to give and receive love and also for a feeling of belonging.
Level 4) ESTEEM NEEDS-

This includes self respect and self- esteem which are the needs to be respected; to
have self respect, and to respect others. Humans include the need to be competent to
achieve, to be successful, and to be open and independent. In addition esteem needs
include the desire to be acknowledge and appreciated for their achievements.
Level 5) SELF-ACTUALIZATION NEEDSMASLOW considered that a very small group of people reach a level called- self
actualization, where all of their needs are met. And it is described as a person finding
their PASSION or MISSION.
MERIT OF HIERARCHY OF NEEDS
Based on totality of personality development.
DEMERITS OF HIERARCHY OF NEEDS
This theory is difficult and impractical to apply in children in dental situations as the
child has an ever changing personality.

SOCIAL LEARNING THEORY BY ALBERT BANDURA 1963

This theory was proposed by A.BANDURA in 1963.
This theory is thought to be the most complete, clinically useful and theoretically a
sophisticated form of behavior therapy.
The two most essential components of this theory are the concepts of modeling and
reinforcement.
Principle of social learning theoryAttention- Extent to which we focus on others behavior.
Retention- our ability to retain a representation of others behavior in memory.
Production processes- our ability to actually perform the actions we observe.
Motivation- our need for the actions we witness, their usefulness to us.
The learning of behavior is affected by four principle elementsAntecedent- determinants- The conditioning is affected if the person is aware of what
is occurring.
Consequent determinants-persons perception and expectancy (cognitive factors)
determine behavior.
Modeling- learning through observation eliminates the trial error search. It is not an
automatic process but requires cognitive factors and involve 4 processes which are1)

Attention process

3)

Motoric reproduction process 4)

1)

2)

Retention process
Reinforcement and motivational process

ATTENTIONAL PROCESS

A child can not learn by observation if the child does not attend the essential feature
of the models behavior. Simply exposing the child to the model does not assure his
attention.
Factors related to going his attention involved the relevancy of the model`s behavior
to that of the observing child. This means that the observer must be able to associate
and identify with the model.
Observational learning can be an important tool in management of dental treatment.
DENTAL APPLICATION- if a young child observes an older sibling undergoing
dental treatment without complaint or uncooperative behavior. He/she is likely to

imitate this behavior. If the older sibling is observed being rewarded, the younger
child will also expect a reward for well being.
2)

RETENTION PROCESS-

If the observer is to reproduce the model`s behavior when the model is no longer
present to serve as a guide the response pattern must be memorized and coded in
symbolic form.
Immediate imitation does not require much cognitive functioning however delayed
imitation requires symbolic transformation and organization of the modeling stimuli
thus the learning requires cognitive development.
3)

MOTORIC REPRODUCTION PROCESS-

This amount of observational learning that a child can exhibit depends upon the level
of skills that the child has attained. These skills must coordinated and refined through
self corrective adjustment based upon performance feedback.
DENTAL APPLICATION- Sitting in one dental chair watching the dentist work
with someone else in an adjacent chair can provide a great deal of observational
learning about what the experience will be like.
4)

REINFORCEMENT AND MOTIVATIONAL PROCESS-

When positive incentives are provided, observational learning will be promptly

translated over performance. Therefore the influence of modeling upon behavior will
be weakened as a result of failure to observe the relevant activities.
Self- regulation- this system involves a process of self- regulation, judgment and
evaluation of individuals responses to his own behavior.
MERITS OF SOCIAL LEARNING THEORY
As compared to operant and classical conditioning, this theory is
Less reductionistic
Provides more explanatory concepts
Encompasses a broader range of phenomena.
DEMERITS OF SOCIAL LEARNING
Based only on observation of behavior of a person with overemphasis on the role of
the environment.

OTHER THEORY- MAHLER`S THEORY (1933)

This theory categorizes the early childhood object relations to understand personality
development.
The period of childhood is thus divided into three stagesNormal autistic phase
Normal symbiotic phase
Separation-individualization phase
1)

NORMAL AUTISTIC PHASE

It is a state of half-sleep, half-wakefulness.
This phase involves achievements of equilibrium with the environment.

2)

NORMAL SYMBIOTIC PHASE (3-4 weeks to 4-5 months).

The infant at this stage is slightly aware of the caretaker but they both are still
undifferentiated.

3)

SEPARATION- INDIVIDUALIZATION PHASE (5to 36 months).

This phase is divided into four sub-phasesDifferentiation (5 to 10months).
Practicing period (10-16 months)
Rapprochement (16 to 24 months)
Consolidation and object constancy (24 to 36 months).

A)

DIFFERENTIATION (5 to 10 months).
The infant becomes alert as cognitive and neurological maturation occurs.
Characteristic anxiety at this period is stranger anxiety.
He differentiates between self and others.

B)

PRACTICING PERIOD (10 to 16 months).

Beginning of this phase is marked by upright locomotion.
The child learns to separate himself from mother by crawling.
Separation anxiety is present as the child still requires the mother for safety.

C)

RAPPROCHMENT (16 to 24 months).

The infant, now a toddler, is more aware of the physical separations.
The child tries to overcome this by showing mother his newly acquired skills.
The mothers efforts to help toddler are not successful, resulting in temper
tantrums.
Rapprochement crisis develops as the child wants to be soothed by the mother,
but is unable to accept her help.
This crisis is resolved as the childs skill improves.

D)

CONSOLIDATION AND OBJECT CONSTANCY (24 to 36 months).

The child achieves a definite senses of individuality and is able to cope with the
mothers absence.
He does not feel uncomfortable on being separated from the mother since he
knows that she will return.
He develops an improved sense of time and can tolerate delay.

MERITS OF MAHLER`S THEORY

Can be applied to children
DEMERITS OF MAHLER`S THEORY
Not a very comprehensive theory

CONCLUSION
In the practice of pediatric dentistry, as indeed of all branches of dentistry, should be
governed by a simple but fundamental philosophy; treat the patient not the tooth. In
this branch we are dealing with the childs feeling, to gain the childs confidence and
cooperation, to perform treatment in a kind, sympathetic manner, and to be concerned
not only with providing the treatment currently required but also with promoting the
childs future dental health by stimulating positive attitudes and behavior regarding
dental care. Therefore a thorough knowledge in child psychology and child
development is essential for the successful treatment of patient of pediatric in dental
office.

REFERANCES
1)

Textbook of Pedodontics -

Shobha Tandon

2)

Textbook of Pediatric Dentistry

Nikhil Marwah

3)

A manual of Pediatric Dentistry

R.J. Andlaw
W.P. Rock