1 Prenatal, Infancy and Childhood Development Antibiotics, - teratogenic effects

Behavioral Medicine 1 anticonvulsants,

lithium, warfarin
A. Pre-natal period Selective - neonatal behavioral syndrome
Serotonin
1. Embryonic Stage: conception to 8 weeks Reuptake
2. Fetal Stage: 8 weeks to birth Inhibitors (SSRIs)
- recognizably human
- maintains an internal equilibrium that interacts 2.b.iii. Radiation Exposure
continuously with the intrauterine environment 2.b.iv. At 2 to 15 weeks AOG gross deformities,
- (+) damage global impact stunted growth, abnormal brain function, or cancer
- girls biological vigor than boys due to second X
chromosome B. Infancy : Birth to 18 months
- (+) behaviors necessary for adaptation outside the womb
Infancy Developmental Landmarks
Fetal Stage Developmental Landmarks Newborn - Reflexes and Survival Systems
4-5 months AOG - vigorous movements breathing sucking, swallowing, and
16 to 20 weeks - grasp reflex circulatory and temperature homeostasis
17 weeks - hears, responds to loud noises with sensory organs are incompletely
18 weeks muscle contractions, movements, and developed
an increased heart rate REM and non-REM sleep
5-6 months AOG - retinal structures can detect bright light crying, smiling
20 weeks flashed on the abdominal wall causing - penile erection in males
25 weeks changes in fetal heart rate and position can make noises
- Moro (startle reflex) 1 day old - (+) can smell mothers milk
7 months AOG - eyelids open 3 days old - distinguish mothers voice
28 weeks - smell and taste are also developed
- sucking reflex Language and Cognitive Development

2.a. Development of the Nervous System Mastery of Comprehension Mastery of Expression

- brain weight = 350 g at birth Birth to 6 months
- 4x in neocortex due to growth in the number and - startle response to loud or - (+) vocalizations other
branching of dendrites sudden sounds than crying
- uterine contractions cause the developing neural - attempts to localize - (+) differential cries for
network to receive and transmit impulses sounds hunger, pain
2.a.i. Pruning - appears to listen, may - vocalizes to show
- programmed elimination of certain brain structures respond with smile pleasure
present at birth - recognizes warning, angry, - plays at making sounds
- occurs to rid of cells that have served their function and friendly voices - babbles (a repeated
- immature brain can be vulnerable implications in - responds to own name series of sounds)
child and adult neuropsychiatric disorders 7- 11 months (Attending to language)
- shows listening selectivity - responds to own name
2.b. Risk factors - listens to music or singing with vocalizations
2.b.i. Maternal Stress - recognizes own name - imitates the melody of
- correlates with levels of stress hormones that act - looks at pictures being utterances
directly on the fetal neuronal network named for up to 1 minute - uses jargon
- anxious mothers hyperac9ve, irritable, and low BW - listens to speech without - (+) gestures, exclamation
infants being distracted by other - plays language games
2.b.ii. Maternal Substance Use sounds (pat-a-cake, peekaboo)
12-18 months (Single-Word)
Alcohol - leads to Fetal alcohol syndrome: growth - shows gross - uses single words
retardation, minor anomalies, short discriminations between - talks to toys, self, or
palpebral fissures, midface hypoplasia, a dissimilar sounds others using long
smooth or short philtrum, and a thin - understands basic body patterns of jargon and
upper lip; and CNS manifestations parts, names of common occasional words
- may be associated with ADHD objects - utterances are 25%
Smoking - leads to prematurity, low BW infants, - (+) understanding of some intelligible
Sudden Infant Death Syndrome (SIDs) new words weekly - articulates vowels
Marijuana - prematurity, low BW infants, withdrawal - identify simple objects correctly with initial and
symptoms - understands up to 150 final consonants often
Cocaine - behavioral abnormalities words by age 18 months omitted
Emotional and Social Development C. Toddler: 18-30 months (2 years old)

Emotional Skills Emotional Behavior Language and Cognitive Development

Birth to 2 months
- Love evoked by touching - Social smile and joy shown Mastery of Comprehension Mastery of Expression
- Fear evoked by loud noise - Responds to emotions of 12-24 months (Two-Word Messages)
- Rage evoked by body others - Responds to simple - Uses two-word utterances
restrictions directions - Imitates environmental
- Brain pathways for - Responds to action sounds in play
emotion forming commands - Refers to self by name,
3-4 months onward - Understands pronouns (me, begins to use pronouns
- Self-regulation of - laughter possible and him, her, you) - Echoes two or more last
emotions starts more control over smiles; - Begins to understand words
- Brain pathways of anger shown complex sentences - uses three-word telegraphic
emotion growing utterances
7-12 months - Utterances 26% to 50%
- Self-regulation of emotion - Able to elicit more intelligible
grows responsiveness - Uses language to ask for
- increased intensity of basic - Denies to cope with stress needs
three 24-36 months (Grammar Formation)
- Understands small body - Uses real sentences with
1. Temperament (Chess and Thomas) parts (elbow, chin, grammatical function word
- innate psychophysiological characteristics eyebrow)
- range of normal behavioral patterns - Understands family name - Usually announces
- from the difficult child at one end of the spectrum to the categories intentions before acting
easy child at the other end - Understands size - Conversations with other
- Rhythmicity - Understands most children, usually just
adjectives monologues
2. Attachment - Understands functions - Jargon and echolalia
- Bonding is the term used to describe the intense gradually drop from speech
emotional and psychological relationship a mother - Increased vocabulary
develops for her baby. Speech 50% to 80%
- Attachment is the relationship the baby develops with its intelligible
caregivers. - P, b, m articulated correctly
- Speech may show rhythmic
3. Stranger Anxiety (at about 26 weeks to 32 weeks) disturbances
- result from a baby's growing ability to distinguish
caregivers from all other persons Emotional and Social Development
- in babies exposed to only one caregiver
Emotional Skills Emotional Behavior
4. Separation anxiety (between 10 and 18 months) 1-2 years
- related to stranger anxiety but not identical to it. - Shame and pride appear; - empathy starting;
- As infants separate by moving away from mother, they envy, embarrassment expressions of feeling
constantly look back and return for reassurance appear - Likes attention and
- Displaces onto other approval
5. Parental Fit children - enjoys play alone or next
- how well the parents relates to the infant to peers
- takes into account temperamental characteristics of both 2-5 years to 3-6 years
parent and child - Can understand causes of - Empathy increases with
- goodness of fit: harmonious and consonant interaction many emotions understanding
between a parent and a child - Can begin to find ways for - More response and less
- Poor fit distorted development and maladaptive regulating emotions and reaction
functioning for expressing them - self-regulation:
- Identifies with adult to - Use your words to convey
cope feeling - Aggression
becomes competition
- By age 5, shows sensitivity
to criticism and cares
about feelings of others
1. Sexual Development Emotional and Social Development
- Children exhibit curiosity about anatomical sex Emotional Skills Emotional Behavior
recognized as healthy and met with age-appropriate 2-5 years to 3-6 years
replies, they acquire a sense of the wonder of life and are - Can understand causes of - Empathy increases with
comfortable with their own roles. many emotions understanding
- Can begin to find ways for - More response and less
1.a. Gender identity regulating emotions and reaction
- conviction of being male or female for expressing them - self-regulation:
- manifests at 18 months and fixed by 24 to 30 mos - Identifies with adult to - Use your words to convey
cope feeling
1.b. Gender role - Aggression becomes
- the behavior that society deems appropriate for one sex competition
or another - By age 5, shows sensitivity
to criticism and cares
2. Sphincter Control and Sleep about feelings of others
- toilet training serves as a paradigm of the family's general
training practices 1. Sibling Rivalry
- control of daytime urination 2 years - birth of a sibling tests capacity of further cooperation and
- control of nighttime urination 4 years sharing
- generally sleep about 12 hours a day, including a 2-hour - depends on child-rearing practice. Favoritism for I any
nap: takes 30 minutes to sleep reason commonly aggravates such rivalry
- If not handled property, the displacement of the firstborn
3. Parenting Issues can be a traumatic event
- Parental task: firmness about the boundaries of
acceptable behavior and encouragement of the child's 2. Play
progressive emancipation 1. Parallel play (2 and 3 years) solitary play alongside
- Children will struggle for the exclusive affection and another child with no interaction between them.
attention of their parents rivalry 2. Associative play (by 3 years) - plays with the same toys in
- balance between punishment and permissiveness and set pairs or in small groups, but still with no real interaction
realistic limits among them.
3. Cooperative play (by age 4) - real interactions and taking
D. Pre-school turns become possible.

Language and Cognitive Development 3. Drawings

Mastery of Comprehension Mastery of Expression
36-54 months (Grammar development)
- Understands prepositions - Correct articulation of n,
- Understands many words w, ng, h, t, d, k, g
- Understands cause and - Uses language to relate
effect incidents from the past
- Understands analogies - Uses wide range of
(Food is to eat, milk is grammatical forms
to________) - Plays with language
- Speech 90% intelligible
- Able to define words
- Can repeat a 12-syllable
sentence correctly
55 mos onward (True Communication)
- Understands concepts of - Uses language to tell
number, speed, time, stories, share ideas, and
space discuss alternatives
- Understands left and right - Increasing use of varied
- Understands abstract grammar; spontaneous
terms self-correction of
- Is able to categorize items grammatical errors
into classes - Stabilizing of articulation f,
v, s, z, l, r, th, and
consonant clusters
- Speech 100% intelligible
- Helps trace the child's growth and express creativity:
- representational and formal in early childhood
- make use of perspective in middle childhood
- become abstract and affect laden in adolescence
- also reflect children's body image concepts and sexual
and aggressive impulses
4. Imaginary Companions
- in children with above-average intelligence and usually in
the form of persons
- may also be anthropomorphized toys
- friendly, relieve loneliness, and anxiety
- disappear by age 12, but they can occasionally persist into
adulthood
E. Middle Childhood
Language and Cognitive Development
- expresses complex ideas
- logical exploration tends to dominate
- increase interest in rules and orderliness
- increase capacity for self-regulation
- ability to concentrate by 9 - 10 years
- (+) complex motor tasks and activities
1. Chum Period
- an important phenomenon
- by 10 years old close same-sex relationship
- absence of a chum during middle childhood is an early
harbinger of schizophrenia (Sullivan)
2. School Refusal
- generally due to separation anxiety
- usually not an Isolated problem
- typically avoid many other social situations
Other Issues in Childhood
1. Sex Role Development
- The sex role also involves identification with culturally
acceptable masculine or feminine ways of behaving
- Ambiguity is created as society grows more tolerant and
sex roles become less rigid.
2. Dreams and Sleep
- At 1 year old experienced as if true
- At 3 years old shared by other children
- At 4 years old unique to each child
- The dream content should be seen in connection with
children's life experience, developmental stage,
mechanisms used during dreaming, and sex
- disturbing dreams peak at 3,6 and 10 years of age want
to keep their bedroom door open or to have a nightlight
- aggressive dreams rare in early childhood
- by age 7, children know that they create their dreams
themselves
- often create rituals as protection
- Parasomnias (at stage 4 sleep) when dreaming is minimal
do not indicate psychopathology
3. Birth Spacing
- close spacing increases prematurity or underweight
births, and malnutrition
- children from large families increases conduct disorder
and slightly decreased verbal intelligence
- due to low parental interaction and discipline
4. Birth Order (Sulloway)
- Firstborn highly valued par9cular if male
- IQ in rstborn reect parents' having more 9me to
interact with the firstborn child
- Firstborn children - more achievement oriented, most
authoritarian; conservative and conformists
- Second and third children have the advantage of their
parents previous experience and can learn from their
older siblings; usually receive the least attention
- the youngest children may receive too much attention
and be spoiled; tend to be rebellious high propor9on of
prominent persons
5. Stepparents
Types of Step Families
- Resembles traditional families
- Absent biological parent is included at times.
Neo-Traditional
- Discipline, boundaries and limits, and
expectations are discussed openly.
- Family coalitions and side-taking are better
avoided.
- Expect to be a traditional family immediately
- The absent biological parent is expected to
disappear and is often criticized.
Romantic
- Stepparent/stepchild difficulties are common.
- Stress is unbearable.
- Few open and frank discussions about problems
- Run by a highly competent mom and her
Matriarchal
companion follows
- Companion is a buddy to the children, not to the
parent
- Birth of a step-sibling causes problems.
6. Adoption
- the process by which a child is taken into a family by one
or more adults who are not the biological parents but are
recognized by law as the child's parents
- usually born out of wedlock 40% born out of teenage
mothers
- disclosure at 2 - 4 years old reduces feelings of betrayal
by adoptive parents and abandonment by biological
parents
- the later the age of adoption, the higher the incidence
and the more severe problems
- may be preoccupied with fantasies of two sets of parents
good and bad parents
- Strong desire to know their biological parents the
experience is generally positive when done during
adolescence or adulthood.
Family Factors in Child Development
1. Family Stability
- separated- and single-parent families low self-esteem,
risk of child abuse incidence of marital problems
eventually, and incidence of mental disorders
- boys are more affected than girls and older children are
less vulnerable; inborn personality characteristics
protective (Rutter)
- death of a parent adverse emotional effects
2. Day Care Centers
- its role in child development is being studied
- children placed in day care centers before 5 years old
less assertive and less effectively toilet trained
- The quality of both the day care center and the homes
from which children come must be taken into
consideration.
3. Parenting Styles (Rutter) 4 types

1. authoritarian
2. indulgent-permissive
3. Indulgent-neglectful
4. authoritative-reciprocal (best)
- marked by firm rules and shared decision-making in a
warm, loving environment self-reliance, self-
esteem, and sense of social responsibility

4. Development and Expression of Psychopathology

- related to both age and developmental level
- developmental and language disorders often diagnosed in
preschool years
- Mild Mental Retardation or learning problems
diagnosed in early school-age years
- Disruptive Behavior Disorder - seen with peer interaction
- Attention Deficit Disorders - seen with demands for
attention in school
- Other conditions (eg schizophrenia and bipolar disorder)
are rare in preschool and school-aged children