Dec 9, 2021 Child psychology 1

Child Psychology
http://hi-dentfinishingschool.blogspot.com/
http://apexiondental.com/
 Definitions (quintessence int.2001; 135p)

• Psychology --- science dealing with human nature, function

and phenomenon of his soul in the main. Its the study of
human mind & its functions

• Child psychology --- science that deals with the mental power
or an interaction between the conscious and subconscious
element in a child

• Emotion --- a feeling or mood manifesting into motor and

glandular activity.

• Behavior --- is any change observed in the functioning of the

organism.
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 Importance of studying child psychology
(quintessence int.2001; 135p) (JDC 1974;35p)
Provides information about
---child's behavior and psychological growth
---psychological scales for appraising a child’s developmental
status
---certain norms of behavior and growth for comparative
purposes
---understanding of basic psychological processes like
learning, motivation, maturation and socialization
---new trends and fads in child care & training
Guides psychological growth of children who experience difficulty
in adjusting to others.

Dec 9, 2021 Child psychology 5

 In Dentistry
(quintessence int.2001; 135p) (JDC 1974;35p)

• To understand the child & know his problem

• To deliver treatment effectively
• To establish effective communication with child
and parents
• To gain confidence of child and parents
• To teach and motivate them about importance of
primary and preventive care
• To plan out effective treatment
• To provide comfortable and satisfactory
treatment

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 Theories proposed on Child Psychology
Psychodynamic theories
-psychosexual theory --- Freud -1905
-psychosocial theory ---Eric Erikson1963
-cognitive theory ---Piaget - 1952
Behavioral theories
-classical conditioning --- Pavlov - 1927
-operant conditioning --- Skinner - 1938
-hierarchy of needs --- Maslow - 1963
-social learning theory --- Bandura – 1954
Miscellaneous theories
-separation & individualization --- M Mahler
-attachment theory --- J Bowlby
-childrenese --- H Ginnott
Current concepts
-information processing
-Vygotsky’s socio-cultural theory
-ecological system theory --- U Brofenbrenner
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 Psychoanalytical theory
Dr. Sigmund Freud 1856-1939

• Founder of classic psychoanalysis

• Oldest of eight children

• 1887-1897 work on hysterical patients---

to develop psychoanalysis

• Based theory on personal experiences

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 Legendary contributions

• Interpretation of dreams –1900

• Topographic model of mind
• Instinct or drive theory
• Stages of psychosexual development
• Structural theory of mind
• Theory of anxiety

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 Instincts – inborn tendencies
• Libido – sexual energy – that force by which the
sexual instinct is represented in the mind – Pleasure
principle – goal of life gain pleasure and avoid pain
• Ego instincts – nonsexual components
• Life & Death instincts – accounts for aggressive
drive – to die or to hurt themselves or others
• Aggressive drives – powerful determinants of
peoples actions - sadism
• Concept of narcissism – self love

Dec 9, 2021 Child psychology 10

 THE DRIVING FORCES OF PERSONALITY TWO
POWERFUL BIOLOGICAL INSTINCTS:

EROS (LIFE) AND THANATOS (DEATH)

positive, life-sustaining: destructive:

eating, sex, respiration, aggression,
body needs masochism
(pleasure from pain & suffering)

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 The Structural theory of the mind

• THE ID —basic need -The Demanding Child

unorganized instinctual drives
pleasure principle. It which brings happiness

• THE EGO — The Traffic Cop – consciousness

reality principle

• THE SUPEREGO — The Judge – moral conscience

• Ruled by the moral principle
• Culture and family restrictions

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 Superego Perfection principle; Internal censor;
Conscience; “Ought nots”, “Should nots”;
Judgmental. Internalized standards, guilt.

Ego Reality principle; Seeks realistic and

acceptable ways to satisfy the Id
(delaying,
planning, modifying impulse); Deliberate,
conscious, rational.

Id Pleasure principle; Passions, instincts,

emotions, wants; Seeks immediate
gratification; Impulsive. Primary, inborn,

Dec 9, 2021
unconscious.
Child psychology 13
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 Psychosexual stages of Development

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 Oral Stage: Birth to 1.5 year

• Mouth, lips, tongue – oral zone

• Interaction with environment: mother's breast is not only is the source of
food – represents her love and care and feeling of safety. Satisfy drive of
hunger and thirst by breast or bottle
• Insufficient and forceful feeding----oral fixation
• If fixated after weaned:
Over Dependency
Over Attachment
Symptoms of oral fixation----
smoking, constant chewing of gums, pens, pencils, nail biting, overeating,
drinking, sarcasm ( the biting personality),Excessive optimism and
pessimism, demandingness, envy and jealousy.

Successful resolution -----trust on others, self reliance and self trust.

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 Anal Stage: 1.5 - 3 years
• Neuromuscular Control: control over sphincters
• attempts to achieve autonomy and independence
• Toilet training – get to impose societal norms
-Self-control
-Freedom of action
• Anal fixation—
anal expulsive personality - unclean
anal retentive personality – very clean
obsessive compulsive neurosis

• Successful resolution---
personal autonomy
independence
initiative
cooperation

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 Phallic Stage: 3 – 5years

• Genital area & functions -

• Interaction with environment -- attraction with opposite sex
parent and envy and fear of same sex parent
Oedipus Complex
Electra complex
• Emerging gender identity
Phallic fixation —
Boys ---anxiety and guilt feelings about sex, fear
of castration, narcissism.
Girls ---envy and inferiority

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• Oedipus Complex
-A boy’s feelings for his mother and rivalries with his father
-Psychological defenses against these threatening thoughts and
feelings
- Resolution - Form personality through identification with father
-Diminish fear of castration
• Castration Anxiety
Unconscious fear of loss of genitals
Fear of powerful people overcoming them
Fear of revenge of the powerful people
• Electra complex
A girl’s feelings of inferiority and jealousy
Turns affections from mother to father

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 Latency Period: 5-11 years of age

• No erogenous zones
• Time between resolution of Oedipus complex and puberty
(superego)

• Interaction with environment---

-focus on other aspects of life, mastery of skills
-time for learning and adjusting to social environment (school)
-same sex friendship,
-sports

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 Genital Stage - Adolescence (11-13yrs)
to Adulthood
• Divided into – preadolescent, early adolescent.
middle, late, post adolescent periods
• Renewed sexual interest and desire, Normal sexual
relations, Marriage, Child-rearing
• Separation from parents, Mature sense of personal
identity
• Social and cultural interactions
• No fixation

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 Limitations of Freud’s Work

 Pessimistic and deterministic approach to personality

 Pathology based theory
 Over emphasis to infantile sexuality
 No controlled studies-poor research
 Overemphasis on differences between men and women
 Unconcerned with interpersonal relations, individual identity
and adaptation over one’s lifetime

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 Psychosocial theory-
Eric H. Erikson

• Born in 1902 in Frankfurt.

• Epigenetic principle --- development occurs in sequential, clearly defined

stages and each stage must be resolved satisfactorily for development to
proceed smoothly

• If not ---- failure in the form of physical, cognitive, social, or emotional

maladjustment

• Accepted Freud's concepts

• Concluded that human personality is determined not only by childhood
experiences but also from those of adulthood

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Dec 9, 2021 Child psychology 24
 Stage 1 - Basic Trust vs. Mistrust (0-1yrs)
 Dependency on mother --Developing trust is the first
task of the ego

 + outcome ---secure attachment with parents and

environment

 The child will let mother out of sight without anxiety

and rage because she has become an inner certainty as
well as an outer predictability.

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 • -ve outcome--- inattentive mother
maternal deprivation syndrome

increased separation anxiety… req parents presence

•The balance of trust with mistrust depends largely on the

quality of maternal relationship
maternal deprivation
syndrome

Both girls are of

age 7 yrs

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 Stage 2 - Autonomy vs. Shame and Doubt (1-
3yrs)

• Toddler learns to talk, walk, use toilets (control over

sphincters) and do things for themselves ---self
control, confidence (parents must not overprotective)

• Reassurance develops confidence

• If denied autonomy, the child will turn angry and

shamed

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• Parental over control---muscular and anal impotence
—doubt

• Shame develops with the child's self-consciousness.

• Terrible two And troublesome three

• Dental visit – make him feel more important, let

mother be with

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 Stage 3 - Initiative vs. Guilt (3-6yrs)
• Initiate motor and intellectual activities, quality of
undertaking, planning, and attacking a task for the
sake of being active and on the move.

• Depends on how much freedom child will get &

intellectual curiosity is satisfied

• Play with peers and learn to interact with

environment

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• Feels guilt over the goals
contemplated, feels unable to
be independent
• Develops sibling rivalry
• The castration complex
occurring in this stage is due to
the child's erotic fantasies.
• Dental visit- more curious
about dentist’s office, they will
tolerate being separated from
mother

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 Stage 4 - Industry vs. Inferiority (6-11yrs)
• School ---- organized program of learning, ability to work and
acquire skills

• The fundamentals of technology are developed – learn the

pleasure of work completion and pride of doing well

• To lose the hope of such "industrious" association may pull

the child back to the more isolated, less conscious, inferiority
--- if discriminated, compared in schools

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• Dental visit – easy to treat, try to please dentist and parents

• Peer group influence

• Wear appliance regularly

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Stage 5 - Identity vs. Role Confusion (or "Diffusion") (12-
21yrs)
• Who am I ? --- to answer - healthy resolution of
earlier conflicts

• The adolescent is newly concerned with how they

appear to others.

• Ego identity ( confidence that the inner sameness

and continuity) as evidenced in the promise of a
career.

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• Preoccupation with appearance
hero worship and ideology
• Group identity
• If not adolescent sink into
confusion ,inability to make
decision & choices, settle on a
school or occupational identity
is disturbing.
• Most orthodontic treatment
carried out in this age – more
conscious about appearance

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 Stage 6 - Intimacy vs. Isolation (21-40yrs)

To love and to work.

Involved in intense and long term relations

The avoidance of these experiences leads to isolation

and self-absorption.

Now true genitality can fully develop.

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 The counterpart of intimacy is distantiation, which is
the readiness to isolate and destroy forces and people
whose essence seems dangerous to one's own.

Inability to develop identity---fear a committed

relationship

The danger at this stage is isolation which can lead to

severe character problems.

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 Stage 7 - Generativity vs. Stagnation (40-65yrs)
Generativity is the concern in establishing and
guiding the next generation. Fruitful parenting

Look outside oneself & care for others

Simply having or wanting children doesn't

achieve Generativity.

Adults need children as much as children need

adults

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 Socially-valued work and disciples are also
expressions of Generativity.

Creation of living legacy

If not --- self concern, isolation absence of intimacy

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 Stage 8 - Ego Integrity vs. Despair(>65yrs)
Ego integrity is the ego's accumulated assurance of its
capacity for order and meaning. It is the sense of
satisfaction

Despair is a loss of hope producing misanthropy and

disgust ---- signified by a fear of one's own death, as
well as the loss of self-sufficiency, and of loved
partners and friends.

Healthy children, Erikson tells us, won't fear life if

their elders have integrity enough not to fear death.

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Cognitive development
Jean Piaget (1896-1980) Gen Dent 2000, 74p

Genetic epistemology – study of acquisition,

modification & abstract ideas and abilities.

Intelligence is the ability to adapt to the

environment

Cognitive development occurs in a series of

stages ---epigenesis

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Dec 9, 2021 Child psychology 41
 Cognitive organization or adaptation occurs through –
1. assimilation
2. accommodation

Assimilation -- people take in new experiences

through their own system of knowledge, a process
comparable to eating and digesting food, which then
becomes part of life.

cognitive structures -- a classification for sensations

and perception
Ex. All flying objects are birds

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• Differentiation occurs by accommodation ---- occurs
when the child changes his or her cognitive structure
or mental category to better represent the
environment.

• When corrected by someone categorize separate

groups of flying objects as birds, bees, aero plane etc.

Intelligence develops as interplay between

assimilation and accommodation

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 Stages of cognitive development

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 Sensorimotor stage – 0-2yrs

• develops rudimentary concepts of objects - objects in the

environment are permanent; do not disappear when the child
is not looking at them.

• Simple modes of thought that are the foundation of language

development

• Communication between a child at this stage and an adult is

extremely limited because of the child’s simple concepts and
lack of language capabilities.

• Little ability to interpret sensory data and a limited ability to

project forward or backward in time.

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 Preoperational stage – 2-7yrs
Good language development
capacity to form mental symbols – represent things
and events not present, children learn to use words to
symbolize these absent objects.

understand the world in the way they sense it through

5 primary senses. Concepts - not seen, heard, smelt,
tasted or felt – ex. Time and health are difficult for
these children to grasp

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 Egocentrism -- child is incapable of assuming another person’s
point of view, make them feel more important

• Centering – giving mirror to observe

Animism -- investing inanimate objects with life. symbolic

fantasy, play and language
Animism can be used to the dental team’s advantage by
giving dental instruments and equipment life –like names and
qualities.

Constructivism – child acquires reality by touching, exploring,

observing---TSD

Cognitive equilibrium – answer to questions asked,

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 Conservation

Reversibility

Conservation of Length (6-7 years)

Conservation of Liquids

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 Conservation of area

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 Stage of concrete operations -7-11yrs
• Good answering capacity

• Decline of egocentrism

• Decline of animism

• Much more like adults but not

• Easy to treat
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 Period of formal operations – 11yrs & above

• Good communication skill (abstract concepts &

reasoning)
• Should be treated as adult
• Concept of imaginary audience – constantly on stage
• Personal fable – uniqueness makes a patient ignore
threats to health
• Easy to treat if interested

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 Behavioral learning theories
quintessence int.2001: 32: 135p

• Learning :--Relatively permanent change in the

behavior that occurs as a result of experience –
modifying behavior

• Behavior is the result of an interaction between innate

or instincts and learning after birth

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 Classical conditioning - Ivan Pavlov
(quintessence int.2001; 135p) (JDC 1974;35p)

Classical conditioning
operates by a simple
process of association of
one stimulus with other---
learning by association

Experiment---Presentation of
food to a hungry dog

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 Three steps
---conditioning
---stimulus generalization
---extinction
1. Neutral stimulus (NS)
2. Unconditional stimulus (US)
3.Unconditional response (UR)
4. Conditional stimulus (CS)
5. Conditional response (CR)
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• Step 1: Before conditioning

• Step 2: Conditioning process

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 Step 3: After conditioning

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 Stimulus generalization

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 Extinction

Before extinction

Extinction process

After extinction

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• First visit
white coat pain of injection
(neutral stimulus) (unconditioned stimulus)

pain of injection fear and crying

(unconditioned stimulus) (response)

• Second visit
sight of white coat pain of injection
(conditioned stimulus) (uncond. stimulus)
pain of injection fear and crying
(unconditioned stimulus) (response)
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Conditioned by previous physician visit

Generalization of dental clinic and physician’s office

Reinforcement --- repeated experiences

Extinction----if not repeated, occurs by discrimination

Discrimination----opposite of generalization

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 OPERANT CONDITIONING: B.F SKINNER
JDC 1974, 31P, QUINTESSENCE INT.2001; 135P)

• Complicated theory
• Related to trial and error
learning
• A person or animal attempts to
solve a problem by trying
different actions until one
proves successful.
• Instrumental conditioning

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• The basic principles:
1.operant behaviors are voluntary
2. the consequence of a behavior is in itself a stimulus
that can affect future behavior.
3.Teach new behaviors – behavior shaping—

‘Procedure of reinforcing the several gradients of a

behavior pattern
or
Building a response by reinforcing its
components in a step by step manner’
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STIMULUS  RESPONSE  CONSEQUENCE

• Classical conditioning - a stimulus leads to a response

• Operant conditioning - a response becomes a further stimulus.

A reinforcer is not necessarily a reward nor is a

punisher necessarily painful

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 Four basic types of operant conditioning:
 Positive reinforcement---if a pleasant consequence follows a
response
Ex. reward for co-operation

 Negative reinforcement---withdrawal of an unpleasant

stimulus after a response
Ex. Stopping treatment if crying

 Omission (time out)---removal of a pleasant stimulus after a

particular response
Ex. Taking out of favorite toy

 Punishment ---when an unpleasant stimulus is presented after

a response
Ex. Sending mother out of operatory
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 -1 & 2 are more suitable for dental office -
1. Positive Reinforcers --immediate
Unlearned reinforcers are food, candy toys
Token reinforcer for habit therapy
Activity which the child likes (permission to leave the dental
chair)
Social reinforcer (giving attention, praise, smiling, ) non
verbal communication—during treatment

2. Negative reinforcers
• Halting treatment b’coz of behavioral resistance is likely to
reinforce undesirable behavior

Dec 9, 2021 Child psychology 65

3 & 4 should be used sparingly with some caution
(aversive learning) – Punishers

• -Voice control, HOME, time out are mild forms of

punishments
-Physical restraints

Other approaches
Contingent distraction
Contingent escape

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• Authoritative dentist 
- have clear, consistent rules & being warm & supportive
-child – dentist interaction – eye to eye contact
-clear instructions in firm voice
-reinforce co-op. behavior
-engage parents in establishing rules
-informed consents-to gain trust & confidence

One should ask the child whether he is ready for the treatment,
given choice to select the tooth to be restored

Dec 9, 2021 Child psychology 67

 Social learning theory –
Albert Bandura

• According to him behavior is acquired

through observation and imitation.
Importance of observing and modeling the behaviors
Famous Babo doll experiment

• General principles
- observing behavior of others outcomes of others
- learning occurs without change in behavior
- cognition play a role in learning

Dec 9, 2021 Child psychology 68

Scope and applications-
--to understand aggression and psychological disorders
--Behavior modeling and modifications

Eg. Ads. about tooth paste & brush

-modeling a mode of behavior management

Factors influencing-
role model and characteristics
child’s psychological ability
environmental factors.. secondary

Dec 9, 2021 Child psychology 69

 Observational learning or modeling

• Four processes
1. Attention – one should perceive & attend to significant
features of modeled behavior
2. Retention – coding the information into long term memory
3. Motor reproduction – observer must learn and posses the
physical capabilities of the modeled behavior
4. Motivation or reinforcements – positive reinforcements such
as rewards (consequences)
Types of reinforces
-a model
-third person
-imitated behavior itself
-consequences of model’s behavior

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• Behaviors learnt through modeling
at home
in schools
surroundings

• Parents’ , friends’ prior experiences – have positive or

negative outcome
• Reciprocal implications
- new behaviors
- frequency of previously learned behaviors
- encourage previously forbidden behaviors
- increases frequency of similar behaviors

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 Applications in dentistry
• Make him/her observe other person
showing desired behavior (live or
audiovisual)/ models
• One should explain the procedure to the
child
• Allowed to imitate the desired behavior
• Reinforce the same
• Open areas with several chairs

Children have never been good listeners to

elders, but they never fail to imitate them

Dec 9, 2021 Child psychology 72

 HIERARCHY OF NEEDS

• Abraham Harold Maslow was born April 1, 1908 in Brooklyn,

New York
• He established Hierarchy of needs by observing basic needs of
individuals.
• He believed that violence exists to fulfill the basic needs

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Dec 9, 2021 Child psychology 74
• Physiological Needs - basic needs - air,
water, food, sleep, sex, etc.- When not
satisfied - feel sickness, irritation, pain,
discomfort, These feelings motivate us to
alleviate them as soon as possible to
establish homeostasis. Once they are
alleviated, we may think about other things

• Safety needs – stability & constancy in a

chaotic world. Ex security of home &
family

• Love & belonging needs – we need to be

needed. Loving and caring partners,
children, friends, society

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• If these needs are not fulfilled – deficit needs

• Esteem needs – self esteem– by mastery of tasks

-- respect from others

• The negative version of these needs is low self-

esteem and inferiority complexes. 

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Self actualization
The need for self-actualization is "the
desire to become more and more what one is, to
become everything that one is capable of becoming."

People who have everything can maximize

their potential. They can seek knowledge, peace,
esthetic experiences, self-fulfillment, oneness with
God, etc.

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• They are reality centered, problem centered,
respect self and others accompanied with
strong ethics.
only 2% of people

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 Separation and Individualization
Margaret Mahler

Dec 9, 2021 Child psychology 79

 Normal Autistic Phase - Birth to 1 month
• maintain physiological homeostasis outside the womb
-monadic system.

• The infant is unable to differentiate between himself and the

outside world.

• Emotional needs are largely physical in nature - gratification

of those needs by the mother as occurring as if by magic

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 Normal Symbiotic Phase – 1-5 months

• This phase begins with an increased sensitivity and awareness

to external stimuli on the part of the infant.

• task of this phase is the formation of the mother-infant bond

and outside world – dyadic system

• Specific smiling response to primary caretaker

• Basic trust towards care taker

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 Subphase I: Differentiation – 5-10 months

• Begins with increasing exploration of mother, face in

particular, skin as well.
• Fascinated by inanimate objects that mother is
wearing - jewelry, hair, glasses.
• "checking back" behavior, or "comparative scanning"
• Stranger anxiety
• Emotional wellbeing until mother’s presence

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 Subphase II: Practicing – 10-16 months

• This phase begins when the baby can physically leave the
mother - crawling or climbing & upright locomotion.
• Separation anxiety – engage in action until mother is in sight
• Emotional refueling
• Psychological birth or hatching
• The infant begins to show intense interest in inanimate objects,
examining them with mouth and hands.
• Mother serves as home base for all exploration and
development.

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Subphase III: Rapprochement - 16 to 24 mnths
• begins to appreciate himself as a separate being, mother's
absence is accompanied by a sense of loss of the "ideal sense
of self“
• Social interaction
• Tries to actively engage mother – wooing
• Ambitendency – rejection as well clinging to mother
Subphase IV: Consolidation and Object
Constancy
24-36 months
•The child develops increased comfort with mother's
absence because he knows she will return (object constancy).

Dec 9, 2021 Child psychology 84

 Attachment Theory
John Bowlby
• Attachment
Emotional tone b/w children and their caregivers
Seeking & clinging to care giver
• Phase I (Birth -8-12weeks)
– Discriminate –by olfactory & auditory stimuli
– Any person in vicinity, infant will
• Orient to that person
• Have tracking movements of the eyes
• Grasp & reach
• Smile
• Babble
• Stop crying on hearing voice / seeeing face

Dec 9, 2021 Child psychology 85

• Phase II(8-12wks to 6mnths)
– Continuation of phase I
– Marked relation to mother
• Phase III (6mnths to 2yrs)
– Attachment to mother
– Greeting her on her return
– Using mother as base from which to explore
– Treating strangers with caution, alarm, withdrawal
• Phase IV(24mnths beyond)
– Mother is seen as independent
– Object permanence
– Insight into mothers feelings & motives
– Observes mothers behavior & influences on it
Dec 9, 2021 Child psychology 86
• Infants tend to attach to one person – monotropic
• Usually to stronger, wiser and able to reduce anxiety & stress
• Attachment - security
– Skin to skin, eye contact, voice
Signal indicator
Infant’s signs of distress that elicit a behavioral response in
the mother
– Crying (hunger, anger, pain)
– Smiling
– Cooing
– Looking

Dec 9, 2021 Child psychology 87

Fear stimuli signal indicator

attachment relieve anxiety mothers care

• Mothers proximity ---- security

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Dec 9, 2021 Child psychology 89
• Disorders of attachment
– Psychosocial dwarfism
– Separation anxiety disorder
– Avoidant personality
– Depressive disorder
– Academic problem
– borderline intelligence

Dec 9, 2021 Child psychology 90

 Childrenese
Dr.Haim Ginnot

• Acknowledge the child’s experience

• Children are equal in dignity
• Praise
• Give children choices, offer options
• Children need to be liked
• Acknowledging correctness
• Children need to be liked

Dec 9, 2021 Child psychology 91

 Theory of information processing

Dec 9, 2021 Child psychology 92

 Vygotsky’s socio-cultural theory

Dec 9, 2021 Child psychology 93

 Ecological systems theory

Dec 9, 2021 Child psychology 94

 Environmental factors influencing child

Dec 9, 2021 Child psychology 95

 Environmental factors influencing child

Parents & Home influence

• Mother influence
• Father influence
Educational Institute
• School life
• Child – teacher
Peer group
• Function of peer group
• Function of play

Dec 9, 2021 Child psychology 96

 Mother attitude

– Over protectiveness
• Excessive contact of the parent and child
• Prolongation of dependence
• Not able to built other interest
• Low level of ego strength,low level of frustration
• Lose confidence
• Excessive sensitive to criticism
– Overprotective –overindulgent
• Aggressive, demanding, display temper tantrums
• Obstinate, stubborn, spoilt
• Try to dominate over dentist

Dec 9, 2021 Child psychology 97

 – Under affectionate
• Well behaved, well adjusted
• Shy
– Rejecting mother – physical violence or verbal ridicule
• Impair growth
• Sense of security- loss
• Inc sense of helplessness
• Undermines his self-esteem
• Bed-wetting, feeding diff, nailbitting
• Anti-social behavior - aggression, cruelty, stealing

Dec 9, 2021 Child psychology 98

 – Acceptance
• Resourceful, cooperative, self-reliant
• Well adjusted in social situation
• Sense of responsibility
– Dominating
• Child- honest, polite, shy, self-conscious, submissive
• Feels Inadequate, inferior, inhibited
• Not able to built up- proper peer relationship
– Submissive
• Every wish – fulfilled – boss over
• Disobedient & irresponsible
• Aggressive, antagonist & careless

Dec 9, 2021 Child psychology 99

 Father influence

• Socialization effect of father

– Influence on child’s social growth
– Father determines mother’s attitude towards home
– Constitutes the court of highest appeal
– Interacts – direct & affectionate manner- off
school hours

Dec 9, 2021 Child psychology 100

 Effect of school life

• Attitudes, behavior pattern of cooperation, Initiative,

fair play, social maturity, self-reliance, honesty
• School life : complex combination of diff factors –
good/bad
• School – lab in which he makes many of his
experimental approaches to social living

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 Role of Teacher

• Key role – “social climate”

• attitude, prejudices, personal-social values are
translated into behavior pattern which become potent
influence on child’s behavior
• Teacher – primary source of approval & disapproval
in classroom- “good” / “bad”
• Appreciation – good – self confidence
• Punishment – shame – disappointment

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 Function of peer group

• Young infant – perceives others as disturber of his relationship

with his mother or father
• Other children – lifeless, later – alive playmates- limiting the
partnership to period of time needed to perform a particular
task
• 2 ½ - 3 yrs – share things
– shift from solitary, independent play to parallel activity
– Peer group – develop & practice skills of cooperation & competition,
autonomy, independence & leadership, followership
– Social interaction & social acceptance by peer constitute a very imp
stage in development of child from dependence to autonomy

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 Function of play

• Play – intermediary step in the development of

thought
• Play for child is a process in which different solution
are tried out in controlled action in the world play
before executed in modified form in the world at
large.
• Essential occupation of child
• Pleasure, motivates child – exploration, sense of well
being

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 Emotional development

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 Emotional development

• Emotion is a state of mental excitement characterized by

physiological, behavioral changes and alterations of feelings
• The pleasant-integrative emotions: Psychophysiological states
which tend to to accompany moderate muscular tension and
verbal reports of pleasure eg: joy, elation, affection, delight,
Mild anxiety and apprehension
• The socially disintegrative emotions:
Psychophysiological states which tend to accompany extreme
muscular tension, heightened smooth musculature response,
and verbal reports of displeasure eg: the strong emotions of
fear, extreme anxiety, anger, jealousy

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• Physiological aspects of emotional behavior:
- “emergency patterns” (Cannon)
- The hypothalumus and sympathetic portion of
autonomic nervous system plays a major role
-  pulse rate, BP, Respiration
- Peristalsis and salivation

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- Starts with an undifferentiated
emotion of excitement
- Delight: Relaxation, smiling in
response to satisfying situation
- Distress:in response to disturbing
stimuli marked by muscular
tension, crying, and checked
breathing
- At 6 months distress differentiates
into fear, disgust and anger
- At 12 months delight differentiates
into elation and affection
- At 18 months, jealousy has been
differentiated from distressful
stem and affection has been
further differentiated into positive
responses to adults and children

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 Fear

• A reaction to a known danger(augmenting the fight or flight

response)
- An unpleasant emotion or effect consisting of
psychophysiological changes in response to realistic threat or
danger to one’s own experience
• - Girls have more fears than boys
Reasons:- An inherent timidity in girls
- Girls are encouraged to display fear
- Fear increases from infancy to young childhood

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• Development of fear:
a. At birth:
- primary response, newborn is unaware of the stimulus
- With age he starts becoming aware of fear, can fight or
flight
- Sometimes, the smells and sounds of equipment or even
the appearance of dentist with glasses and mask may be
frightening

Dec 9, 2021 Child psychology 110

b. Preschooler:
- Fear of animals or being left alone or abandoned
- More apprehensive about failures, learns to fear his prestige
c. Early schooler:
- Fear of the dark, staying alone, shows fear of supernatural powers like
ghosts and witches, imaginary objects and situations fear of war, spies,
beggars etc
d. Late schooler:
- Fear of bodily injury
- Fear of failure, not being liked, competition, fear of punishment
- fear of crowds and heights

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• Fear of Dental situation:
- report a history of traumatic dental experience
- unfavorable family attitudes
a.Innate fear (without stimuli or previous experience)
- Depends on the vulnerability of the individual
b.Subjective fear: Fears transmitted to the individual
- Family experiences, peer, information media
c.Objective fear: Fears due to events, objects and specific
conditioning. Previous experience(dental trauma) or
generalization(medical experience)

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• Fear evoking dental stimuli
- Anaesthetic administration locally by injection
- Extraction
- Sound of drill
• Factors causing dental fear
- Fear of pain or its anticipation
- a lack of trust or fear of betrayal
- fear of loss of control
- fear of the unknown
- fear of intrusion

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• Response to fear:
1. Intellectual level: child is ready to accept the situation and
face the difficulties to achieve results and benefits
2. Emotional level: shows the fight or flight response
3. Hedonic level: reflected as self-centeredness , thereby
accepting what is comfortable and rejecting what is not
without too much concern for the outcome

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 Prevention of fear

Environmental control:
- small children should be verbally prepared for the sudden
onset of unusual stimuli
Increasing the child’s adequacy for meeting difficult
adjustment circumstances
- Parental support when the child is embarking on new
endeavors like entrance to school, the first visit to hospital
Freedom of child movement:
- Permitting the child to approach or withdraw from a new
situation

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 Jealousy

• is a fairly usual emotional reaction among children to actual,

supposed, or threatened loss of parental affection
- Loss of affection involved is that of mother
Characteristics:
- Direct attack on brother or sister to a rather complete type of
social withdrawal
- Regress to more infantile level of adjustment in their toilet,
sleep, and dressing routine

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• Factors associated with jealousy:
- New born baby in the family
- Increased amount of maternal attention towards the new born
- Children in large family
• Preventing the development of jealousy:
- Take some time each day to spend exclusively with older
child
- Be consistent in disciplinary action
- Avoid nagging the child with continuous don’t’s
- Avoid making comparisons that are unfavorable to the older
child
- Attempt to settle interparental tensions outside the child’s
presence

Dec 9, 2021 Child psychology 117

 Anxiety

- is an emotion similar to fear but arising without any

objective source of danger
- Is a reaction to unknown danger
- State of unpleasant feeling combined with an associated
feeling of impending doom or danger from within rather
than from without
- Present by the third year of life
- Typically centers around routines, parent-child and child-
child relationships

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- Frequency of anxiety responses increased with age
- Greatest number of anxiety responses were made to
pictures showing child-child relation
- Anxiety during early preschool is constructive , mild form of
anxiety facilitates learning and problem solving
- Anxiety in the form of worries occur in 5th or 6th grade pupils
- Family and school problems , school progress and personal
adequacy

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 Psychological disorders in children

Dec 9, 2021 Child psychology 120

 Psychological disorders in children
DEPRESSION
aged six to 12, however, one in 10 suffer from the illness of depression.
These children cannot escape their feelings of sadness for long periods of
time.
symptoms
• sadness
• hopelessness
• feelings of worthlessness
• excessive guilt
• change in appetite
• loss of interest in activities
• recurring thoughts of death or suicide
• loss of energy
• helplessness
• fatigue
• low self-esteem
• inability to concentrate
• change in sleep patterns

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Some key behaviors-:
• a sudden drop in school performance
• inability to sit still, fidgeting, pacing, wringing hands
• pulling or rubbing the hair, skin, clothing or other objects;
in contrast:
• slowed body movements, monotonous speech or muteness
• outbursts of shouting or complaining or unexplained irritability
• crying
• expression of fear or anxiety
• aggression, refusal to cooperate, antisocial behavior
• use of alcohol or other drugs
• complaints of aching
• arms, legs or stomach, when no cause can be found

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 Attention-Deficit Disorders (ADD)

• has difficulty finishing any activity that requires concentration

at home, school or play; shifts from one activity to another.
• doesn't seem to listen to anything said to him or her.
• acts before thinking, is excessively active and runs or climbs
nearly all the time; often is very restless even during sleep.
• requires close and constant supervision, frequently calls out in
class, and has serious difficulty waiting his of her turn in
games or groups.

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 Anxiety
• Children have fears that adults often don't understand.
• At certain ages children seem to have more fears than
at others. Nearly all children develop fears of the
dark, monsters, witches, or other fantasy images.
• Over time, these normal fears fade. But when they
persist or when they begin to interfere with a child's
normal daily routine, he or she may need the attention
of a mental health professional.

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 Simple Phobias

• overwhelming fears of specific objects such as an

animal, or situations such as being in the dark, for
which there is no logical explanation. These are very
common among young children.
• these fears go away without treatment. However, a
child deserves professional attention if he or she is so
afraid of dogs, for example, that he or she is terror-
stricken when going outside regardless of whether a
dog is nearby.

Dec 9, 2021 Child psychology 125

 Separation Anxiety Disorder
• diagnosed when children develop intense anxiety, even to the point of
panic, as a result of being separated from a parent or other loved one.
appears suddenly in a child who has shown no previous signs of a problem.
• interferes with children's normal activities.
• refuse to leave the house alone, visit or sleep at a friend's house, go to
camp or go on errands.
• At home, they may cling to their parents or "shadow" them by following
closely on their heels.
• Often, they complain of stomachaches, headaches, nausea and vomiting.
• They may have heart palpitations and feel dizzy and faint.
• trouble falling asleep and may try to sleep in their parents' bed. If barred,
they may sleep on the floor outside the parents' bedroom.
• When they are separated from a parent, they become preoccupied with
morbid fears that harm will come to them, or that they will never be
reunited.

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 Conduct Disorder
Children who have demonstrated at least three of the following behaviors over six
months should be evaluated for possible conduct disorder:
• Steals--without confrontation as in forgery, and/or by using physical force as in
muggings, armed robbery, purse-snatching or extortion.
• Consistently lies other than to avoid physical or sexual abuse.
• Deliberately sets fires.
• Is often truant from school or, for older patients, is absent from work.
• Has broken into someone's home, office or car.
• Deliberately destroys the property of others.
• Has been physically cruel to animals and/or to humans.
• Has forced someone into sexual activity with him or her.
• Has used a weapon in more than one fight.
• Often starts fights.

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 Pervasive Developmental Disorder
• intellectual skills; responses to sights, sounds, smells and other senses; and the ability to
understand language or to talk.
• Youngsters may assume strange postures or perform unusual movements. They may have bizarre
patterns of eating, drinking or sleeping.
• AUTISM
-infants, don't cuddle and may even stiffen and resist affection.
-don't look at their caregivers and may react to all adults with the same indifference.
-tenaciously to a specific individual. fail to develop normal relationships with anyone, not even
their parents.
-They may not seek comfort even if they are hurt or ill,
-fail to develop friendships and generally they prefer to play alone.
-cannot communicate
-repetitive body movements such as twisting or flicking their hands, flapping their arms or
banging their heads.
-environment is changed.
-following rigid routines in precise detail.

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 Summary
Infancy 0-1.5yrs -Careful introduction to dental office
Oral phase -Dentist must be confident and experienced
Basic trust vs. basic
mistrust
Early childhood 1.5- -Requires an introductory visit ( fear of unknown )
3yrs -Attained treatment maturity
Anal phase -Able to sit still – for 10-20 min
Autonomy vs. shame -Understands simple instructions and explanations
and doubt for TSD
-Praise the child’s abilities
-Non-verbal communication
-Indicators of discomfort (some control over
situation)
-Parent may remain near

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Late childhood 3-5yrs -Able to Concentrate for 30 min
Phallic stage -Understands instructions and explanations for TSD
Initiative vs. guilt -Praise the child’s abilities & appearance
-Non-verbal communication
-Parent may remain near-
-Indicators of discomfort (some control over situation)

Early school age Realistic view of treatment

5-12yrs Explain the procedure
Latency Reassure
Industry vs. inferiority Indicators of discomfort (some control over situation)

Adolescence Motivation
12-and above Peer influence
Genital stage
Identity vs. role
confusion
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Conclusion
 References
• Fundamentals of pediatric dentistry-III ed. Mathewson RJ
• Contemporary orthodontics – III ed. Proffit WR
• Pediatric dentistry – Barber TK
• Child psychology – Thompson GG
• Pediatric dental medicine – Forrester DJ
• Pediatric dentistry – scientific foundation –Stewart et al
• Pedodontics – a clinical approach – Koch G et al
• Behavior management – Ripa
• Ped dent 1990;12;79p
• Ped dent 1997;19;8p
• Ped dent 1999;21;102p
• DCNA 1995; 39 ;789p, 771p
• Ped dent 1999;21;463p, 470
• Ped dent 1994; 15; 13p
• quintessence int.2001; 135p
• Internet database
Dec 9, 2021 Child psychology 132
Times of India 16th Dec 07