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Is A Little Learning Such A Dangerous Thing?

Is A Little Learning Such A Dangerous Thing?. Sharing A Vision Conference Springfield, IL 1 October 2003. The University of Chicago. Bennett L. Leventhal, M.D. Irving B. Harris Professor of Child and Adolescent Psychiatry Professor of Psychiatry and Pediatrics

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Is A Little Learning Such A Dangerous Thing?

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  1. Is A Little LearningSuch ADangerous Thing? Sharing A Vision Conference Springfield, IL 1 October 2003

  2. The University of Chicago Bennett L. Leventhal, M.D. Irving B. Harris Professor of Child and Adolescent Psychiatry Professor of Psychiatry and Pediatrics Director, Child and Adolescent Psychiatry Director, The Sonia Shankman Orthogenic School Laboratory of Developmental Neurosciences

  3. Is A Little LearningSuch ADangerous Thing?

  4. A little of what is being learned? A little who is learning?

  5. What is the basic goal of early learning? To enhance developmental outcomes

  6. Nature and Nurture • Interdependent concepts (examples) • Nonhuman primate studies • Effects of abuse on human infants • effect of nurture on nature • Effects of autistic disorder on maternal-infant interaction • effect of nature on nurture • Additive or Synergistic when genetic parents raise child

  7. Basic Premise All considerations of all events in childhood (or in adulthood, for that matter), be they physiologic, psychological or experiential must take place in a developmental context

  8. Why Consider Development?

  9. What is Development? Longitudinal? Cross-Sectional?

  10. Development is a Process Individual and groups of characteristics and variables acting individually and together.

  11. Phases/Stages • Characterized by most prominent signs of rapid development within a given developmental line during a given time • Length of phase determined more by completion of a related set of changes within a developmental line than by number of months or years • Should not be generally assumed that developmental tasks which are not most prominent are not developing or being used

  12. Critical period • Development of a function takes place during a restricted time period relative to gestation • If appropriate stimulation is not present at that time, development will be affected • Example - Hubel and Wiesel - monocular deprivation of kittens during critical period of visual system development (environmental input and NMDA receptor dependent)

  13. Sensitive period • Times during which loss of appropriate environmental stimulation may have adverse consequences, but which may be overridden by stimulation outside of a narrow window • Example - abused or neglected children, who develop relatively normally after rehabilitation of parents' substance abuse, or after placement in a nurturing, structured adoptive home

  14. Normality (necessary concept) • There is no normal race, gender, or sexual preference • Normality must be defined in the context of each person's personal and cultural context • For example, in Physical Diagnosis you won't be diagnosing your male patients as avaginal • Concept around which one should constantly refine one's clinical judgment as a physician

  15. Examples of normal as average not being healthy Although most children in Israel or the Palestinian territories may have experienced violence, it does not make it a healthy experience

  16. Is Successful Development NATURAL? or LEARNED?

  17. What is Successful Development? The optimal use of individual and environmental factors to reach the highest possible level of adaptive functioning

  18. Individual Characteristics • Genetics • Appearance • Size • Attractive/Dysmorphic • Intelligence • Social Skills • Personality • Temperament

  19. Developmental Lines

  20. Development - Longitudinal • Developmental Lines • Physical/Gross & Fine Motor • Cognitive • Language • Psychosexual • Interpersonal/psychosocial • Affective • Moral • Spiritual

  21. Longitudinal Models • Social • Freud • Mahler – Separation-Individuation • Erikson - Psychosocial • Piaget - Cognitive • Language • Motor • Kohut – Object Relations • Kohlberg – Moral • Others

  22. Social Stages of Development • 0-12 months - Infancy • 12 –36 months - Toddler • 36 – 60 months - Preschool • 7 – 12 years - School Age • 12 – 18 years - Adolescence • 18 – ?25 years Young Adulthood • 25 – ?65 years - Adulthood • 65 years + - Older Adulthood

  23. Language • 6 months – Coos, smiles, reaches • 12 months - First words • 18 months - Increasing words • 24 months – 2-3 word sentences • 36 months - 3 word phrases • 8 years - Knows person, place, time

  24. Gross Motor Roll over at 4 mo. • 4 months – roll over • 6 months - Sit unassisted • 12-15 months - Walk unassisted • 30 months - run • 36 months - Stairs one step/foot, Ride tricycle • 6-7 years - Ride bicycle

  25. Fine Motor • 4 weeks – hands fisted • 6 months - Grasps cube • 18 months - Tower of 3 cubes • 3 years - Draws circle • 4 years - Draws square

  26. Development - Cross-sectional • Observation of human development at a given time • Domains are interdependent • Quality of integration of domains is important • The "whole" child or adult is subject of study • Pro and con: See forest well, but trees not as clear

  27. Cross-Sectional Development

  28. Prenatal Development • Almost all neurons “born” before 11 weeks gestation • Almost all cell migration complete by 16 weeks gestation • Drug exposures, most commonly alcohol and nicotine lead to later behavioral problems (dose-related)

  29. Prenatal Development • Nutrition important during prenatal development • Full-term or near-full term developmental failure is mostly due to hypoxia and related to CNS bleeding when birth excessively premature • However, outcomes progressively improving with advances in neonatal care

  30. Post-natal Development • When does it really begin? • At delivery? • In utero, near delivery?

  31. Post-natal Development • Physiological homeostasis is main goal • Key first step is feeding, which requires adequate muscle tone for sucking

  32. Post-natal Development • First 2 months social life largely bilateral • Parental functioning is important • Goodness of fit • Support systems • Time after birth is a sensitive period for developing attachment between caregivers and the infant

  33. Post-natal Development • Bonding vs Attachment • Bonding • Lorenz • like imprinting • a critical period • Attachment • Bilateral • Complex behavioral interaction • Begins at birth

  34. 2-4 months • 2 month social smile is very overdue for first-time parents up all night with frequently crying infants • Parents begin to more reliably read subtle cues and patterns of child (e.g. communication of hunger vs. needing a diaper change • 4 months - rolling over increases the risk for falls • Interest in objects in environment • Color • movement

  35. 4-6 Months • Rolling over at 4 months to sitting up unassisted at 6 months • Child develops more three dimensional view of their world but mobility limited • By 6 months, children are relatively social without much fear of strangers

  36. 6-9 Months • Emergence of normative separation anxiety and stranger wariness • Children become more mobile although not usually walking • Creeping • Crawling • Pulling up and standing • For most children sleep and eating schedules are relatively organized

  37. 9-12 Months • Exciting time with development of single words starting with ‘dada’ (then ‘mama’) and with many other single words by 12 months • Development of walking from assisted to unassisted typically by 12 months • Increasing need for child-proofing (although this should occur prenatally)

  38. 12-18 Months • Generally a time in which child is “in love with the world” enjoying new mobility and its freedom • Object permanence by 12 months • Joint attention by 12 months (will follow a point by a parent to attend to something other than the parent and child, just because of interest to the parent)

  39. 18-36 Month-olds • 18-36 months - anal period (psychosexual), autonomy vs. shame and doubt (psychosocial), separation-individuation • reorganization of nervous system (pruning in primary sensory cortex)

  40. 18-36 Months • “Terrible two’s” • Parental response important • Child struggles to be soothed by parent without feeling smothered • Voracious appetite for learning and trying new things • Language • 2-3 word phrases ->short sentences

  41. 18-36 Months • Ambivalent struggle over autonomy, because child still needs parent • Parent has to set limits where necessary (esp. safety issues) • Parent has to help child find a way out of unsolvable conflicts (provide child with easy-to-understand choices) • Parent has to be secure enough not to have to try to win the power struggles

  42. 36-48 Months • Emergence of focus on more complex relationships and enjoyment of developing skills without focusing on autonomy • Begin to directly play with other children but play is often parallel • Language plays a role in play • Can speak in full thoughts – sentences • Many, but not all children enter nursery school • Independence associated with bowel control – end of traditional anal period

  43. Four year-olds • Has mastered toileting, although accidents not uncommon, especially through the night • Rapid increase in social interest and competence • Nursery school (common, but not compulsory) • Conflicts over autonomy are not most prominent conflict, but persist as a concern • Fundamentals of spoken language mastered – can tell a story and share feelings – but still concrete

  44. Four year-olds • Conflicts over autonomy are not most prominent conflict, but persist as a concern

  45. Four year-olds • Identify self by gender • Gender roles become stereotypic • Internal forces • child feels how they behave is who they are • insecurity leads to conformity • External forces

  46. Four year-old • Learning basic rules of right and wrong • Mastery of aggressive impulses often more difficult for boys than girls • ? due to less well developed social competence in boys (can’t separate out nature from nurture here) vs. preference for aggressive behavior

  47. Four year-old • Triadic relationships are emergent domain • (present before, but diadic relationships often dominate scene earlier) • Competition more prominent • Often competition with same sex parent and less conflictual relationships with opposite sex parent

  48. Five year-old • Kindergarten • Pre-academic skills • early reading • writing currently enhanced by “inventive spelling” - idea is to encourage expression without constraint of spelling rules and details for which child not ready • early reading, mostly by sight identification

  49. Five-year old - Academic • early math skills - especially geometric and functional • Counting and alphabet usually solid • Early adding, but subtraction not typical

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