Childhood Development

Melissa Gendreau MS, LPC

Why “normal” child development when our clientele is complex?

In order to understand the complexities and, at times, extreme presentations that our clientele exhibits, there needs to be the basic understanding of what is “normal”.

Without the understanding of what is “normal”, staff risk having too high of expectations for some clients or “pathologizing” behavior that is actually typical of same-aged “normal” children.

Staff often are asked to be clinician’s eyes and ears, when they are not present, to provide observations of the clients.

Clinicians rely on these observations to help guide diagnoses, treatment planning, therapeutic progress and future recommendations.

Child Development

Development includes cognitive abilities, physical progression, social relatedness skills as well as emotional functioning.

Our population may present with a combination of developmental deficits and abilities.

Once more, it warrants the understanding of normal childhood development to understand how to more effectively work with each child based on where they are functioning.

While the child will benefit from being worked with on their level, staff will likely also have greater understanding and empathy for the child.

The result: Less frustration and distress by all!

Infant to 1 year-old

Clearly we don’t work with this age population, however, this time frame is crucial in the development of who a person may become.

Physical and Cognitive Development: Rolling, sitting, crawling, walking

Curiosity of surroundings and environment

Imitating others

Social and Emotional Development: Attachment: an infant and toddler’s innate understanding that their needs,

physically and emotionally, are going to be met by a caring individual. That attachment is reinforced by the consistent, predictable and loving response of the care taker.

Social awareness: the recognition of familiar people and voices

Social anxiety: “Making strange” or having a preference to being with certain people.

1 year-old to 3 years-old

Physical and Cognitive Development:

Language development from single words to two or three word sentences.

Starting to sort objects by shape and color.

Increased mobility and stability in walking and climbing.

Toilet training

Social Development:

Recognition of peers.

Engage in more parallel play or side by side play

Initial stages of make believe play

Awareness of himself as separate than others.

Growing independence – “I do”

1 year-old to 3 years-old - Continued

Emotional Development:

Varying difficulties with emotion regulation

“Terrible twos”

Tantrums and meltdowns

Difficult to tolerate “No”

Varying abilities to soothe once distressed

Often necessitating external support (ex. mom and dad) to calm down

Initial phases of parents implementing specified parenting strategies and discipline styles

Appropriate Expectations:

Simple, one-step tasks with support - “Mommy and Daddy’s helper”

Examples: putting an empty cup in the sink; helping pick up toys

Preschool age: 3 to 5

Physical development:

Fluid running ability

Alternating feet when going up and down stairs

Jumping and hopping on one foot

Bending over without falling

Toileting without assistance

Dressing and undressing without assistance

Increased fine motor abilities for manipulating pencils

Drawing basic shapes

Drawing stick figures

Using scissors

Preschool age: 3 to 5 - Continued

Cognitive Development:

Differentiating names of colors

Starting to count

Language development – the ability to speak clear enough for strangers to understand.

Speaking in full sentences

Use of future tense

Understanding the concept of time (not the ability to tell time)

Increased story telling and make believe play – imaginary friends

The ability to think about something without the object being present

At times difficulty distinguishing between fantasy and reality.

Comprehension of “same” and “different”

Complete simple puzzles

Follow 3-step directions

Approaches problems from a single point of view

Preschool age: 3 to 5 - Continued

Social Development:

Engaging in reciprocal play with peers

Imitating adults and playmates

Ability to negotiate and take turns

Wants to please friends and be like friends – show affection for playmates

Understands “mine” and “his/hers”

More likely to agree to rules “be good”

Themed play

Good vs. Bad

Heroes vs. Villains

Want to rescue or be rescued

More curious and confident talking with adults

Preschool age: 3 to 5 - Continued

Emotional Development: Can get easily overwhelmed by too many choices or decisions

Appropriate to provide limited choices to foster independence

“Do you want this or this?”

Awareness of sexuality and differing body parts

Self-touch and need for discussions about boundaries and privacy

May start to ask “Where do babies come from?”

Recognition of other’s emotions

May not understand why the emotion is happening

Ability to show sympathy and concern for someone hurt or sad

General desire to make people happy

Development of fears and anxiety

Examples: the dark, monsters, getting hurt, being left behind

Preschool age: 3 to 5 - Continued

Appropriate Expectations:

Cognitively able to follow 3-step directions with support and redirection

Example: Clean your room – pick up toys, put dirty clothes in hamper, attempt to straighten the bed.

It is important that parent’s don’t expect perfection.

All of the toys may not get cleaned up!

The bed is not going to look “nice”!

Modeling expected behaviors is still important and necessary for this age range.

Elementary School Age – 6-10

Cognitive Development:

Progression of reading, writing, spelling, and math

Increased comprehension of the concept of time and ability to tell time

More linear and connected conversation and stories

Ability to follow more complex directions

Ability to utilize multiple classifications even with unlikely objects

Example: same color, number, animals, toys

Some reversibility- 3+4=7 and 7-4=3

Concrete problem solving

Perceptions dominate judgment

Elementary School Age – 6-10 - Continued

Social Development:

Interest in making friendships

Often more same-sex relationships

Generalization of gender roles

Girls are pretty, wear dresses and play with dolls

Boys are strong, are protectors and play with guns and trucks

Still more focus on family

Idealized view parents

“My dad’s the strongest” and “My mom’s the prettiest”

Elementary School Age – 6-10 - Continued

Emotional Development:

Development of morals and values internalized from family

Examples: Manners, thankfulness, responsibility, honesty, kindness, faith

Emotion recognition

Understanding and recognizing a greater number of emotions

Comprehending when and why a person would experience various emotions

Emotion regulation

“Calm before the storm”

Generally pretty emotionally stable

Elementary School Age – 6-10 - Continued

Appropriate Expectations:

Cognitively, a child in this age range is able to comprehend more complex directions.

They may emotionally overwhelmed with completing longer tasks.

Breaking the task into sections maybe beneficial

Once modelled, the child should be able to complete tasks and chores asked of them with greater efficiency.

Parents still should not expect perfection!

Middle School Age – 11 to 14Early Adolescence

Cognitive Development: Initial development of abstract thought and formal logic

Algebraic manipulation: a+b=c

“If – then” statements

Still predominately concrete in overall views

Good vs bad; right vs wrong; awesome vs awful

Perceptions still dominate judgment

More present oriented “in the moment”

Unrealistic future goals

NBA star, rock star, astronaut

Beginning development and experimentation of special skills

Sports, music, art

Middle School Age – 11 to 14Early Adolescence - Continued Social Development:

Expanding social interactions and relationships

Same sex friends and opposite sex friends

Developing relationships with adults outside the family

Favorite teachers, coaches, mentors

Developing love interests and crushes

Focus of interest on teen idols and desirable people

“Puppy love”

Desire to be more independent from parents

Pushing limits with rules and expectations

Increased conflict with parents over daily situations

Less overt affection with parents

Conflict with parents yet home still primary place of safety

Middle School Age – 11 to 14Early Adolescence - Continued Emotional Development:

Puberty and body changes

Increased desire for privacy

Modesty and embarrassment of body changes

Increased body dissatisfaction

Boys desire to be taller, stronger, fitter

Girls desire to be thinner, too much development vs not enough development

Increased emotional reactivity

“Adolescent Angst”

Viewed as moodiness, sensitivity and touchy

Vacillation between periods of maturity and immaturity

Emotional distress expressed through more behavioral outbursts

Middle School Age – 11 to 14Early Adolescence - Continued

Appropriate Expectations:

Cognitively, this age range is more capable of managing multi-step tasks.

Parents may still need to model the expected outcome to increase agreed understanding of “clean”.

Parents still should not expect perfection!

High School 14 to 18Mid-Adolescence

Cognitive Development:

Greater abstract reasoning skills and problem solving

Ability to develop multiple hypotheses and various outcomes

Capable of more goal-oriented tasks

More capable of delaying gratification

Grasp that the perception of others maybe different than their own “Theory of Mind”.

More focused and understood talents

Sports, music, academics,

Capable of greater responsibility

Ex. First job, drivers license

More realistic thoughts about the future and career planning but not solidified

High School 14 to 18Mid-Adolescence - Continued Social Development:

Greater interest in moral reasoning and the meaning of life

Questioning of parents judgment pertaining to life and world views

Examples: lifestyle choices, finances, religion, politics

Belief that parents are not at “wise” as once believed

Increased focus on peers

Continued need for peer approval

Development of intimate relationships

Focus on sexuality and being physically attractive to others

Questioning and experimenting with sexuality and sexual orientation

View of self and peers as invincible

Increased potential for risky behaviors – drugs and sex

High School 14 to 18Mid-Adolescence - Continued

Emotional Development:

Greater emotional control through verbalization.

Less emotional acting out due to impulsivity.

Greater insight pertaining to the connection of emotions, thoughts and then behaviors.

Appropriate Expectation:

Greater ability to complete complex and detail oriented tasks

Parents STILL shouldn’t expect perfection!

“Normal” is still varied and on a continuum

Even “normal” children develop at varied rates

While it is important to understand and learn the basic time line of “normal” development, it is also important to keep in mind the time lines are generalized.

A child may not be “on time” in a certain developmental area and still be viewed as “normal”.

In the end, all children are different and do not develop in a bubble. A child’s environment and exposure can have just as much of an effect on them as their biological predisposition.

In regards to our clientele, if there is a presentation that seems “off” in regards to their chronological age, talk to their case manager and therapist to ensure everyone is on the same page.