Nina Ian John “G” Rachel Mark Jocelle Edo Gienah Jho Kath Aynz Je Glad Nickie Rico

Teacher Dadang Niňa Arlene Vivs Paul F. Rico F. Ren Mai Revs Mavis Jepay Yana Mayi Serge Hung Tope Ag Bien

S3 Lec 1: Prenatal – Adolescence NNoovveem

mbbeerr 1111,, 22001100

MATERNAL STRESS
PRENATAL PERIOD, INFANCY, AND CHILDHOOD
 Stress – high levels of hormones
Embryo – after the egg has been implanted and begins to divide  High levels of anxiety: babies that are hyperactive, irritable and
of LBW and who have problems with sleeping and feeding
 End of 8 weeks – it is called a fetus
 Fetus maintains an internal equilibrium and interacts GENETIC DISORDERS
continuously with the intrauterine environment
 Genetic counseling can be done on prenatal diagnosis using
 Damage to the fetal stage usually has a more global impact
different diagnostic techniques (e.g. Amniocentesis, X-rays,
than damage after birth because the organs are rapidly
fetoscopy, ultrasound, fetal blood and skin sampling, chorionic
growing and are most vulnerable; boys are more vulnerable
villus sampling and α-fetoprotein screening).
to development than girls.
MATERNAL DRUG USE
FETAL LIFE
Fetal Alcohol Syndrome – disorder seen in infants born from
 Fetuses are involved in a variety of behaviors that are
alcoholic mothers
necessary for adaptation in the womb (thumb-sucking, folds
and unfolds the body etc.) S/Sx:
 Anterior vertex position – position in which fetuses usally exit
the uterus.  Growth retardation of prenatal origin
 Pregnant mothers are usually sensitive about the  Micropthalmia
movements of their babies, they describe it as active or  Short palpebral fissures
passive, kicking vigorously or rolling around  Midface hypoplasia
 Smooth or short philtrum
BEHAVIOR
 Thin upper lip
 16-20 weeks: detection of fetal movements  Microcephaly
 14th week: stimulation of ventral skin surfaces  Hyperactivity
 18th week: fetus can hear and responds to loud noises with  History of delayed development
muscle contractions, movements and increased heart rate  Attention deficits
 20th week: retinal structures begin to function  Learning disabilities
 7 months: eyelids begin to open; smell and taste are also  Intellectual deficits
developed  Seizures
 Reflexes present: Grasp (17 weeks), Moro (25 weeks),
Smoking – produces below average infant BW
Sucking (28 weeks)
Narcotics – withdrawal syndrome
NERVOUS SYSTEM
Crack Cocaine – behavioral abnormalities, irritability and crying, and
 Neural Plate – dorsal ectodermal thickening that appears on
decrease desire for human contact
about 16th day of gestation
 6th week – part of the neural tube becomes the cerebral Teratogens: Antibiotics, anticonvulsants, carbamazepine, phenytoin,
vesicles which will later become the cerebral hemispheres progesterone-estrogens, lithium and warfarin.
 10th week – cerebral cortex begins to develop but layers
appear at 6th month; sensory and motor are developed first Radiation – gross birth defects
before association cortex.
 Human brain: 350g (at birth); 1450 g (adult) – fourfold Infancy – 3500g at birth; 50 cm length
increase mainly in the neocortex
 Full term: 37-40 weeks AOG
 Growth is attributed by the number and branching of  Preterm: <34 weeks; birthweight under 2500g (increased risk for
dendrites establishing new connections learning disabilities such as dyslexia, emotional and behavioural
problems, mental retardation, and child abuse)

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 Post-term: born (42weeks AOG) 2 weeks or more beyond  3-4mos: mimicry stage
expected date of birth (characteristically with long nails, scanty  Two phases of smiling
lanugo hair, more scalp hair, and increased alertness)  2mos: endogenous smile which is unrelated to
external stimulation
 4 mos/16th week: exogenous smiling which is
DEVELOPMENTAL LANDMARKS stimulated from the outside usually by the mother.
 The stages of emotional development parallel those of cognitive
Reflexes and Survival Systems at Birth development
 Caregiver is the major stimulus for both aspects of mental
Reflex at Birth Survival System growth.
 Moods:
 Rooting (2mos)  Breathing  1st year: highly variable -> internal stress (e.g. hunger)
 Grasp (4mos)  Sucking  2nd to 3rd year: external social cues
 Babinski (1 year)  Swallowing  Prolonged separation from mother during 6mos of life can lead
 Knee  Circulatory and temp to depression that might persist into adulthood as part of
 Abdominal individual’s character
 Moro (4mos)
 Tonic neck (4mos) AGE EMOTIONAL CAPACITY AND
EXPRESSION

Birth Pleasure, surprise, disgust,

distressed
 1 day old infants can detect the smell of their mother’s milk
 3 day old can distinguish mother’s voice 6-8 weeks Joy

3-4 months Anger

SLEEP – spends greater part of the day and night sleeping (2/3 of
the day) 8-9 months Sadness, fear

- REM sleep: 60% of the time 12-18 months Tender affection, shame
- Sleep-wake cycle is 3 hours

LANGUAGE AND COGNITIVE DEVELOPMENT TEMPERAMENTAL DIFFERENCES

 8 weeks: cry/vocalize  9 Behavioral Dimensions by Stella Chess and Alexander

 Reflexes: voluntary actions (about 2 years) Thomas
 Begin to interact with environment
 End of 2nd year: symbolic play and language
 0-6mos: stare and listen Activity level Motor component present in a
 7-11mos: attending to language given child’s functioning
 12-18mos: single word stage
Rhythmicity Predictability of such function as
STAGES OF COGNITIVE DEVELOPMENT (JEAN PIAGET) hunger, feeding pattern,
elimination, and sleep-wake
Sensorimotor Birth to 2 years cycle
Preoperational 2 to 7 years Approach or withdrawal Response to a new stimulus
such as food, toy, or person
Concrete operations 7 to 11 years
Adaptability Speed and ease with which a
Formal operations 11 years to adolescence
current behaviour can be
modified in response to altered
environmental structure
EMOTIONAL AND SOCIAL DEVELOPMENT
Intensity of reaction The amount of energy used in
 3weeks: imitate faces of adult caregivers mood expression
 Imitation of behaviour are believed to be precursors of infant’s
emotional life

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Threshold of responsiveness Stimulation intensity required to
evoke a discernable response
to sensory stimuli,
environmental objects, and
social contacts
Quality of mood Pleasant, joyful, friendly
behaviour VS unpleasant,
crying, unfriendly behaviour
Distractability The effectiveness of extraneous
environmental stimuli interfering
with or altering the direction of
ongoing behaviour
 Attachment of the first born is decreased
 Social deprivation and maternal neglect: severe developmental
retardation
 Father attachment: play rather than care
 Stranger anxiety – starts on 26 weeks old (6-7months);
developed in 8months; cries and clings to mother when stranger
approaches
 Stranger anxiety is believed to result from baby’s growing ability
to distinguish caregivers from all other persons.
 Separation anxiety (10-18 months): related to stranger anxiety
but not identical to it; separation from one person that baby is
attached to while stranger anxiety occurs even when the baby is
in the arms of the mother
 Crawling is the way infants learn to separate from their mothers
 Margaret Mauhler: theory of separation-individuation

Attention span and persistence Length of time a particular

activity is pursued (attention
span) and the continuation of an
activity in the face of obstacles
(persistence)
 The ratings of individual children showed considerable stability
over a 25-year follow – up period, but some temperamental
traits do not persist
 This can be attributed to genetic effects on personality; that is
some gene actions were discontinuous.
ATTACHMENT
 Attachment – relationship baby develops with caregivers
 Bonding – intense emotional and psychological relationship a
mother develops for her baby
 Infants (1st month) become attuned to social and interpersonal
interaction, show rapidly increasing responsivity to the external
environment and an ability to form a special relationship with
significant primary caregivers.
 Harry Harlow: social learning and effects of social isolation in
monkeys
 John Bowlby: attachment of infants to mothers and concluded
that early separation of infants from their mothers had severe
negative effects on children’s emotional and intellectual
development.
 Attachment behavior – maintenance of physical contact
between the mother and child when the child is hungry,
frightened or in distress
 Mary Ainsworth: expanded Bowlby’s observation and found that
the interaction between mother and baby during the attachment
period influences the baby’s current and future behaviour
significantly.
 Secured base effect – enables a child to move away from
the attachment figure and explore the environment
 Teddy bear/blanket: transitional object
 Maternal sensitivity and responsiveness: main
determinants of secure attachment
 Male infants are less likely to have secure attachments and
are more vulnerable to changes in maternal sensitivity
INFANT CARE
 Parental fit – describes how well the mother or father relates to
the newborn or developing infant
 Temperament – innate psychophysiological characteristics
 Difficult children – 10% of all kids
 Hyperalert physiological makeup, react intensely to stimuli,
sleep poorly, eat at unpredictable times and difficult to
comfort
 Easy children – 40% of all children
 Regular in eating, eliminating, and sleeping; are flexible;
can adapt to change and new stimuli with a minimum of
distress; and are easily comforted when they cry.
 Rest are in between
 Goodness of fit: to characterize the harmonious and consonant
interaction between a mother and a child in their motivations,
capacities, and style of behavior
 Good-enough mothering
 Winnicott: infants begin life in a state of nonintegration, with
unconnected and diffuse experiences, and that mothers
provide the relationship that enables infants’ incipient
selves to emerge
 Mothers supply a holding environment in which infants are
contained and experienced
 If the mother can resonate with the infant’s need, the baby
can become attuned to its own bodily functions and drives
that are the basis for the gradually evolving sense of self.
TODDLER PERIOD
 Accelerated motor and intellectual development
 Has the ability to walk: gives toddler the control over their
actions
 Speech: children first learn to say “no” than “yes”
 Negativism shows independence but if it persists, oppositional
behaviour connotes a problem.
 Language: vocalizations become distinct and can name few
objects and make needs known in one or two words; can use
short sentences (end of 2nd year and into 3rd year)
 Hearing test: child not making two-word sentences by age 2.
DEVELOPMENTAL LANDMARKS

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LANGUAGE AND COGNITIVE DEVELOPMENT
 Listen to explanations
 Create new behaviours
 Engage in symbolic activities
 Self-regulation and concentration
EMOTIONAL AND SOCIAL DEVELOPMENT
 Social referencing – children look to parents for emotional cues
about how to respond to novel events
 Organized demonstration of love and protest
 Anxiety – disapproval and loss of a loved caregiver
 Show exploratory excitement, assertive pleasure, and pleasure
in discovering and developing new behaviour including teasing
and surprising or fooling parent
SEXUAL DEVELOPMENT
 Sexual differentiation
 Gender identity
o Begins 18 months
o Fixed 24-30 months
 Gender role
o Societal norms and expectations from one sex or another
SPHINCTER CONTROL AND SLEEP
 Toilet training – reflect family’s practices
 Daytime urination control completed – 2 ½ years
 Nighttime urination and bowel control completed – 4 years
 Fear of the dark: managed by nightlight
 Duration: 12 hours per day including 2 hour nap
 Average 2 year old – take 30 mins to fall asleep and needs
reassurance before going to bed
PARENTING A TODDLER
 Infants: needs of the baby::Toddlers: firmness about boundaries
of acceptable behaviour
 Parents should not be authoritarian; children must be allowed to
operate for themselves and to learn from their mistakes
 Children are likely to struggle for the exclusive affection and
attention of their parents – results in sibling rivalry
 When demands for exclusive possession are not resolved
effectively, the result is likely, to be jealous
 Fantasies aroused by struggle lead to fear of retaliation and to
displacement of fear onto external objects
 With an equitable, loving family, a child elaborates a moral
system of ethical rights
 Parents need to balance between punishment and
permissiveness and set realistic limits on toddler’s behaviour
PRE-SCHOOL PERIOD
 Marked physical and emotional growth
 Half of adult height
 20 baby teeth
 Ready to enter school
 Mastered the task of primary socialization: control of bowel and
urine, to dress and feed themselves and control their tears and
temper outbursts
DEVELOPMENTAL LANDMARKS
LANGUAGE AND COGNITIVE DEVELOPMENT
 Use of sentences
 Children begin to think symbolically
 Generally, thinking is egocentric: they cannot put themselves in
the position of another child and are incapable of empathy.
 Thinks intuitively and prelogically and do not understand causal
realtions
EMOTIONAL AND SOCIAL BEHAVIOR
Start of Pre-School period
 Can express complex emotions
 Emotions are still influenced by somatic events (e.g. tiredness,
hunger)
 Capacity for cooperation and sharing is emerging
 Anxiety – loss of a person who was loved and depended on and
to loss of approval and acceptance.
 4 year olds: learning to share and to have concern for others
End of Pre-School Period
 Have relatively stable emotions
 Shame and humiliation are evident
 Capacities for empathy and love are developed but fragile and
easily lost if competitive or jealous strivings intervene.
 Anxiety and fear – related to bodily injury and loss of respect,
love and emerging self-esteem
 3 to 6 year old children: aware of their bodies, of the genitalia
and of differences between the sexes.
 “The Band-Aid Phase” – preoccupation with illness or injury
 Develop a division between what they want and what they are
told to do
 Gradually turn parental values into self-obedience, self-guidance
and self-punishment
 Conscience is established: sets the tone for the moral sense of
right or wrong.
 Sibling Rivalry
 Play
 2 to 3 years: Parallel Play (solitary play alongside another
child with no interaction)
 3 years: Associative Play (playing with the same toys in
pairs or small groups)
 4 years: Cooperative Play (real interactions and taking
turns become possible)
 First drawing: circular line with marks for mouth, nose and
eyes; ears added later; arms and sticklike fingers appear
then legs and the last would be the torso.
 Drawings: representational and formal in early childhood,
make use of perspective in middle childhood and become
abstract and affect laden in adolescence.
 Imaginary Companion
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  Appear in children with above-average intelligence
 Between 3 to 10 years: have imaginary companions
 Friendly, relieve loneliness, and reduce anxiety
 Television
MIDDLE YEARS
 Period between 6 y/o and puberty
 Children enter elementary school
DEVELOPMENTAL LANDMARKS
LANGUAGE AND COGNITIVE DEVELOPMENT
 Expresses complex ideas with relations among several
elements
 Show increased interest in rules and orderliness and an
increased capacity for self-regulation
 Conceptual skills develop and thinking becomes organized and
logical
 Ability to concentrate is well established between 9 to 10 y/o
 By the end of this period, children begin to think in abstract
forms.
 Improved gross motor coordination and muscle strength enable
to write fully and draw artistically
 Changes in thinking and reasoning results from maturational
changes in the brain
 Show increased independence, learning and socialization
 Make new identification with other adults – w/c may influence
them in their goals
 Period of peer interaction – same sex parent, with whom the
child identify as his role model
 Empathy and concern for others begin to emerge early in the
middle years; they have well-developed capacities for love,
compassion, and sharing.
 Latency period in psychosexual exploration until the eruption of
sexual impulses during puberty
 Sex play is common among boys but also among girls
 Chum period – Harry Stack Sullivan said that a “chum” or a
“buddy” is an important phenomenon during the school years;
about 10 y/o, children develop a close same sex relationship
which is necessary for psychological growth; absence of chum
is a harbinger of schizophrenia.
ADOLESCENCE
 Characterized by profound biological, psychological, and social
developmental changes
 Biological onset: signaled by rapid rapid acceleration of skeletal
growth and the beginnings of physical sexual development
 Psychological onset: characterized by acceleration of cognitive
development and consolidation of personality formation
 Period of intensified preparation for the coming role of young
adulthood
 As a stage, adolescence is variable
 Divided in three period:
o Early – 11 to 14 y/o
o Middle – 14 to 17 y/o
o Late – 17 to 20 y/o
 These divisions are arbitrary; growth and development occur
along a continuum that varies from person to person.
 Puberty – physical process of change characterized by the
development of secondary sex characteristics; Adolescence –
psychological process of change.
PUBERTY
 Triggered by maturation of the hypothalamic-pituitary-adrenal
glands axes – secretion of sex hormones
 Primary sex characteristics – maturation of reproductive organs
and external genitalia
 Primary sex characteristics – those directly involved in coitus
and reproduction, the reproduction organs and external genitalia
 Secondary sex characteristics – enlarged breasts and hips in
girls; facial hair and lowered voice in boys
 Table 2.3-1 gives a summary of puberty changes (at the last
page)
 Adolescents are sensitive to the opinions of their peers and
constantly compare themselves with others.
 Any deviation, real or imagined, can lead to feelings of
inferiority, low self-esteem, and loss of confidence. Girls are
more sensitive to early physical manifestation of puberty than
are boys.
 Onset of puberty varies:
o Girls enter 12 to 18 months earlier than boys
o Average: 11 y/o for girls (range 8-13) and 13 y/o for boys
(range 10-14)
o Twins tend to have later onset than nontwins
 Changes in hormones:
o Sex hormones slowly increase throughout the adolescence
o FSH and LH: between 17-18 y/o, above adult values
o Testosterone: between 16-17 y/o, large increase which
then decrease and stabilizes at adult level.
o Testosterone is the responsible for masculinization for boys
and estradiol for the feminization of girls
o Testosterone and estradiol influence CNS functioning
o Low levels of estrogen – associated with depressed mood
o High testosterone levels – associated with aggression and
impulsivity
o Androgens are produced – by the testes and adrenals for
boys; by adrenals only for girls
o Levels usually higher in boys than in girls – effects of the
hormone is more pronounced in boys
PSYCHOSEXUAL DEVELOPMENT
 Sex drive triggered by androgens which are higher levels during
adolescence
 Male sex drive peaks between 17-18 y/o
 Girls tend to view love and sex as related; boys find them
separable
 Intellectualization and asceticism as defense mechanisms used
to deal with sex drives
 Intellectualization is manisfested by involvement in ideas and
books; ascetism is manifested by a retreat into grand ideas and
a renunciation of bodily pleasures.
 Early: sexuality is directed outward – crushes, hero worship,
idealization of movie and music stars
 Middle: masturbation occurs as normal activity for both sexes
but religion may engender strong feelings of guilt; heterosexual
crushes are common
 Homosexual orientation is already determined by this time
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MENARCHE LEVELS OF MORALITY (LAWRENCE KOHLBERG)

 Time is determined by a complex interaction of biological and 1st level Punishment and obedience to
psychosocial factors the parent are determining
 Good nutrition, fewer serious illnesses, and overall good Pre-conventional morality factors
physical health promote earlier menarche
 Mother’s age at menarche loosely correlates with her daughter’s 2nd level Children try to conform to gain
approval and to maintain good
COGNITIVE AND PERSONALITY DEVELOPMENT Morality of conventional role- relationships
conformity
 Major task of adolescence is to achieve a secure sense of self
 Identity diffusion is a failure to develop a cohesive self or self- 3rd level (highest) Children voluntarily comply with
awareness
rules on the basis of a concept of
 Identity crisis is partly resolved by the move from dependence to Morality of self-accepted
independence ethical principles and make
moral principles exceptions to the rules in certain
 Negativism becomes an active, verbal way of expressing anger
 Adolescent turmoil – period of significant psychological circumstances
upheaval, personality disorganization and mood and behavior
changes
 Serious mood and behavior disturbances during adolescence RISK TAKING BEHAVIOR
should be considered potential symptoms of psychopathology
and be investigated.  Risk-taking behaviors include: alcohol, tobacco and other
substance use; promiscuous sexual activity w/c is a risk for
PEER GROUP AIDS; accident-prone behavior such as fast driving, etc.
 The reasons for risk-taking behavior vary and relate to
 School experience accelerates and intensifies separation from counterphobic dynamics, the fear of inadequacy, the need to
the family affirm a sexual identity, and group dynamics such as peer
 Adolescents attempt to establish a personal identity separate pressure.
from their parents but close enough to the family structure to be
included. PREGNANCY

PARENTING  The number of teenagers engaging in sexual intercourse is

 The concept of the generation gap between parents and
children has emerged from persons’ experience being parents
of adolescents.
 The gap represents the differences in experiences and
perceptions of life events
 Parents of adolescents report few major altercations and get
along with their children.
 Adolescents are receptive to parental approval and disapproval,
and most adolescents and their parents can bridge the
generation gap successfully. When they do not, the failure may
arise from mental disorders in children, parents or both.
DEVELOPMENT OF MORALS
 Developing a well-defined sense of morality is a major
accomplishment of late adolescence and adulthood
 Morality – conformity to shared standards, rights, and duties.
 The adolescent stage of development internalizes ethical
principles and the control of conduct
 Preschool: simply follow rules set forth by the parents; middle
years: children accept rules but show an inability to allow for
exceptions; adolescent: young persons recognize rules in terms
of what is good for the society at large
 Lawrence Kohlberg: levels of Morality
increasing.
 Boys generally have more sexual partners than do girls, and
boys are less likely than girls to seek emotional attachments
with their sexual partners.
 Sexual abuse during childhood does not increase teenage
pregnancy rates
 Only one third of sexually active teenagers use contraceptives;
most are uneducated about contraceptive use or are unwilling or
unable to obtain contraceptives.
 The average adolescent mother cannot care for her child, who is
either placed in foster care or raised by the teenager’s already
overburned parents or other relatives
 Teenage girls often use abortion services
 Most teenagers elect to have abortions with their parents’
consent, but laws of mandatory parental consent put two rights
into competition: a girl’s claim to privacy and a parent’s need to
know.
PROSTITUTION
 Teenagers constitute a large portion of all prostitutes; most are
girls but boys are involved too as homosexual prostitutes
 Most teenagers involved in prostitution came from broken
homes or were abused as children. And some were victims of
rape
 They are at a high risk for AIDS and many are infected with HIV

EVOLUTION TO ADULTHOOD

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 End of adolescence begins with choosing an occupation and
developing a sense of intimacy that leads to marriage and
parenthood – which are all tasks of young adulthood

Table 2.3-1 Pubertal Stages

CHARACTERISTICS

STAGE GENITAL DEVELOPMENT IN BOYS PUBIC HAIR DEVELOPMENT GENITAL DEVELOPMENT IN GIRLS

1 Testes, scrotum, and penis are about The vellus over the pubis is not further There is elevation of the papillae only
the same size and shape in early developed than over tha abdominal
childhood wall (i.e. no pubic hair)

2 Scrotum and testes are slightly
enlarged. The skin of the scrotum is
reddened and changed in texture.
There is little or no enlargement of the
penis at this stage.
There is sparse growth of long, Breast bud stage. There is elevation
slightly pigmented, tawny hair, straight of the breasts and papillae as small
or slightly curled, chiefly at the base of mounds. Areolar diameter is enlarged
the penis or along the labia over that of stage 1

3 Penis is slightly enlarged, at first The hair is considerably darker, Breast and areolae are both enlarged
mainly in length. Testes and scrotum coarser, and more curled. It spreads and elevated more than in stage 2 but
are larger than stage 2. sparsely over the pubis with no separation of their contours

4 Penis is further enlarged, with growth
in breadth and development of glans.
Testes and scrotum are larger than in
stage 3; scrotum skin is darker than in
earlier stages
Hair is now adult in type, but the area The areolae and papillae form
covered is still considerably smaller secondary mounds projecting above
than in the adult. There is no spread the contours of the breast
to the medial surface of the thighs

5 Genitalia are adult in size and shape.
The hair is adult in quantity an type, Mature stage. The papillae only
with distribution of the horizontal (or project, with the areolae recessed to
classically feminine) pattern. Spread the general contours of the breasts.
is to the medial surface of the thighs
but not up the linea alba or elsewhere
above the base of the inverse triangle

Brought to you by: Luke Psych-walker :D (RPE-ADE-JG)

“Ang counterpart ni OB-wan kenobi”

Match the following characteristics with their corresponding developmental stage

A. Infancy 1. Chum period

B. Toddler 2. Imaginary Companions
C. Preschool 3. Menarche
D. Middle years 4. Social referencing
E. Adolescence 5. Fencing reflex

Reference: Kaplan and Sadock’s Synopsis of Psychiatry Behavioral Sciences/Clinical Psychiatry 9th ed

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