TIS                         

Therapists tend to be most interested in the gross and fine motor development issues in the infant and child. However, development also occurs along the cognitive, psychosocial and emotional realm as well. This chapter gives a brief summary of these areas in order for therapist to maintain a holistic view of the child client.

PSYCHOSOCIAL AND EMOTIONAL DEVELOPMENT

Movement capability may be a therapeutic priority, but other interdependent attributes also influence the child’s performance.

1. Temperament - biologically based and consistent over time. Includes the child’s motor activity level, daily rhythm, moods, adaptability, social interaction, and environmental responsivity.
2. Attachment - parent-child attachment is the basis for overall societal cohesion. The child’s attachment status influences how the child deals with the environment.
   • Severely attached - use the mother’s position as a home base
   • Anxious-avoidant - have minimal contact with the mother in exploration
   • Anxious-resistant - are passive and show great reluctance to separate from the mother (Often seen in premature infants/children, low Apgar scored infants, motorally immature children, and chronically ill children)
3. Motivation
   • Contemporary view - child is an active seeker of stimulation, motivated to explore and gain environmental mastery
   • Basis for goal-oriented behavior
   • Nurtured by responses to infant’s earliest attempt to interact with the environment.
   • Child’s self-perception of limited influence on environmental outcomes may be basis for lack of motivation
4. Cognition - Not equivalent to performance on IQ tests; it is the basis for the child’s problem-solving abilities in multiple domains. Highly dependent on other aspects of development such as temperament and motivation.

DEVELOPMENTAL PERSPECTIVES

1. Affective development - T. Berry Brazelton
   • Boston pediatrician who transformed infant assessment from stimulus-response maneuvers to a consideration of infant abilities.
   • Documented that neonates are socially interactive individuals who demonstrate their competencies when each stage is considered.
2. Cognitive development - Jean Piaget
   • Systematically recorded observations of children’s cognitive behavior; his finding have been replicated world-wide.
   • Organized cognitive development into a sequence of ordinal stages from the infant’s need to directly interact with the environment (sensori-motor stage) to individuals ability to manipulate abstract concepts in the absence of direct experience (formal operational stage).
   • Viewed child as acting on the environment and inferred cognition from motor behaviors observed in younger nonverbal children
   • Basic premise is that children’s mental representations of the world become more sophisticated in proportion to their widening radius of experience
3. Child development in the context of family - Anna Freud
   • Influenced by father, Sigmund, who explored relationship of early childhood to subsequent development of psychopathology
   • Main contribution is influence of family dynamic on child development and critical need to view child in the contest of family
Child develop in the context of society - Erik Erikson
• Expanded on Anna Freud’s emphasis on family interaction to human development in the context of cultural influences on the individual
• Developed an ordinal sequence of psychosocial growth based on progression through specific critical junctions, outcomes of which influenced subsequent behavioral responses
• Applied concept of epigenetic development - individual’s personality forms as ego progresses through developmental stages

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