MODULE 6.

STAGES OF DEVELOPMENT 1, INFANCY

Module Objectives:

1. Summarize overall physical growth during infancy.

2. Explain infant sleep.
3. Identify newborn reflexes.
4. Compare gross and fine motor skills
5. Contrast development of the senses in newborns
6. Identify styles of temperament and explore goodness-of-fit.
7. Describe infant emotions, self-awareness, stranger wariness, and separation anxiety
8. Describe the early theories of attachment.
9. Contrast styles of attachment according to the Strange Situation Technique
10. Explain the factors that influence attachment

TAlK BaCk
Reflective exercise:

LESSON 1. INFANCY

The Brain in the First Two Years

Some of the most dramatic physical change that occurs during this period is in the brain. We
are born with most of the brain cells that we will ever have; that is, about 85 billion neurons
whose function is to store and transmit information. While most of the brain’s neurons are
present at birth, they are not fully mature. During the next several years dendrites, or
branching extensions that collect information from other neurons, will undergo a period of
exuberance. Because of this proliferation of dendrites, by age two a single neuron might have
thousands of dendrites. Synaptogenesis, or the formation of connections between neurons,
continues from the prenatal period forming thousands of new connections during infancy and
toddlerhood. This period of rapid neural growth is referred to as synaptic blooming.

The blooming period of neural growth is then followed by a period of synaptic pruning, where
neural connections are reduced thereby making those that are used much stronger. It is
thought that pruning causes the brain to function more efficiently, allowing for mastery of
more complex skills. Experience will shape which of these connections are maintained and
which of these are lost. Ultimately, about 40 percent of these connections will be lost.
Blooming occurs during the first few years of life, and pruning continues through childhood
and into adolescence in various areas of the brain.

Infant Sleep

A newborn typically sleeps approximately 16.5 hours

per 24-hour period. This is usually polyphasic sleep in
that the infant is accumulating the 16.5 hours over
several sleep periods throughout the day. The infant is
averaging 15 hours per 24-hour period by one month,
and 14 hours by 6 months. By the time children turn
two, they are averaging closer to 10 hours per 24 hours.
Additionally, the average newborn will spend close to
50% of the sleep time in the Rapid Eye Movement (REM)
phase, which decreases to 25% to 30% in childhood.

Sudden Unexpected Infant Deaths (SUID):

Each year in the United States, there are about 3,500 Sudden Unexpected Infant Deaths (SUID).
These deaths occur among infants less than one-year-old and have no immediately obvious
cause (CDC, 2019). The three commonly reported types of SUID are:

Sudden Infant Death Syndrome (SIDS): SIDS is identified when the death of a healthy infant
occurs suddenly and unexpectedly, and medical and forensic investigation findings (including
an autopsy) are inconclusive. SIDS is the leading cause of death in infants 1 to 12 months old,
and approximately 1,400 infants died of SIDS in 2017 (CDC, 2019). Because SIDS is diagnosed
when no other cause of death can be determined, possible causes of SIDS are regularly
researched. One leading hypothesis suggests that infants who die from SIDS have
abnormalities in the area of the brainstem responsible for regulating breathing.

Unknown Cause: The sudden death of an infant less than one year of age that cannot be
explained because a thorough investigation was not conducted, and cause of death could not
be determined. In 2017, 1300 infants died from unknown causes (CDC, 2019). •

Accidental Suffocation and Strangulation in Bed: Reasons for accidental suffocation include:
Suffocation by soft bedding, another person rolling on top of or against the infant while
sleeping, an infant being wedged between two objects such as a mattress and wall, and
strangulation such as when an infant’s head and neck become caught between crib railings.

From Reflexes to Voluntary Movements

Newborns are equipped with a number of reflexes

which are involuntary movements in response to
stimulation. Some of the more common reflexes,
such as the sucking reflex and rooting reflex, are
important to feeding. The grasping and stepping
reflexes are eventually replaced by more voluntary
behaviors. Within the first few months of life these
reflexes disappear, while other reflexes, such as the
eye-blink, swallowing, sneezing, gagging, and
withdrawal reflex stay with us as they continue to
serve important functions. Reflexes offer
pediatricians insight into the maturation and health of
the nervous system.

Reflexes that persist longer than they should can impede normal development (Berne, 2006).
In preterm infants and those with neurological impairments, some of these reflexes may be
absent at birth. Once present, they may persist longer than in a neurologically healthy infant.

Motor Development

Motor development occurs in an orderly sequence as infants move from reflexive reactions
(e.g., sucking and rooting) to more advanced motor functioning. During the prenatal section,
development occurs according to the Cephalocaudal (from head to tail) and Proximodistal
(from the midline outward) principles. For instance, babies first learn to hold their heads up,
then to sit with assistance, then to sit unassisted, followed later by crawling, pulling up,
cruising or walking while holding on to something, and then unassisted walking.

As motor skills develop, there are certain developmental milestones that young children
should achieve. For each milestone there is an average age, as well as a range of ages in
which the milestone should be reached. An example of a developmental milestone is a baby
holding up its head. Babies on average are able to hold up their head at 6 weeks old, and 90%
of babies achieve this between 3 weeks and 4 months old. On average, most babies sit alone at
7 months old. Sitting involves both coordination and muscle strength, and 90% of babies
achieve this milestone between 5 and 9 months old. If the child is displaying delays on several
milestones, that is reason for concern, and the parent or caregiver should discuss this with the
child’s pediatrician. Developmental delays can be identified and addressed through early
intervention.

Motor Skills refer to our ability to move our bodies and manipulate objects. Fine motor skills
focus on the muscles in our fingers, toes, and eyes, and enable coordination of small actions
(e.g., grasping a toy, writing with a pencil, and using a spoon). Newborns cannot grasp objects
voluntarily but do wave their arms toward objects of interest.

At about 4 months of age, the infant is able to reach for an object, first with both arms and
within a few weeks, with only one arm. At this age grasping an object involves the use of the
fingers and palm, but no thumbs. This is known as the Palmer Grasp. The use of the thumb
comes at about 9 months of age when the infant is able to grasp an object using the forefinger
and thumb. Now the infant uses a Pincer Grasp, and this ability greatly enhances the ability to
control and manipulate an object and infants take great delight in this newfound ability.

Gross motor skills focus on large muscle groups that control our head, torso, arms and legs
and involve larger movements (e.g., balancing, running, and jumping). These skills begin to
develop first. Examples include moving to bring the chin up when lying on the stomach, moving
the chest up, and rocking back and forth on hands and knees. But it also includes exploring an
object with one’s feet as many babies do as early as 8 weeks of age if seated in a carrier or
other device that frees the hips. This may be easier than reaching for an object with the hands,
which requires much more practice. Sometimes an infant will try to move toward an object
while crawling and surprisingly move backward because of the greater amount of strength in
the arms than in the legs.

Sensory Capacities

The womb is a dark environment void of visual stimulation. Consequently, vision is one of the
most poorly developed senses at birth, and time is needed to build those neural pathways
between the eyes and the brain. Newborns typically cannot see further than 8 to 10 inches
away from their faces. An 8-week old’s vision is 20/300. This means an object 20 feet away
from an infant has the same clarity as an object 300 feet away from an adult with normal
vision. By 3-months visual acuity has sharpened to 20/200, which would allow them the see
the letter E at the top of a standard eye chart. As a result, the world looks blurry to young
infants.

Hearing: The infant’s sense of hearing is very keen at birth, and the ability to hear is evidenced
as soon as the seventh month of prenatal development. Newborns prefer their mother’s voices
over another female when speaking the same material. Additionally, they will register in utero
specific information heard from their mother’s voice.

Touch and Pain: Immediately after birth, a newborn is sensitive to touch and temperature, and
is also highly sensitive to pain, responding with crying and cardiovascular responses.
Taste and Smell: Studies of taste and smell demonstrate that babies respond with different
facial expressions, suggesting that certain preferences are innate. Newborns can distinguish
between sour, bitter, sweet, and salty flavors and show a preference for sweet flavors.
Newborns also prefer the smell of their mothers. An infant only 6 days old is significantly more
likely to turn toward its own mother’s breast pad than to the breast pad of another baby’s
mother and within hours of birth an infant also shows a preference for the face of its own
mother

Piaget and the Sensorimotor Stage

Schema, Assimilation and Accommodation: Piaget believed

that we are continuously trying to maintain cognitive
equilibrium, or a balance, in what we see and what we know
(Piaget, 1954). Children have much more of a challenge in
maintaining this balance because they are constantly being
confronted with new situations, new words, new objects, etc.
All this new information needs to be organized, and a
framework for organizing information is referred to as a
schema. Children develop schemata through the processes of
assimilation and accommodation

When faced with something new, a child may demonstrate

assimilation, which is fitting the new information into an
existing schema, such as calling all animals with four legs
"doggies" because he or she knows the word doggie. Instead
of assimilating the information, the child may demonstrate accommodation, which is expanding
the framework of knowledge to accommodate the new situation and thus learning a new word
to more accurately name the animal. For example, recognizing that a horse is different than a
zebra means the child has accommodated, and now the child has both a zebra schema and a
horse schema. Even as adults we continue to try and "make sense" of new situations by
determining whether they fit into our old way of thinking (assimilation) or whether we need to
modify our thoughts (accommodation). According to the Piagetian perspective, infants learn
about the world primarily through their senses and motor abilities. These basic motor and
sensory abilities provide the foundation for the cognitive skills that will emerge during the
subsequent stages of cognitive development.

Six Substages of the Sensorimotor Stage

Substage 1: Reflexes. Newborns learn about their world through the use of their reflexes, such
as when sucking, reaching, and grasping. Eventually the use of these reflexes becomes more
deliberate and purposeful.

Substage 2: Primary Circular Reactions. During these next 3 months, the infant begins to
actively involve his or her own body in some form of repeated activity. An infant may
accidentally engage in a behavior and find it interesting such as making a vocalization. This
interest motivates trying to do it again and helps the infant learn a new behavior that originally
occurred by chance. The behavior is identified as circular because of the repetition, and as
primary because it centers on the infant's own body.

Substage 3: Secondary Circular Reactions. The infant begins to interact with objects in the
environment. At first the infant interacts with objects (e.g., a crib mobile) accidentally, but then
these contacts with the objects are deliberate and become a repeated activity. The infant
becomes more and more actively engaged in the outside world and takes delight in being able
to make things happen. Repeated motion brings particular interest as, for example, the infant
is able to bang two lids together from the cupboard when seated on the kitchen floor.

Substage 4: Coordination of Secondary Circular Reactions. The infant combines these basic
reflexes and simple behaviors and uses planning and coordination to achieve a specific goal.
Now the infant can engage in behaviors that others perform and anticipate upcoming events.
Perhaps because of continued maturation of the prefrontal cortex, the infant become capable
of having a thought and carrying out a planned, goal-directed activity. For example, an infant
sees a toy car under the kitchen table and then crawls, reaches, and grabs the toy. The infant
is coordinating both internal and external activities to achieve a planned goal.

Substage 5: Tertiary Circular Reactions. The toddler is considered a “little scientist” and begins
exploring the world in a trial-and-error manner, using both motor skills and planning abilities.
For example, the child might throw her ball down the stairs to see what happens. The toddler’s
active engagement in experimentation helps them learn about their world.

Substage 6: Beginning of Representational Thought. The sensorimotor period ends with the
appearance of symbolic or representational thought. The toddler now has a basic
understanding that objects can be used as symbols. Additionally, the child is able to solve
problems using mental strategies, to remember something heard days before and repeat it,
and to engage in pretend play. This initial movement from a “hands-on” approach to knowing
about the world to the more mental world of substage six marks the transition to
preoperational thought.

Development of Object Permanence

A critical milestone during the sensorimotor period is the development of object permanence.
Object permanence is the understanding that even if something is out of sight, it still exists.
According to Piaget, young infants do not remember an object after it has been removed from
sight.

Piaget studied infants’ reactions when a toy was first shown to them and then hidden under a
blanket. Infants who had already developed object permanence would reach for the hidden toy,
indicating that they knew it still existed, whereas infants who had not developed object
permanence would appear confused. Piaget emphasizes this construct because it was an
objective way for children to demonstrate that they can mentally represent their world.

Children have typically acquired this milestone by 8 months. Once toddlers have mastered
object permanence, they enjoy games like hide and seek, and they realize that when someone
leaves the room they will come back. Toddlers also point to pictures in books and look in
appropriate places when you ask them to find objects. In Piaget’s view, around the same time
children develop object permanence, they also begin to exhibit stranger anxiety, which is a
fear of unfamiliar people. Babies may demonstrate this by crying and turning away from a
stranger, by clinging to a caregiver, or by attempting to reach their arms toward familiar faces,
such as parents. Stranger anxiety results when a child is unable to assimilate the stranger
into an existing schema; therefore, she cannot predict what her experience with that stranger
will be like, which results in a fear response.

Language

Our vast intelligence also allows us to have

language, a system of communication that uses
symbols in a regular way to create meaning.
Language gives us the ability to communicate our
intelligence to others by talking, reading, and
writing. Although other species have at least some
ability to communicate, none of them have
language.

Components of Language

Phoneme: A phoneme is the smallest unit of sound that makes a meaningful difference in a
language. The word “bit” has three phonemes. In spoken languages, phonemes are produced
by the positions and movements of the vocal tract, including our lips, teeth, tongue, vocal
cords, and throat, whereas in sign languages phonemes are defined by the shapes and
movement of the hands.

Morpheme: Whereas phonemes are the smallest units of sound in language, a morpheme is a
string of one or more phonemes that makes up the smallest units of meaning in a language.
Some morphemes are prefixes and suffixes used to modify other words. For example, the
syllable “re-” as in “rewrite” or “repay” means “to do again,” and the suffix “-est” as in
“happiest” or “coolest” means “to the maximum.”

Semantics: Semantics refers to the set of rules we use to obtain meaning from morphemes.
For example, adding “ed” to the end of a verb makes it past tense.

Syntax: Syntax is the set of rules of a language by which we construct sentences. Each
language has a different syntax. The syntax of the English language requires that each
sentence have a noun and a verb, each of which may be modified by adjectives and adverbs.
Some syntaxes make use of the order in which words appear. For example, in English the
meaning of the sentence “The man bites the dog” is different from “The dog bites the man.”

Pragmatics: The social side of language is expressed through pragmatics, or how we

communicate effectively and appropriately with others. Examples of pragmatics include
turntaking, staying on topic, volume and tone of voice, and appropriate eye contact.
Lastly, words do not possess fixed meanings, but change their interpretation as a function of
the context in which they are spoken. We use contextual information, the information
surrounding language, to help us interpret it. Examples of contextual information include our
knowledge and nonverbal expressions, such as facial expressions, postures, and gestures.
Misunderstandings can easily arise if people are not attentive to contextual information or if
some of it is missing, such as it may be in newspaper headlines or in text messages.

Language Developmental Progression

An important aspect of cognitive development is language acquisition. Starting before birth,

babies begin to develop language and communication skills. At birth, babies recognize their
mother’s voice and can discriminate between the language(s) spoken by their mothers and
foreign languages, and they show preferences for faces that are moving in synchrony with
audible language.

 Intentional Vocalizations: In terms of producing spoken language, babies begin to coo

almost immediately. Cooing is a one-syllable combination of a consonant and a vowel
sound(e.g.,cooorba. Cooing serves as practice for vocalization, as well as the infant
hears the sound of his or her own voice and tries to repeat sounds that are
entertaining. Infants also begin to learn the pace and pause of conversation as they
alternate their vocalization with that of someone else and then take their turn again
when the other person’s vocalization has stopped.

 At about four to six months of age, infants begin making even more elaborate
vocalizations that include the sounds required for any language. At about 7 months,
infants begin babbling, engaging in intentional vocalizations that lack specific meaning
and comprise a consonant-vowel repeated sequence, such as ma-ma-ma, da-da, da.

 Children babble as practice in creating specific sounds, and by the time they are a 1
year old, the babbling uses primarily the sounds of the language that they are learning.
These vocalizations have a conversational tone that sounds meaningful even though it
is not. Babbling also helps children understand the social, communicative function of
language.

 Gesturing: Children communicate information through gesturing long before they

speak, and there is some evidence that gesture usage predicts subsequent language
development

Temperament

Temperament is the innate characteristics of the infant,

including mood, activity level, and emotional reactivity,
noticeable soon after birth. Based on the infants’ behavioral
profiles, they were categorized into three general types of
temperament:
  Easy Child (40%) who is able to quickly adapt to routine and new situations,
remains calm, is easy to soothe, and usually is in a positive mood.
 Difficult Child (10%) who reacts negatively to new situations, has trouble
adapting to routine, is usually negative in mood, and cries frequently.
 Slow-to-Warm-Up Child (15%) has a low activity level, adjusts slowly to new
situations and is often negative in mood.

Infant Emotions

At birth, infants exhibit two emotional responses: Attraction and withdrawal. They show
attraction to pleasant situations that bring comfort, stimulation, and pleasure, and they
withdraw from unpleasant stimulation such as bitter flavors or physical discomfort. At around
two months, infants exhibit social engagement in the form of social smiling as they respond
with smiles to those who engage their positive attention.

Social smiling becomes more stable and organized as infants learn to use their smiles to
engage their parents in interactions. Pleasure is expressed as laughter at 3 to 5 months of
age, and displeasure becomes more specific as fear, sadness, or anger between ages 6 and 8
months. Anger is often the reaction to being prevented from obtaining a goal, such as a toy
being removed. In contrast, sadness is typically the response when infants are deprived of a
caregiver.

Fear is often associated with the presence of a stranger, known as stranger wariness, or the
departure of significant others known as separation anxiety. Both appear sometime between 6
and 15 months after object permanence has been acquired. Further, there is some indication
that infants may experience jealousy as young as 6 months of age.

Emotions are often divided into two general categories: Basic emotions, such as interest,
happiness, anger, fear, surprise, sadness and disgust, which appear first, and self-conscious
emotions, such as envy, pride, shame, guilt, doubt, and embarrassment. Unlike primary
emotions, secondary emotions appear as children start to develop a self-concept and require
social instruction on when to feel such emotions. The situations in which children learn self-
conscious emotions varies from culture to culture. Individualistic cultures teach us to feel
pride in personal accomplishments, while in more collective cultures children are taught to not
call attention to themselves, unless you wish to feel embarrassed for doing so.

Forming Attachments
Attachment is the close bond with a caregiver from which the infant derives a sense of
security. The formation of attachments in infancy has been the subject of considerable
research as attachments have been viewed as foundations for future relationships.
Additionally, attachments form the basis for confidence and curiosity as toddlers, and as
important influences on self-concept.

Freud’s Psychoanalytic Theory: According to Freud (1938) infants are oral creatures who obtain
pleasure from sucking and mouthing objects. Freud believed the infant will become attached to
a person or object that provides this pleasure. Consequently, infants were believed to become
attached to their mother because she was the one who satisfied their oral needs and provided
pleasure. Freud further believed that the infants will become attached to their mothers “if the
mother is relaxed and generous in her feeding practices, thereby allowing the child a lot of
oral pleasure,”

Bowlby’s Theory: Building on the work of Harlow and others, John Bowlby developed the
concept of attachment theory. He defined attachment as the affectional bond or tie that an
infant forms with the mother (Bowlby, 1969). An infant must form this bond with a primary
caregiver in order to have normal social and emotional development. In addition, Bowlby
proposed that this attachment bond is very powerful and continues throughout life. He used
the concept of secure base to define a healthy attachment between parent and child (Bowlby,
1982). A secure base is a parental presence that gives the child a sense of safety as the child
explores the surroundings.

Bowlby said that two things are needed for a healthy attachment: The caregiver must be
responsive to the child’s physical, social, and emotional needs; and the caregiver and child
must engage in mutually enjoyable interactions (Bowlby, 1969). Additionally, Bowlby observed
that infants would go to extraordinary lengths to prevent separation from their parents, such
as crying, refusing to be comforted, and waiting for the caregiver to return. He observed that
these same expressions were common to many other mammals, and consequently argued
that these negative responses to separation serve an evolutionary function.

Erikson: Trust vs. Mistrust. Erikson was in agreement on the importance of a secure base,
arguing that the most important goal of infancy was the development of a basic sense of trust
in one’s caregivers. Consequently, the first stage, trust vs. mistrust, highlights the importance
of attachment. Erikson maintained that the first year to year and a half of life involves the
establishment of a sense of trust (Erikson, 1982). Infants are dependent and must rely on
others to meet their basic physical needs as well as their needs for stimulation and comfort. A
caregiver who consistently meets these needs instills a sense of trust or the belief that the
world is a trustworthy place. The caregiver should not worry about overly indulging a child’s
need for comfort, contact or stimulation

Caregiver Interactions and the Formation of Attachment: Most developmental psychologists

argue that a child becomes securely attached when there is consistent contact from one or
more caregivers who meet the physical and emotional needs of the child in a responsive and
appropriate manner. However, even in cultures where mothers do not talk, cuddle, and play
with their infants, secure attachments can develop (LeVine et. al., 1994). The insecure
ambivalent style occurs when the parent is insensitive and responds inconsistently to the
child’s needs.

Consequently, the infant is never sure that the world is a trustworthy place or that he or she
can rely on others without some anxiety. A caregiver who is unavailable, perhaps because of
marital tension, substance abuse, or preoccupation with work, may send a message to the
infant he or she cannot rely on having needs met. An infant who receives only sporadic
attention when experiencing discomfort may not learn how to calm down. The child may cry if
separated from the caregiver and also cry upon their return. They seek constant reassurance
that never seems to satisfy their doubt. Keep in mind that clingy behavior can also just be part
of a child’s natural disposition or temperament and does not necessarily reflect some kind of
parental neglect.

Additionally, a caregiver that attends to a child’s frustration can help teach them to be calm
and to relax. The insecure avoidant style is marked by insecurity, but this style is also
characterized by a tendency to avoid contact with the caregiver and with others. This child may
have learned that needs typically go unmet and learns that the caregiver does not provide care
and cannot be relied upon for comfort, even sporadically.

An insecure avoidant child learns to be more independent and disengaged. The insecure
disorganized/disoriented style represents the most insecure style of attachment and occurs
when the child is given mixed, confused, and inappropriate responses from the caregiver. For
example, a mother who suffers from schizophrenia may laugh when a child is hurting or cry
when a child exhibits joy. The child does not learn how to interpret emotions or to connect with
the unpredictable caregiver. This type of attachment is also often seen in children who have
been abused. Research has shown that abuse disrupts a child’s ability to regulate their
emotions.

Caregiver Consistency: Having a consistent caregiver may be jeopardized if the infant is cared
for in a day care setting with a high turn-over of staff or if institutionalized and given little
more than basic physical care. Infants who, perhaps because of being in orphanages with
inadequate care, have not had the opportunity to attach in infancy may still form initial secure
attachments several years later. However, they may have more emotional problems of
depression, anger, or be overly friendly as they interact with others.

Social Deprivation: Severe deprivation of parental attachment can lead to serious problems.
According to studies of children who have not been given warm, nurturing care, they may
show developmental delays, failure to thrive, and attachment disorders (Bowlby, 1982). Non-
organic failure to thrive is the diagnosis for an infant who does not grow, develop, or gain
weight on schedule and there is no known medical explanation for this failure. Poverty,
neglect, inconsistent parenting, and severe family dysfunction are correlated with non-organic
failure to thrive. In addition, postpartum depression can cause even a well-intentioned mother
to neglect her infant.

Reactive Attachment Disorder: Children who experience social neglect or deprivation,

repeatedly change primary caregivers that limit opportunities to form stable attachments or
are reared in unusual settings (such as institutions) that limit opportunities to form stable
attachments can certainly have difficulty forming attachments. According to the Diagnostic and
Statistical Manual of Mental Disorders, 5th edition (American Psychiatric Association, 2013),
those children experiencing neglectful situations and also displaying markedly disturbed and
developmentally inappropriate attachment behavior, such as being inhibited and withdrawn,
minimal social and emotional responsiveness to others, and limited positive affect, may be
diagnosed with reactive attachment disorder. This disorder often occurs with developmental
delays, especially in cognitive and language areas. Fortunately, the majority of severely
neglected children do not develop reactive attachment disorder, which occurs in less than 10%
of such children. The quality of the caregiving environment after serious neglect affects the
development of this disorder.

CRITICAL THINKING QUESTIONS

1. How important caregivers’ consistency to infants?

2. What can be considered normal emotional development to infants?
3. How do early attachment experiences impact on infants’ emotional
development?

ASSESSMENT: