session 2

Normal and abnormal development

Knowledge of what is normal plays an important part in
determining what is abnormal. Therefore, the normal
development of children is a fundamental issue in relation to
mental health disorders that have been traditionally described
in terms of deviations from normal development and
behaviour. Whilst the boundary between what is normal and
what is abnormal is not distinct, it is important to define as
clearly as possible what is normal or age-appropriate
behaviour, even though this is necessarily somewhat arbitrary.
When considering mental health problems in children and
adolescents it is therefore essential to have an understanding of
normal child development and the processes involved. Many
behaviours are normal at certain ages, but not at others. Also,
many mental health problems in childhood and adolescence
may be manifestations of disturbed development. Childhood
and adolescence are particularly dynamic periods of
development involving many changes.
These include cognitive, emotional, social,
sexual, as well as biological changes. During
this period children are transformed from
helpless, dependent infants to independent, self-
sufficient individuals with their own views. This
is, of course, a complex process with much
continuity and some discontinuities.
Developmental stages:-

Freud
Freud was the first theorist to come up with the idea that children’s
development passes through a series of stages. Unfortunately, his theory was
based on the extrapolation of ideas from his work with adult psychiatric
patients rather than observations of children, so has, over the years, been seen
to be less useful to teachers than other theories. However, Freud’s theory is
still used by many psychiatrists in their work with children who have mental
health problems so it is important for teachers to be aware of it. It is also
important because later theorists built on Freud’s idea and came up with stages
based on their observations of children. The stages of development through
which children are considered to pass are outlined briefly below.
The oral stage (0–1 year)

The stage in which children gain greatest satisfaction

from oral activity.

The anal stage (1–3 years)

The stage in which children’s interest is focused on

defecating.

The phallic stage (3–5 years)

The stage in which children’s attention is focused on their

genitals and the development of sexual identity.

The latency stage (5–12 years)

The stage in which there is a lack of interest in sexuality.

The genital stage(12–18 years plus)

The stage when satisfaction is sought through relationships with the

other sex.

Piaget
Piaget’s theory is based on extensive observations and research
studies with children. It is very well known among educators and is a
useful guide to children’s cognitive development, although not as
useful in considering children’s overall psychological development as
some other theories. Piaget suggests that there are four stages which
children need to pass through in order to achieve an adult level of
thinking. These are outlined briefly below.
The sensori-motor stage (0–2 years)
The stage at which children know the world only by looking, grasping or
mouthing
objects.

The pre-operational stage (2–7 years)

The stage at which children use symbols to help them communicate but these are
limited to their immediate experience. Their thinking is based on impressions
rather than reality and they have irrational notions of cause and effect.

The concrete operations stage (7–11 years)

The stage at which children have learned to think logically. As long as concepts
are in concrete terms they can link cause and effect rationally. However, they are
unable to think using abstract concepts.
The formal operations stage (11 years onwards)
By this stage the child has learned to think in both concrete and abstract
terms and can solve problems using abstract concepts. However, it is
now considered that only around 50 per cent of children will have
arrived at this highest level of thinking by the age of leaving formal
schooling. It is a level of thinking that is regarded as being well beyond
that of primary school children and of many pupils in the secondary
school, particularly those with learning difficulties.
Erikson
One of the most useful stage theories of development is that proposed by
Erikson
(1968),which suggest that children’s psychological development progresses
by them addressing and resolving specific psychosocial conflicts. Resolution
of these conflicts provides a solid foundation for future development
whereas inadequate resolution will lead to problems in later development.
Erikson’s theory covers the entire life span from infancy to old age. It is
helpful in pointing out the key issues which children and young people face
as they move through life. The conflicts that he identifies are outlined
briefly below.
Trust versus mistrust (0–1 year)
The first conflict is concerned with achieving a balance between building up
trusting relationships and risking being let down. Consistency of care in the
first year of life will build a foundation for the development of trusting
relationships with others. Lack of consistency can evoke suspicion and
mistrust and lead to difficulties in relating fully to others.
Autonomy versus shame and doubt (2–3 years)
The second conflict children face is concerned with them developing a
sense of control over their behavior and bodily functions.
Encountering difficulties with this leads children to doubt their
abilities and anticipate failures.

Initiative versus guilt (4–5 years)

At this stage the conflict concerns the development of an increasing
sense of personal agency and responsibility. The alternative is to
experience increasing feelings of self-doubt and guilt
. The fourth conflict, which is the key one during primary schooling, is
concerned with children successfully meeting challenges through being
industrious as opposed to avoiding challenges, accepting failure and therefore
developing an increasing sense of inferiority.
Developmental tasks
A useful way to view the psychosocial conflicts Erikson identified is as
challenges or tasksthat children have to face in order to develop. This is the
approach taken by Havinghurst(1972), who has suggested that there are certain
developmental tasks which children must master at each stage of development in
order to prepare for later life. Successful mastery of these tasks results in well-
adjusted children who are able to cope with the tasks they encounter in later
developmental stages, whereas failure to master the tasks results in
maladjustment and the inability to complete future tasks successfully.
The developmental tasks provide a useful means of assessing children’s
progress within a number of areas, such as social skills and concept
development. As children get older the tasks facing them change, as do
their needs – for example, the care and environment required by an
infant in order to work on relevant tasks differ markedly from those
needed by an adolescent. Failure to make the necessary adjustments
within the family can therefore cause difficulties. An analysis of the
developmental tasks faced by children at different stages, provided by
Havinghurst (1972), is summarised below. He identified the tasks shown
below for preschool-,
primary- and secondary-age children.
Developmental tasks of pre-school-age children (up to 6 years)
• Learning to take solid foods.
• Learning to walk.
• Learning to talk.
• Learning to use the toilet for body wastes.
• Learning about sexual differences and behaviour.
• Learning language concepts to describe social and physical reality.
• Developing readiness for reading.
• Learning to distinguish right and wrong.
Developmental tasks of primary-school-age children (around 6–12 years)
• Learning the physical skills necessary for games, for example, throwing, kicking.
• Building self-esteem and a wholesome attitude towards one’s body.
• Learning to get along with one’s peers.
• Learning appropriate masculine or feminine social roles.
• Developing fundamental skills in reading, writing and arithmetic.
• Developing concepts necessary for everyday living.
• Developing conscience, morality and a core of values.
• Achieving personal independence or autonomy.
• Developing rational attitudes to social groups and institutions.
Hierarchy of children’s needs
An important perspective on children’s development and behavior is provided by
Maslow (1970), who suggested that children have certain basic needs which must be
met if they are to reach their potential in all areas of development. If lower-level needs
are not met children will be unable to meet higher-order needs and progress towards
self- actualisation. Each level of Maslow’s hierarchy is described briefly below.

Physiological needs
The lowest level of the hierarchy comprises physiological needs, such as for
food and shelter. If children do not get enough to eat they will be unable to
concentrate their attention on the various tasks they must address, including
their schoolwork. There is also some evidence to suggest that a poor diet is
linked with long-term problems, such as hyperactivity and mental illness in
adolescence.
Safety needs
This includes physical and psychological safety. Children living in war
zones clearly need to focus on their own safety to the extent that
attention cannot be given to higher level needs. However, children can
also be afraid for their physical safety in their own homes due to
abusing parents, or in their neighborhoods due to high crime levels.
Children in homes where parents are going through a separation or
divorce may have their need for psychological safety threatened and
therefore may be distracted from addressing the developmental tasks
associated with their stages of development.
Love and belonging
The third level is the need for love and belonging, and to feel
accepted as part of a
group. Children who are withdrawn, isolated or rejected by their
peers are therefore unable to move on to address higher-order
needs which are critical to the development of sound mental health.
They may hide their feelings of rejection or react with antisocial
behaviour in order to cover them up.

Self-esteem
This is the need to feel good about oneself. This crucial need is
denied to children who are focused too much on earlier needs and
threatened when they are subjected to excessive criticism or are
ignored by the important people in their lives. The importance of
self-esteem in children’s development cannot be over emphasised
and is discussed in a separate section below.
Self-actualisation
The fifth level of the hierarchy is the fulfilment of one’s potential to the maximum extent
possible. This is only possible if lower-level needs are being met.

Self-esteem
It is clear from the theories previously discussed that the acquisition of self-worth or self-
esteem is one of the most fundamental developmental tasks of childhood. It is therefore not
surprising that in children exhibiting signs of behavioral or mental health problems low self-
esteem tends to be a common feature.
Self-esteem is the individual’s assessment or unconditional appreciation of him- or
herself. The term self-esteem is often confused with the self-concept, the sum total of an
individual’s mental and physical characteristics and his or her evaluation of them (Lawrence,
1987). It has three aspects: thinking (cognitive), feeling (affective) and action (behavioural).
Lawrence explains that for teachers it is useful to consider the self-concept as developing in
three areas: self-image, ideal self and self-esteem. The self-image is how the individual sees
him- or herself whereas the ideal self is what he or she would like to be.
Self-esteem is the individual’s perception of the discrepancy between
the two. How we feel about ourselves is a consequence of how we
interpret our experiences and, in many respects, our self-esteem is a
cumulative record of how we have been treated and how we treat
ourselves throughout life.
Shavelson and Bolus (1982), cited in Lawrence (1987), have proposed
a hierarchy of self-esteem which is useful for teachers since it
illustrates how the global self-esteem of an individual can be
influenced by both academic and non-academic (e.g. social) ability.
Children may feel inadequate in some situations more than others. If children
who have difficulty learning mathematics, for example, are frequently forced to
participate in these activities eventually their overall self-esteem might fall. In
addition, if an individual continues to fail in areas of life which are valued by
significant others then his or her self-esteem will be affected. It is obvious,
therefore, that failure at school can easily lead to low global self-esteem,
particularly when children have learning difficulties