MODULE 4: INFANCY Third, we will explore the baby’s senses.

Every
sense functions at birth—newborns use all of their
Why does it matter? senses to attend to everything and every person. We will
explore how infants’ senses develop and how sensory
Welcome to the story of development from systems like hearing and vision operate, and how infants
infancy through toddlerhood; from birth until about two take in information through their senses and transform it
years of age. Did you ever wonder how babies grow into meaningful information.
from tiny, helpless infants into well-developed and
independent adults? It doesn’t happen overnight, but the Finally, since growth during infancy is so rapid
process begins right from day one. Infancy is a time and the consequence of neglect can be severe, we will
when tremendous growth, coordination, and mental consider some of the influences on early physical
development occur. Most infants learn to walk, growth, particularly the importance of nutrition.
manipulate objects and can form basic words by the end
of infancy. By about 4 months a baby will usually have Overall Physical Growth in Infancy
doubled its birth weight and tripled its birth weight by the
first year. By the age of 2, a baby’s weight will have The average newborn weighs approximately 7.5
quadrupled! pounds, although a healthy birth weight for a full-term
baby is considered to be between 5 pounds, 8 ounces
Researchers have given this part of the life span (2,500 grams) and 8 pounds, 13 ounces (4,000
more attention than any other period, perhaps because grams).[1] The average length of a newborn is 19.5
changes during this time are so dramatic and so inches, increasing to 29.5 inches by 12 months and 34.4
noticeable. We know that much of what happens during inches by 2 years old (WHO Multicentre Growth
these years provides a foundation for one’s life to come, Reference Study Group, 2006).
however, it has been argued that the significance of
development during these years has been overstated For the first few days of life, infants typically lose
(Bruer, 1999). Nevertheless, this is a period of life that about 5 percent of their body weight as they eliminate
contemporary educators, healthcare providers, and waste and get used to feeding. This often goes
parents have focused on quite heavily. It is also a time unnoticed by most parents, but can be cause for
period that can be tricky to study—how do we learn concern for those who have a smaller infant. This weight
about infant speech when they cannot articulate their loss is temporary, however, and is followed by a rapid
thoughts or feelings? For example, through research we period of growth. By the time an infant is 4 months old, it
know that infants understand speech much earlier than usually doubles in weight, and by one year has tripled its
their bodies have matured enough to physically perform birth weight. By age 2, the weight has quadrupled. The
it; thus it is evident that their speech patterns develop average length at 12 months (one year old) typically
before the physical growth of their vocal cords is ranges from 28.5-30.5 inches. The average length at 24
adequate to facilitate speech. months (two years old) is around 33.2-35.4 inches
(CDC, 2010).
In this module, we will examine the rapid
physical growth and development of infants, look at the Monitoring Physical Growth
influences on physical growth and cognitive
development, then turn our attention toward emotional As mentioned earlier, growth is so rapid in
and social development in the early years of life. The infancy that the consequences of neglect can be severe.
early years are a time of rapid physical, cognitive, social, For this reason, gains are closely monitored. At each
and emotional development, which have a direct effect well-baby check-up, a baby’s growth is compared to that
on a baby’s overall development and the adult they will baby’s previous numbers. Often, measurements are
become. expressed as a percentile from 0 to 100, which
compares each baby to other babies the same age. For
PHYSICAL GROWTH AND DEVELOPMENT IN example, weight at the 40th percentile means that 40
NEWBORNS AND TODDLERS percent of all babies weigh less, and 60 percent weight
more. For any baby, pediatricians and parents can be
We’ll begin this section by reviewing the alerted early just by watching percentile changes. If an
physical development that occurs during infancy, a average baby moves from the 50th percentile to the
period that starts at birth and continues until the second 20th, this could be a sign of failure to thrive, which could
birthday. We’ll see how this time involves rapid growth, be caused by various medical conditions or factors in the
not only in observable changes like height and weight, child’s environment. The earlier the concern is detected,
but also in brain development. the earlier intervention and support can be provided for
the infant and caregiver.
Next we will explore reflexes. At birth, infants
are equipped with a number of reflexes, which are Body Proportions
involuntary movements in response to stimulation. We
will explore these innate reflexes and then consider how Another dramatic physical change that takes
these involuntary reflexes are eventually modified place in the first several years of life is a change in body
through experiences to become voluntary movements proportions. The head initially makes up about 50
and the basis for motor development as skills emerge percent of a person’s entire length when developing in
that allow an infant to grasp food, roll over, and take the the womb. At birth, the head makes up about 25 percent
first step. of a person’s length (just imagine how big your head
would be if the proportions remained the same adolescence in various areas of the brain. This activity is
throughout your life!). In adulthood, the head comprises occurring primarily in the cortex or the thin outer
about 15 percent of a person’s length.[2] Imagine how covering of the brain involved in voluntary activity and
difficult it must be to raise one’s head during the first thinking.
year of life! And indeed, if you have ever seen a 2- to
4-month-old infant lying on their stomach trying to raise
the head, you know how much of a challenge this is.

Brain Development in Infancy

Some of the most dramatic physical change that

occurs during this period is in the brain. At birth, the
brain is about 25 percent of its adult weight, and this is
not true for any other part of the body. By age 2, it is at
75 percent of its adult weight, at 95 percent by age 6,
and at 100 percent by age 7 years.

The prefrontal cortex, located behind the

forehead, continues to grow and mature throughout
childhood and experiences an addition growth spurt
during adolescence. It is the last part of the brain to
mature and will eventually comprise 85 percent of the
brain’s weight. 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 (Webb, Monk, & Nelson, 2001). As the prefrontal
cortex matures, the child is increasingly able to regulate
Communication within the central nervous or control emotions, to plan activity, to strategize, and
system (CNS), which consists of the brain and spinal have better judgment. Of course, this is not fully
cord, begins with nerve cells called neurons. Neurons accomplished in infancy and toddlerhood but continues
connect to other neurons via networks of nerve fibers throughout childhood and adolescence.
called axons and dendrites. Each neuron typically has a
single axon and numerous dendrites which are spread Another major change occurring in the central
out like branches of a tree (some will say it looks like a nervous system is the development of myelin, a coating
hand with fingers). The axon of each neuron reaches of fatty tissues around the axon of the neuron. Myelin
toward the dendrites of other neurons at intersections helps insulate the nerve cell and speed the rate of
called synapses, which are critical communication links transmission of impulses from one cell to another. This
within the brain. Axons and dendrites do not touch, enhances the building of neural pathways and improves
instead, electrical impulses in the axons cause the coordination and control of movement and thought
release of chemicals called neurotransmitters which processes. The development of myelin continues into
carry information from the axon of the sending neuron to adolescence but is most dramatic during the first several
the dendrites of the receiving neuron. years of life.
While most of the brain’s 100 to 200 billion Motor Development in Infancy
neurons are present at birth, they are not fully mature.
Each neural pathway forms thousands of new Every basic motor skill (any movement ability)
connections during infancy and toddlerhood. During the develops over the first two years of life. The sequence of
next several years, dendrites, or connections between motor skills first begins with reflexes. Infants are
neurons, will undergo a period of transient exuberance equipped with a number of reflexes, or involuntary
or temporary dramatic growth (exuberant because it is movements in response to stimulation, and some are
so rapid and transient because some of it is temporary). necessary for survival. These include the breathing
There is a proliferation of these dendrites during the first reflex, or the need to maintain an oxygen supply (this
two years so that by age 2, a single neuron might have includes hiccups, sneezing, and thrashing reflexes),
thousands of dendrites. After this dramatic increase, the reflexes that maintain body temperature (crying,
neural pathways that are not used will be eliminated shivering, tucking the legs close, and pushing away
through a process called pruning, thereby making those blankets), the sucking reflex, or automatically sucking on
that are used much stronger. It is thought that pruning objects that touch their lips, and the rooting reflex, which
causes the brain to function more efficiently, allowing for involves turning toward any object that touches the
mastery of more complex skills (Hutchinson, 2011). cheek (which manages feeding, including the search for
Transient exuberance occurs during the first few years a nipple). Other reflexes are not necessary for survival,
of life, and pruning continues through childhood and into but signify the state of brain and body functions. Some
of these include:the babinski reflex (toes fan upward reach for an object, first with both arms and within a few
when feet are stroked), the stepping reflex (babies move weeks, with only one arm. Grasping an object involves
their legs as if to walk when feet touch a flat surface), the use of the fingers and palm, but no thumbs. Stop
the palmar grasp (the infant will tightly grasp any object reading for a moment and try to grasp an object using
placed in its palm), and the moro reflex (babies will fling the fingers and the palm. How does that feel? How much
arms out and then bring to chest if they hear a loud control do you have over the object? If it is a pen or
noise). These movements occur automatically and are pencil, are you able to write with it? Can you draw a
signals that the infant is functioning well neurologically. picture? The answer is, probably not. Use of the thumb
Within the first several weeks of life, these reflexes are comes at about 9 months of age when the infant is able
replaced with voluntary movements or motor skills. to grasp an object using the forefinger and thumb (the
pincer grasp). This ability greatly enhances the ability to
Motor development occurs in an orderly control and manipulate an object, and infants take great
sequence as infants move from reflexive reactions (e.g., delight in this newfound ability. They may spend hours
sucking and rooting) to more advanced motor picking up small objects from the floor and placing them
functioning. This development proceeds in a in containers. By 9 months, an infant can also watch a
cephalocaudal (from head-down) and proximodistal moving object, reach for it as it approaches, and grab it.
(from center-out) direction. For instance, babies first This is quite a complicated set of actions if we remember
learn to hold their heads up, then sit with assistance, how difficult this would have been just a few months
then sit unassisted, followed later by crawling, pulling up, earlier.
cruising, and then 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. If a baby is not holding up his
head by 4 months old, he is showing a delay. 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 (CDC, 2018). If the child is displaying delays
on several milestones, that is a reason for concern, and
the parent or caregiver should discuss this with the
child’s pediatrician. Some developmental delays can be
identified and addressed through early intervention.

Gross Motor Skills

Gross motor skills are voluntary movements

that involve the use of large muscle groups and are
typically large movements of the arms, legs, head, and
torso. These skills begin to develop first. Examples
include moving to bring the chin up when lying on the
stomach, moving the chest up, 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 (Berk, 2007). And 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!

Fine Motor Skills

Fine motor skills are more exact movements of

the hands and fingers and include the ability to reach
and grasp an object. These skills focus on the muscles
in the fingers, toes, and eyes, and enable coordination of
small actions (e.g., grasping a toy, writing with a pencil, Sensory Development in Infancy
and using a spoon). Newborns cannot grasp objects
voluntarily but do wave their arms toward objects of As infants and children grow, their senses play a
interest. At about 4 months of age, the infant is able to vital role in encouraging and stimulating the mind and in
helping them observe their surroundings. Two terms are
important to understand when learning about the stranger’s voice. When the infants heard their mother’s
senses. The first is sensation, or the interaction of voice, they sucked more strongly at the pacifier (Mills &
information with the sensory receptors. The second is Melhuish, 1974). Some of this ability will be lost by 7 or 8
perception, or the process of interpreting what is sensed. months as a child becomes familiar with the sounds of a
It is possible for someone to sense something without particular language and less sensitive to sounds that are
perceiving it. Gradually, infants become more adept at part of an unfamiliar language.
perceiving with their senses, making them more aware
of their environment and presenting more affordances or Pain and Touch
opportunities to interact with objects.
Immediately after birth, a newborn is sensitive to
Vision touch and temperature, and is also sensitive to pain,
responding with crying and cardiovascular responses.
What can young infants see, hear, and smell? Newborns who are circumcised (the surgical removal of
Newborn infants’ sensory abilities are significant, but the foreskin of the penis) without anesthesia experience
their senses are not yet fully developed. Many of a pain, as demonstrated by increased blood pressure,
newborn’s innate preferences facilitate interaction with increased heart rate, decreased oxygen in the blood,
caregivers and other humans. The womb is a dark and a surge of stress hormones (United States National
environment void of visual stimulation. Consequently, Library of Medicine, 2016). According to the American
vision is the most poorly developed sense at birth. Academy of Pediatrics (AAP), there are medical benefits
Newborns typically cannot see further than 8 to 16 and risks to circumcision. They do not recommend
inches away from their faces, have difficulty keeping a routine circumcision, however, they stated that because
moving object within their gaze, and can detect contrast of the possible benefits (including prevention from
more than color differences. If you have ever seen a urinary tract infections, penile cancer, and some STDs)
newborn struggle to see, you can appreciate the parents should have the option to circumcise their sons
cognitive efforts being made to take in visual stimulation if they want to (AAP, 2012).[3]
and build those neural pathways between the eye and
the brain. The sense of touch is acute in infants and is
essential to a baby’s growth of physical abilities,
Although vision is their least developed sense, language and cognitive skills, and socio-emotional
newborns already show a preference for faces. When competency. Touch not only impacts short-term
you glance at a person, where do you look? Chances development during infancy and early childhood but also
are you look into their eyes. If so, why? It is probably has long-term effects, suggesting the power of positive
because there is more information there than in other gentle touch from birth. Through touch, infants learn
parts of the face. Newborns do not scan objects this about their world, bond with their caregiver, and
way; rather, they tend to look at the chin or another less communicate their needs and wants. Research
detailed part of the face. However, by 2 or 3 months, emphasizes the great benefits of touch for premature
they will seek more detail when visually exploring an babies, but the presence of such contact has been
object and begin showing preferences for unusual shown to benefit all children (Stack, D. M. (2010).[4] In
images over familiar ones, for patterns over solids, faces an extreme example, some children in Romania were
over patterns, and three-dimensional objects over flat reared in orphanages in which a single care worker may
images. Newborns have difficulty distinguishing between have had as many as 10 infants to care for at one time.
colors, but within a few months are able to distinguish These infants were not often helped or given toys with
between colors as well as adults. Infants can also sense which to play. As a result, many of them were
depth as binocular vision develops at about 2 months of developmentally delayed (Nelson, Fox, & Zeanah,
age. By 6 months, the infant can perceive depth in 2014).[5] When we discuss emotional and social
pictures as well (Sen, Yonas, & Knill, 2001). Infants who development later in this module, you will also see the
have experience crawling and exploring will pay greater important role that touch plays in helping infants feel
attention to visual cues of depth and modify their actions safe and protected, which builds trust and secure
accordingly (Berk, 2007). attachments between the child and their caregiver.

Hearing Taste and Smell

The infant’s sense of hearing is very keen at Not only are infants sensitive to touch, but
birth. If you remember from an earlier module, this ability newborns can also distinguish between sour, bitter,
to hear is evidenced as soon as the 5th month of sweet, and salty flavors and show a preference for
prenatal development. In fact, an infant can distinguish sweet flavors. They can distinguish between their
between very similar sounds as early as one month after mother’s scent and that of others, and prefer the smell of
birth and can distinguish between a familiar and their mothers. A newborn placed on the mother’s chest
non-familiar voice even earlier. Babies who are just a will inch up to the mother’s breast, as it is a potent
few days old prefer human voices, they will listen to source of the maternal odor. Even on the first day of life,
voices longer than sounds that do not involve speech infants orient to their mother’s odor and are soothed,
(Vouloumanos & Werker, 2004), and they seem to prefer when crying, by their mother’s odor (Sullivan et al.,
their mother’s voice over a stranger’s voice (Mills & 2011).[6]
Melhuish, 1974). In an interesting experiment,
3-week-old babies were given pacifiers that played a
recording of the infant’s mother’s voice and of a
 get all the nutrition they need through colostrum during
Nutrition the first few days of life (CDC, 2018).[1] Breast milk
changes by the third to fifth day after birth, becoming
Good nutrition in a supportive environment is much thinner, but containing just the right amount of fat,
vital for an infant’s healthy growth and development. sugar, water, and proteins to support overall physical
Remember, from birth to 1 year, infants triple their weight and neurological development. It provides a source of
and increase their height by half, and this growth iron more easily absorbed in the body than the iron
requires good nutrition. For the first 6 months, babies found in dietary supplements, it provides resistance
are fed breast milk or formula. Starting good nutrition against many diseases, it is more easily digested by
practices early can help children develop healthy dietary infants than formula, and it helps babies make a
patterns. Infants need to receive nutrients to fuel their transition to solid foods more easily than if bottle-fed.
rapid physical growth. Malnutrition during infancy can
result in not only physical but also cognitive and social The reason infants need such a high fat content
consequences. Without proper nutrition, infants cannot is the process of myelination which requires fat to
reach their physical potential. insulate the neurons. There has been some research,
including meta-analyses, to show that breastfeeding is
Breastfeeding connected to advantages with cognitive development
(Anderson, Johnstone, & Remley, 1999)[2]. Low birth
The use of wet nurses, or lactating women, weight infants had greater benefits from breastfeeding
hired to nurse others’ infants, during the middle ages than did normal-weight infants in a meta-analysis of
eventually declined, and mothers increasingly breastfed twenty controlled studies examining the overall impact of
their own infants in the late 1800s. In the early part of breastfeeding (Anderson et al., 1999). This
the 20th century, breastfeeding began to go through meta-analysis showed that breastfeeding may provide
another decline, and by the 1950s it was practiced less nutrients required for rapid development of the immature
frequently by middle class, more affluent mothers as brain and be connected to more rapid or better
formula began to be viewed as superior to breast milk. In development of neurologic function. The studies also
the late 1960s and 1970s, there was again a greater showed that a longer duration of breastfeeding was
emphasis placed on natural childbirth and breastfeeding accompanied by greater differences in cognitive
and the benefits of breastfeeding were more widely development between breastfed and formula-fed
publicized. Gradually, rates of breastfeeding began to children. Whereas normal-weight infants showed a
climb, particularly among middle-class educated 2.66-point difference, low-birth-weight infants showed a
mothers who received the strongest messages to 5.18-point difference in IQ compared with
breastfeed. weight-matched, formula-fed infants (Anderson et al,
1999). These studies suggest that nutrients present in
Today, new mothers receive consultation from breast milk may have a significant effect on neurologic
lactation specialists before being discharged from the development in both premature and full-term infants.
hospital to ensure that they are informed of the benefits
of breastfeeding and given support and encouragement For most babies, breast milk is also easier to
to get their infants accustomed to taking the breast. This digest than formula. Formula-fed infants experience
does not always happen immediately, and first-time more diarrhea and upset stomachs. The absence of
mothers, especially, can become upset or discouraged. antibodies in formula often results in a higher rate of ear
In this case, lactation specialists and nursing staff can infections and respiratory infections. Children who are
encourage the mother to keep trying until the baby and breastfed have lower rates of childhood leukemia,
mother are comfortable with the feeding. asthma, obesity, type 1 and 2 diabetes, and a lower risk
of SIDS. For all of these reasons, it is recommended that
Breastfeeding could save the lives of millions of mothers breastfeed their infants until at least 6 months
infants each year, according to the World Health of age and that breast milk be used in the diet
Organization (WHO), yet fewer than 40 percent of throughout the first year (U.S. Department of Health and
infants are breastfed exclusively for the first 6 months of Human Services, 2004a in Berk, 2007).
life. Most women can breastfeed unless they are
receiving chemotherapy or radiation therapy, have HIV, Several recent studies have reported that it is
are dependent on illicit drugs, or have active untreated not just babies that benefit from breastfeeding.
tuberculosis. Because of the great benefits of Breastfeeding stimulates contractions in the uterus to
breastfeeding, WHO, UNICEF and other national help it regain its normal size, and women who
organizations are working together with the government breastfeed are more likely to space their pregnancies
to step up support for breastfeeding globally. farther apart. Mothers who breastfeed are at lower risk
of developing breast cancer, especially among
Benefits of Breastfeeding higher-risk racial and ethnic groups (Islami et al.,
2015).[3] Other studies suggest that women who
Breast milk is considered the ideal diet for breastfeed have lower rates of ovarian cancer
newborns due to the nutritional makeup of colostrum (Titus-Ernstoff, Rees, Terry, & Cramer, 2010)[4], and
and subsequent breastmilk production. Colostrum, the reduced risk for developing Type 2 diabetes
milk produced during pregnancy and just after birth, has (Gunderson, et al., 2015)[5], and rheumatoid arthritis
been described as “liquid gold.” Colostrum is packed (Karlson, Mandl, Hankinson, & Grodstein, 2004).[6]
with nutrients and other important substances that help
the infant build up their immune system. Most babies will
 Most mothers who breastfeed in the United stable sitting and oral feeding skills but should be used
States stop breastfeeding at about 6-8 weeks, often in only as a supplement to breast milk or formula. By six
order to return to work outside the home (United States months, the gastrointestinal tract has matured, solids
Department of Health and Human Services (USDHHS), can be digested more easily, and allergic responses are
2011[7]). Mothers can certainly continue to provide less likely. The infant is also likely to develop teeth
breast milk to their babies by expressing and freezing around this time, which aids in chewing solid food.
the milk to be bottle fed at a later time or by being Iron-fortified infant cereal, made of rice, barley, or
available to their infants at feeding time, but some oatmeal, is typically the first solid introduced due to its
mothers find that after the initial encouragement they high iron content. Cereals can be made of rice, barley, or
receive in the hospital to breastfeed, the outside world is oatmeal. Generally, salt, sugar, processed meat, juices,
less supportive of such efforts. Some workplaces and canned foods should be avoided.
support breastfeeding mothers by providing flexible
schedules and welcoming infants, but many do not. And Though infants usually start eating solid foods
the public support of breastfeeding is sometimes lacking. between 4 and 6 months of age, more and more solid
Women in Canada are more likely to breastfeed than are foods are consumed by a growing toddler. Pediatricians
those in the United States, and the Canadian health recommended introducing foods one at a time, and for a
recommendation is for breastfeeding to continue until 2 few days, in order to identify any potential food allergies.
years of age. Facilities in public places in Canada such Toddlers may be picky at times, but it remains important
as malls, ferries, and workplaces provide more support to introduce a variety of foods and offer food with
and comfort for the breastfeeding mother and child than essential vitamins and nutrients, including iron, calcium,
found in the United States. and vitamin D.

In addition to the nutritional and health benefits Milk Anemia in the United States
of breastfeeding, breast milk is free! Anyone who has
priced formula recently can appreciate this added About 9 million children in the United States are
incentive to breastfeeding. Prices for a month’s worth of malnourished (Children’s Welfare, 1998). More still
formula can easily range from $130-$200. Prices for a suffer from milk anemia, a condition in which milk
year’s worth of formula and feeding supplies can cost consumption leads to a lack of iron in the diet. The
well over $1,500 (USDHHS, 2011). prevalence of iron deficiency anemia in 1- to 3-year-old
children seems to be increasing (Kazal, 2002)[8]. The
When Breastfeeding Doesn’t Work body gets iron through certain foods. Toddlers who drink
too much cow’s milk may also become anemic if they
There are occasions where mothers may be are not eating other healthy foods that have iron. This
unable to breastfeed babies, often for a variety of health, can be due to the practice of giving toddlers milk as a
social, and emotional reasons. For example, pacifier when resting, riding, walking, and so on.
breastfeeding generally does not work when the baby is Appetite declines somewhat during toddlerhood and a
adopted, when the biological mother has a transmissible small amount of milk (especially with added chocolate
disease such as tuberculosis or HIV, when the mother is syrup) can easily satisfy a child’s appetite for many
addicted to drugs or taking any medication that may be hours. The calcium in milk interferes with the absorption
harmful to the baby (including some types of birth of iron in the diet as well. There is also a link between
control), when the infant was born to (or adopted by) a iron deficiency anemia and diminished mental, motor,
family with two fathers and the surrogate mother is not and behavioral development. In the second year of life,
available to breastfeed, when there are attachment iron deficiency can be prevented by the use of a
issues between mother and baby, when the mother or diversified diet that is rich in sources of iron and vitamin
the baby is in the Intensive Care Unit (ICU) after the C, limiting cow’s milk consumption to less than 24
delivery process, and when the baby and mother are ounces per day, and providing a daily iron-fortified
attached but the mother does not produce enough vitamin.
breast-milk.
Global Considerations and Malnutrition
One early argument given to promote the
practice of breastfeeding (when health issues are not the In the 1960s, formula companies led campaigns
case) is that it promotes bonding and healthy emotional in developing countries to encourage mothers to feed
development for infants. However, this does not seem to their babies on infant formula. Many mothers felt that
be a unique case. Breastfed and bottle-fed infants adjust formula would be superior to breast milk and began
equally well emotionally (Ferguson & Woodward, 1999). using formula. The use of formula can certainly be
This is good news for mothers who may be unable to healthy under conditions in which there is adequate,
breastfeed for a variety of reasons and for fathers who clean water with which to mix the formula and adequate
might feel left out as a result. means to sanitize bottles and nipples. However, in many
of these countries, such conditions were not available
Introducing Solid Foods and babies often were given diluted, contaminated
formula which made them become sick with diarrhea
Breast milk or formula is the only food a and become dehydrated. These conditions continue
newborn needs, and the American Academy of today and now many hospitals prohibit the distribution of
Pediatrics recommends exclusive breastfeeding for the formula samples to new mothers in efforts to get them to
first six months after birth. Solid foods can be introduced rely on breastfeeding. Many of these mothers do not
from around six months onward when babies develop understand the benefits of breastfeeding and have to be
encouraged and supported in order to promote this those hours happening during daytime naps. As they get
practice. older, these naps decrease from several to typically two
naps a day between ages 9-18 months. Often, periods
The World Health Organization (2018) of rapid weight gain or changes in developmental
recommends initiation of breastfeeding within one hour abilities such as crawling or walking will cause changes
of birth, exclusive breastfeeding for the first six months to sleep habits as well. Infants generally move towards
of life, and introduction of solid foods at six months one 2-4 hour nap a day by around 18 months, and many
together with continued breastfeeding up to two years of children will continue to nap until around four or five
age or beyond. years old.[3]

Children in developing countries and countries Sudden Unexpected Infant Deaths (SUID)
experiencing the harsh conditions of war are at risk for
two major types of malnutrition. Infantile marasmus Each year in the United States, there are about
refers to starvation due to a lack of calories and protein. 3,500 Sudden Unexpected Infant Deaths (SUID). These
Children who do not receive adequate nutrition lose fat deaths occur among infants less than one-year-old and
and muscle until their bodies can no longer function. have no immediately obvious cause (CDC, 2015). The
Babies who are breastfed are much less at risk of three commonly reported types of SUID are:
malnutrition than those who are bottle-fed. After
weaning, children who have diets deficient in protein 1. Sudden Infant Death Syndrome
may experience kwashiorkor, or the “disease of the (SIDS): SIDS is identified when the death of a healthy
displaced child,” often occurring after another child has infant occurs suddenly and unexpectedly, and medical
been born and taken over breastfeeding. This results in and forensic investigation findings (including an autopsy)
a loss of appetite and swelling of the abdomen as the are inconclusive. SIDS is the leading cause of death in
body begins to break down the vital organs as a source infants up to 12 months old, and approximately 1,500
of protein. infants died of SIDS in 2013 (CDC, 2015). The risk of
SIDS is highest at 4 to 6 weeks of age. Because SIDS is
Infant Sleep diagnosed when no other cause of death can be
determined, possible causes of SIDS are regularly
Infants 0 to 2 years of age sleep an average of researched. One leading hypothesis suggests that
12.8 hours a day, although this changes and develops infants who die from SIDS have abnormalities in the
gradually throughout an infant’s life. For the first three area of the brainstem responsible for regulating
months, newborns sleep between 14 and 17 hours a breathing (Weekes-Shackelford & Shackelford, 2005).
day, then they become increasingly alert for longer Although the exact cause is unknown, doctors have
periods of time. About one-half of an infant’s sleep is identified the following risk factors for SIDS are low birth
rapid eye movement (REM) sleep, and infants often weight, siblings who have had SIDS, sleep apnea, of
begin their sleep cycle with REM rather than non-REM African-American or Inuit descent, low socioeconomic
sleep. They also move through the sleep cycle more status (SES), and smoking in the home.
quickly than adults.
2. Unknown cause: The sudden death of
Parents spend a significant amount of time an infant less than one year of age that cannot be
worrying about and losing even more sleep over their explained because a thorough investigation was not
infant’s sleep schedule, but there remains a great deal of conducted and the cause of death could not be
variation in sleep patterns and habits for individual determined.
children. A 2018 study showed that at 6 months of age,
62% of infants slept at least six hours during the night, 3. Accidental suffocation and
43% of infants slept at least 8 hours through the night, strangulation in bed: Reasons for accidental
and 38% of infants were not sleeping at least six suffocation include the following: suffocation by soft
continual hours through the night. At 12 months, 28% of bedding, another person rolling on top of or against the
children were still not sleeping at least 6 uninterrupted infant while sleeping, an infant being wedged between
hours through the night, while 78% were sleeping at two objects such as a mattress and wall, and
least 6 hours, and 56% were sleeping at least 8 strangulation such as when an infant’s head and neck
hours.[1] become caught between crib railings.

The most common infant sleep-related problem The combined SUID rate declined considerably
reported by parents is nighttime waking. Studies of new following the release of the American Academy of
parents and sleep patterns show that parents lose the Pediatrics safe sleep recommendations in 1992, which
most sleep during the first three months with a new advocated that infants be placed on their backs for sleep
baby, with mothers losing about an hour of sleep each (non-prone position). These recommendations were
night, and fathers losing a disproportionate 13 minutes. followed by a major Back to Sleep Campaign in 1994.
This decline in sleep quality and quantity for adults According to the CDC, the SIDS death rate is now less
persists until the child is about six years old. [2] than one-fourth of what is was (130 per 100,000 live
birth in 1990 versus 40 in 2015). However, accidental
While this shows there is no precise science as suffocation and strangulation in bed mortality rates
to when and how an infant will sleep, there are general remained unchanged until the late 1990s. Some parents
trends in sleep patterns. Around six months, babies were still putting newborns to sleep on their stomachs
typically sleep between 14-15 hours a day, with 3-4 of partly because of past tradition. Most SIDS victims
experience several risks, an interaction of biological and e. Avoid baby’s exposure to smoke,
social circumstances. But thanks to research, the major alcohol, and illicit drugs.
risk, stomach sleeping, has been highly publicized.
Other causes of death during infancy include congenital As you can see, there is a recommendation to
birth defects and homicide. now “share a bedroom with parents,” but not the same
sleeping surface. Breastfeeding is also recommended as
Co-Sleeping adding protection against SIDS, but after feeding, the
AAP encourages parents to move the baby to their
The location of sleep depends primarily on the separate sleeping space, preferably a crib or bassinet in
baby’s age and culture. Bed-sharing (in the parents’ the parents’ bedroom. Finally, the report included new
bed) or co-sleeping (in the parents’ room) is the norm is evidence that supports skin-to-skin care for newborn
some cultures, but not in others (Esposito et al. 2015) infants.[9]
[4]. Colvin, Collie-Akers, Schunn and Moon (2014)[5]
analyzed a total of 8,207 deaths from 24 states during Infant Health
2004–2012. The deaths were documented in the
National Center for the Review and Prevention of Child Immunization
Deaths Case Reporting System, a database of death
reports from state child death review teams. The results Preventing communicable diseases from early
indicated that younger victims (0-3 months) were more infancy is one of the major tasks of the Public Health
likely to die by bed-sharing and sleeping in an adult’s System in the USA. Infants mouth every single object
bed or on a person. A higher percentage of older victims they find as one of their typical developmental tasks.
(4 months to 364 days) rolled into objects in the sleep They learn through their senses and tasting objects
environment and changed position from side/back to stimulates their brain and provides a sensory experience
prone. Carpenter et al. (2013)[6] compared infants who as well as learning.
died of SIDS with a matched control and found that
infants younger than three months old who slept in bed Infants have much contact with dirty surfaces.
with a parent were five times more likely to die of SIDS They lay on a carpet that most likely has been
compared to babies who slept separately from the contaminated by adults walking on it; they mouth keys,
parents, but were still in the same room. They concluded rattles, toys, and books; they crawl on the floor; they
that bed-sharing, even when the parents do not smoke hold on to furniture to walk, and much more. How do we
or take alcohol or drugs, increases the risk of SIDS. prevent infants from getting sick? One possible answer
However, when combined with parental smoking and is immunizations.
maternal alcohol consumption and/or drug use, the risks
associated with bed-sharing greatly increased. Many decades ago, our society struggled to find
vaccines and cures for illnesses such as Polio,
Despite the risks noted above, the controversy whooping cough, and many other medical conditions. A
about where babies should sleep has been ongoing. few decades ago parents started changing their minds
Co-sleeping has been recommended for those who on the need to vaccinate children. Some children are not
advocate attachment parenting (Sears & Sears, 2001) vaccinated for valid medical reasons, but some states
[7] and other research suggests that bed-sharing and allow a child to be unvaccinated because of a parent’s
co-sleeping is becoming more popular in the United personal or religious beliefs. At least 1 in 14 children is
States (Colson et al., 2013) [8]. So, what are the latest not vaccinated. What is the outcome of not vaccinating
recommendations? children? Some of the preventable illnesses are
returning. Fortunately, each vaccinated child stops the
The American Academy of Pediatrics (AAP) transmission of the disease, a phenomenon called herd
actually updated their recommendations for a Safe Infant immunity. Usually, if 90% of the people in a community
Sleeping Environment in 2016. The most recent AAP (a herd) are immunized, no one dies of that disease.
recommendations on creating a safe sleep environment
include: In 2017, Community Care Licensing in
California, the agency that regulates childcare centers,
a. Back to sleep for every sleep. Always changed regulations. Before it was possible for parents
place the baby on their back on a firm sleep surface to opt-out of vaccinations due to personal beliefs, but
such as a crib or bassinet with a tight-fitting sheet. this changed after Governor Brown signed a Bill in 2016
to only exclude children from being vaccinated if there
b. Avoid the use of soft bedding, including were medical reasons. Furthermore, all personnel
crib bumpers, blankets, pillows, and soft toys. The crib working with children must be immunized.
should be bare.
COGNITIVE DEVELOPMENT IN INFANTS AND
c. Breastfeeding is recommended. TODDLERS

d. Share a bedroom with parents, but not In addition to rapid physical growth, young
the same sleeping surface, preferably until the baby children also exhibit significant development of their
turns 1 but at least for the first six months. Room-sharing cognitive abilities, particularly in language acquisition
decreases the risk of SIDS by as much as 50 percent. and in the ability to think and reason. You already
learned a little bit about Piaget’s theory of cognitive
development, and in this section, we’ll apply that model
to cognitive tasks during infancy and toddlerhood. Piaget
described intelligence in infancy as sensorimotor or
based on direct, physical contact where infants use
senses and motor skills to taste, feel, pound, push, hear,
and move in order to experience the world. These basic
motor and sensory abilities provide the foundation for
the cognitive skills that will emerge during the
subsequent stages of cognitive development.

Cognitive Development For an overview of the substages of

sensorimotor thought, it helps to group the six substages
In order to adapt to the evolving environment into pairs. The first two substages involve the infant’s
around us, humans rely on cognition, both adapting to responses to its own body, call primary circular
the environment and also transforming it. In general, all reactions. During the first month first (substage one), the
theorists studying cognitive development address three infant’s senses, as well motor reflexes are the
main issues—the typical course of cognitive foundation of thought.
development, the unique differences between
individuals, and the mechanisms of cognitive 1. Substage One: Reflexive Action (Birth
development (the way genetics and environment through 1st month) This active learning begins with
combine to generate patterns of change). automatic movements or reflexes (sucking, grasping,
staring, listening). A ball comes into contact with an
Sensorimotor Intelligence infant’s cheek and is automatically sucked on and licked.
But this is also what happens with a sour lemon, much
How do infants connect and make sense of what to the infant’s surprise! The baby’s first challenge is to
they are learning? Remember that Piaget believed that learn to adapt the sucking reflex to bottles or breasts,
we are continuously trying to maintain cognitive pacifiers or fingers, each acquiring specific types of
equilibrium, or balance, between what we see and what tongue movements to latch, suck, breathe, and repeat.
we know (Piaget, 1954). Children have much more of a This adaptation demonstrates that infants have begun to
challenge in maintaining this balance because they are make sense of sensations. Eventually, the use of these
constantly being confronted with new situations, new reflexes becomes more deliberate and purposeful as
words, new objects, etc. All this new information needs they move onto substage two.
to be organized, and a framework for organizing
information is referred to as a schema. Children develop 2. Substage Two: First Adaptations to the
schemas through the processes of assimilation and Environment (1st through 4th months) Fortunately,
accommodation. within a few days or weeks, the infant begins to
discriminate between objects and adjust responses
For example, 2-year-old Deja learned the accordingly as reflexes are replaced with voluntary
schema for dogs because her family has a Poodle. movements. An infant may accidentally engage in a
When Deja sees other dogs in her picture books, she behavior and find it interesting, such as making a
says, “Look mommy, dog!” Thus, she has assimilated vocalization. This interest motivates trying to do it again
them into her schema for dogs. One day, Deja sees a and helps the infant learn a new behavior that originally
sheep for the first time and says, “Look mommy, dog!” occurred by chance. The behavior is identified as
Having a basic schema that a dog is an animal with four circular and primary because it centers on the infant’s
legs and fur, Deja thinks all furry, four-legged creatures own body. At first, most actions have to do with the body,
are dogs. When Deja’s mom tells her that the animal she but in months to come, will be directed more toward
sees is a sheep, not a dog, Deja must accommodate her objects. For example, the infant may have different
schema for dogs to include more information based on sucking motions for hunger and others for comfort (i.e.
her new experiences. Deja’s schema for dog was too sucking a pacifier differently from a nipple or attempting
broad since not all furry, four-legged creatures are dogs. to hold a bottle to suck it).
She now modifies her schema for dogs and forms a new
one for sheep. The next two substages (3 and 4), involve the
infant’s responses to objects and people, called
Let’s examine the transition that infants make secondary circular reactions. Reactions are no longer
from responding to the external world reflexively as confined to the infant’s body and are now interactions
newborns, to solving problems using mental strategies between the baby and something else.
as two-year-olds. Piaget called this first stage of
cognitive development sensorimotor intelligence (the 3. Substage Three: Repetition (4th through
sensorimotor period) because infants learn through their 8th months) During the next few months, the infant
senses and motor skills. He subdivided this period into becomes more and more actively engaged in the outside
six substages: world and takes delight in being able to make things
happen by responding to people and objects. Babies try
to continue any pleasing event. Repeated motion brings
particular interest as the infant is able to bang two lids
together or shake a rattle and laugh. Another example
might be to clap their hands when a caregiver says
“patty-cake.” Any sight of something delightful will trigger involves learning to use language. This initial movement
efforts for interaction. from the “hands-on” approach to knowing about the
world to the more mental world of stage six marked the
4. Substage Four: New Adaptations and transition to preoperational thinking, which you’ll learn
Goal-Directed Behavior (8th through 12th months) more about in a later module.
Now the infant becomes more deliberate and purposeful
in responding to people and objects and can engage in Development of Object Permanence
behaviors that others perform and anticipate upcoming
events. Babies may ask for help by fussing, pointing, or A critical milestone during the sensorimotor
reaching up to accomplish tasks, and work hard to get period is the development of object permanence.
what they want. Perhaps because of continued Introduced during substage 4 above, object permanence
maturation of the prefrontal cortex, the infant becomes is the understanding that even if something is out of
capable of having a thought and carrying out a planned, sight, it continues to exist. The infant is now capable of
goal-directed activity such as seeking a toy that has making attempts to retrieve the object. Piaget thought
rolled under the couch or indicating that they are hungry. that, at about 8 months, babies first understand the
The infant is coordinating both internal and external concept of objective permanence, but some research
activities to achieve a planned goal and begins to get a has suggested that infants seem to be able to recognize
sense of social understanding. Piaget believed that at that objects have permanence at much younger ages
about 8 months (during substage 4), babies first (even as young as 4 months of age). Other researchers,
understood the concept of object permanence, which is however, are not convinced (Mareschal & Kaufman,
the realization that objects or people continue to exist 2012).[1] It may be a matter of “grasping vs. mastering”
when they are no longer in sight. the concept of objective permanence. Overall, we can
expect children to grasp the concept that objects
The last two stages (5 and 6), called tertiary continue to exist even when they are not in sight by
circular reactions, consist of actions (stage 5) and ideas around 8 months old, but memory may play a factor in
(stage 6) where infants become more creative in their their consistency. Because toddlers (i.e., 12–24 months
thinking. old) have mastered object permanence, they enjoy
games like hide-and-seek, and they realize that when
5. Substage Five: Active Experimentation of someone leaves the room they will come back (Loop,
“Little Scientists” (12th through 18th months) The 2013). Toddlers also point to pictures in books and look
toddler is considered a “little scientist” and begins in appropriate places when you ask them to find objects.
exploring the world in a trial-and-error manner, using
motor skills and planning abilities. For example, the child Learning and Memory Abilities in Infants
might throw their ball down the stairs to see what
happens or delight in squeezing all of the toothpaste out Memory is central to cognitive development. Our
of the tube. The toddler’s active engagement in memories form the basis for our sense of self, guide our
experimentation helps them learn about their world. thoughts and decisions, influence our emotional
Gravity is learned by pouring water from a cup or reactions, and allow us to learn (Bauer, 2008)[2]. It is
pushing bowls from high chairs. The caregiver tries to thought that Piaget underestimated memory ability in
help the child by picking it up again and placing it on the infants (Schneider, 2015)[3].
tray. And what happens? Another experiment! The child
pushes it off the tray again causing it to fall and the As mentioned when discussing the development
caregiver to pick it up again! A closer examination of this of infant senses, within the first few weeks of birth,
stage causes us to really appreciate how much learning infants recognize their caregivers by face, voice, and
is going on at this time and how many things we come to smell. Sensory and caregiver memories are apparent in
take for granted must actually be learned. This is a the first month, motor memories by 3 months, and then,
wonderful and messy time of experimentation and most at about 9 months, more complex memories including
learning occurs by trial and error. language (Mullally & Maguire, 2014)[4]. There is
agreement that memory is fragile in the first months of
6. Substage Six: Mental life, but that improves with age. Repeated sensations
Representations (18th month to 2 years of age) The and brain maturation are required in order to process
child is now able to solve problems using mental and recall events (Bauer, 2008). Infants remember
strategies, to remember something heard days before things that happened weeks and months ago (Mullally &
and repeat it, to engage in pretend play, and to find Maguire, 2014), although they most likely will not
objects that have been moved even when out of sight. remember it decades later. From the cognitive
Take, for instance, the child who is upstairs in a room perspective, this has been explained by the idea that the
with the door closed, supposedly taking a nap. The lack of linguistic skills of babies and toddlers limit their
doorknob has a safety device on it that makes it ability to mentally represent events; thereby, reducing
impossible for the child to turn the knob. After trying their ability to encode memory. Moreover, even if infants
several times to push the door or turn the doorknob, the do form such early memories, older children and adults
child carries out a mental strategy to get the door may not be able to access them because they may be
opened – he knocks on the door! Obviously, this is a employing very different, more linguistically based,
technique learned from the past experience of hearing a retrieval cues than infants used when forming the
knock on the door and observing someone opening the memory.
door. The child is now better equipped with mental
strategies for problem-solving. Part of this stage also Language Development
 language. Instead, they communicate their thoughts and
Given the remarkable complexity of a language, needs with body posture (being relaxed or still),
one might expect that mastering a language would be an gestures, cries, and facial expressions. A person who
especially arduous task; indeed, for those of us trying to spends adequate time with an infant can learn which
learn a second language as adults, this might seem to cries indicate pain and which ones indicate hunger,
be true. However, young children master language very discomfort, or frustration.
quickly with relative ease. B. F. Skinner (1957) proposed
that language is learned through reinforcement. Noam 1. Intentional Vocalizations: Infants begin
Chomsky (1965) criticized this behaviorist approach, to vocalize and repeat vocalizations within the first
asserting instead that the mechanisms underlying couple of months of life. That gurgling, musical
language acquisition are biologically determined. The vocalization called cooing can serve as a source of
use of language develops in the absence of formal entertainment to an infant who has been laid down for a
instruction and appears to follow a very similar pattern in nap or seated in a carrier on a car ride. Cooing serves
children from vastly different cultures and backgrounds. as practice for vocalization. It also allows the infant to
It would seem, therefore, that we are born with a hear the sound of their own voice and try to repeat
biological predisposition to acquire a language sounds that are entertaining. Infants also begin to learn
(Chomsky, 1965; Fernández & Cairns, 2011). Moreover, the pace and pause of conversation as they alternate
it appears that there is a critical period for language their vocalization with that of someone else and then
acquisition, such that this proficiency at acquiring take their turn again when the other person’s
language is maximal early in life; generally, as people vocalization has stopped. Cooing initially involves
age, the ease with which they acquire and master new making vowel sounds like “oooo.” Later, as the baby
languages diminishes (Johnson & Newport, 1989; moves into babbling (see below), consonants are added
Lenneberg, 1967; Singleton, 1995). to vocalizations such as “nananananana.”

Children begin to learn about language from a 2. Babbling and Gesturing: Between 6
very early age (Table 1). In fact, it appears that this is and 9 months, infants begin making even more
occurring even before we are born. Newborns show a elaborate vocalizations that include the sounds required
preference for their mother’s voice and appear to be for any language. Guttural sounds, clicks, consonants,
able to discriminate between the language spoken by and vowel sounds stand ready to equip the child with the
their mother and other languages. Babies are also ability to repeat whatever sounds are characteristic of
attuned to the languages being used around them and the language heard. These babies repeat certain
show preferences for videos of faces that are moving in syllables (ma-ma-ma, da-da-da, ba-ba-ba), a
synchrony with the audio of spoken language versus vocalization called babbling because of the way it
videos that do not synchronize with the audio (Blossom sounds. Eventually, these sounds will no longer be used
& Morgan, 2006; Pickens, 1994; Spelke & Cortelyou, as the infant grows more accustomed to a particular
1981). language. Deaf babies also use gestures to
communicate wants, reactions, and feelings. Because
gesturing seems to be easier than vocalization for some
toddlers, sign language is sometimes taught to enhance
one’s ability to communicate by making use of the ease
of gesturing. The rhythm and pattern of language are
used when deaf babies sign just as when hearing babies
babble.

At around ten months of age, infants can

understand more than they can say. You may have
experienced this phenomenon as well if you have ever
tried to learn a second language. You may have been
Each language has its own set of phonemes able to follow a conversation more easily than to
that are used to generate morphemes, words, and so contribute to it.
on. Babies can discriminate among the sounds that
make up a language (for example, they can tell the 3. Holophrasic Speech: Children begin
difference between the “s” in vision and the “ss” in using their first words at about 12 or 13 months of age
fission); early on, they can differentiate between the and may use partial words to convey thoughts at even
sounds of all human languages, even those that do not younger ages. These one-word expressions are referred
occur in the languages that are used in their to as holophrasic speech (holophrase). For example, the
environments. However, by the time that they are about child may say “ju” for the word “juice” and use this sound
1 year old, they can only discriminate among those when referring to a bottle. The listener must interpret the
phonemes that are used in the language or languages in meaning of the holophrase. When this is someone who
their environments (Jensen, 2011; Werker & Lalonde, has spent time with the child, interpretation is not too
1988; Werker & Tees, 1984). difficult. They know that “ju” means “juice” which means
the baby wants some milk! But, someone who has not
Newborn Communication been around the child will have trouble knowing what is
meant. Imagine the parent who exclaims to a friend,
Do newborns communicate? Certainly, they do. “Ezra’s talking all the time now!” The friend hears only
They do not, however, communicate with the use of
“ju da ga” which, the parent explains, means “I want
some milk when I go with Daddy.” Theories of Language Development

4. Underextension: A child who learns How is language learned? Each major theory of
that a word stands for an object may initially think that language development emphasizes different aspects of
the word can be used for only that particular object. Only language learning: that infants’ brains are genetically
the family’s Irish Setter is a “doggie.” This is referred to attuned to language, that infants must be taught, and
as underextension. More often, however, a child may that infants’ social impulses foster language learning.
think that a label applies to all objects that are similar to The first two theories of language development
the original object. In overextension, all animals become represent two extremes in the level of interaction
“doggies,” for example. required for language to occur (Berk, 2007).

5. First Words and Cultural Influences: 1. Chomsky and Language Acquisition

First words for English-speaking children tend to be Device: This theory posits that infants teach themselves
nouns. The child labels objects such as a cup or a ball. and that language learning is genetically programmed.
In a verb-friendly language such as Chinese, however, The view is known as nativism and was advocated by
children may learn more verbs. This may also be due to Noam Chomsky, who suggested that infants are
the different emphasis given to objects based on culture. equipped with a neurological construct referred to as the
Chinese children may be taught to notice action and language acquisition device (LAD), which makes infants
relationship between objects while children from the ready for language. The LAD allows children, as their
United States may be taught to name an object and its brains develop, to derive the rules of grammar quickly
qualities (color, texture, size, etc.). These differences and effectively from the speech they hear every day.
can be seen when comparing interpretations of art by Therefore, language develops as long as the infant is
older students from China and the United States. exposed to it. No teaching, training, or reinforcement is
required for language to develop. Instead, language
6. Vocabulary Growth Spurt: learning comes from a particular gene, brain maturation,
One-year-olds typically have a vocabulary of about 50 and the overall human impulse to imitate.
words. But by the time they become toddlers, they have
a vocabulary of about 200 words and begin putting those 2. Skinner and Reinforcement: This
words together in telegraphic speech (short phrases). theory is the opposite of Chomsky’s theory because it
This language growth spurt is called the naming suggests that infants need to be taught language. This
explosion because many early words are nouns idea arises from behaviorism. Learning theorist, B. F.
(persons, places, or things). Skinner, suggested that language develops through the
use of reinforcement. Sounds, words, gestures, and
7. Two-Word Sentences and phrases are encouraged by following the behavior with
Telegraphic Speech: Words are soon combined and attention, words of praise, treats, or anything that
18-month-old toddlers can express themselves further increases the likelihood that the behavior will be
by using phrases such as “baby bye-bye” or “doggie repeated. This repetition strengthens associations, so
pretty.” Words needed to convey messages are used, infants learn the language faster as parents speak to
but the articles and other parts of speech necessary for them often. For example, when a baby says “ma-ma,”
grammatical correctness are not yet included. These the mother smiles and repeats the sound while showing
expressions sound like a telegraph (or perhaps a better the baby attention. So, “ma-ma” is repeated due to this
analogy today would be that they read like a text reinforcement.
message) where unnecessary words are not used. “Give
baby ball” is used rather than “Give the baby the ball.” 3. Social Pragmatics: Another language
Or a text message of “Send money now!” rather than theory emphasizes the child’s active engagement in
“Dear Mother. I really need some money to take care of learning the language out of a need to communicate.
my expenses.” You get the idea. Social impulses foster infant language because humans
are social beings and we must communicate because
8. Child-Directed Speech: Why is a horse we are dependent on each other for survival. The child
a “horsie”? Have you ever wondered why adults tend to seeks information, memorizes terms, imitates the
use “baby talk” or that sing-song type of intonation and speech heard from others, and learns to conceptualize
exaggeration used when talking to children? This using words as language is acquired. Tomasello &
represents a universal tendency and is known as Herrmann (2010) argue that all human infants, as
child-directed speech or motherese or parentese. It opposed to chimpanzees, seek to master words and
involves exaggerating the vowel and consonant sounds, grammar in order to join the social world [1] Many would
using a high-pitched voice, and delivering the phrase argue that all three of these theories (Chomsky’s
with great facial expression. Why is this done? It may be argument for nativism, conditioning, and social
in order to clearly articulate the sounds of a word so that pragmatics) are important for fostering the acquisition of
the child can hear the sounds involved. Or it may be language (Berger, 2004).
because when this type of speech is used, the infant
pays more attention to the speaker and this sets up a Moral Reasoning in Infants
pattern of interaction in which the speaker and listener
are in tune with one another. When I demonstrate this in The work of Lawrence Kohlberg was an
class, the students certainly pay attention and look my important start to modern research on moral
way. Amazing! It also works in the college classroom! development and reasoning. However, Kohlberg relied
on a specific method: he presented moral dilemmas and age—are primarily motivated to avoid punishment and
asked children and adults to explain what they would do seek rewards. Neither Kohlberg nor Carol Gilligan nor
and—more importantly—why they would act in that Jean Piaget was likely to predict that infants would
particular way. Kohlberg found that children tended to develop preferences based on the type of behavior
make choices based on avoiding punishment and shown by other individuals.
gaining praise. But children are at a disadvantage
compared to adults when they must rely on language to Experiment 2. Do infants judge others based
convey their inner thoughts and emotional reactions, so on their behavior?
what they say may not adequately capture the
complexity of their thinking. In the research world, the early attempts to
study something, when the researchers work to develop
Starting in the 1980s, developmental a solid and reliable research procedure, is often the
psychologists created new methods for studying the most challenging time. Once the researcher works
thought processes of children and infants long before through initial problems and issues and begins to get
they acquire language. One particularly effective method consistent results, they can gain a deeper understanding
is to present children with puppet shows to grab their by adding new variables or testing different groups of
attention and then record nonverbal behaviors, such as subjects (e.g., older children or children with some
looking and choosing, to identify children’s preferences interesting psychological characteristics).
or interests.
The study you just read about is an example of
A research group at Yale University has been a simple, basic study. The researchers found that infants
using the puppet show technique to study moral thinking preferred puppets that help another puppet (the puppet
of children for much of the past decade. What they have in the giver condition) over puppets that are not nice to
discovered has given us a glimpse of surprisingly another puppet (the puppet in the taker condition). A
complex thought processes that may serve as the common sense interpretation of this simple result is that
foundation of moral reasoning. infants like nice behavior and they dislike hurtful
behavior. And perhaps that is as complicated as an
Experiment 1. Do children prefer givers or 8-month-old infant’s thoughts can be. But maybe not.
takers?
Dr. Hamlin and her colleagues wondered if
In 2011, J. Kiley Hamlin and Karen Wynn put on infants might consider more factors when judging an
puppet shows for very young children: 5-month-old event. Adults generally prefer situations where good
infants. The infants watch a puppet bouncing a ball. things happen to someone rather than something
We’ll call this puppet the “bouncer puppet.” Two other harmful. However, when adults see someone do
puppets stand at the back of the stage, one to left and something bad, they may find satisfaction in seeing that
the other to the right. After a few bounces, the ball gets person punished by having something bad happen to
away from the bouncer puppet and rolls to the side of them. In a nutshell: good things should happen to good
the stage toward one of the other puppets. This puppet people and bad things should happen to bad people.
grabs the ball. The bouncer puppet turns toward the ball This is what is called “just world” thinking, where people
and opens its arms as if asking for the ball back. get what they deserve.

This is where the puppet show gets interesting In the study we will call Experiment 2, Hamlin’s
(for a young infant, anyway!). Sometimes, the puppet team tested 8-month-old infants and repeated the
with the ball rolls it back to the bouncer puppet. This is procedures from Experiment 1 with a major addition. In
the “giver puppet” condition. Other times, the infant sees Experiment 1 (described above), the puppet bouncing
a different ending. As the bouncer puppet opens its arms the ball was a neutral character, neither good nor bad. In
to ask for the ball, the puppet with the ball turns and runs Experiment 2, the infants saw 2 different shows. First,
away with it. This is the “taker puppet” condition. they saw the bouncer puppet either helping or hindering
Although the giver and taker puppets are two copies of another puppet. Then, they watched the same
the same animal doll, they are easily distinguished ball-bouncing puppet show. Here is what happened:
because they are wearing different colored shirts, and
color is a quality that infants easily distinguish and a. Puppet Show #1: A puppet is trying to
remember. open a box, but cannot quite succeed. Two puppets
stand in the background. For some infants, as the first
Each infant sees both conditions: the giver puppet struggles to open the box, one of the puppets in
condition and the taker condition. Just after the end of the back comes forward and helps to open the box. This
the second puppet show (i.e., the second condition), a is the helper puppet. For other children, as the first
new researcher, who doesn’t know which puppet was puppet struggles, a puppet comes from the back and
the giver and which was the taker, sits in front of the jumps on the box, slamming it shut. This is the hinderer
infant with the giver puppet in one hand and the taker puppet. Each infant sees only a helper or a
puppet in the other. The 5-month-old infants are allowed hinderer—not both.
to reach for a puppet. The one the child reaches out to
touch is considered the preferred puppet. b. Puppet Show #2: Just after the infants
have watched the first show, the second puppet show
Remember that Lawrence Kohlberg thought that begins. This is the show that you read about in
children at this age—and, in fact, through 9 years of Experiment 1. The only thing that is new is that the
bouncer puppet, the one that loses the ball, is either the differently to the situations tested in the second
helper puppet from Puppet Show #1 or the hinderer experiment.
puppet from Puppet Show #1. Each infant sees this
puppet lose the ball to a giver, who returns the ball, and Experiment 3. Do infants judge others based
to a taker, who runs off with the ball. The elephant in the on their preferences?
yellow shirt from the first show is now bouncing a ball.
After dropping the ball, the moose in the green shirt Across the first two experiments, infants appear
gives it back to him, while the moose in the red shirt to prefer puppets (and, by extension, maybe people, as
takes it away. well) that are helpful over those that are not helpful.
Experiment 2 complicated our story a bit, but it still
So far we have concluded that even young appears that prosocial behavior is attractive to infants
babies prefer the “nice” puppet and show a preference and antisocial behavior is unattractive. But another
for a puppet who helps another puppet. But this only experiment, again using the bouncing ball show,
happened when the bouncer puppet was the helper from suggests that infants as young as 8-months of age may
the first puppet show. What if, instead of the nice have some other motives that are less altruistic than the
elephant in the yellow shirt bouncing the ball, the first two experiments indicate.
elephant in the red shirt (the one who jumped on the
duck’s box, remember?) was the one bouncing the ball? In a study by Hamlin, Mahanjan, Liberman, and
Imagine the same scenario: the mean elephant in the Wynn from 2013, 9-month-old infants watched the
red shirt is bouncing the ball, he drops it, and the moose bouncing ball show, but with a new twist. At the
in the green shirt gives it to him or the moose in the red beginning of the experiment—Phase 1—the infants were
shirt takes it away. given a choice between graham crackers and green
beans. The experimenters determined which food the
So now things are getting interesting, right? Do infant preferred.
8-month old infants understand the concepts of revenge
or justice? We must always be careful when labeling Then, in Phase 2, the infants watched a puppet
behaviors of children (or animals) with characteristics we make the same choice. For half of the infants, the
use for human adults. In the description above, we have puppet chose the same food that they preferred, saying
talked of “nice puppets” and “mean puppets” and used “Mmmm, yum! I like ___(graham crackers or green
other loaded terms. It is tempting to interpret the choices beans)!” and saying “Eww, yuck! I don’t like _____
of the 8-month-olds as a kind of revenge motive: the bad (graham crackers or green beans!” This was called the
guy gets its just desserts (the hinderer puppet has its SIMILAR condition because the puppet was similar to
ball stolen) and the good guy gets its just reward (the the child in its food preference. For the other half of the
helper puppet is itself helped by the giver). Maybe that is infants, the puppet chose the other food, choosing
what is going on, but we encourage you to consider graham crackers if the infant preferred green beans and
these very sophisticated types of thinking as merely one preferring green beans if the infant liked graham
hypothesis. Remember the facts—what did the puppets crackers. This was the DISSIMILAR condition.
do and what choices did the infants make?—without
committing yourself to the adult-level interpretation. Why did the experimenters do this? They
wanted to know if young children form in-groups and
out-groups by perceiving some people as being like
them and other people as being unlike them. The
experimenters noted in their research introduction that
we (adults) are influenced by our perception that others
are similar to us or not like us. We tend to project
positive qualities—being trustworthy, intelligent,
kind—on people we perceive as similar to ourselves,
and people we see as unlike us are seen as having
negative qualities—being relatively untrustworthy,
unintelligent, and unkind.[1]

The researchers believe that this type of Of course, there is a big difference between
thinking, which is remarkably sophisticated, takes some claiming that adults use similarity to make judgments
cognitive development. They tested 5-month-olds using about others and saying that infants less than a year of
the same procedures, and the results with these age do the same thing. However, the researchers note
younger infants were different. The 5-month-olds that some recent research has suggested that infants
showed an overwhelming preference for the giver less than a year old are more likely to develop peer
puppets, regardless of who was bouncing the ball. friendships with other infants who “share their own food,
Maybe it is too complex for them to understand that the clothing, or toy preferences” compared to those who
bouncer puppet in the second show was the same don’t.
puppet from the first show. Or perhaps their memory
processes are too fragile to hold onto information for that So, back to the experiment. In Phase 3, the
length of time. Maybe the revenge motive is too infants either saw a similar puppet (one that chose the
advanced. Or maybe something else is going on. What food the baby preferred) or a dissimilar puppet (one that
is clear is that 5-month-olds and 8-month-olds respond chose the food the baby did not prefer) bouncing the
ball. As in the other experiments, the ball got away from
the bouncer and rolled to the back of the stage. In one know and believe. This starts with curiosity on your part.
instance, the giver puppet returned the ball and, in the Are the experimenters correct in interpreting reaching
other instance, the taker puppet ran away with the ball. behavior as showing a preference or is something else
Finally, in Phase 4, the 9-month-old baby was shown the going on? Do infants really prefer prosocial behaviors to
giver and taker puppet and the experimenters recorded antisocial behaviors, or is there some other explanation
which of the two puppets the baby preferred (reached for their preferences? How else could we test the moral
out to touch). This video shows the dog in the light blue judgments of infants without using puppet shows? The
shirt giving the ball back to the red bunny that preferred next generation of creative scientists will push beyond
graham crackers. what we know now, with new research methods and new
ideas about the mind.
The experimenters also tested an older group of
babies that were 14-months-old. The results for these We’ll give Dr. Hamlin the last word. Here is part
older babies were consistent with the 9-month-old and, if of her conclusion section from an article that
anything, the effects were stronger. Their results showed summarizes some of the research we have been
that all infants preferred when the giver puppet was nice studying: “In sum, recent developmental research
to the puppet that was similar to them and all infants supports the claim that at least some aspects of human
preferred when puppets were mean to the puppet that morality are innate…Indeed, these early tendencies are
was dissimilar to them. far from shallow, mechanical predispositions to behave
well or knee-jerk reactions to particular states of the
world. Infant moral inclinations are sophisticated,
flexible, and surprisingly consistent with adults’ moral
inclinations, incorporating aspects of moral goodness,
evaluation, and retaliation.“

EMOTIONAL AND SOCIAL DEVELOPMENT DURING

INFANCY

Psychosocial development occurs as children

form relationships, interact with others, and understand
and manage their feelings. In emotional and social
development, forming healthy attachments is very
Conclusions important and is the major social milestone of infancy.
Attachment is a long-standing connection or bond with
This exercise started with a reminder that others. Developmental psychologists are interested in
Lawrence Kohlberg found that children went through a how infants reach this milestone. They ask such
long developmental process in their moral reasoning. questions as: how do parent and infant attachment
Based on children’s reasoning aloud about moral bonds form? How does neglect affect these bonds?
dilemmas, Kohlberg concluded that children younger What accounts for children’s attachment differences?
than about 8 or 9 years of age make moral decisions
based on avoiding punishment and receiving praise. Emotional Development
Neither his research nor that of most others in the 1970s
and 1980s suggested that young children would use At birth, infants exhibit two emotional responses:
multiple sources of information and judgments about the attraction and withdrawal. They show attraction to
meaning of behaviors in their thinking about what sorts pleasant situations that bring comfort, stimulation, and
of behaviors are better or worse. pleasure. And they withdraw from unpleasant stimulation
such as bitter flavors or physical discomfort. At around
If Dr. Hamlin and her colleagues are right, then two months, infants exhibit social engagement in the
infants are much more sophisticated and complex in form of social smiling as they respond with smiles to
their thinking about the world than these earlier those who engage their positive attention. Pleasure is
researchers thought. In Dr. Hamlin’s view, infants like expressed as laughter at 3 to 5 months of age, and
good things to happen to good puppets and people, and displeasure becomes more specific to fear, sadness, or
bad things to happen to bad puppets and people. anger (usually triggered by frustration) between ages 6
Experiment 3 suggests that they make judgments about and 8 months. Where anger is a healthy response to
more than helping and harming behavior. They prefer frustration, sadness, which appears in the first months
others who are like them (green beans vs. graham as well, usually indicates withdrawal (Thiam et al.,
crackers) and they don’t mind if others who are not like 2017).
them have unpleasant experiences.
As reviewed above, infants progress from
The research we have been reviewing is just reactive pain and pleasure to complex patterns of
part of an impressive set of research on infant thinking. socioemotional awareness, which is a transition from
The ideas that the researchers have developed are basic instincts to learned responses. Fear is not always
intriguing and they are consistent with the modern view focused on things and events; it can also involve social
of the infant as an active, creative thinker. At the same responses and relationships. The fear is often
time, remember that science doesn’t rest on an early set associated with the presence of strangers or the
of explanations based on a small set of complicated departure of significant others known respectively as
experiments. Science pushes beyond what we currently stranger wariness and separation anxiety, which appear
sometime between 6 and 15 months. And there is even
some indication that infants may experience jealousy as Self-Awareness
young as 6 months of age (Hart & Carrington, 2002).
During the second year of life, children begin to
Stranger wariness actually indicates that brain recognize themselves as they gain a sense of the self as
development and increased cognitive abilities have an object. The realization that one’s body, mind, and
taken place. As an infant’s memory develops, they are activities are distinct from those of other people is known
able to separate the people that they know from the as self-awareness (Kopp, 2011).[2] The most common
people that they do not. The same cognitive advances technique used in research for testing self-awareness in
allow infants to respond positively to familiar people and infants is a mirror test known as the “Rouge Test.” The
recognize those that are not familiar. Separation anxiety rouge test works by applying a dot of rouge (colored
also indicates cognitive advances and is universal makeup) on an infant’s face and then placing them in
across cultures. Due to the infant’s increased cognitive front of the mirror. If the infant investigates the dot on
skills, they are able to ask reasonable questions like their nose by touching it, they are thought to realize their
“Where is my caregiver going?” “Why are they leaving?” own existence and have achieved self-awareness. A
or “Will they come back?” Separation anxiety usually number of research studies have used this technique
begins around 7-8 months and peaks around 14 months, and shown self-awareness to develop between 15 and
and then decreases. Both stranger wariness and 24 months of age. Some researchers also take language
separation anxiety represent important social progress such as “I, me, my, etc.” as an indicator of
because they not only reflect cognitive advances but self-awareness.
also growing social and emotional bonds between
infants and their caregivers. Cognitive psychologist Philippe Rochat (2003)
described a more in-depth developmental path in
As we will learn through the rest of this module, acquiring self-awareness through various stages. He
caregiving does matter in terms of infant emotional described self-awareness as occurring in five stages
development and emotional regulation. Emotional beginning from birth.
regulation can be defined by two components: emotions
as regulating and emotions as regulated. The first,
“emotions as regulating,” refers to changes that are
elicited by activated emotions (e.g., a child’s sadness
eliciting a change in parent response). The second
component is labeled “emotions as regulated,” which
refers to the process through which the activated
emotion is itself changed by deliberate actions taken by
the self (e.g., self-soothing, distraction) or others (e.g.,
comfort).

Throughout infancy, children rely heavily on their

caregivers for emotional regulation; this reliance is
labeled co-regulation, as parents and children both
modify their reactions to the other based on the cues
from the other. Caregivers use strategies such as Once a child has achieved self-awareness, the
distraction and sensory input (e.g., rocking, stroking) to child is moving toward understanding social emotions
regulate infants’ emotions. Despite their reliance on such as guilt, shame or embarrassment, and pride, as
caregivers to change the intensity, duration, and well as sympathy and empathy. These will require an
frequency of emotions, infants are capable of engaging understanding of the mental state of others which is
in self-regulation strategies as young as 4 months old. At acquired around age 3 to 5 and will be explored in the
this age, infants intentionally avert their gaze from next module (Berk, 2007).
overstimulating stimuli. By 12 months, infants use their
mobility in walking and crawling to intentionally approach Attachment
or withdraw from stimuli.
Psychosocial development occurs as children
Throughout toddlerhood, caregivers remain form relationships, interact with others, and understand
important for the emotional development and and manage their feelings. In social and emotional
socialization of their children, through behaviors such as development, forming healthy attachments is very
labeling their child’s emotions, prompting thought about important and is the major social milestone of infancy.
emotion (e.g., “why is the turtle sad?”), continuing to Attachment is a long-standing connection or bond with
provide alternative activities/distractions, suggesting others. Developmental psychologists are interested in
coping strategies, and modeling coping strategies. how infants reach this milestone. They ask such
Caregivers who use such strategies and respond questions as: How do parent and infant attachment
sensitively to children’s emotions tend to have children bonds form? How does neglect affect these bonds?
who are more effective at emotion regulation, are less What accounts for children’s attachment differences?
fearful and fussy, more likely to express positive
emotions, easier to soothe, more engaged in Researchers Harry Harlow, John Bowlby, and
environmental exploration, and have enhanced social Mary Ainsworth conducted studies designed to answer
skills in the toddler and preschool years. these questions. In the 1950s, Harlow conducted a
series of experiments on monkeys. He separated
newborn monkeys from their mothers. Each monkey Strange Situation experiment, but when their caregivers
was presented with two surrogate mothers. One returned, the securely attached children were happy to
surrogate mother was made out of wire mesh, and she see them. Securely attached children have caregivers
could dispense milk. The other surrogate mother was who are sensitive and responsive to their needs.
softer and made from cloth: This monkey did not
dispense milk. Research shows that the monkeys With avoidant attachment, the child is
preferred the soft, cuddly cloth monkey, even though she unresponsive to the parent, does not use the parent as a
did not provide any nourishment. The baby monkeys secure base, and does not care if the parent leaves. The
spent their time clinging to the cloth monkey and only toddler reacts to the parent the same way they react to a
went to the wire monkey when they needed to be feed. stranger. When the parent does return, the child is slow
Prior to this study, the medical and scientific to show a positive reaction. Ainsworth theorized that
communities generally thought that babies become these children were most likely to have a caregiver who
attached to the people who provide their nourishment. was insensitive and inattentive to their needs (Ainsworth,
However, Harlow (1958) concluded that there was more Blehar, Waters, & Wall, 1978).
to the mother-child bond than nourishment. Feelings of
comfort and security are the critical components of In cases of resistant attachment, children tend to
maternal-infant bonding, which leads to healthy show clingy behavior, but then they reject the
psychosocial development. attachment figure’s attempts to interact with them
(Ainsworth & Bell, 1970). These children do not explore
Building on the work of Harlow and others, John the toys in the room, appearing too fearful. During
Bowlby developed the concept of attachment theory. He separation in the Strange Situation, they become
defined attachment as the affectional bond or tie that an extremely disturbed and angry with the parent. When the
infant forms with the mother (Bowlby, 1969). He believed parent returns, the children are difficult to comfort.
that an infant must form this bond with a primary Resistant attachment is thought to be the result of the
caregiver in order to have normal social and emotional caregivers’ inconsistent level of response to their child.
development. In addition, Bowlby proposed that this
attachment bond is very powerful and continues Finally, children with disorganized attachment
throughout life. He used the concept of a secure base to behaved oddly in the Strange Situation. They freeze, run
define a healthy attachment between parent and child around the room in an erratic manner, or try to run away
(1988). A secure base is a parental presence that gives when the caregiver returns (Main & Solomon, 1990).
children a sense of safety as they explore their This type of attachment is seen most often in kids who
surroundings. Bowlby said that two things are needed have been abused or severely neglected. Research has
for a healthy attachment: The caregiver must be shown that abuse disrupts a child’s ability to regulate
responsive to the child’s physical, social, and emotional their emotions.
needs; and the caregiver and child must engage in
mutually enjoyable interactions (Bowlby, 1969). While Ainsworth’s research has found support in
subsequent studies, it has also met criticism. Some
While Bowlby thought attachment was an researchers have pointed out that a child’s temperament
all-or-nothing process, Mary Ainsworth’s (1970) research (which we discuss next) may have a strong influence on
showed otherwise. Ainsworth wanted to know if children attachment (Gervai, 2009; Harris, 2009), and others
differ in the ways they bond, and if so, how. To find the have noted that attachment varies from culture to
answers, she used the Strange Situation procedure to culture, a factor that was not accounted for in
study attachment between mothers and their infants Ainsworth’s research (Rothbaum, Weisz, Pott, Miyake, &
(1970). In the Strange Situation, the mother (or primary Morelli, 2000; van Ijzendoorn & Sagi-Schwartz, 2008).
caregiver) and the infant (age 12-18 months) are placed
in a room together. There are toys in the room, and the Attachment styles vary in the amount of security
caregiver and child spend some time alone in the room. and closeness felt in the relationship and they can
After the child has had time to explore their change with new experiences. The type of attachment
surroundings, a stranger enters the room. The mother fostered in parenting styles varies by culture as well. For
then leaves her baby with the stranger. After a few example, German parents value independence and
minutes, she returns to comfort her child. Japanese mothers are typically by their children’s sides.
As a result, the rate of insecure-avoidant attachments is
Based on how the toddlers responded to the higher in Germany and insecure-resistant attachments
separation and reunion, Ainsworth identified three types are higher in Japan. However, these differences reflect
of parent-child attachments: secure, avoidant, and cultural variation rather than true insecurity (van
resistant (Ainsworth & Bell, 1970). A fourth style, known Ijzendoorn and Sagi, 1999). Keep in mind that methods
as disorganized attachment, was later described (Main & for measuring attachment styles have been based on a
Solomon, 1990). model that reflects middle-class, US values and
interpretation. Newer methods for assessing attachment
The most common type of attachment—also styles involve using a Q-sort technique in which a large
considered the healthiest—is called secure attachment. number of behaviors are recorded on cards and the
In this type of attachment, the toddler prefers their observer sorts the cards in a way that reflects the type of
parent over a stranger. The attachment figure is used as behavior that occurs within the situation.
a secure base to explore the environment and is sought
out in times of stress. Securely attached children were Types of Attachment
distressed when their caregivers left the room in the
 Attachment is classified into four types: A, B, C,
and D. Ainsworth’s original schema differentiated only 4. Disorganized: Disorganized attachment
three types of attachment (types A, B, and C), but, as (type D) represents the most insecure style of
mentioned above, later researchers discovered a fourth attachment and occurs when the child is given mixed,
category (type D). As we explore styles of attachment confused, and inappropriate responses from the
below, consider how these may also be evidenced in caregiver. For example, a mother who suffers from
adult relationships. We’ll come back to this idea in later schizophrenia may laugh when a child is hurting or cry
modules. when a child exhibits joy. The child does not learn how
to interpret emotions or to connect with the
1. Secure: A secure attachment (type B) is unpredictable caregiver.
one in which the child feels confident that their needs will
be met in a timely and consistent way. The caregiver is How common are the attachment styles among
the base for exploration, providing assurance and children in the United States? It is estimated that about
enabling discovery. In North America, this interaction 65 percent of children in the United States are securely
may include an emotional connection in addition to attached. Twenty percent exhibit avoidant styles and 10
adequate care. However, even in cultures where to 15 percent are resistant. Another 5 to 10 percent may
mothers do not talk, cuddle, and play with their infants, be characterized as disorganized.
secure attachments can develop (LeVine et. al., 1994).
Secure attachments can form provided the child has Psychosocial Development
consistent contact and care from one or more
caregivers. Consistency of contacts may be jeopardized Temperament
if the infant is cared for in a daycare with a high
turn-over of caregivers or if institutionalized and given Perhaps you have spent time with a number of
little more than basic physical care. And while infants infants. How were they alike? How did they differ? Or
who, perhaps because of being in orphanages with compare yourself with your siblings or other children you
inadequate care, have not had the opportunity to attach have known well. You may have noticed that some
in infancy can form initial secure attachments several seemed to be in a better mood than others and that
years later, they may have more emotional problems of some were more sensitive to noise or more easily
depression or anger, or be overly friendly as they make distracted than others. These differences may be
adjustments (O’Connor et. al., 2003). attributed to temperament. Temperament is an inborn
quality noticeable soon after birth. Temperament is not
2. Insecure Resistant/Ambivalent: the same as personality but may lead to personality
Insecure-resistant/ambivalent (type C) attachment style differences. Generally, personality traits are learned,
is marked by insecurity and resistance to engaging in whereas temperament is genetic. Of course, for every
activities or play away from the caregiver. It is as if the trait, nature and nurture interact.
child fears that the caregiver will abandon them and
clings accordingly. (Keep in mind that clingy behavior According to Chess and Thomas (1996),
can also just be part of a child’s natural disposition or children vary on nine dimensions of temperament.
temperament and does not necessarily reflect some kind These include activity level, regularity (or predictability),
of parental neglect.) The child may cry if separated from sensitivity thresholds, mood, persistence or distractibility,
the caregiver and also cry upon their return. They seek among others. These categories include the following:
constant reassurance that never seems to satisfy their
doubt. This type of insecure attachment might be a 1. Activity level. Does the child display
result of not having their needs met in a consistent or mostly active or inactive states?
timely way. Consequently, the infant is never sure that
the world is a trustworthy place or that they can rely on 2. Rhythmicity or Regularity. Is the child
others without some anxiety. A caregiver who is predictable or unpredictable regarding sleeping, eating,
unavailable, perhaps because of marital tension, and elimination patterns?
substance abuse, or preoccupation with work, may send
a message to the infant they cannot rely on having their 3. Approach-Withdrawal. Does the child
needs met. A caregiver who attends to a child’s react or respond positively or negatively to a newly
frustration can help teach them to be calm and to relax. encountered situation?
But an infant who receives only sporadic attention when
experiencing discomfort may not learn how to calm 4. Adaptability. Does the child adjust to
down. unfamiliar circumstances easily or with difficulty?

3. Insecure-Avoidant: Insecure-avoidant 5. Responsiveness. Does it take a small

(type A) is an attachment style marked by insecurity. or large amount of stimulation to elicit a response (e.g.,
This style is also characterized by a tendency to avoid laughter, fear, pain) from the child?
contact with the caregiver and with others. This child
may have learned that needs typically go unmet and 6. Reaction Intensity. Does the child
learns that the caregiver does not provide care and show low or high energy when reacting to stimuli?
cannot be relied upon for comfort, even sporadically. An
insecure-avoidant child learns to be more independent 7. Mood Quality. Is the child normally
and disengaged. Such a child might sit passively in a happy and pleasant, or unhappy and unpleasant?
room filled with toys until it is time to go.
 8. Distractibility. Is the child’s attention It is this goodness-of-fit between child
easily diverted from a task by external stimuli? temperament and parental demands and expectations
that can cause struggles. Rather than believing that
9. Persistence and Attention Span. discipline alone will bring about improvements in
Persistence – How long will the child continue at an children’s behavior, our knowledge of temperament may
activity despite difficulty or interruptions? Attention span help a parent, teacher or other caregiver gain insight to
– For how long a period of time can the child maintain work more effectively with a child. Viewing
interest in an activity? temperamental differences as varying styles that can be
responded to accordingly, as opposed to ‘good’ or ‘bad’
The New York Longitudinal Study was a long behavior. For example, a persistent child may be difficult
term study of infants, on these dimensions, which began to distract from forbidden things such as electrical cords,
in the 1950s. Most children do not have their but this persistence may serve her well in other areas
temperament clinically measured, but categories of such as problem-solving. Positive traits can be
temperament have been developed and are seen as enhanced and negative traits can be subdued. The
useful in understanding and working with children. child’s style of reaction, however, is unlikely to change.
Based on this study, babies can be described according Temperament doesn’t change dramatically as we grow
to one of several profiles: easy or flexible (40%), slow to up, but we may learn how to work around and manage
warm up or cautious (15%), difficult or feisty (10%), and our temperamental qualities. Temperament may be one
undifferentiated, or those who can’t easily be of the things about us that stays the same throughout
categorized (35%). development.

Easy babies (40% of infants) have a positive Erikson’s Stages for Infants and Toddlers
disposition. Their body functions operate regularly and
they are adaptable. They are generally positive, showing Trust vs. Mistrust
curiosity about new situations and their emotions are
moderate or low in intensity. Difficult babies (10% of Erikson maintained that the first year to year and
infants) have more negative moods and are slow to a half of life involves the establishment of a sense of
adapt to new situations. When confronted with a new trust. Infants are dependent and must rely on others to
situation, they tend to withdraw. Slow-to-warm babies meet their basic physical needs as well as their needs
(15% of infants) are inactive, showing relatively calm for stimulation and comfort. A caregiver who consistently
reactions to their environment. Their moods are meets these needs instills a sense of trust or the belief
generally negative, and they withdraw from new that the world is a safe and trustworthy place. The
situations, adapting slowly. The undifferentiated (35%) caregiver should not worry about overindulging a child’s
could not be consistently categorized. These children need for comfort, contact, or stimulation. This view is in
show a variety of combinations of characteristics. For sharp contrast with the Freudian view that a parent who
example, an infant may have an overall positive mood overindulges the infant by allowing them to suck too long
but react negatively to new situations. or be picked up too frequently will be spoiled or become
fixated at the oral stage of development.
No single type of temperament is invariably
good or bad, however, infants with difficult Consider the implications for establishing trust if
temperaments are more likely than other babies to a caregiver is unavailable or is upset and ill-prepared to
develop emotional problems, especially if their mothers care for a child, or if a child is born prematurely, is
were depressed or anxious caregivers (Garthus-Niegel unwanted, or has physical problems that could make
et al., 2017).[1] Children’s long-term adjustment actually them less desirable to a parent. However, keep in mind
depends on the goodness-of-fit of their particular that children can also exhibit strong resiliency to harsh
temperament to the nature and demands of the circumstances. Resiliency can be attributed to certain
environment in which they find themselves. Therefore, personality factors, such as an easy-going temperament
what appears to be more important than child and receiving support from others. A positive and strong
temperament is how caregivers respond to it. support group can help a parent and child build a strong
foundation by offering assistance and positive attitudes
Think about how you might approach each type toward the newborn and parent.
of child in order to improve your interactions with them.
An easy or flexible child will not need much extra Autonomy vs. Shame and Doubt
attention unless you want to find out whether they are
having difficulties that have gone unmentioned. A slow As the child begins to walk and talk, an interest
to warm up child may need to be given advance warning in independence or autonomy replaces their concern for
if new people or situations are going to be introduced. A trust. The toddler tests the limits of what can be touched,
difficult or feisty child may need to be given extra time to said, and explored. Erikson believed that toddlers should
burn off their energy. A caregiver’s ability to accurately be allowed to explore their environment as freely as
read and work well with the child will enjoy this safety allows and, in doing so, will develop a sense of
goodness-of-fit, meaning their styles match and independence that will later grow to self-esteem,
communication and interaction can flow. The initiative, and overall confidence. If a caregiver is overly
temperamentally active children can do well with parents anxious about the toddler’s actions for fear that the child
who support their curiosity but could have problems in a will get hurt or violate others’ expectations, the caregiver
more rigid family. can give the child the message that they should be
ashamed of their behavior and instill a sense of doubt in
their abilities. Parenting advice based on these ideas Circumcision: the surgical removal of the foreskin of
would be to keep your toddler safe, but let them learn by the penis
doing. A sense of pride seems to rely on doing rather
than being told how capable one is (Berger, 2005). Fine Motor Skills: physical abilities involving small body
movements, especially of the hands and fingers, such as
drawing and picking up a coin. The word “fine” in this
context means “small”

Gross Motor Skills: physical abilities involving large

body movements, such as walking and jumping. The
word “gross” in this context means “big”

GLOSSARY OF TERMS Motor Skills: the word “motor” refers to the movement
of the muscles. Motor skills refer to our ability to move
Axons: fibers that extend from the neurons and transmit our bodies and manipulate objects
electrochemical impulses from that neuron to the
dendrites of other neurons Perception: the process of interpreting what is sensed

Cortex: the outer layers of the brain in humans and Pincer Grasp: a developmental milestone that typically
other mammals. Most thinking, feeling, and sensing occurs at 9 to 12 months of age; the coordination of the
involves the cortex index finger and thumb to hold smaller objects;
represents a further development of fine motor skills
Dendrites: fibers that extend from neurons and receive
electrochemical impulses transmitted from other neurons Proximodistal: development that occurs from the center
via their axons or core of the body in an outward direction

Failure to Thrive: decelerated or arrested physical Reflexes: the inborn, behavioral patterns that develop
growth (height and weight measurements fall below the during uterine life and are fully present at birth. These
third or fifth percentile or a downward change in growth are involuntary movements (not learned) or actions that
across two major growth percentiles) and is associated are essential for a newborn’s survival immediately after
with abnormal growth and development birth and include: sucking, swallowing, blinking,
urinating, hiccuping, and defecating
Myelin: a coating of fatty tissues around the axon of the
neuron Sensation: the interaction of information with the
sensory receptors
Neurons: nerve cells in the central nervous system,
especially in the brain Colostrum: the first secretion from the mammary glands
after giving birth, rich in antibodies
Neurotransmitters: brain chemicals that carry
information from the axon of a sending neuron to the Infantile Marasmus: starvation due to a lack of calories
dendrites of a receiving neuron and protein

Percentile: a point on a ranking scale of 0 to 100. The Kwashiorkor: also known as the “disease of the
50th percentile is the midpoint; half of the infants in the displaced child,” results in a loss of appetite and swelling
population being studied rank higher and half rank lower of the abdomen as the body begins to break down the
vital organs as a source of protein
Prefrontal Cortex: the area of the cortex at the very
front of the brain that specializes in anticipation, Malnutrition: a condition that results from eating a diet
planning, and impulse control in which one or more nutrients are deficient

Pruning: the process by which unused connections in Milk Anemia: an iron deficiency in infants who have
the brain atrophy and die been maintained on a milk diet for too long

Synapses: the intersection between the axon of one Bed-Sharing: when two or more people sleep in the
neuron to the dendrites of another neuron same bed

Transient Exuberance: the great, but temporary Co-Sleeping: a custom in which parents and their
increase in the number of dendrites that develop in an children (usually infants) sleep together in the same
infant’s brain during the first two years of life room

Cephalocaudal: refers to growth and development that Immunization: a process that stimulates the body’s
occurs from the head down immune system by causing the production of antibodies
to defend against attack by a specific contagious Ainsworth’s Strange Situation: a sequence of staged
disease episodes that illustrate the type of attachment between a
child and (typically) their mother
Sudden Infant Death Syndrome (SIDS): a situation in
which a seemingly healthy infant, usually between 2 and Attachment: the positive emotional bond that develops
6 months old, suddenly stops breathing and dies between a child and a particular individual
unexpectedly while asleep
Disorganized Attachment (Type D): a type of
Accommodation: when we restructure or modify what attachment that is marked by an infant’s inconsistent
we already know so that new information can fit in better reactions to the caregiver’s departure and return

Assimilation: when we modify or change new Emotional Regulation: the ability to respond to the
information to fit into our schemas (what we already ongoing demands of experience with the range of
know) emotions in a manner that is socially tolerable and
sufficiently flexible to permit spontaneous reactions as
Infantile or Childhood Amnesia: the idea that people well as the ability to delay spontaneous reactions as
forget everything that happened to them before the age needed
of 3 Insecure-Avoidant Attachment (Type A): a pattern of
attachment in which an infant avoids connection with the
Object Permanence: the realization that objects caregiver, as when the infant seems not to care about
(including people) still exist even if they can no longer be the caregiver’s presence, departure, or even return
seen, touched, or heard
Insecure-Resistant/Ambivalent Attachment (Type C):
Primary Circular Reactions: the first two stages of a pattern of attachment in which an infant’s anxiety and
Piaget’s sensorimotor intelligence which involve the uncertainty are evident, as when the infant becomes
infant’s responses to its own body very upset at separation from the caregiver and both
resists and seeks contact on reunion
Schema: a set of linked mental representations of the
world, which we use both to understand and to respond Secure Attachment (Type B): a relationship in which an
to situations infant obtains both comfort and confidence from the
presence of their caregiver
Secondary Circular Reactions: stages 3 and 4 of
Piaget’s sensorimotor intelligence which involves the Secure Base: a parental presence that gives children a
infant’s responses to objects and people sense of safety as they explore their surroundings

Sensorimotor Intelligence: Piaget’s term for the way Self-Awareness: a person’s realization that they are a
infants think (by using their senses and motor skills) distinct individual whose body, mind, and actions are
during the first stage of cognitive development separate from those of other people

Tertiary Circular Reactions: consist of actions (stage Separation Anxiety: fear or distress caused by the
5) and ideas (stage 6) where infants become more departure of familiar significant others; most obvious
creative in their thinking between 9-14 months

Babbling: an infant’s repetition of certain syllables, such Social Smile: a smile evoked by a human face, normally
as ba-ba-ba, that begins when babies are between 6 first evident in infants about 6 weeks after birth
and 9 months old
Stranger Wariness: fear is often associated with the
Holophrase: a single word that is used to express a presence of strangers where an infant expresses
complete, meaningful thought concern or a look of fear while clinging to a familiar
person
Language Acquisition Device (LAD): Chomsky’s term
for the hypothesized mental structure that enables Temperament: inborn differences between one person
humans to learn the language, including the basic and another in emotions, activity, and self-regulation,
aspects of grammar, vocabulary, and intonation which is measured by the person’s typical responses to
the environment
Morpheme: the smallest unit of language that conveys
some type of meaning Autonomy vs. Shame and Doubt: Erikson’s second
crisis of psychosocial development, during which
Naming Explosion: a sudden increase in an infant’s toddlers strive to gain a sense of self-rule over their
vocabulary, especially in the number of nouns, that actions and their bodies
begins at about 18 months of age
Goodness-of-Fit: the notion that development is
Phoneme: a basic sound unit of a given language dependent on the degree of match between children’s
temperament and the nature and demands of the
environment in which they are being raised
Temperament: inborn differences between one person
and another in emotions, activity, and self-regulation,
typically measured by the person’s responses to the
environment

Trust vs. Mistrust: Erikson’s first crisis of psychosocial

development, during which infants learn basic trust if the
world is a secure place where their needs (food, comfort,
attention) are met