Paper  A:  Human  Development  
 
 
 
 
I.  Cognitive  Development  ...................................................................................  2  

II.   Psychosocial  development  and  concept  of  self  ...........................................  5  

III.   Moral  development  .....................................................................................  6  

IV.   Psychosexual  development,  gender  identity  and  puberty  .........................  7  

V.   Temperament  in  children  .............................................................................  9  

VI.   Development  course  of  normal  fear  in  children  ........................................  9  

VII.   Foetal  competencies  and  childhood  capabilities  ......................................  9  

VIII.   Attachment  ...............................................................................................  10  

IX.   Miscellaneous  concepts  in  attachment  ......................................................  12  

 
 Paper  A  Human  Development    

I.  Cognitive  Development  
 
Piaget’s  Theory  
 
[In  every  MCQ  paper  one  can  expect  a  few  questions  on  Piaget’s  theory.  Piaget’s  theory  is  difficult  
to   remember   and   examiners   are   fond   of   ‘catching   you   out’   by   asking   detailed   or   obscure  
questions.  What  follows  is  a  highly  organised  account  of  the  theory  covering  the  main  aspects.  It  
is  worth  re-­‐revising  Piaget  for  a  last  minute  revision]  
Jean  Piaget  (1896-­‐1980),  a  Swiss  genetic-­‐epistemologist  (genetic  =  development;  epistemology  
=   study   of   knowledge),   is   one   of   the   pioneers   in   the   area   of   developmental   psychology.   He  
developed   his   theory   of   cognitive   development   by   systematically   observing   his   own   three  
children.   He   pointed   out   that   children’s   ‘thinking’   developed   through   a   series   of   stages   in   a  
particular   order.   His   theory   is   very   elaborate   and   quite   complicated.   His   theory   has   been   more  
influential   in   the   area   of   education   more   than   in   child   psychiatry   For   the   purpose   of   the  
examination  the  main  features  of  his  theory  are  summarised  here.  
Basic  Tenets  of  Piaget’s  Theory:    
Schemes:  According  to  Piaget  the  basic  blocks  of  knowledge  are  structures  named  schemes.  A  
scheme  (aka  schema)  is  an  organised  pattern  of  thought  or  action  (i.e.  cognitive  structure)  
that  one  constructs  to  interpret  some  aspects  of  one’s  experience  and  behaviour.  They  are  
mental  structures  that  organise  past  experiences  and  provide  a  way  of  understanding  future  
experiences  (a  mould  for  future  reference,  for  future  experiences  will  be  fitted  and  weighed).  
Schemas  may  be  sensory  motor  (e.g.  sucking  schemata),  symbolic  (mental  representations  
such  as  images  or  verbal  codes)  or  operational  (internal  mental  activity).  
Organisation  and  adaptation:  Organisation  is  the  inborn  tendency  to  combine  and  integrate  
available  schemes  into  coherent  systems  of  knowledge.  The  goal  of  organisation  is  adaptation,  
the   process   of   adjusting   to   the   demands   of   the   situation.   Adaptation   is   thought   to   occur  
through  the  following  two  complementary  activities:    
1. Assimilation   is   the   process   by   which   children   try   to   interpret   new   experiences   by  
incorporating   them   into   existing   schemas.   E.g.   A   toddler   who   sees   a   cat   for   the   first  
time  calls  it  a  dog  (implying  that  all  four  legged  creatures  are  dogs)  
2. Accommodation  is  the  process  of  modifying  existing  schemas  to  incorporate  or  adapt  
to   new   experiences.   E.g.   when   the   above   toddler   starts   recognising   that   the   cat   is  
different  from  the  dog,  he  has  formed  a  new  schema.  
Children  progress  through  each  stage  of  development  by  assimilating  and  accommodating  
various  schemas  to  strive  for  a  constant  state  of  equilibrium.  [The  words  assimilation  and  
accommodation  can  be  easily  confused.  One  way  to  keeping  it  in  mind  it  is  remember  that,  
contrary  to  alphabetical  order,  s  or  assimilation  comes  before  the  c  of  accommodation]  
Piaget’s  Stages  of  Cognitive  Development  
Piaget  described  four  major  periods  of  cognitive  development  each  representing  a  qualitatively  
different  level  of  cognitive  functioning:  
 
 
 
 

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 Paper  A  Human  Development    

 
 
Sensorimotor  stage       0-­‐2  years  
Preoperational  stage         2-­‐7years  
Concrete  Operational  stage       7-­‐11years  
Formal  Operational  stage       11-­‐  12  years  and  beyond    
 
 
The  main  features  of  each  of  the  four  stages  are  given  below.  
 
Sensorimotor  stage  (0-­‐2  year):  period  when  infants  coordinate  their  sensory  inputs  and  motor  
capabilities,  forming  new  schema  that  permit  them  to  act  upon  and  get  to  know  the  environment.  
In  this  stage,  learning  occurs  through  motor  activity  and  sensory  experiences.  (Piaget  divided  it  
into  six  sub-­‐stages).  The  main  characteristics  of  this  stage  are:  
 
• Reflex  activity:  Actions  confined  to  exercising  innate  reflexes.  E.g.  sucking  on  the  nipple  
• Circular  reactions:  Primary  circular  reaction  -­‐  intentional  trials  of  reflexes  centred  on  
the  body  E.g.  sucking  the  thumb,  making  sounds,  Secondary  circular  reaction  –  
pleasurable  response  centred  on  an  external  object,  that  is  discovered  by  chance  and  
repeated  over  and  over  E.g.  making  a  noise  by  shaking  a  rattle.    Tertiary  circular  
reaction  where  element  of  curiosity  is  present  and  discovery  through  active  
experimentation.  E.g.  dropping  the  rattle  and  stepping  on  it.  
• Imitative  abilities  
• Development  of  object  permanence  (18-­‐24  months)  i.e.  the  idea  that  objects  continue  
to  exist  even  when  they  are  no  longer  visible.  This  is,  by  far  the  most  remarkable  
achievement  during  the  sensorimotor  stage.  The  ‘hiding  the  doll’  experiment  illustrated  
OP.  Object  permanence  for  the  mother  develops  somewhat  earlier  than  that  for  
inanimate  objects  [Tip:  Object  permanence  occurs  in  Piaget’s  first  stage]  
 
Preoperational  stage  (2-­‐7  years):  
[Most  exam  MCQs  on  Piaget’s  theory  seem  to  be  about  the  preoperational  stage]    
The  main  features  of  this  stage  are:  
• Animism:  attributing  life  and  life-­‐like  qualities  to  inanimate  objects,  E.g.  ‘The  teddy  hit  
me’  
• Transductive  reasoning  (Pre  causal  logic)  this  refers  to  reasoning  from  particular  to  
particular,  so  that  events  that  occur  together  are  assumed  to  be  causally  related  (E.g.  
‘the  moon  moves  because  I  am  waking)  the  two  other  types  of  reason  which  develop  in  
adolescence  are  deductive  reasoning  (making  generalisations  from  particulars)  and  
inductive  reasoning  (reasoning  from  the  particular  to  the  general).    
• Semiotic  function  or  symbolic  function:  the  ability  to  use  one  object  (for  example  
images  and  words)  to  stand  for  another.  E.g.  a  matchstick  drawing  represents  a  man.  
• Egocentrism  does  not  refer  to  selfishness  (the  psychodynamic  concept),  rather  the  
term  refers  to  the  tendency  to  perceive,  understand  and  interpret  the  world  in  terms  of  
the  self.  One  implication  is  that  the  child  cannot  take  another  person’s  perceptual  or  
conceptual  perspective.  Piaget  demonstrated  this  with  ‘the  three  mountain  experiment’.  
 
• Lack  of  conservation  (conservation  is  the  recognition  that  the  properties  of  an  object  
or  substance  does  not  change  when  its  appearance  is  altered  in  some  superficial  way).  
Piaget’s  classic  conservation  studies  of  transferring  water  from  a  short  beaker  to  a  tall  

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 Paper  A  Human  Development    

one  illustrates  the  concept  of  conservation  of  volume.  Similarly.  Conservation  of  mass,  
number  may  be  demonstrated  in  children  6-­‐7  yrs  old.    Lack  of  conservation  is  because  
preoperational  children  lack  the  two  cognitive  operations  that  would  help  them  
overcome  their  perception  bound  reasoning:  decentration  and  reversibility.  
- Centration  refers  to  the  tendency  to  attend  to  or  think  about  one  salient  
feature  of  an  object  and  ignore  others  (contrast  with  decentration).  E.g.  the  
height  of  the  water  in  the  beaker.  
- Reversibility  is  the  ability  to  reverse  or  negate  an  action  by  mentally  
performing  the  opposite  action.  E.g.  transferring  the  water  back  to  the  first  
beaker.  
 
• Lack  of  seriation:    Because  of  the  above  difficulties,  the  child  is  can  classify  objects  
according  to  one  characteristic.  E.g.  If  red  beads,  white  beads  and  blue  beads  are  put  
together  and  asked  to  sort  a  bag  of  different  colours,  different  shapes  including  beads,  
diamonds,  squares  etc  the  child  focuses  only  on  one  property  of  the  objects)  
 
Concrete  Operational  stage  (7  to  11  years)  
 
During  this  period  the  child  masters  a  number  of  mental  operations.  An  operation  is  an  
internalised  action  that  is  part  of  an  organised  structure.  With  the  ability  to  use  these  
operations,  or  concepts,  the  child’s  thinking  is  no  longer  rigid  and  isolated.  Children  in  this  
stage  demonstrate  logical  thought  evidenced  by  their  ability  to  perform  the  conservation  tasks;  
however,  they  lack  the  use  of  abstract  thought.  The  four  important  mental  operations  achieved  
at  this  stage  are  (the  three  Cs  of  the  CO  stage):  
 
• Conservation   (see   above).   [Tip:   Conservation   occurs   during   the   Concrete   Operational  
stage]  
• Class  inclusion  or  classification  (ability  to  classify  objects)  
• Concept   of   transitivity   (the   ability   to   recognise   relations   among   elements   in   a   serial  
order  (if  A>B  and  B>C,  then  A>C)    
 
Yet,   thinking   at   this   stage   is   still   ‘concrete’,   i.e.   they   are   applied   only   to   object,   events   and  
situations   that   are   real   or   physically   present.   Mental   operations   are   carried   out   on   ‘what   is’  
rather  than  ‘what  could  be’.  
 
Formal  Operational  stage  (11  or  12  years  and  beyond)  
 
During  this  stage  children  take  the  results  of  concrete  operations  one  step  further  and  carry  
out  mental  operations  on  ideas  and  propositions;  children  begin  to  think  abstractly,  can  
imagine  how  things  would  work  in  a  hypothetical  world.  Mental  activities  are  performed  on  
ideas  and  propositions  (and  no  longer  need  concrete  objects);  thought  has  become  truly  
logical,  abstract  and  flexible.  It  is  the  kind  of  thinking  we  often  call  scientific  method.  The  
main  achievements  in  this  stage  are:  
 
• Abstract  thinking  
• Hypotheteco-­‐deductive  reasoning  (the  pendulum  experiment)  
• Logical  thinking  
• Propositional  thought  
 
However,  30%  of  adults  do  not  achieve  this  stage  
 

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 Paper  A  Human  Development    

Piaget  pointed  out  that  during  this  stage  adolescents  are  also  idealistic,  i.e.  they  think  about  
what  is  possible  and  see  things  as  ‘how  they  ought  to  be’    rather  than  ‘how  they  are’.  
 
Other   developmental   theories:   Another   influential   developmentalist   is   Leo   Vygotsky.   But  
the  College  tends  not  to  set  questions  about  his  theory.  His  theory  was  embedded  in  a  social  
context   and   proposed   a   ‘social   constructivist’   approach   to   growth   and   cognitive   maturation.  
According  to  him,  development  at  each  level  always  occurs  twice,  first  on  a  social  and  then  on  
an   individual   level;   first   between   people   (interpsychologically)   and   then   internally  
(intrapsychologically).   He   talked   about   the   ‘zone   of   proximal   development’,   which   is   the  
difference  between  an  individual’s  current,  level  of  development  and  his  or  her  potential  level  
of  development.  He  postulates  that  cognition  is  developed  by  children’s  social  dialogues,  with  
other  and  ‘internalised  speech’-­‐  with  themselves.    

II.   Psychosocial  development  and  concept  of  self  

Self-­‐concept  
This  has  3  components:  
1. Self-­‐image  
2. Self-­‐esteem  
3. Ideal  self  
Children   start   to   recognise   themselves   in   the   mirror   aged   18-­‐24   months.   The   concept   of   self  
usually   starts   to   develop   around   5   years   of   age   and   continues   to   develop   throughout   life.  
Though  it  may  be  affected  in  later  years  due  to  physical  changes  (e.g.  illness).    
Erikson’s  theory  
Erikson  believed  that  the  main  task  for  a  person  is  to  achieve  a  sense  of  identity.  To  this  end  a  
person  passes  through  several  stages  which  have  2  poles  –  one  successful  and  one  maladaptive.  
Erikson’s  theory  covers  the  whole  life-­‐span  of  an  individual.  
 
Age  (yrs)   Stage   Description  

0-­‐1  
The  task  is  to  learn  that  primary  care  giver  is  
Trust  vs  Mistrust  
likely  to  meet  basic  needs.  If  this  does  not  
occur  (e.g.  due  to  poor  care)  the  infant  will  
be  left  with  mistrust.      
1-­‐3  
The  task  is  to  become  more  autonomous  and  
Autonomy  vs  Shame  and  
meet  your  own  needs  (e.g.  learn  to  toilet  
doubt  
yourself  and  get  dressed).  If  parents  
discourage  autonomy  or  are  critical  of  
attempts  at  autonomy  shame  and  doubt  will  
develop.  
3-­‐6  
The  task  is  to  develop  a  sense  of  mastery  and  
Initiative  vs  Guilt  
that  initiative  leads  to  desired  result.  Similar  
to  autonomy,  if  this  is  not  encouraged  then  
guilt  will  be  felt  more  frequently.    

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6-­‐12  
The  task  is  to  build  self-­‐confidence  through  
Industry  vs  Inferiority  
doing  the  right  thing,  being  responsible  and  
working  hard  (e.g.  at  school).  Otherwise  a  
feeling  of  inferiority  will  develop.    
12-­‐18  
The  task  is  to  be  able  to  gain  a  sense  of  self  
Identity  vs  Role  
and  find  your  place  in  society.  Otherwise  
confusion  
role  confusion  results  which  leads  to  a  
difficulty  in  understanding  where  you  fit  in.  
Erikson  believed  that  in  Western  culture  
adolescence  offered  a  ‘psychosocial  
moratorium’  allowing  a  transition  from  
childhood  to  adulthood  with  few  
responsibilities  and  pressures.    
20s  
The  task  is  to  be  able  to  form  close  
Intimacy  vs  Isolation  
relationships  with  others  without  fear.  
Otherwise  isolation  results  
Late   20s   –  
The  task  is  to  establish  clear  guidelines  for  
50s   Generativity  vs  
oneself  to  be  able  to  be  productive  and  
Stagnation  
happy  within  this  framework.  Otherwise  
stagnation  ensues  where  a  person  may  
indulge  themselves  and  is  pre-­‐occupied  with  
their  own  needs  
>50  
Ego  integrity  describes  a  state  where  a  
Ego  Integrity  vs  Despair  
person  is  happy  with  his/her  life,  feels  that  it  
makes  sense  and  has  been  fulfilling.  There  is  
also  an  understanding  that  the  cycle  of  life  is  
inevitable.  Otherwise  despair  results  
 

III.   Moral  development  

Kohlberg’s  Theory  
Lawrence   Kohlberg   believed   that   morality   develops   gradually   during   childhood   and  
adolescence.   He   assessed   people’s   moral   reasoning   by   using   ‘moral   dilemmas’.   He   does   not  
provide  age  equivalents  for  each  stage,  but  in  general  his  stages  correspond  to  those  of  Piaget’s  
stages  of  cognitive  development.  
Please   note   that   moral   development   refers   to   knowing   right   from   wrong.   Research   has  
consistently  shown  that  it  is  not  necessarily  related  to  acting  in  a  moral  way.  In  short,  the  stage  
of  moral  development  does  not  determine  moral  behaviour.  
Imminent   justice   and   sacrosanct   rules   are   characters   of   children   up   to   age   10;   rules   are  
considered  sacred,  imposed  from  external  agencies  which  require  unilateral  respect  and  cannot  
be  changed  by  mutual  agreement  of  all  players  of  a  game.  Children  unashamedly  break  rules  in  
spite  of  this  understanding  though.  After  age  10,  laws  become  more  mutual  and  changeable  if  
all  parties  agree.  This  is  really  from  Piaget’s  theory  of  moral  development.  
 

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 Paper  A  Human  Development    

Levels  of  Moral  Development:    

 
Level  1:  Preconventional  morality  (corresponds  roughly  to  the  preoperational  stage  (2-­‐
7y)  
Stage  1:  Individual  obeys  rules  in  order  to  avoid  punishment.    
Stage  2:  Individual  conforms  to  society's  rules  in  order  to  receive  rewards.    
 
Level  2:  Conventional  morality  (corresponds  roughly  to  the  concrete  operational  stage  
(7-­‐11y)  
Stage  3:  Individual  behaves  morally  in  order  to  gain  approval  from  other  people.    
Stage  4:  Conform  to  authority  to  avoid  censure  and  guilt.    
 
Level  3:  Postconventional  morality  (corresponds  roughly  to  the  formal  operational  stage  
(12+)  
Stage  5:  Individual  is  concerned  with  individual  rights  and  democratically  
decided  laws.    
Stage  6:  Individual  is  entirely  guided  by  his  or  her  own  conscience.    
 
 
Piaget’s  theory  
Piaget   did   not   believe   in   using   stages   to   describe   moral   development.   But   he   did   describe   to  
orientations:  
 

Heteronomous:     In  young  children  5  –  10  years.  Morality  which  is  subject  to  someone  
else’s  rules  and  laws.    
Autonomous:   In  older  children,  over  10  years.  Morality  subject  to  the  child’s  own  rules  
and  laws.      

IV.   Psychosexual  development,  gender  identity  and  puberty  

Freud’s  theory  
Freud   believed   that   sexuality   was   evident   from   birth   and   that   a   child   had   sexual   experiences  
throughout   development.   Erogenous   zones   are   zones   of   the   body   which   are   sensitive   at  
different   times   in   development.   Freud   believed   that   though   maturation   usually   occurred  
naturally   children   could   become   fixated   (stuck)   in   a   stage,   which   leads   onto   certain   traits   in  
adulthood.    
 
 
Age   Stage   Description   Fixation  
(yrs)  
0-­‐1   Oral   Baby  derives  pleasure  from   Leads  to  smoking,  
sucking.     overeating,  chewing  gum  

1-­‐3   Anal   Potty  training  occurs  and  the   Anankastic  personality  traits  
child  masters  control  of  
defaecation.  The  child  learns  to  

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comply  with  environment  

3-­‐5/6yrs   Phallic  stage   Child  is  aware  of  anatomical  sex   Persistence  of  Oedipus  
differences.  Oedipus  complex   complex  
occurs  in  this  stage.  Its  resolution  
allows  the  child  to  acquire  its  
sexual  identity  and  superego.  

5/6-­‐ Latency   Sexual  pre-­‐occupations  are   Absence  of  sexual  fulfilment  

puberty   repressed  and  energy  is  
channelled  into  other  pursuits.  Id,  
ego  and  superego  are  well  
balanced.    

Puberty   Genital   Sexual  maturity    

onwards  
       
   
Gender   identity   refers   to   children’s   firm   sense   of   themselves   being   either   male   or   female.  
Gender   role   (acting   masculine   or   feminine)   identity   develops   through   socialisation.   Gender  
orientation   refers   to   the   preference   of   sexual   partners,   i.e.   homo/hetero   sexuality.   Gender  
identity   disorders   is   an   umbrella   term   for   disorders   such   as   transexualism   and   dual   role  
transvestism.   These   usually   manifest   in   adolescence   (though   it   is   possible   to   have   childhood  
gender  identity  disorder,  which  is  rare).    
 
Stages  of  Gender  Identity  Development:  
• Stage  1:  Gender  labelling.  occurs  between  1.5-­‐3  years.  The  child  knows  what  gender  
he/she  is.  
• Stage  2:  Gender  stability.  Between  3-­‐5  years.  Children  realise  that  most  people  keep  
their  gender  for  a  lifetime  (e.g.  they  know  that  they  will  grow  up  into  a  man/woman).  
However  children  still  rely  on  superficial  signs  (e.g.  clothes)  to  determine  gender.    
• Stage  3:  Gender  constancy.  Between  6-­‐7  years.  Children  realise  that  gender  is  
permanent  and  changing  superficial  things  such  as  clothes  will  not  change  that  
person’s  gender.  This  is  similar  to  the  conservation  principle  in  Piaget’s  theory.    
Puberty:  
Girls:   The  average  age  of  menarche  has  fallen  steadily  over  the  last  2  centuries.  It  is  currently  
12  years  and  10  months.  Girls’  peak  growth  spurt  tends  to  occur  around  the  age  of  12.  
 
Boys:   The  first  sexual  change  in  boys  is  the  enlargement  of  testes  and  usually  occurs  around  
the  age  of  11.  The  onset  of  puberty  as  such  is  hard  to  define  in  boys,  but  can  be  seen  to  
start  at  first  ejaculation  which  usually  occurs  around  13  years  of  age.  Boys’  peak  growth  
spurt  occurs  around  14  years  which  coincides  with  appearance  of  facial  and  underarm  
hair  and  the  voice  deepening.      

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V.   Temperament  in  children  

Temperament  can  be  defined  as  a  broad  term  to  describe  behavioural  predispositions  (i.e.  the  
style  of  behaviour)  in  children  which  are  inherent  but  whose  expression  is  subject  to  
environmental  influences.  
Thomas   and   Chess   (1986)   interviewed   parents   about   their   infants   ‘behaviours/’   traits’   studied  
temperamental   development   in   depth   in   a   landmark   study   known   as   the   New   York  
Longitudinal  Study.  Altogether,  they  described  nine  temperamental  traits  (e.g.  level  of  activity,  
regularity  of  biological  functions  etc.).  They  categorized  these  temperamental  traits  into  three  
clusters  based  upon  factor  analysis  of  qualitative  results  -­‐  "easy  child"  40%,  the  "difficult  child,"  
10   %   and   the   "slow-­‐to-­‐warm-­‐up   child,"   15   %   while   the   remaining   35   %   do   not   fall   into   any  
particular   grouping.   The   goodness   of   fit,   or   degree   of   consonance   between   the   child's  
temperament   and   the   parents'   expectations   of   the   child,   is   an   important   predictor   of   future  
development.  
Buss  and  Plomin  (1984)  conceptualised  temperaments  to  be  based  on  ‘emotionality’,  ‘activity’,  
and   ‘sociability’   (EAS).   These   dimensions   were   reportedly   genetically   grounded   and   were  
thought  to  predict  adult  personality  traits.    

VI.   Development  course  of  normal  fear  in  children  

Fear  in  children  shows  a  distinct  developmental  trend  from  birth  onwards.  Initially  they  show  
a   fear   of   falling   and   loud   noises   (inferred   from   the   presence   of   the   startle   response   to  
unexpected  stimuli).  Fear  of  height  and  depth  develops  between  6-­‐12  months  of  age,  i.e.  when  
they   start   crawling   (the   ‘visual   cliff’   experiment   by   Gibson   &   Walk,   1960).   Fear   of   strangers  
develops  from  6  months  of  age,  reaches  its  peak  by  the  first  birthday,  and  starts  to  decline  after  
the  age  of  three  (see  table).  
 
 
 
• 0  –  6  months     Falling,  loud  noises  
•  6  -­‐12  months     Heights,  Strangers    
•  1  year       Separation,  strangers  
•  2  -­‐3  years     The  dark,  animals  
•  5  -­‐8  years     Monsters,  TV  creatures  
•  9  -­‐12  years     Injuries,  disasters  
•  Adolescence     Social  evaluation  
 
Specific  fears  appear  at  specific  periods  and  then  gradually  disappear  as  the  child  grows  older  
as  shown  in  the  diagram  below.  Please  note  these  findings  apply  to  the  development  of  normal  
fears  (and  not  specific  childhood  phobias)  and  imply  that  certain  irrational  fears  are  normal  in  
childhood.    

VII.   Foetal  competencies  and  childhood  capabilities  

One  of  the  remarkable  findings  in  prenatal  (foetal)  research  is  that  during  the  intrauterine  
period  the  foetus  is  capable  of  perceiving,  learning,  and  remembering.  The  infant  is  born  with  
remarkably  well  developed  sensory  competencies  for  hearing,  taste,  smell  and  perception  of  

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pain.  Vision  is  the  least  developed  of  the  senses  because  there  is  little  opportunity  for  it  in  
utero.  
For  example,  the  foetus  has  been  shown  to  habituate  to  stimuli  such  as  sound,  remember  the  
mother’s  voice  through  hearing  it  while  in  the  uterus  and  be  able  to  identify  the  mother’s  smell  
soon  after  birth.  The  difficulty  has  been  to  find  ways  of  studying  these  processes  on  the  foetus  
and  the  newborn  (neonate).  
During  early  development  children  attain  various  competencies  at  roughly  the  same  period,  
although  there  is  much  individual  variation.  Some  of  these  attainments  and  milestones  are  as  
follows:  
Speech  and  language:  babbling  -­‐  6  months;  one  word  -­‐  1  yr.;  2  words  -­‐  2  yrs;  3  words  -­‐  3  yrs;  
telegraphic  speech  -­‐  3ys;  complete  adult  like  speech  -­‐  5yrs.  
Motor  development:  sitting:  6  months;  walking:  12-­‐13  months;  climbs  and  descends  stairs  
without  help  but  holding  on  to  the  rails:  2  –  2  ½  years;  go  up  and  down  the  stairs  one  foot  at  a  
time:  5  years.  
Copying  shapes:        O  =  3yrs;        +  =  4yrs;                    =          4.5  yrs;      =  5  yrs;    =  7yrs  

VIII.   Attachment  
John  Bowlby  coined  the  term  ‘attachment’  to  describe  the  emotional  bond  between  the  infant  
and  his  mother.  He  postulated  that  a  child’s  failure  to  form  a  secure  attachment  to  one  or  more  
persons  in  the  early  years  is  related  to  the  inability  to  develop  close  personal  relationships  in  
adulthood.  Attachment  is  a  specific  dyadic  relationship  -­‐  so  not  an  attribute  of  either  the  child  
or  the  parent.  
Attachment   behaviour   manifests   as   (1)   seeking   proximity   to   the   attachment   figure,   especially  
when   frightened   or   made   anxious,   (2)   secure   base   effects   (exploratory   behaviour   using   the  
mother   as   a   safe   haven)   and   (3)   separation   anxiety   or   distress   (when   separated   from   the  
mother).  Bowlby  also  described  various  phases  of  attachment,  but  the  general  term  attachment  
refers  to  discriminatory  attachment  to  the  mother  figure.  Typically  this  develops  around  9  to  12  
months   (Bowlby   called   it   ‘the   third   quarter   of   the   first   year’)   and,   according   to   Bowlby,  
continues  through  adult  life.    Separation  anxiety  wanes  after  4  to  5  years  when  the  child  begins  
schooling.  
Features  of  attachment:  
• It  is  not  the  result  learning  or  reinforcement  due  to  feeding;  it  is  thought  to  be  innate  
(and  so  learning  theory  doesn’t  hold).  Harlow  first  studied  attachment  in  monkeys.  He  
demonstrated  that  soft  contact  is  more  important  than  provision  of  food  through  his  
monkey  experiments.  Responsiveness  and  total  amount  of  stimulation  provided  by  a  
person  determines  whether  or  not  he  becomes  an  attachment  figure.  
• Attachment  is  polytropic,  i.e.  multiple  attachments  are  the  rule.  The  child  forms  many  
attachments   e.g.   to   the   father   and   others   involved   in   the   care   of   him.   But   there   is   a  
hierarchy  of  attainment  figures  and  one  care  giver,  who  is,  usually  but  not  necessarily,  
the  mother  become  the  primary  attachment  failure.  Because  attachment  is  polytropic,  
maternal   substitute   can   have   an   attachment   independent   of   primary   maternal  
attachment.  
Mary  Ainsworth  later  collaborated  with  Bowlby  and  put  together  her  observations  of  child-­‐
parent  interactions  in  the  ‘strange  situation  procedure’  (SSP)  with  12  month  old  children  in  
which  the  child  observed  when  the  mother  leaves  the  room  leaving  the  child  with  a  stranger  
briefly  and  later  comes  back.  This  procedure  is  thought  to  assess  the  quality  of  attachment.  She  
came  up  with  the  following  styles  of  attachments.    

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Table  3:  Attachment  styles  

Style  of   Description  
attachment  
Anxious-­‐avoidant   Child  ignores  mother  due  to  mother’s  indifference;  few  signs  of  
distress  when  mother  leaves  child  in  a  strange  room,  but  can  be  
easily  comforted  by  strangers.  Find  it  difficult  to  ‘depend’  on  
parenting  figure  
Anxious-­‐resistant  or   Child  is  fussy  while  with  parent;  shows  extreme  distress  on  parental  
Ambivalent   departure  and  seeks  contact  on  parent’s  return;  at  the  same  time  
displaying  anger  (resists  contact).  Actively  resists  contact  with  
strangers  
Secure   Child  plays  when  mother/parent  is  around,  and  largely  ignores  the  
parent  as  they  can  be  ‘trusted’  to  be  there  to  comfort  them  if  needed.  
Clearly  distressed  when  parent  leaves,  and  seeks  immediate  contact  
with  them  on  their  return.  
Disorganised*   Disorganised/disoriented  behaviour  in  the  presence  of  care-­‐giver.  
 
*Note  that  Ainsworth  did  not  describe  the  disorganised  style  of  attachment.  It  is  a  more  recent  
addition   to   attachment   literature   and   Mary   Main   is   credit   with   describing   it.   Most   children  
who   experience   abuse   and   neglect   have   been   shown   to   exhibit   disorganised   attachment  
pattern.    
The   main   determinant   of   secure   attachment   is   the   sensitivity   and   responsiveness   of   the  
caregiver.   In   general,   attachment   depends   on   a   mother’s   ability   to   perceive,   identify   and  
respond   consistently   and   accurately   to   signals   from   her   child.     Attachment   is   a   dyadic  
emotional   relationship   and   as   such   does   not   entirely   depend   on   characteristics   of   mother   or  
the  infant  individually.  Case  series  examined  show  that  though  insecurity  is  higher  in  mentally  
ill   mother   -­‐   infant   dyads,   secure   attachment   is   formed   in   significant   numbers.   There   is   no  
evidence  that  secure  attachment  behaviour  requires  mentally  healthy  caregiver.  
Hunger,  pain,  discomfort,  sickness  and  anxiety  increase  attainment  behaviour.  Fear  of  parents  
also   serves   to   increase   clinging,   but   if   there   is   a   choice   children   prefer   non   punishing   care  
giver.  Though  the  quality  of  attachment  might  be  insecure,  children  of  abusing  parents  show  
similar  or  intense  attachment  behaviour.  
Bowlby   postulated   that   early   attachment   forms   the   building   block   for   future   adult  
relationships.   He   coined   the   term   Internal   Working   Model   (IWM)   to   describe   the   internal  
representations   that   develop   in   children   and   get   organised   in   their   psyche   as   they   grow.   The  
IWM  consists  of  two  elements:  a  view  or  model  of  themselves  and  a  view  or  model  of  others  
(and   the   world   in   general).   The   intergenerational   transmission   of   attachment   (parents   who  
have  had  poor  attachment  have  children  with  insecure  attachment)  was  explained  by  Bowlby  
on  the  basis  of  IWM.  
Though  attachment  insecurity  itself  is  not  clearly  linked  as  a  causative  factor,  poor  quality  of  
early   care   giving   is   associated   with   various   forms   of   later   psychopathology,   most   notably  
depression.   However,   it   is   unlikely   that   poor   attachment   during   childhood   bears   a   direct  
aetiological  relationship  to  any  adult  psychiatric  disorder.  Although  it  is  tempting  to  postulate  
that   in   borderline   PD   attachment   difficulties   are   the   underlying   cause,   there   is   no   research  
evidence  to  support  this  hypothesis.  
Effects  of  Early  separation  from  Parents:  Children  are  able  to  develop  normal  attachment  
with   a   substitute   parent   such   as   an   adoptive   parent   or   a   foster   carer   as   long   as   the   carer   is  
sensitive   to   the   child’s   emotional   needs.   Disruption   of   attachment   through   separations   has  
detrimental   effect,   especially   after   the   age   of   four   or   so.   Thus,   it   is   public   policy   to   ‘free’  

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children   for   adoption   as   early   as   possible.   Research   shows   that   adoption   up   to   the   age   of   4  
years  does  not  interfere  with  attachment  formation  to  the  adoptive  parents.    
Children   brought   up   in   institutions   invariably   show   attachment   disorder.   Those   who   have  
grown   up   in   children’s   homes   may   become   reasonable   parents,   but   studies   show   they   are  
remain  somewhat  insensitive  to  their  children  and  succumb  to  stress  quickly.  Intergenerational  
transmission   of   insecure   attachment   has   been   demonstrated   in   a   number   of   studies.   That   is,  
parents   who   have   not   had   good   attachment   to   their   parents   turn   out   to   have   difficulties  
forming  attachment  to  their  children.  
Attachments   in   adulthood   are   seen   as   extending   from   the   continuum   of   attachment   in  
childhood,   and   is   mainly   categorised   as   'parenting'   or   'romantic'   (Bartholomew   &   Shaver,  
1998).  Unresolved  attachments  stem  from  various  sources  and  provide  relevant  information  in  
understanding   psychopathology.   Mary   Main   has   developed   an   instrument   called   Adult  
Attachment   Interview   (AAI)   that   is   helpful   in   exploring   the   adult’s   attachment   to   his/her  
parent.   It   is   a   semi   structured   interview   that   has   questions   about   the   parent’s   early   experience.  
It   is   scored   qualitatively   and   the   parent’s   attachment   representation   is   classified   into   four  
categories:   Secure,   dismissing,   Preoccupied   and   Disorganised.   Studies   show   that   these  
correspond   to   those   of   their   children’s   attachment   classification,   i.e.   a   mother   with   insecure  
attachment  is  likely  to  have  children  with  insecure  attachment.    
A  related  issue  is  the  effects  of  short  term  separation  of  children  from  their  parents  as  happens  
during  hospitalisation.  Robertson  and  Robertson’s  studies  as  well  as  those  of  Bowlby’s  showed  
that  they  go  through  the  phases  of  protest,  anger  and  despair  (similar  to  those  shown  in  grief).  

Daycare:  Bowlby’s  theory  has  raised  questions  about  early  separation  of  children  from  parents.  
One  question  is  about  the  effect  of  getting  children  into  daycare  in  their  first  year  of  life.  The  
definitive   study   on   the   effect   of   daycare   in   children   is   the   National   Institute   of   Child   Health  
and   Human   Development   (NICHD)   study   in   the   US.   It   is   a   large   longitudinal   study   that   began  
in  1991  and  followed  up  1153  child  dyads  in  10  US  cities  over  several  years;  the  last  report  was  in  
2007.  The  main  findings  are:  

• SSP  carried  out  at  15  months  showed  no  significant  effects  regarding  quantity,  quality,  
age  of  entry  and  attachment  security  
•  Maternal   sensitivity   and   responsiveness   was   directly   associated   with   security   of  
attachment  rather  than  child  or  daycare  factors.  

Thus,  the  current  consensus  is  that  early  daycare  does  not  interfere  with  attachment  formation  
as   long   as   the   primary   attachment   figure   shows   consistent   and   sensitive   parenting.   [A  
summary  if  the  NICHD  study  of  early  child  care  and  development  (2006)  is  available  at  www.  
[Link]/gov/publications/;  please  follow  links]  

IX.   Miscellaneous  concepts  in  development  

Theory   of   mind:   This   refers   to   the   ability   of   the   child   (and   adults)   to   understand   the  
intensions,   beliefs,   and   desires,   i.e.   mental   states.   This   has   been   demonstrated   in   ‘false   belief  
tasks’  such  as  the  Sally  and  Ann  test.  Described  by  Wimmer  and  Perner  (1983),  theory  of  mind  
has   been   shown   to   develop   in   children   around   4   years   of   age.   More   importantly,   it   has   been  
shown  that  child  with  Autism  spectrum  disorder  lack  theory  of  mind  and  finds  reading  other  
people’s  mind  difficult.  
Imprinting   is   the   process   by   which   various   kinds   of   preferences/behaviours   can   be  
determined   by   early   experience   Konrad   Lorenz,   an   ethnologist,   described   the   ‘following  
response’  of  ducklings  and  showed  that  they  became  imprinted  upon  whatever  moving  object  

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they   encountered   during   a   particular   phase   of   development.   Imprinting   is   said   to   occur   in  

certain  critical  or  sensitive  periods  as  allowed  by  the  ‘genetic  programme’.  It  is  now  believed  to  
be   a   form   of   perceptual   learning   that   has   a   lasting,   though   not   a   permanent   effect   in   some  
animals.   If   the   baby   animal   is   brought   up   in   an   environment   where   there   are   no   objects  
imprinting  does  not  develop.  
The   following   table   summarises,   as   best   as   one   can,   the   various   stages   of   development  
according   to   the   various   theories   [a   common   topic   and   a   favourite   of   examiners,   although  
somewhat  unfair].  Note  that  Erikson’s  was  a  Freudian  and  Kohlberg  was  a  follower  of  Piaget,  
hence  their  respective  ages  for  each  of  their  stages  are  the  same:  
Margaret   Mahler   described   the   Individuation-­‐Separation   theory   of   development.   The   stages  
she  described  were  as  follows:  
• First  few  weeks  of  life  –  Autistic  phase.  Child  is  focussed  on  eating  and  sleeping  and  is  
detached  from  everyone  
• Until   5   months   –   Normal   symbiotic   stage.   The   infant   is   aware   of   the   mother   and  
perceives  her  as  being  as  one  with  him.  
• 5  –  24  month  –  Separation-­‐individuation  stage,  during  which  the  child  develops  a  sense  
of  individual  identity.  This  phase  is  split  into  hatching,  practicing,  and  rapprochement.    
Table:  Summary  of  different  theories  of  development  
 

Piaget   0  –  2  yrs.   2yrs  -­‐‑  7yrs   7yrs  –  12  yrs   13  +  years  

  Sensorimotor  Preoperational   Concrete     Formal  Operational  
Operational  
Freud   0  –  18  m   18m  –  3  y  3y  –  7y   7  yrs  –  12  yrs                        13  +  years        
         
Oral   Anal   Phallic   Latency                Genital      
Erickson                                                                                          
Trust   Autonomy   Initiative    Industry         Identity  
vs.    vs.   vs.   Vs.     vs.  
Mistrust   Shame   Guilt   Inferiority                                  
Role  confusion        
 
Kohlberg     Preconventional   Conventional     Post-­‐‑conventional  
Morality   Morality   Morality  
     
-­‐‑Obedience   -­‐‑Approval   -­‐‑Individual  rights  
-­‐‑Fear  of     -­‐‑Conformity     -­‐‑Universal  justice  
punishment-­‐‑  
Of  
 
References  
1. Atkinson,  R.L.,  Atkinson  R.  C.,  Smith,  E.E.,  Bem,  D.J.,  Nolen-­‐Hoeksema,  S.  (1999)  
Hilgard’s  introduction  to  psychology  (13th  Ed.)  Harcount  College  Publishers.  
2. Gross,  R.  D  (2010)  Psychology:  The  science  of  mind  and  behaviour  (6th  Ed)  Hodder  &  
Stoughton.  

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3. Thambirajah,  M.  S.  (2005).  Psychological  Basis  of  Psychiatry.  Elsevier  Churchill  
Livingstone,  Edinburgh.  
4. Johnstone  E,  Cunningham  Owens  D,  Lawrie  SM,  McIntosh  AM,  Sharpe  M.  Companion  
to  Psychiatric  Studies.  (2010)  8th  ed.  Elsevier  Ltd.    
 
 

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