Child psychology & Behavior management l Pediatric dentistry MCQs for dental students

Child psychology & Behavior management with psychology therapy in pediatric dentistry l Pediatric dentistry & dentistry for children MCQs

 

Child psychology :

• Refers to the science of studying the child’s mind and how it functions. This science deals with studying the mental capability of the child and the interaction between the child’s subconscious and conscious elements

 

The objective of studying child psychology is

1. The child psychology help in interpreting the behavior pattern of the child and the different factor which can influence the behavior of the child. This knowledge can help in modulating the behavior pattern of the child through application of various behavior modulation therapy.
2. for better communication with child patient
3. The treatment can be rendered more effectively and efficiently
4. Any psychopathosis can be identified through the knowledge of various psychological disorders
5. Better treatment planning and better management of child patient
6. Help in psychological counseling of the patient suffering from anxiety/ apprehension/ depression
7. The child’s psychological/ cognitive development can be influenced

 

 Theories of child psychology

 

1. Psychodynamic theories

1. Psychosexual theory/ psychoanalytical theory of Sigmund freud.
2. Psychosocial theory of Erik Erikson
3. Cognitive theory of Jean Piaget

2. Theories of learning and development of behavior:

1. Hierarchy of needs by Maslow
2. Social learning theory by Bandura
3. Classical conditioning theory by Pavcov
4. Operant conditioning theory by Skinner

 

Psychoanalytical theory was given by Sigmund Freud in 1905.

• According to this theory, the human personality develops from the biological roots as a result of satisfaction of a set of instincts of which sexual instinct is the most gratifying.
• Freud explain the development in five different psychosexual stages, each stage has a different source of sexual arousal. Any failure to satisfy the sexual gratification in any of the stage may manifest in the form of personality or behavioral trait. Different stages of psychosexual development include:

 Oral stage (0-1.5 year):

• The erogenous zone is the oral cavity. The gratification or pleasure driving activities of the child during this phase of the development include suckling/ sucking, biting, swallowing. Any failure to satisfy the desire can leads to fixation which may manifest in the form various personality traits which include nail biting, envy, excessive optimism, smoking, drinking, narcissism and pessimism.

 Anal stage (1. 5-3 year):

• The erogenous zone in this phase of development is anus. The pleasure driving activities during this stage are Bowel movement and withholding of such movement. The child learn to put control over sphincters particularly anal sphincter. There is realization of increasing voluntary control and the development of personnel autonomy and independence. The anal fixation may result if the gratification through anal expulsion or anal retention is disturbed. The sign of anal fixation include uncleanliness, stubbornness, carelessness, and disorderliness.

 Urethral stage (3-4 year):

• This is a transitional stage between anal and phallic stage. The gratification is derived from exercising control over urinary sphincters or micturition. Any failure to put control over the urinary discharge results in feeling of shame or guilt or feeling of competitiveness.

 Phallic stage (4-5 year) :

• The erogenous zone is genitals. The gratification is derived from the sexual activities. The phase is characterized by the attraction toward the opposite sex parents.
• The attraction of male for mother is known as Oedipus complex and attraction for father in females is known as Electra complex.
• Boys feel castration anxiety and girls have a penis envy feeling. There is increase in sexual activities which include genital masturbation, genital fondling and sexual fantasies.

 Latency stage (beginning of puberty) :

• During this stage child start adjusting and adapting to the adverse environment around him which include the activities at school, home, play ground. The child increasingly engages in the social friend circle and develop other skills. The sexual feeling remain repressed during this phase.

 Genital stage (from puberty to adulthood):

• The stage is characterized by the deve10pment of personality, understanding of the role in the social,  identity of own self and realization of reproductive role.

 

Sigmund Freud’s structural model of the psyche

 

Id:

• The id is the personality component made up of unconscious psychic energy that works to satisfy basic urges, needs, and desires. The id operates based on the pleasure principle, which demands immediate gratification of needs. It functions in the irrational and emotional part of the mind.

Ego:

• The ego is the largely unconscious part of personality that mediates the demands of the id, the superego, and reality. The Ego relates to the real world and operates via the reality principle. The ego prevents us from acting on our basic urges (created by the id), but also works to achieve a balance with our moral and idealistic standards (created by the superego).

Superego:

• The superego is the component of personality composed of our internalized ideals that we have acquired from our parents and from society. The superego works to suppress the urges of the id and tries to make the ego behave morally, rather than realistically.

 

Piaget's theory of cognitive development :

• Piaget explained the congintive development in four stages which include

 1. Sensorimotor period (birth to 2 year):

• The period is characterized by increasing maturation of coordination of inborn reflexes, coordination of sensory motor scheme, development of various elementary schemes and formulation of new scheme.

2. Pre-operational period (2-7 year):

• The period is characterized by the assimilation of new experiences, adjustment to previous experiences, language skill development, learning of how to classify things, and development of  prelogical reasoning.

3. Concrete period (7-11 years):

• This stage is characterized by the development of logical thinking. The child develop the capacity to understand the thing through the ability to reason.

4. Formal operation period (11-15 years):

• More abstract and logical thinking develop during this phase. The child derive the ability to imagine, to think hypothetically and to do the systemic search for the solution of hypothetical or imaginative problem. The child can make decisions, can solve the problem and totally prepare himself or herself for adult role.

 

Classification of child behaviour

Wright’s classification

Cooperative (positive behavior )

• Cooperative behavior : Child is cooperative, relaxed with minimal apprehension.
• Lacking in Cooperative Ability: This group includes very young children, child with specific debilitating or disabling conditions.
• Potentially Cooperative—Child has the potential to cooperate, but because of the inherent fears (subjective / objective) the child does not cooperate.

Uncooperative behavior

• Uncontrolled /Hysterical/ Incorrigible
• Definite/Obstinate behavior:  This behavior can be seen in any age group but usually in spoilt or stubborn children. These children can be made cooperative.
• Tense cooperative: These children are the border line between the positive and negative behavior. The child does not resist treatment but the child is tensed at mind.
• Timid behavior/Shy: This behavior is usually seen in a overprotective child at the first visit. Such child are cooperative
• Whining type-Child has complaining type of behavior and allow for dental treatment but complains throughout the procedure.
• Stoic type — Child are cooperative and passively accept all the treatment without any facial expression. Such behavior is usually seen in physically abused children.

 

 

Lampshire classification of child behavior

1. Cooperative—The child is physically and emotionally relaxed. Child is c00perative throughout the procedure.
2. Tense cooperative—The child is tensed and cooperative at the same time.
3. Outwardly apprehensive—Child avoids treatment initially, usually hides behind the mother and avoids looking or talking to the dentist. The child accepts the dental treatment eventually.