Developmentalism

1. Developmentalism Principles: • physiological development drives psycho-social development • time is a major determinant of personality development • “stages of development” exist; stages cannot be skipped, missed, or avoided

2. Developmental Tasks of Infancy • Motor Skills • Emotive Skills • Cognitive Skills • Social Skills • Integrative skills

3. I. Stages of Motor Development 1 month Lifts head while lying on stomach 2 months Lifts chest while lying on stomach 3 months Rolls over 4 months Sits up with support 6-7 months Sits up alone 8 months Crawls, stands up with help 11 months Stands alone 12 months Walks alone 17 months Walks up steps

4. II. Stages of Emotional Development • Attachment related to genetically based behaviours (crying, sucking, smiling, clinging and following) • Attachment is active and reciprocal • Separation anxiety caused by absence of the attachment figure

5. Attachment • Parents who respond to cries promptly • Appropriate responsiveness of parent more important than time of physical closeness • Categorization of infants: Secure Insecure Ambivalent-resistant Avoidant

6. III. Stages of Cognitive Development • Piaget • Sensorimotor • Pre-operational • Concrete operational • Formal Operational

7. Sensorimotor Stage • 0-2 years of age • Use of senses and motor abilities to understand and respond to the world • Object permanence • Cause-effect reasoning • The development of memory

8. Pre-operational Stage • 2-6 years of age • Ability to hold mental representations • Pretending, play are possible • Ego-centric world-view (“I” vs “you”) • Ability to think symbolically • “The Explosion of Words” • Consequential thinking

9. Concrete Operations • 7-11 years of age • Progressive ego-decentering • Ability to classify, categorize, draw generalizations, stereotype • Ability to consequentialize and seriate (put things in order) • Able to use inductive and deductive logic

10. Formal Operations • 12+ years of age • Able to form and test mental hypothesis • Able to deal with abstractions • Able to understand (though not deal with) ambiguity

11. IV. Stages of Social Development • Belenky’s “Women’s Way of Knowing” • Culture Shock Model • Perry’s Development of College-Aged Students

12. Erikson’s Stages of Human Development

13. Erikson’s Stages of Human Development

14. Stage 1: Infancy (0-1) • Crisis: Trust vs. Mistrust • Description: In early life, infants must rely entirely upon adults to meet basic physiological needs • Positive Outcome: If needs are met consistently and responsively, secure attachment will form

15. Stage 2: Toddler (1-2) • Crisis: Autonomy vs. Doubt Independence vs. Shame • Description: Toddlers learn to walk, talk, use toilets, etc. which represents self-control • Positive Outcome: Confidence to cope with situations that require initiative, choices, control and independence

16. Stage 3: Early Childhood (2-6) • Crisis: Initiative vs. Guilt • Description: Children discover their own power, and must learn to control impulses and childish fantasies • Positive Outcome: Children learn, with consistent discipline to accept without shame that certain things are not allowed

17. Stage 4: School Years (6-12) • Crisis: Industry/Competence vs. Inferiority • Description: Transition from world of home to world of peers and others • Positive Outcome: Pleasure in intellectual stimulation, being productive and succeeding in competition

18. Stage 5: Adolescence (13-20) • Crisis: Identify vs. Role Confusion • Description: With the onset of puberty, children struggle to determine their owh characters, independent of family • Positive Outcomes: Grounded acceptance and sense of self, and one’s own strengths and limitations

19. Stage 6: Early Adulthood (20-35) • Crisis: Intimacy vs. Isolation • Description: Adults learn to share feelings with others and develop intense, mutual inter-dependent relationships with others • Positive Outcomes: The ability to relate and share emotions and thoughts with others and to learn and grow from this

20. Stage 7: Middle Adulthood (35-55) • Crisis: Generativity vs. Stagnation • Description: At the peak of their working lives, adults need to contribute meaningfully to society • Positive Outcomes: Artefacts, creativity, insight, accomplishment, success

21. Stage 8: Late Adulthood (55+) • Crisis: Integrity vs. Despair • Description: Towards the end of life, adults must come to terms with their lives and accept all their dreams did not come true • Positive Outcome: Death with dignity

22. Developmental Explanation for Emotional Responses Rage: (anger due to frustrated desire) Guilt: (self-recrimination due to lack of control) Self-conciousness: (fear of negative evaluation by others) Embarrassment: (experiencing negative evaluation by others) Shame: (enduring state of embarrassment) Social Anxiety: (avoidant/withdrawal behaviours)

23. Behaviours that emerge as a result of emotional responses • Denial (distorting reality) • Downward social comparison • Self-handicapping • Self-focus/narcissism • Rule-boundedness • Borderline

24. Summary of Developmental Perspective • Stages of development cannot be skipped • Personality formation is based on successful, age-appropriate negotiation of fundamental crises • Is there a fixed time in which personality or traits may be formed?

25. Application to Pharmacy Practice • People cannot understand issues which are developmentally beyond them • Need to meet patient at his/her developmental level, not yours • Observed behaviour is not the end-point; reason for emergence of behaviour is important