Infancy and Toddlerhood

We will now turn our attention to the physical, cognitive, and socioemotional development during the first two years.^[1] Researchers have given this part of the lifespan more attention than any other period, perhaps because changes during this time are so dramatic and so noticeable. We have also assumed that what happens during these years provides a foundation for one’s life to come. However, it has been argued that the significance of development during these years has been overstated.^[2]

Physical Growth and Development

The average newborn in the United States weighs about 7.5 pounds (between 5 and 10 pounds) and is about 20 inches in length. For the first few days of life, infants typically lose about 5 percent of their body weight as they eliminate waste and get used to feeding. This often goes unnoticed by most parents but can be cause for concern for those who have a smaller infant. This weight loss is temporary, however, and is followed by a rapid period of growth. By the time an infant is 4 months old, it usually doubles in weight and by one year has tripled the birth weight. By age 2, the weight has quadrupled, so we can expect that a 2-year-old should weigh between 20 and 40 pounds. The average length at one year is about 29.5 inches and at two years it is around 34.4 inches.

Body Proportions: Another dramatic physical change that takes place in the first several years of life is the change in body proportions. The head initially makes up about 50 percent of our entire length when we are developing in the womb. At birth, the head makes up about 25 percent of our length, and by age 25 it comprises about 20 percent our length.

Infant Sleep

A newborn typically sleeps approximately 16.5 hours per 24-hour period. This is usually polyphasic sleep in that the infant is accumulating the 16.5 hours over several sleep periods throughout the day.^[3] The infant is averaging 15 hours per 24-hour period by one month, and 14 hours by 6 months. By the time children turn two, they are averaging closer to 10 hours per 24 hours.

Additionally, the average newborn will spend close to 50% of the sleep time in the Rapid Eye Movement (REM) phase, which decreases to 25% to 30% in childhood.

Sudden Unexpected Infant Deaths (SUID)

Each year in the United States, there are about 3,500 Sudden Unexpected Infant Deaths (SUID). These deaths occur among infants less than one year-old and have no immediately obvious cause.^[4] The three commonly reported types of SUID are:

• Sudden Infant Death Syndrome (SIDS): SIDS is identified when the death of a healthy infant occurs suddenly and unexpectedly, and medical and forensic investigation findings (including an autopsy) are inconclusive. SIDS is the leading cause of death in infants 1 to 12 months old, and approximately 1,500 infants died of SIDS in 2013.^[5] Because SIDS is diagnosed when no other cause of death can be determined, possible causes of SIDS are regularly researched. One leading hypothesis suggests that infants who die from SIDS have abnormalities in the area of the brainstem responsible for regulating breathing.
• Unknown Cause: The sudden death of an infant less than one year of age that cannot be explained because a thorough investigation was not conducted and cause of death could not be determined.
• Accidental Suffocation and Strangulation in Bed: Reasons for accidental suffocation include: Suffocation by soft bedding, another person rolling on top of or against the infant while sleeping, an infant being wedged between two objects such as a mattress and wall, and strangulation such as when an infant’s head and neck become caught between crib railings.

As can be seen in the previous graph (Figure 3.6), the combined SUID death rate declined considerably following the release of the American Academy of Pediatrics safe sleep recommendations in 1992, which advocated that infants be placed for sleep on their backs (nonprone position). These recommendations were followed by a major Back to Sleep Campaign in 1994. However, accidental suffocation and strangulation in bed mortality rates remained unchanged until the late 1990s.

Should infants be sharing the bed with parents?

Colvin, Collie-Akers, Schunn, and Moon (2014) analyzed a total of 8207 deaths from 24 states during 2004–2012 that were contained in the National Center for the Review and Prevention of Child Deaths Case Reporting System, a database of death reports from state child death review teams.^[6] The results indicated that younger victims (0-3 months) were more likely to die by bed-sharing and sleeping in an adult bed/on a person. A higher percentage of older victims (4 months to 364 days) rolled into objects in the sleep environment and changed position from side/back to prone. Carpenter et al. (2013) compared infants who died of SIDS with a matched control and found that infants younger than three months old who slept in bed with a parent were five times more likely to die of SIDS compared to babies who slept separately from the parents, but were still in the same room.^[7]

They concluded that bed-sharing, even when the parents do not smoke or take alcohol or drugs, is related  to an increased risk of SIDS. However, when combined with parental smoking and maternal alcohol consumption and/or drug use, risks associated with bed-sharing greatly increased.

The two studies discussed above were based on American statistics. What about the rest of the world? Co-sleeping occurs in many cultures, primarily because of a more collectivist perspective that encourages a close parent-child bond and interdependent relationship.^[8] In countries where co-sleeping is common, however, parents and infants typically sleep on floor mats and other hard surfaces which minimize the suffocation that can occur with bedding and mattresses.^[9]

Motor Development

Motor development occurs in an orderly sequence as infants move from reflexive reactions (e.g., sucking and rooting) to more advanced motor functioning. As mentioned during the prenatal section, development occurs according to the Cephalocaudal (from head to tail) and Proximodistal (from the midline outward) principles. For instance, babies first learn to hold their heads up, then to sit with assistance, then to sit unassisted, followed later by crawling, pulling up, 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. If the child is displaying delays on several milestones, that is 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.

Motor Skills refer to our ability to move our bodies and manipulate objects. Fine motor skills focus on the muscles in our fingers, toes, and eyes, and enable coordination of small actions (e.g., grasping a toy, writing with a pencil, and using a spoon). Newborns cannot grasp objects voluntarily but do wave their arms toward objects of interest. At about 4 months of age, the infant is able to reach for an object, first with both arms and within a few weeks, with only one arm. At this age grasping an object involves the use of the fingers and palm, but no thumbs. This is known as the Palmer Grasp. The use of the thumb comes at about 9 months of age when the infant is able to grasp an object using the forefinger and thumb. Now the infant uses a Pincer Grasp, and this ability greatly enhances the ability to control and manipulate an object and infants take great delight in this newfound ability. They may spend hours picking up small objects from the floor and placing them in containers. By 9 months, an infant can also watch a moving object, reach for it as it approaches, and grab it.

Gross motor skills focus on large muscle groups that control our head, torso, arms and legs and involve larger movements (e.g., balancing, running, and jumping). These skills begin to develop first. Examples include moving to bring the chin up when lying on the stomach, moving the chest up, and 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.^[10] 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.

Sensory Capacities

Current research techniques have demonstrated just how developed the newborn is with especially organized sensory and perceptual abilities.

Vision: The womb is a dark environment void of visual stimulation. Consequently, vision is the most poorly developed sense at birth and time is needed to build those neural pathways between the eye and the brain. Newborns typically cannot see further than 8 to 16 inches away from their faces, and their visual acuity is about 20/400, which means that an infant can see something at 20 feet that an adult with normal vision could see at 400 feet. Thus, the world probably looks blurry to young infants. Because of their poor visual acuity, they look longer at checkerboards with fewer large squares than with many small squares. Infants’ thresholds for seeing a visual pattern are higher than adults’. Thus, toys for infants are sometimes manufactured with black and white patterns rather than pastel colors because the higher contrast between black and white makes the pattern more visible to the immature visual system. By about 6 months, infants’ visual acuity improves and approximates adult 20/25 acuity.

When viewing a person’s face, newborns do not look at the eyes the way adults do; rather, they tend to look at the chin a less detailed part of the face. However, by 2 or 3 months, they will seek more detail when exploring an object visually and begin showing preferences for unusual images over familiar ones, for patterns over solids, for faces over patterns, and for three-dimensional objects over flat images. Newborns have difficulty distinguishing between colors, but within a few months they are able to discriminate between colors as well as adults. Sensitivity to binocular depth cues, which require inputs from both eyes, is evident by about 3 months and continues to develop during the first 6 months. By 6 months, the infant can perceive depth perception in pictures as well.^[11] Infants who have experience crawling and exploring will pay greater attention to visual cues of depth and modify their actions accordingly.^[12]

Hearing

The infant’s sense of hearing is very keen at birth, and the ability to hear is evidenced as soon as the 7th month of prenatal development. In fact, an infant can distinguish between very similar sounds as early as one month after birth and can distinguish between a familiar and non-familiar voice even earlier. Infants are especially sensitive to the frequencies of sounds in human speech and prefer the exaggeration of infant-directed speech, which will be discussed later. Additionally, infants are innately ready to respond to the sounds of any language, but some of this ability will be lost by 7 or 8 months as the infant becomes familiar with the sounds of a particular language and less sensitive to sounds that are part of an unfamiliar language.

Newborns also prefer their mother’s voices over another female when speaking the same material.^[13] Additionally, they will register in utero specific information heard from their mother’s voice. DeCasper and Spence (1986) tested 16 infants (average age of hours) whose mothers had previously read to them prenatally.^[14] The mothers read several passages to their fetuses, including the first 28 paragraphs of the Cat in the Hat, beginning when they were 7 months pregnant. The fetuses had been exposed to the stories an average of 67 times or 3.5 hours. When the experimental infants were tested, the target stories (previously heard) were more reinforcing than the novel story as measured by their rate of sucking. However, for control infants, the target stories were not more reinforcing than the novel story indicating that the experimental infants had heard them before.

Touch and Pain

Immediately after birth, a newborn is sensitive to touch and temperature, and is also highly sensitive to pain, responding with crying and cardiovascular responses.^[15] Newborns who are circumcised, which is the surgical removal of the foreskin of the penis, without anesthesia experience pain as demonstrated by increased blood pressure, increased heart rate, decreased oxygen in the blood, and a surge of stress hormones.^[16] Research has demonstrated that infants who were circumcised without anesthesia experienced more pain and fear during routine childhood vaccines. Fortunately, many local pain killers are currently used during circumcision.

Taste and Smell

Studies of taste and smell demonstrate that babies respond with different facial expressions, suggesting that certain preferences are innate. Newborns can distinguish between sour, bitter, sweet, and salty flavors and show a preference for sweet flavors. Newborns also prefer the smell of their mothers. An infant only 6 days old is significantly more likely to turn toward its own mother’s breast pad than to the breast pad of another baby’s mother,^[17] and within hours of birth an infant also shows a preference for the face of its own mother.^{[18] [19]}

Infants seem to be born with the ability to perceive the world in an intermodal way; that is, through stimulation from more than one sensory modality. For example, infants who sucked on a pacifier with either a smooth or textured surface preferred to look at a corresponding (smooth or textured) visual model of the pacifier. By 4 months, infants can match lip movements with speech sounds and can match other audiovisual events. Although sensory development emphasizes the afferent processes used to take in information from the environment, these sensory processes can be affected by the infant’s developing motor abilities. Reaching, crawling, and other actions allow the infant to see, touch, and organize his or her experiences in new ways.

Nutrition

Typically, breast milk is considered the ideal diet for newborns (exceptions would include if the milk contains teratogens such as HIV or due to a mother’s consumption of alcohol or other drugs, etc.). Colostrum, the first breast milk produced during pregnancy and just after birth has been described as “liquid gold” (United States Department of Health and Human Services.)^[20] It is very rich in nutrients and antibodies. Breast milk changes by the third to fifth day after birth, becoming much thinner, but containing just the right amount of fat, sugar, water and proteins to support overall physical and neurological development. For most babies, breast milk is also easier to digest than formula. Formula-fed infants tend to experience more diarrhea and upset stomachs. The absence of antibodies in formula often results in a higher rate of ear infections and respiratory infections. Children who are breastfed tend to have lower rates of childhood leukemia, asthma, obesity, Type 1 and 2 diabetes, and a lower risk of SIDS. The USDHHS recommends that mothers breastfeed their infants until at least 6 months of age and that breast milk be used in the diet throughout the first year or two.^[21]

Several recent studies have reported that it is not just babies that benefit from breastfeeding. Breastfeeding stimulates contractions in the uterus to help it regain its normal size, and women who breastfeed are more likely to space their pregnancies further apart. Mothers who breastfeed are at lower risk of developing breast cancer, ^[22] especially among higher-risk racial and ethnic groups.^[23] Women who breastfeed have lower rates of ovarian cancer,^[24] reduced risk for developing Type 2 diabetes,^[25] and rheumatoid arthritis.^[26] In most studies these benefits have been seen in women who breastfeed longer than 6 months.

Mothers can certainly continue to provide breast milk to their babies by expressing and freezing the milk to be bottle fed at a later time or by being available to their infants at feeding time. Some workplaces support breastfeeding mothers by providing flexible schedules and welcoming infants, but many do not. In addition, not all women may be able to breastfeed. Women with HIV are routinely discouraged from breastfeeding as the infection may pass to the infant. Similarly, women who are taking certain medications or undergoing radiation treatment may be told not to breastfeed.^[27]

When to Introduce More Solid Foods

Solid foods should not be introduced until the infant is ready. According to The Clemson University Cooperative Extension (2014), some things to look for include that the infant:

• can sit up without needing support
• can hold its head up without wobbling
• shows interest in foods others are eating
• is still hungry after being breastfed or formula-fed
• is able to move foods from the front to the back of the mouth
• is able to turn away when they have had enough^[28]

For many infants who are 4 to 6 months of age, breast milk or formula can be supplemented with more solid foods. The first semi-solid foods that are introduced are iron-fortified infant cereals mixed with breast milk or formula. Typically rice, oatmeal, and barley cereals are offered as a number of infants are sensitive to more wheat-based cereals. Finger foods such as toast squares, cooked vegetable strips, or peeled soft fruit can be introduced by 10-12 months. New foods should be introduced one at a time, and the new food should be fed for a few days in a row to allow the baby time to adjust to the new food. This also allows parents time to assess if the child has a food allergy. Foods that have multiple ingredients should be avoided until parents have assessed how the child responds to each ingredient separately. Foods that are sticky (such as peanut butter or taffy), cut into large chunks (such as cheese and harder meats), and firm and round (such as hard candies, grapes, or cherry tomatoes) should be avoided as they are a choking hazard. Honey and Corn syrup should be avoided as these often contain botulism spores. In children under 12 months, this can lead to death.^[29]

Cognitive Development: Piaget and the Sensorimotor Stage

Piaget believed that we are continuously trying to maintain cognitive equilibrium, or a balance, in what we see and what we know.^[30] Children have much more of a challenge in maintaining this balance because they are constantly being confronted with new situations, new words, new objects, etc. All this new information needs to be organized, and a framework for organizing information is referred to as a schema. Children develop schemata through the processes of assimilation and accommodation.

When faced with something new, a child may demonstrate assimilation, which is fitting the new information into an existing schema, such as calling all animals with four legs “doggies” because he or she knows the word doggie. Instead of assimilating the information, the child may demonstrate.

Accommodation, which is expanding the framework of knowledge to accommodate the new situation and thus learning a new word to more accurately name the animal. For example, recognizing that a horse is different from a zebra means the child has accommodated, and now the child has both a zebra schema and a horse schema. Even as adults we continue to try and “make sense” of new situations by determining whether they fit into our old way of thinking (assimilation) or whether we need to modify our thoughts (accommodation).

According to the Piagetian perspective, infants learn about the world primarily through their senses and motor abilities.^[31] These basic motor and sensory abilities provide the foundation for the cognitive skills that will emerge during the subsequent stages of cognitive development. The first stage of cognitive development is referred to as the Sensorimotor Period.

Development of Object Permanence

A critical milestone during the sensorimotor period is the development of object permanence. Object permanence is the understanding that even if something is out of sight, it still exists.^[32] According to Piaget, young infants do not remember an object after it has been removed from sight. Piaget studied infants’ reactions when a toy was first shown to an infant and then hidden under a blanket. Infants who had already developed object permanence would reach for the hidden toy, indicating that they knew it still existed, whereas infants who had not developed object permanence would appear confused. Piaget emphasizes this construct because it was an objective way for children to demonstrate that they can mentally represent their world. Children have typically acquired this milestone by 8 months. Once toddlers have mastered object permanence, they enjoy games like hide and seek, and they realize that when someone leaves the room they will come back. Toddlers also point to pictures in books and look in appropriate places when you ask them to find objects.

In Piaget’s view, around the same time children develop object permanence, they also begin to exhibit Stranger Anxiety, which is a fear of unfamiliar people.^[33] Babies may demonstrate this by crying and turning away from a stranger, by clinging to a caregiver, or by attempting to reach their arms toward familiar faces such as parents. Stranger anxiety results when a child is unable to assimilate the stranger into an existing schema; therefore, she can’t predict what her experience with that stranger will be like, which results in a fear response.

Critique of Piaget

Piaget thought that children’s ability to understand objects, such as learning that a rattle makes a noise when shaken, was a cognitive skill that develops slowly as a child matures and interacts with the environment. Today, developmental psychologists think Piaget was incorrect. Researchers have found that even very young children understand objects and how they work long before they have experience with those objects.^{[34] [35]}  For example, Piaget believed that infants did not fully master object permanence until substage 5 of the sensorimotor period.^[36]

However, infants seem to be able to recognize that objects have permanence at much younger ages. Diamond (1985) found that infants show earlier knowledge if the waiting period is shorter.^[37] At age 6 months, they retrieved the hidden object if their wait for retrieving the object is no longer than 2 seconds, and at 7 months if the wait is no longer than 4 seconds. Even earlier, children as young as 3 months old demonstrated knowledge of the properties of objects that they had only viewed and did not have prior experience with them. In one study, 3-month-old infants were shown a truck rolling down a track and behind a screen. The box, which appeared solid but was actually hollow, was placed next to the track. The truck rolled past the box as would be expected. Then the box was placed on the track to block the path of the truck. When the truck was rolled down the track this time, it continued unimpeded. The infants spent significantly more time looking at this impossible event (Figure 3.16).

Baillargeon (1987) concluded that they knew solid objects cannot pass through each other.^[38] Baillargeon’s findings suggest that very young children have an understanding of objects and how they work, which Piaget (1954) would have said is beyond their cognitive abilities due to their limited experiences in the world.^[39]

Language Development

An important aspect of cognitive development is language acquisition. The order in which children learn language structures is consistent across children and cultures.^[40] Starting before birth, babies begin to develop language and communication skills. At birth, babies recognize their mother’s voice and can discriminate between the language(s) spoken by their mothers and foreign languages, and they show preferences for faces that are moving in synchrony with audible language.^{[41] [42]}

Do newborns communicate? Of course they do. They do not, however, communicate with the use of oral language. Instead, they communicate their thoughts and needs with body posture (being relaxed or still), gestures, cries, and facial expressions. A person who spends adequate time with an infant can learn which cries indicate pain and which ones indicate hunger, discomfort, or frustration.

Intentional Vocalizations

In terms of producing spoken language, babies begin to coo almost immediately. Cooing is a one-syllable combination of a consonant and a vowel sound (e.g., coo or ba). Interestingly, babies replicate sounds from their own languages. A baby whose parents speak French will coo in a different tone than a baby whose parents speak Spanish or Urdu. These gurgling, musical vocalizations can serve as a source of entertainment to an infant who has been laid down for a nap or seated in a carrier on a car ride. Cooing serves as practice for vocalization, as well as the infant hears the sound of his or her own voice and tries to repeat sounds that are entertaining. Infants also begin to learn the pace and pause of conversation as they alternate their vocalization with that of someone else and then take their turn again when the other person’s vocalization has stopped.

At about four to six months of age, infants begin making even more elaborate vocalizations that include the sounds required for any language. Guttural sounds, clicks, consonants, and vowel sounds stand ready to equip the child with the ability to repeat whatever sounds are characteristic of the language heard. Eventually, these sounds will no longer be used as the infant grows more accustomed to a particular language.

At about 7 months, infants begin babbling, engaging in intentional vocalizations that lack specific meaning and comprise a consonant-vowel repeated sequence, such as ma-ma-ma or da-da-da. Children babble as practice in creating specific sounds, and by the time they are 1 year old, the babbling uses primarily the sounds of the language that they are learning.^[43] These vocalizations have a conversational tone that sounds meaningful even though it isn’t. Babbling also helps children understand the social, communicative function of language. Children who are exposed to sign language babble in sign by making hand movements that represent real language.^[44]

Children communicate information through gesturing long before they speak, and there is some evidence that gesture usage predicts subsequent language development.^[45] Babies who are deaf 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 is used when deaf babies sign just as it is when hearing babies babble.

Most infants shake their head “no” around 6–9 months, and they respond to verbal requests to do things like “wave bye-bye” or “blow a kiss” around 9–12 months. Children also use contextual information, particularly the cues that parents provide, to help them learn language. Children learn that people are usually referring to things that they are looking at when they are speaking, and that that the speaker’s emotional expressions are related to the content of their speech.^[46]

Children begin using their first words at about 12 or 13 months of age and may use partial words to convey thoughts at even younger ages. These one word expressions are referred to as Holophrasic Speech. For example, the child may say “ju” for the word “juice” and use this sound when referring to a bottle. The listener must interpret the meaning of the holophrase, and when this is someone who has spent time with the child, interpretation is not too difficult. But, someone who has not been around the child will have trouble knowing what is meant. Imagine the parent who to a friend exclaims, “Ezra’s talking all the time now!” The friend hears only “ju da ga” to which the parent explains means, “I want some milk when I go with Daddy.”

The early utterances of children contain many errors, for instance, confusing /b/ and /d/, or /c/ and /z/. The words children create are often simplified, in part because they are not yet able to make the more complex sounds of the real language.^[47] Children may say “keekee” for kitty, “nana” for banana, and “vesketti” for spaghetti because it is easier. Often these early words are accompanied by gestures that may also be easier to produce than the words themselves. Children’s pronunciations become increasingly accurate between 1 and 3 years, but some problems may persist until school age.

A child who learns that a word stands for an object may initially think that the word can be used for only that particular object, which is referred to as underextension. Only the family’s Irish Setter is a “doggie”, for example. More often, however, a child may think that a label applies to all objects that are similar to the original object, which is called overextension. For example, all animals become “doggies”.

First words and cultural influences

First words if the child is using English tend to be nouns. The child labels objects such as cup, ball, or other items that they regularly interact with. In a verb-friendly language such as Chinese, however, children may learn more verbs. This may also be due to the different emphasis given to objects based on culture. Chinese children may be taught to notice action and relationships between objects, while children from the United States may be taught to name an object and its qualities (color, texture, size, etc.). These differences can be seen when comparing interpretations of art by older students from China and the United States.

By the time they become toddlers, children have a vocabulary of about 50-200 words and begin putting those words together in telegraphic speech, such as “baby bye-bye” or “doggie pretty”. Words needed to convey messages are used, but the articles and other parts of speech necessary for grammatical correctness are not yet used. These expressions sound like a telegraph, or perhaps a better analogy today would be that they read like a text message. Telegraphic speech/text message speech occurs when unnecessary words are not used. “Give baby ball” is used rather than “Give the baby the ball.”

Infant-directed Speech

Have you ever wondered why adults tend to use that sing-song type of intonation and exaggeration used when talking to children? This represents a universal tendency and is known as Infant-directed Speech. It involves exaggerating the vowel and consonant sounds, using a high-pitched voice, and delivering the phrase with great facial expression.^[48] Why is this done? Infants are frequently more attuned to the tone of voice of the person speaking than to the content of the words themselves and are aware of the target of speech. Werker, Pegg, and McLeod (1994) found that infants listened longer to a woman who was speaking to a baby than to a woman who was speaking to another adult.^[49] It may be in order to clearly articulate the sounds of a word so that the child can hear the sounds involved. It may also be because when this type of speech is used, the infant pays more attention to the speaker and this sets up a pattern of interaction in which the speaker and listener are in tune with one another.

Socioemotional Development: Infant Temperament

Perhaps you have spent time with a number of infants. How were they alike? How did they differ? How do you compare with your siblings or other children you have known well. You may have noticed that some seemed to be in a better mood than others and that some were more sensitive to noise or more easily distracted than others. These differences may be attributed to temperament. Temperament is the innate characteristics of the infant, including mood, activity level, and emotional reactivity, noticeable soon after birth.

In a 1956 landmark study, Chess and Thomas (1996) evaluated 141 children’s temperament based on parental interviews.^[50] Referred to as the New York Longitudinal Study, infants were assessed on 9 dimensions of temperament including: Activity level, rhythmicity (regularity of biological functions), approach/withdrawal (how children deal with new things), adaptability to situations, intensity of reactions, threshold of responsiveness (how intense a stimulus has to be for the child to react), quality of mood, distractibility, attention span, and persistence. Based on the infants’ behavioral profiles, they were categorized into three general types of temperament:

• Easy Child (40%) who is able to quickly adapt to routine and new situations, remains calm, is easy to soothe, and usually is in a positive mood.
• Difficult Child (10%) who reacts negatively to new situations, has trouble adapting to routine, is usually negative in mood, and cries frequently.
• Slow-to-Warm-Up Child (15%) has a low activity level, adjusts slowly to new situations and is often negative in mood.

The percentages listed above do not equal 100% as some children were not able to be placed neatly into one of the categories. Think about how you might approach each type of child in order to improve your interactions with them. An easy child will not need much extra attention, while a slow to warm up child may need to be given advance warning if new people or situations are going to be introduced. A difficult child may need to be given extra time to burn off their energy. A caregiver’s ability to work well and accurately read the child will enjoy a goodness-of-fit, meaning their styles match and communication and interaction can flow. Parents who recognize each child’s temperament and accept it, will nurture more effective interactions with the child and encourage more adaptive functioning. For example, an adventurous child whose parents regularly take her outside on hikes would provide a good “fit” to her temperament. Remember that parenting and child-rearing is bidirectional; both caregivers and children influence each others behaviors. Revisit the Influences on Parenting section in Part I. Key Concepts to review this information.

Temperament does not change dramatically as we grow up, but we may learn how to work around and manage our temperamental qualities. Temperament may be one of the things about us that stays the same throughout development. In contrast, personality, defined as an individual’s consistent pattern of feeling, thinking, and behaving, is the result of the continuous interplay between biological disposition and experience.

Personality also develops from temperament in other ways.^[51] As children mature biologically, temperamental characteristics emerge and change over time. A newborn is not capable of much self-control, but as brain-based capacities for self- control advance, temperamental changes in self-regulation become more apparent. For example, a newborn who cries frequently doesn’t necessarily have a grumpy personality; over time, with sufficient parental support and an increased sense of security, the child might be less likely to cry.

In addition, personality is made up of many other features besides temperament. Children’s developing self-concept, their motivations to achieve or to socialize, their values and goals, their coping styles, their sense of responsibility and conscientiousness, and many other qualities are encompassed into personality. These qualities are influenced by biological dispositions, but even more by the child’s experiences with others, particularly in close relationships, that guide the growth of individual characteristics. Indeed, personality development begins with the biological foundations of temperament but becomes increasingly elaborated, extended, and refined over time. The newborn that parents gazed upon thus becomes an adult with a personality of depth and nuance.

Erikson: Trust vs Mistrust

As we previously discussed in the Theories section, Erikson formulated an eight-stage theory of psychosocial development. Erikson was in agreement on the importance of a secure base, arguing that the most important goal of infancy was the development of a basic sense of trust in one’s caregivers. Consequently, the first stage, trust vs. mistrust, highlights the importance of attachment. Erikson maintained that the first year to year and a half of life involves the establishment of a sense of trust.^[52] Infants are dependent and must rely on others to meet their basic physical needs as well as their needs for stimulation and comfort. A caregiver who consistently meets these needs instills a sense of trust or the belief that the world is a trustworthy place. The caregiver should not worry about overindulging a child’s need for comfort, contact, or stimulation.

Erikson (1982) believed that mistrust could contaminate all aspects of one’s life and deprive the individual of love and fellowship with others.^[53] Consider the implications for establishing trust if a caregiver is unavailable or is upset and ill-prepared to care for a child. Or if a child is born prematurely, is unwanted, or has physical problems that make him or her less desirable to a parent. Under these circumstances, we cannot assume that the parent is going to provide the child with a feeling of trust.

Mary Ainsworth and the Strange Situation

Developmental psychologist Mary Ainsworth, a student of John Bowlby, continued studying the development of attachment in infants. Ainsworth and her colleagues created a laboratory test that measured an infant’s attachment to his or her parent. The test is called The Strange Situation Technique because it is conducted in a context that is unfamiliar to the child and therefore likely to heighten the child’s need for his or her parent.^[54]

During the procedure, that lasts about 20 minutes, the parent and the infant are first left alone, while the infant explores the room full of toys. Then a strange adult enters the room and talks for a minute to the parent, after which the parent leaves the room. The stranger stays with the infant for a few minutes, and then the parent again enters and the stranger leaves the room. During the entire session, a video camera records the child’s behaviors, which are later coded by trained coders. The investigators were especially interested in how the child responded to the caregiver leaving and returning to the room, referred to as the “reunion.” On the basis of their behaviors, the children are categorized into one of four groups where each group reflects a different kind of attachment relationship with the caregiver. One style is secure and the other three styles are referred to as insecure.

• A child with a secure attachment style usually explores freely while the caregiver is present and may engage with the stranger. The child will typically play with the toys and bring one to the caregiver to show and describe from time to time. The child may be upset when the caregiver departs but is also happy to see the caregiver return.

• A child with an ambivalent (sometimes called resistant) attachment style is wary about the situation in general, particularly the stranger, and stays close or even clings to the caregiver rather than exploring the toys. When the caregiver leaves, the child is extremely distressed and is ambivalent when the caregiver returns. The child may rush to the caregiver but then fails to be comforted when picked up. The child may still be angry and even resist attempts to be soothed.

• A child with an avoidant attachment style will avoid or ignore the mother, showing little emotion when the mother departs or returns. The child may run away from the mother when she approaches. The child will not explore very much, regardless of who is there, and the stranger will not be treated much differently from the mother.

• A child with a disorganized/disoriented attachment style seems to have an inconsistent way of coping with the stress of the strange situation. The child may cry during the separation, but avoid the mother when she returns, or the child may approach the mother but then freeze or fall to the floor.

How common are the attachment styles among children in the United States? It is estimated that about 65 percent of children in the United States are securely attached. Twenty percent exhibit avoidant styles and 10 to 15 percent are ambivalent. Another 5 to 10 percent may be characterized as disorganized.

Some cultural differences in attachment styles have been found.^[55] For example, German parents value independence and Japanese mothers are typically by their children’s sides. As a result, the rate of insecure-avoidant attachments is higher in Germany and insecure-resistant attachments are higher in Japan. These differences reflect cultural variation rather than true insecurity, however.^[56]

Keep in mind that methods for measuring attachment styles have been based on a model that reflects middle-class, U. S. values and interpretation. Newer methods for assessment attachment styles involve using a Q-sort technique in which a large number of behaviors are recorded on cards and the observer sorts the cards in a way that reflects the type of behavior that occurs within the situation.^[57] There are 90 items in the third version of the Q-sort technique, and examples of the behaviors assessed include:

• When child returns to mother after playing, the child is sometimes fussy for no clear reason.
• When the child is upset or injured, the child will accept comforting from adults other than mother.
• Child often hugs or cuddles against mother, without her asking or inviting the child to do so
• When the child is upset by mother’s leaving, the child continues to cry or even gets angry after she is gone.

At least two researchers observe the child and parent in the home for 1.5-2 hours per visit. Usually two visits are sufficient to gather adequate information. The parent is asked if the behaviors observed are typical for the child. This information is used to test the validity of the Strange Situation classifications across age, cultures, and with clinical populations.

Caregiver Interactions and the Formation of Attachment

Most developmental psychologists argue that a child becomes securely attached when there is consistent contact from one or more caregivers who meet the physical and emotional needs of the child in a responsive and appropriate manner. However, even in cultures where mothers do not talk, cuddle, and play with their infants, secure attachments can develop.^[58]

• The insecure ambivalent style occurs when the parent is insensitive and responds inconsistently to the child’s needs. Consequently, the infant is never sure that the world is a trustworthy place or that he or she can rely on others without some anxiety. A caregiver who is unavailable, perhaps because of marital tension, substance abuse, or preoccupation with work, may send a message to the infant he or she cannot rely on having needs met. An infant who receives only sporadic attention when experiencing discomfort may not learn how to calm down. The child may cry if separated from the caregiver and also cry upon their return. They seek constant reassurance that never seems to satisfy their doubt. Keep in mind that clingy behavior can also just be part of a child’s natural disposition or temperament and does not necessarily reflect some kind of parental neglect. Additionally, a caregiver that attends to a child’s frustration can help teach them to be calm and to relax.
• The insecure avoidant style is marked by insecurity, but this style is also characterized by a tendency to avoid contact with the caregiver and with others. This child may have learned that needs typically go unmet and learns that the caregiver does not provide care and cannot be relied upon for comfort, even sporadically. An insecure avoidant child learns to be more independent and disengaged.
• The insecure disorganized/disoriented style represents the most insecure style of attachment and occurs when the child is given mixed, confused, and inappropriate responses from the caregiver. For example, a mother who suffers from schizophrenia may laugh when a child is hurting or cry when a child exhibits joy. The child does not learn how to interpret emotions or to connect with the unpredictable caregiver. This type of attachment is also often seen in children who have been abused. Research has shown that abuse disrupts a child’s ability to regulate their emotions.^[59]

Having a consistent caregiver may be jeopardized if the infant is cared for in a daycare setting with a high turn-over of staff or if institutionalized and given little more than basic physical care. Infants who, perhaps because of being in orphanages with inadequate care, have not had the opportunity to attach in infancy may still form initial secure attachments several years later. However, they may have more emotional problems of depression, anger, or be overly friendly as they interact with others.^[60]

Social Deprivation

Severe deprivation of parental attachment can lead to serious problems. According to studies of children who have not been given warm, nurturing care, they may show developmental delays, failure to thrive, and attachment disorders.^[61] Non-organic failure to thrive is the diagnosis for an infant who does not grow, develop, or gain weight on schedule. In addition, postpartum depression can cause even a well-intentioned mother to neglect her infant.

Children who experience social neglect or deprivation, repeatedly change primary caregivers that limit opportunities to form stable attachments, or are reared in unusual settings (such as institutions) that limit opportunities to form stable attachments can certainly have difficulty forming attachments. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, those children experiencing neglectful situations and also displaying markedly disturbed and developmentally inappropriate attachment behavior, such as being inhibited and withdrawn, minimal social and emotional responsiveness to others, and limited positive affect, may be diagnosed with Reactive Attachment Disorder.^[62] This disorder often occurs with developmental delays, especially in cognitive and language areas. Fortunately, the majority of severely neglected children do not develop Reactive Attachment Disorder, which occurs in less than 10% of such children. The quality of the caregiving environment after serious neglect affects the development of this disorder.

Being able to overcome challenges and successfully adapt is Resiliency. Even young children can exhibit strong resiliency to harsh circumstances. Resiliency can be attributed to certain personality factors, such as an easy-going temperament. Some children are warm, friendly, and responsive, whereas others tend to be more irritable, less manageable, and difficult to console, and these differences play a role in attachment.^{[63] [64]} It seems safe to say that attachment, like most other developmental processes, is affected by an interplay of genetic and socialization influences.

Receiving support from others also leads to resiliency. A positive and strong support group can help a parent and child build a strong foundation by offering assistance and positive attitudes toward the newborn and parent. In a direct test of this idea, Dutch researcher van den Boom (1994) randomly assigned some babies’ mothers to a training session in which they learned to better respond to their children’s needs.^[65] The research found that these mothers’ babies were more likely to show a secure attachment style in comparison to the mothers in a control group that did not receive training.

Erikson: Autonomy vs Shame and Doubt

As the child begins to walk and talk, an interest in independence or autonomy replaces a concern for trust. The toddler tests the limits of what can be touched, said, and explored. Erikson (1982) believed that toddlers should be allowed to explore their environment as freely as safety allows and in so doing will develop a sense of independence that will later grow to self-esteem, initiative, and overall confidence.^[66] If a caregiver is overly anxious about the toddler’s actions for fear that the child will get hurt or violate other’s expectations, the caregiver can give the child the message that he or she should be ashamed of their behavior and instill a sense of doubt in their own abilities. Parenting advice based on these ideas would be to keep your toddler safe, but let them learn by doing.

Conclusion

We have explored the dramatic story of the first two years of life. Rapid physical growth, neurological development, language acquisition, the movement from hands on to mental learning, an expanding emotional repertoire, and the initial conceptions of self and others make this period of life very exciting. These abilities are shaped into more sophisticated mental processes, self-concepts, and social relationships during the years of early childhood.