PsyDactic - Child and Adolescent Psychiatry Board Study Edition
Using the American Board of Psychiatry and Neurology content outline for the Child and Adolescent Psychiatry board exam, starting with the most high yield, Dr. O'Leary has created this podcast for anyone interested in CAPS and also to help him study for the boards. Enjoy!
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PsyDactic - Child and Adolescent Psychiatry Board Study Edition
005 - Piaget and Cognitive Development
Jean Piaget's description of cognitive development is markedly different from psychosexual and psychoanalytic approaches. He was concerned primarily with cognitive abilities. Instead of basically just making up a complex inner life and mode of relating to mommy’s breast, he described the kinds of cognitive tasks children are actually increasingly able to do as they age. Unlike Sigmund Freud and Melanie Klein and more like Anna Freud and Mahler, he actually studied child development in the real world. He advanced the science of child psychiatry not by speculating about why children do what they do, but actually describing what they do.
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The following is on outline of the content of this episode:
Piaget
Welcome to PsyDactic - CAPs board study edition. I am your host, Dr. O'Leary, a child and adolescent psychiatry fellow in the national capital region. This is a podcast I designed to help myself and other CAPs fellows study for their boards. Anyone interested in human development and mental health will likely also get something out of it. For a run-down on how it is produced, please see Episode 001. I am using AI to assist me with the content creation. However, all the content in the podcast should be considered my opinion and no one else's.
This is episode 5. The last episode explored how Freud’s psychoanalytic theory was applied to children by his daughter Anna Freud and by the early theorists of object relations, Melanie Klein and Margaret Mahler. I’m not moving on a very different way of describing development.
Jean Piaget's theory of cognitive development is markedly different from psychosexual and psychoanalytic approaches. He was concerned primarily with cognitive abilities. Instead of basically just making up a complex inner life and mode of relating to mommy’s breast, he described the kinds of cognitive tasks children are actually increasingly able to do as they age. Unlike Sigmund Freud and Melanie Klein and like Anna Freud and Mahler, he actually studied child development in the real world. Whether, as Klein speculated, infants have a complex, unconscious fantasy life where they split mom into good and bad (and then later regret that fantasy) is irrelevant to the actual content of Piaget's work. He advanced the science of child psychiatry not by speculating about why children do what they do, but actually describing what they do. I am belaboring this point because careful observation and classification is the first step in science, and it is a step that Freud and Klein skipped. Instead, they started by theorizing and then classified children’s observable behaviors based on this. That is not science. To be fair, once a strongly supported science has evolved, then one can try to explain particular things based on applying theory, but a real science of child development was barely in its infancy when Sigmund and Klein were basically just making things up.
Piaget, through careful observation, proposed four distinct stages, each marked by qualitative changes in how individuals perceive and reason about the world. As I go over this, I want you to keep in mind that research since Piaget has shown that children’s mental skills probably develop faster and at earlier stages than Piaget supposed. Their ability to actually demonstrate these metal abilities probably lags behind their acquisition of them. That is a technical detail I try to keep in mind when thinking about Piaget. Here's a quick overview of how these stages unfold and then I will go into the nitty-gritty details:
Sensorimotor Stage (Birth to 2 years)
- Key development: Object permanence - the understanding that objects continue to exist even when out of sight.
- How it applies to the lifespan: This stage lays the foundation for all future cognitive development. Infants learn about the world through their senses and feedback from motor actions, building basic schemas (mental frameworks) about objects and their properties. They develop a sense of self as distinct from the outside world.
Preoperational Stage (2 to 7 years)
- Key developments: Symbolic thought (using language and images to represent ideas), egocentrism (difficulty taking another's perspective), and centration (focusing on one aspect of a situation).
- How it applies to the lifespan: Children in this stage start to think symbolically, using language and pretend-play. However, their thinking is still limited by egocentrism and centration, leading to common misconceptions like believing that everyone sees the world as they do (similar to projection).
Concrete Operational Stage (7 to 12 years)
- Key developments: Conservation (understanding that properties like mass, volume, and number remain constant despite changes in appearance), reversibility (ability to mentally reverse actions), and logical reasoning about concrete objects.
- How it applies to the lifespan: Children in this stage become more logical thinkers, able to solve problems and understand concepts like conservation and reversibility. They begin to develop inductive reasoning (going from the concrete to the more general) but still struggle with abstract thinking.
Formal Operational Stage (12 years and older)
- Key developments: Abstract thinking, hypothetical reasoning, and systematic problem-solving using both deductive and inductive reasoning
- How it applies to the lifespan: Adolescents and adults in this stage can think abstractly, consider multiple perspectives, and engage in hypothetical reasoning. They can formulate hypotheses, test them, and draw logical conclusions. This stage marks the development of advanced cognitive abilities that allow for complex problem-solving and critical thinking.
Substages of Piaget
Piaget's Sensorimotor Stage
Piaget's sensorimotor stage is the foundational stage of cognitive development, spanning from birth to approximately 2 years of age. During this period, infants construct their understanding of the world through sensory experiences and motor actions.
To break down the technical details, let's delve into the six substages:
1. Simple Reflexes (Birth to 1 Month)
- Key Development: Reflexive actions dominated behavior.
- Technical Detail: Infants rely on innate reflexes like sucking, rooting, and grasping to interact with their environment. These reflexes are automatic responses to specific stimuli.
2. Primary Circular Reactions (1-4 Months)
- Key Development: Repetition of pleasurable actions centered on the infant's own body.
- Technical Detail: Infants begin to coordinate sensory experiences with motor actions. For example, they might repeatedly suck their thumb or make a noise because it feels good.
3. Secondary Circular Reactions (4-8 Months)
- Key Development: Repetition of actions focused on objects in the external environment. Accidental or incidental interactions can then be repeated as the infant realizes they can affect the world around them.
- Technical Detail: Infants become more interested in the world around them. They may repeatedly shake a rattle to hear the sound or drop a toy to see it fall.
4. Coordination of Secondary Circular Reactions (8-12 Months)
- Key Development: Intentional, goal-oriented behavior and object permanence begin to emerge.
- Technical Detail: Infants start to combine different schemas to achieve specific goals. For instance, they might move an obstacle to reach a desired toy.
5. Tertiary Circular Reactions (12-18 Months)
- Key Development: Experimentation with objects and actions. Piaget refers to kids here as “little scientists.”
- Technical Detail: Infants actively explore their environment, varying their actions to observe the results. They might drop a toy from different heights to see how it lands. A more modern description of this would be Active Inference (you can google this term along with the name Karl Frison if you are interested).
6. Early Symbolic Thought (18-24 Months)
- Key Development: Mental representation and deferred imitation.
- Technical Detail: Infants begin to form mental images of objects and events. They can engage in pretend play and imitate actions they've observed in the past.
Key Technical Concepts:
- Schema: A mental framework or concept that organizes and interprets information.
- Assimilation: The process of incorporating new information into existing schemas.
- Accommodation: The process of modifying existing schemas to accommodate new information.
- Object Permanence: The understanding that objects continue to exist even when out of sight.
Piaget's Preoperational Stage
Piaget's preoperational stage, spanning from roughly 2 to 7 years of age, is characterized by significant cognitive advancements, yet still limited by certain constraints. Here are some of the key technical details:
Substages:
- Symbolic Function Substage (2-4 years):
- Children begin to use symbols to represent objects and ideas.
- They engage in pretend play, using objects to represent other things (e.g., a block as a phone).
- They develop language skills and can use words to represent objects and ideas.
- Intuitive Thought Substage (4-7 years):
- Children begin to ask many questions, demonstrating their curiosity about the world.
- They rely on intuition rather than intentional, structured logical reasoning to understand the world.
- They may struggle with conservation tasks, such as understanding that the amount of liquid remains the same even if it is poured into a different shaped container.
Key Characteristics:
- Symbolic Thought: Children develop the ability to use symbols to represent objects and ideas. This is evident in their use of language, pretend play, and drawing.
- Egocentrism: Children often struggle to see things from another person's perspective. They believe that everyone sees the world as they do.
- Centration: Children tend to focus on one aspect of a situation at a time, ignoring other relevant factors. This can lead to errors in reasoning, such as in conservation tasks.
- Animism: Children often attribute human-like qualities to inanimate objects. They may believe that the sun is angry or that their toys have feelings.
Piaget's Concrete Operational Stage
Piaget's concrete operational stage, typically spanning from ages 7 to 11, is a significant developmental period where children begin to think logically about concrete objects and events. There are not really distinct substages, but instead a perfection and consolidation of latent skills and abilities.
Key abilities:
- Conservation:
- Definition: The understanding that certain properties of objects remain constant, even when their appearance changes.
- Examples: Conservation of mass, volume, and number.
- Technical Detail: Children in this stage can understand that changes in appearance do not necessarily alter the underlying properties of the object. For example, if water is poured from a tall, narrow glass to a short, wide glass, a child in this stage can understand that the amount of water remains the same.
- Reversibility:
- Definition: The ability to mentally reverse actions.
- Technical Detail: This allows children to understand that operations can be undone, which is crucial for logical reasoning.
- Decentration:
- Definition: The ability to consider multiple aspects of a situation simultaneously.
- Technical Detail: Unlike preoperational children who tend to focus on one salient feature, concrete operational children can consider multiple dimensions of a problem. This allows them to solve more complex problems and understand relationships between variables.
- Classification:
- Definition: The ability to sort objects into categories based on their similarities and differences.
- Technical Detail: Children in this stage can classify objects hierarchically and understand class inclusion relationships. For example, they can understand that a poodle is both a dog and an animal.
- Seriation:
- Definition: The ability to arrange objects in order based on a specific attribute, such as size or weight.
- Technical Detail: Children can create logical sequences and understand transitive inference (e.g., if A is taller than B, and B is taller than C, then A is taller than C).
These technical concepts underlie the development of logical reasoning and problem-solving skills during the concrete operational stage. Here they start to use induction, where they can make generalizations (such as categories) from more specific things, but they struggle in their ability to draw conclusions in the opposite direction (using deduction to determine a specific case from a general principle). Part of this is due to their limited ability to conjure all the possible permutations in their head. Although they can think logically, they still struggle with deduction, abstract reasoning and hypothetical thinking, which will develop further in the formal operational stage.
Piaget's Formal Operational Stage
Piaget's formal operational stage, generally beginning around age 12, marks a significant shift in cognitive development, characterized by the ability to think abstractly and hypothetically. Here are some key technical aspects of this stage:
Key Technical Concepts:
- Abstract Thinking:
- Definition: The ability to think about concepts that have no physical reference.
- Technical Detail: Adolescents in this stage can ponder abstract ideas like justice, freedom, and love. They can engage in philosophical discussions and debate complex issues.
- Hypothetical-Deductive Reasoning:
- Definition: The ability to form hypotheses and test them systematically.
- Technical Detail: Adolescents can systematically consider different possibilities and outcomes of a situation. They can engage in scientific reasoning, formulating hypotheses and testing them through experimentation.
- Propositional Logic:
- Definition: The ability to reason logically about abstract propositions.
- Technical Detail: Adolescents can evaluate the truth or falsity of statements based on logical rules, even if the statements are not grounded in reality.
- Metacognition:
- Definition: The ability to think about one's own thinking processes.
- Technical Detail: Adolescents can reflect on their own thought processes, monitor their understanding, and adjust their strategies as needed. This allows them to become more effective learners.
- Idealism
Definition: Adolescents often engage in idealistic thinking, imagining perfect solutions to world problems. In a kind of opposite way, they may demonstrate what has been called pseudostupidity, where they take simple problems and imagine them to be far more complex than they actually are, resulting in the inability to solve them.