2-Year-Old Case Study Two-Year-Old Child

2-year-Old Case Study

Two-Year-old Child Development Case Study

Healthy early childhood development is highly dependent on some rather simple, yet profound variables. The first few feelings that an infant has are very basic instinctual attachments or bonding to his or her immediate environmental surroundings, including caregivers. Security is the primal most comforting feeling an infant has and if it is interrupted in these early often the result is an attachment disorder if not addressed properly. This particular case study is an exploration of child development during these early formative years.

Jason is a playful, bright and healthy two-year-old male, although a little shy. His parents are John, a thirty-two-year-old computer technician and Michelle, a twenty-eight-year-old graphic designer. Both have very serious career goals and Michelle had returned to work twelve weeks after Jason was born. They have been married six years and this is their first and so far only child. Although both appear to be loving parents, they are most certainly focused on many goals in their lives.

While Jason's demeanor is generally good, he has a tendency to be withdrawn at times in different social situations. After his mother returned to work, his maternal grandmother had helped take care of him for approximately six months afterward. After that time Jason was introduced to a local day care facility with an excellent reputation. Initially Jason reacted quite negatively to the situation, crying for some time after being left and refusing to participate in any classroom activities, but eventually he could be left for the day without incident. However he continued to be withdrawn during playtime activities and had minimum of socialization with the other children.

In regards to his development, at this point Jason he has hit most of the typical milestones for his age, he has been walking for some time and has begun running as well. He often runs away from his mother or father at home and gets upset when caught or asked not to. His verbal ability is good and he has begun to string simple sentences together.

Although social activity at this age is often less participatory, Jason has been particularly withdrawn in day care and then becomes explosive and needs a good deal of attention after returning home.

Children who interact infrequently with their peers may lack the opportunity to develop the social skills necessary for the development of healthy interpersonal relationships (e.g., Hartup, 1983). Such social isolation may be the consequence of overt rejection by peers, as a result of aggressive or aversive behavior; however, it also may be a consequence of the child's own tendency to remove him/herself from social interaction, either because of social anxiety or because of a preference for solitude. (Burgess, and Younger)

One of the earliest causes for distress in children is separation anxiety, quite normal at this stage of development. A feeling of separation anxiety usually comes to its peak at around the age of two and begins to diminishes thereafter. ("Separation Anxiety") While normal, if there has been an unevenness in the caregivers responses to the infants needs and a secure attachment does not develop between them, certain attachment disorders may develop causing difficulties for the child's future social acclimation.

Since the attachment bond is really what the child will base his or her model of socialization upon, from infancy forward to two years, the child needs to connect in a positive way and be secure in the comfort of his or her caregivers. Learning how to bond and relate to their caregivers in a style that is appropriate and fulfilling is a useful precursor in creating a healthy image of self as well as one's relationship to others. (Egeland & Erickson) Providing the infant with consistent warm nurturing and positive stimulation during this early stage of development will facilitate the process whereby the child becomes securely attached to his or her caregiver. This will allow the infant "to grow and thrive, babies depend upon the nurturance of adult caregivers who can read their emotional expressions and attend to their physical and emotional needs" (Broderick & Blewitt 111).

Freud's as well as Erickson psychosocial stages of development offer certain guidelines to what the child at this point in development is expecting and the consequences when these expectations are not met. By using this theoretical perspective one may be able to derive some of the reasons behind Jason's lackluster socialization abilities. A review and combination outlook of these stages is in order to help evaluate the stages and possible missteps of Jason's development.

Freud has determined the age between infancy and eighteen months to be the Oral Stage. Here the child is almost completely focused on the satisfaction of oral pleasures. Still floating in what Freud terms the "oceanic" state where the infant sees little or no distinction between him or her self and the world, the child is extremely sensitive to environmental changes. Instinctually the Oral drive is the needed for the child to nurse in order to survive. This drive is then projected onto the entire world. Infants will put anything within reach in their mouths and use this to explore themselves and their world and all the myriad sensations that are occurring. (Jones) for Erickson this is the stage of Trust vs. Mistrust, between birth and one year. A secure attachment with a caregiver facilitates trust and security at this stage, however if the infant's needs are not being met appropriately, such as oral needs for nurturing and the like, feelings of anxiety and mistrust will often develop. Maladaptations at this stage can also lead to sensory distortion or withdrawal. (Erickson & Erickson) Generally for both Freud and Erickson, incompleteness or malignant development at this first stage of psychosocial development would also cascade into difficulties in processing the following stages as well.

According to Freud, at two years of age Jason is now in the Anal stage of development. During this period the child derives pleasure in the eliminating and/or retaining feces. Simply put this is the toilet training phase whereby a certain amount of control over a bodily function is now expected by society by way of the parents guidance and inspection, with proper follow up praise or concern. Theoretically, this can also set the stage for future habits of not only personal hygiene but of expectations of control over one's environment. (Jones) Jason had begun toilet training a few months ago. Because he still has an occasional "mistake" he is still wearing diapers at day care. Generally he does not do so at home while under parental supervision when he can be bettered monitored.

Erickson refers to the stage, between the ages of one and three, as Autonomy vs. Shame and Doubt. One can see how representational this when compared with Freud's Anal stage of development. This is a critical phase when a child begins to develop a sense of independence and the ability to assert themselves within societal and parental parameters. If they are overly controlled at this stage and not given the ability to begin to make some choices for themselves, they may begin to lack confidence and self-esteem leading to a withdrawn social affect. (Erickson & Erickson)

The indicators here appear to suggest some maladaptations have occurred during the first or second part of these stages. While not profound, there are other indications that this behavior may be caused by insecure attachment causing a lack of confidence when in the world outside of the home. The degree and quality of attachment relationship that exists between caregiver and child may also be linked to several other factors such as socioeconomic status, daily stressors, and locus of control. Studies have indicated that early attachment relationships can provide an important foundation for later developmental stages and that a secure attachment may serve as a protective dynamic against the possible negative impact of various adversities and risk factors in the course of life. (Egeland & Erickson) Having a loss of confidence at this stage will certainly impact Jason's later stages of development. This has proven to create certain tendencies in adult life, which are elaborated in the diathesis-stress theory.

Originally used to understand the causes of schizophrenia, simply stated, the diathesis-stress theory is a learned or genetic predisposition to certain vulnerabilities, which, under enough of the right stressors, will become evident. For instance, if prior to achieving a healthy self-identity the child has developed an attachment disorder, which consequently lowers self-esteem and self-worth, than when adversities in adulthood occurs the adult's reaction would be a more diminished self-image and/or a state of depression. However, should the developing adult have achieved a strong sense of self-worth during these early stags of development, he or she will typically see these changes as positive experiences and growth oriented. In the first example the diathesis produces a consequent stress disorder, which result is debilitating. In the second schema we see an example of positive growth. In this example the adult has been well prepare to handle the numerous stress of adulthood and actually grows and develops from these experiences. (Broderick & Blewitt).

Aside from the major issue, at least for the parents, of Jason's reserved social demeanor; there have been several other indicators of acting our behavior that he has presented. On several occasions Jason has complained of stomachaches and headaches prior to having to go to day care or even to any other playtimes where he knows his parents will not be attending. Also, if he has felt threatened by other children in outside settings he will also develop these symptoms in order to be sent home. Then, conversely, after he has been at day care he often does not want to return home and occasionally has a minor tantrum or crying fit. In instances such as these, with seemingly confusing and contradictory symptoms, one must remember that children often do not express anxieties in any direct fashion but often present with symptoms or strange ideologies that can be perplexing and juxtaposed. Lacking the ability to directly articulate their problems, the acting out of hypocondriacal illnesses are often the result (Iconis), and the child is sledom even unaware of his or her own participation in this behavior.

In an adult this would also be considered signs of depression, and in this case one would have to agree that the assessment is warranted. In their article, Cognitive Behavioral Studies, the authors review several studies regarding childhood depression:

Depressed children have low levels of self-esteem and of perceived social and academic confidence (Asarnow, Carlson, & Guthrie, 1987; Kasow, Rehm, & Siegel, 1984). Kaslow et al. (1984) reported that depressed children evaluated their own performances stringently, which in turn was related to distorted perceptions (Haley, Fine, Marriage, Moretti, & Freeman, 1985; Rehm & Carter, 1990). This distorted thinking is seen in negative self-perceptions (Asarnow & Bates, 1988; Asarnow et al., 1987; Hammen, 1988; Kendall, Stark, & Adam, 1990). (Kendall, and Panichelli-Mindel)

Following the original assessment taken from the maladaptations of the psychosocial stages of Freud and Erickson, a possible pattern seems to be emerging. In this case study we find parents who have relegated some of the primary care giving roles to others rather early in the development of the child, twelve weeks after birth. And although for the period of several months while under the maternal grandmother's care there was apparently few signs of problems, there may have been unseen treatment by the grandmother that may have helped to facilitate this social anxiety. For instance, if the grandmother was over indulging the needs of the child during the Oral / Trust vs. Mistrust stages, Jason may have developed subsequent dependent behaviors that have not allowed him to foster his own sense of independence at this latter stage of his development. Consequently, he now presents as shy and reserved around other children or situations outside the home.

While these two psychosocial theories seem to help us fit the profile for Jason, other factors should be considered as well. One of the flaws of both Freud and Erickson is that they do not significantly account for societal and other cultural elements' impact upon human development at large. While these studies may apply to a homogeneous upper to middle-class white European-American cohort, they do not expand well to a cross-cultural segment. Furthermore, Freud's psychosexual theory is often difficult to evaluate for it makes few predictions that can actually be tested by conventional methods of evaluation (Vander Zanden). Therefore, one must certainly consider other factors in analyzing the situation as well.

Hardening back to the diathesis-stress theory, one must evaluate if Jason may or may not also have a genetic predisposition to anxiety or depression. Studies have shown that these disorders have a tendency to run in families. "Some children, probably for genetic reasons, are 'behaviorally inhibited.' Even at the age of four months, their hearts beat faster, and they shrink back when they encounter strangers." ("Separation Anxiety") Therefore, no true assessment would be complete without a medical and psychological history of both parents and child. However, quite often these are seldom preformed as a global evaluation process unless far more extreme childhood difficulties are apparent.

It must also be considered that children are imitators from birth through two years of age and often beyond, constantly mimicking their caregivers and others in order to begin to assimilate behavior. This would be true of negative behaviors as well as positive ones:

Parental socialization has been identified as one of the key mechanisms through which children develop the skills necessary to function in emotionally competent ways, with the discussion of emotion and family emotional expressiveness identified as primary venues through which such emotion socialization occurs. (Suveg, Zeman, Flannery-Schroeder, and Cassano)

The parents themselves do present two opposite sides of the socialization spectrum. Michelle is obviously an energetic and socially adept individual, who is comfortable speaking to large groups as well as in smaller intimate settings to various types of individuals. However, John presents as somewhat withdrawn. His profession of choice is one that keeps him fairly isolated regarding interactions with outsiders. Furthermore, he often seemed uncomfortable during many meetings and spoke very little during them. So, regarding the nature or nurture role here, both certainly have plausible arguments.