Pediatric community experience and outcomes

Pediatric Community Experience

Theories of Childhood Development: Pediatric Community Experience

One of the first theorists of childhood development, Sigmund Freud, advanced a theory of development that centered on the evolution of the child's sexual drive. During the infantile oral stage, the nursing child is supposed to enjoy sucking and take most of his or pleasure through the mouth. The child transitions into the anal stage with toilet training and the child's focus on retaining or expelling feces. The phallic stage is when the child's erogenous zone shifts to the genital region. The conflicts that arise during this period like the Oedipus and Electra complexes with the parents are eventually resolved during the latency period, when the sexual drive is sublimated until puberty when the child enters the final, hopefully resolved genital stage (Stevenson, 1992).

Erik Erikson accepted the Freudian theory of infantile sexuality, but believed that other non-sexual issues were equally important in childhood development. He theorized that the infant moved from stages of "Basic Trust vs. Mistrust," followed by conflicts of "Autonomy vs. Shame and Doubt," "Initiative vs. Guilt," Industry vs. Inferiority, "Identity vs. Role Confusion, "Intimacy vs. Isolation," Generativity vs. Stagnation," and finally into the stage of "Ego Integrity vs. Despair." Personality malformation was likely to occur if the child's conflicts were not resolved, resulting in the child being stuck in one of these stages (Davis & Clifton, 2007, p.1). Jean Piaget, in contrast believed that the child's neurological capacity was the primary influence upon his or her ability to comprehend the world, as the child moved from the sensorimotor, to the preoperational, to the concrete operational stages, followed by the formal operational stage when the child could comprehend such concepts as 'here' and 'away,' and size, shape and mass ("Jean Piaget's Theory of Development,"2007). Lawrence Kohlberg based his ideas of moral development on Piaget's stage theory, stating that children proceeded from the pre-conventional punishment-obedience and personal reward orientation, to the conventional good boy-nice girl orientation/law and order orientation, and finally to the mature social contract orientation/universal ethical principle orientation (Becker, Dorward, & Pasciak, 1996).

Unsurprisingly perhaps, popular media aimed at parents, such as Child magazine, does not emphasize childhood sexual awareness, but rather the control that parents have over their child's intellectual and moral development is. The inability of parents to propel their children beyond the logical progression of stages stressed by Piaget and Kohlberg, or the dangers of arrested development if conflicts are not resolved in Freud and Erickson are subsumed in advice on how the parent can engineer the child's social environment. In the article "Charm School for Tots," the magazine explains what it calls the new Etiquette Revolution for tots at New York's Plaza Hotel, which hosts a class the teaches children how to be respectful of others by offering advice on how to choose the right silverware.