Observational Report
For this report, I had observed (S), a 2-year-old boy, the only son of a mother (M) and father (F) in their mid-thirties. They live in a HDB flat in Singapore with S’s grandfather (K) and grandmother (A). M and F leave S under the care of K and A when they go to work from Mondays to Fridays.
Background
During my observation, S interacted primarily with M . S is friendly, self-reliant and comfortably independent. He is not toilet trained yet but is able to stand without support for a few minutes and walk quite a distance independently. He can repeat certain words but does not have a full-fledged vocabulary or grammar.
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S sits with M on the sofa while she reads the story “Just shopping with mom”. Every time a new page is read, S repeats some of the words together with M and occasionally helps her to turn the pages. He recognizes the story, having already heard it a few times before. Halfway through, S gets down and with a toddler’s gait walks to his toys. Although he does fall a few times, he refuses to be helped by M and continues in the direction of his toys to pick up one in the shape of a green apple and another resembling a carrot and shows it to M while reiterating the words apple and carrot to himself. He gets very excited when S compliments him “Clever boy”, and I am told by M that S repeats this motion every time the story is read. M then prompts S further by asking him what are the colours of the apple and carrot for which he answers with a baby language “geen” and “olange”. M pronounces the green and orange again so that S can copy her. As she narrates the story of how the characters in the book are eating their food, S then pretends to eat the apple and carrot enthusiastically.
His attention is short lived though. Even though M tries to get him to sit with her on the sofa to complete the reading of the book, he gets distracted with his other toys and begins to play with his them. However, during this time he always looks to make sure M is around and eventually at the end of my observation returns to be carried by her.
Discussion
Some of the general motor development for a toddler aged 12-24 months include walking unassisted, carrying toys from place to place and helping to turn pages in a book (Sigelman, 2015; Santrock,2018). As can be observed in the case of S, he is able to walk unassisted for a certain distance and manages to help turn the pages of the book. His language and cognitive skills are also consistent with the developmental milestones (Oswalt, n.d) of a neurotypical child as he can repeat words and associate the words with real life objects (Sigelman, 2015; Santrock,2018).
When M prompts S by asking questions and narrating her story, which is then acknowledged and repeated by S, it indicates a strong scaffolding and shadowing by the mother (Vygotsky, 1978, cited in Simply Psychology, 2018). “Children who are in the zone of proximal development for a specific task can almost perform the task independently, but not quite there yet. However, with an appropriate amount of assistance, these children can accomplish the task successfully.” (Vygotsky, 1978, cited in Simply Psychology, 2018). Vygotsky’s concept of scaffolding is closely related to the concept of the zone of proximal development. “Scaffolding refers to the temporary support given to a child by More Knowledgeable Others, usually parents or teachers, that enable the child to perform a task until such time that the child can already perform the task independently.” (Vygotsky, 1978, cited in Simply Psychology, 2018). In the above scenario, S is learning to perfect his language skills by interacting and learning from his mother.
S appears to have a distinct sense of self and of his independence. He may not always need M but is pleased to return to her demonstrating the need for her support and encouragement. “Infants elicit behaviors to keep caregivers nearby” (Sigelman, 2015; Santrock, 2018). As theorized by Bowlby, the need for secure attachment is crucial for toddlers’ overall development, including the achievement of physical milestones (Bowlby,1969, cited by Helena Klein, n.d).
“Like adults, infants prefer to pay attention to new and interesting things. If they are left in the same environment, over time they become accustomed to their surroundings and pay less attention to them. This process is called habituation.” (JoVE Science Education Database, 2019). Having heard the story recited to him a few times already, S gets distracted and does not complete reading his book.
According to Erikson’s psychosocial theory, toddlers around the ages of 2 to 3 are gaining autonomy and eager to express their independence (Sigelman, 2015; Santrock, 2018). This is apparent in S’s attempt to walk himself whilst refusing help from his mother although he falls a few times. Erikson states it is critical that parents allow their children to explore the limits of their abilities within an encouraging environment which is tolerant of failure (Erikson, 1958, cited in Simply Psychology, 2018). It can be seen from my observation that M is encouraging S to become more independent by allowing him to walk and at the same time protecting him by lending a helping hand when he falls a few times.
“Operant conditioning is a method of learning that occurs through rewards and punishments for behaviour” (Skinner, 1938, cited in Simply Psychology, 2018). “Through operant conditioning, an individual makes an association between a particular behaviour and a consequence” (Skinner, 1938, cited in Simply Psychology, 2018). According to this principle, behaviour that is followed by pleasant consequences is likely to be repeated, and behaviour followed by unpleasant consequences is less likely to be repeated (Skinner, 1938, cited in Simply Psychology, 2018). Noticeably, S who has been complimented whenever he correctly identifies and associates the toys with the words M reads tends to repeat his actions.
Conclusion
As an OHT it is relevant to understand the stages of child development and the milestones achieved. This is especially important when giving oral hygiene instructions as dexterity considerations should be made. Teaching complex toothbrushing techniques will only result in the child not being able to follow and thereof a lack of compliance. Additionally, I am also aware that different children go through the stages of development at different paces and therefore every effort should be made to individually tailor the hygiene routines. (Oswalt, n.d)
Due to the secure attachment with mother’s that most toddlers’ have, I would think it is necessary to always have the mother around especially during the first visit as it will alleviate dental anxiety and create more trust and rapport. It will also be more beneficial to teach the toddler with the mother around considering that the child is becoming more independent, but at the same time will still need the guidance and support of the mother.
Interestingly, toddlers may exhibit habituation, and this can influence my job as an OHT both positively and negatively. In one aspect, once the child becomes accustomed to the same environment and same healthcare professional, it is more likely for them to become more co-operative. However, child may get bored if same style of teaching, for example verbal hygiene instructions are employed at every visit. It will be crucial to always repeat the same message but with different approaches, so that the child’s interest is piqued at every visit.
As a child is more likely to repeat behaviour that is followed by a positive consequence, simple reinforcements such as approval and praise should be used so that the child is motivated to keep up their good behaviour and compliance can be built. Similarly, if a child protests and is uncooperative during treatment, immediately abandoning the session and returning them to the consolation of their parents could inadvertently reinforce the undesirable behaviour.
In conclusion, the observational process has been very enlightening as I was able to relate the theories of development to my profession as an oral health therapist. Although, I have observed only one child it has given me some insight into a toddlers’ growth and development.
References
- Angela Oswalt, M. (n.d). CHILD & ADOLESCENT DEVELOPMENT: OVERVIEW DEVELOPMENTAL STAGES AND MILESTONES OF CHILD DEVELOPMENT. Texas: RELAIS LEARNING.
- Database, J. S. (2019). Developmental Psychology. Habituation: Studying Infants Before They Can Talk. Retrieved from JoVE: https://www.jove.com/science-education
- Klein, H. (2011). Ivory Research: Observing a child at play: mother and toddler interaction. Retrieved from Ivory Research: https://www.ivoryresearch.com/writers/helena-klein/
- McLeod, S. (2018). Simply Psychology: Erik Erikson's Stages of Psychosocial Development. Retrieved from Simply Psychology: https://www.simplypsychology.org
- McLeod, S. (2018). Simply Psychology: Lev Vygotsky. Retrieved from Simply Psychology: https://www.simplypsychology.org
- McLeod, S. (2019). Simply Psychology: Skinner- Operant Conditioning. Retrieved from Simply Psychology: https://www.simplypsychology.org
- Santrock, J. (2018). Essentials of Life-span Development. New York: McGraw-Hill Education.
- Sigelman, C. &. (2015). Life-Span Human Development (8th ed.). USA: Cengage Learning.
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