sitinor/fem3101/februari 2013/pjj1. 2 the birth process stages of childbirth first stage second...
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SITINOR/FEM3101/FEBRUARI 2013/PJJ 1
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The birth processStages of childbirth
First stageSecond stageThird stageFourth stage
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The Baby’s The Baby’s Adaptation to Adaptation to Labor and Labor and DeliveryDelivery
Newborn’s Newborn’s appearanceappearance
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The Newborn Baby Newborn are called Neonate.Newborn are called Neonate. First four weeks of life (neonatal period)First four weeks of life (neonatal period)
A time of transition from the uterus, where a fetus is A time of transition from the uterus, where a fetus is supported entirely by the mother supported entirely by the mother to an independent to an independent existence. existence.
When neonate are first born:When neonate are first born: Covered by fluid from amniotic sacCovered by fluid from amniotic sac Blood from placentaBlood from placenta Brownish fluid from own faeces.Brownish fluid from own faeces. Covered with lanugo (fuzzy prenatal hair)Covered with lanugo (fuzzy prenatal hair) Covered with vernix caseosa (cheesy varnish)Covered with vernix caseosa (cheesy varnish)
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The Newborn Baby
Size and Appearance Size and Appearance New babies have distinctive featureNew babies have distinctive feature a large head a large head
and a receding chinand a receding chin On the head On the head Fontanels (the soft spots) Fontanels (the soft spots) Newborns have a pinkish cast Newborns have a pinkish cast skin so thin that it skin so thin that it
barely covers the capillaries through which blood barely covers the capillaries through which blood flows.flows.
Boys tend to be slightly longer and heavier than girls, Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth and a firstborn child is likely to weigh less at birth than later-borns than later-borns
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The Newborn Baby
WeightWeight :: 2.8 -3.2 kg2.8 -3.2 kg LengthLength :: 51-53 cm (Boy > girl)51-53 cm (Boy > girl) Head Circumference:Head Circumference: 30-33 cm30-33 cm Breathing: Breathing:
Initially Initially fast, short & irregularfast, short & irregular Later Later more stable & with rhythm more stable & with rhythm
Blood pressure become stable in 10 daysBlood pressure become stable in 10 days..
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Is the Baby Healthy? Medical and Behavioral Screening
1. Apgar Scale2. The Brazelton Neonatal Behavioral
Assessment Scale3. Checks are also done for any structural
or physical deformities (eg. spinal defect, cleft palate)
Silver nitrate or tetracycline is usually dropped into neonate eyes to prevent from bacterial infection while passing through birth canal.
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Apgar Scale Apgar Scale is a standard measurement of
a newborn’s condition Introduced by Dr. Virginia Apgar Access newborn
1 min after birth5 min after birth
Assess:Appearance (colour)Pulse (heart beat rate)Grimace (reflex)Activity (muscle tone)Respiration (breathing)
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APGAR SCALESign 0 1 2
Appearance Blue, pale Body pink, extremities blue
Entirely Pink
Pulse Absent Slow (below 100)
Rapid (over 100)
Grimace No response
Grimace Coughing, sneezing, crying
Activity Limp Weak, inactive
Strong, active
Respiration Absent Irregular, slow
Good, Crying
Score: Above 7 = (good/normal) 4 -7 = average, need monitoring 3 & Below = need immediate attention, high risk situation
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Brazelton Neonatal Behavioral Assessment Scale The Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Dr. Berry Brazelton) serves 3 purpose:As an index of neurological integrity after birth
To predict future developmentTo assesses neonates' responsiveness to their physical and social environment
Screening done on 3rd day and repeat again after several days.
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Brazelton Neonatal Behavioral Assessment Scale (NBAS)
Test on four distinct areas: Social behavior (interactive behaviors
in the home) Motor behaviors (reflexes & muscle
activities) Control of physiology (baby’s ability to
quiet himself) Stress response (startle reaction)
High score a neurologically well developed infant
Low score a sluggish infant who need help in responding to social situations, or possible brain damage.
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Babies In-born Reflexes
Reflexes an inborn, automatic response to a particular form of stimulation.
Full term newborns come equipped with a variety of reflexes for use in dealing efficiently with stimuli present in their environment.
Some reflexes are necessary for survival (eg. Rooting & sucking reflexes)
Reflexes are probably genetic in origin & include a timing mechanism that allows them to fade away after a period of time.
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Examples of Newborn Reflexes Eye BlinkEye BlinkWithdrawalWithdrawalRootingRootingSuckingSuckingSwimmingSwimming
MoroMoroPalmar Grasp Palmar Grasp Tonic NeckTonic NeckSteppingSteppingBabinskiBabinski
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In-born ReflexesReflexes Eliciting
StimulusResponse Developme
ntal duration
Babinski
Gentle stroke along sole of foot (heel - toe)
Toes fan out: big toe reflexes
Disappears by end of first year
Moro Sudden lost of support
Arms extended, then brought towards each other
Disappear in 6 months
Palmer Grasp
Rod of finger pressed against infant’s palm
Object grasp Disappear in 3-4 months
Rooting Object lightly brushes infant’s cheek
Baby turns towards object and attempts to suck
Disappear in 3-4 months
Sucking Insert Finger in mouth
Rhythmic sucking Disappear in 3-4 months
Walking Held baby upright. Sole of feet placed on hard surface
Infant step forward as if walking
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RootingRooting
Stroke cheek near Stroke cheek near corner of corner of mouth or or object brushes the object brushes the areaarea
Infant respond by Infant respond by turning head toward turning head toward stimulationstimulation
Disappears at 3 Disappears at 3 weeks when child weeks when child begins to be able to begins to be able to voluntarily turn head voluntarily turn head
Helps infant find Helps infant find nipplenipple
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Moro ReflexHold infant
horizontally on back and let head drop slightly or produce sudden loud sound against surface supporting infant
Infant response is to make an embracing motion by arching back, extending legs, throwing arms outward and then bringing them in toward the body
Disappear at 6 months
Probably in human evolution helped baby cling to mother
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Palmer GraspSpontaneous Spontaneous
grasp of adult’s grasp of adult’s fingerfinger
Disappears at 3-4 Disappears at 3-4 months to allow months to allow reaching and reaching and graspinggrasping
Prepares infant for Prepares infant for voluntary graspingvoluntary grasping
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Tonic Neck ReflexTurn baby's head to one
side while lying on back
Infant responds by lying in a “fencing position” with one arm extended in front of eyes on side to which head is turned other arm is flexed
Disappears at 4 months
May prepare infant for voluntary reaching
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PATTERNS OF GROWTH
Children grow faster during the first years, especially during the first few months.
This rapid growth rate tapers off during the second and third years Physical growth and development follow the
maturational principles of the cephalocaudal principle and proximodistal principle.
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Influences on GrowthInfluences on Growth
Genes interact with environment, i.e. nutrition and living conditions, general health and well-being
Well-fed, well-cared-for children grow taller and heavier than less well nourished and nurtured children
Better medical care, immunization and antibioticsbetter health
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Growth And Nutrition NourishmentNourishment
Breast milk is almost always the best food for Breast milk is almost always the best food for newborns and is recommended for at least the newborns and is recommended for at least the first 12 monthsfirst 12 months
Parents can avoid obesity and cardiac problems Parents can avoid obesity and cardiac problems in themselves and in their children by adopting in themselves and in their children by adopting a more active lifestyle for the entire family--and a more active lifestyle for the entire family--and to breastfeed their babiesto breastfeed their babies
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The BrainFirst 3 years of life is critical to baby’s brain
development.Before & after birth brain growth is
fundamental to future development.It is estimated that about 250,000 brain cells are
form every minute in the uterus.By birth, almost 100 billion nerve cell are
formed, but not fully develop.
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Molding the Brain: The Role of Experience
Smiling, babbling, crawling, walking, and talking are possible due to rapid development of the brain, particularly the cerebral cortex
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Each part of the brain is very important in infuencing a child Each part of the brain is very important in infuencing a child development development integration between child emotions and integration between child emotions and behavior. behavior.
Middle brain: Limbic System• Covers motivation, emotions, &
long term memory, aggressive behavior, body temperature, hunger, nerve system activities, hormon secretion
Outer Brain: Cortex & neocortex
• Divided into lobes/sections (folds) with specific functions.
• Placement of ‘intelligence’ & higer mental process, learning, memory, thinking, language (last to develop)
• Also control vision, hearing, inventing.
Brain stem Contro process such as
breathing, heartbeat muscle movement, kidney process, reflex behavior, sleep, arousal, attention, balance/movement etc.
…BRAIN
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Regions of the Cerebral Cortex
Thin layer on the brain’s Thin layer on the brain’s surface that include lobes or surface that include lobes or sections:sections:
Occipital lobeOccipital lobe Process vision.Process vision.
Temporal LobeTemporal LobeProcess hearingProcess hearing
Parietal LobeParietal LobeProcess sensory stimuliProcess sensory stimuli
Frontal LobeFrontal LobeCritical thinking & problem Critical thinking & problem
solvingsolvingFrontal cortex Frontal cortex area of the area of the
cortex that controls cortex that controls personality and the ability to personality and the ability to carry out planscarry out plans
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Molding the Brain: The Role of Experience
Early experience can have lasting effects on Early experience can have lasting effects on emotional development and the capacity of emotional development and the capacity of the central nervous system to learn and the central nervous system to learn and store informationstore information
Sometimes corrective experience can make up for past deprivation
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...OTAK & NEURON...OTAK & NEURONFirst 3 years of life First 3 years of life children’s brain are children’s brain are
actively building and developing connections actively building and developing connections between the neurons cells.between the neurons cells.
Connections are developed when the brain Connections are developed when the brain are actively receiving stimulus are actively receiving stimulus process process between receiving and sending impulses between receiving and sending impulses between the cells. between the cells.
Through Through axons/dendritesaxons/dendrites send signals to send signals to other neurons & receive incoming message other neurons & receive incoming message through connection called through connection called synapses.synapses.
Brain and Neurons
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Infant States of ArousalStates of arousal are different degrees of sleep
and wakefulnessInfants move in and out of 5 states throughout the
day and night:Regular sleepIrregular sleepDrowsinessAlert Activity Waking activity and crying
Striking individual differences in daily rhythms exist that affect parents’ attitudes toward and interactions with baby.
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Ways to Soothe a Crying Baby
Hold on shoulder Hold on shoulder and rock or walk and rock or walk
SwaddleSwaddlePacifierPacifierRide in carriage, Ride in carriage,
car, swingcar, swingCombine methodsCombine methodsLet cry for short Let cry for short
timetime
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Adjustments to ParenthoodPhysicalPhysicalScheduleScheduleFinancialFinancialTimeTimeGender rolesGender rolesParents’ relationshipParents’ relationship
Pre-birth counselingPre-birth counselingInterventions for high-risk Interventions for high-risk
couplescouples
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EarlyEarly Sensory Capacities Sensory Capacities
Touch Touch HearingHearingVisionVisionTaste Taste SmellSmell
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Touch and Pain
Touch seems to be the first sense to developSensitivity to touch, pain, and temperature change
is well-developed at birth.Pain experienced during the neonatal period may
sensitize an infant to later pain, perhaps by affecting the neural pathways that process painful stimuli
Relieve pain with anesthetics, sugar, gentle holding
Reflexes reveal sensitivity to touch, for example touch on mouth, palms, soles, genitals
Touch helps stimulate physical and emotional development.
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Newborn Senses of Taste and Smell
Prefer sweet tastes at birthQuickly learn to like new tastesHave odor preferences from
birthCan locate odors and identify
mother by smell from birth
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Taste Taste
Babies are born with the ability to communicate their taste preferences to caregivers.
Infant facial expressions indicate they can distinguish among several tastes.
Newborns' rejection of bitter tastes is probably another survival mechanism, since many bitter substances are toxic
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Smell
The responsiveness of infants to the smell of certain foods is similar to that of adults showed that some odor preferences are innate.
A newborn infant is attracted to the odor of her own mother’s lactating breast helps to find food source and to identify own mother a survival mechanism.
Newborns can identify the location of an unpleasant odor and turn head away.
A preference for pleasant odors seems to be learned in utero and during the first few days after birth
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Studies conducted: SStudies conducted: Smell and Tastemell and TasteLipsitt, Engen & Kye (1963) : Baby showed
negative response to the smell of ammonia.Steiner : Baby showed different facial
expression when exposed to different type of scent.
Mac Farlane (1977): Baby can differentiate between own mother’s milk and other mothers’ milk.
Schmidt & Beauchamp (1988) : Baby’s ability to smell is almost equivalent to a 3 years old ability to smell.
Harris & friends: By aged 4 months old, baby like the taste of salt
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• Baby likes the Baby likes the smell of:smell of:• Banana,Banana,• MargerineMargerine• TangerineTangerine
• Baby dislikes Baby dislikes the smell of:the smell of:• AmoniaAmonia• Rotten eggRotten egg
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Hearing Hearing
Well developed at birth - sensitive to voices and biologically prepared to learn language
Hearing is functional before birth ability to discrimination sound develops rapidly after birth. E.g. Infants respond with changes in heart rate to loud sounds (even in the womb)
Can hear wide range of sounds but are more responsive to some than others – i.e. prefer complex sounds to pure tones
Newborns prefer complex sounds such as voices and noises to pure tones - learn sound patterns within days
Newborns prefer speech that is high-pitched and expressive.
There are only a few speech sounds that newborns cannot discriminate, and their ability to perceive speech sounds outside their language is more precise than an adult’s.
Hearing is a key to language development thus hearing impairments should be identified as early as possible
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Developments in Hearing
4 – 6 months
Sense of musical phrasing
6 months“Screen out” sounds from non-native languages
7 – 9 months
Recognize familiar words, natural phrasing in native language
10 months
Can detect words that start with weak syllables
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Studies conducted:HearingDe Casper & Fifer (1980): Baby can
differentiate mother’s voices from others thru’ baby sucking pattern.
Birnhold & Benacerraf (1983): 28th week baby showed his/her response thru facial expression.
Wertheimer (1961) : Baby able to follow source of sound thru’ the “clicker” test.
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Vision
Vision - the least developed sense at birth Vision - the least developed sense at birth Newborns cannot focus their eyes very well Newborns cannot focus their eyes very well
and their and their visual acuity visual acuity fineness of fineness of discrimination, is limiteddiscrimination, is limited
However, newborns explore their However, newborns explore their environment by scanning it for interesting environment by scanning it for interesting sights & tracking moving objects.sights & tracking moving objects.
They can’t yet discriminate colorsThey can’t yet discriminate colors but but color vision will improve in a couple of color vision will improve in a couple of months.months.
Visual perception is poor at birth Visual perception is poor at birth but but improves to 20/100 by age 6 monthsimproves to 20/100 by age 6 months
Binocular vision using both eyes to both eyes to focusfocus
Perception of depth & distance at 4 or 5 Perception of depth & distance at 4 or 5 mth mth
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Infants’ Scanning of Faces
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Face-like Stimuli
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Studies conducted: SightLanglois & friends (1990): Babies are more
attracted to attractive and beautiful human faces.
Fantz (1993): Babies prefer to look at pictures of human.
Aslin (1987): 4 days old babies can differentiate between green and red.
Babies prefer blue and red as compared to other colors.
Gibson & Walk (1960): Visual cliff experiment. 6 mth babies has already develop in-dept perception in visual.
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Steps in Pattern Perception
3 weeks Poor contrast sensitivity.Prefer large simple patterns
2 monthsCan detect fine-grained detail. Prefer complex patterns.
4 monthsCan detect patterns even if boundaries are not really present
12 months
Can detect objects if two-thirds of drawing is missing
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Steps in Depth Perception
Birth – 1 Birth – 1 month month
Sensitivity to motion cues
2 – 4 2 – 4 monthsmonths
Sensitivity to binocular cues
5 –12 5 –12 monthsmonths
Sensitivity to pictorial cues. Wariness of heights
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Improvements in VisionBrain development helps Brain development helps
infants reach adult levels of infants reach adult levels of vision skills:vision skills:
2 months: Focus and color 2 months: Focus and color vision vision
6 months: acuity, scanning 6 months: acuity, scanning & tracking& tracking
6–7 months: depth 6–7 months: depth perceptionperception
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Integrating Sensory Information
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By 1 month, can integrate sight and touch
By 4 months, can integrate sight and sound
4- and 7-month-olds can match facial appearance (boy or man) with sound of voice
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Motor Development MaturityMaturity affect infant perceptual and motor abilities. affect infant perceptual and motor abilities. Milestones of Motor DevelopmentMilestones of Motor Development
Babies first learn simple skills and then combine them into Babies first learn simple skills and then combine them into increasingly complex increasingly complex systems of action Week 1Week 1 : Motor ability progress: Motor ability progress Month 1Month 1 : Chin lift: Chin lift Month 2Month 2 : Reach for object: Reach for object
Denver Developmental Screening TestDenver Developmental Screening Test measures:measures: Gross motor skills (those using large muscles), such as Gross motor skills (those using large muscles), such as
rolling over and catching a ball, and rolling over and catching a ball, and Fine motor skills (using small muscles), such as grasping a Fine motor skills (using small muscles), such as grasping a
rattle and copying a circle. rattle and copying a circle. Language development (for example, knowing the definitions Language development (for example, knowing the definitions
of words) of words) Personality and social development (such as smiling Personality and social development (such as smiling
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Motor DevelopmentNewborn are not able to control their body Newborn are not able to control their body
movement movement no coordination. no coordination.Most movements are due to inborn reflexes Most movements are due to inborn reflexes
(rooting, moro, palmer grasp etc) (rooting, moro, palmer grasp etc) Humans begin to walk later than other species, Humans begin to walk later than other species,
possibly because babies' heavy heads and short possibly because babies' heavy heads and short legs make balance difficultlegs make balance difficult
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Milestone in motor develpment
Birth
Lift headPull self upto stand
Push chestup with arms
Pull up withassistance
Roll from stomach
2 4 6 8 10 12 14 16months
Walk wellalone
Remainsitting withoutassistanceonce up
Walk holdingon to furniture
Sit up withoutassistance
Stand wellalone
Stand holdingon to furniture
Walk backward
Seifert; Child & Adolescent Development 4/eFigure 5.A
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Motor Development
How Motor Development Occurs:How Motor Development Occurs:Maturation in ContextMaturation in Context
According to Thelen, normal babies According to Thelen, normal babies develop the same skills in the same order develop the same skills in the same order because they are built approximately the because they are built approximately the same way and have similar physical same way and have similar physical challenges and needschallenges and needs
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Motor Development
Cultural Influences on Motor DevelopmentCultural Influences on Motor Development
Chances to explore their surroundingsChances to explore their surroundings motor motor development likely to be normal development likely to be normal
Some cultures actively encourage early Some cultures actively encourage early development of motor skills development of motor skills
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Motor Development Training Motor Skills ExperimentallyTraining Motor Skills Experimentally
Gesell concluded that children perform Gesell concluded that children perform certain activities when they are ready, and certain activities when they are ready, and training gives no advantage training gives no advantage
Interaction of biology and environment are Interaction of biology and environment are involved in infant motor developmentinvolved in infant motor development
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Social developmentBaby's ability to interact with other peopleDevelops thru regular interaction with
babies,:FeedingCleaningCaring/loving
Newborn can imitate facial expression.
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AttachmentWhat is attachment?What is attachment?
The The most importantmost important form of social development that form of social development that occurs during infancy is ATTACHMENT, the positive occurs during infancy is ATTACHMENT, the positive emotional bond that develops between a child and a emotional bond that develops between a child and a particular individual. particular individual.
BowlbyBowlby v viewed attachment as iewed attachment as based on infant's needs for based on infant's needs for safety and securitysafety and security (especially from the mother) (especially from the mother)
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Infant AttachmentAttachment
an infant responds positively to specific others, feels better when they are close, and seeks them out when frightened.
Attachment provides a sense of security to the childinformation about the environment
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Infant AttachmentInfant AttachmentCritical for allowing the infant to explore the worldCritical for allowing the infant to explore the worldHaving a strong, firm attachment provides a Having a strong, firm attachment provides a safe basesafe base
from which the child can gain independence.from which the child can gain independence.Attachment:-Attachment:-
adaptive adaptive suggests that the tendency to form relationships is at suggests that the tendency to form relationships is at
least partly biologically based.least partly biologically based.
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Infant AttachmentMary Ainsworth (1978) identified three
major attachment styles:- Secure strong bondingAvoidant negative bonding Anxious/ambivalent display a combination of
positive and negative bonding
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