Child’s psychological development

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What is it about ?

Pediatric consultations at the doctor’s office and with ONE’s services go well beyond simple physical checks and vaccinations. They are also used to monitor the balanced development of the child. Psychological development includes the ability to think, make connections, reason and understand reality. Parents who are involved early can largely ensure this psychological development by stimulating their child and creating a safe environment. It is therefore important to detect problems, which affect both parents (fatigue, postnatal depression) and the child (disturbances in the interaction with those around them), early and to provide adequate and timely psychosocial support if necessary. Apart from the development and upbringing of the child, the doctor will also be interested in the way in which the parents treat their child and in the way in which the child reacts to it.

How to recognize a developmental delay in children?

Each child grows and learns at their own pace, but there are some important milestones that all children should have reached by a certain age. As a parent, you can thus check for yourself to what extent the development of your child follows that of children of his age. This allows the doctor to be alerted in a timely manner and to intervene if necessary.

During the first year of life, a child should be able to:

  • make eye contact and respond to eye contact;
  • babble and / or say a few words;
  • show interest in people;
  • be able to interact with others through simple games (eg “cuckoo weed”);
  • understand another person’s intention, for example by looking at the object pointed at by a parent instead of looking at the finger pointing at it.

Between the ages of 1 and 2, a child should be able to:

  • communicate in a targeted manner using words or gestures;
  • know the meaning of a few words;
  • apply social referencing, that is, quickly examining the parent’s face to check whether a new situation or a new person is safe;
  • obey and understand limits, for example stopping doing something when the parent asks;
  • understand the permanence of objects, for example discovering a toy that a parent is hiding under something;
  • show initiative during interactions;
  • share emotions, for example being happy or sad with parents.

By the age of 3, a child should be able to:

  • speak independently, for example recounting the events of the day;
  • show interest in other children;
  • wait a bit;
  • tolerate a short absence of a parent;
  • distinguish between a man and a woman.

By the age of 4, a child should be able to:

  • to make friends ;
  • participate in interactive games with others.

By the age of 5, a child should be able to:

  • focus on one thing for about 10 to 15 minutes;
  • act in collaboration with others;
  • follow the rules, for example during games;
  • name his best friend.

How is the role of parents observed?

The doctor will ask a number of questions about the parents’ feelings towards the child. Are they happy, tired, do they receive enough support from those around them? What are the positive and negative aspects of raising a child? Are there any difficulties in the family or in education?

In addition, the doctor will study the interactions between the parents and the child. Is there eye contact? How do parents talk about their child? Do they speak to him? Are they holding the child close to them? How does the child react to parents? Is he brisk or listless, does he look well groomed, does he smile at parents and babble?

All of these can indicate parent overwork, psychological problems, or a lack of emotional connection with the child.

What can you do as a parent?

As a parent, you play a crucial role in creating the developmental environment for your child. You have mastered certain determining factors in this matter. As a parent, you can be a positive influence by anticipating certain points. Here are a few examples:

  • Create an environment in which your child can develop and feel safe.
  • Stimulate your child by making eye contact, babbling like him or talking to him, laughing and playing with him.
  • Get involved in your child’s life, for example by being present for health check-ups.
  • Guide your child and set limits as necessary, but be sure to apply them consistently.
  • Use empathy to understand your child’s feelings, feel them, and guide them in the right direction. So you can share your child’s joy when playing and you can comfort your child after a vaccination.
  • If you have any concerns about your child, always talk to the doctor.

There are also some factors over which you as a parent have no direct influence, such as family problems, fatigue or depression. Perhaps they can have a negative impact on your child’s development. So try to openly discuss these issues with your doctor and seek solutions.

What can your doctor do?

It is up to the doctor to pay attention to the psychological development of the child during routine health checks. To do this, it acts in 3 steps:

  • a discussion with the parents, for example on feelings, worries, possible overwork, family load, etc. ;
  • observation of parent-child interactions to gain more information about the child’s skill levels, parents’ attitudes towards the child and their ability to regulate it;
  • examination of the child.

If an anomaly is noted in the child or if the parents are worried, the doctor will analyze the specific problem and the situations in which it occurs. He will thus attempt to map the problems linked to the parents and / or to the child and to offer support. First, the problem is dealt with in consultation. Then, the doctor can possibly refer the parents and the child to a family counselor, a specialist care provider (pediatrician, child psychiatrist) or a related service.

If the origin of the problem is only at the level of the parents, it is possible to opt for moral support from relatives, household help to relieve the parents and possible specialized services.

Source

Foreign clinical practice guide ‘Monitoring the psychological development of the child in pediatric consultation’ (2009), updated on 12.04.2017 and adapted to the Belgian context on 29.12.2019 – ebpracticenet

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