Kaplan + Sadock's Synopsis of Psychiatry, 11e

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31.1 Introduction: Infant, Child, and Adolescent Development

Table 31.1-3 Language Development

Age and Stage of Development

Mastery of Comprehension

Mastery of Expression

0–6 mos

Shows startle response to loud or sudden sounds; Attempts to localize sounds, turning eyes or head; Appears to listen to speakers, may respond with smile; Recognizes warning, angry, and friendly voices; Responds to hearing own name Shows listening selectivity (voluntary control over responses to sounds); Listens to music or singing with interest; Recognizes “no,” “hot,” own name; Looks at pictures being named for up to 1 minute; Listens to speech without being distracted by other sounds Shows gross discriminations between dissimilar sounds (bells vs. dog vs. horn vs. mother’s or father’s voice); Understands basic body parts, names of common objects; Acquires understanding of some new words each week; Can identify simple objects (baby, ball, etc.) from a group of objects or pictures; Understands up to 150 words by age 18 mos Responds to simple directions (“Give me the ball”) Responds to action commands (“Come here,” “Sit down”) Understands pronouns (me, him, her, you) Begins to understand complex sentences (“When we go to the store, I’ll buy you some candy”) Understands small body parts (elbow, chin, eyebrow); Understands family name categories (grandma, baby) Understands size (little one, big one) Understands most adjectives Understands functions (why do we eat, why do we sleep) Understands prepositions (under, behind, between) Understands many words (up to 3,500 at 3 yrs, 5,500 at 4 yrs) Understands cause and effect (What do you do when you’re hungry? cold?) Understands analogies (Food is to eat, milk is to ____

Has vocalizations other than crying; Has differential cries for hunger, pain; Makes vocalizations to show pleasure; Plays at making sounds Babbles (a repeated series of sounds) Responds to own name with vocalizations; Imitates the melody of utterances; Uses jargon (own language); Has gestures (shakes head for no); Has exclamation (“oh-oh”); Plays language games (pat-a-cake, peekaboo) Uses single words (mean age of first word is 11 months; by age 18 months, child is using up to 20 words); “Talks” to toys, self, or others using long patterns of jargon and occasional words; Approximately 25% of utterances are intelligible; All vowels articulated correctly; Initial and final consonants often omitted Uses two-word utterances (“Mommy sock,” “all gone,” “ball here”); Imitates environmental sounds in play (“moo,” “mmm, mmm,” etc.); Refers to self by name, begins to use pronouns; Echoes two or more last words of sentences; Begins to use three-word telegraphic utterances (“all gone ball,” “me go now”); Utterances 26% to 50% intelligible; Uses language to ask for needs Uses real sentences with grammatical function words (can, will, the, a); Usually announces intentions before acting “Conversations” with other children, usually just monologues Jargon and echolalia gradually drop from speech Increased vocabulary (up to 270 words at 2 years, 895 words at 3 years); Speech 50% to 80% intelligible P, b, m articulated correctly; Speech may show rhythmic disturbances Correct articulation of n, w, ng, h, t, d, k, g ; Uses language to relate incidents from the past; Uses wide range of grammatical forms: plurals, past tense, negatives, questions; Plays with language: rhymes, exaggerates; Speech 90% intelligible, occasional errors in the ordering of sounds within words; Able to define words; Egocentric use of language rare; Can repeat a 12-syllable sentence correctly; Some grammatical errors still occur Uses language to tell stories, share ideas, and discuss alternatives; Increasing use of varied grammar; spontaneous self-correction of grammatical errors; Stabilizing of articulation f, v, s, z, l, r, th, and consonant clusters; Speech 100% intelligible predictable interactions, an infant’s social and emotional reper- toire expands with the interplay of caregivers’ social responses (Table 31.1-5). In the first year, infants’ moods are highly variable and inti- mately related to internal states such as hunger. Toward the sec- ond two thirds of the first year, infants’moods grow increasingly related to external social cues; a parent can get even a hungry infant to smile. When the infant is internally comfortable, a sense of interest and pleasure in the world and in its primary caregivers should prevail. Prolonged separation from the mother

7–11 mos

Attending-to- Language

12–18 mos

Single-Word

12–24 mos

Two-Word Messages

24–36 mos

Grammar Formation

36–54 mos Grammar

Development

55 mos on True

Understands concepts of number, speed, time, space; Understands left and right; Understands abstract terms; Is able to categorize items into semantic classes

Communication

(Reprinted from Rutter M, Hersov L, eds. Child and Adolescent Psychiatry . London: Blackwell; 1985, with permission.)

emotional life. The smiling response occurs in two phases: the first phase is endogenous smiling, which occurs spontaneously within the first 2 months and is unrelated to external stimula- tion; the second phase is exogenous smiling, which is stimu- lated from the outside, usually by the mother, and occurs by the 16 th week. The stages of emotional development parallel those of cog- nitive development. Indeed, the caregiving person provides the major stimulus for both aspects of mental growth. Human infants depend totally on adults for survival. Through warm and