妇幼保健学课件儿童心理健康促进

1、儿童心理健康促进安徽医科大学儿少卫生与妇幼保健学系陶芳标一、认识儿童的心理行为发育一、认识儿童的心理行为发育-m妊儿童的心霆活心理行为发育是指諭、个ewttew为芳式髄年齡增 上而龙生的ContinuityStage theory(Discontinuity)(3)Figure 1-3A major difference among developmental theories is(a) whether development occur in distinct stages, as Piaget, Freud, and Erikson maintained or (b) whether i

2、t proceeds continuously, as learning theorists and informationprocessing theorists propose.一、认识儿童的心理行为发育:脑发育的年龄特征重量发育年龄特点25 days40 days/出生时脑重350400g，是成人脑 重的4/4,而此时新生儿体重相当于成 人体重的5%一、认识儿童的心理行为发育一、认识儿童的心理行为发育5 months6 months7 months蕈 CerebellumBrain stem8 months9 monthsFigure 4-2Fetal brain devJ gestat

3、ion th rod which controls as breathing, d grows, the fron the cerebrum ( mass). Specific1 outer covering functionsf such but large areas are free for hig thinking, reme| The brain stem conical layer h lower-level tun main tains balan grows most ra(Source: Casacr. 199/婴儿期脑重增长速度最快，6个月时 为出生时的两倍，相当于成人脑重

4、的 一半，而体重达成人一半时要到40岁/第一年婴儿脑重接近成人的60%第二年末为出生时的3倍，约为成人脑重的75%/到6岁左右，儿童脑重接近成人的90%o一、认识儿童的心理行为发育一、认识儿童的心理行为发育增粗；神经纤维的髓鞘化，在6岁前速度最快，以后减慢30岁左右全部完成;6岁以后以轴突和树突间的联系加强、神经环路的增加为Spontaneous bursts of electrical activity strcngtbcn some of these connections, while others (the connections that are not reinforced by

5、activity) atrophy.A神经细胞（神经元）发育的年龄特征/出生后的发育表现为神经细胞的体积增大，神经纤维增多、增长、Figure 4-3Wiring the bram. development of neural connections before ond after birth.After birth, the Ixain expediences a second growth spurt, as tho axons (which send and dendrites (whk: receive them) cxplcxie with tH?w connections. Ll

6、ectrical *ctivit)6 triQQArod by a flool of nsory experiences, fine-tunes the brain*s circuitrydetermining which connections will be reicilned and wbkh will be pruned.:心理发育阶段理论性心理发展阶社会心理发展阶段认知发展阶段理段理论(Freud)理论（Erikson）论（Piaget）（M岁口唇期基本依恋感觉运动期I-IV期23岁肛门期自主-害羞与怀疑感觉运动期V-VI期36岁性器期积极-内疚前运算期711 岁潜伏期勤奋自卑具体运

7、算期1218岁生殖器期自我认同角色混乱形式运算期一、认识儿童的心理行为发育X-The Viannesc physician Sigmund Freud developed an original, in flue ntial. and controversial theory of emotional development in childhood, based on his adult patie nts* recol lectio ns. His daughter Anna, shown here with her father, followed in his professional

8、 footsteps and con structed her own theories of personality development.Freuds PsychosexualStages口唇期(Oral, birth to 1 year)肛门期(Anal, 1 to 3 years)性器期(Phallic, 3 to6 yrs)潜伏期(Latency, 7- llyrs)生殖器期(Genital,12 to 18 yrs)一、认识儿童的心理行为发育The psychoanalyst Erik H. I from Freudian theory in er societal, rathe

9、r than chief I; influences on personality, development as proceedin crises, or turning points, tt life span.Erikson Psychosocial Stage 基本依恋(Basic trust vs. mistrust, 0-1) 自主害羞与怀疑 (Autonomy vs. Shame and doubt, 1-3) 积极内疚(Initiative vs. guilt, 3-6) 勤奋自卑(Industry vs. inferiorty, 7-11) 自我认同-角色混乱 (Identi

10、ty vs. role confusion, 12-18) 亲密孤独(Intimacy vs. isolation. Young adulthood)一、认识儿童的心理行为发育The Swiss psychologist Jean Piaget studied childrens cognitive development by observing and talking with his own youngsters and others.感觉运动期(Sensomotor, Birth to2 years)前运算期(Preoperational subperiod, 2-6 yrs) 具体运

11、算期(concrete operational subperiod, 7-11 yrs) 形式运算期(Formal operational,12 yrs through adulthood)一、认识儿童的心理行为发育一、认识儿童的心理行为发育一、认识儿童的心理行为发育1. Conservation of NumberTwo rows of chips are placed m one-to-one correspondence. The child admits their equality. One of the rov/s is stretched out. The child is as

12、ked whether each row still has the same number.一、认识儿童的心理行为发育一、认识儿童的心理行为发育一、认识儿童的心理行为发育2. Conservation of LengthTwo sticks are presented to the child He or she admits their equality.One of the sticks is moved to the right The child is asked whether they are still the same length.一、认识儿童的心理行为发育一、认识儿童的心

13、理行为发育一、认识儿童的心理行为发育3 Conservation of AreaThe child and the experimenter both have identical sheets of cardboard. The experimenter places wooden blocks on these in identical positions The child is asked whether each cardboard has the same amount of space remaining The experimenter scatters the blocks

14、on one of the cardboard sheets The child is asked the same question.一、认识儿童的心理行为发育一、认识儿童的心理行为发育一、认识儿童的心理行为发育4. Conservation of SubstanceThe experimenter presents two identical clay balls.The child admits that they have equal amounts of clay.One of the balls is rolled out. The child is asked whether t

15、hey still contain equal amounts一、认识儿童的心理行为发育一、认识儿童的心理行为发育一、认识儿童的心理行为发育5. Conservation of VolumeTwo balls of clay are placed in two identical glasses with an equal amount of water. The child is asked whether they displace equal amounts of water.The experimenter changes the shape of one of the balls a

16、nd asks the child the same questionStage 1: Before conditioningFlash bulbAnna blinksUCSUCR(Unc on ditio ned(Unc on ditionedstimulus)response)UCS automatically produces UCR Neutral stimulus does not produce blinkingStage 2: ConditioningCameraAnna does not blink 7NeutralInterestno blinkingstimulusPavb

17、v经典的条 件反射理论(Psivlovs Classiccoudlrioning)Stage 3: After conditioning一、认识儿童的心理行为发育一、认识儿童的心理行为发育Flashbulband camera一、认识儿童的心理行为发育一、认识儿童的心理行为发育Anna blinksCameraAnna blinks一、认识儿童的心理行为发育UCS pairedUCRwith neutralstimulusCS(Con ditionedstimulus)CR(Conditi onedresponse)一、认识儿童的心理行为发育一、认识儿童的心理行为发育UCS is paired

18、 with neutral stimulus.UCS produces UCR.Neutral stimulus (camera) is now the conditioned stimulus. It produces a CR, blinking，which is like the UCR produced by the flashbulbFigure 14Three steps in classical conditioning.一、认识儿童的心理行为发育一、认识儿童的心理行为发育using reinforcement and ping techniques, it is sible t

19、o train animals h as these polar bears to age in relatively complex aviors. even things they ild never do in their nat- 1 environment. Such be- iors are taught step by )and do not require that animals have an overall lerstanding of what they doing. (Elizabeth Wei- J Pholo Researchers, JFather picks

20、up TerrellTerrell smilesAR (accidental response)R (reinforcement)Terrell keeps smilingDR (deliberate response)Skinners紡协刪棘皈gistnrinrinlo mu, Wft. *ME,右无.和汝岌作力冷交盘 文化X度備亲U*.文 ltff&1 严色竺|金号近个人Ittfta卜口皿凤八“农尢W?”笈囱音|RfWttbaDaESh 菇zLHlLUExuit.斤需卩衣三RC3WFa|RMifrUuna；.不列大蛊动】2*彷“ 口彫|r去样外i:|rX砂m知f 开 f rRfflW7l

21、J8为金台小J9二，中飯木RM-千MQV叫人fjg计*|:山人*谥|10匸11仪住仪眾7对|鼻八n塔丽屮空|n険小人5“|衣示紙n小九“aws讯中gq下広久itULHl :RU枳WK1餌中-.E4絵Eis It助时三仔审中二网合二林些足电10/严屮 | ”匚妙夬/ITp5Jtx7T 2cm并足CliU午2?K130116 130上等（超常）中上等2.3%13.6%中等中下等68.3%13.6%3511570 84二、心理行为发育评纟:定义行为评定通常是用 问卷的方法通过他评或自评 对儿童心理活动、心理症状或行为表现的发生频率或严重程度进行评定，从而对儿童的行为作出定性的评价。:工具儿童行为评定

22、量表儿童&为评室儿童行为调査表（父母问卷）编号儿童姓名性别年龄学枝班级填农人姓名与儿童的关系联系地址邮编电话请根据您孩子的情况，其实地填写下列内容，将喜欢的运动或活动内容 填在左边格子内.在中间、右边的空格内打1 一请写出您的孩子最d欢1的运动.如：游泳.辰乓球. 丼球、篮球、环自行车、36 步祥与其他同年龄的孩子比 校他花在这些运动上的 时间是多还是少？与其他同年龄的孩子比较，他 在这项运动上做御较好还是较运动项目不知较少一样较多不知较差样较好123不荐欢任何运动（是）.二.请写出孩子除运动外踐 蓉欢的活动.如：樂郎、布 娃娃、看书、玩乐曹、唱歎 等（不包括看电视）与其他同年龄的孩子比 较，

23、他花在这些活动上的 时间是多还泉少？与其他同年龄的孩子比较.他 在这项活动中做得较好还是较 差？活动项目不知较少一樟较多不知较差样较好1.23r-不喜欢任何活动 Conners简明症状问卷1不安宁或活动过多2.易激惹，好冲动3.打扰其他儿童4.注意力短暂5.经常坐立不安6易分心7.要求必须立即满足&常容易哭9.情绪变化迅速、激烈10易发脾气，暴躁Parents can often help hy peractive ch订dren through a variety of special tech niques, including teaching the child how to divi

24、de work into small manageable segments. Suzanne Szasz/Photo Researchers, Inc.) Achenbac儿童行为量表(Achenbach ChildChecklist, CBCL)Depression in children is now recognized with greater frequency. (LHrike VVe/sch/ Photo Researchers. IncJ二、心理行为发育评价It is normal for young children to cling to parents in times

25、 of threat. But will this child continue to be so preoccupied with contact later? If so, this may be one sign of anxiety disorder. (In dex Stock International, Inc.)A结果评定/计算总分 /与划界值比较，看 是否高于划界值，如是 ,有该项行为问题计算各因子分八、请根据您的孩子最近6个月的藏弱下表，凡是菲爲廣滴 现的行为则在右侧的2字上画圈,如果有时出现或有-点儿的行为则在1字 上画圈，如果根本不出现的行为则在0字上画眛如请不要遗漏，

26、毎 条都要填写。1、行为幼稚与年龄不符0122、过敏性疾病012描述具体内容：3好争论0124、哮喘0125、行为举止象异性丿110126、驗地大便0127、吹牛、自夸0128、精神不集中，注意力0129、老是想某些事情，不能摆脱（强迫性思维）012例如：10、坐不住、不能安静或活动过多01211好魅大人或过分依赖01212、诉说寂寞01213、困感、做輔里糊涂01214、好哭012二、心理行为发育评价外向IVT分VI511000白分位什2IIinIVVVIVBvinIXE进旦躯体化诉述分裂样不合群不成熟强迫冲敌盍:退缩违纪行为攻击性行为多动84图62 一名12岁多动症男孩行为问题剖析图三、识

27、别儿童心理卫生问题/障碍:0岁、1岁儿童发展任务头的控制坐站走大小便控制三、识别儿童心理卫生问题/障碍三、识别儿童心理卫生问题/障碍亲子依念基本的情绪社会性情感In this illustration of the strange situation, the infant first explores the playroom on his own, as long as his mother is present. But when she leaves, he begins to cry. On her return, however, he is immediately comfort

28、ed and stops crying. The conclusion: he is securely attached.婴儿依念类型安全型当母亲离开时有不安的表现；当母亲回 来时表现出热情、友好、平静。不安全型焦虑矛盾型母亲离开时和离开期间，抗议、 哭叫；母亲回来时，感激，拥抱，当同时又生气, 当母亲安慰时，激动不安回避型 当母亲离开时，似乎没有不安，表现 冷漠；当母亲回来时，不寻求身体接触和安慰 26岁儿童的发展任务跑跳前进走直线 骑三轮车倒退走直线使用双词句使用多词句使用代词合作性与社会性游戏 学会一定的自我控制Compensatoiy preschool education, such

29、 as the Head Start program these children are enrolled in, often yields long- lasting gains. Some positive effects oi Head Start have held up through high school有羞耻感、内疚感和成就感 建立伙伴关系什么是儿童心理卫生问题/心理障碍儿童心理行为严重的偏离了一般儿童的发育水平 或发育轨迹。如果是一过性，不严重影响儿童的生活和社会适 应，称之为儿童心理卫生问题如果其持续时间较长，多种心理行为以综合征方 式出现，严重地影响儿童的生活和社会适应

30、，称之 为心理障碍儿童心理卫生问题/心理障碍识别的原贝IJ心理活动与环境统一心理活动与行为统一心理行为与年龄统一个性特征的稳定性三、识别儿童心理卫生问题/障碍儿童心理发育障碍A精神发节込滞雪力俺下卷金他应能力負擴出珈孑岌节附仪（怡多之渤）三、识别儿童心理卫生问题/障碍儿童心理发育障碍卷舍立$陳码（无卷立俊聘丸立流）语害岌育陳码事龛纸获窄，笛弟刻板感弦过做或込羅也篡参乏，拐潼笛弟陳码，卷含他应俺下儿童心理发育障碍涯童缺略徉多动障码沼动过多涯盍力砂陷（黑申圉碓缶分紀不紡询）於筠冲邸三、识别儿童心理卫生问题/障碍儿童心理发育障碍铀动祿码多为物吋俊抽动以45多多见侖复岌俊、不圭、金虫、傑匡、无0的单一

31、的或 多部铉抽为或岌步抽动，仅吃徳、拐兔诊細易部抽 动常见儿童心理发育障碍铀动祿码能鱼童咅克制，経物吋向，入睡后游失，栓奋亲发 珈神务俊障码八手天天出珈，一夭多次，至少扬篌2W,祷篌不超血除器凌傑如爲汲傑铀动儿童心理发育障碍纟观区處体鋳（君他、不客）夕卜翌不名於筠（分篇障码）儿童心理发育障碍语害的芋律陳码34岁多出观过分弟涯、步幺敌择可加削病伟9理住癡育Baumr i nd教育观管教(Control)期望(Maturity demand ) 亲子交流(Parent-child communication )关爱(Nurturance)合理的时机适当的方法 .必要的技能Howard Gardne

32、r, here uorki)ig u.ith a y(mng child, deveb嗣 the view that intelligence comes in seven differem fcnms: verbal, tnatherruidcal, iibility to slxiiiolly aiwlyze the uorU, movement stalls, nxsighifid skills f(/r avuilyzingour&elves, insightful skills for cnxalyzing others, arul musical skills、9理住癡育心理发育规律的知识儿童家庭教育和护理 儿童保教中心理卫生 精神障碍的早期识别无条件的积极关爱iwsnoiwH