Effects of Stress in Early Childhood: Interplay of Attachment, Self-Esteem, Temperament and Emotional Reactions

Effects of a Stressful Event in Early Childhood on Social Development: Interplay of Attachment, Self-Esteem, Temperament, and Emotional Reactions

Alison Maira
Simon Fraser University
EDUC 322-C 100 The Social Lives Of School Children

Case Study: E.J. Age: 3 years 4 months Hospitalization and Diagnosis of Epilepsy

E.J. was a normally developing 3 year old achieving all appropriate developmental milestones. On July 20 2015, E.J.’s mother noticed that she was falling down frequently despite there being no obstacles in her way. This progressed rapidly to falling over while sitting and being unable to stand. Later that evening, E.J.’s parents took her to their local Children’s Hospital to be assessed by the doctors there.
A week long hospital stay ensued. E.J. underwent eight blood tests, including three failed attempts to insert the needle after multiple tries. She underwent an EEG test, which required her to be sleep deprived, have electrodes glued to her head, a strobe light flashed in her eyes, and hyperventilation. E.J. also had an MRI test and a spinal fluid tap, both of which required general anaesthetic. Upon coming out of the anaesthetic after the spinal tap procedure, E.J. experienced post-operative delirium. Disoriented, unable to recognize her parents, she screamed for hours and hit herself repeatedly. E.J.’s symptoms worsened until she could not walk or sit unsupported. Worry increased for the doctors and E.J.’s parents. After several days of testing, an EEG test revealed that E.J. was having seizures. A diagnosis of atypical Rolandic epilepsy was made. Anti-seizure medications were prescribed and E.J. was released from the hospital when the medication began to take effect and control the seizures.

Teacher Observation:
E.J.’s reaction to this stressful event will be assessed by examining four key elements of social development: attachment, self-esteem, temperament, and emotional reactions. Specifically, how these factors affect and influence each other and how the negative effects of this major stressor can be mitigated by sensitive caregiving.

Attachment is the most influential factor in this scenario, the lynch-pin that directly affects all the others. Attachment is commonly defined as a positive connection between a child and a special caregiver (Kostelnik, Soderman, Whiren, Rupiper, & Gregory, 2012). The benefits of secure attachment are beyond the scope of this discussion, but suffice to say it has been well documented that secure attachment results in lower cortisol production and higher production of opioids and oxytocin in a child’s brain, (Sunderland, 2016) which helps mitigate the effects of cortisol producing (stressful) situations. E.J. has a strong attachment to both of her parents. They are conscientious about giving E.J. physical affection, speaking warmly to her, and spending time reading, playing, and talking together every day. After her hospitalization, E.J. sought out both parents for more holding, rocking, and reading together. Her parents allowed this increase in attachment behaviors, and they decreased to their previous levels before hospitalization within about six weeks of discharge

Attachment builds self esteem
The consistent, responsive care of attachment leads a child to believe that they are worthy of attention and love (Kostelnik et al., 2012). Knowing that one is valued by others, one’s “worth”, is an important dimension of self-esteem (Kostelnik et al., 2012). Self-esteem encompasses three dimensions – worth, competence, and power over one’s situation (Kostelnik et al., 2012). After the stress of hospitalization, E.J,’s self-esteem was diminished, possibly as a result of having no power over her situation. She was forced to participate in painful, frightening procedures against her will. The medical professionals assured E.J.’s parents that her vigorous protests were an indicator of healthy self-esteem – valuing oneself and asserting one’s wishes – and advised them to offer affection and reassurance (attachment behaviors) to rebuild it.
E.J. cried more than was usual for her after her return home. She asked repeatedly why the doctors and nurses did not stop hurting her even when she asked them to. E.J. expressed confusion and doubt about her abilities to defend herself. She needed to hear repeated explanations of what happened to her at the hospital. Her parents complied and made sure they offered physical affection during these conversations to rebuild E.J.’s self-esteem. These behaviors diminished about four weeks after discharge and E.J. began asserting herself again.

Attachment mitigates temperament
E.J.’s temperament appears to be mostly ‘slow to warm up’ (Kostelnik et al., 2012). She prefers to observe a new situation before engaging. E.J.’s parents have found that she engages in new situations more quickly when one of her preferred caregivers offers warmth and affection while she observes. By using attachment behaviors in new situations, E.J.’s ‘slow to warm up’ temperament is mitigated. Temperament is a genetically based inborn set of characteristics (Kostelnik et al., 2012) so there was no noticeable change in E.J.’s temperament after the stress of hospitalization. However, due to her natural tendency to be slow and cautious in new situations, the onslaught of brand new events that were frightening and painful, taking place in a noisy environment with bright lights at a fast pace, probably caused more stress and higher cortisol levels than what a child with an easy temperament would have experienced.

Attachment regulates emotional reactions
A child who is experiencing an emotionally intense reaction to stress can cope more effectively when a trusted adult helps them to acknowledge their feelings and teaches them coping strategies (Kostelnik et al., 2012). Strategies include encouraging the child to take three deep breaths and talking to themselves i.e. “I can do it” (Kostelnik et al., 2012). Adding warmth and physical affection to these conversation will further strengthen the bond of attachment. High quality, secure attachment can mitigate strong emotional reactions in children when they are reassured and calmed by preferred caregivers.
E.J. appeared to be emotionally fragile after discharge. She cried over minor incidents that did not bother her before hospitalization. She had periods of quiet withdrawal when she said nothing and retreated to her room. E.J.’s parents increased their responsiveness. They had repeated conversations about coping strategies while holding her. Over a period of several weeks, E.J. learned to use coping strategies such as talking to herself and identifying her feelings with words. Her negative emotions diminished slowly and had disappeared by about eight weeks after returning home from the hospital.
Although attachment plays the dominant role in connecting and influencing other factors of social development, there are several other connections between these factors observed in E.J.’s case.

Self-Esteem influences emotional reactions
If a child has a healthy self-esteem, believing that they are worthy, competent, and have control over their lives (Kostelnik et al., 2012) it is likely that they would be willing to express their feelings and use words to describe them. A child with poor self-esteem would be unlikely to volunteer information about their feelings, and might be reluctant to even express them, possibly believing that they are “not that good” or “not good at many things” (Kostelnik et al., 2012). This
was observed in E.J.’s case. In the early days after hospital discharge when her self-esteem was low, E.J. would not talk about her feelings or express them. She would withdraw into silence and retreat to a hiding place. As time passed and her parents stepped up their attachment behaviors, she was able to express her emotions, tell them how she was feeling, and use the coping strategies they taught her.

Temperament affects emotional reactions
Considering that a key component of temperament is emotional regulation (Kostelnik et al. 2012), it is reasonable to expect that a child’s temperament could affect their emotional reactions to stress. As a child with a slow to warm up temperament, E.J. reacts strongly to new situations. This manifested after she came home from the hospital in her new medical fears – taking her anti-seizure medication, doctor’s follow-up appointments and ambulance sirens. Her parents are aware of her temperament, and realized that this could result in a more intense emotional reaction than a child with an easy temperament (Kostelnik et al., 2012). They adjusted their responses accordingly and offered many repetitions of reassurance and comfort.

Serious illness and hospitalization is one of the most severe stressors of a young child’s life (Rennick, Dougherty, Chambers, Stremler, Childerhose, Stack…Hutchinson, 2014). Persistent psychological and behavioral difficulties affect approximately 25% of children following discharge (Rennick et al., 2014). Issues such as decreases in self-esteem and emotional well-being, increases in fearfulness and anxiety, sleep disturbances and increased medical fears are common after hospitalization (Rennick et al., 2014). E.J. displayed all of these common post-discharge symptoms. An effort by her parents to promote attachment ameliorated these symptoms. All were greatly diminished by eight weeks after discharge.
Increasing the attachment bond had an interesting ripple effect across other elements of social development as it interacted with self-esteem, temperament, and emotional reactions. Attachment positively influenced self-esteem, emotional reactions to stress, and mitigated temperament. In addition, self-esteem and temperament affected emotional reactions.
Two years after the trauma of her hospitalization and diagnosis, E.J. is a well-adjusted 5 year old doing well in preschool and entering a mainstream kindergarten class in the fall.

Kostelnik, M., Soderman A., Whiren A., Rupiper M., & Gregory, K. (2012). Guiding children’s social development & learning: Theory and skills. Stamford, United States: Cengage Learning
Rennick, J., Dougherty G., Chambers, C., Stremler, R., Childerhose, J., Stack, D.,… Hutchinson, J. (2014). Children’s psychological and behavioral responses following pediatric intensive care unit hospitalization. Bio Medical Central Pediatrics, 14, 276. doi:10.1186/1471-2431-14-276
Sunderland, M. (2016) The science of parenting. New York, United States: DK Publishing.

Piano Recital Cancelled

Hello Lovely Parents and Students,
It is with considerable regret and after much consideration I have decided to cancel our Summer Piano Concert scheduled for Saturday June 17 2017. As some of you know, my dad had a major setback following his bike accident at the beginning of April. He is now at Royal Inland Hospital in Kamloops, recovering from three emergency neurosurgeries. He is healing, but fragile. The road back to health is long and uncertain. My husband and I, my sisters and their partners will be travelling to Kamloops on the weekends to be with him for the foreseeable future.
Thank you all for your understanding,

Alison Maira
B. Mus, Jazz Studies & Music Education
BCRMTA – BC Registered Music Teachers Assn.
BCMEA – BC Music Educators Assn.
The Mobile Piano Geek: http://www.alisonmaira.com

Piano Lessons End Of Term Newsletter

Hello Lovely Parents and Students,

Here we are at the end of another year of teaching and learning! As always, I have learned a lot. About piano, about music, and about life. I hope you and your children have too. Now is the time of year when I must ask you all to declare your piano lesson intentions.

There are three options:

– continue with lessons during the summer,

– stop for the summer but resume in September, or

– give notice that you are terminating your lessons at the end of June.
For summer lessons: scheduling is a somewhat casual affair. Simply ask for the times and dates you would like (my availability is Tuesday, Wednesday, and Thursday  11:30am-7:30pm. You can keep your regular time slot if you like. I will invoice you for all the lessons you have booked for July and August, with payment required up front before July lessons begin. We proceed as normal, except there are no make-up lessons for summer cancellations. Please let me know if you wish to continue with your current time slot when regular weekly lessons resume in September.
For taking a summer break from lessons: I require a non-refundable deposit to reserve your current time slot. This is in the form of a postdated cheque for the amount of September lessons. If you continue in September, the deposit is applied to September lessons. If you change your mind about continuing, the deposit is not refunded.


Thank you all for trusting me to help you or your children learn and grow at the piano.  See you all this week, and happy practicing!



Recital! Recital! Recital!


Hello Lovely Parents and Students,

Our annual Summer Piano Concert will take place on Saturday June 17 at 1:00 pm. The location is Mount Olivet Church, 1700 Mountain Hwy, North Vancouver. I invite all of my students to seize this performance opportunity! And please bring your family and friends. Everyone is welcome. Students should go through their 2017 learned repertoire, choose their best solo and duet, and prepare it for their lesson this week so they will have plenty of time to polish their selections and get really comfortable with them. Performing is exciting and exhilarating if you are prepared. Performing is terrifying and a unique form of dreadful torture if you are not prepared. I’m just sayin. As an experienced teacher and performer. 

     Students can arrive early at the church to warm up on the grand piano. Church appropriate attire please. Please rsvp to me by June 13. 

     Thanks for reading and I look forward to seeing all your shining faces on June 17th.


Lesson Designs Using Discovery Learning and Expository Teaching Theories

Lesson Designs Using Discovery Learning and Expository Teaching Theories
Alison Maira
Simon Fraser University
EDUC 220-3 Educational Psychology

Lesson Designs Using Discovery Learning and Expository Teaching Theories

Lesson Design # 1: C = Pi x D Using Bruner’s Discovery Learning Theory

Materials needed: A piece of string, ruler, calculator, worksheet containing 4 circles of different sizes, pencil, and eraser.

In today’s lesson I will teach a class of grade 4 students how to find the circumference of a circle by using a piece of string (Jacobsen et al., 2006) and using the formula C = Pi x D. (Jacobsen et al., 2006). The class has already learned how to calculate the perimeter of two dimensional geometric shapes by placing a piece of string around the outside edges and then measuring the string with a ruler. They have also learned about the diameter and radius of a circle.
I will start the lesson by asking the class if they remember what the words ‘diameter’ and ‘radius’ mean. If they cannot, I will review those terms by drawing a diagram of a circle on the board and indicating where the diameter and radius are.
Then I will ask “Can you think of another distance we can find for a circle? It is the same kind of distance we studied yesterday in our class about measuring geometric shapes.” I will draw a diagram of a circle on the board, hoping the students will make a connection between the action of me drawing a circle and the idea of measuring the distance around it.
If there is silence or confusion in response to my question, I will prompt the students by asking “In yesterday’s class when we measured geometric shapes with a piece of string and a ruler, what kind of distance were we measuring?” If the students cannot remember the concept of ‘perimeter’ from yesterday’s class, I will review it by writing ‘perimeter’ and its definition on the board. If the students answer my question correctly (“the distance around the circle”) I will say “That’s right. There is a different word for a circle’s perimeter, and that word is circumference”. I will write ‘circumference’ next to the circle I have drawn on the board and a short definition. Then I will ask them “How can we measure a circle’s circumference?” If the students guess incorrectly I will prompt the students by asking “How did we measure the perimeter of the shapes we studied yesterday?” If the students don’t remember, I will hold up a piece of string.
If the students answer correctly, I will ask the students to measure the circles on their worksheet with a piece of string and find the circumference and diameter of each. When the measurements have been completed, I will ask the students “Do you see a pattern between the diameter and circumference of each circle?” If the students cannot see a pattern, I will prompt them by saying “Is the circumference bigger than the diameter?” When they say “Yes”, I will ask “By about how much? An estimate.” Having already learned the multiplication table, students should be able to answer “About 3 times bigger” If the students answer incorrectly, I will say “Let’s see if a pattern becomes visible when we divide the circumference of each circle by its diameter”. Students will use their calculators and find the circumference divided by the diameter is slightly more than 3 in every case.
If the students answer correctly (“about 3 times bigger”) I will say “That’s right. Let’s make a better estimate by dividing the circumference by the diameter for each circle.” As the students complete their calculations, I anticipate the answers will be close to 3.14, but not exact. I will tell the students “Good work everyone! We almost got it. This number is called ‘pi’ and it is actually 3.14. Here is its Greek symbol.” I will write the symbol on the board, and 3.14. I will ask the class “How can we find the circumference of a circle if we know the diameter and pi?” If the class cannot answer correctly, I will write on the board C/D = Pi/1 and ask the students to cross multiply, (which they have learned previously) producing C x 1 = Pi x D, which reduces to C = Pi x D.
If the class answers correctly and expresses the formula, I will write it on the board. C = Pi x D. My last step in the lesson will be to reinforce students learning by writing a series of diameter measurements on the board and asking the students to solve for circumference by using C = Pi x D. When the students have finished their calculations and have shown that they can use the formula correctly, I will close the lesson by saying “Great work, everyone. We have discovered what ‘circumference’ is and the formula C = Pi x D. We also discovered two ways to measure circumference, by using this formula and with a piece of string. Now that you know how to measure the distance around a shape’s outside edges, tomorrow we will learn how to measure the space inside their boundaries. This is called ‘area’. (Pierce, 2016)

How Lesson Design #1 Incorporates Bruner’s Discovery Learning Theory
Bruner’s theory of discovery demands much from the learner. The student must be actively involved in discovering new knowledge through engagement with things and concepts (Sugarman, 2017). Discovery learning is based on inductive reasoning. (Sugarman, 2017) This is when a generalization or concept is arrived at upon understanding specific examples. (Eggen, Kauchak, and Harder, 1979). Intuition and guesswork are encouraged in the discovery learning model (Takaya, 2008), as a means for students to grasp the structure of the subject, and to nurture their confidence. (Takaya, 2008) Bruner also believed that understanding the structure of a subject was critical to discovery learning (Takaya, 2008) and that structure is essentially a way to understand the interrelatedness of things (Takaya, 2008) Discovery learning seeks to develop intrinsic motivation, the notion that learning and increasing one’s knowledge is its own reward (Takaya, 2008).
By asking the students to use a piece of string, ruler, and calculator, I have provided things to actively engage with that illustrate the concept they are to learn and allow them to do so through a hands on activity. Not writing down the formula on the board at the beginning of the lesson and allowing the students to discover it at the end of the lesson utilizes inductive reasoning. The general principle was derived from calculating specific examples. I helped the students understand the subject’s structure by showing the relationship between what they already knew (how to find perimeter using a piece of string) to new knowledge (how to find circumference – a circle’s perimeter – by using a piece of string). I encouraged the students to guess (use their intuition) what the formula for circumference would be, given the diameter and pi and knowing that C divided by D = Pi. Finally, I provided them with opportunities to make discoveries so they would experience the reward of learning new things for the sake of knowledge itself, increasing their intrinsic motivation and desire to learn more.

Lesson Design #2: C = Pi x D Using David Ausubel’s Expository Teaching Theory
Materials needed: A piece of string, ruler, calculator, worksheet containing 4 circles of different sizes, pencil, and eraser.

In today’s lesson I will teach a class of grade 4 students how to find the circumference of a circle by using the formula C = Pi x D. (Jacobsen et al., 2006). The class knows how to calculate the perimeter of two dimensional geometric shapes by placing a piece of string around the outside edges, marking it, and then measuring the string with a ruler. They have also learned about the diameter and radius of a circle.
Advance Organizer: I will say to the class “We have learned how to find the perimeter of two dimensional geometric shapes by using a piece of string to measure the distance around the outside edges and then measuring the string against a ruler. Today we will learn how to find the perimeter of a circle, which is called the circumference. We will calculate the circumference of a circle by using the formula ‘circumference equals pi times diameter’ and check our answers by using a piece of string.” I will write on the board: C = Pi x D C= circumference, pi = 3.14, D = diameter.
I will distribute a worksheet containing four different sized circles and a piece of string to each student. I will say “You have all the information necessary to use the formula. Please take out your calculators and find the circumference of circle A on your handout by measuring the diameter and multiplying it by pi. Then check your answer, measuring the circumference with a piece of string and checking it against your ruler.” When most of the class has completed the task and arrived at the correct answer I will write the problem and answer on the board. To provide sufficient practice and make sure the material is thoroughly learned (Ivie, 1998) I will ask the students to complete more examples from their handout as well as additional examples I will draw on the board. When the math class ends, I will say “Good work everyone! You have learned how to measure the circumference of a circle using the formula C = Pi x D. Now you know how to find the distance around the outside edge of geometric shapes. Tomorrow we will keep working with these familiar shapes, but we will learn how to measure the space inside their boundaries. This is called area.” (Pierce, 2016) Students who need extra help will be referred to the resource teacher for tutoring.

How Lesson Design #2 Incorporates Ausubel’s Expository Teaching Theory
Ausubel’s theory of expository teaching relies on the use of an advance organizer.(Eggen et al., 1979) This statement can be expository – describing a new concept, or comparative -showing similarities or differences with previously learned information. (Sugarman, 2017). It is presented before instruction to help students connect old information with new and activate prior knowledge (Sugarman, 2017).
Relating present content with past and future lessons creates a hierarchical arrangement of knowledge that Ausubel believed to be helpful for remembering old information and facilitating the capacity to learn new things. (Sugarman, 2017). Expository teaching uses deductive reasoning, where a generality given first leads to a specific solution (Eggen et al., 1979). It maximizes teacher control and time management in the classroom (Jacobsen at al., 2006) and is not concerned with the student’s learning process or their engagement with the subject (Eggen et al., 1979). Expository teaching uses repetition and guided practice to ensure the new information is incorporated into the learner’s cognitive structure (Ivie, 1998).
I have incorporated these elements of the expository teaching theory into Lesson Design #2 by giving a comparative advance organizer, when I compared finding the circumference of a circle to the past lesson of ‘perimeter’. I also used an expository advance organizer to present new information by writing the formula on the board. By relating finding perimeter with finding circumference, I hoped to activate a hierarchy of information that looks like this: Math> Geometry> Shapes> Perimeter> Circumference> C= Pi x D, a hierarchy that will be remembered and create an organized structure that new information can be easily added to. I incorporated deductive reasoning into my lesson design when I wrote the formula on the board before explaining it to the students, and then taught them what that generalization meant through the use of specific examples. I maximized teacher time management and control by ending the lesson on time, and by referring struggling students to the resource teacher outside of class time. I did not encourage the students to ask questions nor did I check their level of engagement. I gave the class extra problems to solve to help them assimilate the new information into their cognitive structures through repetition and guided practice.

Eggen, P., Kauchak, D., & Harder, R. (1979) Strategies for teachers: Information processing models in the classroom. Englewood Cliffs, New Jersey: Prentice-Hall
Ivie, S. (1998) Ausubel’s learning theory: An approach to higher order thinking skills. High School Journal, 82(2), 35-42. Retrieved from http://www.jstor.org/stable/40364708
Jacobsen, D., Eggen, P., & Kauchak, D. (2006) Methods for teaching: Promoting student learning in K-12 classrooms. Upper Saddle River, New Jersey: Pearson Education
Pierce, R. (2016, November 7) What is area? Math Is Fun. Retrieved from http://www.mathisfun.com/geometry/area.html
Sugarman, J. (2017) Ausubel’s theory of learning [PowerPoint slides]. Retrieved from http://canvas.sfu.ca/courses/30137/files?preview=5780076
Sugarman, J. (2017) Bruner’s theory of discovery learning [PowerPoint slides]. Retrieved from http://canvas.sfu.ca/courses/30107/files?preview=5780076
Takaya, K. (2008) Jerome Bruner’s theory of education: From early Bruner to later Bruner. Interchange 39(1), 1-19. doi: 10.1007/s10780-008-9039-2

Sharlene, Duet and Solo

Sharlene is one of my Wednesdayday afternoon ladies. She is a model student, practicing diligently every week and trying her hand at many different genres.

Shirley, Duet and Solo

Another adult student who is a real pleasure to teach. This year Shirley has been studying Nat King Cole, and more recently, The Beatles. Shirley’s choice of repertoire always puts me in a good mood. You just can’t be miserable and play smooth, beautiful pop standards like Mona Lisa, L-O-V-E, and Michelle every week.