What is the term for mental structures or organized patterns of thought or behavior?

Psychological Theories that have Contributed to the Development of Occupational Therapy Practice

Moses N. Ikiugu PhD, OTR/L, in Psychosocial Conceptual Practice Models in Occupational Therapy, 2007

Jean Piaget's Stages of Cognitive Development

Jean Piaget's theory of cognitive development was based on his construct of cognitive structure.13,66,67,75 By cognitive structure, Piaget meant patterns of physical/mental action underlying acts of intelligence. He also called these structures cognitive schema. The schema are used to interpret information in such a way that it makes sense and helps one understand the environment. He saw these structures as corresponding to stages of child development. In Piaget's view, the purpose of intelligence was to help humans adapt to the environment. In the process of adaptation, cognitive structures changed through the process of assimilation and accommodation.

Assimilation referred to interpretation of events according to existing cognitive structures/schema. Accommodation referred to change in cognitive structure to accommodate changes in the environment. Cognitive development was conceptualized to be a constant effort to adapt to the environment by continual balance between assimilation and accommodation. As this process of adaptation took place, Piaget argued, a child went through stages of cognitive development where increasingly complex cognitive processes were used at every stage to solve environmental problems. Piaget's stages of cognitive development are presented in Table 3-3.

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The Cognitive Disabilities Conceptual Model of Practice

Moses N. Ikiugu PhD, OTR/L, in Psychosocial Conceptual Practice Models in Occupational Therapy, 2007

Preview Questions

1.

Discuss the interdisciplinary basis of the Cognitive Disabilities model of practice. Explain how Piaget's theory of cognitive development relates to the model.

2.

Concisely state the theoretical core of the Cognitive Disabilities model of practice.

3.

Explain the postulations of the Cognitive Disabilities model about the following, and use the Allen Cognitive Levels to explain the postulations.

a.

Function

b.

Dysfunction

c.

Change

4.

Describe the model's guidelines for clinical assessment and intervention.

5.

Discuss the consistency of the Cognitive Disabilities model with each of the following:

a.

The occupational therapy paradigm

b.

The philosophy of pragmatism

c.

The complexity/chaos theoretical framework

6.

Discuss available empirical evidence supporting clinical effectiveness of the Cognitive Disabilities model as a guide to intervention in occupational therapy practice.

7.

Suggest any modifications that may improve the model.

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URL: https://www.sciencedirect.com/science/article/pii/B9780323041829500180

Alexithymia

V. Panaite, L.M. Bylsma, in Encyclopedia of Human Behavior (Second Edition), 2012

Cognitive Aspects

One core characteristic of alexithymia is the difficulty in identifying and describing one's feelings. Lane and Schwartz created a cognitive development model for emotion on the basis of Piaget's theories of cognitive development. They proposed that this ability to identify and describe feelings develops over time just as cognition does. The cognitive development model as applied to emotion has five stages of emotional experience, starting with physical sensations, action tendencies, single emotions, blends of emotion, and blends of emotional experience. Additionally, the level of emotional development also depends on what and how much people know about emotions.

Research shows that people who score high in alexithymia not only have difficulty in verbal and nonverbal emotion recognition but also show impaired recognition of facial expressions. Cognitive deficits in alexithymia have also been proposed to potentially be adaptive, to the extent that people capable of a complex cognitive understanding of emotions also being more likely to potentially be more impacted by extreme emotional experiences (i.e., traumatic experiences). Given that alexithymia has often been observed in people with mental or physical illnesses that are likely to be associated with increased emotional distress, such a trait can be protective in the short term, although marked deficits in emotional processing most often have been shown to lead to protracted anhedonia and apathy.

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URL: https://www.sciencedirect.com/science/article/pii/B9780123750006000185

Spirituality, Religion and Healthy Development in Adolescents

S. Burg, ... L.J. Miller, in Encyclopedia of Adolescence, 2011

Models of Spiritual and Religious Development

One of the leading theories of spiritual development is Fowler's theory of faith development. In this model, Fowler builds upon the work of other developmental theories including Erikson's psychosocial theory, Piaget's theory of cognitive development, and Kohlberg's cognitive theory of moral development. Fowler holds that these developmental stages occur in the same pattern and progression for all individuals and are correlated with certain ages of development.

Fowler suggests that there are three elements at work in this process, namely the self, others, and what he terms “shared centers of values and powers.” Spiritual development occurs over seven stages, starting with stage zero, from birth to 2 years of age, when the infant has primal or undifferentiated faith. This stage broadly correlates with Erikson's stage of trust versus mistrust, as the infant is confronted with determining the safety of its environment. During stage one, which lasts from ages 3 to 7, the child's faith is considered ‘intuitive or projective.’ At this point, the child's psyche is unprotected and exposed to its own unconscious, resulting in the birth of imagination. In this stage, self-awareness begins, as the child integrates perception of reality within an internal paradigm, allowing them to understand the cultural norms of the society. The next stage is the ‘mythic-literal’ stage, which lasts until adolescence. At this point, the individual begins to synthesize and internalize relevant rituals and symbols. At this stage of development, these symbols are interpreted at a simplistic level and are not recognized beyond their obvious external attributes. Individuals in stage two believe that the universe operated in a wholly just manner, with all actions equally reciprocated and balanced in cause and effect. In addition, during stage two, deities are always depicted as anthropomorphic. Fowler suggests that there are those who remain in stage two for their entire lives.

The first three stages correspond closely with the child's evolving cognitive abilities and mirror the first three stages in Piaget's theory of development; sensorimotor, preoperational, and concrete operational. Stage three, which Fowler terms synthetic conventional faith, begins at adolescence and is correlated with formal operations, Piaget's final stage of development. At this developmental stage, the ego is dominant and the individual is able to use logic and hypothetical thinking to create and evaluate ideas. However, many individuals do not use these abilities to ascertain their own personal faith and instead conform to the beliefs of those around them, leaving them spiritually underdeveloped. In Fowler's words, “At Stage 3 a person has an ‘ideology,’ a more or less consistent clustering of values and beliefs, but he or she has not objectified it for examination and in a sense is unaware of having it.” Stage three therefore can be equated with the conventional religious beliefs of most individuals. Based on his population sample, Fowler concluded that one quarter of adults do not evolve beyond stage three.

Fowler's fourth stage of faith development reflects intuitive reflective faith and generally occurs during one's mid-20s to late 30s. At this point, the individual no longer conforms to external influence and begins to take personal responsibility for their own faith and beliefs. This can cause the individual to struggle, inflicting angst and doubt. At this point, the individual might endure a ‘psychic undoing,’ where everything that the individual once took as absolute truth begins to be questioned, causing a crisis of faith.

Fowler's fifth stage occurs when the individual develops ‘conjunctive faith,’ most often occuring during a midlife crisis. During this stage, the individual is propelled by disillusionment and tragedy. Success at this stage allows the individuals to regain that which they had previously abandoned, as they begin to rededicate themselves to their faith.

After stage five, there is a conspicuous gap before one enters the sixth stage, termed ‘Universal Faith.’ There are very few people who reach this stage. When an individual reaches stage six, they have achieved enlightenment; the individual no longer has apprehensions between their highest possibilities and perceived loyalties, and thus becomes an activist in their own right and of their own unique model. Historical figures who are said to have reached this stage include Abraham Lincoln, Mother Teresa, Martin Luther King, Jr, and Mahatma Gandhi.

Another leading theory of spiritual development is Oser's stages of religious development. While this theory is not solely concerned with spirituality, it seeks to explain the development of spirituality in the context of belief in religion or a higher power. It is important to understand how spirituality develops in relation to religion, as the two are so closely related for many people. Oser's approach consists of five hierarchical stages, without regard to age. In the first stage, “the ultimate being does it…,” individuals believe they must always obey the will of their chosen Divinity, and that their personal actions have minimal effect on the action of this higher power. For most individuals, this stage occurs during early childhood. During the second stage, “the ultimate being does it, if …” the individual places a higher emphasis on the capacity of their actions to affect the will of a higher power. Individuals at this stage believe they have influence through praying, doing good deeds, and obeying religious doctrines. In the third stage, “the ultimate being and the human kind do …” and the Divine is no longer seen as having a distinct sphere of action and is not in responsible for all that occurs. At this stage, the individual's will is the crucial element in social relations and individual matters.

The fourth and fifth stages, “human kind does through an ultimate being's doing,” are combined because Oser believes they blend into each other. These stages most often occur during adulthood, and at this point, it is believed that the Divine is not only the basis of the universe, but of each individual's existence. Individuals in this stage believe that their lives are given more meaning through their belief and relationship with a higher power, and through their actions which honor God. The fifth stage occurs very rarely and is typified by the presence of the higher power in every action no matter how vast or minute. This stage is quite similar to Fowler's final stage of faith development, and Oser offers the same esteemed historical individuals as examples of such attainment.

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URL: https://www.sciencedirect.com/science/article/pii/B9780123739513000429

More Similarities than Differences in contemporary Theories of social development?

Campbell Leaper, in Advances in Child Development and Behavior, 2011

2 Bridging Cognitive-Developmental Theory and Gender Schema Theory

Both cognitive-developmental theory and gender schema theory are constructivist models that emphasize the importance of children's gender concepts in guiding their attention and shaping their interests. That is, they similarly propose that children are motivated to match their behavior to their understandings of what it means to be a girl or a boy. The two theories differ, however, in their model of developmental change. The cognitive-developmental model of gender development is based on Piaget's theory of cognitive development. It reflects a stage model whereby age-related qualitative changes in the structure of children's thinking are postulated to occur. In contrast, gender schema theory is derived from information-processing accounts of cognitive functioning. It reflects a continuous model of development whereby age-related quantitative increases in children's information-processing abilities are postulated to occur.

Qualitative (or discontinuous) and quantitative (or continuous) models of developmental change are generally considered incompatible (Reese & Overton, 1970). However, neo-Piagetian theorists have pointed to possible ways to reconcile information-processing and stage approaches (see Morra, Gobbo, Marini, & Sheese, 2008). Perhaps, similar work could be undertaken to reconcile gender schema and cognitive-developmental models of gender development. Incorporating neo-Piagetian models into gender schema theory could strengthen the theory by addressing how age-related changes in children's cognitive processing might influence how children and adolescents perceive and think about gender. To my knowledge, there have been no prior efforts to bridge neo-Piagetian theory and gender schema theory.

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Qualitative Case Studies

S.B. Merriam, in International Encyclopedia of Education (Third Edition), 2010

Generalizing from Qualitative Case Studies

The worth of qualitative case studies for contributing to the knowledge base of a field and to improving practice has been challenged over the years. Most recently, the federal government's preference for evidence-based research, that is, research that is experimental or quasi-experimental, has led to some questioning of all forms of qualitative research. However, those who conduct research in education for the most part fully appreciate what can be learned from qualitative research and qualitative case studies. In a recent presentation critiquing the new gold standard of randomized controlled trials in educational research, Shields (2007) argues for qualitative case studies: “The strength of qualitative approaches is that they account for and include difference – ideologically, epistemologically, methodologically – and most importantly, humanly. They do not attempt to eliminate what cannot be discounted. They do not attempt to simplify what cannot be simplified. Thus, it is precisely because case study includes paradoxes and acknowledges that there are no simple answers, that it can and should qualify as the gold standard” (p. 13).

Education is a social science that involves real people in real time and an in-depth snapshot of some aspect of educational practice can be enormously instructive to others in the field. Such studies can also lead to models or theories that inspire even more research. For example, Piaget's theory of cognitive development, which has inspired literally thousands of studies over the years, was derived from case studies of his two children. Moreover, in citing single cases, experiments, and the experiences of Galileo, Newton, Einstein, Bohr, Darwin, Marx, and Freud, Flyvbjerg (2004) makes the point that both human and natural sciences can be advanced by a single case. He also argues that formal generalizations based on large samples are overrated in their contribution to scientific progress.

The problem of generalizing from a qualitative case study is a problem only if one thinks from a positivist understanding of knowledge construction and relies on the statistical notion of generalizing from a random sample to a population. There are other ways to think about generalizability more congruent with the constructivist philosophy underlying qualitative research. Perhaps because a case study focuses on a single unit, a single instance, the issue of generalizability looms larger here than with other types of qualitative research. However, much can be learned from a particular case. Readers can learn vicariously from an encounter with the case through the researcher's narrative description (Stake, 2005). The colorful description in a case study can create an image – “a vivid portrait of excellent teaching, for example – can become a prototype that can be used in the education of teachers or for the appraisal of teaching” (Eisner, 1991: 199). Further, Erickson (1986) argues that since the general lies in the particular, what we learn in a particular case can be transferred to similar situations. It is the reader, not the researcher, who determines what can apply to his or her context. Stake (2005: 455) explains how this knowledge transfer works: case researchers “will, like others, pass along to readers some of their personal meanings of events and relationships – and fail to pass along others. They know that the reader, too, will add and subtract, invent and shape – reconstructing the knowledge in ways that leave it…more likely to be personally useful.”

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Coach Behaviors and Goal Motives as Predictors of Attainment and Well-Being in Sport

Alison L. Smith, in Sport and Exercise Psychology Research, 2016

Motivation for sport

Motivation has remained a consistent topic of interest in sport and exercise psychology, and has comprised numerous definitions and theories (see Roberts & Treasure, 2012, for review). Of these theories, self-determination theory (SDT; Deci & Ryan, 1985; see also Ekkekakis & Zenko, Chapter 18) has received considerable support in sport, as well as numerous other contexts. At its heart, the theory draws from humanistic and psychodynamic theories of personality (Maslow, 1955) and cognitive theories of development (Piaget, 1971) in recognizing the inherent tendency of humans to progress toward optimal functioning. However, the theory also recognizes contributions of operant behaviorist (Skinner, 1953) and social-cognitive (Bandura, 1986) interpretations of the conditioned and socially reactive human, respectively. The result is a comprehensive theory comprising the origins, nature, and implications of motivation.

SDT emphasizes the need to consider quality of motivation, in addition to quantity. Expanding upon previous notions of motivation as comprising intrinsic and extrinsic motivation (Deci, 1971), SDT proposes that multiple motives can be identified and organized along a continuum reflecting the extent to which they are self-determined (Deci & Ryan, 1985). At the least self-determined end of this continuum, external motives reflect externally controlled behavior prompted by rewards or punishments, such as the athlete motivated to avoid a coach’s fitness punishment. Moving along the continuum, introjected motives include behaviors prompted by internal pressures of guilt, shame, or pride, for example, the athlete motivated to avoid the shame of defeat. Identified motives reflect more self-determined behavior mobilized by the identification of personal meaning or value, such as the athlete motivated by the value they identify in their training sessions. Finally, at the most self-determined end of the continuum, intrinsic motives underlie behaviors engaged in for their inherent interest or enjoyment. Consistent with SDT, research in sport has typically supported the benefits of more self-determined motives for improving task performance and psychological well-being (see Ntoumanis, 2012, for review). Accordingly, the basketball players engaging in training due to the enjoyment they experience (intrinsic) or because they identify value in the act of training (identified), will experience more positive outcomes than the players training due to guilt (introjected) or to avoid punishment (external).

SDT proposes that distinct motives are shaped by factors in the social environment (Deci & Ryan, 1985). Through the level of control emphasized and amount of information provided, social factors (eg, the coach) can either foster or undermine self-determined motivation (Deci & Ryan, 1980). Specifically, controlling environments that emphasize pressure (eg, continuous coach-driven pressure to perform) and minimize opportunities for choice undermine self-determined motivation and promote a move toward the less self-determined end of the continuum. In contrast, the provision of information (eg, task-relevant feedback) promotes self-determined motivation.

Vallerand and Losier (1999) proposed three social/environmental factors that can influence an athlete’s self-determination; experiences of success versus failure, competition, and coach behaviors. Due to the possibilities for intervention, coach behaviors have received the greatest attention, with research primarily addressing this through the implications of autonomy-supportive versus controlling behaviors. Autonomy-support refers to behaviors that support the development of athlete autonomy through minimizing pressure, providing a rationale for actions, and providing opportunities for choice versus those that undermine autonomy and exert pressure. Research to date has typically supported the use of autonomy-supportive behaviors (Gagné, Ryan, & Bargmann, 2003). More recent findings have also highlighted the independent negative implications of controlling coach behaviors such as the use of controlling statements and the enforcement of punishments (Bartholomew, Ntoumanis, Ryan, & Thøgersen-Ntoumani, 2011; Duda & Appleton, Chapter 17).

In addition to expanding the concept of motivation and highlighting the role of social factors, SDT considers the link from these two elements to psychological health and well-being (Deci & Ryan, 1985). Specifically, SDT proposes three innate and universal psychological needs, the satisfaction of which is essential for optimal functioning. These needs include the need to experience oneself as the initiator of one’s behavior (autonomy), the need to feel effective in one’s actions (competence), and the need to feel connected to the social world (relatedness). These needs are not learned motives but reflect inherent requirements for psychological growth. Furthermore, these needs do not drive behavior but are supported or thwarted through our interaction with the social environment. Consistent with SDT, the link from need satisfaction to psychological well-being has consistently been evidenced in studies examining athlete groups (eg, Adie, Duda, & Ntoumanis, 2012; Reinboth, Duda, & Ntoumanis, 2004). In addition, these studies have emphasized the contribution of coach behaviors to the satisfaction of athletes’ needs (see also Duda & Appleton, Chapter 17).

The expanded concept of motivation offered by SDT provides an opportunity to examine the inherent quantity of motivation to which inconsistencies in goal-setting research in sport have been attributed (Weinberg & Weigand, 1993). In contrast to minimizing the effect of such motivation as Locke (1991) recommends, SDT provides an approach through which the quality of motivation underlying goals can be explored in greater detail. The consideration of social factors also provides a mechanism through which practitioners (eg, coaches) can influence goal setting. Finally, the concept of psychological needs presents an area for further developing goal research to include the consequences for well-being.

Despite the apparent benefits of exploring goal setting through SDT, this approach has not been exploited in sports research until recently. However, such an approach was evident within wider psychology literature. In a refinement of SDT, Sheldon and Elliot (1999) proposed the self-concordance model to address the processes underlying goal striving and its effects upon psychological well-being. The model comprises two stages, namely goal striving and goal outcomes, which together reflect the entire sequence from goal selection to the consequences of goal attainment.

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How can child life specialists help address dental fear and anxiety in children?: A review

Colleen Verrett, Brittany M. Wittenberg, in Pediatric Dental Journal, 2021

3.2 Piaget's theory of cognitive development

Jean Piaget's theory of cognitive development identifies stages of knowledge construction throughout childhood [8]. (See Table 2). The stages identified by Piaget include the sensorimotor stage in infancy and toddlerhood, the pre-operational stage for preschoolers, the concrete operational stage for school-aged children, and the formal operational stage for adolescents [8]. The sensorimotor stage consists of the development of object permanence (knowing an object still exists when out of sight), language, and practical knowledge that later forms into representational knowledge [8]. Infants in this stage learn through sensory experiences via new sights, sounds, tastes, and physical sensations [8]. For example, a dental appointment typically encompasses all the developing child's senses: the taste and feel of the cold, metal mirror; the sound of water spraying, air suctioning, or the chair operating; the smell of the hygienist's gloves; and the sight of fingers and tools entering the child's mouth. Each of these sensory experiences provide the foundation for the developing child's knowledge construction of dental procedures.

Table 2. Piaget's theory of cognitive development.

Developmental LevelStageDescription
Infant and toddler (birth-2 years) Sensorimotor Development of object permanence; learn through sensory experiences via new sights, sounds, tastes, and physical sensations [8]
Preschool-aged (3–6 years) Pre-operational Begin to understand the meaning and representations of language and symbolic thought; children think magically, without logic or realistic reasoning [8]
School-aged (7–11 years) Concrete operational Logical understanding of events and realistic understanding of operations and the world around them [8]
Adolescence (12 years and older) Formal operational Understand hypotheticals, reasoning, and abstract thought [8]

The pre-operational stage constitutes the beginning of understanding the meaning and representations of language and symbolic thought [8]. During this stage, children think magically, without logic or realistic reasoning [8], and can experience heightened anxiety in healthcare settings because they are not able to understand the reason for the procedure or the process steps of their dental experience. For example, a 4-year-old might be fearful that the suction used will take all the air from their body (magical thinking). Therefore, providing developmentally appropriate preparation for preschool-aged children with clear and concise language, so that the explanation does not lead to magical thinking, can help minimize the formation of irrational fears and misconceptions about the dental environment, thus minimizing DFA experienced by children at this developmental level.

As children move to the concrete operational stage, they are better able to understand ordering, construction, and spatial operations [8]. This means children have a logical understanding of events and a realistic understanding of operations and the world around them [8]. Due to the structure of Piaget's theory of cognitive development, children in the concrete operational stage are also at risk of developing DFA due to fear of the unknown [8]. In addition, children's need for a sense of competency at this developmental level can be accommodated by providing developmentally appropriate explanations about the logical steps of the dental procedure and the purpose of the procedure, thus minimizing the fear of the unknown and heightened risk of DFA [7]. For example, a 7-year-old who does not know what treatment is being done inside their mouth might worry that each new tool will hurt them. Before using a new tool in the child's mouth, allowing the child to handle the scaler and understand its purpose (to scrape dirt off their teeth) can foster a sense of competence and mastery of the dental experience. By providing developmentally appropriate explanations and demonstrations on the use of the tool prior to the dental procedure, children are able to psychologically prepare for the use of the tool and understand the reason behind the tool usage.

In the formal operational stage of adolescence, children develop the ability to understand hypothetical situations, reasoning, and abstract thought [8]. For example, a developmentally appropriate adolescent receiving treatment for a cavity is able to understand why their tooth needs a filling without a visual or concrete explanation. However, with this ability to understand reasoning without concrete examples comes new fears of abstract ideologies. For example, common misconceptions of adolescents undergoing general anesthesia is that they will wake up, feel pain, or die during the procedure. Despite understanding the reason for and function of general anesthesia for procedures, adolescents may worry that the worst-case, hypothetical scenario will happen to them. One way to address these fears is to reassure adolescents that these fears are typical and to provide developmentally appropriate education about the procedural steps [6].

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Symptom Experience of Children With Cancer Younger Than Eight Years of Age: An Integrative Review

Lei Cheng RN, PhD, ... Qiongfang Kang RN, BSN, in Journal of Pain and Symptom Management, 2019

Discussion

The purpose of this review was to synthesize current evidence regarding symptom experience of children with cancer younger than eight years of age. Often these younger children were included in studies of children in a wide age range; this review suggests that there were limited studies describing symptoms has specifically targeted children less than eight years of age.

Based on the 12 reviewed studies, our main findings are young children are a particularly disadvantaged group in terms of symptom reports as there are very few instruments that span this age range. In this study, PedsQL Cancer Modules (for age five to seven years) were the most frequently used instruments for evaluating self- and proxy-reported multiple symptoms, with pain, worry, and anxiety as the most commonly reported intense symptoms.

Characteristics of children's symptom reports are closely related to their cognitive development. Although children as young as five years of age can provide a self-report of their symptoms, variability of responses and difficulty were reported by previous studies when obtaining responses with younger children.1,24 According to Piaget's theory of cognitive development,25 children under the age of eight are still in the process of reaching concrete operational stage, as exemplified in one of the included studies, these children would believe that they were nauseous because they vomited instead of making an independent assessment of the severity of their nausea.6 In this study, we also found that these younger children reported more physical symptoms but less psychological symptoms. This was consistent with the evidence that younger children were more concerned with pain as they lack the cognitive maturity to develop autonomous strategies and therefore might be less able to cope with it.22,26 Meanwhile, previous researchers also suggested that cognitive development could affect precision in measuring and interpreting the symptom experience, as most self-report measures have higher accuracy with older children.27 This further leads to the discussion about the suitable way to collect symptom reports for this age group of children.

In this study, three categories of symptom reporters existed, including children reporters alone (usually aged over five years), children and parent reports, and parents alone. Parent proxy symptom report was commonly used for this age group. However, as shown in our results, there existed inconsistent concordance between children's and parents' reports.17–20,23 Although parents were more concerned about the impact of cancer on children's cognitive abilities, children at this age were more sensitive about the direct and apparent symptoms such as treatment anxiety. Meanwhile, some symptoms (such as nausea) were proved to be unreliable to use proxy reporters.6 Therefore, to understand the entire symptom experience of this age group, it is necessary to get children's self-reports. Given these children's cognitive maturity, most of the studies that used child reporters employed expressive visualized instruments with face scales for response options (such as PeNAT and DOLLS). Previous studies also suggested that modern electronic and computer technologies (e.g., virtual reality, computer games) helped elicit children's self-report symptoms, as used in the older children.28,29 Furthermore, influenced by their family environment and cognitive development level, children's symptom vocabulary may vary across ages and families. Ruland et al. conducted a review listing the terms or expressions children with cancer use to describe their symptoms.30 It concluded that more research were needed to better understand differences in symptom experiences among different age groups and that it would be imperative to ascertain these children's own age-specific symptom expressions. In response to this calling, a recent published article described the development of a new self-report symptom screening tool (mini-SSPedi) for children aged four to seven years receiving cancer treatments.31 The authors proposed a stepwise approach incorporating three phases, that is, establishing an appropriate instrument structure, evaluating understanding of each symptom, and testing the entire instrument. The result showed this instrument was understandable and easy to complete among cancer and pediatric hematopoietic stem cell transplantation recipients between four and seven years of age.

During the literature search, two qualitative studies, which recruited children with cancer less than eight years of age, were identified as they explored children's own symptom expressions.32,33 However, we were unable to include them in this review, as results for this particular age group were not reported separately. Nevertheless, findings from the two studies provided insightful implications for future symptom studies on the younger children. Particularly, these authors found that children experienced symptoms as feeling states and that cancer symptoms were viewed in the context of assigned meanings. Obviously, there is a need for more qualitative studies to fully understand these children's symptom experience.

This integrative review has some limitations. First, the included articles were limited to Chinese and English in light of the authors' language competency. Second, in spite of the fact that search strategies were developed by agreement of all the authors, there are still potential eligible studies on this particular age group that may have been missed for inclusion. Third, the main keyword search term “symptoms” might possibly bias the findings, as most subheadings under the MeSH term “signs and symptoms” were related to the physical domain, which could be the narrow scope of all the symptoms experienced by children aged under eight years. Fourth, some qualitative data of the included studies did not describe the symptom profiles extensively, which implies the possibility of certain biases being introduced by the interpretation of the reviewers, although discussions were held before agreement was finally reached.

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What is the term for an organized pattern?

In psychology and cognitive science, a schema (plural schemata or schemas) describes a pattern of thought or behavior that organizes categories of information and the relationships among them.

Are mental structures that organize patterns and adapt over time?

schema, in social science, mental structures that an individual uses to organize knowledge and guide cognitive processes and behaviour. People use schemata (the plural of schema) to categorize objects and events based on common elements and characteristics and thus interpret and predict the world.

WHAT IS organization in Piaget's theory?

Organisation defines how experiences are related to each other. The organisation of information and experiences makes the human thinking process more efficient. Adaptation is the tendency to adjust to the environment.

What is the term used by Piaget for cognitive framework?

Piaget's Stages of Cognitive Development Piaget's theory of cognitive development proposes 4 stages of development. sensorimotor stage: birth to 2 years. preoperational stage: 2 to 7 years. concrete operational stage: 7 to 11 years. formal operational stage: ages 12 and up.