Apert syndrome is a rare genetic disorder, which is characterised by a broad range of physiological and emotional symptoms. According to the National Organisation for Rare Disorders (2012), Apert syndrome incorporates numerous signs and physical complications: skull abnormalities, brain deficiencies, a range of mental problems such as profound retardation, and facial problems like exorbitism.
The purpose of this paper is to compare the level of development in a girl with Apert syndrome to the behaviours, which all children are expected to display at this stage of cognitive development.
Stages of Development
According to Jean Piaget, the process of cognitive development in children covers four essential stages. First, the sensor monitor stage is the period of infancy. At this stage, children rely on motor activity and the use of symbols (Huitt & Hummel, 2003). Second, the pre-operational stage of development covers toddler years and early childhood. During this period, children improve their language skills and develop better imagination and memory. However, they continue to rely on egocentric thinking (Huitt & Hummel, 2003).
Third, at the concrete operational stage of cognitive development, children become more logical and intelligent in their interactions with the world, and operational thinking gradually replaces egocentrism (Huitt & Hummel, 2003). Fourth, the formal operational stage coincides with adolescence and transition to adulthood, when the use of symbols becomes more logical, speeding up the development of formal thinking (Huitt & Hummel, 2003).
Comparing Stages of Development across the Developmental Milestones
M. displays the signs of mild mental retardation, which are characteristic of Apert syndrome. She does not meet the cognitive-developmental criteria for her age. The girl has not passed the formal operational stage of development, as proposed by Piaget (Huitt & Hummel, 2003). The analysis of the behaviours and decisions displayed by the girl suggests that she is still at the concrete operational stage of cognitive development.
At this stage of development, children develop and improve their logical thought (Huitt & Hummel, 2003). M. has not yet entered the formal operational stage of development. She displays poor higher-order reasoning capacity. She cannot make logical inferences or think creatively. M. can make a purchase but does not understand why she receives the change back. It is an example of higher-order logical thinking, which is characteristic of the formal operational stage of cognitive development (Huitt & Hummel, 2003).
According to McLeod (2010), children as old as M. are capable of ordering and classifying things, as well as combining facts and items to make more sophisticated conclusions. M. does not meet these developmental milestones. She cannot make simple calculations and does not know how to match the number of coins received with the amount printed on the receipt.
Such cognitive problems are further exacerbated by the deficiencies in the fundamental intellectual functions. M. has problems with abstract thinking, reasoning, and judgment. Apart from the problems noted above, M. does not understand why, while washing her hands, she must necessarily rub the back of her hands. Another example is when she uses her fingers instead of the utensils while eating. The abovementioned problems indicate the lack of abstract thinking – M. cannot imagine the results of her actions (Huitt & Hummel, 2003).
She does not identify or understand the relationship between different things, such as rubbing the back of her hand and the ways in which her actions influence the quality of hand washing. M. also displays poor money management skills. She can count from 1 to 20, but she finds it difficult to use this knowledge and may even skip numbers.
In other words, M. fails to use her logical symbols effectively, as children at the formal operational stage usually do. Her actions are more characteristic of the concrete operational stage of development when the basic capacity to manipulate simple logical symbols develops and improves (Huitt & Hummel, 2003).
The formal operational stage implies the development of excellent abstract thinking abilities and skills, and it comes as no surprise that children at this stage of cognitive development are expected to possess exemplary language skills. More specifically, children will not use symbols and abstract concepts logically and effectively unless they develop sufficient language abilities and skills (Huitt & Hummel, 2003).
Numerous examples confirm that M. meets the language milestones for her stage of cognitive development. First, she constructs and speaks long sentences without any obvious difficulties. It means that the girl can think logically and use her thinking skills to build complex sentence structures. It may also indicate her willingness to assume complete responsibility for personal decisions and actions, as she speaks the language of adults (CDC, 2014).
Second, M. can express and describe her feelings openly. She is very social and ready to build effective relationships with other people. Based on the developmental milestones described by the Centres for Disease Control and Prevention (2014), friendships are extremely important to the normal cognitive development of the child during this period. It is possible to say that the social relations built with others will speed up the cognitive and emotional maturation of M., even despite her diagnosis.
Unfortunately, the girl’s speech becomes less clear and more confusing when she is emotional or frustrated. However, these problems cannot be attributed to any language deficiency or the absence of effective abstract or logical thinking skills. Such language problems can be detected in children without any signs of mental retardation, even when they have enough reasoning capacity to draw inferences from the relationships among abstract concepts/phenomena.
Gross and fine motor development
Overall, the girl meets the criteria of gross motor development for her age, although the problems she is facing about fine motor skills cannot be ignored. The latter is the direct results of her diagnosis – M.’s fingers are fused to the extent that does not allow developing effective fine motor skills. Such physical problems have profound implications for the way M. manages objects.
On the one hand, because her upper and lower extremities are fused, she finds it difficult to put one object on the top of another one and cannot always pick up coins or use utensils. According to the CDC (2014), children of this age should be encouraged to participate in a variety of social and physical activities, but these activities are mostly unavailable to M. because of her physical disease.
On the other hand, the girl has acquired essential motor skills such as dressing herself, making her bed, making her laundry, and others. Still, these skills are more characteristic of the children at the concrete stage of development rather than those who have entered the formal operational stage. To a large extent, it is due to her physical deficiencies that M. fails to meet the developmental milestones for her age, particularly in terms of physical development.
Social relations and play with other children
Overall, the girl meets the developmental milestones for her age, when it comes to socialisation, relationship building, and plays with other children. CDC (2014) suggests that children of this age seek to become more independent in their relationships with family members.
At the same time, they want to build stronger and more productive relations with peers. Peer pressure increases considerably when children enter the formal operational stage (CDC, 2014; Huitt & Hummel, 2003). As children are getting ready to start middle or junior high school, their desire to become more independent looks quite logical. Below are some of the many examples, which show how M. meets the social developmental milestones for her age.
First, M. constantly interacts with peers and invites them to join her activities. Second, she displays solid leadership skills and always wants to be the first in all social activities involving peers. The fact that she does not like and does not accept others’ advice implies that egocentrism is still a characteristic feature of her cognitive and emotional development (Huitt & Hummel, 2003). However, at the formal operational stage of development, egocentrism usually gives place to socialisation and active engagement in social activities with peers.
The signs of egocentrism are equally obvious in M.’s relations with adults, as well as her group activities. M. seeks attention, cries, and stumbles her feet when the group decides to act in ways that differ from her decisions and orientations. She walks in between people within groups without any excuse. It is possible to assume that, when it comes to socialisation and relations with adults, M. is somewhere between the concrete and formal operational stages of cognitive development (Huitt & Hummel, 2003).
“Early in this period, there is a return to egocentric thought” (Huitt & Hummel, 2003, p. 27). Still, she acts like a cognitively mature adolescent who is capable of making independent decisions and can rely on peer relationships and groups.
In conclusion, developmental milestones provide important information on how children develop and acquire essential thinking and social skills. At the centre of this comparative analysis is the figure of M., a young girl with Apert syndrome, who has almost finished the concrete operational stage of cognitive development but has not entered the formal concrete stage, according to Piaget.
The patterns of M.’s cognitive development have been analysed along several different lines, such as cognitive development, gross and fine motor skills, social relations, and relations with adults. M. displays the signs of mental retardation, which are characteristic of Apert syndrome. Her abstract thinking and reasoning skills are rather limited. M. faces difficulties with using abstract notions and predicting outcomes of her actions. At the same time, she has wonderful language skills.
The girl builds and speaks complex sentence structures. As any child of her age, M. is socially oriented. She shows the level of independence needed to build effective relations with peers. Unfortunately, egocentrism remains a predominant feature of her actions and decisions. This is still one of the brightest elements of the concrete operational stage, as proposed by Piaget (Huitt & Hummel, 2003).
CDC. (2014). Middle childhood (9-11 years of age). Web.
Huitt, W. & Hummel, J. (2003). Educational psychology interactive. Valdosta, GA: Valdosta State University.
McLeod, S. (2010). Formal operational stage. Web.
National Organization for Rare Disorders. (2003). NORD guide to rare disorders. Philadelphia, PA: Lippincott Williams & Wilkins.