2025 – PAGE 198 – DEVELOPMENTAL MILESTONES & ANTICIPATORY GUIDANCE
COGNITION
COGNITIVE REASONING VERSUS CONCRETE THINKING
Cognitive development refers to the development of the ability to THINK AND REASON. Children (6 to 12 years old) develop the ability to think in CONCRETE ways (concrete operations), such as how to combine (addition), separate (subtract or divide), order (alphabetize and sort), and transform objects and actions (change things such as 5 pennies = 1 nickel). Cognitive reasoning begins to develop in early adolescence and is complete by approximately 21 years of age.
| AGE | COGNITIVE | SOCIAL |
| 6–12 yo | Self-conscious over small things (hair). Values winning. Early concrete thinking. Routines become automatic. Begins making plans to meet specified goals. | More independence. Minor rebellion as children start to talk back to parents. Fears the idea of death and rejection. Able to appreciate others’ points of view. Attachment to non-parental adults (as in teachers). |
| 10–13 yo | Concrete thinking still predominates. Needs explicit discussions. Impulsive without good cognition = BAD COMBINATION! | Increasing emphasis on peer relations. Major rebellion against parents. |
| 14–16 yo | Cognition begins to develop. Still very impulsive. | Peers are the most influential group in effecting change and providing emotional support. Adolescents often begin to show interest in romantic relationships. Sexual orientation becomes clearer during this time (parents’ orientation and difficult upbringing do NOT influence sexual orientation). |
| 17–21 yo | Body image and GENDER ROLE defined. Idealistic (in college)! Cognitive development is now complete. Life goals tend to be the center of patient discussions. Still some impulsiveness, but now with cognition of consequences. | Individual relationships become extremely important. |
- NOTE: GENDER ROLES refer to the social and behavioral norms for a man or woman in a given culture (what the role of a man or woman is, etc.). SEXUAL ORIENTATION refers to whether a person is heterosexual or homosexual.