Anton Došen

Hello everyone. For my letter E post in the #AtoZChallenge on disability, I’d like to talk about emotional development. This is one of my pet peeves, as I myself am considered as having a very significant gap between my intellectual and my emotional level of functioning. For people with an intellectual disability, this is often the case too. In an ideal situation, regardless of developmental level, a person’s intellectual and emotional functioning are in sync. That way, after all, they can more or less be understood like you would a child of their developmental age. (I know that infantilizing disabled people is highly discriminatory, so it’s more complicated than that. For the purpose of this blog post though, I will not go into that. And, for the record, I personally find the concept quite useful for myself.)

The concept of emotional development in intellectual disability here in the Netherlands is most well-known from child psychiatrist Anton Došen. Došen wrote a book on working with developmental ages. He explained about intellectual and emotional development. People’s emotional development rarely surpasses their intellectual level.

In the book, he detailed either seven or five stages of child emotional development. I say possibly seven because a typically-developing child goes through seven stages, but intellectually disabled people aren’t presumed to reach an intellectual level beyond that comparable of a twelve-year-old child. For this reason, Došen postulates that the last two stages aren’t relevant to people with intellectual disabilities.

The stages are:

1. adaptation phase: 0-6 months. Babies learn to adapt to the world outside of the womb. Babies will not yet explore the world around them, but will explore their own bodies. They will learn to adapt to temperature changes, sensory stimuli, etc. People stuck in this stage will usually show severe agitation when overstimulated, but they are not able to consciously direct this at other people or their environment. Disabled people stuck just in this stage are usually profoundly and multiply impaired, although people with severe mental illness or developmental disabilities such as autism may regress into this stage at times. I, for one, do.


2. First socialization phase: 6-18 months. This is the stage in which a child (or disabled person stuck in this stage) will be focused primarily on the caretaker as an extension of themself. Secure attachment is of prime importance for children at this age and insecurely attached individuals might be stuck at this stage (again, me). Many individuals with less severe intellectual disabilities or even no intellectual disability at all, are emotionally at this level (like myself). They, like individuals stuck in the first stage, require individual support.


3. First individuation phase: 18-36 months. During this stage, children learn that they are their own person separate from the caretaker. This can lead to conflicts related to their need for autonomy vs. their need for care. They, like children in the previous stage, experience separation anxiety. It is also common for individuals stuck at this stage, particularly more verbally capable ones like myself when I’m well, to engage in power struggles. Think of the “Terrible Twos”. Individuals who function at this level, will be able to cope with less one-on-one support.


4. Identification phase: 3-7 years. During this phase, children learn to identify with important role models such as their caretakers and learn social rules and norms from them. Early on in this stage, children will still often feel tempted to do things that aren’t okay, but later on, they will learn to follow socially-accepted rules even when the caretaker isn’t present. Children or people who function at this level often come across as self-centered because they are unable to see things from another’s point of view. For this reason, they can (unintentionally) hurt each other. The ability to understand another’s viewpoint doesn’t develop until a child is about six-years-old. Individuals in this stage can be supported from a distance (in a group setting), but will need individual support when stressed.


5. Sense of reality: 7-12 years. During this phase, children are usually in primary school, so contact with peers is more important than contact with caretakers. Children will learn to think logically and their distress tolerance will increase. Individuals in this stage need less support than those in the previous stages. It is more important to negotiate responsibilities with the client and to discuss conflict situations after they’ve occurred. I, honestly, cannot relate to anything within the description for this phase.

The next two phases are the second socialization and second individuation phase, which are usually only reached by typically-developing young people. I have not been able to find information on these stages yet.

The scale for emotional development used in the Netherlands for understanding people with intellectual and developmental disabilities, makes use of eight different domains of emotional development, on which a person can be scored differently. For instance, on the domain of body awareness, someone might score as functioning between 0-6 months, while in the area of handling material, that same person might be seen as functioning like someone between 7-12 years. Someone can also regress back into an earlier phase when under severe stress.