Lifespan Development. Tara L. Kuther

pain associated with circumcision (American Academy of Pediatrics, 1999). Treatment as simple as administering a sugar solution to infants aids in pain management (Matsuda, 2017).

      The medical benefits of circumcision are debated (Beal, 2017; Freedman, 2016). Benefits include reduced risk of having urinary tract infections, developing penile cancer, and acquiring HIV (American Academy of Pediatrics Task Force on Circumcision Policy, 1999; American Medical Association, 1999; Morris et al., 2017). Some argue that these are relatively rare conditions and that the evidence regarding HIV transmission comes from research with adult males in Africa. Whether the same effects apply to infants in Western industrialized countries is uncertain (Alanis & Lucidi, 2004). Moreover, behavior is a more important factor in preventing HIV infection than is circumcision.

      In 1999, both the American Medical Association and American Academy of Pediatrics joined medical associations in Canada, Europe, and Australia in concluding that the benefits of circumcision are not large enough to recommend routine circumcision; instead, it is a parental decision. However, in 2012, the American Academy of Pediatrics (AAP) modified its view to note that although it is a parental decision, the benefits of circumcision justify providing access to the procedure (by insurance companies) to families who choose it. Critical physicians and representatives of medical associations in Canada, Australia, and several European countries counter that the revised recommendation was not based on medical evidence but instead reflected cultural bias on the part of the AAP to support social practices common in the United States (Frisch et al., 2013).

      Regardless, formal recommendations by medical associations may ultimately have little sway on parents (Freedman, 2016). Education about the risks and benefits of circumcision, especially the controversy over the medical necessity of circumcision, generally does not influence parental decisions regarding circumcision (Binner, Mastrobattista, Day, Swaim, & Monga, 2003). Instead, it is tradition and culture, especially social factors such as religion, that influence parental decisions about circumcision. For example, in Jewish cultures, a boy is circumcised on the eighth day after birth in a ritual celebration known as a bris, in which the boy is welcomed as a member of the community. Parents’ decisions are also influenced by social factors such as whether the father is circumcised and the desire that the child resemble his peers (Bo & Goldman, 2008). The decision is complicated, as parents weigh health risks and benefits with contextual factors such as religious and cultural beliefs, as well as personal desires, to determine what is best for their child.

      Description

      Figure 4.11 Rates of Circumcision Performed, 1979–2010

      Source: Owings et al. (2013).

      Notes: Rates represent circumcisions performed during the birth hospitalization.Circumcision is identified by International Classication of Diseases, Ninth Revision, Clinical Modication (ICD–9–CM) procedure code 64.0.

      What Do You Think?

      1 In your view, what are the most important considerations in making a decision about whether to circumcise a newborn boy?

      2 Imagine that you had a newborn boy. Would you choose to circumcise your son? Why or why not?

      Infants show innate preferences for some tastes (Ross, 2017). For example, both bottle-fed and breastfed newborns prefer human milk—even milk from strangers—to formula (Marlier & Schaal, 2005). Newborns prefer sugar to other substances, and a small dose of sugar can serve as an anesthetic, distracting newborns from pain (Gradin, Eriksson, Schollin, Holmqvist, & Holstein, 2002). Experience can modify taste preferences, beginning before birth: Fetuses are exposed to flavors in amniotic fluid that influence their preferences after birth (Beauchamp & Mennella, 2011; Forestell, 2016). In one study, the type of formula fed to infants influenced their taste preferences at 4 to 5 years of age (Mennella & Beauchamp, 2002). Infants who were fed milk-based formulas and protein-based formulas were more likely to prefer sour flavors at 4 to 5 years of age compared with infants who were fed soy-based formulas, who, in turn, were more likely to prefer bitter flavors.

      Intermodal Perception

      All stimuli we encounter involve more than one type of sensory information. For example, we see a dog but we also hear its bark. Not only are infants able to sense in multiple modalities, but they are able to coordinate their senses. Intermodal perception is the process of combining information from more than one sensory system (Johnson & Hannon, 2015). Sensitivity to intermodal relations among stimuli is critical to perceptual development and learning—and this sensitivity emerges early in life (Lewkowicz, Leo, & Simion, 2010). That is, infants expect vision, auditory, and tactile information to occur together (Sai, 2005). For example, newborns turn their heads and eyes in the direction of a sound source, suggesting that they intuitively recognize that auditory and visual information co-occur and provide information about spatial location (Newell, 2004).

      Newborns show a preference for viewing their mother’s face at 72, 12, and even just 4 hours after birth (Pascalis, Dechonen, Morton, Duruelle, & Grenet, 1995). It was once believed that infants’ preference for their mother’s face was innate. Are infants born knowing their mother’s face? In one study, neonates were able to visually recognize their mother’s face only if the face was paired with their mother’s voice at least once after birth (Sai, 2005). Thus, intermodal perception is evident at birth because neonates can coordinate auditory (voice) and visual stimuli (face) to recognize their mother. They quickly remember the association and demonstrate a preference for her face even when it is not paired with her voice.

      Infants integrate touch and vision very early in life. In one classic study, 1-month-old infants were presented with a smooth-surfaced pacifier or one with nubs on it (see Figure 4.12). After exploring it with their mouths, the infants were shown two pacifiers—one smooth and one nubbed. The infants preferred to look at the shape they had sucked, suggesting that they could match tactile and visual stimuli (Meltzoff & Borton, 1979). In another example, 8- to 31-day-old infants fitted with special goggles were presented with a virtual object created by a shadow caster (Bower, Broughton, & Moore, 1970). The virtual object was an illusory object that could be seen by the infant but not touched. When the infant reached for the object, his or her hand felt nothing and flailed through the air. Infants exposed to the virtual object attempted to reach for it and became distressed when they did not feel it, suggesting that vision and touch are integrated and infants expect to feel objects that they can see and reach. Although young infants show impressive capacities to integrate visual and tactile information, these senses are not completely integrated at birth. Newborns can visually recognize an object previously held but not seen, but they cannot tactually recognize an object previously seen and not held, suggesting that intermodal relations among senses are not bidirectional at birth (Sann & Streri, 2007).

      We have seen that individuals are embedded in and interact dynamically with their context. James and Eleanor Gibson studied perceptual development from an ecological perspective, emphasizing that perception arises through interactions with the environment (Adolph & Kretch, 2015). Rather than collecting small pieces of sensory information and building a representation of the world, the Gibsons argued that the environment itself provides all the information needed and we perceive the environment directly, without constructing or manipulating sensory information.

      Figure 4.12 Nubbed vs. Smooth Pacifier Used to Study Intermodal Perception

      Source: Meltzoff and Borton, 1979.

      Perception arises from action. Infants actively explore their environment with their eyes, moving their heads and, later, reaching their hands and, eventually, crawling. Perception