The next stage of language development is reading. Here there must be an association of graphic symbols with the auditory, visual, and kinesthetic images of words already acquired. Usually the written word is learned by associating it with the spoken word rather than with the seen object. The integrity of the superior gyrus of the temporal lobe (Wernicke area) and contiguous parieto-occipital areas of the dominant hemisphere are essential to the establishment of these cross-modal associations. Writing is learned soon after reading, the audiovisual symbols of words being linked to cursive movements of the hand. The tradition of beginning grade school at 5 or 6 years is based not on an arbitrary decision but on the empirically determined age at which the nervous system of the average child is ready to learn and execute the tasks of reading, writing, and, soon thereafter, calculating.
Once language is fully acquired, it is integrated into all aspects of complex action and behavior. Movements of volitional type are activated by a spoken command or the individual’s inner phrasing of an intended action. Every plan for the solution of a problem must be cast into language, and the final result is analyzed in verbal terms. Thinking and language are, therefore, inseparable.
Anthropologists see in all this a grander scheme wherein the individual recapitulates the language development of the human race. They point out that in primitive peoples, language consisted of gestures and the utterance of simple sounds expressing emotion and that, over periods of time, movements and sounds became the conventional signs and verbal symbols of objects. Later these sounds came to designate the abstract qualities of objects. Historically, signs and spoken language were the first means of human communication; graphic records appeared much later. Native Americans, for instance, never reached the level of syllabic written language. Writing commenced as pictorial representation and only much later in human evolution were alphabets devised. The reading and writing of words are comparatively late achievements. For further details concerning communicative and cognitive abilities and methods of assessment, the reader may consult the monograph by Minifie and Lloyd.
The terms sexual and sexuality have several meanings in medical and nonmedical writings. The most obvious one relates to the functions of the male and female sexual organs through which procreation occurs and the survival of the species is assured as well as to behaviors that serve to attract the opposite sex and ultimately lead to mating. The terms refer also to a person’s concern or preoccupation with sex, erotic desires, or activities. A more ambiguous meaning has been proposed by some psychologists, for whom the term is equated with all growth and development, the experience of pleasure, and survival.
Much of now discredited Freudian psychoanalytic theory centers on the sexual development of the child and, on the basis of questionable observations, espouses the view that repression of the sexual impulse and the psychic conflicts resulting therefrom are the main sources of neurosis and possibly psychosis.
The following are the main chronologic steps in sexual development, taken from the observations of Gesell and colleagues and itemized in de Ajuriaguerra’s monograph. The timetable of menarche and other aspects of sexual development show considerable variation. If sexuality is not allowed natural expression, it often becomes a source of worry and preoccupation. Perverse derangements of psychosexual function are another matter entirely and are not addressed here.
This denotes a preferential erotic attraction to members of the same sex. Most psychiatrists exclude from the definition of homosexuality those patterns of behavior that are not motivated by specific preferential desire, such as the incidental homosexuality of adolescents and the situational homosexuality of prisoners.