Unit 2

Infancy and Childhood

Readings and Resources

eBook:

Zastrow, C., Kirst-Ashman, K.K. & Hessenauer, S.L. (2019).  Empowerment series: Understanding human behavior and the social environment (11th Ed.). Cengage Learning.

· Chapter 2: Biological Development in Infancy and Childhood

· Chapter 3: Psychological Development in Infancy and Childhood

· Chapter 4: Social Development in Infancy and Childhood

Articles, Websites, and Videos:

Erik Erikson is a well-known Psychologist and Psychoanalyst known who devoted his work to understanding the psychosocial development of individuals. This video explains the 8 stages of psychosocial development and reviews Erikson’s beliefs on how all of us move through these stages in our lifespan. https://youtu.be/04wbdxzkvYU

Doesn’t everyone like to play with children? Do we understand the multiple benefits of play? In this video, play is examined emphasizing how it supports responsive relationships, strengthens core life skills and reduces sources of stress for young children . https://youtu.be/pjoyBZYk2zI

A child’s temperament can affect many aspects of their lives. This video examines the three major temperament styles of children, including descriptions of their behaviors, and identifies which parenting style is the best for a particular child and their temperament.

Chapter 2 Biological Development in Infancy and Childhood

Chapter Introduction

 

Camille Tokerud/Taxi/Getty Images

Learning Objectives

This chapter will help prepare students to

 

· LO 1 Describe the dynamics of human reproduction (including conception, the diagnosis of pregnancy, fetal development, prenatal influences and assessment, problem pregnancies, and the birth process)

· LO 2 Explain typical developmental milestones for infants and children

· LO 3 Examine the abortion controversy (in addition to the impacts of social and economic forces)

· LO 4 Explain infertility (including the causes, the psychological reactions to infertility, the treatment of infertility, the assessment process, alternatives available to infertile couples, and social work roles concerning infertility)

Juanita lovingly watched her 1-year-old Enrico as he lay in his crib playing with his toes. Enrico was her first child, and Juanita was very proud of him. She was bothered, however, that he could not sit up by himself. Living next door was a baby about Enrico’s age, whose name was Teresa. Not only could she sit up by herself, but she could crawl, stand alone, and was even starting to walk. Juanita thought it was odd that the two children could be so different and have such different personalities. That must be the reason, she thought. Enrico was just an easygoing child. Perhaps he was also a bit stubborn. Juanita decided that she wouldn’t worry about it. In a few weeks, Enrico would probably start to sit up.

.

The Second Trimester

Fetal development continues during the second trimester. Toes and fingers separate. Skin, fingerprints, hair, and eyes develop. A fairly regular heartbeat emerges. The fetus begins to sleep and wake at regular times. Its thumb may be inserted into its mouth.

For the mother, most of the unappealing symptoms of the first trimester subside. She is more likely to feel the fetus’s vigorous movement. Her abdomen expands significantly. Some women suffer edema, or water retention, which results in swollen hands, face, ankles, or feet.

The Third Trimester

The third trimester involves completing the development of the fetus. Fatty tissue forms underneath the skin, filling out the fetus’s human form. Internal organs complete their development and become ready to function. The brain and nervous system become completely developed.

An important concept that becomes relevant during the sixth and seventh months of gestation is  viability. This refers to the ability of the fetus to survive on its own if separated from its mother. Although a fetus reaches viability by about the middle of the second trimester, many infants born at 22–25 weeks “do not survive, even with intensive medical care, and many of those who do experience chronic health or neurological problems” (Sigelman & Rider, 2012, p. 100).

The viability issue becomes especially critical in the context of abortion. The question involves the ethics of aborting a fetus that, with external medical help, might be able to survive. This issue underscores the importance of obtaining an abortion early in the pregnancy when that is the chosen course of action.

For the mother, the third trimester may be a time of some discomfort. The uterus expands, and the mother’s abdomen becomes large and heavy. The additional weight frequently stresses muscles and skeleton, often resulting in backaches or muscle cramps. The size of the uterus may exert pressure on other organs, causing discomfort. Some of the added weight can be attributed to the baby itself, amniotic fluid, and the placenta. Other normal weight increases include those of the uterus, blood, and breasts as part of the body’s natural adaptation to pregnancy.

Pregnancy Apps

Many women now use technology as a way to get advice about their pregnancy and parenting. Mobile apps, such as “BabyBump Pregnancy,” “My Pregnancy & Baby Today,” “WebMD Pregnancy,” and “Parenting Tips,” help parents by providing information on subjects such as tracking your period, what to expect during your pregnancy, what your baby looks like in the womb (complete with pictures and photos), fetal development information, tips on how to have a healthy pregnancy, questions to ask at doctors’ appointments, contraction timing, and much more. For those who want up-to-date advice or information, an app might be a source of information to look into. It is important to note, however, that these apps should not be used as a substitute for the prenatal care given by a medical professional, especially for women with at-risk pregnancies.

2-1dPrenatal Influences

Numerous factors can influence the health and development of the fetus. These include the expectant mother’s nutrition, drugs and medication, alcohol consumption, smoking habits, age, stress, and a number of other factors.

Nutrition

1. Should a pregnant woman who consumes alcohol or illegal drugs that damage her child be punished as a criminal? Should her child be taken from her? If so, with whom should the child be placed?

Alcohol

; Yarber & Sayad, 2016, p. 371). Transmission can often be prevented or infants treated successfully. For example, acquired immune deficiency syndrome (AIDS), which is transmitted by the human immunodeficiency virus (HIV), can infect a fetus through the placenta; it can also infect an infant at birth if there is contact with the mother’s blood, or through breast milk. However, administration of certain drugs, such as azidothymidine (AZT), to the mother during pregnancy and to the infant after birth, in addition to performing a cesarean section (surgical removal of the infant from the womb), has radically decreased mother-to-infant HIV transmission rates in the United States (Santrock, 2016).

2-1fPrenatal Assessment

Tests are available to determine whether a developing fetus has any of a variety of defects. These tests include  ultrasound sonography,  fetal MRI,  amniocentesis,  chorionic villus sampling, and  maternal blood tests.

“The development of brain imaging techniques has led to increasing use of  fetal MRI to diagnose fetal malformations” (Schmid et al., 2011). “MRI (magnetic resonance imaging) uses a powerful magnet and radio images to generate detailed images of the body’s organs and structures” (Santrock, 2016, p. 61). Ultrasound sonography is generally the first and much more common option for fetal screening because it is cost effective and safe. However, when a clearer image or more information is required to provide an accurate diagnosis and effective treatment planning, an MRI can be used. Frequently, ultrasound sonography will identify a potential abnormality and a subsequent MRI will offer a more comprehensive, clearer picture of what’s involved (Mangione et al., 2011). “Among the fetal malformations that fetal MRI may be able to detect better than ultrasound sonography are certain central nervous system, chest, gastrointestinal, genital/urinary, and placental abnormalities” (Nemec et al., 2011; Triulzi, Managaro, & Volpe, 2011; Amini, Wikstrom, Ahlstrom, & Axelsson, 2011; Santrock, 2016, p. 61).

discusses how social workers can help pregnant women access and maximize the use of prenatal care.

depicts various birth positions.

The birth process is an amazing experience.

Blend Images – ERproductions Ltd/Brand X Pictures/Getty Images

Figure 2.1Forms of Birth Presentation

In 1 in 25 deliveries, babies are born in a  breech presentation (Santrock, 2016, p. 101). Here, the buttocks and feet appear first and the head last as the baby is born. This type of birth may merit more careful attention. Often a cesarean section is performed (Santrock, 2016). A  cesarean section, or  C-section, is a surgical procedure in which the baby is removed by making an incision in the abdomen through the uterus. Cesarean sections account for over 32 percent of all births in the United States (CDC, 2015).

Note that more cesarean sections are carried out in the United States than in any other nation (Santrock, 2013). Cesarean sections are necessary when the baby is in a difficult prenatal position, when the baby’s head is too large to maneuver out of the uterus and vagina, when fetal distress is detected, or when the labor has been extremely long and exhausting. Today it is usually safe with only minimal risks to the mother or infant. The mother’s recovery, however, will be longer because the incisions must heal.

A common recommendation following a cesarean delivery is that all future deliveries be done via a cesarean delivery. Despite this, many women whose first child was born through a cesarean birth want to explore a  VBAC (vaginal birth after cesarean). Physicians are concerned about risks associated with VBAC procedures, but due to recent studies showing risks being low, it has been determined that a trial of labor can be attempted for most women (Papalia & Martorell, 2015).

Finally, about 1 percent of babies are born with a  transverse presentation (Dacey, Travers, & Fiore, 2009). Here the baby lies crossways in the uterus. During birth, a hand or arm usually emerges first in the vagina. As such positions also merit special attention, a cesarean section is typically performed (Santrock, 2016).

In the United States, 98.8 percent of all births occur in hospital settings, and a doctor is usually present (Martin et al., 2012). However, it’s quite a different scene throughout much of the world, where home births and  midwifery (the practice of having a person who is not a physician assist a mother in childbirth) are much more common. Although midwives are present for only 8.1 percent of births in the United States (American College of Nurse-Midwives, 2012), this reflects a significant increase from the less than 1 percent evident in 1975 (Martin et al., 2005).

Families also have the option of hiring a doula. A doula is a hired, trained professional who provides emotional and physical support to a woman and her partner during her entire pregnancy, from pregnancy to the postpartum period. A doula’s main role is to provide support during the labor and delivery; however, it is important to note that a doula is not a medical professional. Research has shown that support from a doula might be associated with decreased use of pain medication, decreased length of labor, and a decrease in negative childbirth experiences during the labor process (MFMER, 2016).

Natural Childbirth

addresses the circumstances of low-birth-weight infants internationally.

Highlight 2.2

An International Perspective on Low-Birth-Weight Infants

Santrock (2013) reflects on the circumstances of low-birth-weight infants in various countries around the world:

The incidence of low birth weight varies considerably from country to country. In some countries, such as India and Sudan, where poverty is rampant and the health and nutrition of mothers are poor, the percentage of low birth weight babies reaches as high as 31 percent … In the United States, there has been an increase in low birth weight infants in the last two decades. The U.S. low birth weight rate of 8.2 percent in 2007 is considerably higher than that of many other developed countries (Hamilton et al., 2009). For example, only 4 percent of infants born in Sweden, Finland, Norway, and Korea are low birth weight, and only 5 percent of those born in New Zealand, Australia, and France are low birth weight.

The causes of low birth weight also vary (Mortensen et al., 2009). In the developing world low birth weight stems mainly from the mother’s poor health and nutrition (Christian, 2009). For example, diarrhea and malaria, which are common in developing countries, can impair fetal growth if the mother becomes affected while she is pregnant. In developed countries, cigarette smoking dining pregnancy is the leading cause of low birth weight (Fertig, 2010). In both developed and developing countries, adolescents who give birth when their bodies are not fully matured are at risk of having low birth weight babies (Malamitsi-Puchner & Boutsikou, 2006). In the United States, the increase in the number of low birth weight infants is due to such factors as the use of drugs, poor nutrition, multiple births, reproductive technologies, and improved technology and prenatal care, resulting in a higher survival rate of high-risk babies (Chen et al., 2007). Nonetheless, poverty still is a major factor in preterm birth in the United States… (p. 121)

provides a case example of how one young woman struggled with her dilemma.

Highlight 2.3

Case Example: Single and Pregnant

Roseanne was 21 years old and two months pregnant. She was a junior at a large midwestern state university, majoring in social work. Hank, the father, was a 26-year-old divorce she met in one of her classes. He already had a 4-year-old son named Ronnie.

Roseanne was filled with ambivalent feelings. She had always pictured herself as being a mother someday—but not now. She felt she loved Hank but had many reservations about how he felt in return. She’d been seeing him once or twice a week for the past few months. Hank didn’t really take her out much, and she suspected that he was also dating other women. He had even asked her to babysit for Ronnie while he went out with someone else.

That was another thing—Ronnie. She felt Ronnie hated her. He would snarl whenever she came over and make nasty, cutting remarks. Maybe he was jealous that his father was giving Roseanne attention.

The pregnancy was an accident. She simply didn’t think anything would happen. She knew better now that it was too late. Hank had never made any commitment to her. In some ways she felt he was a creep, but at least he was honest. The fact was that he just didn’t love her.

The problem was, what should she do? A college education was important to her and to her parents. Money had always been a big issue. Her parents helped her as much as they could, but they also had other children in college. Roseanne worked odd, inconvenient hours at a fast-food restaurant for a while. She also worked as a cook several nights a week at a diner.

What if she kept the baby? She was fairly certain Hank didn’t want to marry her. Even if he did, she didn’t think she’d want to be stuck with him for the rest of her life. How could she possibly manage on her own with a baby? She shared a two-bedroom apartment with three other female students. How could she take care of a baby with no money and no place to go? She felt dropping out of college would ruin her life. The idea of going on welfare instead of working in welfare was terrifying.

What about adoption? That would mean seven more months of pregnancy while she was going to college. She wondered what her friends and family would say about choosing adoption as an option. She thought about how difficult that would be—she would always wonder where her child was and how he or she was doing. She couldn’t bear the thought of pursuing this option.

Yet, the idea of an abortion scared her. She had heard so many people say that it was murder.

Roseanne made her decision, but it certainly was not an easy one. She carefully addressed and considered the religious and moral issues involved in terminating a pregnancy. She decided that she would have to face the responsibility and the guilt. In determining that having a baby at this time would be disastrous both for herself and for a new life, she decided to have an abortion.

Fourteen years have passed. Roseanne is now 35. She is no longer in social work, although she finished her degree. She does have a good job as a court reporter. This job suits her well. She’s been married to Tom for three years. Although they have their ups and downs, she is happy in her marriage. They love each other very much and enjoy their time together.

Roseanne thinks about her abortion once in a while. Although she is using no method of contraception, she has not yet gotten pregnant. Possibly she never will. Tom is 43. He has been married once before and has an adult child from that marriage. He does not feel it is a necessity for them to have children.

Roseanne is ambivalent. She is addressing the possibility of not having children and is looking at the consequences of that alternative. She puts it well by saying that sometimes she mourns the loss of her unborn child. Yet, in view of her present level of satisfaction and Tom’s hesitation about having children, she feels that her life thus far has worked out for the best.

Additionally, the abortion issue provides an excellent opportunity to distinguish between personal and professional values. Each of us probably has an opinion about abortion. Some of us most likely have strong opinions either one way or the other. In practice, our personal opinions really don’t matter. However, our professional approach does. As professionals, it is our responsibility to help clients come to their own decisions. Our job is to assist clients in assessing their own feelings and values, in identifying available alternatives, and in evaluating as objectively as possible the consequences of each alternative. It is critical that social workers provide options, not advice.

The National Association of Social Workers (NASW) has established issue and policy statements on family planning and reproductive choice that include its stance on abortion. A policy is a clearly stated or implicit procedure, plan, rule, or stance concerning some issue that serves to guide decision making and behavior. The statements read as follows:

presents some international perspectives on abortion policy.

Spotlight on Diversity 2.1

International Perspective on Abortion Policy

Abortion incidence and policy vary around the world as explained by the following statistics (Guttmacher, 2016c). During 2010–2014, an estimated 56 million abortions occurred each year worldwide. This number is up from the rates of abortions from 1990 to 1994, mainly due to population growth. However, rates vary significantly among countries, especially between developed and developing nations. Women in developing regions have a higher likelihood of having an abortion than in developed regions. In developing regions, the number of abortions annually in 2014 was 50 million, whereas in developed regions the number was 7 million. The highest rates of abortion in 2010–2014 were in the Caribbean and South American, with the lowest rates being in North America and Western and Northern Europe. Induced abortions can be medically safe when done in accordance with recommended guidelines, but globally many are performed in unsafe conditions. Almost all abortion related deaths occur in developing countries.

Women who are poor that live in developing countries have little access to family planning services and few economic resources to pay for safe abortions. As a result, they are more likely to encounter health problems related to unsafe abortion practices. In places where abortion is legal, it tends to be much safer. On the other hand, where abortion is forbidden, it is less safe. That makes sense as legality offers the opportunity for trained, knowledgeable, and skilled personnel to perform abortions.

Huge variations exist around the world in abortion policy (Cohen 2009):

Throughout Europe, except for Ireland and Poland, abortion is broadly legal, widely available and safe … China was the first large developing country to enact a liberal abortion law—in 1957. The Soviet Union and the central and western Asian republics enacted similar laws in the 1950s. Over the next 50 years, abortion become legal on broad grounds in a wide range of less developed countries, including Cuba (1965), Singapore (1970), India (1971), Zambia (1972), Tunisia (1973), Vietnam (1975), Turkey (1983). Taiwan (1985), Mongolia (1989), South Africa (1996) and Cambodia (1997). Indeed, the worldwide trend in abortion law has continued to be toward liberalization. And since 1997, another 21 countries or populous jurisdictions have liberalized their laws, including Colombia, Ethiopia, Iran, Mexico City, Nepal, Portugal, and Thailand. During this same period, only three countries—El Salvador, Nicaragua, and Poland—have increased restrictions.

Today, 60% of the world’s 1.55 billion women of reproductive age (15–44) live in countries where abortion is broadly legal.

The remaining 40% live where abortion is highly restricted, virtually all in the developing world. In Africa, 92% of women of reproductive age live under severely restrictive laws; in Latin America, 97% do.

Also consider the following global facts (Cohen, 2009):

· Unsafe abortions take the lives of 70,000 women annually (or 12.5 percent of all deaths related to pregnancy).

· Around the world, seven women die from an unsafe abortion every hour.

· Eight million women experience complications from abortion that can be very serious.

· Almost 3 million women who experience serious complications related to abortion receive no medical attention.

Cohen (2009) makes the following conclusions. The most effective way to address unwanted pregnancy is to provide readily available contraception to prevent pregnancy from occurring to begin with. However, in developing nations where resources are scarce, this is now a difficult, perhaps impossible, goal. Women who are desperate will resort to abortion whether it is legal or not. In places where abortion is not legal, it is likely unsafe and potentially deadly.

Restricting Access

There are several ways legislation can restrict access to abortion (Center for Reproductive Rights [CRR], 2014). First, states can enact mandatory delays before an abortion can be performed. For example, a state may require a 24-hour waiting period from the time a woman initiates the abortion process to the time the procedure is completed. The decision to abort can be very painful for many reasons, and a waiting period can result in significant stress. Critics indicate that such rules aim to impose obstacles in getting abortions, thus discouraging women from doing so. This rule makes access to abortion especially difficult for poor women from rural areas who have to travel significant distances for the abortion and have little or no money for lodging.

A second type of restriction requires women to receive designated material that may present a negative view of abortion or counseling prior to undergoing an abortion. Critics of this legislation maintain that it only encourages women to delay an abortion procedure; “intrudes on a woman’s autonomy and dignity; interferes with the physician’s professional practice; and corrupts the informed consent process” (CRR, 2009).

The following summarizes state waiting periods and mandatory counseling requirements (Guttmacher Institute, 2016a).

· Thirty-five states require that women receive counseling prior to receiving an abortion.

· Twenty-seven of these states also require that a specified period of time, usually 24 hours, elapse between counseling and the actual abortion.

· Thirteen states require two separate visits to the facility, one for counseling and another to begin the waiting period.

A third legal barrier concerns requiring teenagers to either notify one or both parents or receive consent from one or both parents before getting an abortion. Some states also allow minors to seek a court order to exempt them from parental involvement. Thirty-eight states have enacted parental involvement laws (Guttmacher Institute, 2016b). Fear of confronting parents may cause many young women to delay making the decision to have an abortion. Receiving court permission, where allowed, may also result in difficult delays.

addresses another very controversial issue—the late-term abortion procedure known as intact dilation and extraction (referred to by some as “partial-birth abortion”).

Highlight 2.4

Intact Dilation and Extraction (Late-Term Abortion)

Intact dilation and extraction (D&X) is “a late-term abortion involving partial delivery of a viable fetus before extraction” (Berube, 2002, p. 1014). It is performed after “20 weeks and before viability” (Crooks & Baur, 2014, p. 323). Although physicians refer to it as  intact dilation and extraction, its opponents often refer to it as  partial-birth abortion (DiNitto, 2005, p. 462). Opponents view the procedure as “the interference with the birth of a live baby, rather than the termination of a pregnancy” (Greenberg, Bruess, & Conklin, 2011, p. 264). In practice, it has been “reserved for situations when serious health risks to the woman, or severe fetal abnormalities, exist” (Crooks & Baur, 2014, p. 323).

In November 2003, President Bush “signed into law the first ban on a specific abortion procedure,” namely the D&X, making it “a criminal offense for doctors to perform the procedure, even to preserve the woman’s health” (DiNitto, 2005, p. 462). In April 2007, the Supreme Court upheld this law that “includes no health exception” and prohibits the procedure from being used (Guttmacher Institute, 2013a).

The following facts reflect the current state of partial-birth abortion (Guttmacher Institute, 2013a):

· At the time of this writing, 32 states have established bans on “partial-birth” abortion, 19 of which are in effect and 13 of which have been blocked by a court.

· The definition of “partial-birth” abortion varies widely from one state to another.

· All 32 state laws incorporate some kind of exception.

In reality, the majority (61.2%) of abortions are performed at less than 9 weeks’ gestation, and 88.6 percent at or before 12 weeks (U.S. Census Bureau, 2011).

Ethical Question 2.4

1. What is your opinion about intact dilation and extraction? Should it be legally allowed if the pregnant woman faces serious health risks with continued pregnancy? If the woman risks death? If the fetus suffers from serious mental or physical abnormalities?

discusses contraception in greater detail.)

Women give several reasons for having an abortion. “Three-fourths of women cite concern for or responsibility to other individuals; three-fourths say they cannot afford a child; three-fourths say that having a baby would interfere with work, school or the ability to care for dependents; and half say they do not want to be a single parent or are having problems with their husband or partner” (Guttmacher Institute, 2016). Many abortions are also performed annually in the United States following a rape.

indicates, about one-third of all abortions were performed for women ages 20 to 24. Almost three-quarters of all abortions were for women between the ages of 15 and 29, which makes sense in terms of maximum female fertility. The largest number of women having abortions (41%) had not had any children. This was followed by those having had one previous child (26%) and two or more previous children (19%).

Table 2.1

Facts about Women Having Abortions  2014

Age	Total Abortions (%)
Under 15	.2
15 to 17 years	3.4
18 to 19 years	8.2
20 to 24 years	33.6
25 to 29 years	26.5
30 to 34 years	15.9
35 to 39 years	9.1
40 years and over	3.1
Number of previous childbirths
None	40.7
One	26.2
Two or more	19.1

“Fifty-one percent of women who have abortions had used a contraceptive method (usually the condom or hormonal method) during the month they became pregnant” (Guttmacher Institute, 2016).

Almost 86 percent of women having abortions are unmarried (Jerman, Jones, & Onda, 2016). Abortions are spread across races. Thirty-nine percent of abortions occur to non-Hispanic white women, 28 percent to non-Hispanic African American women, 25 percent to Hispanic women, and 3 percent to women of other races (Jerman, Jones, & Onda, 2016). Thirty percent of women having an abortion state they are protestant and 24 percent Catholic (Guttmacher Institute, 2016). Women having abortions tend to be poor. Forty-nine percent of women having abortions have incomes below the federal poverty line, and another 26 percent have incomes of 100 to 199 percent of the poverty line (Guttmacher Institute, 2016).

2-6dMethods of Abortion

Several different procedures are used to perform abortions, depending on how far the pregnancy has progressed. The cost for an abortion during the first trimester is about $1,500 depending on the length of gestation, where you get services, and what type of services they are (Planned Parenthood, 2016). Costs are higher when the abortion occurs later in the pregnancy. The two major kinds of abortion are a medication abortion (sometimes referred to as an “abortion pill”) and abortion procedures performed within a clinic. Methods used early in pregnancy include vacuum aspiration and medication abortion. Procedures used later on include dilation and evacuation, and intact dilation and evacuation (discussed in  ). Illegal abortion will also be mentioned.

Medication Abortion

A  medication abortion is an abortion induced by taking certain drugs. The most commonly used drug in the United States,  mifepristone (formerly referred to as RU-486), triggers a deterioration of the uterine lining (Planned Parenthood, 2016). It was approved by the U.S. Food and Drug Administration (FDA) for use as an abortion drug in 2000, and has been used in several European countries for over a decade earlier. The process involves taking mifepristone and then taking a dose of  misoprostol (a prostaglandin that triggers uterine contractions) up to three days later. As mentioned, mifepristone causes the uterine lining to break down, which makes it unable to support a fetus. The subsequent dose of misoprostol then causes uterine contractions that expel the fetus. A medication abortion can be performed up to 70 days (10 weeks) after the first day of a woman’s last period and costs up to $800; note that some states restrict the period of use to 49 days (Planned Parenthood, 2016).

A majority of women abort within four or five hours of taking misoprostol; overall, the process is 97 percent effective (Planned Parenthood, 2008a). Potential side effects include dizziness, severe cramping, nausea, diarrhea, abdominal pain, and mild fever or chills (most of which can be reduced by taking Tylenol or ibuprofen [e.g., Advil], not aspirin) (Planned Parenthood, 2013). In 2011, about 23 percent of all abortions were medication abortions (Guttmacher Institute, 2016b).

Vacuum Aspiration

Vacuum aspiration (also referred to as  vacuum curettage or  suction curettage) is a procedure used up to 16 weeks after a missed period (Planned Parenthood, 2016). The cervical entrance is enlarged, and the contents of the uterus are evacuated through a suction tube. Usually done under local anesthesia, the procedure involves first dilating the cervix (i.e., widening the opening into the uterus) by inserting a series of rods with increasing diameters. Then a small tube is inserted into the vagina and subsequently through the cervix into the uterus. The tube is connected to a suction machine that vacuums out the fetal tissue from the uterus. Sometimes,  curettage (scraping with a small, spoon-shaped instrument called a curette) is used afterward (Planned Parenthood, 2016). The entire procedure takes about 5 to 10 minutes in addition to preparation time (Planned Parenthood, 2016).

Most abortions are performed in clinics, where staff usually require that a patient remain for a couple hours following an abortion. Primary side effects include some bleeding and cramping, which are considered normal. Vacuum aspiration is considered a very safe procedure and rarely has complications.

Dilation and Evacuation

Second-trimester abortions are more complicated and involve greater risks. An abortion method that can be used during the fourth and fifth months of pregnancy is dilation and evacuation (D&E). This method resembles vacuum aspiration in that fetal material is initially suctioned out of the uterus and then usually scraped out with a curette. However, because a D&E is performed later in pregnancy, a greater amount of fetal material must be removed. General anesthesia instead of local is used. Potential complications include those associated with vacuum aspiration and those resulting from general anesthesia.

Illegal Abortion

explores the psychological effects of abortion on both women and men.

Spotlight on Diversity 2.2

Effects of Abortion on Women and Men

Research indicates that most women demonstrate positive adjustment a year after an abortion and rarely suffer long-term psychological effects from an abortion (Hyde & DeLamater, 2014; Munk- Olsen et al., 2011). Many women “report feeling relieved, satisfied, and relatively happy, and say that if they had the decision to make over again they would do the same thing”; there is little support for the existence of a “postabortion syndrome” characterized by traits similar to those of posttraumatic stress disorder  (Hyde & DeLamater, 2014, p. 181).

However, Kelly (2008) cautions:

Although serious emotional complications following abortion are quite rare, some women and their male partners experience some degree of depression, grieving, regret, or sense of loss. These reactions tend to be even more likely in second or third abortions. Support and counseling from friends, family members, or professionals following an abortion often help to lighten this distress, and it typically fades within several weeks after the procedure. Counseling often helps in cases where the distress does not become alleviated in a reasonable time. (p. 324)

A frequently ignored psychological aspect of abortion is the male’s reaction to the process. Many men experience feelings of “residual guilt, sadness, and remorse” (Yarber & Sayad, 2013, p. 355). A man may feel ambivalent about the pregnancy and the abortion similar to that felt by his pregnant partner. Many clinics now provide counseling for male partners of women seeking abortion (Yarber & Sayad, 2013). Both partners should receive the counseling they need to make difficult decisions and to cope with whatever feelings they are experiencing.

2-6fArguments for and against Abortion

Numerous arguments have been advanced for and against permitting abortions. Many of these views are related to how facts are interpreted and presented. Following is a sampling of arguments in favor of abortion rights:

· Permitting women to obtain an abortion corresponds with the principle of self-determination and allows women to have greater freedom of choice concerning their own bodies and lives.

·

provides several more scenarios for you to work out on your own. Remember, there are no easy or perfect answers.

Highlight 2.5

More Abortion-Related Ethical Dilemmas in Practice

Apply the hierarchy of ethical principles to each of the following case examples.

Scenario A

A 45-year-old woman becomes pregnant. She already has seven children and numerous grandchildren. Her personal physician refused to prescribe birth control pills for her because of her age and other health reasons. Nor did he discuss other forms of contraception with her or offer her the alternative of sterilization. Physically, it would be hazardous for her to have more children. She comes to you, distraught and crying. She doesn’t know what to do.

Scenario B

A 32-year-old woman with a severe intellectual disability becomes pregnant. She is unable to take care of herself independently. She has a history of numerous sexual encounters. Her genetic background indicates that she would probably have a child with an intellectual disability. It is clear that she would be unable to care for a child herself.

Scenario C

A 19-year-old college student is six weeks pregnant. She has been going with her boyfriend for seven months. For the past three months, they have been seeing only each other, but they do not consider themselves serious as yet. She had been using a diaphragm and contraceptive cream, but they failed to protect her. She doesn’t want a baby right now. However, she feels terribly guilty about getting pregnant.

Scenario D

A married 24-year-old woman is pregnant. She already has one child with a genetic defect. She and her husband have been through genetic evaluation and counseling at a local university. The conclusion is that because both parents have, a history of significant genetic problems, the chances for a normal child are extremely small. The couple was deciding upon a sterilization procedure when she became pregnant.

Scenario E

A married 28-year-old medical technician has been unaware of being pregnant until now, the seventh week of gestation. Throughout her pregnancy, she has been exposed to dangerous X-rays. The possibility that her fetus has been damaged by the radiation is very high. She and her husband want children at some time, but they dread the thought of having a baby with a serious impairment.

Scenario F

Four months ago, a married man of 42 had a vasectomy. His 41-year-old wife just found out that she is five weeks pregnant. Some sperm had apparently still been present in his semen. The couple already have three children in their teens. They do not want more.

Scenario G

A 14-year-old girl is pregnant. It happened one night when she was out drinking. She had never really considered using contraception. She’s shocked that she’s pregnant and is having difficulty thinking about the future.

Scenario A

A 16-year-old girl was raped by a middle-aged man as she walked home from school one night and became pregnant. Both she and her parents are horrified and plagued with worry. They come to you for help. The girl desperately wants an abortion.

Application of Ethical Principles in Scenario A

Consider Principle 1, the need to protect life. If you personally adopt an antiabortion stance and feel that abortion is murder, what do you do? A professional social worker’s personal values must be acknowledged yet put aside in professional situations. The young woman and her parents want her to have the abortion.

We then look at Principle 2, which calls for the nurturance of equality and the combating of inequality. According to this principle, people should be treated equally. In this case, they should have equal access to services. A neighboring state, its border only 25 miles away, allows abortions for all women who want them within the first trimester. Is this fair? Is this ethical? Should you help the young woman and her parents seek an abortion in a state that has different rules? Or should you work actively in your own state to advocate for change so that abortion would be a legal alternative for clients such as this?

summarizes how age affects a woman’s fertility.

Highlight 2.6

Aging Affects a Woman’s Fertility

As a woman ages, five conditions affect her fertility (American Society for Reproductive Medicine, 2012a; CDC, 2013c):

1. Her ovaries’ ability to release eggs ready for fertilization declines.

2. The number of eggs has decreased.

3. The health of the eggs themselves weakens.

4. A woman is more likely to experience other health problems that negatively affect fertility.

5. Her risk of miscarriage increases.

Whether ovulation has occurred can be detected by daily monitoring of a woman’s morning temperature. Basal body temperature charts can be used for this purpose. A woman may experience a slight dip in body temperature on the day before ovulation. Immediately after ovulation, the body temperature rises slightly. There should be “a temperature shift of at least. 4 degrees over a 48-hour period to indicate ovulation” (Fertilityplus, 2010).

Another cause of infertility in women involves blocked fallopian tubes (CDC, 2016).  Pelvic inflammatory disease (PID) is an infection of the female reproductive tract (especially the fallopian tubes) that can cause inflammation and scar tissue that blocks tubes. It often results from STIs such as gonorrhea and chlamydia (both described in  ). Tumors or various congenital abnormalities can also cause blocked tubes.

Other conditions affecting a woman’s fertility include physical abnormalities in the uterine wall and benign fibroid tumors (ASRM, 2012). Endometriosis—the growth of tissue resembling that of the uterine lining outside the uterus, which often results in severe pain—can also cause infertility.

Male Infertility

Common causes of male infertility are low sperm count and decreased sperm motility (sperm’s ability to maneuver quickly and vigorously) (CDC, 2016). Another frequent cause of male infertility is a condition called varicocele (pronounced VAIR-ih-koh-seel) (Hyde & DeLamater, 2014; NWHIC, 2009). Here the veins on a man’s testicle(s) are enlarged, thereby producing too much heat and affecting sperm production. Numerous conditions can affect sperm count. Age, environmental toxins, declining health conditions, medical problems, smoking, use of drugs or alcohol, use of some medications, and radiation treatment and chemotherapy for cancer have all been blamed as contributors to infertility (NWHIC, 2009).

Couple-Related Causes of Infertility

Sometimes infertility results from a mixture of conditions and behaviors shared by a couple. It may involve timing and frequency of intercourse or specific coital techniques used. Occasionally, infertility is a consequence of antibodies produced by a woman that attack the man’s sperm (Hyde & DeLamater, 2017).

2-7bPsychological Reactions to Infertility

Some people experience serious reactions to infertility. They may show signs of depression, guilt, deprivation, frustration, or anger as they pursue infertility counseling. They may feel that their lives are out of their control. In many ways feelings resemble those of grieving, including denial, anger, bargaining, depression, and finally, acceptance (Greenberg et al., 2014; Kübler-Ross, 1969).

).

The first thing to be done in the case of suspected infertility is to bring the matter out into the open. People need to talk about their ideas and feelings. Only then can the various alternatives be identified and a plan of action determined. The couple’s sexual practices concerning pregnancy should also be discussed to make certain they have accurate and specific information.

2-7dAssessment of Infertility

The assessment of infertility usually begins with a general physical examination to evaluate the couple’s overall health; potential physical problems that might be inhibiting fertility are also investigated (ASRM, 2012). Additionally, the couple is asked about their sexual behavior to determine whether it is conducive to conception (ASRM, 2012).

Subsequently, infertility assessment typically involves a regimen of tests (Greenberg et al., 2014; NWHIC, 2009). Assessment of the male entails tests that evaluate the number, normality, and mobility of sperm. Sometimes hormonal tests are also conducted.

The first step in assessing female infertility usually involves evaluating whether the woman is ovulating each month. This can be done by monitoring her own body temperature fluctuations each day, by using home ovulation test kits that can be purchased over the counter at drug or grocery stores, or by a physician administering blood tests to establish hormone levels or taking ultrasounds of the ovaries. If it is determined that the woman is ovulating regularly, additional tests may include X-rays of the fallopian tubes and uterus after injecting dye ( hysterosalpingography). The X-ray indicates whether the tubes are open and profiles the shape of the uterus. A laparoscopy may also be performed, in which a thin, tubular instrument is inserted into the body cavity to examine the female reproductive organs directly for any abnormalities.

2-7eAlternative Options for Starting a Family

Alternatives available to individuals and couples, both infertile and fertile, who want children include adoption, conventional treatment using surgery or drugs, in vitro fertilization, and various forms of assisted reproductive technology, all of which are explained in the following sections.

Adoption

Adoption is the legal act of taking in a child born to other parents and formally making that child a full member of the family. To provide a home and family for a child who has none is a viable and beneficial option for infertile couples.

Currently, there is an emphasis on encouraging parents to adopt children with special needs—that is, children who require additional support in the form of medical or financial help for adoptive placement; factors involved in special needs may include race, age, being part of a sibling group, or having a physical or mental disability (Barth, 2008). People pursuing the adoption alternative also often seek the adoption of foreign-born children (Barth, 2008; Crosson-Tower, 2013).

Surgery and Fertility Drugs

Conventional treatments including surgery or drugs are generally used first to treat infertility in 85 to 90 percent of all cases (Greenberg et al., 2014). Microsurgery has been used to correct blocked fallopian tubes, and remove pelvic adhesions and patches of tissue supporting endometriosis; examples of microsurgery for infertile men are vasectomy reversal and repairing varicose veins in the scrotum and testes (Hyde & DeLamater, 2017).

For women who have problems ovulating, drugs such as Clomid or Seraphine (taken orally), Repronex, or Gonal-F (both given by injection) may be prescribed to stimulate ovulation (Mayo Clinic, 2013b). Note, however, that such “fertility drugs” can result in multiple births, which may cause greater problems for both mothers and infants (American Society for Reproductive Medicine, 2012b). Infants may be born prematurely and experience health problems such as breathing difficulties, bleeding blood vessels in their brains, low birth weight, and other birth defects. Mothers may have difficulties during pregnancy including high blood pressure, diabetes, and low blood count (anemia). They may also encounter problems during the delivery of multiple infants.

Unfortunately, drug treatment for male infertility is much less advanced.

Intrauterine Insemination

Intrauterine insemination (IUI) (also referred to as  artificial insemination [Al]) is the process of “injecting the woman with sperm from her partner or a donor” (Yarber & Sayad, 2016, p. 378). It tends to be used when the male’s infertility problems are mild or the cause of a couple’s infertility is unknown (CDC, 2013c). During IUI, sperm are deposited directly into the uterus instead of the vagina. This tends to enable pregnancy in cases where sperm have difficulty penetrating cervical mucus, as it allows it to bypass that barrier. Additionally, it gives sperm a head start.

Human sperm can be frozen for up to 10 years, thawed, and then used to impregnate (Carroll, 2013b). For a fee, a sperm bank collects and maintains sperm either for the donors themselves or for nondonors, depending on the arrangement made by the donor.

The sperm used in Al may be the husband’s or partner’s. This procedure might also be used for family planning purposes—for example, a man might deposit his sperm in the bank, then undergo a vasectomy, and later withdraw the sperm to have children. High-risk jobs or onset of a serious illness might prompt a man to make a deposit in case of impending sterility. It is possible to pool several ejaculations from a man with a low sperm count and to inject them simultaneously into the uterus or vaginal canal.

A second type of artificial insemination is by a donor other than the husband or partner. This practice has been used for several decades to circumvent male infertility and also when the partner is a carrier of a genetic disease (e.g., a condition such as hemophilia).

In recent years, an increasing number of single women have requested the services of a sperm bank. A woman requests the general genetic characteristics she wants from the father, and the sperm bank then tries to match the request from the information known about its donors. Donors are paid for their sperm and remain anonymous.

addresses some of them.

Ethical Question 2.6

1. What if the surrogate mother changes her mind shortly before birth or right after birth and decides to keep the baby?

If the child is born with severe mental or physical disabilities, who will care for the child and pay for the expenses? Should it be the surrogate mother, the contracting adoptive couple, or society?

Should the best interests of the resulting children rather than their procreators be taken into account? At some point in the children’s lives, should they be told that they have a surrogate mother somewhere? How might this affect their own psychological well-being?

Acceptance of Childlessness

For some infertile couples, accepting childlessness may be the most viable option. Each alternative has both positive and negative consequences that need to be evaluated. The positive aspects of childlessness need to be identified and appreciated. Increasing numbers of people are choosing to remain childless for various reasons. Not having children allows the time and energy that children would otherwise demand to be devoted to other activities and accomplishments. These include work, career, and recreational activities. A couple might also have more time to spend with each other and invest in their relationship as a couple. Children are expensive and time-consuming.

On the one hand, children can provide great joy and fulfillment. On the other hand, they also can cause problems, stress, and strain. Infertile couples (as well as fertile couples) may benefit from evaluating both sides of the issue.

discusses the effects of macro systems on infertility.

Highlight 2.7

The Effects of Macro Systems on Infertility

Unlike abortion issues, which are fairly well crystallized and articulated, the issues, ethics, and values concerning infertility and reproductive technologies are only now being discovered and defined. Abortion has been available for a long time. However, modern technology has allowed sophisticated means of artificial fertilization to be undertaken for only a few decades. Additionally, new developments are rapidly advancing.

A major issue is that most fertility enhancement techniques are expensive. They may be available, but not to poor people and the uninsured. Organizations within the community will provide services only if they are paid. Is this fair or appropriate? Should infertile wealthy people be allowed to enjoy such advances when infertile poor people are not? Should these expensive advances be pursued at all in view of the world’s exploding population? Vital philosophical and ethical issues are involved here. Once again, there are no easy answers.

2-7fSocial Work Roles, Infertility, and Empowerment

Social workers may assume a number of roles to empower and help people address infertility: enabler, mediator, educator, broker, analyst/evaluator, and advocate. Social workers can enable people in making their decisions concerning the options available to infertile people. In cases in which the members of a couple disagree for some reason, a social worker can assume a mediator role to help them come to some compromise or mutually satisfactory decision. The social worker as educator can inform clients about options and procedures with specific and accurate data. The broker role is used to connect clients with the specific resources and infertility procedures they need.

The role of analyst/evaluator might be used to evaluate the relative effectiveness of different fertility clinics and the appropriateness of different assisted reproductive technologies to meet a couple’s or individual’s needs. As an advocate, a social worker might need to speak on behalf of clients if they are being denied services or if the process for receiving infertility treatment is overly cumbersome or expensive.

addresses client empowerment by using a feminist perspective on fertility counseling.

· LO 1 Summarize psychological theories about personality development (including psychodynamic, neo-Freudian psychoanalytic, behavioral, phenomenological, and feminist theories)

· LO 2 Use critical thinking to evaluate theory

· LO 3 Relate human diversity to psychological theories

· LO 4 Examine Piaget’s theory of cognitive development

· LO 5 Review the information-processing conception of cognitive development

· LO 6 Apply Vygotsky’s theory of cognitive development

· LO 7 Explain emotional development (including the development of temperament and attachment)

·

covers it extensively within the context of its application to effective parenting.   addresses other psychological theories in depth, including those of Erik Erikson and Lawrence Kohlberg, and applies them to adolescence and young adulthood.

3-1aThe Psychodynamic Conceptual Framework

Sigmund Freud is perhaps the best known of all personality theorists. This section discusses psychodynamic theory in some detail because of its historical significance. Arlow (1995) explains: “Originating as a method for treating psychoneurotic disorders, psychoanalysis has come to serve as the foundation for a general theory of psychology. Knowledge derived from the treatment of individual patients has led to insights into art, religion, social organization, child development, and education” (p. 15).

Adler (2006) describes Freud as the

theoretician who explored a vast new realm of the mind, the unconscious: a roiling dungeon of painful memories clamoring to be heard and now and then escaping into awareness by way of dreams, slips of the tongue and mental illness … [He was the] philosopher who identified childhood experience, not racial destiny or family fate, as the crucible of character … Not many still seek a cure on a psychoanalyst’s couch four days a week, but the vast proliferation of talk therapies—Jungian and Adlerian analyses, cognitive behavioral and psychodynamic therapy—testify to the enduring power of his idea. (p. 43)

. One dimension of the mind consisted of the  conscious, the  preconscious, and the  unconscious. Freud thought that the mind was composed of thoughts (ideas), feelings, instincts, drives, conflicts, and motives. Most of these elements in the mind were thought to be located in the unconscious or preconscious. Elements in the preconscious area had a fair chance to become conscious, whereas elements in the unconscious were unlikely to arise to a person’s conscious mind. The small conscious cap at the top of   indicates Freud’s theory that a person was aware of only a fraction of the total thoughts, drives, conflicts, motives, and feelings in the mind.

Figure 3.1Freud’s Conception of the Mind

The repressed area was a barrier under which disturbing material (primarily thoughts and feelings) had been placed by the defense mechanism of repression. Repression is a process in which unacceptable desires, memories, and thoughts are excluded from consciousness by sending the material into the unconscious under the repressed barrier. Freud thought that once a material has been repressed, it has energy and acts as an unconscious irritant, producing unwanted emotions and bizarre behavior, such as anger, nightmares, hallucinations, and enuresis.

The Id, Superego, and Ego

The second dimension of the mind was composed of the  id, superego, and  ego. These parts are interrelated and impact the functioning of each other.

The id is the primitive psychic force hidden in the unconscious. It represents the basic needs and drives on which other personality factors are built. The id involves all of the basic instincts that people need to survive. These include hunger, thirst, sex, and self-preservation. The id is governed by the pleasure principle; that is, the instincts within the id seek to be expressed regardless of the consequences. Freud believed that these basic drives, or instincts, involved in the id provide the main energy source for personality development. When the id is deprived of one of its needs, the resulting tension motivates a person to relieve the discomfort and satisfy the need. The id’s relationship with the ego allows a person to rationally determine a means to fulfill the need.

The ego is the rational component of the mind. It begins to develop, through experience, shortly after birth. The ego controls a person’s thinking and acts as the coordinator of personality. Operating according to the reality principle, the ego evaluates consequences and determines courses of action in a rational manner. The id indicates to a person what is needed or wanted. The ego then helps the person figure out how to get it.

The third component of this dimension of the mind is the superego, or conscience. Normally developing between the ages of 3 and 5, it consists of the traditional values and mores of society that are interpreted to a child by the parents. The superego’s main function is to determine whether something is right or wrong. When an instinctual demand strives for expression that the superego disapproves of, the superego sends a signal of anxiety as a warning to the ego to prevent the expression of the instinct. The emotion of guilt is said to originate from the superego. Without the superego to provide a sense of right and wrong, a person would be completely selfish. That is, a person would use the ego to rationally determine a means of getting what the id wanted, regardless of the consequences on other people.

An example of how the id, ego, and superego might function together is provided in the case of a 9-year-old girl looking at a hand-carved wooden horse in a store (she adores horses and hopes to own one someday). She has only $26.67 to her name and the wooden horse she craves costs $45.00. Her id, functioning by the pleasure principle, urges her to take the toy horse. Her ego reasons that she could slip the horse under her jacket and race out of the store. Her ego also encourages her to look to see if anyone, especially those “nosy” clerks, are anywhere around. She’s just about to do it when her superego propels itself into action. Clearly reminding her that stealing is wrong, it raises questions such as what her parents would think about her if she were to get caught. They would be terribly disappointed. Maybe she would even be kicked out of Girl Scouts. As a result, the girl gives the toy horse one last lingering look, sighs, and starts on her way home. Her ego has already begun to work on how much lawn mowing she will have to do to earn the money needed to purchase the wooden toy horse.

Psychosexual Development

Freud came to realize that many people had sexual conflicts, and he made sexuality a focus of his theories. The term he used for the energy of the id’s biological instincts was  libido. This energy was primarily conceived as being sexual energy. Freud thought sexuality included physical love, affectionate impulses, self-love, love for parents and children, and friendship associations.

defines common defense mechanisms postulated by Freud.

Highlight 3.1

Definitions of Common Defense Mechanisms Postulated by Psychoanalytic Theory

· Compensation: struggling to make up for feelings of inferiority or areas of weakness. For example, a stock market analyst’s intense, aggressive competitiveness might be geared to compensating for internal feelings of inferiority. Or a man who was a weakling as a child might work to become a Mr. Atlas competition bodybuilder as an adult to compensate for his former weakness.

· Repression: mechanism through which unacceptable desires, feelings, memories, and thoughts are excluded from consciousness by being sent down deep into the unconscious. For example, you might repress an unpleasant incident, such as a fight with your best friend, by blocking it from your conscious memory.

· Sublimation: mechanism whereby consciously unacceptable instinctual demands are channeled into acceptable forms for gratification. For example, aggression can be converted into athletic activity.

· Denial: mechanism through which a person escapes psychic pain associated with reality by unconsciously rejecting reality. For example, a mother may persistently deny that her child has died.

· Identification: mechanism through which a person takes on the attitudes, behavior, or personal attributes of another person whom he or she had idealized (parent, relative, popular hero, etc.). Reaction formation: blocking out “threatening impulses or feelings” by acting out an “opposite behavior”; for example, a mother who resents her children might emphasize how much she loves them and could never live without them (Coon, 2002, p. 413).

· Regression: mechanism that involves a person falling back to an earlier phase of development in which he or she felt secure. Some adults when ill, for example, will act more childish and demanding, with the unconscious goal of having others around them give them more care and attention.

· Projection: mechanism through which a person unconsciously attributes his or her own unacceptable ideas or impulses to another. For example, a person who has an urge to hurt others may feel that others are trying to hurt him.

· Rationalization: mechanism by which an individual, faced with frustration or with criticism of his or her actions, finds justification for them by disguising from him- or herself (as he or she hopes to disguise from others) his or her true motivations. Often, this is accomplished by a series of excuses that are believed by the person. For example, a student who fails an exam may blame it on poor teaching or having long work hours, rather than consciously acknowledging the real reasons—for instance, that she had “partied hardy” the night before.

Freud’s phases of psychosexual and personality development include the oral, anal, phallic, latency, and genital stages.

Oral Stage

This phase extends from birth to approximately 18 months. It is called oral because the primary activities of a child are centered around feeding and the organs (mouth, lips, and tongue) associated with that function. Feeding is considered to be an important area of conflict, and a child’s attention is focused on receiving and taking. People fixated at this stage were thought to have severe personality disorders, such as schizophrenia or psychotic depression.

discusses social learning theory in depth and applies it to effective parenting. Therefore, it is addressed only briefly here.

3-1ePhenomenological Conceptual Frameworks: Carl Rogers

Feminist theories are based on the concept of feminism and the basic themes involved in that definition. Feminism is the “doctrine advocating social, political, and economic rights for women equal to those of men” and the “movement for the attainment of such rights” (Nichols, 1999, p. 483). They are included here with other theories of personality development because they provide a context for women’s development and experience throughout the life span.

, provides a good example of work focusing on gender-related differences in life experience. Her proposed sequence of levels and transitions differ significantly from the traditional stages of moral development proposed by Kohlberg (1963, 1968, 1969, 1981a, 1981b), arguing that the latter relate primarily to the experience of men.

A fourth principle inherent in feminist theories is  egalitarianism, a philosophy that people should be treated equally as individuals without focusing on gender (Hyde, 2008). This approach diverges from the traditional emphasis on hierarchies of power, where some (historically, men) have greater power and control over others. An egalitarian perspective is democratic, emphasizing the use of consensus building, collaboration, and the sharing of tasks (Hyde, 2008).

The fifth feminist principle, closely related to that of ending patriarchy, is that of  empowerment (Hyde, 2008; Land, 1995; Netting & O’Connor, 2003), defined as the “process of increasing personal, interpersonal, or political power so that individuals can take action to improve their life situations” (Gutierrez, 2001, p. 210). A feminist perspective emphasizes the need to empower women, enhance their potential for self-determination, and expand opportunities. Means of empowerment include assertiveness training, enhancing self-esteem, improving communication and problem-solving skills, and learning conflict resolution and negotiating skills (Van Den Bergh & Cooper, 1986).

A sixth concept underlying feminist theories is that of “ valuing process equally with product” (Hyde, 2008; Van Den Bergh & Cooper, 1986, p. 6). It is not only important what you get done, but how you get it done. A traditional patriarchal approach stresses the importance of the end result. For example, the fact that a male chief executive officer of a large oil company has amassed amazing wealth is considered significant. The traditional view would not consider how he had hoarded his wealth as significant (by ruthlessly stepping on competitors, breaking environmental regulations, and consistently making decisions on his own, not the employees’ nor the public’s, best interests). Feminist theories focus on decision making based on equality and participation by all. The concept of “having power over” others is irrelevant. Thus, feminist theories focus on aspects of process such as making certain all participants have the chance to speak and be heard, adhering to principles of ethical behavior, working toward agreement or consensus, and considering personal issues as important.

A seventh underlying principle in feminist theories is the idea that “ the personal is political” (Bricker-Jenkins & Lockett, 1995, p. 2531; GlenMaye, 1998; Hyde, 2008). Personal experience is integrally intertwined with the social and political environment.  Sexism is “prejudice or discrimination based on sex, especially discrimination against women” that involves “behavior, conditions, or attitudes that foster stereotypes of social roles based on sex” (Mish, 2008, p. 1141). Feminist theories maintain that sexism is the result of the social and political structure. It does not simply involve problems experienced by isolated individuals.

Another implication of this principle is that the political environment can be changed and improved by personal actions. Thus, personal experience can be used to alter the political environment, which in turn can improve the personal experience. For example, individual women can collectively campaign for a candidate who supports women’s issues, thus applying their personal actions to the political arena. As a result, the candidate gets elected and seeks to improve her supporters’ work environments and access to resources, a political result that affects women’s personal lives.

discusses the diversity of feminist theories that vary in their relative emphasis on these nine concepts.

). “What would happen to the average American corporation if it had to start paying all of its secretaries as much as plumbers earn? (Both jobs require a high school education and a certain amount of manual dexterity and specific skills)” (Hyde & Else-Quest, 2013, p. 54). Marxist feminism seeks a total transformation of the current capitalist system such that wealth would be spread much more equally across classes, including women and other oppressed populations.

Marxist feminism contends that there are “two solutions to women’s exploitation in capitalism: wages for housework and government subsidization of wives and children” (Lorber, 2010, p. 48). This calls for women working in the home to be paid for that work because it is work, just as others are paid for working outside the home (Lorber, 2010).

Radical Feminism

Radical feminism perceives “liberal feminism and cultural feminism as entirely too optimistic about the sources of women’s oppression and the changes needed to end it” (Hyde & Else-Quest, 2013, p. 54). From this perspective, “men’s control” over women “manifests itself in gender roles, family relationships, heterosexuality, and male violence against women, as well as the wider male-dominated world of work, government, religion, and law … For radical feminists, women’s liberation requires the eradication of patriarchy and the creation of women-centered ways of living” (Kirk & Okazawa-Rey, 2010, p. 12). “Collective political and social action [is] … essential. Given the difficulty of changing social institutions, radical feminists sometimes advocate separatist communities in which women can come together to pursue their work free of men’s oppression” (Hyde & Else-Quest, 2013, p. 54).

Postmodern Feminism

“ Postmodern feminism is not focused on social action, but rather is an academic movement that seeks to reform thought and research within colleges and universities” (Hyde & Else-Quest, 2013, p. 54). “It is particularly concerned with the issue of  epistemology, which is the question of how people—whether lay-people or scientists—know. How do we know about truth and reality?” (Hyde & Else-Quest, 2013, p. 54). “Postmodern feminism claims that gender and sexuality are performances, and that individuals modify their displays of masculinity and femininity to suit their own purposes. Males can masquerade as women, and females can pass for men. Postmodern feminism argues that, like clothing, sexuality and gender can be put on, taken off, and transformed” (Lorber, 2010, p. 195).

Lorber (2010) explains:

Postmodern feminism examines the ways societies create beliefs about gender at any time (now and in the past) with discourses embedded in cultural representations or texts. Not just art, literature, and the mass media, but anything produced by a social group, including newspapers, political pronouncements, and religious liturgy, is a text. A text’s discourse is what it says, does not say, and hints at (sometimes called a subtext). The historical and social context and the material conditions under which a text is produced become part of the text’s discourse. If a movie or newspaper is produced in a time of conservative values or under a repressive political regime, its discourse is going to be different from what is produced during times of openness or social change. Who provides the money, who does the creative work, and who oversees the managerial side all influence what a text conveys to its audience. The projected audience also shapes any text, although the actual audience may read quite different meanings from those intended by the producers. Deconstruction is the process of teasing out all these aspects of a text. (pp. 268–269)

Deconstruction can be applied to any set of beliefs. In a way, it is a form of critical thinking. Deconstruction involves analysis of underlying meanings and assumptions when presented with an occurrence, trend, or so-called fact. It focuses on not how the phenomenon is objectively represented or portrayed, but rather on subjective interpretation within the phenomenon’s social, political, and economic context.

Lorber (2010) continues:

Soap operas and romance novels are “read” by women … action films and war novels are the stuff of men’s spectator-ship. Postmodern feminism deconstructs cultural representations of gender, as seen in movies, video, TV, popular music, advertising— whether aimed at adults, teenagers, or children—as well as paintings, operas, theater productions, ballet, and the Olympics. These are all discourses that overtly and subliminally tell us something about female and male bodies, sexual desire, and gender roles. A romantic song about the man who got away glorifies heterosexuality … These discourses influence the way we think about our world, without questioning the underlying assumptions about gender and sexuality. They encourage approved-of choices about work, marriage, and having children by showing them as normal and rewarding and by showing what is disapproved of as leading to a “bad end.”

By unpacking the covert as well as more obvious meanings of texts, postmodern deconstruction reveals their messages. We can then accept or reject them, or use them for our own purposes. The memoirs and the life histories of transgendered people, and the activities of gay men and lesbian women, as depicted in the media, create a different discourse. (p. 269)

Diversity and Intersectionality

Still another perspective on feminism questions the usefulness of clustering all women together. To what extent are the issues faced by lesbians, white women, and women of color the same or different? Some have criticized various feminist perspectives for giving lesser priorities to the issues confronting female groups other than white women (Hyde & Else-Quest, 2013; Lorber, 2010). Newer trends in feminist research and thinking involve a broader perspective on the human condition (Hyde & Else-Quest, 2013; Lorber, 2010). Examining “women and men across different racial ethnic groups, social classes, religions, nationalities, residencies, [and] occupations” reflects a trend of the future (Lorber, 2010, p. 306).

The concept of intersectionality applies here.  Intersectionality is “the idea that people are complex and can belong to multiple, overlapping diverse groups” (Kirst-Ashman, 2013, p. 67). “The intersectional perspective acknowledges the breadth of human experiences, instead of conceptualizing social relations and identities separately in terms of either race or class or gender or age or sexual orientation”; rather, an intersectional approach focuses on the “ interactive effects” of belonging to multiple groups (Murphy, Hunt, Zajicek, Norris, & Hamilton, 2009, p. 2). “Race, class, and gender are inseparable determinants of inequalities” that interconnect to generate numerous aspects of oppression; the resulting great burden of oppression can affect interpersonal relationships, people’s rights, how people are treated, and how they go about their daily lives (Murphy et al., 2009, p. 7). For example, “the meaning of womanhood for a middle-class, middle-age, African American woman is different than that held by a working-class, older, White woman” (Murphy et al., 2009, p. 10). (Intersectionality is addressed further in  .)

The Feminist Future

The special needs of women and the issues they face must continue to be addressed. The issues, gender roles, and cultural expectations for women of color merit ongoing attention (Hyde & Else-Quest, 2013). Additionally, more awareness, research, and concentrated effort should focus “on adjustment problems in women, particularly on depression, anxiety, alcoholism, and eating disorders, because they can be so devastating. We need to know what causes depression and what can be done to prevent it (e.g., changing child-rearing practices, school policy, violence against women, or family roles)” (Hyde & Else-Quest, 2013, p. 358).

The development of feminist theories is anything but stagnant. There is a dynamic, rapidly growing body of research and ideas that focus on the importance of understanding women’s gender roles, issues, qualities, and oppression. (  addresses women’s needs and issues in much greater depth.)

Ethical Question 3.1

1. What are your views about the various approaches to feminism? What is the fair way to treat women and men? What kinds of efforts, if any, do you think should be undertaken to improve current conditions?

Feminist Identity Development

How do people become feminists? One study focused on students enrolled in women’s studies courses, which are, of course, feminist based. Attending such classes tends to modify the attitudes and perceptions of both women and men, although perhaps more significantly for women. Five steps in the development of a feminist identity emerged for women (Bargad & Hyde, 1991; Hyde, 2002; Hyde & Else-Quest, 2013, pp. 358–359):

1. Passive acceptance. During this stage, women simply don’t think critically about gender issues or oppression. They passively accept that the way things are is the way they should be.

2. Revelation. This stage is characterized by the “Aha!” experience that yes, indeed, inequities do exist between women and men. A woman begins to confront issues and think more deeply about oppression. Common reactions during this stage include heated anger and resentment toward men.

3. Embeddedness. At this stage a woman becomes emotionally linked with other women, and receives support and sustenance from them. She begins to feel stronger in her identity as a woman.

4. Synthesis. Now a woman begins to assume a “positive feminist identity” that goes beyond focusing on gender-role differences. She gains greater understanding of herself as a woman and no longer resents men. Rather, she assesses her relationships with men as individuals.

5. Active commitment. During this stage, a woman’s feminist identity is firmly established. She uses her confidence to advocate on behalf of women to address inequities, oppression, and women’s issues.

3-1gCritical Thinking about the Relevance of Theory to Social Work

We have reviewed a number of psychological theories about human behavior that can help us better understand how people function. This section examines how theories are relevant to social work practice, and   proposes an approach for evaluating theory.

Highlight 3.2

Use Critical Thinking to Evaluate Theory

LO 2

The Evaluation of Theory

There are many ways to evaluate theory. This is partly because theories can concern virtually anything from the best method of planting a garden to whether intelligent extraterrestrials. Four major approaches for evaluating theory are provided here. The approaches are applied to various theories throughout the text and are not necessarily presented in the order of importance. Different theories may require different orders and emphases in terms of how they can best be evaluated.

1. Evaluate the theory’s application to client situations. In what ways is the theory relevant to social work? In what ways does the theory provide a means to help us think about our clients and how to help them? For example, a theory about the mating patterns of gorillas would probably be very difficult to apply to any practice situation. However, a theory that hypothesizes how interpersonal attraction occurs between people might help you to work with an extremely shy, lonely young adult with serious interpersonal problems.

2. Evaluate the research supporting the theory. Research often involves singular, obscure, or puzzling findings. Such findings may be vague and may or may not be true. For example, the sample of people studied in a particular research project may have been extremely small. Thus, results may have been due primarily to chance. Or the sample may not have resembled the entire population very well. Therefore, the results should be applied only to the sample studied and not to anything or anybody else. (Consider this a commercial for why you need to take a research course!) On the one hand, it’s important to be cautious about assuming that any research study establishes a fact. On the other hand, when more and more studies continue to support each other, a fact (or as close as we can come to a fact) may begin to develop.

A student once complained to me about her textbook. She said that the author confused her by presenting “facts”—in reality, research findings—that were contradictory. She said she hated such contradictions and wanted the author to tell her what was or was not a fact. My response was that I didn’t think the world was like that. It cannot be so clearly divided, even though it sometimes seems that it would be more convenient that way. Facts are the closest estimation of the truth we can come to based on the limited information we have. For example, people believed that the world was flat until somebody discovered that it was round. They believed that the northern lights were reflections of sunlight off the polar ice cap until someone discovered that they are really the effect of solar radiation on the earth’s ionosphere.

Research can help establish whether theories portray facts or not. In other words, research can help determine how accurate and useful any particular theory is. We need theories to guide our thinking and our work so that we may undertake research-informed practice.

However, there are at least two problems with evaluating research in support of a theory. First, you might not have access to all, most, or any of the relevant research. Research findings (which often are interpreted as facts) can be found in thousands of journals. Second, there may be no research specifically directed at finding the specific facts you need to help you verify a theory in your own mind.

3. Evaluate the extent to which the theory coincides with social work values and ethics. Does the theory involve an underlying assumption that coincides with the mission of social work. According to the National Association of Social Workers’ (NASW) Code of Ethics, “the primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (NASW, 2008).

One example of how a theory can support or contradict professional ethics involves the ethical standard that social workers must be “sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice” (NASW, 2008). Consider a theory that one group of people is by nature more intelligent than another group. This theory obviously conflicts with professional values. Therefore, it should not be used or supported by social workers.

Another example is the theory that women are too emotional, flighty, and lacking in intellectual capability to vote or hold a political office. This theory was espoused by the powerful majority of men who held public office until 1920, when women finally won the right to vote after a long, drawn-out battle for this right. This theory, too, stands in direct opposition to professional values and ethics.

Another section discusses the importance of being sensitive to human diversity when examining psychological theories. It also introduces several concepts that are useful in that process.

4. Evaluate the existence and validity of other comparable theories. Are there other theories that adhere better to the first three evaluation criteria? If so, which theory or theories should be chosen to guide our assessments and practice?

The medical model and systems theory were compared earlier. The social work profession now subscribes to systems theory, which provides a better perspective for respecting people’s dignity and rights and for targeting the macro environment in order to effect change, reduce oppression, and improve social conditions.

Sometimes, two or more theories will have basic similarities. Recall the discussion concerning the differences between systems theory and the ecological model in  . Both approaches provide frameworks for how to analyze the world and what to emphasize. Many of the concepts they employ are similar or identical. It was concluded that the ecological model is an offshoot of  systems theory. This text assumes a systems theory perspective, yet adopts some ecological concepts.

For instance, the term system is used in both. Both  social environment and  coping are ecological terms. Thus, many times it may be determined that a combination of theories provides the best framework for viewing the world within a social work context. Each social worker needs to determine the theoretical framework or combination of frameworks best suited for his or her practice context.

At other times, no theory will be perfectly applicable. Perhaps you will decide that only one or two concepts make any sense to you in terms of working with clients. The quest for the perfect theory resembles the pursuit of the perfect fact. It’s very difficult to achieve perfection. Thus, when evaluating theories, be flexible. Decide which concepts in any particular theory have the most relevance to you and your work with clients.

, we defined the term theory (or conceptual framework) as a coherent group of principles, concepts, and ideas organized to explain some observable occurrence or trend. In effect, theory provides a way for people to view the world. It helps them sort out and make sense of what they see. Likewise, it aids them in understanding how and why things are the way they are and work the way they do. Different theories provide us with different explanations.

For instance, consider the differences between systems theory and the medical model in trying to explain the reasons for human behavior. From the 1920s to the 1960s, social work programs used a medical model approach to human behavior. The  medical model, developed by Sigmund Freud, views clients as “patients.” The task of the social worker providing services is to first diagnose the causes of a patient’s problems and then provide treatment. The patient’s problems are viewed as being inside the patient.

The medical model conceptualizes emotional and behavioral problems as “mental illnesses.” People with such problems are given medical labels such as  schizophrenic,  psychotic,  bipolar, or  insane. Adherents of the medical approach believe the disturbed person’s mind is affected by some generally unknown, internal condition, thought to be due to a variety of possible causative factors inside the person. These include genetic endowment, metabolic disorders, infectious diseases, internal conflicts, unconscious uses of defense mechanisms, and traumatic early experiences that cause emotional fixations and prevent future psychological growth.

In the 1960s, social work began questioning the usefulness of the medical model. Environmental factors were shown to be at least as important as internal factors in causing a client’s problems. Also, research demonstrated that psychoanalysis was probably ineffective in treating clients’ problems (Stuart, 1970). Social work shifted at least some of its emphasis to a reform approach. A reform approach seeks to change systems to benefit clients. Antipoverty programs such as Head Start  and Job Corps  are examples of efforts to change systems to benefit clients.

In the past several decades, social work has increasingly focused on using a systems approach to viewing clients and the world surrounding them. This approach integrates both treatment and reform by emphasizing the dysfunctional transactions between people and their physical and social environments. Human beings are viewed as being in constant interaction with other micro, mezzo, and macro systems within their social environment.

provides some suggestions for how to do this.   stresses the importance of being sensitive to diversity when evaluating theories.

Psychological theories of development often focus on prescribed stages through which people progress throughout their lives. Such theories are also oriented to expectations about what is normal and what is abnormal during each stage. An issue facing us as we evaluate psychological theories is the rigidity with which some attempt to structure human development. In reality, people experience different worlds as they progress through their lives and time. We have established that their experiences are altered by many aspects of diversity and the intersectionality of factors. Such factors include “age, class, color, culture, disability and ability, ethnicity, gender, gender identity and expression, immigration status, marital status, political ideology, race, religion/spirituality, sex, sexual orientation, and tribal sovereign status” (CSWE, 2015).

A woman will experience life differently than a man because of variables related to being a woman. An American of Asian background will encounter different treatment and issues than will an American of Northern European origin moving through the same time. Thus, it is critically important to be sensitive to the vast differences people can experience because of their membership in certain groups or other characteristics.

For decades, social work has been moving to view clients and the world from a less rigid, more open-minded perspective that is sensitive to diversity and individual differences. The field has worked “to encompass new perspectives on women’s development and roles and the unique experiences, characteristics, strengths, and coping strategies of African Americans, Latinos, Asians, and other people of color and of other oppressed groups such as gay men and lesbians,” in addition to incorporating principles such as empowerment (Goldstein, 2008). It is up to us as social workers to be sensitive to people’s varying perspectives and needs. We must not make value judgments based on rigid assumptions about how people are supposed to behave. Rather, we must maintain flexibility thinking about human behavior and nurture our appreciation of differences.

People’s progress through life involves much more than distinct, predefined periods tied and limited to a person’s age and development. Rather, we should view life stages and circumstances as the result of integral interaction with many aspects of the environment. Various transitional points are experienced differently depending on an individual’s life context as characterized by the many variables described earlier (Devore & Schlesinger, 1999). The life course may be divided into seven transitional points—entry, childhood, adolescence, emerging adulthood, adulthood, later adulthood, and old age (Devore & Schlesinger, 1999, pp. 68–69). Persons with divergent characteristics and backgrounds can experience these transitional points in distinctly different ways.

For example, during the childhood transitional period, children’s psychological profiles are shaped by the ideas of their parents and of other people around them. This social context, in turn, is the product of culture. Berk (2012a) provides an example:

Culture influences emotional self-regulation. In a striking illustration, researchers studied children in two collectivist [that emphasizes the importance of group well-being above that of the individual] subcultures in rural Nepal. In response to stories about emotionally charged situations (such as peer aggression or unjust parental punishment), Hindu children more often said they would feel angry but would try to mask their feelings. Buddhist children, in contrast, interpreted the situation so that they felt OK, rather than angry. “Why be angry?” they explained. “The event already happened.” In line with this difference, Hindu mothers reported that they often teach their children how to control their emotional behavior, whereas Buddhist mothers pointed to the value their religion places on a calm, peaceful disposition (Cole & Tamang 1998; Cole, Tamang, & Shrestha, 2006). Compared to both Nepalese groups, U.S. children preferred conveying anger verbally in these situations; for example, to an unjust punishment, they answered, “If I say I’m angry, he’ll stop hurting me!” (Cole, Bruschi, & Tamang, 2002). Notice how this response fits with the Western individualistic emphasis on personal rights and self-expression. (p. 491)

Other examples of life-course differences involve the adolescent transitional period. Adolescents raised in different cultural environments with different experiences and treatment view their developing life, gender roles, and sexuality in very diverse ways. A female Puerto Rican adolescent learns her expected role by closely observing her mother and caring for the family’s children; however, there often is no mention of sex (Devore & Schlesinger, 1999). Kelly (2008) comments on Japanese adolescent sexuality:

In Japan, sexuality has been minimized and regulated as being tangential to the performance of responsible duty. Japanese youth consider chastity very important. There is less teenage sexual activity and far less single motherhood than in the United States, although abortion is quite accessible. Japanese youth often rush into sexual activity during late adolescence, as if making up for their more chaste earlier years. As the age of marriage becomes even later, the rate of premarital pregnancies and “shotgun” weddings has been increasing. (p. 159)

The transitional period of emerging adulthood provides more examples of diverse life course experiences. Young people experience this as a time of decision making about marrying or remaining single and pursuing a work or career path. Devore and Schlesinger (1999) remark:

For young Jewish women … [t]he plan to work continues a tradition established long ago by grandmothers and mothers whose diverse occupations were important to the survival of the family. Jewish tradition more easily accepts employment of women. In the present, however, the emerging Jewish woman has choice. The Jewish value of education is traditional but in the past was more reserved for men. Women now attend college in equal numbers with men but may experience conflict as they make the choice. “As a young Jewish woman I am achievement oriented, committed to individual achievement, accomplishment and career—but, I am equally committed to marriage. What then of my children? If I am to be a responsible mother then I must remain at home with my young children.” … Such is the ethnic dilemma shared by Italians and Slavic young women.

A young married Navajo woman expects to hold to the traditions of the past. Her husband is the formal head of the household, but she has as much, or perhaps even more, influence in the family management due to a reverence for matrilineal descent [heritage based on the female line]. This tradition provides her with support from the extended family, with her brothers assuming responsibility in the teaching and discipline of their nieces and nephews. Women and men, sisters and brothers participate in the retention of the ethnic reality. (pp. 77–78)

The important point here is the need for sensitivity to diversity when evaluating human behavior, regardless of which theory you apply.

Other concepts are also helpful when examining and evaluating psychological theories and their application to diverse populations. They include worldview (Choudhuri, Santiago-Rivera, & Garrett, 2012; Diller, 2015; Lum, 2007), spirituality (Canda, 2008; Canda & Furman, 2010; Cunningham, 2012), and the strengths perspective (Kim, 2008; Saleebey, 2013).

Worldview

A concept helpful for appreciating diversity when applying psychological theory to behavior is the  worldview perspective. Worldview concerns people’s perceptions of the world around them and how they fit into that world. Perceptions include awareness of the surrounding environment, social status, social roles, legal rights, and economic status, among the many other variables characterizing people’s lives. Not only do worldviews consist of “our attitudes, values, opinions, and concepts, but they also affect how we think, define events, make decisions, and behave” (Sue & Sue, 2008, p. 294).

EP 2.1.1b, 2.1.1e, 2.1.5c

Understanding that people have different worldviews involves looking beyond the narrow boundaries of our daily existence. It means developing an openness and awareness of life in other neighborhoods, counties, states, and countries. It also requires developing an appreciation of differences instead of fear and aversion. It encourages us to allow new perceptions of the world to penetrate our consciousness instead of clinging doggedly to what we already know. There are many other ways to live than the way we are accustomed to.

The African American worldview is characterized by a strong achievement and work orientation.

Brian Summers/First Light/Getty Images

Sue and Sue (2008) reflect:

For marginalized groups in America, a strong determinant of worldviews is very much related to the subordinate position assigned to them in society. Helping professionals who hold a worldview different from that of their clients, and who are unaware of the basis for this difference, are most likely to impute negative traits to clients. In most cases, for example, clients of color are more likely to have worldviews that differ from those of therapists [and social workers]. Yet many therapists [and social workers] are so culturally unaware that they respond according to their own conditioned values, assumptions, and perspectives of reality without regard for other views. Without this awareness, counselors [and social workers] who work with culturally diverse groups may be engaging in cultural oppression. (p. 294)

Spirituality

A second concept important in understanding human diversity and psychological development is  spirituality. Spirituality “includes one’s values, beliefs, mission, awareness, subjectivity, experience, sense of purpose and direction, and a kind of striving toward something greater than oneself” (Frame, 2003, p. 3). The spiritual domain is an important means by which many people organize their view of the world. The spiritual dimension is part of their reality. Therefore, it must be considered when you assess human behavior from a psychological perspective even though you may have very different beliefs concerning spirituality than your clients or your colleagues.

Spiritual beliefs can provide people with hope, support, and guidance as they progress through life. Spirituality, including Fowler’s (1981) seven stages of faith, will be discussed further in  .   explores spirituality and some of the major religions.

The Strengths Perspective

EP 2.1.10e

The strengths perspective is a third concept that is useful in increasing sensitivity to human diversity, and understanding people from various ethnic and cultural backgrounds.   introduced the concepts of empowerment and strengths-based social work practice. Norman (2005) explains:

Strengths-based social work practice focuses on helping client systems tap into the strengths within them … Potential strengths include cultural values and traditions, resources, coping strategies, family, friends, and community support networks. Past successful experiences need to be linked to solving current problems … The client is the expert in identifying past success and in developing solutions based on past experiences. Focusing on concrete tasks and objectives … works better for people of color than more abstract methods…

Even when we are talking the same language, our perceptions of an interaction are culturally influenced … Different groups of people translate nonverbal communication, such as spatial observance, handshaking, and eye contact, in different ways … Mastering cross-cultural communication is the key to effective practice with individuals, families, groups, and communities of color. This requires sharpening observation and listening skills as well as learning about clients’ cultural beliefs and traditions. (pp. 403, 407)

3-2 Examine Piaget’s Theory of Cognitive Development

LO 4

Specific theories and conceptual frameworks concerning how people develop their capacities to think and understand have also been developed. Cognition involves the ability to take in information, process it, store it, and finally retrieve and use it. In other words, cognition involves the ability to learn and to think. The most noted of the cognitive theorists is probably Jean Piaget. Piaget (1952) proposed that people go through various stages in learning how to think as they develop from infancy into adulthood. His theory, which concerns the stages through which people must progress in order to develop their cognitive or thinking ability, was derived from careful observations of his own children’s growth and development.

Piaget postulates that virtually all people learn how to think in the same way. That is, as people develop they all go through various stages of how they think. In infancy and early childhood, thinking is very basic and concrete. As children grow, thinking progresses and becomes more complex and abstract. Each stage of cognitive development is characterized by certain principles or ways in which an individual thinks.

The following example does an exceptionally good job of illustrating how these changes occur. In his studies, Piaget would show children of various ages two glass containers filled with a liquid. The containers were identical in size and shape, and held an equal amount of liquid (see  ). Children inevitably would agree that each container held the same amount of liquid. Piaget then would take the liquid from one of the containers and pour it into another taller, narrower glass container. Interestingly enough, he found that children under age 6 would frequently say that the taller glass held more even though the amount of liquid in each was identical. Children approximately age 6 or older, however, would state that despite the different shapes, both containers held the same amount of liquid. Later studies established that the results of this experiment were the same for children of various backgrounds and nationalities.

Figure 3.2Conservation

Children under age 6 would say that the taller glass holds more, even though the amount of liquid in each is identical.

This example demonstrated how children in different cognitive stages thought about or conceptualized the problem. Younger children tended to rely directly on their visual perceptions to make a decision about which glass held more or less liquid. Older children, however, were able to do more logical thinking about the problem. They thought about how liquid could take various forms and how the same amount could look different depending on its container. The older children illustrated a higher, more abstract level of cognitive development. This particular concept involving the idea that a substance can be changed in one way (e.g., shape) while remaining the same in another (e.g., amount) is called  conservation.

illustrates how values can be shaped depending on the cultural environment in which a child is raised.

North American culture encourages independence on the part of children (Vander Zanden et al., 2007). From birth on, children usually sleep in a room apart from their parents. Children are often placed out of the home in day care while their parents work. “Parents also reinforce a preference for objects rather than people to be used as means of comforting in times of distress. Children are supplied and rely on ‘blankies,’ pacifiers, and stuffed animals rather than parents or other people to console them when they are upset or conflicted. Parents and children become adversaries over sleeping arrangements as children get older. The ‘terrible twos’ revolve around the young child’s eventual demand for independence” (Vander Zanden et al., 2007, p. 55). The culture generally encourages independence and competition. Children compete in school. Young adults compete for college admission. Workers compete for raises and advancement in their workplace environments.

In contrast, Vander Zanden and his colleagues (2007) describe how other cultures may encourage interdependence instead of independence:

Child-rearing practices in many other cultures stress interdependence, sometimes called collectivism, over independence or individualism, with the focus on ties to family. Children are socialized to think of themselves as being part of a group or community, rather than an individual at odds with those in the vicinity. For example, in the Pacific Island nation of Kiribati, an infant is in constant contact with some member of the extended family during the first year of life—sleeping with, eating with, and tagging along to work with a family member. These infants are socially involved in all of the day-to-day activities of the mother and father. Three generations of a family will gather around the baby to sing traditional songs while the infant is initiated into the social and cultural rhythms of the community. Rather than battling parents over issues of independence, the caregivers support the needs of the infant as they carry out the routine activities—there is no battle of the wills. (p. 55)

At least three concepts are important in understanding Vygotsky’s perspective: the zone of proximal development, scaffolding, and private speech (Vygotsky, 1934/1986).

3-4aThe Zone of Proximal Development

The  zone of proximal (meaning “near”)  development is “the difference between what a learner can accomplish independently and what he or she can accomplish with the guidance and encouragement of a more skilled partner” (Shaffer & Kipp, 2010, p. 283; Vygotsky, 1978). In other words, the zone “refers to a range of tasks that the child cannot yet handle alone but can do with the help of … [others who are better at performing the activity.] To understand this idea, think of a sensitive adult … who introduces a child to a new activity. The adult picks a task that the child can master but that is challenging enough that the child cannot do it by herself. Or the adult capitalizes on an activity that the child has chosen. The adult guides and supports, adjusting the level of support offered to fit the child’s current level of performance. As the child joins in the interaction and picks up mental strategies, her competence increases, and the adult steps back, permitting the child to take more responsibility for the task. This form of teaching—known as scaffolding [discussed in the  ]—promotes learning at all ages” (Berk, 2012a, p. 224).

The zone of proximal development, then, reflects the level of thinking a child can master when participating in an activity by him- or herself, compared to the higher level of learning that can occur by watching and interacting with others who know more about the activity. Consider the following example (Shaffer & Kipp, 2010):

Tanya, a 4-year-old, has just received her first jigsaw puzzle. She attempts to work the puzzle but gets nowhere until her father sits down beside her and gives her some tips. He suggests that it would be a good idea to put together the corners first, points to the pink area at the edge of one corner piece and says, “Let’s look for another pink piece.” When Tanya seems frustrated, he places two interlocking pieces near each other so that she will notice them, and when Tanya succeeds, he offers words of encouragement. As Tanya gradually gets the hang of it, he steps back and lets her work more and more independently. (p. 283)

3-4bScaffolding

One means by which children learn in the zone of proximal development is a process called scaffolding. In commonplace language, a scaffold implies a structure of support. Vygotsky defined  scaffolding as the process whereby “adults help children learn how to think by ‘scaffolding,’ or supporting, their attempts to solve problems or discover principles” (Coon & Mitterer, 2009, p. 126; Daniels, 2005). Caregivers use scaffolding as they adjust their level of guidance and support to the level of help the child needs. In effect, the child and the caregiver are adjusting their behavior by responding reciprocally to each other.

Santrock (2016) elaborates:

For example, in the game peek-a-boo, parents initially cover their babies, then remove the covering and register “surprise” at the babies’ reappearance. As infants become more skilled at peek-a-boo, infants gradually do some of the covering and uncovering. In addition to peek-a-boo, pat-a-cake and “so-big” are other caregiver games that exemplify scaffolding and turn-taking sequences. (p. 211)

3-4cPrivate Speech

Consider Timmy, a 4-year-old who talks to himself intensively as he draws a picture of his house. Vygotsky emphasized the significance of  private speech, “comments that are not intended for others but are designed to help children regulate their own behavior” (Kail & Cavanaugh, 2016, p. 139; Vygotsky, 1934/1986).

Kail and Cavanaugh (2016) describe the significance of private speech:

Vygotsky viewed private speech as an intermediate step toward self-regulation of cognitive skills (Fernyhough, 2010). At first, children’s behavior is regulated by speech from other people that is directed toward them. When youngsters first try to control their own behavior and thoughts, without others present, they instruct themselves by speaking aloud. Private speech seems to be children’s way of guiding themselves, of making sure that they do all the required steps in solving a problem. Finally, as children gain ever greater skill, private speech becomes inner speech, which was Vygotsky’s term for thought (pp. 139–140)

discusses cross-cultural expectations and temperament.

An infant’s temperament involves emotionality, activity, and sociability.

John Henley/Jupiter images

Spotlight on Diversity 3.4

Cross-Cultural Diversity in Expectations and Temperament

Parental and social expectations that vary dramatically from one culture to another can affect the development of temperament. Malaysian infants tend to be less flexible and responsive to new situations and more reactive to outside stimuli than American infants; this may be due to the fact that Malaysian parents shelter children from new conditions that necessitate adaptability, on the one hand, and promote sensitivity to new sensations such as the need for a diaper change, on the other (Banks, 1989; Papalia & Feldman, 2012).

Sigelman and Rider (2009) comment on an example posed by the Masai in East Africa:

In most settings, an easy temperament is likely to be more adaptive than a difficult one, but among the Masai during famine, babies with difficult temperaments outlived easy babies. Why? Perhaps because Masai parents believe that difficult babies are future warriors or perhaps because babies who cry loud and long get noticed and fed. As this example suggests, a particular temperament may be a good fit to the demands of one environment but maladaptive under other circumstances. (p. 315)

One cross-cultural study of Canadian and Chinese 2-year-olds found significant differences in temperament, with Chinese children generally being much shyer and more withdrawn than Canadian children (Chen et al., 1998). Canadian mothers were much more punitive and overprotective in orientation with shy children, whereas Chinese mothers supported and encouraged introverted behavior. Perhaps, this difference is due to the expectation in Western countries such as Canada that children should be more outgoing and assertive if they’re ever going to get anywhere in this world. Mothers might react to shy behavior either with cold rejection or with coddling. In contrast, introversion and self-control are valued in China. Therefore, mothers might encourage this sort of temperament and discourage more aggressive behavior.

Another example involves a group of Mayans in southern Mexico, the Zinacantecos (Greenfield & Childs, 1991). Their infants tend to be very quiet and relatively immobile as newborns. Bernstein, Penner, Clarke-Stewart, and Roy (2008) explain that Mayan mothers

reinforce this innate predisposition toward restrained motor activity by swaddling their infants and by nursing at the slightest sign of movement … This combination of genetic predisposition and cultural reinforcement is culturally adaptive: Quiet Mayan infants do not kick off their covers at night, which is important in the cold highlands where they live; inactive infants are able to spend long periods on their mother’s back as she works at the loom; infants who do not begin to walk until they can understand some language do not wander into the open fire at the center of the house. (p. 480)

3-5cAttachment

Attachment “is a strong affectional tie that binds a person to an intimate companion and is characterized by affection and a desire to maintain proximity” (Sigelman & Rider, 2012, p. G-2). Attachment theory, originally developed by John Bowlby (1969), provides a major perspective on initial human relationships. Kail and Cavanaugh (2016) remark:

According to Bowlby, children who form an attachment to an adult—that is, an enduring socio-emotional relationship—are more likely to survive. This person is usually the mother but need not be; the key is a strong emotional relationship with a responsive, caring person. Attachments can form with fathers, grandparents, or someone else. (p. 162)

Attachment theory emphasizes the importance of interaction between the parent (or other caregiver) and the child that results in emotional bonding. The infant is viewed as an active participant in the relationship-building process. This perspective differs from Freud’s oral stage, which stresses the infant’s passivity and dependence on the caregiver.

Stages of Attachment

addresses cross-cultural differences in attachment.

Spotlight on Diversity 3.5

Cross-Cultural Differences in Attachment

As with temperament, social expectations adopted by parents (or other caregivers) for children’s levels of attachment, dependence, activity, or autonomy may affect how attachment develops. Berk (2012b) reflects:

German infants show considerably more avoidant attachment than American babies do. But German parents encourage their infants to be nonclingy and independent, so the baby’s behavior may be an intended outcome of cultural beliefs and practices (Grossmann et al., 1985). In contrast, a study of infants of the Dogon people of Mali, Africa, revealed that none showed avoidance attachment to their mothers (True, Pisani, & Oumar, 2001). Even when grandmothers are primary caregivers (as they are with firstborn sons). Dogon mothers remain available to their babies, holding them close and nursing them promptly in response to hunger and distress. (p. 268)

A high proportion of Japanese infants demonstrate anxious-resistant attachment. They are quite wary of strangers (Berk, 2012b), perhaps because Japanese mothers keep their infants very close to them. Japanese parents value infants’ dependence on them and expect infants to resist separation; thus, anxious-resistant attachment is a normal expectation for the development of the Japanese parent–child relationship (Rothbaum, Weisz, Pott, Miyake, & Morelli, 2000).

Finally, although cultural variations in attachment do exist, secure attachment still tends to be the norm in most infant-caregiver relationships (van IJzendoorn & Sagi, 1999).

3-6 Examine Self-concept, Self-esteem, and Empowerment

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All individuals form impressions about who they think they are. It’s almost as if each person develops a unique theory regarding who exactly she feels she is. This personal impression of one’s own “unique attributes and traits,” both “positive and negative,” is referred to as the self-concept (Sigelman & Rider, 2012, p. 348). The idea of self-concept was introduced earlier in a discussion of Carl Rogers’s self theory. A related idea is that of self-esteem.  Self-esteem refers to a person’s judgment of his or her own value. Although self-concept may include more aspects about the self than just value, the two terms are often used interchangeably.

Self-concept is an important theme throughout mental health literature. Improving one’s self-concept is often seen as a therapeutic goal for people with adjustment problems and as a means of empowerment. One’s self-concept is important throughout life. In order to continue working, living, striving, and positively interacting with others, one must have a positive self-concept. In other words, one must feel good enough about oneself to continue living and being productive. This is just as true for children as it is for adults.   demonstrates the effects of positive and negative self-concepts in children.

Highlight 3.3

The Effects of Positive and Negative Self-Concepts

Two 5-year-old girls, one with a good self-concept and the other with a relatively poor self-concept, illustrate the enormous effects of self-concept. Julie, who has a positive perception of self, is fairly confident in new situations. When she enters kindergarten, she assertively introduces herself to her peers and eagerly makes new friends. She frequently becomes a leader in their games. She often volunteers to answer her teacher’s questions. Her teacher considers her happy and well adjusted.

In contrast, Mary has a relatively poor self-concept. She does not think very highly of herself or her abilities. On her first day of kindergarten, she usually stays by herself or lingers on the fringes of activities. She speaks little to others out of fear that they might criticize her. She really wants to be liked but is worried that there is nothing to like about her. Thus, it is easier for her to remain quiet and unobtrusive. For example, one day the teacher brings out pieces of colored clay for the children to play with. Being so quiet and afraid, Mary does not rush up to her teacher to get hers even though playing with clay is one of her favorite pastimes. Rather, she waits until all the other children have their clay and are returning to their seats.

By the time Mary approaches the teacher, all the clay has been handed out. Instead of clay, her teacher gives her a coloring book and some crayons. Mary takes them passively and begins to color a big yellow duck. All the while she is crying silently to herself. She is very disappointed that she did not get any clay. She also is hoping no one will notice that she is different from everyone else. Mary has a poor self-concept. She is afraid of others and what they might think. She does not have much self-esteem.

The self-concept is an abstract idea. It is difficult to explain exactly what it involves. However, it is still an important factor in a person’s ability to function. People of virtually any age need to feel good about themselves in order to be confident and enjoy life’s experiences.

1. Should children be informed of their IQ? Should parents be told of their child’s results? What are the reasons for your answers?

3-8eOther Potential Problems with IQ Scores

The use of IQ tests alone to categorize people is problematic for several reasons. One is cultural bias, discussed in  . Another is that the definition of IQ is arbitrary. At its most basic level, an IQ score reflects how well people perform on an IQ test. It does not provide a reliable indication of competence in the real world.

Spotlight on Diversity 3.6

Explain Cultural Biases and IQ Test

LO 10

It is critical to be vigilant about the potential for cultural biases in IQ tests. White middle- and upper-class children historically have had an unfair advantage over non-white children on these tests. Similarly, urban children have had advantages over rural children, and middle-class children over lower-class children in general. Biases can involve the use of words, concepts, and contexts that are more familiar to some children than to others.

For example, Kail and Cavanaugh (2013, p. 219) discuss the question, “A conductor is to an orchestra as a teacher is to what?” They pose the possible answers as “book,” “school,” “class,” or “eraser.” Children who have been exposed to the concept of “orchestra,” perhaps having attended a concert, are more likely to provide the correct answer than children who have little or no idea what orchestras or conductors are.

What is considered significant by members of a culture can influence what children consider important, and hence how they answer questions on IQ tests. Plotnik and Kouyoumdjian (2011) comment on how other cultures perceive the concept of intelligence differently by emphasizing other aspects of human behavior and existence:

For example, the Taiwanese conception of intelligence emphasizes how one understands and relates to others, including when and how to show intelligence (R. J. Sternberg & Yang, 2003). In Zambia (Africa), parents describe the intelligence of their children as including cognitive abilities as well as showing social responsibility, which is considered equally important (Serpell, 2003). In Micronesia, people demonstrate remarkable navigational skills as they sail long distances using only information from stars and sea currents (Ceci et al., 1997). These navigational abilities certainly indicate a high degree of intelligence that would not be assessed by traditional Western IQ tests. Thus, the definition of intelligence differs across cultures. (p. 291)

Even testing situations and children’s comfort level in them can affect IQ test results. Specific variables include the test-takers’ relationship with the test-giver, their ability to sit quietly and respond to instructions, and their understanding of the dynamics involved in taking tests successfully, such as going through the entire test first, answering the questions they know, pacing themselves, and then returning to the more difficult items so that they are able to complete most of the test (Ceci, 1991).

Much attention has been paid to  cultural fairness in IQ tests. Culture-fair IQ tests try to include test items and terms that are familiar to children from as many cultural and socioeconomic backgrounds as possible. However, because a totally “culture-free” test (i.e., one with no culturally biased content at all) is impossible to achieve, it is important to remain sensitive to fairness and strive to make tests as “culture fair” as possible.

Another problem with IQ tests is that placing IQ labels on people may become self-fulfilling prophecies. An individual with a low IQ score may stop trying to reach his or her true potential. A person labeled with a high IQ may develop an inappropriately superior, even arrogant, attitude. We all probably know people like this.

Another potential problem with IQ scores is that they do not take motivation into account. A person with a lower IQ score who works hard and is motivated may attain much higher levels of achievement and success than a person with a higher IQ who is not motivated to use it. Simply having the ability does not necessarily mean that it will be put to use.

Many aspects of an individual’s personality, ability to interact socially, and adapt to society are not directly related to IQ. In effect, IQ is only one facet of an individual. People have numerous other strengths and weaknesses that make up their unique personalities. Each person is an individual whose worth and dignity merit appreciation.

3-9 Analyze Intellectual Disabilities and the Importance of Empowerment

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Intellectual disability (formerly referred to as  mental retardation) is a condition characterized by intellectual functioning that is significantly below average and accompanying deficits in adaptive functioning, both of which occurred before reaching adulthood (American Psychiatric Association [APA], 2013a, 2013b). Note two important points about the terms intellectual disability and mental retardation. First, the term intellectual disability has a less negative connotation than the term mental retardation. Second, it is important to refer to people with intellectual disabilities as people before referring to any disability they might have. For example, referring to them as intellectually, mentally, or cognitively challenged people tends to emphasize the disability because the disability is stated first. Our intent is simply to respect their right to equality and dignity. (Note that some states may use other terms for people with intellectual disabilities. Terms might include cognitive impairment, cognitive disability, mental impairment, mental disability, or mental handicap; more consistent and positive changes in terminology should occur over time to better understand and appreciate these people [Friend, 2011, p. 235].)

).

recognizes the four traditional categories of intellectual disability, which historically emphasized IQ scores. The categories are noted here with their traditional IQ scores (APA, 2000, p. 42):

Mild:	IQ of 50–55 to approximately 70
Moderate:	IQ of 35–40 to 50–55
Severe:	IQ of 20–25 to 35–40
Profound:	IQ below 20 or 25

The ranges in each category reflected the varying results that can be attained on different IQ tests, the 5 percent measurement error in the tests themselves, and the importance of taking adaptive functioning into account (APA, 2000). For example, a person scoring 40 on an IQ test but suffering from serious deficits in adaptive ability might be placed in the “Severe” category. On the other hand, another person scoring 40 who has many adaptive strengths might be placed in the “Moderate” category.

Highlighting adaptive ability and achievement allows the individual to be evaluated as a unique functioning being. Older definitions of intellectual disability placed greater importance on IQ alone, which does not necessarily provide an accurate picture of someone’s ability to function and make decisions on a daily basis.

The new DSM-5 is the primary diagnostic tool used in the United States for mental and emotional disorders. New diagnostic procedures stress both clinical assessment of intellectual ability and extensive evaluation of adaptive functioning in addition to standardized IQ tests. The American Association on Intellectual and Developmental Disabilities (AAIDD, 2013) also emphasizes the use of adaptive skill areas when evaluating an individual’s ability to function independently. Additionally, the AAIDD (2013) stresses that the community social environment, “linguistic diversity,” and “cultural differences in the way people communicate” and behave be taken into account when assessing intellectual disability.

Ethical Question 3.3

1. Do people with intellectual disabilities have the right to have children?

3-9bThe Significance of Empowerment by Support Systems

In addition to highlighting adaptive skill areas, it is important to evaluate the configuration and intensity of support an individual needs—“intermittent,” “limited,” “extensive,” or “pervasive”—besides considering IQ and adaptive skill acquisition (Hallahan, Kauffman, & Pullen, 2009, p. 148; Kirk, Gallagher, Coleman, & Anastasiow, 2012; Lightfoot, 2009a).  Intermittent support is the occasional provision of support whenever it is needed. People needing only intermittent support function fairly well by themselves; they need help from family, friends, or service-providing agencies only sporadically. This usually occurs when they are experiencing periods of stress or major life transitions (such as a health crisis or job loss).  Limited support is intensive help or training provided for a limited time to teach specific skills, such as job skills, or to assist in major life transitions such as moving from one’s parental home.  Extensive support is long-term, continuous support that usually occurs daily and affects major areas of life both at home and at work. Finally,  pervasive support is continuous, consistent, and concentrated. People need pervasive support for ongoing survival.

discusses current legislation concerning people with disabilities.

Spotlight on Diversity 3.8

The Americans with Disabilities Act: The Pursuit of Social and Economic Justice

The intent of the Americans with Disabilities Act (ADA) of 1990 was to provide the millions of Americans who have disabilities with access to public places, work settings, and “the mainstream of public life” (Jimenez, 2010; Smolowe, 1995a, p. 54; U.S. Department of Justice, 2005). “Unemployment and economic stress are major concerns” for people with disabilities (Segal, 2010, p. 112). The ADA “was intended as a sweeping civil rights law that works to eliminate discrimination against people with disabilities in the areas of employment, public accommodations, state and local government, transportation and communications” (Lightfoot, 2009b, p. 449; U.S. Department of Justice, 2005).

The ADA includes under its umbrella people who have intellectual disabilities, other developmental disabilities (various serious chronic conditions), and physical disabilities. “An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered” (U.S. Department of Justice, 2005).

The ADA is one attempt by a national macro system to improve the lives of people with disabilities and provide them with greater social and economic justice. The ADA consists of four major provisions (U.S. Department of Justice, 2005). Title I forbids job and employment discrimination against people with disabilities and requires employers to provide “the full range of employment-related opportunities available to others.” It “prohibits discrimination in recruitment, hiring, promotions, training, pay, social activities, and other privileges of employment.” It also restricts an employer’s questions about a person’s disability prior to making a job offer.

Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. For example, it prohibits discrimination in recruitment, hiring, promotions, training, pay, social activities, and other privileges of employment. It restricts questions that can be asked about an applicant’s disability before a job offer is made, and it requires that employers make reasonable accommodation to the known physical or mental limitations of otherwise qualified individuals with disabilities, unless it results in undue hardship.

Title II requires all state and local governments to provide equal opportunities to people with disabilities. Applicable services include those involved in “public education, employment, transportation, recreation, health care, social services, courts, voting, and town meetings.” These governing bodies are also required to make buildings accessible, modify policies to avoid discrimination, and provide communication channels for people with “hearing, vision, or speech disabilities.” Title II also prohibits “public transportation services, such as city buses and public rail transit (e.g., subways, commuter rails, Amtrak)” from discriminating against people with disabilities. This often entails making services accessible or providing individualized transportation when needed.

Title III requires that “businesses and nonprofit service providers” that offer goods and services to the public provide equal opportunities to people with disabilities. These include “restaurants, retail stores, hotels, movie theaters, private schools, convention centers, doctors’ offices, homeless shelters, transportation depots, zoos, funeral homes, day care centers, and recreation facilities including sports stadiums and fitness clubs.” Such accommodation often includes making locations accessible and making opportunities (e.g., for credentials requiring testing) or information available to people with disabilities.

Title IV requires that state and national telecommunication relay services accommodate people with hearing and speech impairments. These entities must allow people with such disabilities communications access 24 hours a day, 7 days a week. “Title IV also requires closed captioning of federally funded public service announcements.”

In summary, the ADA requires “universal access to public buildings, transit systems, and communications networks” (Smolowe, 1995a, p. 54). Significant gains have been made in terms of curb ramps, wide bathroom stalls, and public vehicles with lifts for wheelchairs for persons with physical disabilities.

However, employers and public agencies must make only “reasonable accommodation.” In reality, they are not compelled to provide such access or encouragement if the ensuing costs would result in “undue hardship,” often in the form of “undue financial and administrative burdens.” Because of the vagueness in terminology and lack of specification regarding how changes must be implemented, gains have been limited (Karger & Stoesz, 2013). What do the words reasonable accommodation, undue hardship, and undue administrative and financial burdens mean? What kind of accommodation is reasonable? How much money is unduly excessive? How can discrimination against capable people with intellectual or other specific disabilities be prohibited and equal opportunity enforced?

People with disabilities often experience “exclusion from typical activity and opportunity afforded to those who are not considered disabled” (DePoy & Gilson, 2004, p. 41; Mackelprang, 2008; Mackelprang & Salsgiver, 2009). Consider the following economic facts about people with disabilities (U.S. Census Bureau, 2016):

· Only 17.5 percent are employed.

· The median earnings for people with a disability are $21,232 compared to $31,324 for people without a disability.

· Twenty-eight percent of people with disabilities live in poverty compared to 12 percent without a disability.

Additionally, bear in mind the following about people with disabilities (National Organization on Disability, 2004, 2011; Patchner & DeWeaver, 2008):

· Twenty-two percent report that they have been victims of discrimination in some situation.

· Twenty-two percent of those who are employed report having been victimized by discrimination on the job.

· The extent of disability directly impacts quality of life in virtually every aspect of living. Jimenez (2010) describes more recent ADA amendments:

The ADA Amendments Act of 2008 was designed to enlarge coverage of the ADA by overturning a series of U.S. Supreme Court cases, which limited the number of persons who could demonstrate they were disabled. These new amendments call for “the definition of disability to be construed in favor of broad coverage of individuals,” shifting the burden of proof to those who would deny disabled persons the protection of the law. The amendments favor broad coverage of conditions that interfere with activities of daily living, as well as thinking and learning, working, lifting, and speaking. Unfortunately, the amendments did not clarify the important question in the ADA of what are “reasonable accommodations” that employers must make for… persons [with disabilities]. Under the amendments, Congress recognized that… persons [with disabilities] are often denied the right to participate fully in society because of social prejudice, as well as due to the existence of societal and institutional barriers. (p. 193)

The battle for equal access and opportunity for people with disabilities has not been won. Much of the public attention to the act has focused on people with physical disabilities, many of whom require wheelchairs for transportation. Where do people with intellectual and other developmental disabilities fit in? The ADA “will be successful only to the extent that these individuals [with disabilities] and those who advocate on their behalf learn about the ADA and use it as a means to ensure employment [and other] opportunities” (Kopels, 1995, p. 345).

1. Should people with intellectual disabilities be mainstreamed (i.e., be integrated into regular school classes) or be provided with separate special education to meet their special needs? What are the pros and cons of each approach?

3-9dSocial Work Roles

Social workers can perform many roles when working with people who have intellectual or other developmental disabilities. Social workers can function as  enablers, helping people with intellectual disabilities and their families make decisions and solve problems. Social workers can be  brokers, linking clients to the resources (e.g., transportation, job placements, or group homes) they need in order to go about their daily lives.  Educator is another major role. People who have intellectual disabilities may need information about employment, interpersonal relationships, and even personal hygiene. Social workers can also function as  coordinators who oversee a range of support services that clients need.

Social workers can also fulfill roles within the macro-system context. They can assume administrative functions as  general managers within agencies providing services to clients and their families. In this capacity, they can evaluate the effectiveness of the services provided. Are clients getting what they really need? Is service provision as efficient as possible? Finally, social workers can serve as  initiators,  negotiators, and  advocates. In communities and states where needed services are not readily available or are nonexistent, practitioners can work with organizational, community, and government macro systems to change policies so that clients can have access to what they need.

discusses the importance of empowering people with disabilities to advocate for themselves and get control of their own lives.

Mackelprang and Salsgiver (2009) call for social workers and other human services professionals to emphasize the empowerment of people with disabilities. They stress the importance of identifying and focusing on the strengths and abilities of people with disabilities and the necessity of supporting their self-advocacy. They focus on the need to recognize and appreciate human difference rather than problems in functioning. Such an empowerment stance highlights the following six principles:

1. “People with disabilities are capable, have potential, and are important members of society.

2. Devaluation and a lack of resources, not individual pathology, are the primary obstacles facing persons with disabilities.

3. Disability, like race and gender, is a social construct, and intervention with people with disabilities must be political in nature.

4. There is a Disability culture and history that professionals should be aware of in order to facilitate the empowerment of persons with disabilities.

5. There is a joy and vitality to be found in disability.

6. Persons with disabilities have the right to self-determination and the right to guide professionals’ involvement in their lives” (Mackelprang & Salsgiver, 2009, pp. xv–xvii).

Lightfoot (2009b) elaborates on the importance of  consumer-directed services (services that maximize the choice and self-determination of consumers, in this case, people with disabilities):

A growing trend in the area of disability policy is for people with disabilities to direct their own services. The move toward consumer-directed services, also known as consumer-controlled services, emanates from the concern that agency-controlled, services often do not meet the individual needs of people with disabilities and further increase the dependence on professionals and systems that people with disabilities experience. When agencies control services, people with disabilities have little choice over the personnel providing services, including services that are quite personal in nature. Consumer-directed services allow people with disabilities to hire, train, supervise, and fire their own staff with public money … [T]here are consumer-directed demonstration projects across the country that allow people of all ages who have disabilities to control the services they use (Benjamin, Matthias, & Franke, 2000; Mahoney, Simone, & Simon-Rusinowitz, 2000). Public social services policies for people with disabilities are likely to increasingly allow consumer-directed options, particularly as baby boomers age and desire more control over the supports they receive. (p. 457)

3-10 Examine Learning Disabilities

LO 12

Learning disabilities are commonly defined in one of two ways—the federal definition established in P. L. 94–142 and the definition adopted by the National Joint Committee on Learning Disabilities (NJCLD) (Friend, 2011; Hallahan et al., 2012). The federal definition is as follows:

Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia … Disorders not included [:] … Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage. (Individuals with Disabilities Education Act [IDEA], 20 U.S.C. §1401 [2004], 20 CFR §300.8[c][10]) (U.S. Department of Education, n.d.)

The NJCLD is an organization made up of representatives from a range of professional organizations that deal with students who have learning disabilities (Hallahan et al., 2012). The NJCLD found the abovementioned federal definition lacking in several ways (Hallahan et al., 2012). First, the definition makes no reference to causal factors, whereas the NJCLD considers “central nervous system dysfunction within the individual” as the cause (p. 187). Second, there is no mention of adults and the fact that a learning disability is a lifelong condition. Third, the definition fails to indicate that people with learning disabilities often experience difficulties regulating their own behavior (including problem solving) and face problematic issues in social interaction. Fourth, the definition includes terms that are hard to define and understand (e.g., “perceptual handicaps” or “minimal brain dysfunction”). Fifth, the definition includes spelling, which NJCLD feels falls under the umbrella of writing. Sixth, it fails to note that learning disabilities may occur concurrently with other disabilities (Friend, 2011).

Therefore, the NJCLD (2010) defines learning disabilities as follows:

Learning disabilities is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although learning disabilities may occur concomitantly with other handicapping conditions (for example, sensory impairment, mental retardation, serious emotional disturbance), or with extrinsic influences (such as cultural differences, insufficient or inappropriate instruction), they are not the remit of those conditions or influences.

Both of these definitions are complex. Friend (2011) cites the following fundamental dimensions that characterize learning disabilities in general:

Learning disabilities comprise a heterogeneous group of disorders. Students with learning disabilities may have significant reading problems (dyslexia), difficulty in mathematics (dyscalculia), or a disorder related to written language (dysgraphia). They may have difficulty with social perceptions, motor skills, or memory. Learning disabilities can affect young children, students in school, and adults. No single profile of a person with a learning disability can be accurate because of the interindividual differences [relating to an individual’s unique interacting traits] in the disorder.

· Learning disabilities are intrinsic to the individual and have a neurobiological basis. Learning disabilities exist because of some type of dysfunction in the brain, not because of external factors such as limited experience or poor teaching.

· Learning disabilities are characterized by unexpected underachievement. That is, the disorder exists when a student’s academic achievement is significantly below her intellectual potential even after intensive, systematic interventions have been implemented to try to reduce the learning gap …

·

describes some other disabilities that can have an impact on children.

Spotlight on Diversity 3.10

Other Disabilities That Can Affect Children

People with disabilities are at risk of being oppressed, discriminated against, ignored, ridiculed, and denied equal rights. Intellectual disabilities and learning disabilities are only two of the many disabilities that can affect children. Other disabilities arbitrarily mentioned here (considered developmental disabilities) include autistic spectrum disorders, cerebral palsy, hearing problems, vision problems, and epilepsy.

Autistic spectrum disorders (ASDs) “can cause significant social, communication and behavioral challenges” (CDC, 2016). People with ASDs have brains that process information in ways unlike the brains of other people. Such a disorder reflects a lifelong condition that begins before age 3. Because ASDs involve a  spectrum, people can experience aspects characterizing ASDs in different ways, ranging from mild to severe.

Due to recent changes in the Diagnostic Statistical Manual (DSM V), several conditions that used to be diagnosed separately now are diagnosed under autism spectrum disorder, including autistic disorder, pervasive developmental disorder not otherwise specified, and Asperger’s syndrome (CDC, 2016c).

People with ASDs typically demonstrate intense inner-directedness and a number of other symptoms (CDC, 2010b). These include difficulties in social skills, such as problems communicating and lack of normal emotional reactions to others, including attachment. They often have trouble talking about their own feelings or being aware of other people’s feelings. People with ASDs may avoid eye contact and being physically touched. They frequently demonstrate sensory distortion such as underreacting to pain and overreacting to noise. They may engage in repetitive, self-stimulating movements and behavior such as hand flapping, spinning their bodies, or rocking back and forth.

Cerebral palsy (CP) is a disability involving problems in muscular control and coordination resulting from damage to the brain’s muscle-control centers before or during birth, or in the first years of life. Variations in muscle tone may result in movements that are very stiff and difficult, jerky, unbalanced, or floppy. Depending on the extent of damage, lack of balance, difficulty walking, tremors, involuntary movements, problems with precise motions, and difficulty talking or eating can result.

Hearing problems range from mild hearing losses to total deafness. They can result from any part of the ear not functioning normally and effectively. At least 50 percent of hearing problems in children are due to genetic causes, 25 percent due to “maternal infections during pregnancy, complications after birth, and head trauma,” and 25 percent due to unknown factors (CDC, 2015b). Symptoms in infants may involve failure to respond to sounds and in young children delayed speech.

Vision impairment “means that a person’s eyesight cannot be corrected to a ‘normal’ level. Vision impairment may be caused by a loss of visual acuity, where the eye does not see objects as clearly as usual. It may also be caused by a loss of visual field, where the eye cannot see as wide an area as usual without moving the eyes or turning the head” (CDC, 2015c). The severity of vision impairment may be classified in different ways. To be eligible for designated educational or federal programs in the United States, “blindness” is legally defined as visual acuity that is 20/200 or worse (i.e., when a person sees at 20 feet what a person with normal vision can see at 200 feet) (CDC, 2015c).

Epilepsy (commonly referred to as seizure disorder) consists of various disorders marked by disturbed electrical rhythms of the central nervous system and manifested in convulsive attacks. Symptoms range from periods of unconsciousness resembling daydreaming to violent convulsions.

Concurrent disabilities are also common. For example, a person with intellectual disabilities might also have a hearing impairment and/or epilepsy.

discusses behavior modification techniques with respect to effective parenting. For ADHD children, behavior modification focuses on specifying and reinforcing good behavior and decreasing poor behavior by monitoring and structuring each behavior’s consequences.

A major ongoing study initiated in the 1990s and sponsored by the National Institute of Mental Health is being conducted to evaluate the effectiveness of both drug and psychosocial treatment (i.e., psychologically and behaviorally oriented intervention with child and family) (Richters et al., 1995). Kail and Cavanaugh (2013) summarize findings. Initial results indicate that medication can often be effective in treating hyperactivity as such. However, related issues including specific academic problems, social skill development, and working in conjunction with parents are addressed slightly better when medication is administered along with the provision of psychosocial treatment. It should also be noted that medication is only effective when it is closely monitored with consistent visits to health-care providers and there is ongoing communication with school staff about the drug’s effects and the child’s behavior.

Friend (2011) expresses a number of factors to consider before using ADHD drug treatment, including the following:

· “The child’s age

· Prior attempts at other interventions and their impact on the behaviors of concern

· Parent and child attitudes toward using medication …

· Severity of symptoms

· Availability of adults in the household to supervise use of medications, ensuring that medications are taken regularly and as prescribed.” (p. 182)

3-11bSocial Work Roles

Social work roles with respect to clients with both ADHD and learning disabilities are similar to those used with clients who have intellectual disabilities. Social workers function as brokers to help link clients with resources. In the school setting, “besides participating in the multidisciplinary team conferences and consultation, social workers coordinate IEP [Individualized Education Program and IFSP [Individualized Family Service Plan] conferences, serve as trained mediators … lead parent education and informational groups, function as case managers, and facilitate the development of relationships that link the services of the school with those found in the community” (Atkins-Burnett, 2010, p. 187). Practitioners also function as advocates to effect positive change in macro systems that are not responsive to clients’ needs.

Chapter 4 Social Development in Infancy and Childhood

Chapter Introduction

Yellow Dog Productions/Photodisc/Getty Images

Learning Objectives

This chapter will help prepare students to

· LO 1 Explain the concept of socialization

· LO 2 Analyze the family environment (including variations in family structures, positive family functioning, macro systems and the pursuit of social and economic justice, and family system dynamics)

· LO 3 Apply systems theory concepts to families

· LO 4 Assess the family life cycle

· LO 5 Explain diverse perspectives on the family life cycle

· LO 6 Describe learning theory

· LO 7 Apply learning theory concepts to practice (including positive reinforcement, punishment, issues related to the application of learning theory, and time-out from reinforcement)

· LO 8 Examine common life events that affect children (including treatment of children in families, sibling subsystems, and gender-role socialization)

· LO 9 Recognize ethnic and cultural differences in families

· LO 10 Assess relevant aspects of the social environment (including the social aspects of play with peers, bullying, the influence of television and the media, and the school environment)

· LO 11 Examine child maltreatment (including incidence, physical child abuse, child neglect, psychological maltreatment, Child Protective Services, treatment approaches for child maltreatment and sexual abuse, and trauma-informed care)

“My dad could punch out your dad, I bet!” Jimmy yelled at Harry, the neighborhood bully. Harry had just bopped Jimmy in the nose. Jimmy, who was small for his age, felt hurt. So he resorted to name-calling as he edged away from his aggressor. Since his own house was a full two blocks away, Jimmy had to do some fast thinking about how to get there without everybody thinking he was chicken. The worst thing was that Harry was also a pretty fast runner.

To Jimmy’s surprise and delight, Harry was apparently losing interest in this particular quarry. Somebody called out from the next block and was trying to interest Harry, a good fullback, in a game of football.

and  .)

Negotiation is also clearly related to good communication and good relationships. When faced with decisions or crises, healthy families involve all family members, so as to come to solutions for the mutual good. Conflicts are settled through rational discussion and compromise instead of open hostility and conflict. If one family member feels strongly about an issue, healthy families work to accommodate his or her views in a satisfactory way. Both unhealthy and healthy families suffer conflict and disagreements, but a healthy family deals with conflict much more rationally and effectively.

Families can be compared and evaluated on many other dimensions and variables. The specific variables are not as important as the concept that children are socialized according to the makeup of their individual family environments. The family teaches children what types of transactions are considered appropriate. They learn how to form relationships, handle power, maintain personal boundaries, communicate with others, and feel that they are an important subset of the whole family system.

4-2cMacro Systems, Families, and the Pursuit of Social and Economic Justice

We have established that families provide an immediate, intimate social environment for children as they develop. However, families do not exist in a vacuum. They are in constant interaction with numerous other systems permeating the macro social environment. Families can provide care and nurturance only to the extent that other macro systems in the environment, including communities and organizations, provide support and empower them.

For example, unemployment may soar because of an economic slump. Political decisions such as increasing business taxes may have sparked the slump. Ideologically, the general public may feel that in “a free country” of rugged individualists, it is each person’s responsibility to find and succeed in work. The public may not support political decisions to subsidize workers by providing long-term unemployment benefits or developing programs for job retraining. At the same time, legislators concerned about the increasing unemployment rate and their reelection may hesitate to impose increasing restrictions on business and industry such as more stringent (and costlier) pollution control regulations. Thus, the physical environment suffers.

This example, of course, is overly simplistic. Volumes have been written on each aspect of the political, economic, environmental, and ideological dimensions of the social environment. However, the point is that it is impossible to comprehend a family’s situation without assessing that family within the context of the macro social environment. For example, economic downturns and unemployment may leave a parent jobless and poverty-stricken. That parent will then be less able to provide the food, shelter, health care, and other necessities for a family environment in which children can flourish.

Likewise, the resources available to agencies and communities for dispersal to clients depend on legislative and organizational policies. For instance, U.S. society is structured such that all citizens have the right to receive a high school education. This idea is based in ideology that, in turn, is reflected by legislative and administrative policy that regulates how that education is provided.

.)

In summary, a number of facts point to the need for adequate day care to serve the nation’s children. First, most women work outside the home because of economic necessity. Second, the majority have the additional burden of being primary homemakers. Third, many women have no mate to help with child care.

Day care facilities are clearly inadequate to meet the nation’s needs (Kirk & Okazawa-Rey, 2013; Lein, 2008). Parents often struggle to find adequate, affordable, and accessible day care for their children. Many day care centers refuse to accept small infants because of the difficulty of caring for them. Furthermore, numerous children in the United States are provided day care in private homes, unregulated by public standards.

Why doesn’t the government require that facilities be developed to meet the day care need? There is no clear answer. Cost may be one possibility. Low priority may be another.

Ethical Questions 4.1

1. As a student social worker, what do you think about the nation’s day care situation? How critical is it, especially for women? To what extent might you be willing to seek out answers for how to solve this problem and others like it?

4-2dThe Dynamics of Family Systems

In order to understand family functioning, it’s helpful to view the family within a systems perspective. Systems theory applies to a multitude of situations, ranging from the internal mechanisms of a computer to the bureaucratic functioning of a large public welfare department to the interpersonal relationships within a family. Regardless of the situation, understanding systems theory concepts helps you to understand dynamic relationships among people. Systems theory helps to conceptualize how a family works. Basic systems theory concepts were introduced in  . The   reviews those concepts and shows how they can be applied to family systems.

Systems theory helps us understand how a family system is intertwined with many other systems. Each member of a family is affected by what happens to any of the other members. Each member and the family as a whole are also affected by the many other systems in the family’s environment. For instance, if Johnny flunks algebra, the family works with the school system to help him make improvements. The entire family might have to cancel their summer vacation because Johnny has to attend summer school. The school system directly affects the family system.

A second example concerns Shirl, Johnny’s mother and the family’s primary breadwinner. She works as an engineering supervisor for Bob Bear, a corporation based in Racine, Wisconsin, that makes tractors. New World International, an immense conglomerate corporation, owns Bob Bear. What if New World International decides to close down the Bob Bear plant in Racine because of inadequate profits and to move the large plant to Bonetraill, North Dakota? Bonetraill is a far cry from small, but urban, Racine. One possibility for the family is to move two states away to a totally different environment because Shirl has been offered a comparable position in Bonetraill. Lennie, Johnny’s father, is a journalist for the local paper. In the event of a move, he would have to find a new job. The whole family would have to leave their neighborhood and friends. Another alternative is for Shirl to seek a new job in the Racine area. However, the economy there is depressed, and she would have difficulty finding a position with a salary anywhere near the one she is currently earning. Thus, the family system is seriously affected by the larger Bob Bear system, and the Bob Bear system by the even larger New World International system.

Another important reason can be given for understanding systems theory as it relates to families. Intervention in families with problems is a major concern of social work. Family therapy is intervention by a social worker or other  family therapist with members of a family to improve communication and interaction among members and to pursue other changes and goals they wish to pursue. Family therapy is based on the idea that the family is a system. In finding solutions to problems within a family, the target of intervention is the family system.

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4-3 Apply Systems Theory Concepts to Families

LO 3

A number of the basic systems theory concepts introduced in   will be briefly redefined here and then applied to examples of family situations.

4-3aSystems

A  system is a set of elements that form an orderly, interrelated, and functional whole. Several aspects of this definition are important. The idea that a system is a “set of elements” means that a system can be composed of any type of things as long as these things have some relationship to each other. Things may be people, or they may be mathematical symbols. Regardless, the set of elements must be orderly. In other words, the elements must be arranged in some order or pattern that is not simply random. The set of elements must also be interrelated. They must have some kind of mutual relationship or connection with each other. Additionally, the set of elements must be functional. Together they must be able to perform some regular task, activity, or function and fulfill some purpose. Finally, the set of elements must form a whole.

Families are systems. Any particular family is composed of a number of individuals, the elements making up the system. Each individual has a unique relationship with the other individuals in the family. Spouses normally have a special physical and emotional relationship with each other. In a family with seven children, the two oldest sisters may have a special relationship with each other that is unlike their relationship with any of the other siblings. Regardless of what the relationships are, together the family members function as a family system. These relationships, however, are not always positive and beneficial. Sometimes, a relationship is negative or even hostile. For example, a 3-year-old daughter may be fiercely jealous of and resentful toward her newborn brother.

4-3bHomeostasis

Homeostasis refers to the tendency of a system to maintain a relatively stable, constant state of equilibrium or balance. A homeostatic family system functions effectively. The family system is maintaining itself and may even be thriving. However, a homeostatic family system is not necessarily a perfect family. Mother may still become terribly annoyed at father for never wanting to go out dancing. Ten-year-old Bobby may still be maintaining a D average in English. Nonetheless, the family is able to continue its daily existence, and the family system itself is not threatened.

Homeostasis is exceptionally important in determining whether outside therapeutic intervention is necessary. Absolute perfection is usually unrealistic. However, if the family’s existence is threatened, the system may be in danger of breaking apart. In these instances, the family system no longer has homeostasis.

For instance, an 89-year-old maternal great-grandmother, Tula, no longer can care for herself. She has been living alone since the death of her husband 20 years earlier. Her eyesight is failing, and her rheumatoid arthritis puts her in constant pain. She remains fairly alert, however, with only some minor forgetfulness. Tula had raised her only grandchild, Jasmine, now age 35, since Jasmine was 3 when her own mother was killed in a car accident. Jasmine’s father left before Jasmine was born, never to be heard from again. Tula and Jasmine have always been very close.

Jasmine refuses to place Tula in a nursing home. She feels responsible for Tula because Jasmine is the only grandchild, and she would like to “pay back” all the care she received when she was young.

Jasmine’s husband, Hank, however, hates the idea of having Tula move in. Tula, he feels, has always tried to intervene in his marriage. He feels that she takes sides with his wife and constantly tells him what to do. He also feels she talks incessantly and is so hard of hearing that she listens to Jeopardy reruns loud enough to deafen him, even when he’s working down in the basement. Hank also feels that Tula’s presence in the home would seriously disrupt his own children’s lives. His son Bill is 11 and Bob is 8.

explores this new conceptualization of diverse family life cycles. Although the stages resemble those in the traditional approach, discussion focuses on the variability within each stage. Families are significantly affected by a wide range of conditions and issues. The stages described in   may occur, but not necessarily in that order or at all. Rather, each family experiences a complex existence, as a system and as a collection of individuals, within an environmental context involving “race, ethnicity, class, gender, sexual orientation, religion, age, family status” and “disability” (p. 18). Additionally, “current or longstanding social, political, and economic issues” directly affect family life and the family life cycle; such matters include “random violence, affirmative action, de facto school and neighborhood segregation, gay and lesbian adoption or marriage, welfare reform, abortion rights, the education of all our children, prejudice against legal and illegal immigrants, health care and insurance, tax cuts, layoffs, social services to [older adults] … and other groups, cost and availability of infertility treatments, and physician-assisted suicide” (p. 18).

Spotlight on Diversity 4.1

Explain Diverse Perspectives on the Family Life Cycle

LO 5

McGoldrick and her colleagues (2011) articulate the following seven family life-cycle stages; these proposed stages may be considered as a “map” for examining and assessing how families respond to their widely diverse issues and circumstances (pp. 16–17).

Stage 1: Leaving Home: Emerging Young Adults

Early young adulthood arbitrarily extends from age 18 to 21, and older young adulthood from 22 to about 30 or older (Arnett, 2007; Fulmer, 2011). In the past, young adulthood marked the cessation of the dependence upon family of origin and the entrance into the world of independent living and work. Now, however, the concept of “breaking ties” with the family of origin is no longer so important. Whereas that old model “overemphasized separation,” the new perspective “blends separation and attachment by recognizing the need for individuation while retaining cross-generational relationships” (Fulmer, 2011, p. 176).

Stage 1 is often characterized by entrance into the self-supporting work world, formulation of intimate friendships and relationships, and possibly experimentation with mind-altering substances (Fulmer, 2011). However, these experiences are affected by a number of factors. For example, “poor urban groups have easier access to stronger drugs in their neighborhoods than do college students”; this may put such urban youth who are poor into high-risk groups for drug addiction and the negative repercussions resulting from addiction (Fulmer, 2011, p. 179). College students, on the other hand, may just use drugs “recreationally,” not necessarily suffering such dire consequences.

Another example of diverse circumstances concerns chronic illness and its effects on a family with an emerging young adult. Rolland (2011) explains:

If illness onset coincides with the launching … phases of the family life cycle [Stage 1], it can derail a family’s natural momentum. Illness or disability in a young adult may requires a heightened dependency and return to the family of origin for disease-related caretaking. The autonomy ad individuation of parents and child are in jeopardy, and separate interests and priorities may be relinquished or put on hold. Family dynamics as well as disease severity will influence whether the family’s reversion lo a child-rearing-like structure is a temporary detour or a permanent reversal. (p. 357)

Stage 2: Joining of Families through Marriage/Union

To varying degrees, marriage can require adjustment, compromise, and snuggle. Even small issues like how to arrange cereal boxes on the shelf, make spaghetti, or take out the garbage can require communication and cooperation. People going through Stage 2 may form a commitment with each other and readjust their relationships with friends and family as they establish themselves as a couple (McGoldrick, 2011).

However, numerous issues can make a couple’s adjustment to each other more difficult (McGoldrick, 2011). These include inadequate jobs or resources, differences in “religious, racial, ethnic, or class background,” disparities in “financial power, socioeconomic status, education, career option or skills,” and “issues with family of origin” (e.g., poor relationships with parents or siblings, financial dependence on parents, or living too far away or too close) (p. 210).

Gay and lesbian couples may face additional issues, such as loss of external family support, lack of legal acknowledgment, barriers to marriage, safety concerns, and job and/or financial discrimination based solely on their relationship status. Furthermore, “the stigmatizing of homosexual couples by our society means that their relationships are often not validated by their families or communities and they must cope with prejudice on a daily basis. The AIDS crisis produced a terrible trauma for the gay community and its impact on a whole generation of gay men at the point of forming couple relationships cannot be underestimated” (McGoldrick, 2011, p. 201).

Stage 3: Families with Young Children

Cultural values significantly affect how children are socialized, what values they acquire, and what behaviors they learn. “One cannot view the socialization of certain behaviors independently from the cultural context. Cultures define the basic values and ideals as well as the agents who teach the values and the settings in which they are taught” (Gardiner, Mutter, & Kosmitzki, 1998, p. 148). Greder and Allen (2007) reflect that “cultural traditions shape parenting by influencing child-rearing practices, expectations of roles of children at different ages and stages of development, where families live, family structure, and roles and responsibilities of adults in families” (p. 123).   and   discuss further the influence of culture.

Greder and Allen (2007) continue that economic hardship also severely affects parenting ability:

Households headed by single mothers, individuals, and families from ethnic minority groups and families with pre-school children are overrepresented among those in the population who live in poverty … Geography and generations also play important roles in determining who becomes poor, as do factors such as adolescent parenting, insufficient education, lack of job training, and chronic unemployment. Limited access to health care (and resulting poor health outcomes), inadequate housing and homelessness and violent or unsupportive neighborhoods all contribute to the economic barriers confronting poor families. (p. 125)

Stage 4: Families with Adolescents

In the United States, adolescence can be a difficult period. Adolescents strive to establish their own identities, which often results in conflict with parents. Parents often struggle to maintain control, while adolescents vehemently resist it. Ethnic diversity and cultural values can add to the complexity of these scenarios.

As later chapters will explore, identity development is very important in adolescence. It, too, is subject to diverse factors. Preto (2011) addresses identity development for adolescents of color:

For African Americans, Latinos, Asians, and other adolescents of color, forming an identity goes beyond values and beliefs about gender, since they have to first cope with how society defines them, marginalizes, and oppresses them. For African Americans, forming a positive identity as a Black male or Black female in a racist society in which being Black has been demeaned for centuries poses a grave challenge for adolescents and their parents … Although there has been an increased visibility of African Americans in the popular culture, even more so since the election of Barack Obama as president the insidious effects of racism on the everyday lives of Blacks in this country hasn’t gone away. (p. 236)

Social class also impacts the conditions surrounding and the opportunities provided for adolescents. For example, families in the upper-level social classes, who have higher levels of education and greater income potential, view adolescents as needing attention, direction, and safekeeping; in contrast, working-class and poor families regard their adolescents as active participants needed to help with important family responsibilities such as washing, cooking, and babysitting (Kliman, 2011).

Stage 5: Launching Children and Moving on at Midlife

When children leave home to be on their own, family life often changes dramatically in many ways (McGoldrick et al., 2011). The original couple must reestablish itself as its own system. Relationships are developed with grown children, their partners, and grandchildren. The couple may establish new interests, activities, and relationships to replace the time no longer needed for child-care duties. The couple system’s own parents may require help and attention as they themselves age.

However, Stage 5 is also characterized by great diversity (Preto & Blacker, 2011). People may be married or in permanent couple systems, divorced, single, or remarried (possibly multiple times) by this stage of life. Some people are well adjusted. Others may face the clichés of a “midlife crisis” or “the empty nest syndrome.” People with greater assets and higher socioeconomic status often enter midlife in good health, eagerly seeking out new and exciting experiences. However, people in the lower socioeconomic classes frequently experience economic hardship, especially with diminishing availability of jobs, industrial downsizing and movement of production to other countries, and work environments characterized by escalating technology.

Stage 6: Families in Late Middle Age

Families in late middle age often face a range of conditions (Walsh, 2011). Stage 6 is often characterized by retirement and grandparenthood. Many people remain vibrant and healthy. As with other stages in life, socioeconomic status and available resources dramatically affect the quality of life in late middle age. People with many resources can experience travel, recreational pursuits, and good living conditions. People with inadequate resources may be forced to keep working, sometimes taking minimum-wage jobs to keep them afloat. Such people may not have adequate housing, food, or health care.

Other aspects of diversity, including race, also affect late middle age. For instance, increasing numbers of African American grandparents are assuming responsibility for their grandchildren (Brownell & Fenley, 2009; Cox, 2002, 2005; Diller, 2015; Misiewicz, 2012; Sue & Sue, 2008). Primary reasons include crack cocaine or alcohol addiction, incarceration for drug- or alcohol-related crimes, mental illness, and unwillingness to surrender custody of grandchildren to public foster care (Cox, 2002, 2005). “Surrogate parenting has been a pattern for African American grandparents in U.S. society” (Cox, 2002, p. 46).

These grandparents experience undue pressures when assuming such responsibility and are “prone to an increased incidence or exacerbation of depression and insomnia, hypertension, back and stomach problems … as well as increased use of alcohol and cigarettes … In addition, grandparents tend to ignore their problems and associated stresses to meet the needs of their grandchildren” (Cox, 2002, p. 46).

Cox (2002) calls for  empowerment practice on their behalf and explains: “The immediate goals of empowerment practice are to help clients achieve a sense of personal power, become more aware of connections between individual and community problems, develop helping skills, and work collaboratively toward social change” (p. 46, citing Gutierrez, GlenMaye, & DeLois, 1995).

Cox calls for providing grandparents with information on a range of relevant topics and teaching them various skills to empower them. The recommended curriculum includes the following content: “(1) introduction to empowerment; (2) importance of self-esteem; (3) communicating with grandchildren; (4) dealing with loss and grief; (5) helping grandchildren deal with loss; (6) dealing with behavior problems; (7) talking to grandchildren about sex, HIV/AIDS, and drugs; (8) legal and entitlement issues; (9) developing advocacy skills; (10) negotiating systems; [and] (11) making presentations” so that they can share their knowledge with others (p. 47).

Stage 7: Families Nearing the End of Life

Facing the reality that life is coming to an end is important for families (McGoldrick et al., 2011). Often, this involves people dealing with losses, including the deaths of partners and friends. Preparing for one’s own death and legacy is also part of this stage. Decisions may be made about where to reside as health declines and increased supportive care is required.

Great diversity characterizes this stage. Depending on your cultural background, there are numerous ways of viewing and dealing with old age and death. For example, Dhooper and Moore (2001) maintain that

Native American   [older adults] … those aged 65 and above, are more traditional in their philosophy and values and have a deeper understanding of racism and oppression against Native people as a result of having a longer history of experience with these forces. [Early in the last century] … the BIA [Bureau of Indian Affairs] sanctioned field agents to alter Native customs. “Forbidden were the wearing of long hair by males, face painting of both sexes, and wearing Indian dress” (Hirschfelder & Kreipe de Montano, 1993, p. 22) … The [older adults] … have been the vanguards of their culture and have passed down their traditions and cultural beliefs throughout the generations. Through the [older adults] … “traditional values are sustained … The ancient languages are spoken and taught, traditional ceremonies are observed and baskets are woven” (L. Hall, 1997, p. 755). As such they are held in high regard by their people and are treated respectfully. “Generally Native American traditional values consist of sharing, cooperation and a deep respect for elders” (Garrett, 1999, p. 87). (p. 191)

Similarly, various cultures view and deal with death very differently. Consider the approach assumed by the Lebanese:

Lebanese families are generally very expressive in their response to death, even after several generations of living in the United States. Extreme displays of emotion are common, and it is not unusual for older family members to ask the deceased to get up and perform a favored deed one last time (i.e., to dubkee, a Lebanese dance, or cook a favored meal). After the deceased is unable to respond to the request, the grief of the family is amplified and followed by wailing and crying. For immigrant Lebanese several decades ago, it was not uncommon to jump into the grave at the cemetery if a child had preceded a parent in death. In recent times Lebanese American reactions to death are less dramatic but still highly emotional and demonstrative. Calmness at wakes is perceived as a lack of love for the deceased, and emotional outbursts are perceived as respect for the deceased. Because of the strong bonds and emotional attachments of Lebanese families, wakes and funerals are highly charged experiences. (Simon, 1996, p. 374)

The Hindu perception and treatment of death involves the following:

Death is a particularly potent symbolic event among Hindus, given their beliefs about karma [destiny] … As with weddings, traditional rituals associated with death and mourning are likely to be modified when Indians live in the United States.

Mourning cycles vary, but … customs include a 10- to 12-day mourning ritual …in addition to requiring extensive absence from work. In keeping with Indian sex-role traditions, widows are expected to perform many rituals of sacrifice glorifying the family, whereas widowers and other family members are not required to observe such rites. (Almeida, 1996, p. 408)

Mindell (2007) explains Jewish families’ view and handling of death:

Judaism, regardless of denomination—Reform, Conservative, or Orthodox—has the overriding values of honoring the dead and comforting the mourners. Burial is usually within twenty-four hours after the death and the funeral service begins with the cutting of a garment or a black ribbon attached to the mourners, the immediate family of the deceased. This ritual is a visual representation of the individual being separated—cut away—from the loved one. The period of mourning at home after the burial lasts for one week. This ritual is called Shiva, the Hebrew word for seven. Friends, family, and neighbors visit the mourners in the home during Shiva, which provides the opportunity to share stories about the deceased, how his or her life touched others, and provide the bereaved a supportive environment to also share memories and to grieve. The first thirty days, referred to as Sheloshim, the Hebrew word for thirty, after the funeral is a time when the family might attend morning and evening services. Mourning ends after the first year, the anniversary of the death, when a tombstone is dedicated. At each anniversary of the death, the Yahzeit, the family lights a special twenty-four-hour memorial candle. Mourning is seen as a process that has stages and takes time. Rituals enable the living to remember the dead.

The religious customs that are practiced during the continuum of an individual’s life allow one to cope with difficult happenings, experiences, and emotions, in a supportive, emotional “home” as she or he struggles to make sense out of events that seem to have no meaning. The manner in which the struggle is done, the emotions expressed, and how the community supports its members reflect the religious and cultural history of the group and help to define the identity of the members of the group. (pp. 231–232)

Additional Issues Affecting Multiple Phases of the Family Life Cycle

Many other dimensions of diversity affect the life cycle of families and individuals. For example,   presents material on the life cycle of LGBTQ families and individuals. We will arbitrarily address two additional issues here that affect various life-cycle stages—adults who remain single and families dealing with immigration status.

Single Adults

Simply put, many adults for various reasons neither marry nor commit themselves to long-term intimate partnerships. The seven-stage family life cycle just described doesn’t really apply to them. The demographic picture has changed. More people remain single now than in past decades, people who do marry do so later than before, people often delay childbearing, and many people live much longer than they have in the past (Berliner, Jacob, & Schwartzberg, 2011).

Berliner and her colleagues (2011) describe four life-cycle stages often encountered by people who remain single. First, during their 20s, people establish their adult status. They make the transition from being dependent on their family of origin to starting their independent lives. They develop new contexts for living by establishing work status and friendship relationships.

During the second stage in their 30s, single adults may face “the single crises” (Berliner et al., 2011, p. 166). They contend with the condition that they are single and may remain so. They may develop new life objectives and possibilities that don’t include marriage. They may consider having children.

In their third phase of midlife, single adults may accept the fact that they may indeed neither marry nor have children. The dream of “the perfect family” may not materialize. They may take a new look at the status of work in their lives and attend to their financial future as single adults. They determine to view their status as single adults as valid and positive. Establishing social networks of friends for emotional support is also important.

The fourth phase entails “putting it all together” (Berliner et al., 2011, p. 166). This concerns single adults making decisions about work and their financial future. It means stressing the positive aspects of being free and independent. It also involves planning for future living conditions in the case of failing health. Finally, they cope with the decreasing health and death of people important to them.

Immigration Status

Immigration status is “a person’s position in terms of legal rights and residency when entering and residing in a country that is not that person’s legal country of origin” (Kirst-Ashman & Hull, 2012b, p. 26). Migrating from one country to another can powerfully affect a family’s life cycle.

People who migrate can assume any of the following statuses:

· Immigrants “are those individuals who depart their country of origin voluntarily in search of better economic and living arrangement” (Delgado, Jones, & Rohani, 2005, p. 5). They may be either permanent or temporary (e.g., students or seasonal workers); they may have either legal or illegal status, as described next (Potocky, 2008).

· Undocumented immigrants “are those individuals who enter this country without proper (legal) documentation, and have done so for reasons similar to those who are in this country as immigrants” (Delgado et al., 2005, p. 5). They sometimes are referred to as illegal aliens.

· Refugees “are those individuals who are forced to leave their country because of human rights violations and threats to safety” (Delgado et al., 2005, p. 5). They may also be victims of natural or man-made disasters (Potocky, 2008).

Migration to a new country and environment can dramatically affect a family’s life cycle (Falicov, 2011). Regardless of where a family is in its life cycle, migration forces family members to face major changes and disruptions. It also involves experiencing the losses of the known and familiar patterns of their old existence. “The age at the time of migration, the stage of personal development, and the length of stay in the adopted country alter how migration is constructed and lived over time” (Falicov, 2011, p. 337). Ability to adapt to new circumstances varies widely depending on the family member’s age. The experience will be very different for babies, “school-age children, adolescents, young adults,” and older adults (Falicov, 2011, p. 337). For example, young children generally have the ability to acquire a new language much more easily than older adults (Potocky, 2008).

There are many dimensions to the migration experience and many questions to ask about how the experience affects various family members. Garcia (2009) raises issues and questions to address in order to understand the family’s circumstances at whatever phase of the life cycle they’re in:

1. The process of immigration: Was the move voluntary or involuntary? Anticipated or not anticipated? What were the points of transit on the way to the United States? Who was left behind, what separations occurred with family members? What is the status of immigration documentation?

2. Social power changes and coping: Have there been socioeconomic, educational, occupational adjustments? Shifts in new employment or unemployment status? Shifts in family decision making due to structural family changes? What are the effects of language and literacy fluency in the new country? Is the immigrant facing workplace-related stressors? Is so, what types of stressors (e.g., supervisory, interpersonal, xenophobic [involving an intense dislike or fear of foreigners or foreign customs], immigration authorities)?

3. Economic and housing resources: What are the immigrant’s debt commitments and assets? What is the status of housing (e.g., quality), transportation, access to communication technology?

4. Physical and psychological health status: Are the immigrant’s basic needs for food and shelter being met? Can the immigrant utilize and/or access professional health providers and/or cultural healers? Are there any antecedent health conditions prior to immigration, during the immigration process (e.g., loss of health, limb)? What is the immigrant’s current health status?

5. Family system and social networks: What are the family constellations, structures, communication patterns, multi-generational experiences, and coping abilities? What social support systems, if any, is the family involved with (e.g., extended family, friends, religious, community, political, recreational)? To what degree is the individual or family isolated and/or active with social contacts?

6. Cultural: Profile and qualities of individuals’ social identity? In what ways and to what degree is the individual identified with his or her traditional culture, with the new American culture, and/or with other cultures (e.g., religious, people with disabilities, gender orientation)? (pp. 84–85)

Within the context of the family system’s life cycle, we will now turn our attention back to the social development of young children. We will focus on how children become integrated into their family system and how they learn to behave (or misbehave). Learning theory provides a relevant, conceptual base for understanding how socialization and learning occur. Thus, we will emphasize the theoretical basis for learning theory and its applications to practical parenting.

4-5 Describe Learning Theory

LO 6

“Mom! I want a candy bar! You promised! I want one right now! Mom!” Four-year-old Huey screamed as loudly as he possibly could. He and his mother were standing in the checkout line at the local supermarket. An older adult woman was checking out in front of them. Two other women and a man were waiting in line behind them.

Huey’s mother saw everybody looking at her and her young son. Huey simply would not stop screaming. She tried to shush him. She scolded him in as much of a whisper as she could muster. She threatened that he would never see the inside of a McDonald’s again. Absolutely nothing would work. Huey just kept on screaming.

Finally, in total exasperation, his mother grabbed the nearest candy bar off the shelf, ripped off the wrapper, and literally stuck the thing into Huey’s mouth. A peaceful silence came over the grocery store. All witnessing the event breathed a sigh of relief. Huey stood there with a happy smile on his sticky face. One might almost say he was gloating.

The family environment has already been established as the primary agent of children’s socialization. It provides the critical social environment in which children learn. The next logical question to address concerns how children learn. The social and emotional development of children is frequently a focus of social work intervention. Children sometimes create behavior problems. They become difficult for parents and other supervising adults to manage. When they enter school, these management problems often continue. Teachers and administration find some children difficult to control. Frequently, as children get older, problems escalate.

Children can learn how to be affectionate, considerate, fun-loving, and responsible. But they can also learn how to be selfish, spoiled, and inconsiderate. This latter state is not good for parents and other supervising adults, nor for the children themselves. Children need to cooperate with others. They need to know how to get along in social settings in order to become emotionally mature, well-adjusted adults. Learning theory concepts are useful for recognizing why anyone, child or adult, behaves the way he does. However, the concepts are especially helpful when addressing the issue of behavior management.

4-5aCritical Thinking: Evaluation of Theory

In order to change behavior, it first must be understood.  Learning theory is a theoretical orientation that conceptualizes the social environment in terms of behavior, its preceding events, and its subsequent consequences. It posits that behavior can be learned, and therefore maladaptive behavior can be unlearned. Learning theory provides a framework for understanding how behavior develops. We will focus on learning theory for several reasons. First, it emphasizes the social functioning of people within their environments. The total person in dynamic interaction with all aspects of the environment is the focus of attention. This is in contrast to many other theoretical approaches that focus primarily on the individual’s personality or isolated history.

Second, learning theory emphasizes the importance of assessing observable behaviors. It also stresses the use of behaviorally specific terms in defining behaviors. This helps to make any particular behavior more clearly understandable.

portrays this relationship.

Figure 4.1A Stimulus–Response Relationship

Much respondent behavior is unlearned; that is, a response is naturally emitted after exposure to a stimulus. This stimulus is called an  unconditioned (naturally occurring)  stimulus.  Respondent conditioning (also called  classical or Pavlovian conditioning) occurs when a person learns to respond to a new stimulus that does not naturally elicit a response. This new stimulus is called a  conditioned (learned)  stimulus. In order to accomplish this, the new stimulus is paired with the stimulus that elicited the response naturally. The person then learns to associate the new stimulus with a particular response even though it had nothing to do with that response originally.

For example, Mr. Bartholomew, a third-grade teacher, slaps students very hard on the hand when they talk out of turn. (This punitive physical behavior, of course, could get Mr. Bartholomew into a LOT of trouble.) As a result of this stimulus, the slapping, students fear Mr. Bartholomew. By associating Mr. Bartholomew with getting a slap on the hand, the students eventually learn to fear Mr. Bartholomew even when he isn’t slapping them. Mr. Bartholomew himself has been paired with the hand slapping until he elicits the same response that the slapping did.   helps to illustrate this relationship.

Figure 4.2Respondent Conditioning

Some behavioral techniques used by social workers involve the principles of respondent conditioning.  Systematic desensitization provides an example. Systematic desensitization is a procedure in which a person with a phobia practices relaxation while imagining scenes of the fear-producing stimulus. A  phobia is “a fear in which the level of anxiety or escape and avoidance behavior is severe enough to disrupt the person’s life” (Miltenberger, 2012, p. 552). The extreme fear or anxiety may involve almost anything. Examples include snakes, enclosed places, or school.

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Highlight 4.1

Consequences and Recurring Behavior

The Johnsons hired their neighbor, 9-year-old Eric, to mow their lawn once a week during the summer. Eric, not being sophisticated in the ways of money management, failed to discuss how much he would be paid per hour. Eric slaved away for four hours one Saturday afternoon when he would rather have been playing baseball.

When Eric had finished, Mr. Johnson came out, complimented Eric on what a fine job he had done, and gave him $12 for his trouble. Unfortunately, $12 worked out to be $3 per hour. Mr. Johnson thought this was more than adequate. Mr. Johnson himself had been paid only a grand total of $1 for doing a similar job when he was a boy. Eric, however, felt this was more than chintzy on Mr. Johnson’s part. He knew that $12 would barely begin to cover the brand new Xbox of his dreams.

The consequences for Eric’s lawn-mowing behavior were not positive. He did not receive his expected $32. Thus, Eric never mowed Mr. Johnson’s lawn again. Instead he turned to other, more generous and benevolent neighbors to upgrade his financial future. He also learned to make salary one of the first items on his business agenda. If Mr. Johnson had given him his expected rate of $8 an hour, Eric would have been a dependable and industrious worker for him throughout the summer. In other words, more favorable consequences for Erie would have encouraged his lawn-mowing behavior. He would have been conditioned to mow Mr. Johnson’s lawn. As it turned out, Mr. Johnson was doomed to mowing his own lawn for the remainder of the summer.

accidentally dropped and return it to the social worker. The social worker may then model for the parent how the child can be positively reinforced for his good behavior. The social worker may say, “Thank you for picking up my pencil for me, Larry. That was very helpful of you.”

Another example of modeling within a social work practice context is  role playing, practicing behavior through a trial run in preparation for a later situation in which some goal is to be achieved (such as gaining greater understanding of another’s position or learning more effective communication skills). For example, a social worker might ask a mother who has trouble controlling her son to role-play that son and mimic his behavior. She is instructed to act the way she thinks her son would act. The social worker may then model for the parent some appropriate, effective things to say to the son when the son behaves in that way. Such modeling provides the opportunity for the parent to learn new ways of responding to her son.

Modeling can also teach children inappropriate and ineffective behavior. For example, consider a mother who strikes other family members whenever she gets the least bit irritated with them. She is likely to act as a model for that type of behavior. Her children may learn that striking others is the way to express their anger.

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Figure 4.3Positive Reinforcement, Negative Reinforcement, Punishment, and Extinction

4-6 Apply Learning Theory Concepts to Practice

LO 7

As children become socialized, they learn and assimilate various behaviors. Because learning is a complicated process, sometimes the behaviors they learn are not those that their parents would prefer. Behavior management is a major issue for many parents.

Parents have various alternative ways of responding to a child’s behavior. At any point, an individual can follow alternative plans of action. For each alternative, there are consequences. The critical task is to evaluate each alternative and select the one with the most advantageous results. Learning theory concepts provide parents with a means of understanding the alternatives open to them and predicting the potential consequences of each alternative. It can help them gain control over their children’s behavior.

An example of parental alternatives in response to behavior is provided by Tung, age 4. At the dinner table, Tung nonchalantly and without warning says an unmentionable four-letter word. Tung’s parents are shocked. At this point, they can respond in several different ways. They can ignore the fact that Tung said the word. Without being given undue attention, saying the word may be stopped. A second alternative is to tell Tung calmly that the word is not considered a very nice word. They might add that some people use it when they’re angry and that other people don’t really like to hear it. They might also ask him not to use the word anymore. A third alternative is for the parents to display their horror and disbelief, scream at Tung never to say that word again, and send him to bed without being allowed to finish his supper.

1. What are your thoughts about punishing children? What was your experience with punishment as a child? If punishment was used, in what ways were you punished? Did punishment work or not? Why?

4-6cAdditional Issues

provides another example of accidental training.

Highlight 4.2

Accidental Training

Tommy was an only child. His parents, who were in their late 30s, had tried to have children for years without success. When Tommy came along, they were overjoyed. Both parents thought almost everything Tommy did was “simply darling.” One time, when Tommy was 3 years old, he approached some dinner guests and asked for money. He had learned that money bought ice cream and other good things. Two things occurred. First, his parents thought it was cute, so they laughed. Then they appropriately told him that asking for money was not a good thing to do. But they maintained happy, smiling faces all the while. Tommy thus received massive social reinforcement in the form of praise and attention for his begging behavior. Second, Tommy did receive $2, which he later spent for mocha fudge ice cream. The guests were not quite as entertained by Tommy’s behavior as his parents were. But they felt he was a cute kid and gave him money to avoid embarrassment in front of his parents.

The next time Tommy’s parents had guests, Tommy did the same thing. He came out for display, said hello, and then asked them if he could have some money. He received a similar reaction. As time went on, Tommy consistently continued his begging behavior in front of guests. His parents became less entertained as the years passed. They discovered that an 8-year-old Tommy coming out and asking guests for money was no longer as cute as a 3-year-old doing the same thing. However, by the time Tommy was 8, they were having a terrible time trying to decrease or extinguish his begging behavior. For an extended period of time, Tommy had accidentally been trained to beg. Such extensive accidental training had become very difficult to extinguish.

Behaviorally Specific Terminology

A major advantage of conceptualizing behavior in terms of learning theory is the emphasis on  specificity. A behavior must be clearly and concisely defined. A clear description of behavior allows for all involved in the behavioral management of a child to understand exactly what behavior, including problem behavior, involves.

For example, Jessica, age 9, was described by her teachers as too passive. It is difficult to know what is meant by “too passive.” The word passive is relatively abstract. The image of a passive Jessica is quite vague. However, if Jessica’s passivism is defined in terms of her behavior, as it would be with a learning theory conceptualization, the image of Jessica becomes more distinct. Jessica’s passivism might be described behaviorally in the following way:

illustrates how this might be applied to Jessica’s situation.

Table 4.1

Behavior Chart: Number of Times Jessica Raises Her Hand

	Mon.	Tues.	Wed.	Thurs.	Fri.
8:00–8:59 am	0	0	0	0	0
9:00–9:59 am	0	0	0	0	0
10:00–10:59 am	0	0	0	0	0
11:00–11:59 am	0	0	0	0	0
12:00–12:59 am	0	0	0	0	1
1:00–1:59 pm	0	1	1	0	1
2:00–3:00 pm	0	0	1	3	3

Whenever Jessica raised her hand in class, her teacher would make a note of it on her behavior checklist. The total number of times could be counted. It could thus be clearly established if an improvement occurred.

We have not addressed the specific types of treatment that could be used to decrease Jessica’s passivism. A treatment program could be established in various ways. For example, positive reinforcement could be administered whenever she raises her hand. This could take the form of verbal praise, a piece of candy, or a token that could be used to buy something she really wanted.

The Importance of Parental Attention

1. What are your thoughts about using time-outs in child management? To what extent, if any, do you think they work? If they should be used, under what circumstances are they appropriate? Should any caregiver (e.g., day-care providers, teachers, and babysitters) be allowed to administer them, or should parents be the only ones to do so? What are the reasons for your answers?

Grounding

One other thing should be noted regarding the use of time-outs. Frequently, parents use grounding or sending children to their rooms to curb children’s behavior. Although superficially these techniques might resemble time-outs, they don’t seem to be very effective. Perhaps too many positive reinforcers are available in a child’s room. Often this form of time-out is administered long after the actual behavior occurs. The actual time of restriction is certainly longer than the recommended time period of a maximum of several minutes.

Ethical Questions 4.4

1. To what extent, if any, do you think grounding works? What were your experiences with grounding if you had any? What were the results? Would you consider grounding as a means of disciplining your own children? Why?

4-7 Examine Common Life Events That Affect Children

LO 8

Some basic aspects of family functioning have already been examined. These included a conceptualization of family systems and an examination of learning theory applied to parenting situations. Several other social aspects of childhood merit attention. Common events or situations involving the family that frequently affect the lives of children are discussed here. These include membership in sibling subsystems and gender-role socialization. Ethnic and cultural differences in families, the social aspects of play with peers, the influence of television, and the school environment are also examined. The incidence and dynamics of physical abuse, neglect, emotional maltreatment, and sexual abuse of children are explored. Finally, the treatment of child abuse and neglect is explained.

4-7aMembership in Family Systems

1. What type of parenting style do you think is best, and why? What style did your parents use? To what extent was it effective, and why?

One potential problem with the conclusion that an authoritative style is best is that it may not clearly reflect the values and effective child-rearing practices evident in other cultures.   addresses the importance of cultural context in the assessment of the effectiveness of parenting style.   explores ethnic and cultural differences in families.

Spotlight on Diversity 4.2

Cultural Context and Parenting Style

Various ethnic groups have markedly different parenting styles that don’t fit neatly into the permissive/authoritarian/authoritative classification system. Specific variations involve how parents perceive and demonstrate caring and control. For example, Chinese American parents are generally viewed as more demanding concerning control of their children’s behavior (Berk 2012a; Papalia & Martorell, 2015). For one thing, “most Chinese parents strictly control their children’s aggressive behavior” and demand “that their children display no aggressive behavior under any circumstances” (Ou & McAdoo, 1999, p. 255). The Baumrind system emphasizes control as characterizing an authoritarian parenting style. However, this approach suggests a somewhat different intent and purpose than that of the Western authoritarian parenting style. “High control [in Chinese culture] reflects the Confucian belief in strict discipline, respect for elders, and socially desirable behavior, taught by deeply involved parents” (Berk, 2013, p. 582). Chinese tradition emphasizes that a “child, no matter how old, should remain emotionally and financially attached to the parents,” and there are “strong indications of a lack of independence training in child rearing” (Lin & Liu, 1999, p. 238). The Chinese view control of children as a means to teach “obedience and cooperation,” the “values most emphasized.” … “Frequent receiving and giving of help between generations is seen by Chinese as an indication of family solidarity. Most children are expected to turn their earnings over to their parents to be used for general family needs” (p. 238).

So what Western eyes might view as an authoritarian trait is really a demonstration of warmth, support, and caring from the Chinese perspective. These latter values more closely characterize authoritative parents in Baumrind’s classification system, but without stressing the American values of rugged individualism and free choice (Papalia & Martorell, 2015) Berk (2013) reflects:

In Hispanic, Asian Pacific Island families, and Caribbean families of African and East Indian origin, firm insistence on respect for parental authority is paired with high parental warmth—a combination suited to promoting competence and strong feelings of family loyalty (Harrison, Wilson, Pine, Chan, & Buriel, 1994; Roopnarine & Evans, 2007). In one study, Mexican-American mothers living in poverty who adhered strongly to their cultural traditions tended to combine warmth with strict, even somewhat harsh, control—a style that served a protective function, in that it was associated with reduced child and adolescent conduct problems (Hill, Bush, & Roosa, 2003). Although at one time viewed as coercive, contemporary Hispanic fathers typically spend much time with their children and are warm and sensitive (Garcia Coll & Pachter, 2002; Jambunathan, Burts, & Pierce, 2000). In Caribbean families that have immigrated to the United States, fathers’ authoritativeness—but not mothers’—predicted preschoolers’ literacy and math skills, probably because Caribbean fathers take a larger role in guiding their children’s academic progress (Roopnarine, Krishnakumar, Metindogan, & Evans, 2006).” (p. 582)

African American mothers also tend to require immediate and rigorous compliance with their directions (Berk, 2012a). Their approach, however, combines caring and affection with strict discipline and rarely involves physical punishment. This no-nonsense tactic is viewed as a means of helping children regulate their behavior and keep themselves safe even when in a treacherous environment; children view such parental control as a means of caring for their welfare (Brody & Flor, 1998).

In summary, it is important to recognize the cultural context of child rearing, parental expectations, and social responsibilities before stating unilaterally that one parenting style is “best.” Learning from clients about their culture and cultural expectations concerning parenting style is a career-long process.

Spotlight on Diversity 4.3

Recognize Ethnic and Cultural Differences in Families: Empowerment through Appreciation of Strengths

LO 9

The father’s role in the family, the availability and nature of support systems, and perspectives on disciplining children vary greatly among cultures (Santrock, 2016). Despite these variations, research on 186 cultures throughout the world revealed a pattern of successful parenting (Santrock, 2008; Whiting & Edwards, 1988). The variables that emerged are  consistency in the form of supportive control and genuine caring for children.

When assessing the dynamics of families from various cultures, three factors are important. First, cultural variations involving expectations and values reflect each culture. Second, people of different cultures living in the United States and Canada experience varying degrees of assimilation into the majority culture simply by living there. Third, people not of European origin frequently experience discrimination and oppression because of their differences.

Two other perspectives are helpful when thinking about multicultural diversity in families: cultural pluralism and internal variations or subgroups within a culture. In conceptualizing a multicultural nation, it is helpful to think in terms of  cultural pluralism instead of a melting pot. A melting pot implies that all people blend together into one uniform whole. Cheese fondue comes to mind, where the cheese and other ingredients blend together in one bubbling mass. This is not really the case with a multicultural society. Rather, people from different cultures come together, and each cultural group retains its own rich spirit and customs. This is cultural pluralism. One of those huge lollipops made up of multicolored swirls comes to mind. It is one mammoth piece of candy, yet it is made up of distinct swirls of brilliant blue, red, yellow, orange, pink, and green blending together to various degrees.

Hispanic nuclear and extended family members celebrate a child’s birthday.

Mark Burnett/Alamy Stock Photo

Still another perspective useful in understanding cultural diversity involves respecting and appreciating the differences within large groups. For example, among Native Americans, there are far more than 500 specific groups (Weaver, 2008).

Social workers should strive to learn from clients about their diverse cultures. To be effective, this is a career-long process. Here we discuss some of the values, beliefs, and perspectives assumed by three cultural groups in American society: Hispanics, Native Americans, and Asian Americans.

Hispanic Families

established that the terms Hispanic and Latino have generally been used to refer to people originating in countries where Spanish is spoken. However, we also noted that the terms in reality refer to people originating in a number of places. No one term is acceptable to all the groups of Spanish-speaking people.

The U.S. Census Bureau collects information by having people identify themselves as being Hispanic or not.

People who identify with the terms “Hispanic” or “Latino” are those who classify themselves in one of the specific Hispanic or Latino categories listed on the decennial census questionnaire and the various Census Bureau survey questionnaires-”Mexican, Mexican Am. Chicano” or “Puerto Rican” or “Cuban”-as well as those who indicate that they are “another Hispanic, Latino, or Spanish Origin”…Persons with other Hispanic origins (e.g., Salvadoran, Nicaraguan, Argentinean) were able to write in their specific origin group. The Census Bureau’s code list contains over 30 Hispanic or Latino Subgroups (2013).

According to the census, of those classifying themselves as Hispanic, 65.4 percent are of Mexican heritage, 8.9 percent Puerto Rican, 3.5 percent Cuban, and 16 percent Central or South American (U.S. Census Bureau, 2011). However, for any particular family, Goldenberg and Goldenberg (1998) caution: “Socioeconomic, regional, and demographic characteristics vary among Hispanic American groups, making cultural generalizations risky. Within groups, the counselor needs to be alert to the client’s generation level, acculturation level, languages spoken, educational background, socioeconomic status, rural or urban residence, adherence to cultural values, and religiosity/spirituality” (p. 307).

Keeping in mind that specific variations exist within the many subgroups, we will discuss some cultural themes important to Hispanic families in general. These include the significance of a common language, the importance of family relationships including extended family, and the traditional strictness of gender roles.

The first theme important in understanding the environment for children growing up in Hispanic families is the significance of a  common language (Delgado-Romero, Nevels, & Capielo, 2013; Furman, Negi, & Loya, 2010). Everyday communication among Hispanic people is frequently in English. Almost 60 percent of Latinos speak only English, or at least speak it fluently, and almost 80 percent speak Spanish fluently; the uniting symbolic importance of the Spanish language should not be disregarded (Longres & Aisenberg, 2008). So many cultural activities and aspects of pride are associated with Spanish. Consider the cultural events and holidays (e.g., Cinco de Mayo for Mexican Americans, which celebrates the glorious day a small Mexican army defeated a French army battalion). Other cultural aspects may be celebrated and promoted, such as community murals reflecting important aspects of culture, art, or history, and traditional foods associated with a Hispanic heritage (Delgado, 2007).

A second theme involves the importance of both nuclear and extended  family relationships (Diller, 2015; Longres & Aisenberg, 2008; Magana & Ybarra, 2010). Hispanic people generally place great value on maintaining the original two-parent family and its intensive involvement with the extended family. Commitment to the extended family group and upholding responsibilities to family members are emphasized. Note, however, that these family ideals are not always realized when families face the harsh realities of poverty, unemployment, and immigration difficulties (Longres & Aisenberg, 2008).

It is also important to be aware of the community support systems often available to Hispanic families. These include botanicas, bodegas, clubs sociales, canto familial, compadrazo, and faith healers. “ Botanicas are shops that sell herbs as well as records and novels in Spanish.  Bodegas are grocery stores, but they also serve as information centers for the Hispanic community, providing such information as where folk healers can be found. [Mexican, Puerto Rican, and Cuban Hispanic cultures espouse folk healers who help people deal with physical, emotional, and spiritual difficulties.]  Club sociales provide recreation as well as links to community resources, including employment and housing.” There also are “special friends who furnish reciprocal support called  como familial” and “the ritual kinship of  compadrazo” people who “participate in baptisms, first communions, confirmations, and marriages, and often serve as parent substitutes” (Chilman, 1993, p. 160).

A third theme often characterizing Hispanic families is the traditional  strict division of gender roles (Delgado-Romero et al., 2013; Dhooper & Moore, 2001; Sanchez & Jones, 2010; Weaver, 2005). Weaver (2005) reports that historically there have been “clear and distinct expectations for men and women. Men are expected to be strong, and women are expected to be submissive to male authority” (Weaver, 2005, pp. 145–146). However, Santiago-Rivera, Arredondo, and Gallardo-Cooper (2002) caution that “considerable debate” exists

over the extent to which Latinos adhere to traditional gender roles in contemporary U.S. society. Although evidence suggests that gender roles are undergoing transformation, the complexities surrounding this phenomenon are far from clear-cut … When examining gender role-based behaviors among Latinos, one must consider a variety of influencing factors such as socioeconomic indicators (e.g., level of education, income), place of residency, migration experience, language, and family composition. These determinants significantly influence gender roles. (p. 51)

Many “Latinas now work outside the home and may wield decision-making power about family finances” (Weaver, 2005, p. 146). Additionally, “more Latinas are heading households and as a result must take on roles that were traditionally dominated by men. As single heads of households, women are responsible for making major decisions about the welfare of their families and for providing for and nurturing their children” (Santiago-Rivera et al., 2002, p. 51). In summary, “it is important to understand evolving gender roles within Latino families” (Weaver, 2005, p. 146).

Native American Families

We have stressed that there are hundreds of Native American groups with hundreds of languages and dialects. Sensitivity to differences among tribes and appreciation of these differences are vital to effective social work practice. However, as with Hispanic people, several themes characterize many Native American groups. These include the importance of extended family, cooperation, mutual respect, harmony with nature, the concept of time, spirituality, and noninterference.

As with Hispanic people, family ties, including those with  extended family, are very important (Diller, 2015; Paniagua, 2005; Sue & Sue, 2008). Extended family members include parents, children, cousins, aunts, uncles, grandparents, and even other community members who are integrally involved with the family. Diller (2015) explains:

Although the specifics of power distribution, roles, and kinship definitions vary from tribe to tribe, the vast majority of Native Peoples live in an extended family system that is conceptually different from the Western notion of family. Some tribes are matrilineal, which means that property and status are passed down through the women of the tribe. When a Hopi man marries, for example, he moves in with his wife’s family, and it is the wife’s brothers, not the father, who have primary responsibility for educating the sons. Family lies define existence, and the very definition of being a Navaho or a Sioux resides not within the individual’s personality, but rather in the intricacies of family and tribal responsibilities. When strangers meet, they identify themselves, not by occupation or residence but by who their relatives are. Individual family members feel a close and binding connection with a broad network of relatives (often including some who are not related by blood) that can extend as far as second cousins. (p. 270)

A second concept in Native American culture involves the emphasis on  cooperation (Diller, 2015; Sue & Sue, 2008). The collective well-being of the family and tribe takes precedence over that of the individual (Paniagua, 2005). Weaver (2005) elaborates: “A sense of identity is rooted in group membership. Native people often refer to themselves as members of the Native community, regardless of their geographic location … Social cooperation is often valued over independent decision making. The wishes and plans of individuals must be balanced along with the needs of family and community members … This emphasis on the group leads to strong mutual support networks. The well-being of the group is paramount” (p. 90). Sue and Sue (2008) comment on how this emphasis on cooperation affects children: “Indian children tend to display sensitivity to the opinions and attitudes of their peers. They will actively avoid disagreements or contradictions. Most do not like to be singled out and made to perform in school unless the whole group would benefit” (p. 350).

A third theme that characterizes Native American culture is  mutual respect, as Weaver (2005) explains: “Respect is emphasized in all social interactions. There are appropriate ways to communicate respectfully with others, including limiting eye contact and not interrupting someone who is speaking. People are accorded respect for the different roles they fulfill within a community. Elders are respected for their knowledge and wisdom, children are respected as the future of Native Nations, and leaders are respected for their willingness to sacrifice their own needs on behalf of First Nations [Native American] communities” (p. 91).

A fourth concept important in Native American culture is that of  harmony with nature. Diller (2015) elaborates: “Native American cultures emphasize the interconnectedness and harmony of all living things and natural objects. This spiritual holism affirms the value and interdependence of all life forms. Nature is held in reverence, and Native people believe that it is their responsibility to live in harmony and safeguard the valuable resources we have been given” (p. 271).

A fifth theme of Native American life, related to harmony with nature, is the  concept of time (Bearse, 2008; Diller, 2015). Time is considered an aspect of nature. Time flows along with life and, therefore, should not control or dictate how you live. Hence, other aspects of life, including interactions with other people, become more important than getting somewhere on time. Sue and Sue (2008) further describe this orientation: “Indians are very much involved in the present rather than the future. Ideas of punctuality or planning for the future may be unimportant. Life is to be lived in the here and now” (p. 350).

A sixth theme of Native American values concerns the importance of  spirituality (Bearse, 2008; Sue & Sue, 2008). “The spirit, mind, and body are all interconnected. Illness is a disharmony between these elements” (Sue & Sue, 2008, p. 351). Spirituality, involving both tribal religion and Christianity, plays a critical role in the lives of many Native Americans. Although religious beliefs vary from one tribe to another, “religion is incorporated into their being from the time of conception, when many tribes perform rites and rituals to ensure the delivery of a healthy baby, to the death ceremonies, where great care is taken to promote the return or the person’s spirit to the life after this one” (Ho, 1987, p. 73).

A seventh important concept for Native Americans is  noninterference (Sue & Sue, 2008, p. 350). “It is considered inappropriate in Native American culture to intrude or interfere in the affairs of others. Boundaries and the natural order of things are to be respected … With regard to communication, a premium is placed on listening” (Diller, 2015, p. 270). It is generally considered better “to observe rather than react impulsively” (Sue & Sue, 2008, p. 350). Silence is often used as a means of conveying respect (Diller, 2015).

Asian American Families

People who are typically considered Asian Americans are composed of three basic groups that, in turn, consist of numerous subgroups. These are “Asian Americans (Japanese, Chinese, Filipinos, Asian Indians, and Koreans), Asian Pacific Islanders (Hawaiians, Samoans, and Guamanians), and Southeast Asian refugees (Vietnamese, Cambodians, and Laotians)” (Paniagua, 2005, p. 73). Obviously, there is great variation among these groups, even though they are clustered under the umbrella term Asian Americans. Here we discuss four themes that tend to characterize many Asian American families: the significance of family, interdependence, investment made in children, and patriarchal hierarchy.

Like Hispanic people and Native Americans, Asian Americans tend to consider the  family as the primary unit and individual family members as secondary in importance (Balgopal, 2008; Diller, 2015; Leong, Lee, & Chang, 2008). Phillips (1996) elaborates: “The welfare and the integrity of the family are of great importance. The individual is expected to submerge or to repress emotions, desires, behaviors, and individual goals to further the welfare of family and maintain its reputation. The individual is obligated to save face, so as to not bring shame onto the family. Therefore, there is incentive to keep problems within the family so that the family will not ‘lose face’” (p. 1).

A second theme, related to the significance of the family, is  interdependence (Balgopal, 2008; Diller, 2015; Leong et al., 2008; Sue, 2006). “Studies have found that for most Asian Americans, their immediate and extended family are important loci of identity formation, social learning, support, and role development” (Leong et al., 2008, p. 117). “Children are expected to strive for family goals and not to engage in behaviors that would bring dishonor to the family. Asian American parents tend to show little interest in the child’s viewpoint regarding family matters. Instead, the emphasis is on family harmony, adapting to the needs of others, and adherence to ‘correct’ values (Rothbaum, Morelli, Pott, & Liu-Constant, 2000). Asian American adolescents appear to retain the expectation to assist, support, and respect their family even when exposed to a society that emphasizes adolescent autonomy and independence (Fuligni et al., 1999)” (Sue & Sue, 2008, pp. 362–363). An expectation that children will care for elderly parents is also important (Balgopal, 2008; Green, 1999).

A third theme characterizing many Asian American families  involves hierarchical relationships (Balgopal, 2008; Sue, 2006; Sue & Sue, 2008). “Communication flows down from the parent to the child, who is expected to defer to the adults” (Sue & Sue, 2008, p. 363). Similarly, younger children are to defer to older children (Sue, 2006). Asian American families tend to have high expectations regarding children’s behavior and tend to impose stricter discipline when misbehavior occurs (Balgopal, 2008; Sue, 2006; Sue & Sue, 2008). “Problem behavior in children is thought to be due to a lack of discipline. However, differences in parenting style between Asian American groups have been found. Japanese and Filipino American families tend to have the most egalitarian relationships, while Korean, Chinese, and Southeast Asian Americans are more authoritarian (Blair & Qian, 1998)” (Sue & Sue, 2008, pp. 364–365).

A fourth theme involves  patriarchal hierarchy (Balgopal, 2000, 2008; Sandtra & Madathil, 2013; Sue, 2006; Sue & Sue, 2008). Traditional values designate that men and older family members have greater status than other family members. Diller (2011) explains: “Family and gender roles and expectations are highly structured. Fathers are the breadwinners, protectors, and ultimate authorities. Mothers oversee the home, bear and care for children, and are under the authority of their fathers, husbands, inlaws, and at times even sons. Male children are highly prized … Older daughters are expected to play a caretaking function with younger siblings” (p. 274).

A Note on Difference

Our discussion concerning cultural themes of values and behaviors is general and brief. Actual practices may vary dramatically from one ethnic group to another and from one family to another. The point here is to enhance your sensitivity to and appreciation of potential cultural differences so that you may better understand and serve your clients.

A variety of other issues involving children and families will be discussed in  . These include single-parent families, families of divorce, blended families, mothers working outside the home, family communication, family interaction, and common problems facing families.

4-7bMembership in Sibling Subsystems

Siblings compose a child’s most intimate and immediate peer group. Brothers and sisters will affect the development and behavior of a child. Siblings learn how to play with each other. They act as models for each other. They also learn how to fight with each other.

The Coming of a New Baby

. A sociogram can be created to illustrate the results of each question asked. Our example plots out two questions. The first reflects students’ feelings about who they thought was the strongest leader in the group. The second illustrates which peer they most liked in the group.

Figure 4.4Sociograms of a Special Education Class

1. Is there too much violence on television? Should the amount of violence be monitored? Is so, who should be responsible for setting standards and scrutinizing content? Should children’s viewing of television be limited? If so, in what ways?

4-8dThe School Environment

School provides a major arena for socialization, where children are taught social customs, rules, and communication skills. Schools can influence children’s dreams and aspirations about future careers. Schools help to mold the ways in which children think. Specific issues related to the school environment will be discussed here. They include the teacher’s impact, the elements of an effective classroom, and the effects of social class and race.

The Teacher’s Impact

Students frequently perform at the level of their teachers’ expectations. This is sometimes referred to as a  self-fulfilling prophecy—that is, students will perform to the level of expectation placed upon them. Higher expectations, therefore, can result in greater achievement.

There is some indication that low achievers are even more responsive to higher teacher expectations than are higher achievers (Madom, Jussim, & Eccles, 1997; Martin & Fabes, 2009; Smith, Jussim, & Eccles, 1999). Teachers should avoid categorizing students as poor performers, but rather should encourage them to work to the best of their ability.

Martin and Fabes (2009) reflect on how teachers can also influence children’s social development (Pianta, 2006): “This influence can be quite positive, encouraging feelings of competence and well-being. For example, teachers have been found to enhance positive outcomes for students if they

· (1)

reduce the tendency of students to compare themselves with one another,

· (2)

use cooperative interaction strategies in the classroom,

· (3)

promote beliefs about students’ competencies rather than their deficiencies,

· (4)

increase chances for students to be successful, and

· (5)

are warm, encouraging, and supportive (Pianta & Stuhlman, 2004; Stipek, 1997)” (p. 437).

Effective School Environments

The school environment can be a warm, welcoming place that encourages learning and productivity. Or, it can be a scary, intimidating setting that discourages students from even being there. A substantial body of research has established that the following variables are related to an effective school environment (Rathus, 2014b; Shaffer & Kipp, 2010, pp. 624–625):

·

discusses how an educational program was developed to emphasize cultural strengths and meet the educational needs of Hawaiian students.

Spotlight on Diversity 4.4

Head Start and Cultural Responsiveness

Head Start is a program aimed at increasing the readiness to early childhood education and improves school readiness for low-income children. In 2014, Head Start programs served over 900,000 children, 29 percent who spoke a language other than English at home (Head Start, 2016). In 2007, the Improving Head Start for School Readiness Act was created to support children whose primary language was not English and who represent the diverse culture in the United States (National Center on Cultural and Linguistic Responsiveness, 2013).

Head Start has adopted 10 multicultural principles to ensure they were effectively meeting the needs of the different cultures among their community and workers. These 10 principles include the following: “1) Every individual is rooted in culture, 2) The cultural groups represented in the communities and families of each Head Start program are the primary sources for culturally relevant programming, 3) Culturally relevant and diverse programming requires learning accurate information about the cultures of different groups and disregarding stereotypes, 4) Addressing cultural relevance in making curriculum choices and adaptations is a necessary, developmentally appropriate practice, 5) Every individual has the right to maintain his or her own identify while acquiring the skills required to function in our diverse society, 6) Effective programs for children who speak languages other than English require continued development of the first language while the acquisition of English is facilitated, 7) Culturally relevant programming requires staff who both reflect and are responsive to the community and families served, 8) Multicultural programming for children enables children to develop an awareness of, respect for, and appreciation of individual and cultural differences, 9) Culturally relevant and diverse programming examines and challenges institutional and personal biases, and 10) Culturally relevant and diverse programming and practices are incorporated in all systems and services and are beneficial to all adults and children” (Head Start, 2016). These principles have a strong focus on working with the family and communities to ensure children’s needs are met.

According to data, Head Start does appear to be working (National Head Start Association, 2016). Aikens, Kopack Kleing, Tarullo, and West (2013) found that children in Head Start make progress towards norms in language, literacy, and math during the program year; and also show gains in social-emotional development as a result of participating in Head Start at both 3 and 4 years of age. In another study, it was found that parents were more likely to enroll their child for a second year of Head Start if the program was supportive of their culture and that Dual Language Learners and Black children benefited more than other groups from Head Start (U.S. Department of Health and Human Services, 2010). Early education programs using utilizing multicultural principles may help children of diverse backgrounds be ready for school.

Ongoing research is needed to establish what is really happening in school environments. Perhaps greater resources are necessary to update materials and enhance the multicultural learning atmosphere. Other targets of change may include teacher attitudes and skills. Teachers may require special training to meet the special needs of people from various cultural backgrounds.

Ethical Question 4.7

1. What elements in the classroom environment do you believe are most effective, and why?

Race, Ethnicity, and Schools

raises some questions about what is considered discipline versus what constitutes abuse.

Angry outbursts and loss of emotional control on the part of parents can result in child abuse.

BananaStock/jupiter images

Crosson-Tower (2013) reflects on some of the issues concerning the cultural context of abuse versus parental discipline:

Some cultures have customs or practices that child protection [agencies] would consider abusive. For example, some Vietnamese families, in a ritual called cao gio, rub their children with a coin heated to the point that it leaves burn marks. It is an intentional act, but designed, in that culture, to cure a variety of ills. Do the parents’ good intentions exempt this practice from being considered abusive? Similarly, the use of corporal punishment is sanctioned in many Hispanic cultures, but is seen as abusive in this culture when it becomes excessive. Some child protection advocates adopt the “When in Rome do as the Romans do” attitude that says that minorities must abide by the laws of the culture in which they now reside. One Puerto Rican social worker, working in a predominantly Hispanic section of New York City, vehemently disagreed: “Yes, there are laws, but those laws were made by Anglos. Is it fair to deprive new immigrants of everything including their customs? Maybe the laws should be changed?” The reality is that if a child is reported as being harmed for whatever reason, a child protection agency will usually investigate. If the reason is one of culture, this will be considered. (p. 180)

Social workers should orient themselves to learning from their clients about clients’ cultures. This is a career-long process, as the extent of variations in values and customs is infinite.

Characteristics of Physically Abused Victims

Both physical indicators and behavioral indicators provide clues that a child is being physically abused. Physical indicators can be broken down into six basic categories.

1. Bruises. Bruises on any infant should be suspect. Infants are not yet mobile. Therefore, it’s not likely that they can bruise themselves. Bruises in unusual places or forming unusual patterns may indicate physical abuse. Bruises that take a recognizable shape such as a hand mark or a belt mark should be noted. Finally, bruises that display a variety of colors may portray abuse. This may be an indication that a series of bruises have been received over time. On lighter-skinned people, bruises usually progress from an initial bright red to blue to blackish-purple within the first day; they become shaded with a dark green color after about 6 days and finally turn pale green or yellow after 5 to 10 days.

2. Lacerations. Cuts, scrapes, or scratches, especially if they occur frequently or their origin is poorly explained, may indicate physical abuse. Lacerations on the face and genitalia should be noted. Bite marks also may indicate abuse.

3. Fractures. Bone fractures and other skeletal injuries may indicate abuse. Strangely twisted fractures and multiple fractures are especially telltale signs. Infants’ fractures may be the result of abuse. Additional indicators are joint dislocations and injuries in which the periosteum, the thin membrane covering the bone, is detached.

4. Burns. Burns, especially ones that take odd forms or are in patterns, may indicate abuse. Children have been burned by cigarettes and ropes (from being tied up and confined). Burns that occur on inaccessible portions of the body such as the stomach, genitals, or soles of the feet are clues to abuse. Patterned burns may indicate that the child has been burned with some hot utensil. Sac-like burns result when a hand or foot has been submerged into a hot liquid. A doughnut-shaped burn will occur on the buttocks if a child has been immersed in very hot water. The central unburned area results from where the child’s skin touched the bottom of the receptacle holding the water.

5. Head injuries. Head injuries that can indicate abuse include skull fractures, loss of hair due to vigorous pulling, and subdural hematomas (blood collected beneath the outer covering of the brain after strenuous shaking or hitting). Black eyes should be suspect. Retinas may detach or hemorrhage if a child is shaken vigorously.

6.

1. Do parents have the right to spank their children? When does discipline become abuse?

Characteristics of Abusers

The dynamics behind child physical abuse are complex and varied. However, the general characteristics of it tend to fall within six major domains (Crosson-Tower, 2013, 2014; Kolko, 2002; Miller-Perrin & Perrin, 2013; Runyon & Urquiza, 2011). Although no one person may have all the problems mentioned, a person will likely experience some.

Need for Personal Support and Nurturance

A basic quality characterizing abusers is low self-esteem. Their emotional needs often remain unfulfilled from their own childhoods. Because their own needs were not met, they are unable to meet the needs of their children. They often invite rejection and hostility because they have little confidence in their own abilities. They don’t know how to reach out for support. On the one hand, they often feel they are undeserving. On the other hand, they still have desperate needs for human support.

Social Isolation

Perpetrators’ own self-confidence may be low. They feel that no one will like them, so they isolate themselves. They reject attention, even though they need others for emotional support. They fear rejection, so they don’t try to reach out to others. As a result, when normal everyday stresses build up, they have no one to help them cope.

Communication and Relationship Difficulties

Relationships that abusers do have with family, a significant other, and others are often stormy. Communication may be difficult, hostile, and ineffective. Low self-esteem can also affect the relationship with a partner or a significant other. Abusers may not know how to get their needs met. They may allow their disappointments and anger to build up because they don’t know how to express these feelings more appropriately to others. They may feel isolated and alone even within a marriage or partnership. Children may become easy targets for parents who can’t communicate with each other. Children may provide a conduit for the expression of violence and anger that are really directed at a spouse or a significant other.

Poor Parenting Skills

Many abusive people don’t know how to raise their children in a nurturant family environment. Their own family of origin’s environment may have been hostile and abusive. They may never have observed nurturant behavior on the part of their own parents and caregivers. They couldn’t learn what they weren’t taught.

Additionally, their expectations for what constitutes inappropriate behavior at the various development levels may be lacking. For instance, their demands on the child for behavioral submission and even perfection may be very inappropriate. Parenting behavior may be inconsistent, hostile, or lacking in positive interaction.

Poor General Coping Skills

Perpetrators may be unable to cope with stress, lashing out at their children instead. They may lack anger management skills. In addition to not knowing how to meet their own emotional needs, they may not have learned to separate their feelings and emotions from their behavior. Therefore, if they get mad, they don’t talk about it; they hit.

Another unlearned skill involves the appropriate delineation of responsibility. Perpetrators tend to blame others for their mistakes. For example, it’s the child’s fault that he got hit and broke his arm, because he was naughty.

They may also lack decision-making or problem-solving skills. Abusers tend to have little confidence in their own ability, and so have little faith in their own judgment. They have difficulty articulating and evaluating the pros and cons of their alternatives, and are indecisive.

) in which they trust parents and respond positively and consistently to their parents’ presence and interaction (Erickson & Egeland, 2011). Children may act “passive and withdrawn” with parents or the “parent exhibits low sensitivity to and involvement with [the] child” (Bamett et al., 2011, p. 96). Children may also display problems in peer relationships, including “deficits in prosocial behavior, social withdrawal, isolation, [and] few reciprocal friendships” (Barnett et al., 2011, p. 96).

11. “Cognitive and academic deficits” (Barnett et al., 2011, p. 96). Children may exhibit language deficits, poor academic achievement, low grades, deficits in intelligence, decreased creativity, and difficulties in problem solving (Barnett et al., 2011). One study found that neglected children tend to experience greater cognitive and academic problems than do physically abused children (Hildyard & Wolfe, 2002).

12. “Emotional and behavioral problems” (Barnett et al., 2011, p. 97). Neglected children may exhibit indifference, withdrawal and isolation, low self-esteem, behavioral and verbal aggression, difficulties in paying attention, and psychiatric symptoms such as those characterizing anxiety or depression (Barnett et al., 2011).

Two pronounced physical conditions that can result from extreme neglect are nonorganic failure-to-thrive syndrome and psychosocial dwarfism (Crosson-Tower, 2014).  Nonorganic failure-to-thrive syndrome (NFTT) occurs in infancy. It is characterized by infants who are “below the fifth percentile in weight and often in height” (Crosson-Tower, 2014, p. 70). This means that 95 percent of all other infants that age weigh more. Additionally, the infant must have had normal health at one time. Lags in psychomotor development are also apparent.

Psychosocial dwarfism (PSD) can affect children age 18 months to 16 years. In these children, “emotional deprivation promotes abnormally low growth. PSD children are also below the fifth percentile in weight and height, exhibit retarded skeletal maturation, and a variety of behavioral problems” (Crosson-Tower, 2014, p. 71). Additionally, they tend to have speech difficulties and problems in their social interactions.

Characteristics of Neglectful Parents

Crosson-Tower (2013) explains: “Parents who neglect were often neglected themselves as children. For them, it is a learned way of life. Their childhoods have produced in them nothing but anger and indifference. Their adult lives are dedicated to meeting the needs that were not met for them as they were growing up” (p. 186).

Mothers who neglect their children can be divided into five basic types (Crosson-Tower, 2013; Polansky, Chalmers, Buttenwieser, & Williams, 1991; Polansky, Holly, & Polansky, 1975):

1. The indifferent, lethargic mother is best described as numb. She has little or no emotional response and has little energy to do anything.

2. The impulsive, irresponsible mother treats her children inconsistently and often inattentively. She has poor impulse control and lacks coping strategies.

3. The depressed mother is reacting to life’s unhappy circumstances by giving up. Unlike the indifferent mother, she experiences extreme emotion by being depressed and miserable.

4. Mothers with intellectual disabilities neglect children because of their cognitive inabilities and a lack of the adequate support they need to help them assume their responsibilities. Note that not all women with intellectual disabilities neglect their children.

5. Mothers with serious mental illness, such as psychosis, are unable to function because of bizarre thought processes, delusions, or extreme anxiety.

Ethical Questions 4.9

1. Should parents who neglect their children be punished or receive treatment? How should this be accomplished?

4-9dPsychological Maltreatment

Psychological maltreatment is illustrated in the following case scenarios:

· A mother locks her 3-year-old son in a dark closet as a method of punishment.

·

for suggestions about how to talk and positively relate to victims of sexual abuse.

5. Inability of the survivor to cope. Some individuals have a personality structure that naturally allows them to cope more effectively with crises and stress. Human personality is a complicated concept.

Highlight 4.4

Suggestions for Talking to Children Victimized by Sexual Assault

· Always believe the child. It takes courage to talk about such difficult things, and it’s easy to turn the child off.

· Be warm and empathic. Encourage the child to talk freely to you. Reflecting the child’s feelings back is useful.

· Don’t react with shock or disgust no matter what the child tells you, that only communicates to the child that he or she is the one to blame.

· Encourage the child to share all feelings with you, including the negative ones. Even getting the angry feelings out helps the child overcome the feelings of victimization. Give the child the chance to ventilate his or her feelings so he or she can deal with them.

· Listen to the child, Don’t disagree or argue. Interrupt only when you have to in order to understand what the child is saying.

· Talk to the child in a private place. The child may feel much more comfortable if others aren’t around to hear.

· Tell the child that he or she is not the only child who has had this experience. Other children have, too.

· Allow the child to express feelings of guilt Emphasize to the child that it was not his or her fault. The adult abuser is the one who has a problem and needs help.

· Talk in language that the child can understand. Give accurate information when it’s needed. Let the child repeat things back to you to make certain he or she understands.

· Tell the child that you are very glad he or she told you about the incidents. Emphasize that it was the right thing to do.

· Ask if the child would like to ask you any questions, and be sure to answer them honestly.

· Do not treat the child any differently after he or she has told you. This only communicates that you think he or she is to blame or did the wrong thing.

· If the child asks you to keep the abuse secret, answer honestly. Tell the child that you only want to help, that secrets that hurt people aren’t good to keep, and that the secrets need to be brought out into the open in order to help the person who abused him or her.

· Finally, depending on your situation, don’t let the issue drop. If you are the social worker involved, pursue the problem. Otherwise, tell the parents and/or the appropriate authorities so that the child can get help.

Treatment of Children Who Have Been Sexually Abused: Social Work Role

identifies a number of components that can be used in cognitive-behavioral therapy.

Highlight 4.5

Use of Cognitive-Behavioral Techniques with Children Who Have Been Sexually Abused

Miller-Perrin and Perrin (2013) identify and describe the following components of cognitive-behavioral therapy that can be used to help children who have been sexually abused:

· Psychoeducation: Providing accurate information about the problem of sexual abuse and common reactions to this abuse. This component also includes teaching safety skills to help children feel empowered and to help them protect themselves from future victimization.

· Anxiety Reduction Techniques: Training and practice in various relaxation skills to reduce fear and anxiety.

· Affective Expression: Building various skills to help children express and manage their feelings effectively.

· Exposure Therapy: Gradual exposure to elements of the abuse experience in order to decondition negative emotional responses to memories of the abuse. This component involves verbal, written, and play activities to encourage children to share and process abuse-related experiences.

· Cognitive Therapy Techniques: Identifying negative attributions and distorted cognitions (e.g., irrational thinking and inaccurate perceptions) associated with the abuse and replacing them with more accurate thoughts and beliefs.

· Parenting Skills: Training parents in various management techniques to help them become more effective parents. (Rational therapy, a cognitive therapy approach, is described in depth in Chapter 8.) (p. 138)

A fourth treatment goal involves enhancing family communication, support, functioning, and understanding of the abuse (Crosson-Tower, 2014). Individual concerns are dealt with in addition to family interaction issues. Miller-Perrin and Perrin (2013) explain:

Typical themes addressed in family-oriented therapies include parents’ failure to protect the victim from abuse, feelings of guilt and depression resulting from the abuse, the inappropriateness of secrecy, the victims anger toward parents, the perpetrator’s responsibility for the abuse, appropriate forms of touch, confusion about blurred role boundaries, poor communication patterns, and the effect the abuse has had on the child. (p. 142)

Trauma-Informed Care

Approximately 35 million children ages 0–17 have faced one or more types of trauma (National Survey of Children’s Health, 2011/2012). Children may face trauma in their own lives (e.g., maltreatment, domestic violence, poverty, separation from parents) or may face trauma through the witnessing of violence, war, or natural disasters. Children are more vulnerable than adults to psychological harm from these events (Papalia & Martorell, 2015). Children’s responses vary depending on their age and the nature and severity of exposure (Papalia & Martorell, 2015; Santrock, 2016).

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