Children and Adolescents
John Sargent, MD
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• Learning Objectives:• 1) Understand the process and context of
the development of children• 2) Learn the process of adolescent
development through early, middle and late adolescence
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Development in Infancy
A.) Dependent upon health and capacities including motor skills, sensory abilities
B.) Dependent upon availability of attuned, available, caring adults
C.) Consistency of adult involvement is most important
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Importance of learning to communicate and to obtain consistent reinforcement of communicating wants and needs
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Importance of parental affiliation – parental caring for child as he or she is
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Early motor development enhances relating capacity and mobility – rolling over, sitting, crawling, walking, climbing, running
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Motor development both builds autonomy and the capacity for exploration but also increases the need for social interaction, supervision and limit setting
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Language development begins before age 1 with babbling, proceeds to single words, putting words together by age 2 and greater vocabulary and complexity of syntax through age 5
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Language development furthers modulation of emotions and impulses – through prefrontal cortical modulation of arousal
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Language development also furthers preoperational, egocentric thinking and capacity for solitary and peer play
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Preschool programs require capacity for nurturance, adult availability, physical play, routines, rest, use of language
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Importance of alternatives to language for developmentally delayed, deaf and autistic children
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School aged children engage increasingly in group experiences (teams, classes and clubs)
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Through progression to concrete reasoning school aged children require consistency, challenge and reinforcement and clear support for and standards for success
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Differences in cultural background, size, gender and skills become increasingly more important leading to in groups and out groups
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Specific vulnerabilities in preschool children include parental loss, parental neglect and domestic violence
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Specific vulnerabilities among school aged children include ADHD, learning disabilities and conflictual parental relationship
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Adolescence is the journey between childhood and adulthood
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PhysiologicCognitiveEmotionalBehavioral
change occurs, often asynchronously
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Goals of Adolescence
1.) Learn skills necessary to be prepared for occupational and relationship competency in adulthood
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Goals of Adolescence, cont.2.) Gain the capacities for self-direction and
decision making
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Goals of Adolescence, cont.3.) Have memorable and meaningful
experiences that represent contributions and lead to belonging
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Goals of Adolescence, cont.4.) Avoid problems that have long-term
consequences and a life of their own
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Goals of Adolescence, cont.5.) Build the capacity for autonomy upon a
foundation of connections and a set of personal values
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Some challenges which can persist into adulthood that frequently have inception in adolescence include:A.) eating disordersB.) substance abuseC.) incarceration and persistent
unlawful behavior
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Some challenges…, cont.
D.) handicap following injury/accidentE.) school failure/dropoutF.) HIVG.) teen pregnancy(ies)
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Frequently these risk factors occur together and have
exponential effects
Some challenges…, cont.
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Family and community factors can exacerbate riskA.) Parental substance abuse,
psychopathology, or criminalityB.) Conflictual parental relationship
or post-divorce conflictC.) Parental job loss or movingD.) Poverty
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Family and community factors…, cont.
E.) Poor schoolsF.) Community violence/school bullyingG.) Exposure to gangs and antisocial peers
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H.) Lack of access to resources and adult role models
I.) Lack of opportunity to develop and refine unique skills
J.) Inadequate or poor informationK.) A rejecting or unsupportive
community
Family and community factors…, cont.
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Role of cultural and ethnic/racial differenceA.) Differing views about American
cultureB.) Pressure to maintain culture of
originC.) Confusion about being true to
one’s own cultureD.) Defining a unique cultural
adaptation
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Sexual Orientation Issues
A.) Concerns about being differentB.) Family responsesC.) Peer acceptance and support
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Sources of resiliency among adolescentsA.) Adult/parental supportB.) IntelligenceC.) AttractivenessD.) Even/easy personalityE.) A unique talent or ability
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Other sources of resiliencyA.) Positive framing of contribution
and circumstances by othersB.) Experience of competent
problem-solvingC.) Experience of regard and an
expectation of honesty and integrity
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Course of Development
A.) Generally successful: 60% continuous growth
B.) Staggered but progressive growth: 20%
C.) Challenged development: 20% of youth – at risk for varied poor outcomes
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Characteristics of successful growthA.) Decreasing age of onset of
puberty (earlier for girls)B.) Consistent age of brain
maturation with completion of frontal lobe maturation at age 25
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Characteristics of successful growth, cont.C.) Supervision and support
synchronous with and consistent with fluctuating skills
D.) Opportunities for negotiation, communication and exploration of concerns through language
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Challenges to successful developmentA.) Arbitrary and excessive efforts at
external controlB.) Lack of appreciation of
adolescent ambivalence
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Challenges to successful development, cont.C.) Fluctuation between absent
supervision and authoritarian control
D.) Parental helplessness and abandonment
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Community problems that impact youth developmentA.) Lack of after school or
extracurricular opportunitiesB.) Lack of work opportunities
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Community problems that impact youth development, cont.C.) Negative views about teenagersD.) Confusion between recognition of
physical maturity and awareness of slow psychosocial/emotion regulation development
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Characteristics of Positive Youth Development:
ConfidenceCompetence
CaringConnectionCharacter
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Youth who do well:
A.) Have a positive connection with their school
B.) Have positive relationships with youth who have a positive relationship with school
C.) Are engaged positively with adults who care about them
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Adolescence can be divided into 3 sectionsA.) Early – ages 11-14B.) Mid – ages 14-16C.) Late – ages 17-19
Many aspects of adolescence persist into 20’s
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Early Adolescence
A.) Focus upon physical changesB.) Developing interests which may
change rapidlyC.) Need adult supervisionD.) Need structure and monitored
expectations
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Early Adolescence, cont.
E.) Want greater privacyF.) More aware of emotional
experienceG.) Beginning to reflect on self and
experienceH.) Impulse control can be a
challenge
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Mid Adolescence
A.) More time with peersB.) Strong desire to belong, activities
based on belongingC.) Beginning partnering
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Mid Adolescence, cont.
D.) Abstract reasoning, problem solving used more frequently
E.) Wants and utilizes more independence in decision making
F.) Expects competence and expects to make contributions to social groups
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Late Adolescence
A.) Greater self-direction, self-monitoring
B.) Greater capacity for judgment and impulse control
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Late Adolescence, cont.
C.) More independent decision making
D.) More involvement in longer term relationships
E.) Parents/adults more in the role of advisor/ mentor
F.) More consistent values and beliefs