Birth Complications...

After birth there are many complications that may arise, some life threatening to the newborn. One such illness is jaundice, which affects 60% of newborns (Gross, 2008). Jaundice is a symptom of the liver not fully being able to break down red blood cells thus causing yellowing of the eyes and skin (Gross, 2008). Physiological jaundice, as this is named, occurs more often in preterm and breastfed babies and lasts only about ten days (Gross, 2008). Pathological jaundice, however, is much more serious and occurs within twenty four hours after birth (Gross, 2008). This type of jaundice can lead to brain dame or death if left untreated (Gross, 2008). Typically mild cases of jaundice do not require treatment, but for the more severe, phototherapy with ultraviolet light is utilized (Gross, 2008).

Cerebral palsy is also a disorder which may present itself after birth. Cerebral Palsy is brain damage that occurs before, during, or immediately after the birth process and is recognized by decreased muscle tone, decreased coordination, speech and language impairments, etc. (Berk, 2008). Cerebral Palsy occurs in one in five hundred North American births and can rage in severity from mild to serious (Berk, 2008). Ten percent of all cases of cerebral palsy are the result of anoxia (Berk, 2008). After the initial anoxia, cell death can continue to occur even hours later, known as the secondary damage (Berk, 2008) There are several contributors of anoxia such as the separation of the placenta occurring too soon, or placenta abrutio (Berk, 2008). This condition is often related to teratogens being exposed during the prenatal period such as tobacco, alcohol, drugs, etc (Berk, 2008). Placenta Previa is another cause in which the blastocyte is attached so low in the uterus that it actually covers the cervical opening, thus when the cervix dilates; the placenta detaches too early (Berk, 2008). The baby may also fail to breathe after birth due to prenatal injury or impairment to respiratory system during development (Berk, 2008). Etiology of Cerebral Palsy aside, this is most often a condition the parent is not prepared for or expecting upon birth, and may not be detected immediately.

Valerie Poling

References:

Berk, L. E. (2008). Foundations of Development. In L. E. Berk, Infants, Children and Adolescents (pp. 129-145). Allyn and Bacon.
Gross, D. (2008). Physical Growth Health and Nutrition. In D. Gross, Infancy: Development from Birth to Age 3 (pp. 156-160). Pearson Education, Inc: Allyn and Bacon.

Self concept - Is it as Fragile as I have heard? How to build and develop self esteem?

Self concept is the focus of Erickson’s stage of development referred Industry versus Inferiority (Berk, 2008). This stage of development is often referred to as Latency (Harder, 2009). In this stage of development, children gain feelings of competence as they learn and acquire new skills, overcome new obstacles, and take on new challenges (Berk, 2008). Children become capable of new skills and the knowledge base then increases furthering industry (Harder, 2009). Feelings of inferiority emerge when these new challenges are not met and when the child begins to see inadequacies with themselves as they compare to peers (Berk, 2008). Feelings of inferiority are directly related to perceived inadequacies as they view their peer’s abilities (Harder, 2009). Also during this period, social comparisons begin to emerge where the child notices physical attributes and compares to their peers, examines their abilities and perceptions of how others view them (Berk, 2008). These comparisons reflect several peers, not just one, as is noted in earlier stages of development (Berk, 2008).

During middle childhood the ability to change behavior and establish the connection of specific characteristics to desired behaviors is developed (Berk, 2008). This allows children to perceive characteristics as positive and welcomed by peers, thus assuming the behaviors attributed to these characteristics are the behaviors to strive for (Berk, 2008). Self concept, therefore, is the result of cognitive abilities and the feedback from peers (Berk, 2008). The formula can be explained as the perception of what the child perceives peers to think about the child minus the view the child has of themselves equals the self concept.

Self Esteem is defined as feelings of self worth due to success in a specific domain that children self evaluate (Berk, 2008). Children evaluate at least four common areas that include academics, social competencies, physical abilities, and physical appearance (Berk, 2008). Physical attributes are considered the greatest influence of self worth for a child during this stage of development (Berk, 2008).

Self esteem, as well as, self concept can be influenced by a variety of external factors. Culture impacts self esteem based on the traditional child rearing methods. Some cultures praise achievements while others promote humble acceptance of one’s abilities (Berk, 2008). Some cultures promote social comparisons through activities, competition, etc. (Berk, 2008). Some cultures, however, focus on family rather than social activities (Berk, 2008). Gender bias is also an influential factor in the parental expectations placed on the child may promote or deter a skill or desired activity (Berk, 2008). The family structures, especially extended family units that provide supportive environments for child development, are influential on positive self esteem (Berk, 2008). The neighborhood or community plays a critical factor in the development of self concept and worth. Some research indicates that the relationships with school and community are far more significant than parental relationships at this stage of development (Harder, 2009). Thus the characteristics viewed by these local influences have the capability of altering self concept during these developmental years. In positive, supportive communities, this value system can improve the child’s perception of self. However, in areas of high crime, gang activity, etc. it may negatively influence a child’s behavior in an attempt for the child to be perceived positively by his peers.

Valerie Poling

References:
Berk, L. (2008). Infants, Children and Adolescents. Boston: Pearson.
Harder, A. (2009). The Developmental Stages of Erik Erikson. Retrieved 03 02, 2010, from The Learning Place Online. com: http://www.learningplaceonline.com/stages/organize/Erikson.htm
Huitt, W. (2009). Self Concept and Self Esteem. Retrieved 03 02, 2010, from Educational Psychology Interactive: Self concept and self esteem: http://www.edpsycinteractive.org/topics/regsys/self.html


Ok, so how exactly are you going to build self concept for your child? This is the real question, right?

Well, I have put some thought into it and came up with a few ideas, but I would love to hear yours...


Building Self Concept:

1. Encourage your child to try new things- whether it be a sport, art, group, peer activity, take on a challenging new class, etc. And then use assistance, mentoring, and other sources to teach and model this to your child. This may be difficult- and you do not want to set your child up to fail, but there is no learning without trying... And you do not want your child to fear new things. So, if you are going to try soccer, and your child seems to not quite get the hang of it, you will need to intervene and assist. You can grab the coach and ask for some extra "training time", you can hit your local college and see if there is a student who would be willing to "tutor" your child in this area, do you know someone who has a child that excels or is good in this area? Set something up to get your child assistance so that when they do self comparison with other children, they feel that they measure up.

2. Praise and encouragement. Not excessively, but enough that your child knows you are proud and you are available if they struggle.

3. Do not be over stringent if they want to quit- it is not always a horrible thing to be a quitter. Why waste time if they truly are not going to get it? But, do wait long enough to give it a chance, and wait to hear from the mentors you have asked to help- do they think this skill is beyond your child's abilities? And if you do quit, try to replace it with something else just as meaningful.

Great choices for building self esteem are soccer, gymnastics, newspaper or editorial clubs, writing clubs, academic clubs like math league, musical instruments, theatre or drama, participation in a social organization that helps others, YMCA classes, swimming, etc. Match the activity to your child- don't put your child who is extremely overweight in gymnastics where they are going to be humiliated in tight clothing, or literally will not be able to do the tasks. Don't put your child who barely grasps simple addition into academic competitions for this area, and dont put your very shy and timid child in a position where they will have to perform in front of an audience the first time around- these will impair their self concept and self esteem for these areas.


Ideas? What are some great ways to build and ensure positive self esteem and self concept develop? What are some great activities that can assist with this? Personal stories?

Fun craft for you and the kids- teach recycling, too!

Plastic Bottle Birdfeeder | FaveCrafts.com

This is a great way to teach recycling and have fun with your kids! Fantastic project for the family, and then you have all spring to watch the birds come and go...

Any other green ideas out there?

Your Adolescent and drugs! How soon do we need to worry?

Substance abuse is a common concern for most parents during adolescence. By the end of high school it is estimated that seventeen percent of kids smoke cigarettes, twenty eight percent engage in heavy drinking of alcohol and forty percent use illegal drugs (Berk, 2008). These numbers appear high, but in actuality they are down from the last decade (Berk, 2008). The reason adolescents use drugs and alcohol is suspected to be due to a sensation seeking need (Berk, 2008). This attempt to experience sensation and experiment with drugs and alcohol is usually considered normal (Berk, 2008). However, abuse of these substances does occur and becomes a social problem for many youth.
The reason some adolescents try or experiment with substances and are able to walk away, while others become addicted or begin routine use is not a perfect cause and effect relationship. There are many theories as to the etiology of addiction. Abusers are different than the occasional experimenters (Berk, 2008). There are biological and environmental differences that likely influence the addiction process.
Abusers often show differences in early childhood years such as impulsive behavior, social and emotional dysfunction, disruptive and hostile behaviors, etc (Berk, 2008). As adolescents they maintain many of these personality traits and show decreased cognitive abilities, self regulation, and engage in anti social behaviors (Berk, 2008). By the first grade indicators for drug abuse can be correlated to temperament and behavior (Swan, 1995). These indicators include shyness, aggressiveness, rebellious behaviors, and gender (Swan, 1995). Although adolescents who abuse drugs and alcohol have decreased cognitive abilities, research indicates that first graders who score higher on Readiness for School tests have a higher correlation to drug use at adolescents (Swan, 1995). The genetic component of addiction should not be overlooked. Many predispositions exist for addictive behaviors and can be linked to parental abuse of drugs and alcohol (Berk, 2008).
The environment also plays a role in addiction. Lower socioeconomic status seems to link to the rates of addiction and abuse of alcohol and drugs (Berk, 2008). Family mental health issues, abuse, neglect, and exposure to authority figures abusing drugs and alcohol also increase the risk for the child to engage in addictive behaviors (Berk, 2008). Drug use by parents observed in the early childhood years is considered an indicatory of later abuse by the child (Swan, 1995).
Historically there has been a suspicion that the use of medication by parents to control children’s behavior in the early years may increase the risk for later drug abuse. As more parents attempt to treat children with stimulants and ADHD drugs, the theory was that the child will learn to self medicate in later life (Berk, 2008). A Longitudinal study of one hundred seventy six middle class Caucasian boys treated with ADHD stimulants, however, attempted to dispel this belief. The research cited by A Kaplan in the July 1, 2008 Psychiatric Times issue, found that boys who started treatment earlier than age six had decreased drug abuse than those who started treatment after age eight (Kaplan, 2008). Comparison group rates of drug use were similar to those of early treatment (Kaplan, 2008). Kaplan does not believe that treatment with ADHD medications is linked to the onset of addictive behavior, but does recognize that the diagnosis of ADHD may be associated with addiction (Kaplan, 2008). Kaplan further suggests nine indicators or predictors for addictive behavior in regards to the use of ADHD medication (Kaplan, 2008). Variables include the duration of treatment with medications, the age treatment began, the dosage, the severity of the diagnosis, the socioeconomic status of the family, and parental characteristics including psychopathology (Kaplan, 2008).
Although there are many indicators and factors that appear to increase the risk of drug abuse and addictive behavior for adolescents, the protective factors are available to prevent this unfortunate result. These protective factors include achievement in school, after school activities and close family connections (Swan, 1995). Family involvement is the greatest influential factor in middle childhood, but by adolescence, peer influence is much greater (Swan, 1995).

Valerie Poling

Child and Adolescent Development

References:

Berk, L. (2008). Physical Development in Adolescence. In L. Berk, Infants, Children and Adolescents (pp. 532-567). Boston: Pearson.
Kaplan, A. (2008). Risk of Substance Abuse Not increased by ADHD Drugs. Psychiatric Times , Vol8.
Swan, N. (1995, January). Early Childhood Behavior and Temperament Predict Later Substance Use. Retrieved March 6, 2010, from National Institiute on Drug Abuse: http://www.drugabuse.gov/NIDA_Notes/NNVol10N1/Earlychild.html



As a parent, my child is only 4, but whenever the opportunity arises, I am already preparing him to say "NO Way!" to drugs or alcohol. My husband thinks this is way too early to start, but in the social climate we live in today, is it really? I don't want him to be curious, I don't want him to try that initial "experiment"- but according to research the "experimental stage" is healthy and normal. What are your thoughts? How are you handling the issue of drugs with your children? Alcohol? I have heard parents say that if "my kid is going to drink I want them to do it at home where I can keep them safe", but do you really think they are going to ONLY drink at home? Do you think that will curb their interest? I personally feel that education of the risks and outcomes is the key... I would really love to hear from you on this...Feel free to comment, you can do so anonymously, too!

Should At Risk Children Be Removed From the Home?

The debate presented is should children who are at risk for abuse remain with their families? This is a difficult dilemma and does not allow for a universal position. Unfortunately, there are many factors which influence the predicament. For example, considerations must be given to whether the family is at risk for abuse, or if abuse has occurred. Also, the professional advocates must look at the developmental stage of the child in determining whether more harm is likely to come to the child, and if that harm is greater than that of removing the child from the home. Furthermore, the type of abuse must be examined to determine whether it is neglect, physical abuse, sexual abuse, or psychological abuse. The professional must further examine what the likely outcomes for the child will be. Will the child be placed in a foster care or institutional setting? Will reunification with the family be the likely plan or will permanency in an alternative setting be the hope for the child? Availability of the resources in the community must also be examined. Finally, the objective must remain clear that the child is the point of interest, not political agenda’s, parental bias, and racial or cultural discrimination.

The position this writer takes in the debate of child abuse and reunification with the family is that each specific case must be looked at individually by trained professionals with experience and knowledge in the area of child maltreatment and the outcomes. The influential indicators for each individual decision must include the chronological and developmental age of the child, the ability of the community and professionals to provide intense intervention, the occurrence or risk of the abuse, and the likelihood that the perpetrator of the abuse can alter their behavior. A family simply being “at risk” for child abuse is not enough to justify removal from their home, however, previous occurrences of abuse, neglect, or maltreatment to the child question or siblings does justify immediate action by the professionals, community, and advocacy agencies.

Certain premises have to be universally understood and accepted by advocacy agencies and society to promote and accept the interventions required to adequately address the cataclysm of child maltreatment. In 2006 the United Nations and World Health Organization recognized child abuse and neglect as a major public health issue (Giardino, 2008). Paolo Sergio PinheriroGiardino, 2008). Pinheriro further suggested that a child is dependent on adults completely; therefore more protection should be available, not less, as many private sectors suggest that the government is too interfering with personal family units (Giardino, 2008). As of 2006, in the United States, nine hundred five thousand children were maltreated with sixty three percent of these cases being substantiated neglect, sixteen percent were deemed physical abuse, eight percent classified as sexual abuse and six percent presented as psychological abuse (Giardino, 2008). Furthermore, according to the National Center on Child Abuse Prevention Research, in 2006 One thousand five hundred thirty children died as a result of abuse and neglect (Giardino, 2008). Seventy eight percent of these children were under the age of three (Giardino, 2008). These numbers would suggest that the national plan to address abuse and neglect is not working. Similar to the United Nations, the United States needs to address child maltreatment as a public health issue with funding for research and prevention, intervention, and adequate services to meet the needs of these children. Furthermore, the largest percentage of abuse is in the form of neglect and the largest mortality rate is with children under age three, therefore specific measures need to address and follow the family after the birth of a child to age three.

General understanding of the cycle of abuse is critical to prevention and intervention. Child maltreatment can be recognized in four specific forms, including physical abuse, sexual abuse, neglect and emotional abuse (Child Welfare Information Gateway). The impact of neglect may not be apparent in early stages, but as the child develops it impairs the health and physical development, intellectual development, emotional development and social or behavioral development (Child Welfare Information Gateway). The impact of maltreatment is also dependent upon the child age, presence of adults and services that provide protection or security, the frequency, duration and severity of the neglect, along with the relationship of the child to caregiver (Child Welfare Information Gateway). Early maltreatment impairs the ability of attachment for the child, which has longstanding adverse outcomes (Child Welfare Information Gateway). Furthermore, research finds the first few years of life are sensitive periods for cognitive growth as neural synapses are formed at a high rate (Child Welfare Information Gateway). Research has show that maltreated children have increased rates of cognitive deficits, language delays, and increased rate of later diagnosis of mental retardation (Child Welfare Information Gateway).

The outcomes for maltreated children are devastating and have the potential to be lifelong. A major component of emotional and psychosocial development is the ability to attach to a primary caregiver in the first year of life (Child Welfare Information Gateway). It is estimated that seventy to one hundred percent of maltreated infants form insecure attachments (Child Welfare Information Gateway). Attachment disorders result from attempts to attach by the infant that are met with unresponsive, painful interactions (Ziegler). The attachment dysfunction manifests as an adaption or coping mechanism of the child (Ziegler). Most of these adaptations occur pre-cognitively, therefore become ingrained in the child’s personality unconsciously (Ziegler). Typically, individual therapy, cognitive interventions, and insight can not overcome attachment problems as a form of treatment (Ziegler).

Disorganized attachments are highly correlated to maltreated children (Berk, 2008). These children show contradictory behavior, flat affect, depression, etc. (Berk, 2008). This type of attachment is related to internalizing situations with fear, anxiety and other crisis emotions, and displaying externalized behaviors such as aggression (Berk, 2008). The situation may not be hopeless, however. The continuity of caregiving determines the extent to which the attachment may or may not impair later life (Berk, 2008). If negative caregiving persists, research indicates the likelihood of disorganized later behavior and developmental impairments (Berk, 2008). Research of infant subjects in a Romanian orphanage found that babies placed in a loving home after age four were still able to develop positive emotional relationships and bonds with the caregiver, thus it appears attachment can occur up to age six (Berk, 2008).

A fundamental acceptance of the impact of maltreatment can assist professionals in their pursuit of appropriate placement of the child. Depending upon the age of the child, the severity of the maltreatment, and the likelihood of successful intervention or continued parental offenses must all be taken into account. Foster care is not a permanent solution; rather it is a temporary service responding to a crisis situation (Barbell & Freundlich, 2001). The ultimate objective is to find a safe permanent placement in a safe loving environment (Barbell & Freundlich, 2001). The factors that increase the risk of abuse and neglect include poverty, homelessness, drug and alcohol abuse, and declining community and family support (Barbell & Freundlich, 2001). While the need for these services increases, the availability of these services to meet the needs declines (Barbell & Freundlich, 2001). Many opponents of the interference of state advocacy agencies claim that the foster care system is already overburdened and should not focus on intervention and only interfere with the most severe cases. This is true; the service agencies are stretched thin with little hopes of more funding coming soon. Between 1984 and 1995 foster care placement increased sixty five percent while the available foster parents dropped by four percent (Barbell & Freundlich, 2001). Several changes in policy have occurred in the past twenty years. One significant event is the Adoption Assistance and Child Welfare Act of 1980 which stated that reasonable effort to keep families together be promoted, but alternative permanency solutions need to be created quickly in situations where reunification would not be an option (Barbell & Freundlich, 2001). Again, the foster parent is not a replacement for permanency. The objectives for children where reunification is not possible include adoption and kinship placement (Barbell & Freundlich, 2001). Recently, guardianship has become a viable permanency option for children facing foster care (Barbell & Freundlich, 2001). In 2000, forty three percent of children in foster care were slated for reunification with family, and sixty percent actually returned home (Barbell & Freundlich, 2001).

When consideration is given to remove a child from the home, the actual resources and availability of a safe residential setting has to be considered. There are many placement options, including foster care, kinship care, adoption, and institutionalization. However, each individual case needs to be examined to determine if the harm at the current home setting is greater than the harm at the placement options. For example, if the only available placement option for a 3month old infant is institutionalization, but the form of maltreatment occurring at home is malnutrition, than obviously the risks for cognitive, social and emotional development from disrupted attachment in the institutional setting far outweigh the cost of immediate intervention in the home to teach the parent health and nutrition skills. Yet, if the malnutrition is simply an indicator of far worse neglect and abusive acts such as physical abuse, emotional detachment from the infant, severe emotional neglect, etc. than the temporary placement in an institutional setting may be appropriate with the hopes of obtaining an alternative setting in the near future, such as foster care or a placement with a relative.
In theory, maltreatment in any form is unacceptable. However, reality concedes that there are not enough adequate alternative placements for children who suffer maltreatment. The ultimate goal has to consider whether the family situation is open and receptive to intervention, training, and learning a new form of parenting and caregiver response. If this is possible, than intervention is the choice. If the family dysfunction is so great that the likelihood the abuse will continue or present again in the future, than alternative placement must be sought.

The key to the crisis of child maltreatment must focus on prevention. Strategies need to not only recognize the factors that increase the likelihood of maltreatment, but have the resources to support the at risk family during the sensitive periods of child development. Recognition fact that reoccurrence is high with many forms of maltreatment, especially those that are psychologically derived such as sexual abuse, should indicate an immediate and required intervention for specific at risk populations. In these specific situations, reunification should never be an option. The focus must remain on the child and the child’s ability and potential for healthy development when services are required to intervene. Sensitivity and trust are likely absent in these children’s working models of the world around them, so it is the community and agency’s responsibility to introduce these concepts. Once intervention has concluded, follow up services must be continued along with supports within the immediate environment to ensure a safe haven for the child’s development.

A 2006 report to the United Nations in which he proclaimed that no violence against children can be justified, yet all violence against children is preventable. In conclusion, the debate over removing children at high risk for maltreatment must be individualized to the unique situation of the family and the child. The developmental and chronological age must guide the appropriate interventions with special attention given to the critical formation of healthy attachments. Removal of a child should not be an automatic response, but if the child is in a life threatening situation, victim of sexual or physical abuse, immediate action must be taken. Simultaneously, the risk factors associated with the likelihood of maltreatment must be addressed by the community and social services, with adequate funding and support to ensure that children have a safe haven. Finally, when children are removed, a thorough investigation of the allegations, as well as, a review of the current developmental abilities of the child should be reviewed to determine the impact of the maltreatment.











References:
Barbell, K., & Freundlich, M. (2001). Foster Care Today. Washington DC: Casey Family Program National Center for Resource Family Support.

Berk, L. (2008). Infants, Children and Adolescents. Boston: Pearson.

Child Welfare Information Gateway. (n.d.). Understanding the Causes of Neglect. Retrieved August 14, 2008, from Not Alone: http:www.enotalone.com/article/9889.html

Giardino, A. P. (2008). child maltreatment: Is the glass half full yet? Journal of Forensic Nursing , 1-3.

Ziegler, D. P. (n.d.). Understanding and treating attachment problems in children. Retrieved February 5, 2010, from Attachment Disorders: http://www.addictionrecov.org/paradigm/P_PR_F98/Attachment_Di...



Take a minute and share your thoughts or your story with us... Should a child be removed if they are at risk? What severity of abuse or neglect requires a child be removed? Thoughts, ideas, etc....