What does theories mean in child development? - Sage-Advices University of Utah, Department of Psychology, College of Social & Behavioral Science. The importance of engaged and attuned adults does not end in the newborn period. For children at higher risk for toxic stress responses, targeted secondary interventions with tiered services (eg, HealthySteps84,85) may be needed. Relational health, in the form of at least one SSNR, is a universal, biological imperative for children to fulfill their potential; to be healthy and resilient; to be successful academically, economically, and socially; and, perhaps most importantly, to be the caregivers that value and build SSNRs with subsequent generations. Both genetic and epigenetic factors interact with. Below we briefly discuss each of the five components, review relevant empirical support, and identify enduring questions. Rather, an integrated public health approach (see Fig 1) is needed to support all children, including those with delays in development and special health care needs.8082 The foundation for any public health approach is universal primary prevention. The biological theory asserts that most behaviors are inherited and shaped by adaptation to one's external environment. In addition to the domains and timing of chaos, ecobiodevelopmental theory argues that the intensity of environmental chaos is important- that adverse environmental experiences which are deep, prolonged, and extensive are more detrimental to children's health and well-being than unfavorable experiences that . Driving this transformation are advances in developmental sciences as they inform a deeper understanding of how early life experiences, both nurturing and adverse, are biologically embedded and influence outcomes in health, education, and economic stability across the life span. Acknowledge that a wide range of adversities, from discrete, threatening events to ongoing, chronic life conditions, share the potential to trigger toxic stress responses and inhibit the formation of SSNRs. To move forward (to proactively build healthy, resilient children), the pediatric community needs to embrace the concept of relational health.15 Relational health refers to the ability to form and maintain SSNRs, as these are potent antidotes for childhood adversity and toxic stress responses.57,113 Not only do SSNRs buffer adversity and turn potentially toxic stress responses into tolerable or positive responses, but they are also the primary vehicle for building the foundational resilience skills that allow children to cope with future adversity in an adaptive, healthy manner.16,17 These findings highlight the need for multigenerational approaches that support parents and adults as they, in turn, provide the SSNRs that all children need to flourish. The previous policy statement12 and technical report2 on childhood toxic stress noted the 10 adverse childhood experiences (ACEs) studied in the landmark ACEs Study that began in the 1990s: physical, emotional, or sexual abuse; physical or emotional neglect; problematic parental substance misuse; parental mental illness; parental separation or divorce; intimate partner violence; and an incarcerated house member.23 These adversities are associated with a wide array of negative outcomes in a dose-dependent manner, such that the higher the ACE score (1 point for each category experienced before the age of 18 years), the higher the risk for unhealthy behaviors such as tobacco, alcohol, and other substance use; risky sexual behaviors; and obesity.23,24 Dose-dependent relationships have also been found between ACE scores and several of the leading causes of adult morbidity and mortality,23,24 including cardiovascular disease,25 lung disease,26 liver disease,27 mental illness,28 and cancer.29, These well-established associations between ACEs and poor health outcomes decades later highlight the importance of understanding the biological mechanisms that allow adversity in childhood to get under the skin and to negatively impact life-course trajectories.3036 As discussed in the 2012 AAP technical report,2 toxic stress responses, in which the physiologic stress response to adversity is large, chronic, and unmitigated by social-emotional buffers, are one such mechanism. PDF The Life Long Effects of Early Childhood Adversity Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. Development of an Eco-Biodevelopmental Model of Emergent Literacy See the Appendix for full descriptions of the abbreviations. ACEs are common stressful traumatic experiences which affect children's neurodevelopment. Ecobiodevelopmental theory asserts that: (a)early experiences create the structure of the brain (b)genes are the dominant determinant of brain development (c)early interventions cannot overcome the power of poverty in brain development (d)improving early nutrition could break the cycle of poverty 4. Overview of Lecture - Part 1. Several researchers have noted that many other experiences in childhood are also associated with poor outcomes later in life, and these include being raised in poverty,41 left homeless,4244 exposed to neighborhood violence,4547 subjected to racism,4850 bullied,51,52 or punished harshly.53 This finding suggests that there is a wide spectrum of adversity that runs from discrete, threatening events (such as being abused, bullied, or exposed to disasters or other forms of violence) to ongoing, chronic life conditions (such as exposure to parental mental illness, racism, poverty, neglect, family separation or a placement in foster care, and environmental toxins or air pollution; unrelenting anxiety about a global pandemic, climate change, or deportation; or social rejection because of ones sexual orientation or gender identity). Relational health explains how SSNRs buffer adversity and promote the skills needed to be resilient in the future. Educate residents about the many different facets of a fractured early childhood system of care (eg, Medicaid, Individuals with Disabilities Education Act Parts C and B, Child Care and Development Block Grants, Head Start, etc), as there is little collaboration or communication between the systems, funders, and programs that address child health, out-of-home child care, education, special education, protective services, or public health. Solutions Manual for Lifespan Development Canadian 5th Edition by Boyd Emerging data supporting a biological sensitivity to context (see the Appendix for a glossary of terms, concepts, and abbreviations) begin to explain heterogeneous responses to both adversity and interventions at the population level.92,131136 Consequently, there is an urgent need for a battery of biological, behavioral, and contextual markers that might better stratify both the risks and predicted responsiveness to interventions at the individual level.37 FCPMHs (see the Appendix for a detailed description) are well placed to begin matching levels of need with specific types of interventions, a process known as vertical integration.82. Similarly, many of the risk factors for toxic stress responses that are the targets of secondary interventions are also potential barriers to the development of SSNRs that need to be identified and addressed (eg, child ACE scores, parent ACE scores, SDoHs, or even a strong biological sensitivity to context). Reciprocal experiences with engaged and attuned adults (like those that occur during developmentally appropriate play) that build SSNRs; they are warm, affirming, and inclusive, and they promote early relational health. Tertiary preventions in the toxic stress framework are focused on the evidence-based practices that treat toxic stress-related morbidities such as anxiety, depression, oppositional defiant disorder, posttraumatic stress disorder, and substance abuse disorder. 605 PDF Help Me Grow National Center. Repair strained or compromised relationships. Typically, restorative justice allows the victims and the offenders to mediate a restitution agreement that is satisfactory to both parties. Periods of Development 1. The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Advocate that health systems, payers, and policy makers at all levels of government align incentives and provide funding to promote the universal primary prevention work discussed in this policy statement. In the case of toxic stress responses, universal primary prevention means trying to prevent the precipitants of toxic stress responses (eg, advocating to address the spectrum of adversities discussed above) as well as promote healthy, adaptive responses to adversity through the provision of social supports that nurture the development of foundational resilience skills (such as task persistence, curiosity, and self-regulation).16,19,59,83, A public health approach to prevent childhood toxic stress is a public health approach to promote relational health. FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. The 3 principles described above, each of which is grounded in the research literature, provide a science-based framework for developing innovative strategies to promote SSNRs at the dyadic level, family level, and community level. Itasca, IL: American Academy of Pediatrics; 2018. Early exposure to environmental chaos and children's physical and They have been proven useful and effective in addressing mental health symptoms in pediatrics across the age spectrum (as per the AAP policy statement on mental health competencies in pediatric care). Empirical explorations of an evolutionary-developmental theory, Biological sensitivity to context: I. Essentials of Human Behavior | SAGE Publications Inc What is ecobiodevelopmental theory? The text will thoroughly support students' understanding of human behavior theories and research and their applications to social work engagement, assessment, intervention, and evaluation across all levels of practice. Changing community contexts will require healthy, trusting, and robust partnerships with a wide array of local community partners from multiple sectors (education, social services, and businesses), not only to facilitate family access to the requisite community interventions but also to coordinate effective advocacy campaigns to secure both those interventions and family-friendly public policies. Many studies show significant correlations between early neglect and later social, emotional and behavioural difficulties, Life Course Theory. Promote SSNRs by building 2-generational relational skills. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for . For example, positive relational experiences, such as engaged, responsive caregivers,59,6265 shared childrens book reading,6668 access to quality early childhood education,6971 and opportunities for developmentally appropriate play with others66,7274 are associated with positive impacts on learning, behavior, and health. Adapted with permission from Garner AS, Saul RA. Posted on June 1, 2022 by Toxic stress defines the problem. Integrated behavioral health services as part of the FCPMH team might be the next layer for parents who need additional assistance (eg, parental depression), and the need for more intensive skill building (eg, PCIT) for some parents becomes yet another focus for collaboration with key services within the community (eg, ABC, PCIT, CPP, and TF-CBT). A convergence of evidence from neurobiology and epidemiology, Insights into causal pathways for ischemic heart disease: adverse childhood experiences study, Adverse childhood experiences and chronic obstructive pulmonary disease in adults, Adverse childhood experiences and self-reported liver disease: new insights into the causal pathway, Adverse childhood experiences and prescribed psychotropic medications in adults, Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study, Putting the concept of biological embedding in historical perspective, How experience gets under the skin to create gradients in developmental health, Brain on stress: how the social environment gets under the skin, DNA Methylation: A Mechanism for Embedding Early Life Experiences in the Genome, Discrimination, racial bias, and telomere length in African-American men, Discrimination and telomere length among older adults in the United States, The link between discrimination and telomere length in African American adults, Capitalizing on advances in science to reduce the health consequences of early childhood adversity, Leveraging the biology of adversity to address the roots of disparities in health and development, Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention, Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper No. By focusing on the safe, stable, and nurturing relationships (SSNRs) that buffer adversity and build resilience, pediatric care is on the cusp of a paradigm shift that could reprioritize clinical activities, rewrite research agendas, and realign our collective advocacy. Module 3 Understanding & Using Theories - HDFS 501 - Studocu The capacity to respond to adversity in a healthy, adaptive manner; resilience is the manifestation of skills (eg, social skills, emotional regulation, language, and executive functions) that can be modeled, taught, learned, practiced, and reinforced. What Vulnerability Theory Is and Is Not - Emory University These perspectives offer different interpretations of the nature of society and the role of . 7. Learning Objective: Describe the structure and function of genes. Available at: https://psych.utah.edu/research/labs/biological-sensitivity.php. Early childhood experiences, both adverse and positive, appear to be biologically embedded and influence both disease and wellness across the life course.30 The ecobiodevelopmental model of disease and wellness explains how the ongoing but cumulative and reciprocal dance between ecology and biology leads to changes at the molecular (eg, methylation patterns), cellular (eg, brain connectivity patterns), and behavioral levels (eg, tobacco, alcohol, or other substance use).2,17 These changes are either adaptive or maladaptive depending on the context, and they are either benefits or risks to future health, academic success, and economic productivity.75. Research done by author Mary Eberstadt shows that the sexual revolution was a Pandora's Box, unleashing many of the ills . Provide or support positive parenting classes; participate in ROR, VIP, and other programs that support the dyad. The FCPMH alone cannot leverage significant change within the community context. The ecobiodevelopmental model suggests that, to improve the likelihood of positive developmental outcomes across the life span, efforts should be made to improve the salient features of the childs environment. Doing so will require all health professionals to address their implicit biases, develop cultural humility, and provide culturally competent recommendations. Embrace an ecobiodevelopmental model for understanding how both adverse and positive relational experiences in childhood become biologically embedded and impact both negative and positive outcomes across the life course. culturally effective: the family and child's culture, language, beliefs, and traditions are recognized, valued, and respected. Conversely, early supports that allow new mothers more opportunities to bond with, breastfeed, and simply stroke their children are associated with decreases in the methylation of the glucocorticoid receptor gene, perhaps allowing infants to downregulate their stress responses more effectively.78,79 This finding is one of the most significant predictions of the ecobiodevelopmental model: the biological mechanisms that underlie the embedding of significant childhood adversity may also underlie the embedding of positive relational experiences in childhood. 10.1542/peds.2021-052582. Foremost on the advocacy agenda will be the need for serious payment reforms that consider the complexity of care attributable to adverse family and community contexts and include financial supports that incentivize families to engage with an FCPMH.204 Payment reforms need to be sufficient to allow FCPMHs to spend more time with families, function as interdisciplinary teams, integrate into their communitys initiatives and services to support children and families (horizontal integration), and anchor medical neighborhoods that not only foster wellness in childhood but promote positive outcomes across the life span. FCPMHs are well-suited and even inclined to support the formation and maintenance of SSNRs as outlined in this policy statement, but they are not currently funded to do so.205. An integrated, biodevelopmental framework is offered to promote greater understanding of the antecedents and causal pathways that lead to disparities in health, learning, and behavior in order to inform the development of enhanced theories of change to drive innovation in policies and programs. asserts that complex forms of thinking have their origins in social interactions rather than in the child's private exploitations Children's learning of new cognitive skills is guided by an adult or a more skilled child who structures the child's learn ing experience - a process called scaffolding To create an appropriate scaffold, the parent must gain and keep the child's . Based on the EBD model, The Ecobiodevelopmental Theory model of toxic stress experiences provoke these memories, Shonkoff is associated directly to other theoretical which are essentially created by interactions models of human development. An important consideration across many harmed and exploited communities (such as American Indian or Alaska Native populations) is the accumulation of toxic stress responses across generations, sometimes referred to as historical trauma.60 Although higher levels of historical trauma are associated with poorer health outcomes, the science underlying these associations is only now being studied rigorously.61 A detailed discussion of historical trauma and the special needs of these communities is beyond the scope of this policy statement, but the layered, integrated public health approaches presented here to prevent childhood toxic stress and promote relational health might inform efforts to address historical trauma as well. Molecular biological processes play an essential role in human development. Domains, timing, and intensity of chaos were predictive of children's mental and physical health. The toxic stress and its impact on development in the Shonkoff's Communication could be further enhanced by cultural humility,164,165 implicit bias training,166171 a more diverse health care team (eg, providing families and patients the opportunity to seeing themselves reflected in the sex, ethnicity, and cultural backgrounds of the team members), and access to professional interpreters. The challenge, then, is not only to prevent adversity but also (for mothers, fathers, and other engaged adults) to actively promote positive relational experiences throughout infancy and childhood. Acronym for Parent-Child Interaction Therapy; PCIT is an evidence-based intervention to change the patterns of parent-child interactions to improve the parent-child relationship. According to studies, how a human brain is structured shares connections to various subsequent behaviors. In the decade since the first AAP policy statement and technical report on childhood toxic stress were published, even more evidence has accumulated that: What happens in childhood does not stay in childhood.186,187 Adverse experiences in childhood are not destiny, but for many children, significant adversity bends life-course trajectories for the worse. Ecobiodevelopmental Theory b. Overview of Domain-Specific Theories. Secondary preventions in the relational health framework are focused on identifying the potential individual, family, and community barriers to SSNRs by developing respectful and caring therapeutic relationships with patients, families, and communities. Acronym for Trauma-Focused Cognitive Behavioral Therapy; TF-CBT is an evidence-based, manualized, skills-based therapy that allows parents and children to better process emotions and thoughts related to traumatic experiences. An evolutionary-developmental theory of the origins and functions of stress reactivity, Risky decision making from childhood through adulthood: contributions of learning and sensitivity to negative feedback, Biological sensitivity to context moderates the effects of the early teacher-child relationship on the development of mental health by adolescence, Links between shared reading and play, parent psychosocial functioning, and child behavior: evidence from a randomizedcontrolled trial, Attendance at well-child visits after Reach Out and Read, Reach Out and Read: evidence based approach to promoting early child development, Triple P-Positive Parenting Program as a public health approach to strengthening parenting, Maintenance of treatment gains: a comparison of enhanced, standard, and self-directed Triple P-Positive Parenting Program, Home visiting and the biology of toxic stress: opportunities to address early childhood adversity, Guiding principles for team-based pediatric care, Training pediatric residents in a primary care clinic to help address psychosocial problems and prevent child maltreatment, Linking urban families to community resources in the context of pediatric primary care, Medical-legal strategies to improve infant health care: a randomized trial, Applying a 3.0 transformation framework to guide large-scale health system reform. Realizing the full impact of these principles within primary care practice, however, will also require fundamental changes in medical education and payment models. Executive functions are the cognitive skills needed to control behavior and attain goals. LIFESPAN CHP2.docx - Chp 2- evolutionary theories Theories This policy statement asserts that to move forward (to proactively build not only the healthy, happy children of today but also the well-regulated parents and productive citizens of the future) family-centered pediatric medical homes (FCPMHs) (see the Appendix for a detailed description) need to universally promote relational health. The currently ascendant Ecobiodevelopmental Theory argues that severe childhood stressors (known as Adverse Childhood Experiences or ACEs) affect children's genetic predispositions, brain. 12.1: Social Emotional Theories of Development Build the therapeutic alliance; promote positive parenting; encourage developmentally appropriate play. Doing so will require all trainees to address their implicit biases, develop cultural humility, and provide culturally competent recommendations. Foster strong, trusted, respectful, and effective collaborations with the community partners who are well-positioned to provide the individualized prevention, intervention, and treatment strategies. But underlying this approach are 2 fundamental assumptions. However, policy statements from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent. ecobiodevelopmental (EBD) framework to stimulate fresh thinking about the promotion of health and prevention of disease across the lifespan. In the past decade or so, biomedical researchers have proposed an ecobiodevelopmental framework for studying health and disease across the life course . Life Course Theory asserts that non-communicable diseases . Similarly, symptomatic children need to be referred to evidence-based treatment programs (eg, ABC, PCIT, CPP, TF-CBT), but these are supplemental to and do not replace either targeted interventions for potential barriers to SSNRs or the aforementioned universal primary preventions. Part 1 - Overview of Developmental Domains, Periods, and Theories a. Domains of Development b. The first is that pediatric providers will have the financial supports needed to expand their capacity for developing respectful, continuous, trusted, and nurturing relationships with both the patients and caregivers of the patients who they serve. Universal screening for prevalent barriers seen in that practice; facilitate, track, and follow-up on referrals offered. The lifelong effects of early childhood adversity and toxic stress Preventing Childhood Toxic Stress: Partnering With Families and Social dominance, school bullying, and child health: what are our ethical obligations to the very young? : Working Paper No. Although children experiencing discrete catastrophic events such as abuse are at a high risk for toxic stress responses, epidemiology suggests that the largest number of children at risk for toxic stress responses are those affected by ongoing chronic life conditions such as neglect.54,55 This finding suggests that although interventions targeting children with acute threats are needed urgently (eg, efforts preventing physical abuse, child trafficking, and gun violence), those interventions alone will almost certainly miss large segments of the population (eg, those experiencing the threats of parental mental illness, racism, poverty, social isolation) who may also develop toxic stress responses and their associated poor outcomes. The common factors are communication skills that help to build a therapeutic alliance (the bond felt between the clinician and patient and/or family, a powerful factor in facilitating emotional and psychological healing), which, in turn, increases the patient and/or familys optimism, feelings of well-being, and willingness to work toward improved health. Acronym for Reach Out and Read; ROR is a nonprofit organization and early literacy program. This title is accompanied by a complete teaching and learning package. In the presence of SSNRs, a limited degree of childhood adversity (eg, normative childhood frustrations and setbacks) can lead to the positive stress responses that build the rudiments of resilience: a set of social and emotional skills that allow children to adapt to future adversity in a healthy manner. The model is separated into three categories: 1) ecological, 2) biological and 3) developmental.
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