Working with Families

1. Working with Families

2. Influences

3. Define Family • Take a minute and write your definition of family

4. Family A family is a group of two people or more (one of whom is the householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family. Census 20000

5. Family The family is a group of individuals with a continuing legal, genetic and/or emotional relationship. Society relies on the family group to provide for the economic and protective needs of individuals, especially children and the elderly. (1984) (2003) American Academy of Family Physicians

6. Family A family is a social group organized or governed by a repeatable set of rules. Jackson (1965) Family rules: Marital grid pro quo. Archives of General Psychiatry. 12: 589-594.

7. Family “A family is people who live together who help and love each other.” A second grade student. In Fuller and Olsen. 1998. Home-School Relations. Allyn and Bacon.

8. Circle of Courage During this slide presentation, think of these four characteristics in families and children: • Belonging • Independence • Generosity • Mastery

9. Census: U.S. Families

10. Percent of Children in Household Most children spend the majority of their childhood living with two parents; however, significant proportions of children have more diverse living arrangements. Information about the presence of parents and other adults in the family, such as the parent's unmarried partner, grandparents, and other relatives, is important for understanding children's social, economic, and developmental well-being.

11. Children in Household Type

12. Children in the U.S. The number of children determines the demand for schools, health care, and other services and facilities that serve children and their families.

13. U.S. Population • In 1999, there were 70.2 million children in the United States, 0.3 million more than in 1998. This number is projected to increase to 77.2 million in 2020. • The number of children under 18 has grown during the last half-century, increasing about half again in size since 1950. • During the "baby boom" (1946 to 1964), the number of children grew rapidly. • During the 1970s and 1980s, the number of children declined and then grew slowly. • Beginning in 1990, the rate of growth in the number of children increased, although not as rapidly as during the baby boom. • In 1999, there were approximately equal numbers of children--between 23 and 24 million--in each age group 0 to 5, 6 to 11, and 12 to 17 years of age.

14. Children vs. Adults 65 and Older In contrast, senior citizens (adults ages 65 and older) have increased as a percentage of the total population since 1950, from 8 to 13 percent. By 2020, they are projected to make up 17 percent of the population.

15. U.S. Children by Race Increases in the percentages of Hispanic and Asian/Pacific Islander children are due to both fertility and immigration. Much of the growth in the percentage of Hispanic children is due to the relatively high fertility of Hispanic women.

16. Speak Another Language at Home The percentage of children who speak English with difficulty varies by region of the country, from 2 percent of children in the Midwest to 11 percent of children in the West.

17. Births to Unwed Mothers Increases in births to unmarried women are among the many changes in American society that have affected family structure and the economic security of children. Children of unmarried mothers are at higher risk of having adverse birth outcomes, such as low birthweight and infant mortality, and are more likely to live in poverty than children of married mothers.

18. Births to Unwed Mothers In 1998, 33 percent of all births in the U.S. were to unmarried women.

19. National Ambient Air Quality In 1998, 24 percent of children lived in areas that did not meet at least one of the Primary National Ambient Air Quality Standards, down from 31 percent in 1990. The Clean Air Act established Primary National Ambient Air Quality Standards which are designed to establish limits to protect public health, including the health of sensitive populations such as asthmatics and children.

20. Type of Care Arrangement The type of child care received is related to the age of the child. Children from birth through age 2 were more likely to be in home-based care, either with a relative or nonrelative, than to be in center-based care. Forty-two percent were in home-based care (about 25 percent with a relative and 17 percent with a nonrelative), and about 16 percent were in center-based care in 1999.

21. Family Education • According to Burton L. White, expert on early childhood and Project Director of Harvard University's Pre-School Project: " . . . the informal education that families provide for their children makes more of an impact on a child's total educational development than the formal educational system."

22. First Classroom Home is the first classroom. Parents are the first and most essential teachers (Boyer, 1991, p 33)

23. Brain Development • MAKING CONNECTIONS • A child is born with over 100 billion neurons or brain cells. • These neurons form connections, called synapses, which make up the wiring of the brain.

24. Brain Development • EARLY EXPERIENCES At age eight months an infant may have 1,000 trillion synapses. • By age 10 the number of synapses decrease to about 500 trillion. • The final number of synapses is largely determined by a child's early experiences, which can increase or decrease the number of synapses by as much as 25 percent.

25. Brain Development • "USE IT OR LOSE IT!" The brain operates on a "use it or lose it" principle: only those connections and pathways that are frequently activated are retained. • Other connections that are not consistently used will be pruned or discarded so the active connections can become stronger.

26. Brain Development • DEFINING LANGUAGE SKILLS When an infant is three months old, his brain can distinguish several hundred different spoken sounds. • Over the next several months, his brain will organize itself more efficiently so that it only recognizes those sounds that are part of the language he regularly hears. • During early childhood, the brain retains the ability to relearn sounds it has discarded, so young children typically learn new languages easily and without an accent.

27. Brain Development • THE POWER OF THE SPOKEN WORD The power of early adult-child interactions is remarkable. • Researchers found that when mothers frequently spoke to their infants, their children learned almost 300 more words by age two than did their peers whose mothers rarely spoke to them. • However, mere exposure to language through television or adult conversation provided little benefit. • Infants need to interact directly with others. • Children need to hear people talk to them about what they are seeing and experiencing, in order for their brains to fully develop language skills.

28. Brain Development • THE LOVING TOUCH Warm, responsive caregiving not only meets an infant's basic, day-to-day needs for nourishment and warmth, but also responds to their preferences, moods and rhythms. • Recent research suggests that this kind of consistent caregiving is not only comforting for an infant, it plays a vital role in healthy development. • The way that parents, families and other caregivers relate and respond to their young children, and the way they respond to their children's contact with the environment, directly affect the formation of the brain's neural pathways.

29. Brain Development • CREATING ONE STABLE BOND • Researchers who examine the life histories of children who have succeeded despite many challenges, have consistently found that these children have had at least one stable, supportive relationship with an adult early in life.

30. Breast-feeding • Breast-feeding is good for a baby -- and most experts say they believe it's also good for a baby's developing brain. Those who had been breast-fed for seven to nine months scored higher on IQ tests than those breast-fed for one month or less, according to a study in the Journal of the American Medical Association in May. • A recent study by the University of Kentucky finds that breast-fed babies have an IQ three to five points higher than that of formula-fed babies. "Infants deprived of breast milk are likely to have lower IQ, lower educational achievement, and poorer social adjustment than breast-fed infants." • Numerous studies show marked increases in various illnesses in children who are not breast-fed, including increases in otitis media, gastroenteritis, and upper respiratory track infections.  Bottle-fed babies in the U.S. are much more likely to have to be hospitalized and suffer a death rate double that of breast-fed infants even after controlling for other variables.  Allergies and asthma are also much more common in individuals who were bottle-fed.

31. Abuse and Neglect on Brain Development • At the CIVITAS Child Trauma Programs at Baylor College of Medicine, Bruce Perry and co-workers have studied the impact of neglect and trauma on the neurobiology of over 1,000 abused and neglected children. • In one study, 20 children who had been raised in globally under-stimulating environments- children who were rarely touched or spoken to and who hadlittle opportunity to explore and experiment with toys- were examined with sophisticated new brain-imaging techniques and other measures of brain growth. • The children were found to have brains that were physically 20 to 30 percent smaller than most children their age and, in over half the cases, parts of the children's brains appeared to have literally wasted away.

32. Nutrition and Brain Development • PROPER PRENATAL CARE Many studies have shown the devastating effects on intelligence and brain development from a lack of basic nutrients at the prenatal stage, in infancy and early childhood. • Educational and outreach campaigns to alert women to the importance of nutrition during pregnancy would also be helpful in preventing problems that can arise in this critical period when brain cells begin to form.

33. Dendrites • Dendrites are thin, branching fibers lined with receptors at which the dendrite receives information from other neurons. The greater the surface area, the greater the amount of information. Some dendrites are covered with spines which greatly increase its surface area.

34. Nicotine and Brain Development • Observable effects included significantly reduced thickness of the cerebral cortex, smaller cerebral cortex neurons, and reduced brain weight. • Also noted was an overall decrease in "dendritic branching" (connections to other brain cells), as seen in the camera lucida drawings at right. • The present study also shows that the greater the dose of nicotine, the greater the biological effects upon the offspring. • This research provides an excellent biological model to support the many other studies linking increased hyperactivity, attention deficits, lower IQ, and learning disabilities in children with parents who smoked during pregnancy. 

35. Cigarettes and Pregnancy About nine million children 5 and under in the United States are exposed to tobacco smoke Cigarette smoking during pregnancy can result in low birth weight babies.  It has been associated with infertility, miscarriages, tubule pregnancies, infant mortality and childhood morbidity.  Cigarette smoking may cause long-term learning disabilities.      A Johns Hopkins University Study found that children of mothers who smoke were more likely to have cleft palates than children of nonsmokers. Mothers who smoke only 10 cigarettes a day cause their children under 5 to have positive blood tests for nicotine and cancer-causing compounds. Maternal smoking during pregnancy increases the risk of asthma in children. Smoking during pregnancy has been linked as a risk factor for a severe anti-social behavior in children, called "conduct disorder."

36. Second Hand Smoke and Cognition • More than 33 million children in the United States are exposed to levels of second hand smoke consistent with the adverse effects seen in this study. • Forty-three percent of American children are exposed to environmental tobacco smoke in their own homes. • Eighty-five percent of children have detectable levels of cotinine in their blood.

37. Malnutrition, both before and during the first few years after birth, has been shown to result in stunted brain growth and slower passage of electrical signals in the brain (Pollitt & Gorman, 1994; Shonkoff & Phillips, 2000). These effects on the brain are linked to cognitive, social, and behavioral deficits with possible long-term consequences (Karr-Morse & Wiley, 1997). For example, iron deficiency (the most common form of malnutrition in the United States) can result in cognitive and motor delays, anxiety, depression, social problems, and problems with attention (Shonkoff & Phillips, 2000). Protein deficiency can result in motor and cognitive delays and impulsive behavior (Pollitt & Gorman, 1994). The social and behavioral impairments may be more difficult to "repair" than the cognitive impairments, even if the nutritional problems are corrected (Karr-Morse & Wiley, 1997). Malnutrition

38. Neglect "These images illustrate the negative impact of neglect on the developing brain. In the CT scan on the left is an image from a healthy three year old with an average head size. The image on the right is from a three year old child suffering from severe sensory-deprivation neglect. This child's brain is significantly smaller than average and has abnormal development of cortex." These images are from studies conducted by a team of researchers from the Child Trauma Academy (www.ChildTrauma.org) led by Bruce D. Perry, M.D., Ph.D.

39. According to a study by the National Center on Addiction and Substance Abuse: • Alcohol is the leading drug abused by U.S. teens. • Underage drinkers account for 19.7 percent of alcohol consumed in U.S. • 78 percent of high school students have tried alcohol. • 30 percent of them admit to binge drinking at least once a month. • Average age of first drink among 12-to-20-year-olds is 14. Alcohol and Brain Development

40. FAS & the Brain • Children with FAS often suffer lifelong consequences from "in utero alcohol exposure," such as mental retardation, learning disabilities, and serious behavioral problems.

41. Premature Births • Increasing since 1980 • Approximately 1 in 20 births are born before they are due. A premature birth is one which occurs before 37 weeks of pregnancy. A normal pregnancy is 40 weeks long. • The brain: Very small babies are prone to bleeding in the brain. This is especially true with babies weighing less than 1 kg.

42. Obesity & Schools • According to 2002 stats, more than 10 PERCENT of America's children between ages 2-5 are overweight, increasing by at least one-third over the past decade. By the numbers, more than 9 million kids ages 6-19 (a majority between ages 12-19) were overweight or obese. • New evidence on the relationship between childhood overweight and academic performance using a nationally representative data set of kindergartners in the United States. • Significant differences in test scores in relation to overweight status at the beginning of kindergarten and the end of first grade can be explained by other individual characteristics, including parental education and the home environment. • However, overweight is more easily observable in relation to other students compared with socioeconomic characteristics, and its significant association with worse academic performance can contribute to the stigma of overweight as early as the first years of elementary school.

43. Attachment • Skeels • Spitz • Bowlby • Tizard and Hodges • Rutter • Ainsworth • Brazelton and Yogman

44. Skeels Skeels and Dye, for example, removed children aged 7-30 months from a very depriving orphanage to a mental retardation colony, where as the only young children present they received a great deal of attention. At the time of transfer the children were very retarded - the thirty month old child, for example, could not stand alone. Over the next 18 months the children made rapid progress. Most were then adopted, and their outcome as adults was entirely normal. The methodology of this research has been severely criticized, but the case studies undoubtedly provide evidence of the potentially powerful effect of a changed environment on development.

45. Renee Spitz In 1946-48 Renee Spitz did a remarkable study on infants born to felon mothers. At the time it was believed if they removed an infant from a felon mother and placed the child in a foundling home which would give the infant the best of professional care the infant would thrive. Whereas if they left the infant with the felon mother, it was believed the infant would not flourish as well and would learn to become a felon itself. But instead by 1 year of age 25% of the infants in the foundling home died, compared to zero infants that remained with their mothers. At two years of age an astounding 37% of the infants in the foundling home died, compared to zero infants that remained with their mothers! At age 1, on the average infants in the foundling home had an IQ of 72 vs 105 of those who remained with their mothers. At 2 years of age all of the infants that remained with their mothers were gusty, running, playing, and many fed themselves with a spoon. In the foundling home 5 of 21 walked unassisted, 9 of 21 ate w/spoon, 1 of 21 spoke 12 words, 3 of 21 were of normal weight.

46. John Bowlby

47. Tizard and Hodges • The age 0-2 is a sensitive period for children in their development. • Children need to form stable attachments with someone, usually an adult during this period. • Partially in support of Bowlby’s findings, this research indicates that the effects last several years – up to the age of 16. • The research suggest that maternal deprivation or a failure to form attachments cause social problems: • an inability to form relationships with peers • an inability to form relationships with siblings • bullying behavior • Being quarrelsome at school • Difficulty in forming relationships with their parents (with the exception of the adopted group) or careworkers.

48. Rutter • Rutter, et al. (2000) studied the development of children adopted from Romanian orphanages. When each child was 6 years old, the researchers assessed what proportion of the adopted children were functioning "normally." They found that 69 percent of the children adopted before the age of 6 months were functioning normally, 43 percent of the children adopted between the ages of 7 months and 2 years, and 22 percent of the children adopted between the ages of 2 years and 3½ years.

49. Mary Ainsworth Ainsworth finds 15 mother-infant pairs and studies their behavior from birth by visiting them at home every three weeks for four hours. The observer notes any attachment behaviors, especially in situations where they are likely to happen, and the mothers response. After one year, the babies are put in 20 minute laboratory "strange situations." Results show that mothers who responded right away to infant crying had minimum crying, securely attached babies who responded well to being picked up as well as being put down. They greeted the mother with joy upon her return and protested her departure only when put in an unfamiliar situation. On the other hand, the insecure baby cried a lot, but treated the mother's absence with indifference often ignoring her upon her return as a defense mechanism. The strange situations showed the difference between the secure, avoidant, and ambivalent-resistant babies.

50. Brazelton and Yogman • Analyzed the process of early attachment and studies • Looked specifically at the interaction between infant and parent, even covering the effects of experiences in-utero. • Found that child appears to be born with responses, including the ability to develop a reciprocal relationship with the caregiver.