Environmental Influences

Why are environmental factors important?

They have a continous influence accross the lifespan

What is the key idea of Bronfenbrenner’s (1979) ecological systems theory?

There are interrelated environmental systems that affects a persons development

What is the microsystem (1st ecological system)?

People who directly interact with the child - the immediate environment

e.g. family, school

The microsystem is a ____ way relationship

The microsystem is a 2 way relationship

What is the mesosystem (2nd ecological system)?

The connections between the microsystems

e.g. how the school interacts with parents

What is the exosystem (3rd ecological system)?

Indirect influences that affect the child

e.g. thoughts of others, community resources

What is the macrosystem (4th ecological system)?

The cultural context that shapes all systems

e.g. societal values

What is the chronosystem (1st ecological system)?

A time dimension

e.g. historic events, technology changes, current gov.

Define social determinants of health

The conditions that people are born, grow up and live in that shape daily life

What are the 4 social determinants of health?

SES

Neighbourhood environment

Education opportunities

Access to healthcare

What is the Marmot review (2020) evidence for social determinants of health?

Low SES = poorer health regardless of country wealth

What is Public Health England (2019) evidence for social determinants of health?

Communication and cognitive development are impacted by poverty and housing

What is the RCSLT (2020) evidence for social determinants of health?

Children from disadvantaged backgrounds are more likely to have SLCN

How does social determinants of health impact children? Name 3 ways

Poverty associated with SLCN

Limited access to early education

Parental education and economic stability impact service access

How does social determinants of health impact adults with neurological disorders? Name 2 ways

Lower income and education = worse outcomes

Less access to specialist care

How does social determinants of health impact diverse populations? Name 2 ways

Racism and lingustic barriers limit access to care

Differing levels of trust in healthcare

Name 2 ways structural barriers impact people

Lack of transport

Inability to navigate complex service systems

Describe the medical model of disability

Disability is part of the person

Focus on what is wrong rather than what they need

Aim to treat/manage impairment

Describe the social model of disability

Disability is created by barriers

Focus on people having impairments but society fails to provide access

Aim to change soicety to accommodate all needs

What is the BioPsychoSocial model? (Engle, 1977)

An alternative to the medical model

Biological, psychological and social factors interact dynamically to influence mental/physical health

What biological factors are part of the BioPsychoSocial model? Name 2

Physical health

Genetics

What psychological factors are part of the BioPsychoSocial model? Name 4

Thoughts, emotions, coping mechanisms and beliefs

What social factors are part of the BioPsychoSocial model? Name 4

Environmental factors

SES

Cultural context

Family circumstances

What type of approach is the BioPsychoSocial model?

Hollistic approach - person-centred care is key

What is interactional understanding in terms of the BioPsychoSocial model?

Disabil

What is contextutal understanding in terms of the BioPsychoSocial model?

Ack

What model of disability does the ICF use?

BioPsychoSocial model

What are the 4 key aspects of the ICF?

Standardisation of language

Neutral approach - focus on what they can do

Components interact - health condition affects body function

Measurement - scale to define difficulties

Define intersectionality (Crenshaw, 1989)

Interconnected nature of social categories e.g. race, gender, disability

Provide 3 examples of how intersectionality links to healthcare

Increases barriers to education and health

Communication needs are under-identified or misunderstood

Clinics reflect biases

How does low socioeconomic status link to education and healthcare?

Reduced service access

Decreased quality of life - worse education, worse healthcare

Longer wait times for specialist care

How would SLTs reduce the impact of SES?

Targeted interventions

Increased awareness of difficulties facing patients

What are the stages of gender identity development?

2-3yrs = see physical difference, label B/G

3-5yrs = experiment

5-7yrs = follow societal norms

Adolescence = exploration and solidification

What are schemas?

Mental framework that helps people organise info

e.g. knowing the appropriate behaviour