Shannon Casebeer Lecture Notes - Family and Development

Foundations and Definitions of the Family Unit

• Definition of Family: According to the lecture, family is defined strictly by the patient. Specifically, "Family is what the patent says it is and who they decide."
• Family Types: The following classifications represent the various structures a family may take:
  • Nuclear: The traditional family structure.
  • Extended: Includes relatives beyond the nuclear unit, such as grandparents, aunts, uncles, and cousins.
  • Blended: Formed when parents bring children from previous relationships into a new joint household.
  • Social: Groups that function as a family through social ties rather than strictly biological ones.
  • LGBTQ: Families headed by individuals or couples identifying as lesbian, gay, bisexual, transgender, or queer.
  • GrandFamilies: Households where grandparents are the primary caregivers for their grandchildren.
  • Foster: Temporary family units where adults care for children who are unable to live with their biological parents.

Qualities and Patterns of a Functional Family

• Functional Family Qualities: A healthy, functional family unit is characterized by the following traits (refer to Table $24.3$ in the Foundations textbook for additional details):
  • Promoting Well-being: A consistent sense of commitment toward encouraging and promoting the well-being of every family member.
  • Appreciation and Encouragement: A felt sense of appreciation and active encouragement offered for tasks that members complete.
  • Quality Time: A directed and intentional effort toward spending quality time with individual members.
  • Sense of Purpose: A shared sense of purpose that serves to encourage progress and resilience during both good and difficult times.
  • Harmony: A maintained sense of harmony between the various members of the family.
  • Effective Communication: The practice of clear, open, and impactful communication.
• Family Patterns: Families often follow one of four primary power and decision-making structures:
  • Autocratic Family: Characterized by a rigid structure where one or more leaders hold absolute power.
  • Patriarchal Family: A system where the male head of the household holds the primary authority.
  • Matriarchal Family: A system where the female head of the household holds the primary authority.
  • Democratic Family: A structure where family members participate in decision-making and have a voice in the unit's direction.

Erikson’s Stages of Psychosocial Development

• Infancy ($Birth$ to $1$ year): Basic Trust vs. Mistrust.
• Toddler ($1-3$ years): Autonomy vs. Shame.
• Preschool ($4-6$ years): Initiative vs. Guilt.
• School Age ($7-11$ years): Industry vs. Inferiority.
• Adolescence ($12-19$ years): Identity vs. Role Confusion.
• Young Adult ($20-44$ years): Intimacy vs. Isolation.
• Middle Adult ($45-64$ years): Generativity vs. Stagnation.
• Older Adult ($65+$ years): Ego Integrity vs. Despair.

Piaget’s Stages of Cognitive Development

• Sensorimotor Stage: Occurs from $Birth$ to $2$ years.
• Preoperational Thought Stage: Occurs from $2-7$ years.
• Concrete Operational Thought Stage: Occurs from $7-11$ years.
• Formal Operational Thought Stage: Occurs from $12+$ years.

Growth and Motor Development in Infants

• Weight Gain: An infant's birth weight is expected to triple within the first year. For example, if a child's birth weight is $6\,lbs$, the expected weight at $1$ year of age is $18\,lbs$.
• Vital Signs:
  • Apical Pulse: In a $2$-month-old infant, an apical pulse of $\text{120 BPM}$ is considered normal.
  • Respirations: In a $12$-month-old child, a respiration rate of $\text{30 RPM}$ (breaths per minute) would be normal.
• Motor Milestones (Prone and Sitting):
  • $2$ Months: When placed in a prone position (lying on the stomach), the child is expected to hold their head up slightly.
  • $4$ Months: When placed prone, the child should be able to raise their head at a $90$ degree angle.
  • $4-6$ Months: The child should be able to hold a sitting position briefly, provided they have guidance.
  • $7$ Months: The child should be able to sit up alone and unsupported.

Developmental Milestones and Caregiver Teaching

• Nutrition and Introduction of Solids:
  • Infants should not be introduced to solid foods until they are between $4$ and $6$ months old.
  • When solid foods are introduced, they must be offered one at a time.
  • Several days should pass between the introduction of different foods to ensuring that any allergic responses can be correctly identified.
  • To promote independence during eating, caregivers should start by offering finger foods to younger children.
• Toilet Training: This process should begin only when the child has reached the necessary neurological and muscular development, which typically occurs between $18$ and $24$ months of age.

Stress and Regression in Children

• Common Signs of Stress: Children may exhibit various symptoms when under stress, including:
  • Mood swings.
  • Acting out behaviors.
  • Changes in eating or sleeping patterns.
  • Frequent somatic symptoms for which there is no clear physical cause, such as stomachaches or headaches.
  • Excessive clinging to parents.
  • Thumb-sucking.
  • Bedwetting.
• Regression: Stress can cause a child to return to behaviors associated with an earlier stage of development (e.g., a toilet-trained child returning to bedwetting).

The Older Adult

• Key Concepts:
  • Presbycusis: Age-related hearing loss.
  • Ageism: Discrimination or prejudice against individuals based on their age.
  • Biological Programming Theory: A theory regarding the aging process based on internal biological clocks.
  • Integrity vs. Despair: The primary psychosocial conflict for older adults according to Erikson, where individuals reflect on their lives to find a sense of fulfillment or regret.

Other Psychosocial Theorists

• Ivan Pavlov: Known for "Conditioning response"; famously experimented with salivating dogs to demonstrate how stimuli trigger behaviors.
• Abraham Maslow: Known for the "Maslow Hierarchy of Needs," which structures human requirements from basic physiological needs to self-actualization.