Children and Adolescents

John Sargent, MD
• Learning Objectives:
• 1) Understand the process and context of
the development of children
• 2) Learn the process of adolescent
development through early, middle and late
adolescence

2
 Development in Infancy
A.) Dependent upon health and capacities
including motor skills, sensory abilities
B.) Dependent upon availability of attuned,
available, caring adults
C.) Consistency of adult involvement is
most important

3
Importance of learning to communicate and
to obtain consistent reinforcement of
communicating wants and needs

4
Importance of parental affiliation – parental
caring for child as he or she is

5
Early motor development enhances relating
capacity and mobility – rolling over,
sitting, crawling, walking, climbing,
running

6
Motor development both builds autonomy
and the capacity for exploration but also
increases the need for social interaction,
supervision and limit setting

7
Language development begins before age 1
with babbling, proceeds to single words,
putting words together by age 2 and
greater vocabulary and complexity of
syntax through age 5

8
Language development furthers
modulation of emotions and impulses –
through prefrontal cortical modulation of
arousal

9
Language development also furthers
preoperational, egocentric thinking and
capacity for solitary and peer play

10
Preschool programs require capacity for
nurturance, adult availability, physical
play, routines, rest, use of language

11
Importance of alternatives to language for
developmentally delayed, deaf and
autistic children

12
School aged children engage increasingly in
group experiences (teams, classes and
clubs)

13
Through progression to concrete reasoning
school aged children require consistency,
challenge and reinforcement and clear
support for and standards for success

14
Differences in cultural background, size,
gender and skills become increasingly
more important leading to in groups and
out groups

15
Specific vulnerabilities in preschool children
include parental loss, parental neglect and
domestic violence

16
Specific vulnerabilities among school aged
children include ADHD, learning
disabilities and conflictual parental
relationship

17
Adolescence is the journey between
childhood and adulthood

18
Physiologic
Cognitive
Emotional
Behavioral
change occurs, often asynchronously

19
Goals of Adolescence

1.) Learn skills necessary to be prepared for

occupational and relationship
competency in adulthood

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Goals of Adolescence, cont.

2.) Gain the capacities for self-direction and

decision making

21
Goals of Adolescence, cont.

3.) Have memorable and meaningful

experiences that represent contributions and
lead to belonging

22
Goals of Adolescence, cont.

4.) Avoid problems that have long-term

consequences and a life of their own

23
Goals of Adolescence, cont.

5.) Build the capacity for autonomy upon a

foundation of connections and a set of
personal values

24
Some challenges which can persist
into adulthood that frequently have
inception in adolescence include:
A.) eating disorders
B.) substance abuse
C.) incarceration and persistent unlawful
behavior

25
Some challenges…, cont.

D.) handicap following injury/accident

E.) school failure/dropout
F.) HIV
G.) teen pregnancy(ies)

26
Some challenges…, cont.

Frequently these risk factors occur

together and have exponential effects

27
Family and community factors can
exacerbate risk
A.) Parental substance abuse,
psychopathology, or criminality
B.) Conflictual parental relationship or post-
divorce conflict
C.) Parental job loss or moving
D.) Poverty

28
Family and community factors…, cont.

E.) Poor schools

F.) Community violence/school bullying
G.) Exposure to gangs and antisocial peers

29
Family and community factors…, cont.
H.) Lack of access to resources and adult
role models
I.) Lack of opportunity to develop and
refine unique skills
J.) Inadequate or poor information
K.) A rejecting or unsupportive community

30
Role of cultural and ethnic/racial
difference
A.) Differing views about American culture
B.) Pressure to maintain culture of origin
C.) Confusion about being true to one’s own
culture
D.) Defining a unique cultural adaptation

31
Sexual Orientation Issues

A.) Concerns about being different

B.) Family responses
C.) Peer acceptance and support

32
Sources of resiliency among
adolescents
A.) Adult/parental support
B.) Intelligence
C.) Attractiveness
D.) Even/easy personality
E.) A unique talent or ability

33
Other sources of resiliency

A.) Positive framing of contribution and

circumstances by others
B.) Experience of competent problem-
solving
C.) Experience of regard and an expectation
of honesty and integrity

34
Course of Development

A.) Generally successful: 60% continuous

growth
B.) Staggered but progressive growth: 20%
C.) Challenged development: 20% of youth –
at risk for varied poor outcomes

35
Characteristics of successful
growth
A.) Decreasing age of onset of puberty
(earlier for girls)
B.) Consistent age of brain maturation with
completion of frontal lobe maturation at
age 25

36
Characteristics of successful
growth, cont.
C.) Supervision and support synchronous
with and consistent with fluctuating skills
D.) Opportunities for negotiation,
communication and exploration of
concerns through language

37
Challenges to successful
development
A.) Arbitrary and excessive efforts at
external control
B.) Lack of appreciation of adolescent
ambivalence

38
Challenges to successful
development, cont.
C.) Fluctuation between absent supervision
and authoritarian control
D.) Parental helplessness and abandonment

39
Community problems that impact
youth development
A.) Lack of after school or extracurricular
opportunities
B.) Lack of work opportunities

40
Community problems that impact
youth development, cont.
C.) Negative views about teenagers
D.) Confusion between recognition of
physical maturity and awareness of slow
psychosocial/emotion regulation
development

41
Characteristics of Positive Youth
Development:

Confidence
Competence
Caring
Connection
Character

42
Youth who do well:

A.) Have a positive connection with their

school
B.) Have positive relationships with youth
who have a positive relationship with
school
C.) Are engaged positively with adults who
care about them

43
Adolescence can be divided into 3
sections
A.) Early – ages 11-14
B.) Mid – ages 14-16
C.) Late – ages 17-19
Many aspects of adolescence persist into
20’s

44
Early Adolescence

A.) Focus upon physical changes

B.) Developing interests which may change
rapidly
C.) Need adult supervision
D.) Need structure and monitored
expectations

45
Early Adolescence, cont.

E.) Want greater privacy

F.) More aware of emotional experience
G.) Beginning to reflect on self and
experience
H.) Impulse control can be a challenge

46
Mid Adolescence

A.) More time with peers

B.) Strong desire to belong, activities based
on belonging
C.) Beginning partnering

47
Mid Adolescence, cont.

D.) Abstract reasoning, problem solving

used more frequently
E.) Wants and utilizes more independence in
decision making
F.) Expects competence and expects to
make contributions to social groups

48
Late Adolescence

A.) Greater self-direction, self-monitoring

B.) Greater capacity for judgment and
impulse control

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Late Adolescence, cont.

C.) More independent decision making

D.) More involvement in longer term
relationships
E.) Parents/adults more in the role of
advisor/ mentor
F.) More consistent values and beliefs

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