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Growth Patterns

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Page 1: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Growth Patterns

Page 2: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Middle Childhood

• Chapters 11-13– Physical– Cognitive– Socioemotional Development

Page 3: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Patterns of Growth Occur in Middle Childhood?

• Height and Weight– Gain a little over 2 inches and 5 to 7 pounds per year– Boys are slightly heavier and taller than girls until 9 or 10– About age 11, boys develop more muscle and girls more fatty tissue

• Extensive individual deviations in height and weight

Page 4: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 11.1

Growth Curves for Height and Weight

Page 5: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Patterns of Growth Occur in Middle Childhood?

• Brain Development– Frontal lobe – executive functions

• Planning and self-regulation• Cognitive flexibility• Goal setting• Fluid reasoning

– Information processing

Page 6: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Many Children in the United States Are Overweight?Why Are They Overweight?

• Overweight involves both weight and body composition• 16% to 25% of children and adolescents in US are overweight• Most overweight children become overweight adults• Overweight children and adolescents

– Often are rejected by peers– Perform poorly in sports– Have poorer body images than children of normal weight

• At greater risk for physical health problem

Page 7: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 11.2

Percentages of Children (Ages 6 – 11) and Adolescents (Ages 12 – 19) Who Are Overweight

Page 8: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Causes of Obesity?

• Heredity• Amount of fat cells (adipose tissue)

– Hunger drive is connected with quantity of fat in these cells• More fat cells – feel hunger sooner

• Environmental factors– Obese parents may model poor dietary and exercise habits– Sedentary habits

• TV watching encourages snacking, exposes children to commercials for food, and is low physical activity

• Stressors and emotional reactions

Page 9: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Are There Sex Differences in Motor Skills?

• Boys show slightly greater overall strength– More forearm strength – batting and throwing

• Girls show greater coordination and flexibility– Dance, balancing, gymnastics

• Boys more likely to be encouraged in athletics• Physical activity decreases with age in both sexes

Page 10: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Run-of-the-Mill Failure to “Listen” to Adults Differ From Attention-Deficit Hyperactivity Disorder?

• Characteristics of ADHD– Developmentally inappropriate or excessive inattention,– Impulsivity, and– Hyperactivity

• Onset occurs by age 7– Behaviors must persist for at least 6 months– Impairs function at school– Difficulty getting along with others– More common in boys than girls

• Some argue ADHD is over-diagnosed and overmedicated

Page 11: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Causes of ADHD?

• Heredity– Runs in families

• Coexists with other disorders – Anxiety, oppositional defiant disorder, mood disorders, ticks

• Food coloring and preservatives are not responsible• Inefficient inhibitory processes

– Lack of executive control in the brain

Page 12: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Why Are Children with ADHD Treated with Stimulants?

• Hyperactivity stems from inability of cerebral cortex to inhibit more primitive areas of the brain

• Block reuptake of dopamine and noradrenaline– Stimulates the cerebral cortex

• Children with ADHD on stimulants demonstrate– Increased attention span, improved cognitive performance– Reduction in disruptive, annoying, and aggressive behavior

• Use of stimulants is controversial– May suppress growth

Page 13: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Treatment and Outcome of ADHD

• Cognitive behavioral therapy is an alternative treatment– Focus on self-control and problem-solving

• Some children “outgrow” ADHD– At least two-thirds exhibit one or more symptoms in adolescence

and adulthood

Page 14: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are Learning Disabilities?

• Characterized by inadequate development of specific academic, language, and speech skills– Problems with reading, math, writing– Difficulties with speaking or understanding speech– Problems with motor coordination

• Performs below expectations for age and intelligence– Without evidence of other handicaps

• Usually persists throughout life

Page 15: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 11.4

Writing Sample of a Dyslexic Child

Page 16: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Origins of Dyslexia?

• Genetic factors– Parent or sibling with dyslexia

• Neurological problems – “Faulty wiring” in left hemisphere – angular gyrus– Difficulty associating letters with sounds

• Phonological processing problems• Double-deficit hypothesis

– Deficits in phonological processing and in naming speed

Page 17: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Piaget: The Concrete-Operational Stage

Page 18: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Meant by the Stage of Concrete Operations?

• Beginnings of adult logic– Involves tangible objects, not abstract ideas

• Characterized by– Reversibility and flexibility– Less egocentric– Decentration

Page 19: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Meant by the Stage of Concrete Operations?

• Demonstrate understanding of conservation– Object can have several properties or dimensions– Child can de-center and focus on more than one dimension

• Conservation of mass develops first

Page 20: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 12.1

Conservation of Mass

Page 21: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Can We Apply Piaget’s Theory of Cognitive Development to Educational Practices?

• Learning involves active discovery– Find stimulating materials instead of imposing knowledge

• Instruction geared to student’s level– Consider the level of cognitive development

• Encourage development of perspective taking– Encourage group discussions and peer interaction

Page 22: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Moral Development

The Child as Juror

Page 23: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Piaget View the Development of Moral Reasoning?

Two stages of moral development• Moral Realism – ‘objective morality’

– Emerges at about age 5– Behavior is correct when it conforms to authority or rules

• Rules are absolutes– Punishment is inevitable

• Immanent justice or automatic retribution• Do not excuse accidental behavior

Page 24: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Piaget View the Development of Moral Reasoning?

Two stages of moral development• Autonomous Morality

– Emerges between ages 9 and 11– Social rules are arbitrary agreements that can be changed

• Circumstances can require breaking rules– Consider the intentions of the wrongdoer

• Decentration and increased empathy– Develops as a result of cooperative peer relationships

Page 25: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Kohlberg’s Theory of Moral Development?

• Emphasis on taking on the perspective of others• Moral reasoning follows the same sequence in all children• Three levels with two stages within each level

Page 26: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Kohlberg’s Theory of Moral Development?

• Preconventional level– Obedience and punishment– Instrumental orientation

• Conventional level– Good-boy/Good-girl orientation– Law-and-order orientation

• Postconventional level– Contractual, legalistic orientation– Universal ethical principles orientation

Page 27: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Information-Processing

Learning, Remembering,

Problem Solving

Page 28: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is the Difference Between Piaget’s View of Cognitive Development and the Information Processing Approach?

• Information Processing– Cognitive development akin to computer systems

• Information input, storage, retrieval, output

• Key Elements – Selective attention– Capacity for storage and retrieval of information– Strategies for processing information

Page 29: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Development of Selective Attention

• Pay attention to relevant features of a task– Ability to focus attention and screen out distractions improves – Attend to multiple aspects of a problem

Page 30: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Do Children Understand About the Functioning of Their Cognitive Processes and Their Memory?

• Metacognition– Knowledge and control of cognitive abilities

• Metamemory – Children’s awareness of the functioning of their memory

• As children develop they utilize more strategies for memory

Page 31: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Intellectual Development, Creativity, and Achievement

Page 32: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Intelligence?

• Achievement– What a child has learned– Specific content area

• Intelligence– Child’s underlying learning ability– Cognitive basis for academic achievement

Page 33: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Theories of Intelligence

Page 34: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are “Factor Theories” of Intelligence?

• Behaviors we consider intelligent have a common factor – Spearman g or “general intelligence”

• Broad reasoning and problem solving– S or “specific capacities”

• Individual abilities– Factor Analysis

• Primary Mental Abilities - Thurstone

Page 35: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What is Sternberg’s Triarchic Theory of Intelligence?

Three Prong Theory of Intelligence• Analytical intelligence

– Academic ability

• Creative intelligence– Ability to cope with novel situations

• Practical intelligence– Ability to adapt to demands of the environment

Page 36: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 12.5

Sternberg’s Triarchic Theory of Intelligence

Page 37: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What is Meant by Multiple Intelligences?

Different kinds of intelligence (Gardner)• Can be advanced in one kind of intelligence and deficient in

others– Critics question whether special talents represent an intelligence

Page 38: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 12.6

Gardner’s Theory of Multiple Intelligences

Page 39: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Emotional and Social Intelligence

• Emotional intelligence– Recognition and control of one’s feelings

• Social intelligence– Ability to read social concerns of others and respond appropriately

Page 40: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Measurement of Intellectual Development

• Stanford-Binet Intelligence Scale (SBIS)– Binet-Simon scale

• Assumed intelligence increases with age• Older child must answer more items to obtain comparable score

to younger child (mental age)• Yielded a score – mental age (MA)

– Terman adapted Binet-Simon to become Stanford-Binet• Yields a score – intelligence quotient (IQ)• 2-year-olds to adults

Page 41: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Measurement of Intellectual Development

• Wechsler Scales– Subtests measure different intellectual tasks

• Compares performance on one type of task with another– Wechsler Preschool and Primary Scales of Intelligence (WPPSI)– Wechsler Intelligence Scales for Children (WISC)– Wechsler Adult Intelligence Scales (WAIS)

Page 42: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 12.7

Performance Items on an Intelligence Test

Page 43: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Figure 12.8

Variations in IQ Scores

Page 44: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

The Testing Controversy

• IQ test scores – Should not be sole criteria for placement– Accurately measure skills necessary in today’s high tech work

• Culture-bias versus Culture-free– Bias for African American and lower social class– Cattell’s Culture-Fair Intelligence Test

• Culture-free tests have not been successful– Disadvantaged children consistently score lower– Do not predict academic success

Page 45: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Intelligence Develop?

• Advances in middle childhood– Symbolize experiences and manipulate symbols– Vocabulary development– Increase logical and complex thought

• Two major spurts – About age 6 – entry to school– About age 10 or 11

• Predictive power increases during middle childhood

Page 46: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Differences in Intelligence

• Mental Retardation– Significant limitations

• Intellectual functioning (IQ scores of 70 to 75), and in• Adaptive behavior

– Causes of mental retardation• Biological• Cultural-familial retardation

• Giftedness– Outstanding abilities and high performance

• In specific academic area• Leadership, arts, or bodily talents

Page 47: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Creativity?

• Ability to do things novel and useful (Sternberg)– Solve problems without expected solutions

• Creative children– Take chances,– Refuse to accept limitations,– Appreciate art and music,– Use available materials to make unique things,– Challenge social norms,– Take unpopular stands, and– Question ideas

Page 48: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is the Relationship Between Creativity and Intelligence?

• Creativity overlaps with intelligence– Sternberg’s Triarchic Theory includes creative intelligence– Gardner’s Multiple Intelligences include creative areas

• Explanation for lack of relationship– Intelligence testing requires convergent thinking– Creative thinking requires divergent thinking

Page 49: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Roles of Nature and Nurture on the Development of Intelligence?

• Genetic Influences– Measured through kinship and adoption studies– More closely related – more similar IQ scores– Heritability – about 40 to 60%

• Environmental Influences– Some studies consider

• Situational factors that affect IQ testing• Stereotype vulnerability• Exploring ability to rebound from early deprivation• Effects of positive early environments

Page 50: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Does the Research Reveal About the Advantages and Disadvantages of Bilingualism?

• Bilingual children have more cognitive flexibility– Aware of different cultures – broadens perspectives

• Learning a second language increases expertise in first language

Page 51: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Theories of Social and Emotional Development in Middle Childhood

Page 52: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are Some Features of Social and Emotional Development in Middle Childhood?

• Psychoanalytic Theory– Freud’s latency period– Erikson’s industry versus inferiority

• Social Cognitive Theory– Depend less on external rewards and punishments– Increase regulation of their behavior

• Cognitive-Developmental Theory– Decrease in egocentrism– Capacity to see the perspective of others

Page 53: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is the Relationship Between Social Cognition and Perspective-Taking?

• Social Cognition– Development of knowledge about the social world– Understanding the relationship between self and others

• Key to development of social cognition– Ability to assume the perspective of another– Five levels of perspective-taking skills

Page 54: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Self-Concept Develop in Middle Childhood?

• Children progress from– Focus on external (appearance) to – Internal characteristics

• Social relationships and group memberships are significant– Females more likely to define themselves in terms of groups

Page 55: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Self-Esteem Develop in Middle Childhood?

• Competence and social acceptance contribute to self-esteem– As children begin self appraisal, self-esteem initially declines

• Gender differences in self-esteem– Girls – higher on reading, academics, and helping others– Boys – higher on math, physical ability, and physical appearance

Page 56: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Does Self-Esteem Develop in Middle Childhood?

• Influences on self-esteem– Socialization and gender stereotypes– Parenting style– Relationship to parents– Social acceptance by peers– Genetics

Page 57: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Learned Helplessness, and How Does It Develop?

• Acquired belief that one cannot obtain the rewards one seeks– “Helpless child” quits following failure– Doubt ability and believe success is based on ability, less on effort

• Sex Differences– Girls have less confidence in math than boys

• Even when they are performing at a comparable level

Page 58: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

The Family

Page 59: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Kinds of Influences Are Exerted by the Family During Middle Childhood?

• Parent – Child Relationships– Focus on school-related matters, chores, peer activities– Coregulation – transfer of control from parent to child– Spend less time with parents than during younger years– Become more critical of parents– View parents as main source of emotional support

Page 60: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Effects of Having Lesbian or Gay Parents?

• Research Focus– General adjustment

• Comparable to children of heterosexual parents– Sexual orientation

• Prefer toys, clothing, and friends typical for their sex and age• Generally heterosexual orientation

Page 61: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Effects of Divorce on the Children?

• Divorce impacts all aspects of family life– Difficult to isolate effects of divorce

• Typical conflict is with child rearing– Young child may feel responsible for conflict

• Children of divorce – More likely to have conduct disorders, lower self-esteem, drug

abuse and poor grades– Physical health may decline, at least temporarily– More impact during first year

Page 62: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Effects of Divorce on the Children?

• Decline in quality of parenting and financial status• Cross-cultural research shows consistent effects• Boys tend to have a harder time coping with divorce

– Tend to take longer to recover

• Status of mother related to child’s well-being• Psychological treatment is helpful for children

– Many programs also involve parent

Page 63: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Life in Stepfamilies

• No conclusive effects of living in stepfamilies• Unique risks in stepfamilies

– Greater risk of being physically abused by stepparents– Infanticide occurs 60 times more often in stepfamilies– Higher incidence of sexual abuse by stepparents

Page 64: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Should Parents Who Bicker Remain Together for The Children?

• Parental conflict– Linked to problems similar to divorce– Creates a physical stress reaction in children

• Adjustment problems– Present in children of divorce– May be greater in children living with parental conflict

Page 65: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Effects of Maternal Employment on Children?

• Greatest concern is lack of supervision• No evidence of negative effects• Some indication of positive effects

– Greater independence, emotional maturity, and higher achievement orientation

– More flexible gender roles

Page 66: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Peer Relationships

Page 67: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is the Impact of Peers During Middle Childhood?

• Socialization Influence– Increasing importance of peers– Exert pressure to conform– Broaden children

• Difference relating to parents versus peers– Learn appropriate emotional responses to each – Peers may serve as a sounding board– Peers provide “real-world” practice

Page 68: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Characteristics of Popular and Rejected Children?

• Popular Children– Tend to be attractive and mature for age– Socially skilled– Have higher self-esteem and success

• Rejected Children– Show behavioral and learning problems– Are aggressive and disruptive

• Aggressive Children– Tend to seek out other aggressive children

Page 69: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

How Do Children’s Concepts of Friendship Develop?

• Early Middle Childhood– Friendships based on proximity, shared activities

• 8- to 11-year-olds– Friends are nice to each other and trustworthy– Pick friends similar in personality and behavior

• Tend to be segregated by sex– Girls develop closer friendships

Page 70: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are Conduct Disorders?

• Conduct disorders– Child consistently breaks rules or violates rights of others– Emerge around age 8, more prevalent in boys– Tend to endure

• Origins of conduct disorder– Genetic component– Inconsistent discipline, antisocial family members, deviant peers

• Treatment of conduct disorders– Cognitive behavioral techniques involving parent training– Teach children social, coping, and problem-solving skills

Page 71: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Childhood Depression?

• Depressed children– Feel sad, down in the dumps– Show poor appetite, insomnia, difficulty concentrating – Loss of self-esteem and of interest in people and activities they enjoy– Feel hopeless and show thoughts of suicide

• Many children do not recognize their own depression until age 7– Cognitive development to perceive internal states

• Estimate 5% to 9% of children are seriously depressed in any year

Page 72: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Childhood Depression?

• Origins of depression– Low levels of social and academic competence– Stressful life events and poor problem solving– Attribute failures to internal, stable, and global factors– Genetic factors

• Treatment of depression– Psychotherapy– Antidepressants

Page 73: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

Childhood Anxiety

• Generalized anxiety disorder• Phobias• Separation anxiety disorder• Obsessive-compulsive disorder

Page 74: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Is Separation Anxiety Disorder?

• Persistent and excessive separation anxiety– Inappropriate for developmental level– Interferes with activities

• Children with SAD– Cling to parents and may refuse to attend school

• Frequently develops after stressful life event

Page 75: Growth Patterns. Middle Childhood Chapters 11-13 –Physical –Cognitive –Socioemotional Development

What Are the Connections Between Separation Anxiety Disorder, School Phobia, and School Refusal?

• SAD may be expressed as school phobia• School phobia – fear of school or refusal to attend

– May occur outside of presence of SAD

• School refusal – May occur for reasons other than fear or anxiety

• Treatments – Get the child to attend school– Cognitive-behavioral approaches– Antidepressant medication