welcome to the story of your life In this chapter we explore the fascinating tale of how you have grown and developed into the person you are today We also look at some ideas about who you will grow into tomorrow Yours is a story of lifespan development Figure 9.1 From the start of life to the end the process of human growth and development is more obvious in infancy and childhood Yet your development is happening this moment and will continue minute by minute for the rest of your life Who you are today and who you will be in the future depends on a blend of genetics environment culture relationships and more As you continue through each phase of life you have experienced firsthand much of what is discussed in this chapter Now consider what psychological science has to say about your physical cognitive and psychosocial development from the womb to the tomb Learning objectives By the end of this section you will be able to define and distinguish between the three domains of development Physical cognitive and psychosocial Discuss the normative approach to development Understand the three major issues in development Continuity and discontinuity One common course of development or many unique courses of development And nature versus nurture My heart leaps up when I behold a rainbow in the sky So was it when my life began so is it now I am a man So be it when I shall grow old or let me die The child is father of the man I could wish my days to be bound each to each by natural piety Wdsworth 1802 In this poem William Werdsworth writes "The child is father of the man What does this seemingly inongruous statement mean And what does it have to do with lifespan development?" Wsworth might be suggesting that the person he is as an adult depends largely on the experiences he had in childhood Consider the following questions To what extent is the adult you are today influenced by the child you once were To what extent is a child fundamentally different from the adult he grows up to be These are the types of questions developmental psychologists try to answer by studying how humans change and grow from conception through childhood adolescence adulthood and death They view development as a lifelong process that can be studied scientifically across three developmental domains Physical cognitive and psychosocial development Physical development involves growth and changes in the body and brain the senses motor skills and health and wellness Cognitive development involves learning attention memory language thinking reasoning and creativity Psychosocial development involves emotions personality and social relationships We refer to these domains throughout the chapter Connect the concepts Research methods in developmental psychology You've learned about a variety of research methods used by psychologists Developmental psychologists use many of these approaches in order to better understand how individuals change mentally and physically over time These methods include naturalistic observations case studies surveys and experiments among others Naturalistic observations involve observing behavior in its natural context A developmental psychologist might observe how children behave on a playground at a daycare center or in the child's own home While this research approach provides a glimpse into how children behave in their natural settings researchers have very little control over the types and/or frequencies of displayed behavior In a case study developmental psychologists collect a great deal of information from one individual in order to better understand physical and psychological changes over the lifespan This particular approach is an excellent way to better understand individuals who are exceptional in some way but it is especially prone to researcher bias and interpretation and it is difficult to generalize conclusions to the larger population In one classic example of this research method being applied to a study of lifespan development Sigman Freud analyzed the development of a child known as Little Hans Freud 1909 1949 Freud's findings helped inform his theories of psychosexual development in children which you will learn about later in this chapter Little Genie the subject of a case study discussed in the chapter on thinking and intelligence provides another example of how psychologists examine developmental milestones through detailed research on a single individual In Jeanie's case her neglectful and abusive upbringing led to her being unable to speak until at age 13 she was removed from that harmful environment As she learned to use language psychologists were able to compare how her language acquisition abilities differed when occurring in her latest stage development compared to the typical acquisition of those skills during the ages of infancy through early childhood From Crashen Curtis Wrigler and Wrigler 1974 Curtis 1981 The survey method asks individuals to self-report important information about their thoughts experiences and beliefs This particular method can provide large amounts of information in relatively short amounts of time However validity of data collected in this way relies on honest self-reporting and the data is relatively shallow when compared to the depth of information collected in a case study An example of comprehensive survey was the research done by Ruth W Howard in 1934 She obtained her doctorate by surveying 229 sets of triplets The most comprehensive research of triplets completed at the time This pioneering woman was also the first African-American woman to earn a PhD in psychology American Psychological Association 2019 Experiments involve significant control over extraneous variables and manipulation of the independent variable As such experimental research allows developmental psychologists to make causal statements about certain variables that are important for the developmental process Because experimental research must occur in a controlled environment researchers must be cautious about whether behaviors observed in the laboratory translate to an individual's natural environment Later in this chapter you will learn about several experiments in which toddlers and young children observe scenes or actions so that researchers can determine at what age specific cognitive abilities develop For example children may observe a quantity of liquid poured from a short fat glass into a tall skinny glass As the experimenters question the children about what occurred the subjects answers help psychologists understand at what age a child begins to comprehend that the volume of liquid remained the same although the shapes of the containers differ across these three domains physical cognitive and psychosocial The normative approach to development is also discussed This approach asks what is normal development In the early decades of the 20th century normative psychologists studied large numbers of children at various ages to determine norms i.e average ages of when most children reach specific developmental milestones in each of the three domains Guessel 1933 1939 1940 Guessel and il 1946 Hall 1904 Note that while they are still in use the terms normal and normative often require deeper consideration and some researchers and practitioners aim to avoid them Psychologists often consider typical or normal signs in order to diagnose when a child may need examination or support Although children develop at slightly different rates we can use these age related averages as general guidelines to compare children with same age peers to determine the approximate ages they should reach specific normative events called developmental milestones Eg crawling walking writing dressing naming colors speaking in sentences and starting puberty Not all normative events are universal meaning they are not experienced by all individuals across all cultures Biological milestones such as puberty tend to be universal but social milestones such as the age when children begin formal schooling are not necessarily universal Instead they affect most individuals in a particular culture Gelin Ilg 1946 For example in some countries children begin school around five or six years old But other countries children often enter school at an advanced age or have limitations or interruptions in their education For example UNESCO estimates that nearly 244 million of the world's schoolage children do not attend school Antonyini's 2022 To better understand the normative approach imagine two new mothers Louisa and Kimberly who are close friends and have children around the same age Louisa's daughter is 14 months old and Kimberly's son is 12 months old According to the normative approach the average age a child starts to walk is 12 months However at 14 months Louisa's daughter still isn't walking She tells Kimberly she is worried that something might be wrong with her baby Kimberly is surprised because her son started walking when he was only 10 months old Should Louisa be worried Should she be concerned if her daughter is not walking by 15 months or 18 months Issues in developmental psychology There are many different theoretical approaches regarding human development As we evaluate them in this chapter recall that developmental psychology focuses on how people change And keep in mind that all the approaches that we present in this chapter address questions of change Is the change smooth or uneven Continuous versus discontinuous Is this pattern of change the same for everyone Or are there many different patterns of change One course of development versus many courses How do genetics and environment interact to influence development Nature versus nurture Is development continuous or discontinuous Continuous development views development as a cumulative process gradually improving on existing skills Figure 9.2 With this type of development there is gradual change Consider for example a child's physical growth adding inches to height yearbyear In contrast theorists who view development as discontinuous believe that development takes place in unique stages It occurs at specific times or ages With this type of development the change is more sudden such as an infant's ability to conceive object permanence Is there one course of development or many Is development essentially the same or universal for all children i.e there is one course of development or does development follow a different course for each child depending on the child's specific genetics and environment i.e there are many courses of development Do people across the world share more similarities or more differences in their development How much do culture and genetics influence a child's behavior Stage theories hold that the sequence of development is universal For example in cross-cultural studies of language development children from around the world reach language milestones in a similar sequence Gliteman in Newport 1995 Infants in all cultures coup babble They begin babbling at about the same age and utter their first word around 12 months old Yet we live in diverse contexts that have a unique effect on each of us For example researchers once believed that motor development follows one course for all children regardless of culture However child care practices vary by culture and different practices have been found to accelerate or inhibit achievement of developmental milestones such as sitting crawling and walking Carassic Adolf Tis Lamanda and Bournestein 2010 for instance Let's look at the HA society in Paraguay They spend a significant amount of time foraging in forests While foraging ache mothers carry their young children rarely putting them down in order to protect them from getting hurt in the forests Consequently their children walk much later They walk around 23 to 25 months old in comparison to infants in western cultures who begin to walk around 12 months old However as ash children become older they are allowed more freedom to move about and by about age nine their motor skills surpass those of US children of the same age Ashe children are able to climb trees up to 25 ft tall and use machetes and other tools Kaplan and Dove 1987 As you can see our development is influenced by multiple contexts so the timing of basic motor functions may vary across cultures However the functions themselves are present in all societies Figure 9.3 Figure 9.3 All children across the world love to play Whether in a Florida or B South Africa children enjoy exploring sand sunshine and the sea How do nature and nurture influence development Are we who we are because of nature biology and genetics Or are we who we are because of nurture our environment and culture This long-standing question is known in psychology as the nature versus nurture debate It seeks to understand how our personalities and traits are the product of our genetic makeup and biological factors and how they are shaped by our environment including our guardians peers and culture For instance why do biological children sometimes act like their parents Is it because of genetics or because of early childhood environment and what the child has learned from the parents What about children who are adopted Are they more like their biological families or more like their adoptive families And how can siblings from the same family be so different We are all born with specific genetic traits inherited from our biological parents such as eye color height and certain personality traits Beyond our basic genotype however there is a deep interaction between our genes and our environment Our unique experiences in our environment influence whether and how particular traits are expressed And at the same time our genes influence how we interact with our environment Diamond 2009 Lobo 2008 This chapter will show that there is a reciprocal interaction between nature and nurture as they both shape who we become But the debate continues as to the relative contributions of each Dig deeper The achievement gap How does socioeconomic status affect development The achievement gap refers to the persistent difference in grades test scores and graduation rates that exist among students of different ethnicities races and in certain subjects genders Winerman 2011 Research suggests that these achievement gaps are strongly influenced by differences in socio-economic factors that exist among the families of these children While the researchers acknowledge that programs aimed at reducing such socioeconomic discrepancies would likely aid in equalizing the aptitude and performance of children from different backgrounds they recognize that such large-scale interventions would be difficult to achieve Therefore it is recommended that programs aimed at fostering aptitude and achievement among children with lower socioeconomic status may be the best option for dealing with issues related to academic achievement gaps Duncan and Magnus 2005 Children from low-income households perform significantly more poorly than their middle and highincome peers on a number of educational variables They have significantly lower standardized test scores graduation rates and college entrance rates and they have much higher school dropout rates There have been attempts to correct the achievement gap through state and federal legislation But what if the problems start before the children even enter school Psychologists Betty Hart and Todd Rizley 2006 spent their careers looking at early language ability and progression of children in various income levels In one longitudinal study they found that although all the parents in the study engaged and interacted with their children parents with middle and high income status interacted with their children differently than parents with lower income status After analyzing 1,300 hours of parent child interactions the researchers found that middle and highincome parents talk to their children significantly more starting when the children are infants By 3 years old children from higher inome households knew almost double the number of words known by their peers from lower inome households and they had heard an estimated total of 30 million more words than the children from low-income households Hart and Wrizley 2003 And the gaps only become more pronounced Before entering kindergarten children with higher income status score 60% higher on achievement tests than their peers with lower income status Lee and Burkeham 2002 There are solutions to this problem At the University of Chicago experts are working with low-income families visiting them at their homes and encouraging them to speak more to their children on a daily and hourly basis Other experts are designing preschools in which students from diverse economic backgrounds are placed in the same classroom In this research children with lower socioeconomic status made significant gains in their language development likely as a result of attending the specialized preschool Shakar and BB 2007 What other methods or interventions could be used to decrease the achievement gap What types of activities could be implemented to help the children of your community or a neighboring community Learning objectives By the end of this section you will be able to discuss Freud's theory of psychosexual development Describe the major tasks of child and adult psychosocial development according to Ericson Discuss PGE's view of cognitive development and apply the stages to understanding childhood cognition Describe Coberg's theory of moral development Compare and contrast the strengths and weaknesses of major developmental theories There are many theories regarding how babies and children grow and develop into happy healthy adults We explore several of these theories in this section Psychosexual theory of development Sigman Freud 1856 to 1939 believed that personality develops during early childhood For Freud childhood experiences shape our personalities and behavior as adults Freud viewed development as discontinuous He believed that each of us must pass through a series of stages during childhood and that if we lack proper nurturance and parenting during a stage we may become stuck or fixated in that stage Freud's stages are called the stages of psychosexual development According to Freud children's pleasure- seeeking urges are focused on a different area of the body called an erogynous zone at each of the five stages of development: oral anal phallic latency and genital While most of Freud's ideas have not found support in modern research we cannot discount the contributions that Freud has made to the field of psychology Psychologists today dispute Freud's psychosexual stages as a legitimate explanation for how one's personality develops But what we can take away from Freud's theory is that personality is shaped in some part by experiences we have in childhood These stages are discussed in detail in the chapter on personality psychosocial theory of development Eric Ericson 1902 to 1994 figure 9.4 another stage theorist took Freud's theory and modified it as psychosocial theory Ericson's psychosocial development theory emphasizes the social nature of our development rather than its sexual nature While Freud believed that personality is shaped only in childhood Ericson proposed that personality development takes place all through the lifespan Ericson suggested that how we interact with others is what affects our sense of self or what he called the ego identity Figure 9.4 Eric Ericson proposed the psychosocial theory of development In each stage of Ericson's theory there is a psychosocial task that we must master in order to feel a sense of competence Ericson proposed that we are motivated by a need to achieve competence in certain areas of our lives According to psychosocial theory we experience eight stages of development over our lifespan from infancy through late adulthood At each stage there is a conflict or task that we need to resolve Successful completion of each developmental task results in a sense of competence and a healthy personality Failure to master these tasks leads to feelings of inadequacy According to Ericson 1963 trust is the basis of our development during infancy birth to 12 months Therefore the primary task of this stage is trust versus mistrust Infants are dependent upon their caregivers So caregivers who are responsive and sensitive to their infant's needs help their baby to develop a sense of trust Their baby will see the world as a safe predictable place Unresponsive caregivers who do not meet their baby's needs can engender feelings of anxiety fear and mistrust Their baby may see the world as unpredictable As toddlers ages 1 to 3 years begin to explore their world they learn that they can control their actions and act on the environment to get results They begin to show clear preferences for certain elements of the environment such as food toys and clothing A toddler's main task is to resolve the issue of autonomy versus shame and doubt by working to establish independence This is the me do it stage For example we might observe a budding sense of autonomy in a 2-year-old child who wants to choose her clothes and dress herself Although her outfits might not be appropriate for the situation her input in such basic decisions has an effect on her sense of independence If denied the opportunity to act on her environment she may begin to doubt her abilities which could lead to low self-esteem and feelings of shame Once children reach the preschool stage ages 3 to 6 years they are capable of initiating activities and asserting control over their world through social interactions and play According to Ericson preschool children must resolve the task of initiative versus guilt By learning to plan and achieve goals while interacting with others preschool children can master this task Those who do will develop self-confidence and feel a sense of purpose Those who are unsuccessful at this stage with their initiative misfiring or stifled may develop feelings of guilt How might overcontrolling parents stifle a child's initiative During the elementary school stage ages 7 to 11 children face the task of industry versus inferiority Children begin to compare themselves to their peers to see how they measure up They either develop a sense of pride and accomplishment in their schoolwork sports social activities and family life or they feel inferior and inadequate when they don't measure up What are some things parents and teachers can do to help children develop a sense of competence and a belief in themselves and their abilities In adolescence ages 12 to 18 children face the task of identity versus role confusion According to Ericson an adolescent's main task is developing a sense of self Adolescence struggle with questions such as "Who am I and what do I want to do with my life?" Along the way most adolescence try on many different selves to see which ones fit Adolescence who are successful at this stage have a strong sense of identity and are able to remain true to their beliefs and values in the face of problems and other people's perspectives What happens to apathetic adolescents who do not make a conscious search for identity or those who are pressured to conform to their parents' ideas for the future These teens will have a weak sense of self and experience role confusion They are unsure of their identity and confused about the future People in early adulthood ages 19 to 29 are concerned with intimacy versus isolation After we have developed a sense of self in adolescence we are ready to share our life with others Ericson said that we must have a strong sense of self before developing intimate relationships with others Adults who do not develop a positive self-concept in adolescence may experience feelings of loneliness and emotional isolation When people reach 30 they enter the time known as middle adulthood which extends to age 64 The social task of middle adulthood is generativity versus stagnation Generativity involves finding your life's work and contributing to the development of others through activities such as volunteering mentoring and raising children Those who do not master this task may experience stagnation having little connection with others and little interest in productivity and self-improvement From age 65 to the end of life we are in the period of development known as late adulthood Ericson's task at this stage is called integrity versus despair He said that people in late adulthood reflect on their lives and feel either a sense of satisfaction or a sense of failure People who feel proud of their accomplishments feel a sense of integrity and they can look back on their lives with few regrets However people who are not successful at this stage may feel as if their life has been wasted They focus on what would have should have and could have been They face the end of their lives with feelings of bitterness depression and despair Table 9.1 summarizes the stages of Ericson's theory Cognitive theory of development Jean Pia 1896 to 1980 is another stage theorist who studied childhood development figure 9.5 Instead of approaching development from a psychoanalytical or psychosocial perspective Pia focused on children's cognitive growth He believed that thinking is a central aspect of development and that children are naturally inquisitive However he said that children do not think and reason like adults PG 19301932 His theory of cognitive development holds that our cognitive abilities develop through specific stages which exemplifies the discontinuity approach to development As we progress to a new stage there is a distinct shift in how we think and reason Figure 9.5 Jean Pia spent over 50 years studying children and how their minds develop Pia said that children develop schamatada to help them understand the world Schamata are concepts mental models that are used to help us categorize and interpret information By the time children have reached adulthood they have created schamatada for almost everything When children learn new information they adjust their schamatada through two processes assimilation and accommodation First they assimilate new information or experiences in terms of their current schamatada Assimilation is when they take in information that is comparable to what they already know Accommodation describes when they change their schamatada based on new information This process continues as children interact with their environment For example 2-year-old Abdul learned the schema for dogs because his family has a Labrador retriever When Abdul sees other dogs in his picture books he says "Look mommy dog." Thus he has assimilated them into his schema for dogs One day Abdul sees a sheep for the first time and says "Look mommy dog." having a basic schema that a dog is an animal with four legs and fur Abdul thinks all furry four-legged creatures are dogs When Abdul's mom tells him that the animal he sees is a sheep not a dog Abdul must accommodate his schema for dogs to include more information based on his new experiences Abdul's schema for dog was too broad since not all furry four-legged creatures are dogs He now modifies his schema for dogs and forms a new one for sheep Like Freud and Ericson PJ thought development unfolds in a series of stages approximately associated with age ranges He proposed a theory of cognitive development that unfolds in four stages Sensory motor pre-operational concrete operational and formal operational Table 9.2 The first stage is the sensory motor stage which lasts from birth to about 2 years old During this stage children learn about the world through their senses and motor behavior Young children put objects in their mouths to see if the items are edible And once they can grasp objects they may shake or bang them to see if they make sounds Between 5 and 8 months old the child develops object permanence which is the understanding that even if something is out of sight it still exists Bogarts Shinsky and Schilling 2000 According to Pia young infants do not remember an object after it has been removed from sight PJ studied infants reactions when a toy was first shown to an infant and then hidden under a blanket Infants who had already developed object permanence would reach for the hidden toy indicating that they knew it still existed Whereas infants who had not developed object permanence would appear confused In Pia's view around the same time children develop object permanence they also begin to exhibit stranger anxiety which is a fear of unfamiliar people Babies may demonstrate this by crying and turning away from a stranger by clinging to a caregiver or by attempting to reach their arms toward familiar faces such as parents Stranger anxiety results when a child is unable to assimilate the stranger into an existing schema Therefore she can't predict what her experience with that stranger will be like which results in a fear response Pia's second stage is the pre-operational stage which is from approximately 2 to 7 years old In this stage children can use symbols to represent words images and ideas which is why children in this stage engage in pretend play A child's arms might become airplane wings as they zoom around the room Or a child with a stick might become a brave knight with a sword Children also begin to use language in the pre-operational stage but they cannot understand adult logic or mentally manipulate information The term operational refers to logical manipulation of information So children at this stage are considered to be pre-operational Children's logic is based on their own personal knowledge of the world so far rather than on conventional knowledge For example dad gave a slice of pizza to 10-year-old Ko and another slice to her three-year-old brother Kenny Kenny's pizza slice was cut into five pieces So Kenny told his sister that he got more pizza than she did Children in this stage cannot perform mental operations because they have not developed an understanding of conservation which is the idea that even if you change the appearance of something it is still equal in size as long as nothing has been removed or added During this stage we also expect children to display egoentrism which means that the child is not able to take the perspective of others A child at this stage thinks that everyone sees thinks and feels just as they do Let's look at Kenny and Ko again Ko's birthday is coming up so their mom takes Kenny to the toy store to choose a present for his sister He selects an Iron Man action figure for her thinking that if he likes the toy his sister will too An egocentric child is not able to infer the perspective of other people and instead attributes his own perspective PJ's third stage is the concrete operational stage which occurs from about 7 to 11 years old In this stage children can think logically about real concrete events They have a firm grasp on the use of numbers and start to employ memory strategies They can perform mathematical operations and understand transformations such as addition is the opposite of subtraction and multiplication is the opposite of division In this stage children also master the concept of conservation Even if something changes shape its mass volume and number stay the same For example if you pour water from a tall thin glass to a short fat glass you still have the same amount of water Remember Ko and Kenny in the pizza How did Ko know that Kenny was wrong when he said that he had more pizza Children in the concrete operational stage also understand the principle of reversibility which means that objects can be changed and then returned back to their original form or condition Take for example water that you poured into the short fat glass You can pour water from the fat glass back to the thin glass and still have the same amount minus a couple of drops The fourth and last stage in PJ's theory is the formal operational stage which is from about age 11 to adulthood Whereas children in the concrete operational stage are able to think logically only about concrete events children in the formal operational stage can also deal with abstract ideas and hypothetical situations Children in this stage can use abstract thinking to problem solve look at alternative solutions and test these solutions In adolescence a renewed egoentrism occurs For example a 15-year-old with a very small pimple on her face might think it is huge and incredibly visible under the mistaken impression that others must share her perceptions beyond formal operational thought As with other major contributors of theories of development several of Pia's ideas have come under criticism based on the results of further research For example several contemporary studies support a model of development that is more continuous than Pia's discrete stages Courage and how 2002 Seagler 2005 2006 many others suggest that children reach cognitive milestones earlier than PGE describes by Arjun 2004 Dehavia and Spelky 2010 According to Pia the highest level of cognitive development is formal operational thought which develops between 11 and 20 years old However many developmental psychologists disagree with Pia suggesting a fifth stage of cognitive development known as the post-formal stage Basetches 1984 Commons and Brassette 2006 Cenote 1998 In postformal thinking decisions are made based on situations and circumstances and logic is integrated with emotion as adults develop principles that depend on contexts One way that we can see the difference between an adult in post-formal thought and an adolescent in formal operations is in terms of how they handle emotionally charged issues It seems that once we reach adulthood our problem-solving abilities change As we attempt to solve problems we tend to think more deeply about many areas of our lives such as relationships work and politics Laboui Veif and Deal 1999 Because of this postformal thinkers are able to draw on past experiences to help them solve new problems Problem- solving strategies using postformal thought vary depending on the situation What does this mean Adults can recognize for example that what seems to be an ideal solution to a problem at work involving a disagreement with a colleague may not be the best solution to a disagreement with a significant other Connect the concepts Neurocon constructivism The genetic environmental correlation you've learned about concerning the birectional influence of genes and the environment has been explored in more recent theories Nukem 2011 One such theory neuroconstructivism suggests that neural brain development influences cognitive development Experiences that a child encounters can impact or change the way that neural pathways develop in response to the environment An individual's behavior is based on how one understands the world There is interaction between neural and cognitive networks at and between each level consisting of these genes neurons brain body social environment These interactions shape mental representations in the brain and are dependent on context that individuals actively explore throughout their lifetimes Westerman Marishall Johnson Sirua Spratling and Thomas 2007 An example of this would be a child who may be genetically predisposed to a difficult temperament They may have parents who provide a social environment in which they are encouraged to express themselves in an optimal manner The child's brain would form neural connections enhanced by that environment thus influencing the brain The brain gives information to the body about how it will experience the environment Thus neural and cognitive networks work together to influence genes i.e attenuating temperament body i.e may be less prone to high blood pressure and social environment i.e may seek people who are similar to them socioultural theory of development Levigotssky was a Russian psychologist who proposed a socioultural theory of development He suggested that human development is rooted in one's culture A child's social world for example forms the basis for the formation of language and thought The language one speaks and the ways a person thinks about things are dependent on one's cultural background Vigotssky also considered historical influences as key to one's development He was interested in the process of development and the individual's interactions with their environment John Steiner and man 1996 Moral theory of development A major task beginning in childhood and continuing into adolescence is discerning right from wrong Psychologist Lawrence Colberg 1927 to 1987 extended upon the foundation that PG built regarding cognitive development Colberg believed that moral development like cognitive development follows a series of stages To develop this theory Coberg posed moral dilemmas to people of all ages and then he analyzed their answers to find evidence of their particular stage of moral development Before reading about the stages take a minute to consider how you would answer one of Coberg's best known moral dilemmas commonly known as the Hines dilemma In Europe a woman was near death from a special kind of cancer There was one drug that the doctors thought might save her It was a form of radium that a drugist in the same town had recently discovered The drug was expensive to make but the drugist was charging 10 times what the drug cost him to make He paid $200 for the radium and charged $2,000 for a small dose of the drug The sick woman's husband Hines went to everyone he knew to borrow the money but he could only get together about $1,000 which is half of what it cost He told the drugist that his wife was dying and asked him to sell it cheaper or let him pay later But the drugist said "No I discovered the drug and I'm going to make money from it." So Hines got desperate and broke into the man's store to steal the drug for his wife Should the husband have done that Colberg 1969 page 379 How would you answer this dilemma Coberg was not interested in whether you answer yes or no to the dilemma Instead he was interested in the reasoning behind your answer After presenting people with this and various other moral dilemmas Colberg reviewed people's responses and placed them in different stages of moral reasoning Figure 9.6 According to Coberg an individual progresses from the capacity for preconventional morality before age nine to the capacity for conventional morality early adolescence and toward attaining postconventional morality once formal operational thought is attained which only a few fully achieve Coberg placed in the highest stage responses that reflected the reasoning that Hines should steal the drug because his wife's life is more important than the pharmacist making money The value of a human life overrides the pharmacist's greed Figure 9.6 Colberg identified three levels of moral reasoning Preconventional conventional and postconventional Each level is associated with increasingly complex stages of moral development It is important to realize that even those people who have the most sophisticated postconventional reasons for some choices may make other choices for the simplest of preconventional reasons Many psychologists agree with Coberg's theory of moral development but point out that moral reasoning is very different from moral behavior Sometimes what we say we would do in a situation is not what we actually do in that situation In other words we might talk the talk but not walk the walk How does this theory apply to people of different genders Coberg 1969 felt that more men than women move past stage 4 in their moral development He went on to note that women seem to be deficient in their moral reasoning abilities These ideas were not wellreceived by Carol Gilligan a research assistant of Colberg who consequently developed her own ideas of moral development In her groundbreaking book In a Different Voice: Psychological Theory and Women's Development Gilligan 1982 criticized her former mentors theory because it was based only on upper class white men and boys She argued that women are not deficient in their moral reasoning She proposed that different genders reason differently Girls and women focus more on staying connected and the importance of interpersonal relationships Therefore in the Hines dilemma many girls and women respond that Hines should not steal the medicine Their reasoning is that if he steals the medicine is arrested and is put in jail then he and his wife will be separated and she could die while he is still in prison Learning objectives By the end of this section you will be able to describe the stages of prenatal development and recognize the importance of prenatal care Appraise physical cognitive and emotional development that occurs from infancy through childhood Compare and contrast physical cognitive and emotional development that occurs during adolescence Examine physical cognitive and emotional development that occurs in adulthood From the moment we are born until the moment we die we continue to develop As discussed at the beginning of this chapter developmental psychologists often divide our development into three areas Physical development cognitive development and psychosocial development Mirroring Ericson's stages lifespan development is divided into different stages that are based on age We will discuss prenatal infant child adolescent and adult development Prenatal development how did you come to be who you are From beginning as a one- cell structure to your birth your prenatal development occurred in an orderly and delicate sequence There are three stages of prenatal development Germanal embriionic and fetal Let's take a look at what happens to the developing baby in each of these stages Germinal stage weeks one to two In the discussion of biocsychology earlier in the book you learned about genetics and DNA DNA is passed on to the child at the moment of conception Conception occurs when sperm fertilizes an egg and forms a zygote Figure 9.7 A zygote begins as a one- cell structure that is created when a sperm and egg merge The genetic makeup and sex of the zygote are set at this point During the first week after conception the zygote divides and multiplies going from a one cell structure to two cells then four cells then eight cells and so on This process of cell division is called mitosis Mitosis is a fragile process and fewer than 1/ half of all zygot survive beyond the first two weeks Hall 2004 After 5 days of mitosis there are 100 cells and after 9 months there are billions of cells As the cells divide they become more specialized forming different organs and body parts In the germinal stage the mass of cells has yet to attach itself to the lining of the uterus Once it does the next stage begins Figure 9.7 Sperm and OAM fuse at the point of conception Embryionic stage weeks 3 to 8 After the zygote divides for about 7 to 10 days and has 150 cells It travels down the fallopian tubes and implants itself in the lining of the uterus Upon implantation this multisellular organism is called an embryo Now blood vessels grow forming the placenta The placenta is a structure connected to the uterus that provides nourishment and oxygen to the developing embryo via the umbilical cord Basic structures of the embryo start to develop into areas that will become the head chest and abdomen During the embryionic stage the heart begins to beat and organs form and begin to function The neural tube forms along the back of the embryo developing into the spinal cord and brain Fetal stage weeks 9 to 40 When the organism is about 9 weeks old the embryo is called a fetus At this stage the fetus is about the size of a kidney bean and begins to take on the recognizable form of a human being as the tail begins to disappear From 9 to 12 weeks the sex organs begin to differentiate At about 16 weeks the fetus is approximately 4.5 in long Fingers and toes are fully developed and fingerprints are visible By the time the fetus reaches the sixth month of development 24 weeks it weighs up to 1.4 pounds Hearing has developed so the fetus can respond to sounds The internal organs such as the lungs heart stomach and intestines have formed enough that a fetus born prematurely at this point has a chance to survive outside of the womb Throughout the fetal stage the brain continues to grow and develop nearly doubling in size from weeks 16 to 28 Around 36 weeks the fetus is almost ready for birth It weighs about six pounds and is about 18.5 in long And by week 37 all of the fetus's organ systems are developed enough that it could survive outside the uterus without many of the risks associated with premature birth The fetus continues to gain weight and grow in length until approximately 40 weeks By then the fetus has very little room to move around and birth becomes imminent The progression through the stages is shown in figure 9.8 Eight Prenatal influences During each prenatal stage genetic and environmental factors can affect development The developing fetus is completely dependent on the person carrying it Routine prenatal care which is medical care during pregnancy that monitors the health of both the pregnant person and the fetus Figure 9.9 is important because it can reduce the risk of complications during pregnancy NIH 2013 In fact people who are trying to become pregnant or who may become pregnant should discuss pregnancy planning with their doctor They may be advised for example to take a vitamin containing folic acid which helps prevent certain birth defects or to monitor aspects of their diet or exercise routines People can face health risks without prenatal care which is not provided equitably across populations or locations Back in Scrimshaw 2020 Figure 9.9 A pregnant person receives an ultrasound as part of their prenatal care Recall that when the zygote attaches to the wall of the uterus the placenta is formed The placenta provides nourishment and oxygen to the fetus Most everything a pregnant person ingests including food liquid and even medication travels through the placenta to the fetus Hence the common phrase eating for two Everything in the environment affects the fetus If they are exposed to something harmful the child can show lifelong effects A teragen is any environmental agent biological chemical or physical that causes damage to the developing embryo or fetus There are different types of teratagens Alcohol and most drugs cross the placenta and affect the fetus Alcohol is not safe to drink in any amount during pregnancy Alcohol use during pregnancy has been found to be the leading preventable cause of intellectual disabilities in children in the United States Meyer and West 2001 Excessive drinking while pregnant can cause fetal alcohol spectrum disorders with lifelong consequences for the child ranging in severity from minor to major Table 9.3 Fetal alcohol spectrum disorders FASD are a collection of birth defects associated with heavy consumption of alcohol during pregnancy Physically children with FASD may have a small head size and abnormal facial features Cognitively these children may have poor judgment poor impulse control higher rates of ADHD learning issues and lower IQ scores These developmental problems and delays persist into adulthood Strik at all 2004 Based on studies conducted on animals it also has been suggested that alcohol consumption during pregnancy may predispose offspring to like alcohol Young and Tobol 2007 Smoking is also considered a terratogen because nicotine travels through the placenta to the fetus When the pregnant person smokes the developing baby experiences a reduction in blood oxygen levels According to the Centers for Disease Control and Prevention 2013 smoking while pregnant can result in premature birth low birthw weightight infants still birth and sudden infant death syndrome SIDS heroin cocaine methamphetamine Almost all prescription medicines and most over-the-counter medications are also considered teratogens Babies born with a heroin addiction need heroin just like an adult with a heroin addiction The child will need to be gradually weaned from the heroin under medical supervision Otherwise the child could have seizures and die Other teratogens include radiation viruses such as HIV and herpes and reubella German measles People who were raised in the United States are much less likely to be afflicted with reubella because most receive childhood immunizations or vaccinations that protect the body from disease Each organ of the fetus develops during a specific period in the pregnancy called the critical or sensitive period Figure 9.8 For example research with primate models of FASD has demonstrated that the time during which a developing fetus is exposed to alcohol can dramatically affect the appearance of facial characteristics associated with fetal alcohol syndrome Specifically this research suggests that alcohol exposure that is limited to day 19 or 20 of gestation can lead to significant facial abnormalities in the offspring Ashley Magnus Omnell and Claren 1999 Given regions of the brain also show sensitive periods during which they are most susceptible to the teratogenic effects of alcohol Tran and Kelly 2003 What do you think Should people who use drugs during pregnancy be arrested and jailed As you now know people who use drugs or alcohol during pregnancy can cause serious lifelong harm to their child Some have advocated mandatory screenings for pregnant people who have a history of problematic drug use and if they continue using to arrest prosecute and incarcerate them Murphy 2014 For example in the 1990s South Carolina implemented such a quote fetal protection law called the inter agency policy on management of substance abuse during pregnancy which had disastrous results The inter agency policy applied to patients attending the obstetrics clinic at MUSC which primarily serves patients who are indigent or on Medicaid It did not apply to private obstetrical patients The policy required patient education about the harmful effects of substance abuse during pregnancy A statement also warned patients that protection of unborn and newborn children from the harms of illegal drug abuse could involve the Charleston police the solicitor of the 9inth Judicial Court and the Protective Services Division of the Department of Social Services DSS Jo Marshall and Pearl Mutter 1995 PP 120 to 121 As with similar laws this policy seemed to deter pregnant people from seeking prenatal care deterred them from seeking other social services and was applied solely to people with low incomes resulting in lawsuits The program was cancelled after 5 years during which 42 women were arrested A federal agency later determined that the program involved human experimentation without the approval and oversight of an institutional review board IRB Many states including Massachusetts Florida California Illinois and Utah have mandatory reporting laws that require healthcare providers to inform child protective services when they suspect that a fetus or infant is exposed to drugs of abuse Even though prosecutions are rarely pursued in these states pregnant people still report reluctance to seek care for either their pregnancy or their substance abuse and make efforts to hide both from providers Work 2023 What were the flaws in these programs and how could states and health care providers improve them What are the ethical implications of charging pregnant people with child abuse Infancy through childhood The average newborn weighs approximately 7.5 lbs Although small newborns are not completely helpless because their reflexes and sensory capacities help them interact with the environment from the moment of birth All healthy babies are born with newborn reflexes inborn automatic responses to particular forms of stimulation Reflexes help the newborn survive until it is capable of more complex behaviors These reflexes are crucial to survival They are present in babies whose brains are developing normally and usually disappear around four to 5 months old Let's take a look at some of these newborn reflexes The rooting reflex is the newborn's response to anything that touches their cheek When you stroke a baby's cheek the baby naturally turns the head in that direction and begins to suck The sucking reflex is the automatic unlearned sucking motions that infants do with their mouths Several other interesting newborn reflexes can be observed For instance if you put your finger into a newborn's hand you will witness the grasping reflex in which a baby automatically grasps anything that touches the palms The moral reflex is the newborn's response to the sensation of falling The baby spreads the arms pulls them back in and then usually cries How do you think these reflexes promote survival in the first months of life What can young infants see hear and smell Newborn infant's sensory abilities are significant but their senses are not yet fully developed Many of a newborn's innate preferences facilitate interaction with caregivers and other humans Although vision is their least developed sense newborns already show a preference for faces Babies who are just a few days old also prefer human voices They will listen to voices longer than sounds that do not involve speech Vulammanos and Vorer 2004 And they seem to prefer their mother's voice over a stranger's voice Mills and Melhouch 1974 In an interesting experiment 3-week old babies were given pacifiers that played a recording of the infant's mother's voice and of a stranger's voice When the infants heard their mother's voice they sucked more strongly at the pacifier Mills and Melhush 1974 Newborns also have a strong sense of smell For instance newborn babies can distinguish the smell of their own mother from that of others In a study by Mcfarlane 1978 oneweek old babies who were being breastfed were placed between two gauze pads One gauze pad was from the bra of a nursing mother who is a stranger and the other gauze pad was from the bra of the infant's own mother More than twothirds of the week old babies turn toward the gauze pad with their mother's scent Physical development In infancy toddlerhood and early childhood the body's physical development is rapid Figure 9.10 On average newborns weigh between 5 and 10 pounds And a newborn's weight typically doubles in six months and triples in one year By 2 years old the weight will have quadrupled So we can expect that a 2-year-old should weigh between 20 and 40 lb The average length of a newborn is 19.5 in increasing to 29.5 in by 12 months and 34.4 in by 2 years old WH multic-enter growth reference study group 2006 figure 9.10 children experience rapid physical changes through infancy and early childhood During infancy and childhood growth does not occur at a steady rate Carell Lu Roger and Chasain 2004 growth slows between 4 and 6 years old During this time children gain 5 to seven pounds and grow about 2 to 3 in per year Once females reach 8 to n years old their growth rate outpaces that of males due to a pubertal growth spurt This growth spurt continues until around 12 years old coinciding with the start of the menstrual cycle By 10 years old the average female weighs 88 lb and the average male weighs 85 lbs It was previously believed that we are born with all of the brain cells we will ever have More recent research suggests that neurogenesis the formation of neurons can continue through adulthood However the vast majority of neural connections and pathways occur during the first few years of a child's life National Institute of Neurological Disorders and Stroke 2019 This period of rapid neural growth is called blooming Neural pathways continue to develop through puberty The blooming period of neural growth is then followed by a period of pruning where neural connections are reduced It is thought that pruning causes the brain to function more efficiently allowing for mastery of more complex skills Hutchinson 2011 Blooming occurs during the first few years of life and pruning continues through childhood and into adolescence in various areas of the brain The size of our brains increases rapidly For example the brain of a 2-year-old is 55% of its adult size and by 6 years old the brain is about 90% of its adult size Tanner 1978 During early childhood ages 3 to six the frontal loes grow rapidly Recalling our discussion of the four loes of the brain earlier in this book the frontal loes are associated with planning reasoning memory and impulse control Therefore by the time children reach school age they are developmentally capable of controlling their attention and behavior Through the elementary school years the frontal temporal occipital and parietal loes all grow in size The brain growth spurts experienced in childhood tend to follow Pia's sequence of cognitive development so that significant changes in neural functioning account for cognitive advances Colin Wishaw 2009 Overman Bashalier Turner and Pster 1992 Motor development occurs in an orderly sequence as infants move from reflexive reactions eg sucking and rooting to more advanced motor functioning For instance babies first learn to hold their heads up then to sit with assistance and then to sit unassisted followed later by crawling and then walking Motor skills refer to our ability to move our bodies and manipulate objects Fine motor skills focus on the muscles in our fingers toes and eyes and enable coordination of small actions Eg grasping a toy writing with a pencil and using a spoon Gross motor skills focus on large muscle groups that control our arms and legs and involve larger movements eg balancing running and jumping As motor skills develop there are certain developmental milestones that young children should achieve Table 9.4 Four for each milestone there is an average age as well as a range of ages in which the milestone should be reached An example of a developmental milestone is sitting On average most babies sit alone at 7 months old Sitting involves both coordination and muscle strength and 90% of babies achieve this milestone between 5 and 9 months old In another example babies on average are able to hold up their head at 6 weeks old And 90% of babies achieve this between 3 weeks and four months old If a baby is not holding up their head by four months old they are showing a delay If a child is displaying delays on several milestones that is reason for concern and the parent or caregiver should discuss this with a child's pediatrician Some developmental delays can be identified and addressed through early intervention Cognitive development In addition to rapid physical growth young children also exhibit significant development of their cognitive abilities PJ thought that children's ability to understand objects such as learning that a rattle makes a noise when shaken was a cognitive skill that develops slowly as a child matures and interacts with the environment Today developmental psychologists think PJ was incorrect Researchers have found that even very young children understand objects and how they work long before they have experience with those objects Bay Gian 1987 Bay Gian Lee Girtner and Wu 2011 For example children as young as 3 months old demonstrated knowledge of the properties of objects that they had only viewed and did not have prior experience with them In one study three-month-old infants were shown a truck rolling down a track and behind a screen The box which appeared solid but was actually hollow was placed next to the track The truck rolled past the box as would be expected Then the box was placed on the track to block the path of the truck When the truck was rolled down the track this time it continued unimpeded The infants spend significantly more time looking at this impossible event Figure 9.11 Balarjin 1987 concluded that they knew solid objects cannot pass through each other Balarjen's findings suggest that very young children have an understanding of objects and how they work which Pia 1954 would have said is beyond their cognitive abilities due to their limited experiences in the world Figure 9.11 In Balarin study infants observed a truck A Roll down an unobstructed track B roll down an unobstructed track with an obstruction box beside it and C roll down and pass through what appeared to be an obstruction Just as there are physical milestones that we expect children to reach there are also cognitive milestones It is helpful to be aware of these milestones as children gain new abilities to think problem solve and communicate For example infants shake their head no around 6 to9 months and they respond to verbal requests to do things like wave bye-bye or blow a kiss around 9 to 12 months Remember Pia's ideas about object permanence We can expect children to grasp the concept that objects continue to exist even when they are not in sight by around 8 months old Because toddlers i.e 12 to 24 months old have mastered object permanence They enjoy games like hideand seek and they realize that when someone leaves the room they will come back Loop 2013 Toddlers also point to pictures in books and look in appropriate places when you ask them to find objects Preschool age children i.e 3 to 5 years old also make steady progress in cognitive development Not only can they count name colors and tell you their name and age but they can also make some decisions on their own such as choosing an outfit to wear Preschool age children understand basic time concepts and sequencing eg before and after and they can predict what will happen next in a story They also begin to enjoy the use of humor in stories because they can think symbolically They enjoy pretend play and inventing elaborate characters in scenarios One of the most common examples of their cognitive growth is their blossoming curiosity Preschool-aged children love to ask why An important cognitive change occurs in children this age Recall that Pia described two to three-year-olds as egocentric meaning that they do not have an awareness of others points of view Between 3 and 5 years old children come to understand that people have thoughts feelings and beliefs that are different from their own This is known as theory of mind Tom Children can use this skill to tease others persuade their parents to purchase a candy bar or understand why a sibling might be angry When children develop tom they can recognize that others have false beliefs Dennit 1987 Callahan at all 2005 Cognitive skills continue to expand in middle and late childhood 6 to 11 years old Thought processes become more logical and organized when dealing with concrete information Figure 9.12 Children at this age understand concepts such as the past present and future giving them the ability to plan and work toward goals Additionally they can process complex ideas such as addition and subtraction and cause and effect relationships However children's attention spans tend to be very limited until they are around 11 years old After that point it begins to improve through adulthood Figure 9.12 Because they understand luck and fairness children in middle and late childhood 6 to 11 years old are able to follow rules for games Credit Edwin Martinez One wellressearched aspect of cognitive development is language acquisition As mentioned earlier the order in which children learn language structures is consistent across children and cultures Hatch 1983 You've also learned that some psychological researchers have proposed that children possess a biological predisposition for language acquisition Starting before birth babies begin to develop language and communication skills At birth babies apparently recognize their mother's voice and can discriminate between the languages spoken by their mothers and foreign languages and they show preferences for faces that are moving in synchrony with audible language Blossom and Morgan 2006 Pickins 1994 Spelulin Cortalu 1981 Children communicate information through gesturing long before they speak and there is some evidence that gesture usage predicts subsequent language development Iverson and Golden Meadow 2005 In terms of producing spoken language babies begin to coo almost immediately Cooing is a one-cllable combination of a consonant and a vowel sound Eg C or ba Interestingly babies replicate sounds from their own languages A baby whose parents speak French will coo in a different tone than a baby whose parents speak Spanish or erdo After cooing the baby starts to babble Babbling begins with repeating a syllable such as mama dada or baba When babies are about 12 months old we expect them to say their first word for meaning and to start combining words for meaning at about 18 months At about 2 years old a toddler uses between 50 and 200 words By 3 years old they have a vocabulary of up to 1,000 words and can speak in sentences During the early childhood years children's vocabulary increases at a rapid pace This is sometimes referred to as the vocabulary spurt and has been claimed to involve an expansion in vocabulary at a rate of 10 to 20 new words per week Recent research may indicate that while some children experience these spurts it is far from universal As discussed in Ganganger and Brent 2004 it has been estimated that 5-year-olds understand about 6,000 words speak 2,000 words and can define words and question their meanings They can rhyme and name the days of the week Sevenyear-olds speak fluently and use slang and cliches Stor and Wittison 1974 What accounts for such dramatic language learning by children Behaviorist BF Skinner thought that we learn language in response to reinforcement or feedback such as through parental approval or through being understood For example when a 2-year-old child asks for juice he might say "Me juice." To which his mother might respond by giving him a cup of apple juice Noam Chomsky 1957 criticized Skinner's theory and proposed that we are all born with an innate capacity to learn language Chsky called this mechanism a language acquisition device L Who is correct Both Chomsky and Skinner are right Remember that we are a product of both nature and nurture Researchers now believe that language acquisition is partially inborn and partially learned through our interactions with our linguistic environment Gliteman in Newport 1995 Storen Wittison 1974 Attachment Psychosocial development occurs as children form relationships interact with others and understand and manage their feelings In social and emotional development forming healthy attachments is very important and is the major social milestone of infancy Attachment is a long-standing connection or bond with others Developmental psychologists are interested in how infants reach this milestone They ask such questions as how do parent and infant attachment bonds form How does neglect affect these bonds What accounts for children's attachment differences Researchers Harry Harlo John Bulby and Mary Ainsworth conducted studies designed to answer these questions In the 1950s Harlo conducted a series of experiments on monkeys He separated newborn monkeys from their mothers Each monkey was presented with two surrogate mothers One surrogate monkey was made out of wire mesh and she could dispense milk The other monkey was softer and made from cloth This monkey did not dispense milk Research shows that the monkeys preferred the soft cuddly cloth monkey even though she did not provide any nourishment The baby monkeys spent their time clinging to the cloth monkey and only went to the wire monkey when they needed to be fed Prior to this study the medical and scientific communities generally thought that babies become attached to the people who provide their nourishment However Harlo 1958 concluded that there was more to the mother child bond than nourishment Feelings of comfort and security are the critical components to maternal infant bonding which leads to healthy psychosocial development Building on the work of Harlo and others John Bulby developed the concept of attachment theory He defined attachment as the affectional bond or tie that an infant forms with the mother Bulby 1969 An infant must form this bond with a primary caregiver in order to have normal social and emotional development In addition Bulby proposed that this attachment bond is very powerful and continues throughout life He used the concept of secure base to define a healthy attachment between parent and child 1988 a secure base is a parental presence that gives the child a sense of safety as he explores his surroundings Bulby said that two things are needed for a healthy attachment The caregiver must be responsive to the child's physical social and emotional needs and the caregiver and child must engage in mutually enjoyable interactions Bulby 1969 Figure 9.13 Figure 9.13 Mutually enjoyable interactions promote the parent infant bond While Bulby thought attachment was an all or nothing process Mary Ainsworth's 1970 research showed otherwise Ainssworth wanted to know if children differ in the ways they bond and if so why To find the answers she used the strange situation procedure to study attachment between mothers and their infants 1970 In the strange situation the mother or primary caregiver and the infant aged 12 to 18 months are placed in a room together There are toys in the room and the caregiver and child spend some time alone in the room After the child has had time to explore her surroundings a stranger enters the room The mother then leaves her baby with the stranger After a few minutes she returns to comfort her child Based on how the infants/toddlers responded to the separation and reunion Ainsworth identified three types of parent child attachments: secure avoidant and resistant Ainsworth and Bell 1970 A fourth style known as disorganized attachment was later described Maine and Solomon 1990 The most common type of attachment also considered the healthiest is called secure attachment Figure 9.14 In this type of attachment the toddler prefers his parent over a stranger The attachment figure is used as a secure base to explore the environment and is sought out in times of stress Securely attached children were distressed when their caregivers left the room in the strange situation experiment But when their caregivers returned the securely attached children were happy to see them Securely attached children have caregivers who are sensitive and responsive to their needs Figure 9.14 In secure attachment the parent provides a secure base for the toddler allowing him to securely explore his environment Credit Carrie Cesic With avoidant attachment the child is unresponsive to the parent does not use the parent as a secure base and does not care if the parent leaves The toddler reacts to the parent the same way she reacts to a stranger When the parent does return the child is slow to show a positive reaction Ainsworth theorized that these children were most likely to have a caregiver who was insensitive and inattentive to their needs Ainsworth Blar Waters and Wall 1978 In cases of resistant attachment children tend to show clingy behavior but then they reject the attachment figures attempts to interact with them Ainssworth and Bell 1970 These children do not explore the toys in the room as they are too fearful During separation in the strange situation they became extremely disturbed and angry with the parent When the parent returns the children are difficult to comfort Resistant attachment is the result of the caregivers's inconsistent level of response to their child Finally children with disorganized attachment behaved oddly in the strange situation They freeze run around the room in an erratic manner or try to run away when the caregiver returns Maine and Solomon 1990 This type of attachment is seen most often in kids who have been abused Research has shown that abuse disrupts a child's ability to regulate their emotions While Ainsworth's research has found support in subsequent studies it has also met criticism Some researchers have pointed out that a child's temperament may have a strong influence on attachment Jery 2009 Harris 2009 and others have noted that attachment varies from culture to culture a factor not accounted for in Aworth's research Rothbomb Weiss Pot Miyak and Morelli 2000 Von Eisendor and Sagi Schwarz 2008 Self-concept Just as attachment is the main psychosocial milestone of infancy the primary psychosocial milestone of childhood is the development of a positive sense of self How does self-awareness develop Infants don't have a self-concept which is an understanding of who they are If you place a baby in front of a mirror they will reach out to touch their image thinking it is another baby However by about 18 months a toddler will recognize that the person in the mirror is themsel How do we know this In a well-known experiment a researcher placed a red dot of paint on children's noses before putting them in front of a mirror Amsterdam 1972 Commonly known as the mirror test this behavior is demonstrated by humans and a few other species and is considered evidence of self-recognition Archer 1992 At 18 months old they would touch their own noses when they saw the paint surprised to see a spot on their faces By 24 to 36 months old children can name and or point to themselves in pictures clearly indicating self-recognition Children from 2 to four years old display a great increase in social behavior once they have established a self-concept They enjoy playing with other children but they have difficulty sharing their possessions Also through play children explore and come to understand their gender roles and can label themselves as a girl or boy Chick Hmaner and Hunter 2002 By four years old children can cooperate with other children share when asked and separate from parents with little anxiety Children at this age also exhibit autonomy initiate tasks and carry out plans Success in these areas contributes to a positive sense of self Once children reach 6 years old they can identify themselves in terms of group memberships I'm a first grader School age children compare themselves to their peers and discover that they are competent in some areas and less so in others Recall Ericson's task of industry versus inferiority At this age children recognize their own personality traits as well as some other traits they would like to have For example 10-year-old Laya says "I'm kind of shy I wish I could be more talkative like my friend Alexa." Development of a positive self-concept is important to healthy development Children with a positive self-concept tend to be more confident do better in school act more independently and are more willing to try new activities Makobi 1980 Ferrer and Fugate 2003 Formation of a positive self-concept begins in Ericson's toddlerhood stage when children establish autonomy and become confident in their abilities Development of self-concept continues in elementary school when children compare themselves to others When the comparison is favorable children feel a sense of competence and are motivated to work harder and accomplish more Self-concept is re-evaluated in Ericson's adolescent stage As teens form an identity they internalize the messages they have received regarding their strengths and weaknesses keeping some messages and rejecting others Adolescence who have achieved identity formation are capable of contributing positively to society Ericson 1968 Dig deeper phenomenological variant of ecological systems theory PVES Kenneth and my Clark were pioneering psychologists responsible for the first psychological study used in a Supreme Court case Their research with African-American children and doll choices was used to highlight the harmful effects of segregation and provided support for the Browns and the NAACP in their lawsuit against the Board of Education The finding that African-American children were more likely to choose a white doll over a black doll in both northern and southern states led them to theorize that the children did not have a healthy concept of themselves Clark and Clark 1950 The Clark's research differed from that of Inz Beverly Proer who also studied African-American children in segregated and integrated schools in Cincinnati Parents could choose either environment for their children during the 1930s She found among other factors that the self-concept of children at segregated schools was more positive versus those in integrated schools partly due to teachers low expectations Proser also noted that the child's personality should be considered when choosing a segregated school or an integrated school Benjamin Henry and McMahon 2005 Later researchers suggested that African-American children choosing a doll that did not look like them was not an indication of their self-esteem or their self-image For instance Rogers and Meltzoff 2017 found that gender identity was more important than race in their study of diverse children whose average age was about 10 years old Thus for children that young the meaning of race is an evolving process as opposed to adolescents search for identity The ethnic minority children in the study did view racial identity as important compared to their white counterparts For teenagers who are members of ethnic minority groups racial/ethnic/cultural identity can be paramount depending on the family's processes Racial socialization involves teaching them the positive aspects of their in-roup usually by caregivers Most of the students in a study by Nebblet Smalls Ford Muian and Sellers 2009 reported having received such messages but a few received no racial socialization messages They found that these messages played a role in how they felt about their in-roup Some theories have been developed to explain the behaviors of ethnic minority youth One such theory is the phenomenological variant of ecological systems theory PV put forth by Margaret Beiel Spencer It is a merging of phenomenology and Bron Brener's ecological systems theory A phenomenological approach is based on how a person makes meaning of their experiences For example young African-American boys have different experiences in educational settings compared to African-American girls Consequently the meaning they assign to those experiences differs Bronen Brener's ecological systems theory suggests that development occurs based on interactions among environments such as school family and community Bronen Brener 1977 The research that Spencer DRI and Hartman 1997 conducted with African-American adolescent boys and girls was explained by PVES They found that negative learning attitudes were predicted by unpopularity with peers for girls and boys Additionally for boys more stress predicted a less negative attitude toward learning possibly due to focus on the school environment instead of on personal issues This occurred along with perceiving that teachers had positive expectations of African-American boys The researchers surmised that pvest accounted for how others perceptions and their subsequent attitudes were related and worked both ways What can parents do to nurture a healthy self-concept Diana Bomand 1971-191 proposed that parenting style may be a factor The way we parent is an important factor in a child's socioeotional growth Balrin developed and refined a theory describing four parenting styles: authoritative authoritarian permissive and uninvolved With the authoritative style the parent gives reasonable demands and consistent limits expresses warmth and affection and listens to the child's point of view Parents set rules and explain the reasons behind them They are also flexible and willing to make exceptions to the rules in certain cases For example temporarily relaxing bedtime rules to allow for a nighttime swim during a family vacation Of the four parenting styles the authoritative style is the one that is most encouraged in modern American society American children raised by authoritative parents tend to have high self-esteem and social skills However effective parenting styles vary as a function of culture And as Small 1999 points out the authoritative style is not necessarily preferred or appropriate in all cultures In authoritarian style the parent places high value on conformity and obedience The parents are often strict tightly monitor their children and express little warmth In contrast to the authoritative style authoritarian parents probably would not relax bedtime rules during a vacation because they consider the rules to be set and they expect obedience This style can create anxious withdrawn and unhappy kids However it is important to point out that authoritarian parenting is as beneficial as the authoritative style in some ethnic groups Russell Crockett and Cow 2010 For instance first generation Chinese American children raised by authoritarian parents did just as well in school as their peers who were raised by authoritative parents Russell Atall 2010 For parents who employ the permissive style of parenting the kids run the show and anything goes Permissive parents make few demands and rarely use punishment They tend to be very nurturing and loving and may play the role of friend rather than parent In terms of our example of vacation bedtimes permissive parents might not have bedtime rules at all Instead they allow the child to choose their bedtime whether on vacation or not Not surprisingly children raised by permissive parents tend to lack self-discipline and the permissive parenting style is negatively associated with grades Dornbush Ritter Leman Roberts and Frolley 1987 The permissive style may also contribute to other risky behaviors such as alcohol abuse Bar and Hoffman 2010 Risky sexual behavior especially among female children Donnenburgg Wilson Emerson and Bryant 2002 And increased display of disruptive behaviors by male children Parent at all 2011 However there are some positive outcomes associated with children raised by permissive parents They tend to have higher self-esteem better social skills and report lower levels of depression Darling 1999 With the uninvolved style of parenting the parents are indifferent uninvolved and sometimes referred to as neglectful They don't respond to the child's needs and make relatively few demands This could be because of severe depression or substance abuse or other factors such as the parents extreme focus on work These parents may provide for the child's basic needs but little else The children raised in this parenting style are usually emotionally withdrawn fearful anxious perform poorly in school and are at an increased risk of substance abuse Darling 1999 As you can see parenting styles influence childhood adjustment But could a child's temperament likewise influence parenting Temperament refers to innate traits that influence how one thinks behaves and reacts with the environment Children with easy temperaments demonstrate positive emotions adapt well to change and are capable of regulating their emotions Conversely children with difficult temperaments demonstrate negative emotions and have difficulty adapting to change and regulating their emotions Difficult children are much more likely to challenge parents teachers and other caregivers Thomas 1984 Therefore it's possible that easy children i.e Social adaptable and easy to soothe tend to elicit warm and responsive parenting While demanding irritable withdrawn children evoke irritation in their parents or cause their parents to withdraw Sansson and Rothbart 1995 Everyday connection The importance of play and recess According to the American Academy of Pediatrics 2007 unstructured play is an integral part of a child's development It builds creativity problem solving skills and social relationships Play also allows children to develop a theory of mind as they imaginatively take on the perspective of others Outdoor play allows children the opportunity to directly experience and sense the world around them While doing so they may collect objects that they come across and develop lifelong interests and hobbies They also benefit from increased exercise and engaging in outdoor play can actually increase how much they enjoy physical activity This helps support the development of a healthy heart and brain Unfortunately research suggests that today's children are engaging in less and less outdoor play Clemens 2004 Perhaps it is no surprise to learn that lowered levels of physical activity in conjunction with easy access to calorie-dense foods with little nutritional value are contributing to alarming levels of childhood obesity Carnick and Kanekar 2012 Despite the adverse consequences associated with reduced play some children are overscheduled and have little free time to engage in unstructured play In addition some schools have taken away recess time for children in a push for students to do better on standardized tests And many schools commonly use loss of recess as a form of punishment Do you agree with these practices Why or why not Adolescence Adolescence is a socially constructed concept In pre-industrial society children were considered adults when they reached physical maturity But today we have an extended time between childhood and adulthood called adolescence Adolescence is the period of development that begins at puberty and ends at emerging adulthood which is discussed later In the United States adolescence is seen as a time to develop independence from parents while remaining connected to them Figure 9.15 The typical age range of adolescence is from 12 to 18 years And this stage of development also has some predictable physical cognitive and psychosocial milestones Figure 9.15 Peers are a primary influence on our development in adolescence Physical development As noted above adolescence begins with puberty While the sequence of physical changes in puberty is predictable the onset and pace of puberty vary widely Several physical changes occur during puberty such as adrenarch and gonadar the maturing of the adrenal glands and sex glands respectively Also during this time primary and secondary sexual characteristics develop and mature Primary sexual characteristics are organs specifically needed for reproduction like the uterus and ovaries and testes Secondary sexual characteristics are physical signs of sexual maturation that do not directly involve sex organs such as development of breasts and hips and development of facial hair and a deepened voice Minaryarchy the beginning of menstrual periods usually occurs around 12 to 13 years old and spur March the first ejaculation around 13 to 14 years old During puberty people experience a rapid increase in height i.e growth spurt For females this begins between 8 and 13 years old with adult height reached between 10 and 16 years old Males begin their growth spurt slightly later usually between 10 and 16 years old and reach their adult height between 13 and 17 years old Both nature i.e genes and nurture eg nutrition medications and medical conditions can influence height Because rates of physical development vary so widely among teenagers puberty can be a source of pride or embarrassment Early maturing boys tend to be stronger taller and more athletic than their later maturing peers They are usually more popular confident and independent but they are also at a greater risk for substance abuse and early sexual activity Flannry Row and Gully 1993 Cultiala Hino Rimpula Rissan and Rantin 2001 Early maturing girls may be teased or overtly admired which can cause them to feel self-conscious about their developing bodies These girls are at a higher risk for depression substance abuse and eating disorders G Conjure and Elder 2001 Greyber Lewinsson Celely and Brooks Gun 1997 Strealmore Moore and Catchelin 1999 Late blooming boys and girls i.e they develop more slowly than their peers may feel self-conscious about their lack of physical development Negative feelings are particularly a problem for late maturing boys who are at a higher risk for depression and conflict with parents Greyberall 1997 and more likely to be bullied Pollock and Schustster 2000 Psychologists and clinicians also study the impact of gender identity and the impacts of puberty on transgender and gender non-conforming youth This is a relatively recent area of study and the impact should not be overgeneralized However the research seems to indicate that transgender and gender non-conforming youth who are supported in their identity do not have significantly higher incidences of depression or anxiety symptoms when compared to control groups while those who are not supported exhibit more symptoms and risk factors Olsen Derwood and Mccclaclin 2016 Expression and exploration of gender identity can take many forms and manifest at different times depending on a wide array of factors The adolescent brain also remains under development Up until puberty brain cells continue to bloom in the frontal region Adolescence engage in increased risk-taking behaviors and emotional outbursts possibly because the frontal loes of their brains are still developing Figure 9.16 Recall that this area is responsible for judgment impulse control and planning and it is still maturing into early adulthood Casey Tottenham Lon and Dursten 2005 Figure 9.16 Brain growth continues into the early 20s The development of the frontal lobe in particular is important during this stage Cognitive development More complex thinking abilities emerge during adolescence Some researchers suggest this is due to increases in processing speed and efficiency rather than as the result of an increase in mental capacity In other words due to improvements in existing skills rather than development of new ones Bjorkland 1987 Case 1985 During adolescence teenagers move beyond concrete thinking and become capable of abstract thought Recall that Pia refers to this stage as formal operational thought Teen thinking is also characterized by the ability to consider multiple points of view imagine hypothetical situations debate ideas and opinions eg politics religion and justice and form new ideas Figure 9.17 In addition it's not uncommon for adolescence to question authority or challenge established societal norms Cognitive empathy also known as theory of mind which we discussed earlier with regard to egoentrism relates to the ability to take the perspective of others and feel concern for others Shames Tor and Aharon Perets 2005 Cognitive empathy begins to increase in adolescence and is an important component of social problem solving and conflict avoidance According to one longitudinal study levels of cognitive empathy begin rising in girls around 13 years old and around 15 years old in boys Vandergraph at all 2013 Teens who reported having supportive fathers with whom they could discuss their worries were found to be better able to take the perspective of others Miklakovska Dorz and Sunnins 2011 figure 9.17 Teenage thinking is characterized by the ability to reason logically and solve hypothetical problems such as how to design plan and build a structure Credit US Army RDEK psychosocial development adolescents continue to refine their sense of self as they relate to others Ericson referred to the task of the adolescent as one of identity versus role confusion Thus in Ericson's view an adolescent's main questions are "Who am I and who do I want to be?" Some adolescence adopt the values and roles that their parents expect for them Other teens develop identities that are in opposition to their parents but align with a peer group This is common as peer relationships become a central focus in adolescence lives As adolescence work to form their identities they pull away from their parents and the peer group becomes very important Shanahan Male Ozgood and Crowder 2007 Despite spending less time with their parents most teens report positive feelings toward them Moore Guzman Hair Litman and Garrett 2004 Warm and healthy parent child relationships have been associated with positive child outcomes such as better grades and fewer school behavior problems in the United States as well as in other countries Hair at all 2005 It appears that most teens don't experience adolescent storm and stress to the degree once famously suggested by G Stanley Hall a pioneer in the study of adolescent development Only small numbers of teens have major conflicts with their parents Steinberg and Morris 2001 and most disagreements are minor For example in a study of over 1,800 parents of adolescence from various cultural and ethnic groups Barber 1994 found that conflicts occurred over day-to-day issues such as homework money curfews clothing chores and friends These types of arguments tend to decrease as teens develop Galamos and Almeida 1992 There is emerging research on the adolescent brain Galvin Hair Voss Glover and Casey 2007 examined its role in risk-taking behavior They used fMRI to assess the reading's relationship to risk-taking risk perception and impulsivity The researchers found that there was no correlation between brain activity and the neural reward center and impulsivity and risk perception However activity in that part of the brain was correlated to risk-taking In other words risk-taking adolescence experienced brain activity in the reward center The idea that adolescence however are more impulsive than other demographics was challenged in their research which included children and adults Emerging adulthood The next stage of development is emerging adulthood This is a relatively newly defined period of lifespan development spanning from 18 years old to the mid20s characterized as an inbetween time where identity exploration is focused on work and love When does a person become an adult There are many ways to answer this question In the United States you are legally considered an adult at 18 years old but other definitions of adulthood vary widely In sociology for example a person may be considered an adult when they become self-supporting choose a career get married or start a family The ages at which we achieve these milestones vary from person to person as well as from culture to culture For example in the African country of Malawi 15year-old in Jamele was married at 14 years old and had her first child at 15 years old In her culture she is considered an adult Children in Malawi take on adult responsibilities such as marriage and work eg carrying water tending babies and working fields as early as 10 years old In stark contrast independence in western cultures is taking longer and longer effectively delaying the onset of adult life What factors are leading to these changes regarding financial and familial independence It seems that emerging adulthood is a product of both western culture and our current times Arnette 2000 People in higher income and more industrialized countries are living longer allowing the freedom to take an extra decade to start a career and family Changes in the workforce also play a role For example 50 years ago a young adult with a high school diploma could immediately enter the workforce and climb the economic ladder That is no longer the case Bachelors and even graduate degrees are required more and more often even for entry- levelvel jobs are net 2000 In addition many students are taking longer five or six years to complete a college degree as a result of working and going to school at the same time After graduation many young adults return to the family home because they have difficulty finding a job The term boomerang generation describes recent college graduates for whom lack of adequate employment upon college graduation often leads to a return to the parental home Davidson 2014 Changing cultural expectations may be the most important reason for the delay in entering adult roles Young people are spending more time exploring their options So they are delaying marriage and work as they change majors and jobs multiple times putting them on a much later timetable than their parents are net 2000 Adulthood Adulthood begins around 20 years old and has three distinct stages early middle and late Each stage brings its own set of rewards and challenges Physical development By the time we reach early adulthood 20 to early 40s our physical maturation is complete although our height and weight may increase slightly In young adulthood our physical abilities are at their peak including muscle strength reaction time sensory abilities and cardiac functioning Most professional athletes are at the top of their game during this stage People often carry and give birth to children in the young adulthood years so they may see additional weight gain and breast changes Middle adulthood extends from the 40s to the 60s Figure 9.18 Physical decline is gradual The skin loses some elasticity and wrinkles are among the first signs of aging Visual acuity decreases during this time Fertility gradually declines with the approach to the onset of menopause the end of the menstrual cycle around 50 years old Middle adulthood tends toward weight gain in the abdominal area for men and in the hips and thighs for women Hair begins to thin and turn gray Figure 9.18 Physical declines of middle and late adulthood can be minimized with proper exercise nutrition and an active lifestyle Late adulthood is considered to extend from the 60s on This is the last stage of physical change The skin continues to lose elasticity Reaction time slows further and muscle strength diminishes Smell taste hearing and vision so sharp in our 20s decline significantly The brain may also no longer function at optimal levels leading to problems like memory loss dementia and Alzheimer's disease in later years Cognitive development Because we spend so many years in adulthood more than any other stage cognitive changes are numerous In fact research suggests that adult cognitive development is a complex everchanging process that may be even more active than cognitive development in infancy and early childhood Fiser Yan and Stewart 2003 Unlike our physical abilities which peak in our mid20s and then begin a slow decline our cognitive abilities remain steady throughout early and middle adulthood Our crystallized intelligence information skills and strategies we have gathered through a lifetime of experience tends to hold steady as we age It may even improve For example adults show relatively stable to increasing scores on intelligence tests until their mid-30s to mid-50s Bailey and Odin 1955 However in late adulthood we begin to experience a decline in another area of our cognitive abilities fluid intelligence information processing abilities reasoning and memory These processes become slower How can we delay the onset of cognitive decline Mental and physical activity seems to play a part Figure 9.19 Research has found adults who engage in mentally and physically stimulating activities experience less cognitive decline and have a reduced incidence of mild cognitive impairment and dementia Herzog Kramer Wilson and Lindenburgger 2009 Larsson at all 2006 Pod wills at all 2005 figure 9.19 Cognitive activities such as playing mahajang chess or other games can keep you mentally fit The same is true for solo pastimes like reading and completing crossword puzzles Credit Philippe put researchers have examined the aging brain by comparing it to brain functioning in younger people Forceman and colleagues 2011 compared elderly participants to younger participants who in the study were asked to report the direction of movement of a set of dots They were given feedback regarding speed and accuracy The researchers found that older participants made more errors and were slower due to degeneration of corticostrial connections In other words the decreased ability typically assigned to elderly people may be due to circumstances in the brain beyond their control Interestingly other researchers have found similarities in spatial representations when comparing children aged 6 to 7 to those over the age of 80 RIO Diero and Ichini 2016 reported that this is due to neurodeeneration in older adults and immature neurology in young children Many elderly people experience dementia changes in the brain that negatively affect cognition Alzheimer's disease is one type of dementia initially studied by medical researcher Solomon Carter Fuller Alzheimer's disease has a genetic basis Plaques in the brain are due to cell death which then causes those affected with the disease severe forgetfulness A person can forget how to walk talk and eventually eat The disease can be mitigated by assessing environmental factors Exposure to lead iron and zinc increase risk and nutritional factors The Mediterranean diet lowers risk Aurora Mal and Khakar 2015 Although there is no cure there is hope Cognitive rehabilitation can offset mild cognitive impairment as it can evolve into dementia Garcia Batansas Gimenez Mixo Aradondo and Cabrera Ompier 2015 examined the use of virtual reality as a possible cognitive rehabilitative method They suggested that virtual reality technology should involve daily living activities memory and language among other considerations psychosocial development There are many theories about the social and emotional aspects of aging Some aspects of healthy aging include activities social connectedness and the role of a person's culture According to many theorists including George Veant 2002 who studied and analyzed over 50 years of data we need to have and continue to find meaning throughout our lives For those in early and middle adulthood meaning is found through work Sterns and Huik 2001 and family life Marcus Riff Kuran and Palmersh 2004 These areas relate to the tasks that Ericson referred to as generativity and intimacy As mentioned previously adults tend to define themselves by what they do their careers Earnings peak during this time yet job satisfaction is more closely tied to work that involves contact with other people is interesting provides opportunities for advancement and allows some independence more in Zogi 2006 than it is to salary Ayenar Wells and Schwarz 2006 How might being unemployed or being in a dead-end job challenge adult well-being Positive relationships with significant others in our adult years have been found to contribute to a state of well-being Riff and Singer 2009 Most adults in the United States identify themselves through their relationships with family particularly with spouses children and parents Marcus atall 2004 While raising children can be stressful especially when they are young research suggests that parents reap the rewards down the road as adult children tend to have a positive effect on parental well-being Um Pudovska and Rechek 2010 Having a stable marriage has also been found to contribute to well-being throughout adulthood Veant 2002 Another aspect of positive aging is believed to be social connectedness and social support As we get older socioeotional selectivity theory suggests that our social support and friendships dwindle in number but remain as close if not more close than in our earlier years Karstensson 1992 Figure 9.20 Figure 9.20 Social support is important as we age Credit Gabriel Roachcha Learning objectives By the end of this section you will be able to discuss hospice care Describe the five stages of grief critique issues regarding living wills do not resuscitate DNR orders and hospice care Every story has an ending Death marks the end of your life story Figure 9.21 Our culture and individual backgrounds influence how we view death In some cultures death is accepted as a natural part of life and is embraced In contrast until about 50 years ago in the United States a doctor might not inform someone that they were dying and the majority of deaths occurred in hospitals In 1967 that reality began to change with Sicily Saunders who created the first modern hospice in England The aim of hospice is to help provide a death with dignity and pain management in a humane and comfortable environment which is usually outside of a hospital setting In 1974 Florence Wald founded the first hospice in the United States Today hospice provides care for 1.65 million Americans and their families Because of hospice care many terminally ill people are able to spend their last days at home Figure 9.21 Different cultures societies and religions have varying practices surrounding death For example people's bodies may be a buried in a cemetery b cremated and buried at sea as in this US Navy ceremony or c cremated such as in this Hindu ceremony in Bali Research has indicated that hospice care is beneficial for the patient Brumley and Cuidanos and Cheron 2003 Brumley Edall 2007 Godkin Kant and Doster 1984 and for the patients family roads Mitchell Miller Connor and Tino 2008 Godkin at all 1984 hospice patients report high levels of satisfaction with hospice care because they are able to remain at home and are not completely dependent on strangers for care Brumley at all 2007 In addition hospice patients tend to live longer than non-hospice patients Connor Pianen Fitch Spence and Iwasaki 2007 Teammill at all 2010 Family members receive emotional support and are regularly informed of their loved ones treatment and condition The family members burden of care is also reduced McMillan at all 2006 Both the patient and the patients family members report increased family support increased social support and improved coping while receiving hospice services Godkin at all 1984 How do you think you might react if you were diagnosed with a terminal illness like cancer Elizabeth Kubler Ross 1969 who worked with the founders of hospice care described the process of an individual accepting his own death She proposed five stages of grief Denial anger bargaining depression and acceptance Most individuals experience these stages but the stages may occur in different orders depending on the individual In addition not all people experience all of the stages It is also important to note that some psychologists believe that the more a dying person fights death the more likely they are to remain stuck in the denial phase This could make it difficult for the dying person to face death with dignity However other psychologists believe that not facing death until the very end is an adaptive coping mechanism for some people Whether due to illness or old age not everyone facing death or the loss of a loved one experiences the negative emotions outlined in the Kubler Ross model Nolan Hookima and Larsson 1999 For example research suggests that people with religious or spiritual beliefs are better able to cope with death because of their hope in an afterlife and because of social support from religious or spiritual associations Hood Spila Hunsburgger and Corsich 1996 Macintosh Silver and Wartman 1993 Palazzian 1996 Samurel 1991 Wartman and Park 2008 A prominent example of a person creating meaning through death is Randy Pouch who was a well-loved and respected professor at Carnegie Melon University Diagnosed with terminal pancreatic cancer in his mid-40s and given only 3 to 6 months to live Pouch focused on living in a fulfilling way in the time he had left Instead of becoming angry and depressed he presented his now famous last lecture called Really achieving your childhood dreams In his moving yet humorous talk he shares his insights on seeing the good in others overcoming obstacles and experiencing zero gravity among many other things Despite his terminal diagnosis Pouch lived the final year of his life with joy and hope showing us that our plans for the future still matter even if we know that we are dying As individuals become more knowledgeable about medical procedures and practices some people want to ensure that their wishes and desires are known in advance This ensures that if the person ever becomes incapacitated or can no longer express themselves their loved ones will know what they want For this reason a person might write a living will or advanced directive which is a written legal document that details specific interventions a person wants For example a person in the last stages of a terminal illness may not want to receive life extending treatments A person may also include a do not resuscitate DNR order which they would share with family and close friends A DNR order states that if a person stops breathing or their heart stops beating medical personnel such as doctors and nurses are not to take steps to revive or resuscitate the patient A living will can also include a health care proxy which appoints a specific person to make medical decisions for you if you are unable to speak for yourself People's desire for living wills and DNRs are often influenced by their religion culture and upbringing