Peds Exam 1 Blueprint
Chapter 27
Developmental theory
o Duvall’s Developmental Stage of the Family
Stage I: Marriage and an Independent Home: The Joining of Families
Re-establish couple identity
Realign relationships with extended family
Make decisions regarding parenthood
Stage II: Families with Infants
Integrate infants into the family unit
Accommodate to new parenting and grandparenting roles
Maintain marital bond
Stage III: Families with Preschoolers
Socialize children
Parents and children adjust to separation
Stage IV: Families with Schoolchildren
Children develop peer relations
Parents adjust to their children’s peer and school influences
Stage V: Families with Teenagers
Adolescents develop increasing autonomy
Parents refocus on midlife marital and career issues
Parents begin a shift toward concern for the older generation
Stage VI: Families as Launching Centers
Parents and young adults establish independent identities
Parents renegotiate marital relationship
Stage VII: Middle-Aged Families
Reinvest in couple identity with concurrent development of
independent interests
Realign relationships to include in-laws and grandchildren
Deal with disabilities and death of older generation
Stage VIII: Aging Families
Shift from work role to leisure and semiretirement or full
retirement
Maintain couple and individual functioning while adapting to the
aging process
Prepare for own death and dealing with the loss of spouse and/or
siblings and other peers
Parenting styles
o Authoritarian- parents try to control their children’s behavior and attitudes
through unquestioned mandates.
They establish rules and regulations or standards of conduct that they
expect to be followed rigidly and unquestioningly.
Punishment need not ne corporal but may be stern withdrawal of love and
approval.
, Careful training often results in rigidly conforming behavior in the
children who tend to be sensitive, shy, self-conscious, retiring, and
submissive.
They are more likely to be courteous, loyal, honest, and dependable but
docile.
o Permissive- exert little or no control over their children’s actions.
They avoid imposing their own standards of conduct and allow their
children to regulate their own activity as much as possible.
These parents consider themselves a resources for the children, not role
models.
If rules do exist, the parents explain the underlying reason, elicit the
children’s opinions, and consult them in decision-making processes.
They employ lax, inconsistent discipline; do not set sensible limits; and do
not prevent the children from upsetting the home routine.
These parents rarely punish the children.
o Authoritative- parents combine practices. They direct their children’s behavior
and attitudes by emphasizing the reason for rules and negatively reinforcing
deviations.
They respect the individuality of each child and allow the child to voice
objections to family standards or regulations.
Parental control is firm and consistent but tempered with encouragement,
understanding, and security.
Control is focused on the issue not on withdrawal of love or fear of
punishment. Parents realistic standards and reasonable expectations
produce children with high self-esteem who are self-reliant, assertive,
inquisitive, content, and highly interactive with other children.
Box 27.5 Feelings and Behaviors of Children Related to Divorce
o Infancy
Effects of reduced mothering or lack of mothering
Increased irritability
Disturbance in eating, sleeping, and elimination
Interference with attachment process
o Early Preschool Children (2 to 3 years old)
Frightened and confused
Blame themselves for the divorce
Fear of abandonment
Increased irritability, whining, tantrums
Regressive behaviors (thumb sucking, loss of elimination control)
Separation anxiety
o Later Preschooler Children (3 to 5 years old)
Fear of abandonment
Blame themselves for the divorce, decreased self-esteem
Bewilderment regarding all human relationships
Become more aggressive in relationships with other (siblings, peers)
Engage in fantasy to seek understanding of the divorce
o Early School-Age Children (5 to 6 years old)
, Depression and immature behavior
Loss of appetite and sleep disorders
May be able to verbalize some feelings and understand some divorce-
related changes
Increased anxiety and aggression
Feelings of abandonment by departing parent
o Middle School-Age Children (6 to 8 years old)
Panic reactions
Feelings of deprivation; loss of parent, attention, money, and secure future
Profound sadness, depression, fear insecurity
Feelings of abandonment and rejection
Fear regarding the future
Difficulty expressing anger at parents
Intense desire for reconciliation of parents
Impaired capacity to play and enjoy outside activities
Decline in school performance
Altered peer relationships; become bossy, irritable, demanding, and
manipulative
Frequent crying, loss of appetite, sleep disorders
Disturbed routine, forgetfulness
o Later School-Age Children (9 to 12 years old)
More realistic understanding of divorce
Intense anger directed at one or both parents
Divided loyalties
Ability to express feelings of anger
Ashamed of parental behavior
Desire for revenge, may wish to punish the parent they hold responsible
Feelings of loneliness, rejection, and abandonment
Altered peer relationships
Decline in school performance
May develop somatic complaints
May engage in aberrant behavior, such as lying, stealing
Temper tantrums
Dictatorial attitude
o Adolescents
Able to disengage themselves from parent conflict
Feelings of a profound sense of loss: of family, childhood
Feelings of anxiety
Worry about themselves, parents, siblings
Expression of anger, sadness, shame, embarrassment
May withdraw from family and friends
Disturbed concept of sexuality
May engage in acting-out behavior
Telling the Children
o If possible, the initial disclosure should include both parents and siblings,
followed by individual discussions with each child.
Chapter 27
Developmental theory
o Duvall’s Developmental Stage of the Family
Stage I: Marriage and an Independent Home: The Joining of Families
Re-establish couple identity
Realign relationships with extended family
Make decisions regarding parenthood
Stage II: Families with Infants
Integrate infants into the family unit
Accommodate to new parenting and grandparenting roles
Maintain marital bond
Stage III: Families with Preschoolers
Socialize children
Parents and children adjust to separation
Stage IV: Families with Schoolchildren
Children develop peer relations
Parents adjust to their children’s peer and school influences
Stage V: Families with Teenagers
Adolescents develop increasing autonomy
Parents refocus on midlife marital and career issues
Parents begin a shift toward concern for the older generation
Stage VI: Families as Launching Centers
Parents and young adults establish independent identities
Parents renegotiate marital relationship
Stage VII: Middle-Aged Families
Reinvest in couple identity with concurrent development of
independent interests
Realign relationships to include in-laws and grandchildren
Deal with disabilities and death of older generation
Stage VIII: Aging Families
Shift from work role to leisure and semiretirement or full
retirement
Maintain couple and individual functioning while adapting to the
aging process
Prepare for own death and dealing with the loss of spouse and/or
siblings and other peers
Parenting styles
o Authoritarian- parents try to control their children’s behavior and attitudes
through unquestioned mandates.
They establish rules and regulations or standards of conduct that they
expect to be followed rigidly and unquestioningly.
Punishment need not ne corporal but may be stern withdrawal of love and
approval.
, Careful training often results in rigidly conforming behavior in the
children who tend to be sensitive, shy, self-conscious, retiring, and
submissive.
They are more likely to be courteous, loyal, honest, and dependable but
docile.
o Permissive- exert little or no control over their children’s actions.
They avoid imposing their own standards of conduct and allow their
children to regulate their own activity as much as possible.
These parents consider themselves a resources for the children, not role
models.
If rules do exist, the parents explain the underlying reason, elicit the
children’s opinions, and consult them in decision-making processes.
They employ lax, inconsistent discipline; do not set sensible limits; and do
not prevent the children from upsetting the home routine.
These parents rarely punish the children.
o Authoritative- parents combine practices. They direct their children’s behavior
and attitudes by emphasizing the reason for rules and negatively reinforcing
deviations.
They respect the individuality of each child and allow the child to voice
objections to family standards or regulations.
Parental control is firm and consistent but tempered with encouragement,
understanding, and security.
Control is focused on the issue not on withdrawal of love or fear of
punishment. Parents realistic standards and reasonable expectations
produce children with high self-esteem who are self-reliant, assertive,
inquisitive, content, and highly interactive with other children.
Box 27.5 Feelings and Behaviors of Children Related to Divorce
o Infancy
Effects of reduced mothering or lack of mothering
Increased irritability
Disturbance in eating, sleeping, and elimination
Interference with attachment process
o Early Preschool Children (2 to 3 years old)
Frightened and confused
Blame themselves for the divorce
Fear of abandonment
Increased irritability, whining, tantrums
Regressive behaviors (thumb sucking, loss of elimination control)
Separation anxiety
o Later Preschooler Children (3 to 5 years old)
Fear of abandonment
Blame themselves for the divorce, decreased self-esteem
Bewilderment regarding all human relationships
Become more aggressive in relationships with other (siblings, peers)
Engage in fantasy to seek understanding of the divorce
o Early School-Age Children (5 to 6 years old)
, Depression and immature behavior
Loss of appetite and sleep disorders
May be able to verbalize some feelings and understand some divorce-
related changes
Increased anxiety and aggression
Feelings of abandonment by departing parent
o Middle School-Age Children (6 to 8 years old)
Panic reactions
Feelings of deprivation; loss of parent, attention, money, and secure future
Profound sadness, depression, fear insecurity
Feelings of abandonment and rejection
Fear regarding the future
Difficulty expressing anger at parents
Intense desire for reconciliation of parents
Impaired capacity to play and enjoy outside activities
Decline in school performance
Altered peer relationships; become bossy, irritable, demanding, and
manipulative
Frequent crying, loss of appetite, sleep disorders
Disturbed routine, forgetfulness
o Later School-Age Children (9 to 12 years old)
More realistic understanding of divorce
Intense anger directed at one or both parents
Divided loyalties
Ability to express feelings of anger
Ashamed of parental behavior
Desire for revenge, may wish to punish the parent they hold responsible
Feelings of loneliness, rejection, and abandonment
Altered peer relationships
Decline in school performance
May develop somatic complaints
May engage in aberrant behavior, such as lying, stealing
Temper tantrums
Dictatorial attitude
o Adolescents
Able to disengage themselves from parent conflict
Feelings of a profound sense of loss: of family, childhood
Feelings of anxiety
Worry about themselves, parents, siblings
Expression of anger, sadness, shame, embarrassment
May withdraw from family and friends
Disturbed concept of sexuality
May engage in acting-out behavior
Telling the Children
o If possible, the initial disclosure should include both parents and siblings,
followed by individual discussions with each child.
