1. 1
Introduction to Normal and Abnormal Behavior in Children and Adolescents

2. Introduction Research studies in abnormal child psychology seek to:
Define normal and abnormal behavior for children of different ages, sexes, and ethnic and cultural backgrounds
Identify the cases and correlates of abnormal behavior
Make predictions about long-term outcomes
Develop and evaluate methods for treatment and/or prevention

3. Features That Distinguish Child and Adolescent Disorders
When adults seek services for children, it is not often clear who has what “problem”
Many child and adolescent problems
Involve a failure to show expected developmental progress
Are not entirely abnormal
Interventions are often intended to promote further development

4. Historical Views and Breakthroughs
Ancient Greek/Roman view
The disabled were a burden - scorned, abandoned, or put to death
Before the 18th century
Children were subjected to harsh treatment and largely ignored
By end of 18th century
Interest in abnormal child behavior surfaced

5. The Emergence of Social Conscience – Locke and Itard
John Locke (17th century)
Believed children should be raised with thought and care, not indifference and harsh treatment
Jean-Marc Itard (19th century)
Focused on the care, treatment, and training of “mental defectives”

6. The Emergence of Social Conscience – Hollingworth and Rush
Leta Hollingworth
Distinguished individuals with mental retardation (“imbeciles”) from those with psychiatric disorders (“lunatics”)
Benjamin Rush
Claimed that children were incapable of adult- like insanity
Children with normal cognitive abilities but disturbing behavior suffer from “moral insanity”

7. Early Biological Attributes
Late 19th century: mental illnesses were viewed as biological problems
This was thwarted by the prevailing bias that the individual was at fault for deviant or abnormal behavior
Clifford Beers’ efforts led to detection and intervention

8. Early Biological Attributes – Eugenics and Sterilization
Early 20th century: society reverted to a belief that disorders could not be influenced by treatment or learning
There was a return to custodial care and punishment of behaviors
Mental disorders viewed as “diseases” led to fear of contamination
Eugenics (sterilization) and segregation (institutionalization) were implemented

9. Early Psychological Attributes – Psychoanalytic Theory
Linked mental disorders to childhood experiences and surroundings
Focused on the interaction of developmental and situational processes
Purported that mental disorders can be helped with proper environment or therapy
Retains a role as a model for abnormal child psychology

10. Early Psychological Attributes – Behaviorism
Laid the foundation for evidence-based treatments
Key studies
Pavlov’s research on classical conditioning
Watson’s studies on the elimination of children’s fears and the theory of emotions
Famous study: Little Albert

11. Evolving Forms of Treatment – Psychodynamic Approaches
1930 to 1950: psychodynamic approaches prevailed
Most children with intellectual or mental disorders were institutionalized
Late 1940s: Spitz’ studies pointed out the harmful impact of institutional life
1945 to1965: institutionalization decreased
Placement in foster care and group homes increased

12. Evolving Forms of Treatment – Behavioral Approaches
1950s and early 1960s: behavior therapy emerged as a systematic approach to treatment of child and family disorders
Behavior therapy is a prominent form of therapy

13. Progressive Legislation – IDEA
IDEA (Individuals with Disabilities Education Act) requires:
Free and appropriate public education for children with special needs in the least restrictive environment
Each child must be assessed with culturally appropriate tests
An individualized education program (IEP) for each child

14. Progressive Legislation – The UN
United Nations General Assembly (2007) adopted a new convention to protect the rights of persons with disabilities
The convention supports the attitude of considering persons with disabilities as individuals with human rights

15. What Is Abnormal Behavior in Children and Adolescents?
Childhood disorders are accompanied by various layers of abnormal behavior or development
Must also be sensitive to each child’s stage of development
Disorders are commonly viewed as deviancies from normal
Boundaries between normal and abnormal functioning are arbitrary

16. Defining Psychological Disorders
Patterns of behavioral, cognitive, emotional, or physical symptoms linked with one or more of the following:
Distress
Disability
Increased risk for further suffering or harm
Culture and circumstances matter
The characteristics describes behaviors, not causes

17. Labels Describe Behavior, Not People
Stigmatization is a challenge
Separate the child from the disorder
Problems may be the result of children’s attempts to adapt to abnormal or unusual circumstances
According to DSM-5 guidelines
The primary purpose of using terms is to help describe and organize complex features of behavior patterns

18. Competence The ability to successfully adapt in the environment
Successful adaptation is influenced by culture and ethnicity
Abnormal child psychology considers:
The degree of maladaptive behavior
The extent to which normal developmental milestones are met
Knowledge of developmental tasks provides important background information

19. Examples of Development Tasks
Table 1.1 Examples of developmental tasks
Source: From The Development of Competence in Favorable and Unfavorable Environments: Lessons from Research on Successful Children, by A. S. Masten and J. D. Coatsworth, 1998, American Psychologist, 53, 205–220. Copyright © 1998 by the American Psychological Association. APA is not responsible for the accuracy of this translation. Photo Credits (top to bottom): Flashon Studio/Shutterstock.com; Gelpi/Shutterstock.com; OLJ Studio/Shutterstock.com.

20. Developmental Pathways
The sequence and timing of particular behaviors as well as the relationships between behaviors over time
Two types of developmental pathways
Multifinality - various outcomes may stem from similar beginnings
Equifinality - similar outcomes stem from different early experiences and developmental pathways

21. Multifinality and Equifinality
Figure 1.1 (a) Multifinality: Similar early experiences lead to different outcomes; (b) Equifinality: Different factors lead to a similar outcome
Source: Cengage Learning 2012
Photo Credits: (a) © 2011 SW Productions/Jupiterimages Corporation; (b) © iStockphoto .com/Sarah Salmela.

22. Key Considerations in Developmental Pathways
There are many contributors to disordered outcomes in each child
Contributors vary among children who have the same disorder
Children express features of their disturbances in different ways
Pathways leading to particular disorders are numerous and interactive

23. Risk Factors and Protective Factors
Risk factor: a variable that precedes a negative outcome of interest
Examples: chronic poverty, care-giving deficits, parental mental illness, death of a parent, disasters, and family breakup
Protective factor: a personal or situational variables that mitigates a child developing a disorder

24. Resilience The ability to fight off or recover from misfortune
Associated with strong self-confidence, coping skills, avoiding risk situations
Connected to a “protective triad” of resources:
Strength of the child
Strength of the family
Strength of the school/community

25. Characteristics of Those Who Display Resilience
Figure 1.2 Characteristics of children and adolescents who display resilience in the face of adversity
Source: Based on Masten & Coatsworth, 1998
Photo Credits: (top to bottom) Odua Images/Shutterstock.com; Apollofoto/Shutterstock.com; iofoto/Shutterstock.com

26. The Significance of Mental Health Problems Among Children and Youth
One in eight children has a mental health problem (North American studies)
Many others are at risk for later development of a psychological disorder
The majority of children needing mental health services do not receive them
The demand for children’s mental health services is expected to double over the next decade

27. The Changing Picture of Children’s Mental Health
A better ability to distinguish among disorders has led to increased and earlier recognition of problems
There is a greater awareness of younger children’s and teens’ unique mental health issues
Evidence-based prevention and treatment programs are more prominent

28. Prevalence of Mental Health Issues
Mental health problems are more likely in children:
From disadvantaged families
From abusive or neglectful families
Receiving inadequate child care
Born with very low birth weight
Whose parents have a mental illness or substance abuse problems

29. What Affects Rates and Expression of Mental Disorders?
New pressures and social changes may place children at increased risk for development of disorder
Environmental stressors may:
Act as nonspecific stressors - bring about poor adaptation or the onset of a disorder
Affect the extent to which a child’s problems are attenuated or exacerbated

30. Poverty
One in five children in the U.S. and one in seven in Canada live in poverty
Native American/First Nations and African American children are at greatest risk
Poverty is associated with:
Impairments in learning ability and school achievement, less education, low-paying jobs, inadequate health care, single-parent status, poor nutrition, and exposure to violence

31. Socioeconomic Disadvantages Associated with Poverty
Poverty’s impact on children
More conduct problems, chronic illness, school problems, emotional disorders, and cognitive/learning problems
Poverty indirectly impacts children’s adjustment, which affects learning and mental health

32. Sex Differences Boys and girls express problems differently
Certain disorders are more common in boys than girls, and vice versa
Aggression is expressed more directly by boys; expressed more indirectly by girls
Sex differences appear negligible in children under age three
Disparities increase with age

33. Externalizing Problems
Higher in boys than girls in preschool and early elementary years
Exhibited as acting-out behaviors, e.g., aggression and delinquency
Rates for boys and girls converge by age 18

34. Internalizing Problems
Higher rates in girls
Associated with:
Anxiety, depression, or withdrawn behavior
Somatic complaints
Eating disorders
Emotional disorders with peak age of onset in adolescence

35. Trajectories of Externalizing and Internalizing Problems
Figure 1.3 Normative developmental trajectories of externalizing problems (left graph) and internalizing problems (right graph) from the Child Behavior Checklist. Ages are shown on the x axis. The y axis represents the raw scores (higher scores means more problems)
Source: Adapted from the normative development of child and adolescent problem behavior., by Bongers, I. L., Koot, H. M., van der Ende, J., & Verhulst, F. C., 2003, Journal of Abnormal Psychology, 112, 179–192. Copyright © 2003 by the American Psychological Association. Reprinted with permission. APA is not responsible for the accuracy of this translation.

36. Sex Differences and Resilience
Types of childrearing environments that predict resilience
For boys:
A male role model
Structure and rules
Encouragement of emotional expressiveness
For girls:
Households that combine risk taking and independence with support from female caregiver

37. What is Race?
Most cultural anthropologists see race as a socially constructed concept, not a biological one
Minority children in the U.S. are overrepresented in rates of some disorders
Substance abuse, delinquency, and teen suicide

38. The Effects of Race and Ethnicity
When controlling for other effects (SES, gender, age, referral status)
Few differences emerge in relation to race or ethnicity
Barriers remain in access to, and quality and outcomes of, care for minority children
Minority children face multiple disadvantages, including poverty and marginalization

39. What is Culture?
Values, beliefs, and practices that characterize a particular ethnocultural group
Contribute to development and expression of children’s disorders
Affect how people/institutions react to children’s problems
Affect how problems are expressed

40. Culture and Diversity
Important not to generalize research from one culture to another
Social and cultural beliefs and values influence:
The meaning given to behaviors
The way in which behaviors are responded to
The forms of expression and their outcomes

41. Child Maltreatment and Non-Accidental Trauma: Prevalence
Nearly one million cases of child abuse and neglect occur in the U.S. each year
Estimate: more than one-third of 10- to 16- year-olds experience physical and/or sexual assaults
Acts of violence contribute to PTSD, major depressive disorder, or substance abuse/dependence

42. Child Maltreatment and Non-Accidental Trauma: Consequences
Financial consequences of abuse and trauma: $124 billion per year in the U.S.
More attention needs to be given to developing new ways to prevent and help those exposed to maltreatment and trauma

43. Special Issues Concerning Adolescents and Sexual Minority Youths
Early- to mid-adolescence is an important transitional period for healthy adjustment
Issues during adolescence
Substance use, risky sexual behavior, violence, accidental injuries, and mental health problems
Special needs and problems of adolescents are receiving greater attention

44. Special Issues: Lesbian, Gay, Bisexual, and Transgendered (LGBT) Youths
LGBT youths in middle and high schools are more likely to be victimized by their peers and family members
LGBT youths have higher rates of mental health problems

45. Lifespan Implications
Impact is most severe when problems go untreated for extended periods of time
About 20% of children with the most chronic and serious disorders:
Are least likely to finish school
Are most likely to have social problems and psychiatric disorders
Lifelong consequences associated with child psychopathology are costly

46. Lifespan Implications – Solutions
Children can overcome major obstacles
When provided with circumstances and opportunities that promote healthy adaptation and competence
Major initiatives for prevention and intervention have resulted from recognition of children’s mental health problems

47. Looking Ahead Children cannot advocate on their own behalf
Viewing the whole child is the best strategy in understanding abnormal child and adolescent psychology
Efforts to change policies and programs directed to- ward children and youths are gaining momentum