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Learning Objectives: Late Adulthood Definition and Demographics
• Describe the increase in the number of individuals who are currently identified as late adults
• Describe the increase in late adulthood worldwide
• Explain gender and ethnic differences in the number of individuals identified as late adults
• Explain the different ways developmental psychologists describe aging
• Explain the difference between life span and life expectancy
• Define the three age categories for late adulthood
• Explain what factors contribute to becoming a centenaria
Late adulthood spans the time when we reach our mid-sixties until death. This is the longest developmental stage across the lifespan. In this chapter, we will consider the growth in numbers for those in late adulthood, how that number is expected to change in the future, and the implications this will bring to both the United States and worldwide. We will also examine several theories of human aging, the physical, cognitive, and socioemotional changes that occur with this population, and the vast diversity among those in this developmental stage. Further, ageism and many of the myths associated with those in late adulthood will be explored.
• 9.1: Late Adulthood
Late adulthood, which includes those aged 65 years and above, is the fastest growing age division of the United States population (Gatz, Smyer, & DiGilio, 2016). Currently, one in seven Americans is 65 years of age or older.
• 9.2: Life Expectancy
Lifespan or Maximum Lifespan is referred to as the greatest age reached by any member of a given population (or species). For humans, the lifespan is currently between 120 and 125. Life Expectancy is defined as the average number of years that members of a population (or species) live. According to the World Health Organization (WHO) (2016) global life expectancy at birth in 2015 was 71.4 years, with females reaching 73.8 years and males reaching 69.1 years.
• 9.3: Age Categories in Late Adulthood
There have been many ways to categorize the ages of individuals in late adulthood. In this chapter, we will be dividing the stage into three categories: Young–old (65-84), oldest-old (85- 99), and centenarians (100+) for comparison. These categories are based on the conceptions of aging including, biological, psychological, social, and chronological differences. They also reflect the increase in longevity of those living to this latter stage.
• 9.4: Theories of Aging
There are many theories that attempt to explain how we age, however, researchers still do not fully understand what factors contribute to the human lifespan (Jin, 2010). Research on aging is constantly evolving and includes a variety of studies involving genetics, biochemistry, animal models, and human longitudinal studies (NIA, 2011a). According to Jin (2010), modern biological theories of human aging involve two categories.
• 9.5: Physical Changes of Aging
Aging process varies significantly from individual to individual and from one organ system to another. However, some key generalization can be made including heart muscles thickening with age, arteries becoming less flexible, and lung capacity diminishing. Kidneys become less efficient in removing waste from the blood, and the bladder loses its ability to store urine. Brain cells also lose some functioning, but new neurons can also be produced.
• 9.6: Nutrition
A healthy diet is necessary for older adults to increase mental acuteness, resistance to illness and disease, boost energy levels, improve immune system strength, recuperation speed, and have greater effectiveness in the management of chronic health problems.
• 9.7: Chronic Conditions
Chronic illnesses are illnesses that are ongoing, generally incurable conditions that require continuing medical attention and affect daily life. As individuals live longer, diseases that affect older individuals will become more prevalent, and the burden of chronic illness grows with age. Less than 50% of adults 50-64 have a chronic condition, yet 90% aged 75 and up do (Cohen, 2011). Older women are more likely to have a chronic condition than are older men (83% vs. 88%) (CDC, 2009).
• 9.8: Brain Functioning
Research has demonstrated that the brain loses 5% to 10% of its weight between 20 and 90 years of age. This decrease in brain volume appears to be due to the shrinkage of neurons, lower number of synapses, and shorter length of axons. The normal decline in cognitive ability throughout the lifespan has been associated with brain changes, including reduced activity of genes involved in memory storage, synaptic pruning, plasticity, and glutamate and GABA (neurotransmitters) receptors.
• 9.9: Sexuality
Older men and women are often viewed as genderless and asexual. There is a stereotype that elderly individuals no longer engage in sexual activity and when they do, they are perceived to have committed some kind of offense. These ageist myths can become internalized, and older people have a more difficult time accepting their sexuality (Gosney, 2011). Additionally, some older women indicate that they no longer worry about sexual concerns anymore once they are past the child bearing years.
• 9.10: Cognitive Development in Late Adulthood
There are numerous stereotypes regarding older adults as being forgetful and confused, but what does the research on memory and cognition in late adulthood reveal? Memory comes in many types, such as working, episodic, semantic, implicit, and prospective. There are also many processes involved in memory, thus it should not be a surprise that there are declines in some types of memory and memory processes, while other areas of memory are maintained or even show some improvement with age.
• 9.11: Attention and Problem Solving
Changes in sensory functioning and speed of processing information in late adulthood often translates into changes in attention. Research has shown that older adults are less able to selectively focus on information while ignoring distractors, although Jefferies and her colleagues found that when given double time, older adults could perform at young adult levels. Other studies have also found that older adults have greater difficulty shifting their attention between objects or locations.
• 9.12: Intelligence and Wisdom
altes (1993) introduced two additional types of intelligence to reflect cognitive changes in aging. Pragmatics of intelligence are cultural exposure to facts and procedures that are maintained as one ages and are similar to crystalized intelligence. Mechanics of intelligence are dependent on brain functioning and decline with age, similar to fluid intelligence. Baltes indicated that pragmatics of intelligence show little decline and typically increase with age.
• 9.13: Neurocognitive Disorders
A Major Neurocognitive Disorder is diagnosed as a significant cognitive decline from a previous level of performance in one or more cognitive domains and interferes with independent functioning, while a Minor Neurocognitive Disorder is diagnosed as a modest cognitive decline from a previous level of performance in one of more cognitive domains and does not interfere with independent functioning. There are several different neurocognitive disorders that are typically demonstrated in late adulthoo
• 9.14: Work and Retirement
Older adults are just as capable as younger adults at the workplace. In fact, jobs that require social skills, accumulated knowledge, and relevant experiences favor older adults (Erber & Szuchman, 2015). Older adults also demonstrate lower rates of absenteeism and greater investment in their work. In 2015, 8.8 million adults aged 65 or older were employed or actively seeking employment. This constitute about 5.6% of the U.S. labor force (AOA, 2016).
• 9.15: Psychosocial Development in Late Adulthood
Stereotypes of people in late adulthood lead many to assume that aging automatically brings poor physical health and mental decline. These stereotypes are reflected in everyday conversations, the media, and even in greeting cards (Overstreet, 2006). Age is not revered in the United States, and so laughing about getting older in birthday cards is one way to get relief. The negative attitudes people have about those in late adulthood are examples of ageism, or prejudice based on age.
• 9.16: Living Arrangements
Do those in late adulthood primarily live alone? No. In 2014, of those 65 years of age and older, approximately 72% of men and 46% of women lived with their spouse. Between 1900 and 1990 the number of older adults living alone increased, most likely due to improvements in health and longevity during this time. Since 1990 the number of older adults living alone has declined, because of older women more likely to be living with their spouse or children (Stepler, 2016c).
• 9.17: Erikson - Integrity vs. Despair
How do people cope with old age? According to Erikson, the last psychosocial stage is Integrity vs. Despair that includes, “a retrospective accounting of one’s life to date; how much one embraces life as having been well lived, as opposed to regretting missed opportunities”. This stage includes finding meaning in one’s life and accepting one’s accomplishments, but also acknowledging what in life has not gone as hoped.
• 9.18: Generativity in Late Adulthood
Research suggests that generativity is not just a concern for midlife adults, but for many elders, concerns about future generations continue into late adulthood. As previously discussed, some older adults are continuing to work beyond age 65. Additionally, they are volunteering in their community, and raising their grandchildren in greater numbers.
• 9.19: Social Networks in Late Adulthood
A person’s social network consists of the people with whom one is directly involved, such as family, friends, and acquaintances. As individuals age, changes occur in these social networks, and The Convoy Model of Social Relations and Socioemotional Selectivity Theory address these changes. Both theories indicate that less close relationships will decrease as one ages, while close relationships will persist. However, the two theories differ in explaining why this occurs.
• 9.20: Late Adult Lifestyles
• 9.21: Gay and Lesbian Elders
Approximately 3 million older adults in the United States identify as lesbian or gay (Hillman & Hinrichsen, 2014). By 2025 that number is expected to rise to more than 7 million (National Gay and Lesbian Task Force, 2006). Despite the increase in numbers, older lesbian and gay adults are one of the least researched demographic groups, and the research there is portrays a population faced with discrimination.
• 9.22: Elder Abuse
Current research indicates that at least 1 in 10, or approximately 4.3 million, older Americans are affected by at least one form of elder abuse per year (Roberto, 2016). Those between 60 and 69 years of age are more susceptible than those older. This may be because younger older adults more often live with adult children or a spouse, two groups with the most likely abusers.
• 9.23: Substance Abuse and the Elderly
Alcohol and drug problems, particularly prescription drug abuse, have become a serious health concern among older adults. Although people 65 years of age and older make up only 13% of the population, they account for almost 30% of all medications prescribed in the United States. According to the National Council on Alcoholism and Drug Dependence (NCADD) (2015), the following statistics illustrate the significance of substance abuse for those in late adulthood:
• 9.24: Successful Aging
Although definitions of successful aging are value-laden, Rowe and Kahn (1997) defined three criteria of successful aging that are useful for research and behavioral interventions. They include: (1) Relative avoidance of disease, disability, and risk factors, like high blood pressure, smoking, or obesity, (2) Maintenance of high physical and cognitive functioning, (3) Active engagement in social and productive activities.
• 9.R: Late Adulthood (References)
09: Late Adulthood
Late adulthood, which includes those aged 65 years and above, is the fastest growing age division of the United States population (Gatz, Smyer, & DiGilio, 2016). Currently, one in seven Americans is 65 years of age or older. The first of the baby boomers (born from 1946-1964) turned 65 in 2011, and approximately 10,000 baby boomers turn 65 every day. By the year 2050, almost one in four Americans will be over 65, and will bed expected to live longer than previous generations. According to the U. S. Census Bureau (2014b) a person who turned 65 in 2015 can expect to live another 19 years, which is 5.5 years longer than someone who turned 65 in 1950. This increasingly aged population has been referred to as the “Graying of America”. This “graying” is already having significant effects on the nation in many areas, including work, health care, housing, social security, caregiving, and adaptive technologies. Table 9.1 shows the 2012, 2020, and 2030 projected percentages of the U.S. population ages 65 and older.
Table 9.1 Percent of United States Population 65 Years and Older
Percent of United States Population 2012 2020 2030
65 years and older 13.7% 16.8% 20.3%
65-69 4.5% 5.4% 5.6%
70-74 3.2% 4.4% 5.2%
75-79 2.4% 3.0% 4.1%
80-84 1.8% 1.9% 2.9%
85 years and older 1.9% 2.0% 2.5%
Compiled from data from An Aging Nation: The older population in the United States. United States Census Bureau. http://www.census.gov/prod/2014pubs/p25-1140.pdf
The "Graying" of the World
Even though the United States is aging, it is still younger than most other developed countries (Ortman, Velkoff, & Hogan, 2014). Germany, Italy, and Japan all had at least 20% of their population aged 65 and over in 2012, and Japan had the highest percentage of elderly. Additionally, between 2012 and 2050, the proportion aged 65 and over is projected to increase in all developed countries. Japan is projected to continue to have the oldest population in 2030 and 2050. Table 9.2 shows the percentages of citizens aged 65 and older in select developed countries in 2012 and projected for 2030 and 2050.
Table 9.2 Percentage of Citizens 65 years and Older in Six Developed Countries
Percent of Population 65 and Older 2012 2030 2050
America 13.7% 20.3% 22%
Japan 24% 32.2% 40%
Germany 20% 27.9% 30%
Italy 20% 25.5% 31%
Canada 16.5% 25% 26.5%
Russia 13% 20% 26%
Compiled from data from An Aging Nation: The older population in the United States. United States Census Bureau. http://www.census.gov/prod/2014pubs/p25-1140.pdf
According to the National Institute on Aging (NIA, 2015b), there are 524 million people over 65 worldwide. This number is expected to increase from 8% to 16% of the global population by 2050. Between 2010 and 2050, the number of older people in less 250%, compared with only a 71% increase in developed countries. Declines in fertility and improvements in longevity account for the percentage increase for those 65 years and older. In more developed countries, fertility fell below the replacement rate of two live births per woman by the 1970s, down from nearly three children per woman around 1950. Fertility rates also fell in many less developed countries from an average of six children in 1950 to an average of two or three children in 2005. In 2006, fertility was at or below the two-child replacement level in 44 less developed countries (NIA, 2015d).
In total number, the United States is projected to have a larger older population than the other developed nations, but a smaller older population compared with China and India, the world’s two most populous nations (Ortman et al., 2014). By 2050, China’s older population is projected to grow larger than the total U.S. population today. As the population ages, concerns grow about who will provide for those requiring long-term care. In 2000, there were about 10 people 85 and older for every 100 persons between ages 50 and 64. These midlife adults are the most likely care providers for their aging parents. The number of old requiring support from their children is expected to more than double by the year 2040 (He, Sengupta, Velkoff, & DeBarros, 2005). These families will certainly need external physical, emotional, and financial support in meeting this challenge. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.01%3A_Late_Adulthood.txt |
Life Expectancy vs Lifespan
Lifespan or Maximum Lifespan is referred to as the greatest age reached by any member of a given population (or species). For humans, the lifespan is currently between 120 and 125. Life Expectancy is defined as the average number of years that members of a population (or species) live. According to the World Health Organization (WHO) (2016) global life expectancy at birth in 2015 was 71.4 years, with females reaching 73.8 years and males reaching 69.1 years.
Women live longer than men around the world, and the gap between the sexes has remained the same since 1990. Overall life expectancy ranged from 60.0 years in the WHO African Region to 76.8 years in the WHO European Region. Global life expectancy increased by 5 years between 2000 and 2015, and the largest increase was in the WHO African Region where life expectancy increased by 9.4 years. This was due primarily to improvements in child survival and access to antiretroviral medication for the treatment of HIV. According to the Central Intelligence Agency (2016) the United States ranks 43rd in the world for life expectancy.
World Healthy Life Expectancy: A better way to appreciate the diversity of people in late adulthood is to go beyond chronological age and examine how well the person is aging. Many in late adulthood enjoy better health and social well-being than average and would be aging at an optimal level. In contrast, others experience poor health and dependence to a greater extent than would be considered normal. When looking at large populations, the WHO (2016) measures how many equivalent years of full health on average a newborn baby is expected to have. This age takes into account current age-specific mortality, morbidity, and disability risks and is referred to as The Healthy Life Expectancy. In 2015, the global Healthy Life Expectancy was 63.1 years up from 58.5 years in 2000. The WHO African Region had the lowest Healthy Life Expectancy at 52.3 years, while the WHO Western Pacific Region had the highest at 68.7 years.
Life Expectancy in America: In the United States the overall life expectancy is 79.7 years, however, life expectancies vary by sex, race, and ethnicity. Table 9.3 shows the life expectancy of three demographic groups for males and females for a child born in 2012 (Ortman et al., 2014). As can be seen, females enjoy a longer life expectancy, and overall Hispanics have the highest life expectancy.
Table 9.3 2012 U. S. Life Expectancy by Sex, Race, and Ethnic Origin in Years
Demographic Female Male
All Groups 81.97 77.32
Non-Hispanic White and Asian or Pacific Islander 81.7 77.1
Non-Hispanic Black and American Indian or Alaskan Native 78.0 71.7
Hispanic 83.7 78.9
Compiled from data from An Aging Nation: The older population in the United States. United States Census Bureau. http://www.census.gov/prod/2014pubs/p25-1140.pdf
American Healthy Life Expectancy: To determine the current United States Healthy Life Expectancy (HLE), factors were evaluated in 2007-2009 to determine how long an individual currently at age 65 will continue to experience good health (CDC, 2013). The highest Healthy Life Expectancy (HLE) was observed in Hawaii with 16.2 years of additional good health, and the lowest was in Mississippi with only 10.8 years of additional good health. Overall, the lowest HLE was among southern states. Females had a greater HLE than males at age 65 years in every state and DC. HLE was greater for whites than for blacks in DC and all states from which data were available, except in Nevada and New Mexico.
Although improvements have occurred in overall life expectancy, children born in the United States today may be the first generation to have a shorter life span than their parents. Much of this decline has been attributed to the increase in sedentary lifestyle and obesity. According to the American Heart Association (2014), currently one in three American children is overweight or obese. The rate of childhood obesity tripled from 1971 to 2011, and obesity in children is associated with a range of health problems, including high blood pressure, type 2 diabetes, elevated blood cholesterol levels, and psychological concerns including low self-esteem, negative body image and depression. Excess weight is associated with an earlier risk of obesity-related diseases and death. In 2007 former Surgeon General Richard Carmona stated, “Because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents” (p. 1).
Gender Differences in Life Expectancy
Biological Explanations: Biological differences in sex chromosomes and different pattern of gene expression is theorized as one reason why females live longer (Chmielewski, Boryslawski, & Strzelec, 2016). Males are heterogametic (XY), whereas females are homogametic (XX) with respect to the sex chromosomes. Males can only express their X chromosome genes that come from the mother, while females have an advantage by selecting the “better” X chromosome from their mother or father, while inactivating the “worse” X chromosome. This process of selection for “better” genes is impossible in males and results in the greater genetic and developmental stability of females.
In terms of developmental biology, women are the “default” sex, which means that the creation of a male individual requires a sequence of events at a molecular level. According to Chmilewski et al. (2016):
These events are initiated by the activity of the SRY gene located on the Y chromosome. This activity and change in the direction of development results in a greater number of disturbances and developmental disorders, because the normal course of development requires many different factors and mechanisms, each of which must work properly and at a specific stage of the development. (p. 134)
Men are more likely to contract viral and bacterial infections, and their immunity at the cellular level decreases significantly faster with age. Although women are slightly more prone to autoimmune and inflammatory diseases, such as rheumatoid arthritis, the gradual deterioration of the immune system is slower in women (Caruso, Accardi, Virruso, & Candore, 2013; Hirokawa et al., 2013).
Looking at the influence of hormones, estrogen levels in women appear to have a protective effect on their heart and circulatory systems (Viña, Borrás, Gambini, Sastre, & Pallardó, 2005). Estrogens also have antioxidant properties that protect against harmful effects of free radicals, which damage cell components, cause mutations, and are in part responsible for the aging process. Testosterone levels are higher in men than in women, and are related to more frequent cardiovascular and immune disorders. The level of testosterone is also responsible, in part, for male behavioral patterns, including increased level of aggression and violence (Martin, Poon, & Hagberg, 2011; Borysławski & Chmielewski, 2012). Another factor responsible for risky behavior is the frontal lobe of the brain. The frontal lobe, which controls judgment and consideration of an action’s consequences, develops more slowly in boys and young men. This lack of judgment affects lifestyle choices, and consequently many more boys and men die by smoking, excessive drinking, accidents, drunk driving, and violence (Shmerling, 2016).
Lifestyle Factors: Certainly not all the reasons women live longer than men are biological. As previously mentioned, male behavioral patterns and lifestyle play a significant role in the shorter lifespans for males. One significant factor is that males work in more dangerous jobs, including police, fire fighters, and construction, and they are more exposed to violence. According to the Federal Bureau of Investigation (2014) there were 11,961 homicides in the U.S. in 2014 (last year for full data) and of those 77% were males.
Males are also more than three times as likely to commit suicide (CDC, 2016a). Further, males serve in the military in much larger numbers than females. According to the Department of Defense (2015), in 2014 83% of all officers in the Services (Navy, Army, Marine Corps and Air Force) were male, while 85% of all enlisted service members were male.
Additionally, men are less likely than women to have health insurance, develop a regular relationship with a doctor, or seek treatment for a medical condition (Scott, 2015). As mentioned in the middle adulthood chapter, women are more religious than men, which is associated with healthier behaviors (Greenfield, Vaillant & Marks, 2009). Lastly, social contact is also important as loneliness is considered a health hazard. Nearly 20% of men over 50 have contact with their friends less than once a month, compared to only 12% of women who see friends that infrequently (Scott, 2015). Overall, men’s lower life expectancy appears to be due to both biological and lifestyle factors. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.02%3A_Life_Expectancy.txt |
There have been many ways to categorize the ages of individuals in late adulthood. In this chapter, we will be dividing the stage into three categories: Young–old (65-84), oldest-old (85- 99), and centenarians (100+) for comparison. These categories are based on the conceptions of aging including, biological, psychological, social, and chronological differences. They also reflect the increase in longevity of those living to this latter stage.
Young-old: Older adults between the ages of 65 and 84 comprise the young-old category (Ortman et al., 2014). This time-period has also been identified by Laslett (1989) as the “third age” because it follows childhood (the first age) and work and parenting (the second age). According to Barnes (2011a), this age category spans the post-employment years until approximately 80-85 years when age-related limitations occur in the areas of physical, emotional, and cognitive development. Generally, this age span includes many positive aspects and is considered the “golden years” of adulthood. Why so positive?
Individuals at this age often have fewer responsibilities than in previous stages, and when combined with adequate finances and good health, they can pursue leisure and self-fulfillment opportunities. It is also an unusual age in that people are considered both in old age and not in old age (Rubinstein, 2002). When compared to those above 85 (known as the fourth age), the young-old experience relatively good health and social engagement (Smith, 2000), knowledge and expertise (Singer, Verhaeghen, Ghisletta, Lindenberger, & Baltes, 2003), and adaptive flexibility in daily living (Riediger, Freund, & Baltes, 2005). The young-old also show strong performance in attention, memory, and crystallized intelligence. In fact, those identified as young-old are more similar to those in midlife than those who are 85 and older. This group is less likely to require long-term care, to be dependent or poor, and more likely to be married, working for pleasure rather than income, and living independently. Chronic diseases, such as cardiovascular disease, hypertension, and cancer, are among the most common (especially later in this period), but because they are linked to lifestyle choices, they typically can be can prevented, lessoned, or managed (Barnes, 2011b). Overall, those in this age period feel a sense of happiness and emotional well-being that is better than at any other period of adulthood (Carstensen, Fung, & Charles, 2003; George, 2009; Robins & Trzesniewski, 2005).
Oldest-old: This age group is sometimes called the “fourth-age” and often includes people who have more serious chronic ailments among the older adult population. In the U.S., the oldest-old represented 14% of the older adult population in 2015 (He, Goodkind, & Kowal, 2016). This age group is one of the fastest growing worldwide and is projected to increase more than 300% over its current levels (NIA, 2015b). The oldest-old are projected to be nearly 18 million by 2050, or about 4.5% of the U. S. population, compared with less than 2% of the population today. Females comprise more than 60% of those 85 and older, but they also suffer from more chronic illnesses and disabilities than older males (Gatz et al., 2016).
While this age group accounts for only 2% of the U. S. population, it accounts for 9% of all hospitalizations (Levant, Chari & DeFrances, 2015). Those 85 and up are less likely to be discharged and more likely to die in hospital. The most common reasons for hospitalization for the oldest-old were congestive heart failure, pneumonia, urinary tract infections, septicemia, stroke, and hip fractures. In recent years, hospitalizations for many of these medical problems have been reduced. However, hospitalization for urinary tract infections and septicemia has increased for those 85 and older.
Those 85 and older are more likely to require long-term care and to be in nursing homes than the youngest-old. Almost 50% of the oldest-old require some assistance with daily living activities (APA, 2016). However, most still live in the community rather than a nursing home, as shown in Figure 9.7 (Stepler, 2016b). The oldest-old are less likely to be married and living with a spouse compared with the majority of the young-old (APA, 2016; Stepler, 2016c). As can be seen, in Figure 9.7, gender is also an important factor in the likelihood of being married or living with one’s spouse.
Centenarians: A segment of the oldest-old are centenarians, that is, 100 and older, and some are also referred to as supercentarians, those 110 and older (Wilcox, Wilcox & Ferrucci, 2008). In 2015 there were nearly half a million centenarians worldwide, and it is estimated that this age group will grow to almost 3.7 million by 2050. The U. S. has the most centenarians, but Japan and Italy have the most per capita (Stepler, 2016e). Most centenarians tended to be healthier than many of their peers as they were growing older, and often there was a delay in the onset of any serious disease or disability until their 90s. Additionally, 25% reached 100 with no serious chronic illnesses, such as depression, osteoporosis, heart disease, respiratory illness, or dementia (Ash et al. 2015). Centenarians are more likely to experience a rapid terminal decline in later life, meaning that for most of their adulthood, and even older adult years, they are relatively healthy in comparison to many other older adults (Ash et al., 2015; Wilcox et al., 2008). According to Guinness World Records (2016), Jeanne Louise Calment has been documented to be the longest living person at 122 years and 164 days old (See Figure 9.8). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.03%3A_Age_Categories_in_Late_Adulthood.txt |
Learning Objectives: Physical Development in Late Adulthood
• Describe different theories of aging
• Describe the changes in physical appearance in late adulthood
• Describe the sensory changes in late adulthood
• Describe chronic health conditions during late adulthood
• Describe the importance of nutrition and exercise in late adulthood
• Describe the physical and functional changes in the brain during late adulthood
• Explain what happens in Parkinson’s disease
• Explain how sleep patterns change in late adulthood
• Explain how sexuality changes in late adulthood
Why do we age? There are many theories that attempt to explain how we age, however, researchers still do not fully understand what factors contribute to the human lifespan (Jin, 2010). Research on aging is constantly evolving and includes a variety of studies involving genetics, biochemistry, animal models, and human longitudinal studies (NIA, 2011a). According to Jin (2010), modern biological theories of human aging involve two categories. The first is Programmed Theories that follow a biological timetable, possibly a continuation of childhood development. This timetable would depend on “changes in gene expression that affect the systems responsible for maintenance, repair, and defense responses,” (p. 72). The second category includes Damage or Error Theories which emphasize environmental factors that cause cumulative damage in organisms. Examples from each of these categories will be discussed.
Genetics: One’s genetic make-up certainly plays a role in longevity, but scientists are still attempting to identify which genes are responsible. Based on animal models, some genes promote longer life, while other genes limit longevity. Specifically, longevity may be due to genes that better equip someone to survive a disease. For others, some genes may accelerate the rate of aging, while others decrease the rate. To help determine which genes promote longevity and how they operate, researchers scan the entire genome and compare genetic variants in those who live longer with those who have an average or shorter lifespan. For example, a National Institutes of Health study identified genes possibly associated with blood fat levels and cholesterol, both risk factors for coronary disease and early death (NIA, 2011a). Researchers believe that it is most likely a combination of many genes that affect the rate of aging.
Evolutionary Theory: Evolutionary psychology emphasizes the importance of natural selection; that is, those genes that allow one to survive and reproduce will be more likely to be transmitted to offspring. Genes associated with aging, such as Alzheimer Disease, do not appear until after the individual has passed their main reproductive years. Consequently, natural selection has not eliminated these damaging disorders from the gene pool. If these detrimental disorders occurred earlier in the development cycle, they may have been eliminated already (Gems, 2014).
Cellular Clock Theory: This theory suggests that biological aging is due to the fact that normal cells cannot divide indefinitely. This is known as the Hayflick limit, and is evidenced in cells studied in test tubes, which divide about 40-60 times before they stop (Bartlett, 2014). But what is the mechanism behind this cellular senescence? At the end of each chromosomal strand is a sequence of DNA that does not code for any particular protein, but protects the rest of the chromosome, which is called a telomere. With each replication, the telomere gets shorter. Once it becomes too short the cell does one of three things. It can stop replicating by turning itself off, called cellular senescence. It can stop replicating by dying, called apoptosis. Or, as in the development of cancer, it can continue to divide and become abnormal. Senescent cells can also create problems. While they may be turned off, they are not dead, thus they still interact with other cells in the body and can lead to an increase risk of disease. When we are young, senescent cells may reduce our risk of serious diseases such as cancer, but as we age they increase our risk of such problems (NIA, 2011a). Understanding why cellular senescence changes from being beneficial to being detrimental is still under investigation. The answer may lead to some important clues about the aging process.
DNA Damage: Over time DNA, which contains the genetic code for all organisms, accumulates damage. This is usually not a concern as our cells are capable of repairing damage throughout our life. Further, some damage is harmless. However, some damage cannot be repaired and remains in our DNA. Scientists believe that this damage, and the body’s inability to fix itself, is an important part of aging (NIA, 2011a). As DNA damage accumulates with increasing age, it can cause cells to deteriorate and malfunction (Jin, 2010). Factors that can damage DNA include ultraviolet radiation, cigarette smoking, and exposure to hydrocarbons, such as auto exhaust and coal (Dollemore, 2006).
Mitochondrial Damage: Damage to mitochondrial DNA can lead to a decaying of the mitochondria, which is a cell organelle that uses oxygen to produce energy from food. The mitochondria convert oxygen to adenosine triphosphate (ATP) which provides the energy for the cell. When damaged, mitochondria become less efficient and generate less energy for the cell and can lead to cellular death (NIA, 2011a).
Free Radicals: When the mitochondria uses oxygen to produce energy, they also produce potentially harmful byproducts called oxygen free radicals (NIA, 2011a). The free radicals are missing an electron and create instability in surrounding molecules by taking electrons from them. There is a snowball effect (A takes from B and then B takes from C, etc.) that creates more free radicals which disrupt the cell and causes it to behave abnormally (See Figure 9.11). Some free radicals are helpful as they can destroy bacteria and other harmful organisms, but for the most part they cause damage in our cells and tissue. Free radicals are identified with disorders seen in those of advanced age, including cancer, atherosclerosis, cataracts, and neurodegeneration. Some research has supported adding antioxidants to our diets to counter the effects of free radical damage because the antioxidants can donate an electron that can neutralize damaged molecules. However, the research on the effectiveness of antioxidants is not conclusive (Harvard School of Public Health, 2016).
Immune and Hormonal Stress Theories: Ever notice how quickly U.S. presidents seem to age? Before and after photos reveal how stress can play a role in the aging process. When gerontologists study stress, they are not just considering major life events, such as unemployment, death of a loved one, or the birth of a child. They are also including metabolic stress, the life sustaining activities of the body, such as circulating the blood, eliminating waste, controlling body temperature, and neuronal firing in the brain. In other words, all the activities that keep the body alive also create biological stress.
To understand how this stress affects aging, researchers note that both problems with the innate and adaptive immune system play a key role. The innate immune system is made up of the skin, mucous membranes, cough reflex, stomach acid, and specialized cells that alert the body of an impending threat. With age these cells lose their ability to communicate as effectively, making it harder for the body to mobilize its defenses. The adaptive immune system includes the tonsils, spleen, bone marrow, thymus, circulatory system and the lymphatic system that work to produce and transport T cells. T-cells, or lymphocytes, fight bacteria, viruses, and other foreign threats to the body. T-cells are in a “naïve” state before they are programmed to fight an invader, and become “memory cells”. These cells now remember how to fight a certain infection should the body ever come across this invader again. Memory cells can remain in your body for many decades, and why the measles vaccine you received as a child is still protecting you from this virus today. As older adults produce fewer new T-cells to be programmed, they are less able to fight off new threats and new vaccines work less effectively. The reason why the shingles vaccine works well with older adults is because they already have some existing memory cells against the varicella virus. The shingles vaccine is acting as a booster (NIA, 2011a).
Hormonal Stress Theory, also known as Neuroendocrine Theory of Aging, suggests that as we age the ability of the hypothalamus to regulate hormones in the body begins to decline leading to metabolic problems (American Federation of Aging Research (AFAR) 2011). This decline is linked to excess of the stress hormone cortisol. While many of the body’s hormones decrease with age, cortisol does not (NIH, 2014a). The more stress we experience, the more cortisol released, and the more hypothalamic damage that occurs. Changes in hormones have been linked to several metabolic and hormone related problems that increase with age, such as diabetes (AFAR, 2011), thyroid problems (NIH, 2013), osteoporosis, and orthostatic hypotension (NIH, 2014a). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.04%3A_Theories_of_Aging.txt |
The Baltimore Longitudinal Study on Aging (BLSA) (NIA, 2011b) began in 1958 and has traced the aging process in 1,400 people from age 20 to 90. Researchers from the BLSA have found that the aging process varies significantly from individual to individual and from one organ system to another. However, some key generalization can be made including heart muscles thickening with age, arteries becoming less flexible, and lung capacity diminishing. Kidneys become less efficient in removing waste from the blood, and the bladder loses its ability to store urine. Brain cells also lose some functioning, but new neurons can also be produced. Many of these changes are determined by genetics, lifestyle, and disease. Other changes in late adulthood include:
Body Changes: Everyone’s body shape changes naturally as they age. According to the National Library of Medicine (2014) after age 30 people tend to lose lean tissue, and some of the cells of the muscles, liver, kidney, and other organs are lost. Tissue loss reduces the amount of water in your body and bones may lose some of their minerals and become less dense (a condition called osteopenia in the early stages and osteoporosis in the later stages). The amount of body fat goes up steadily after age 30, and older individuals may have almost one third more fat compared to when they were younger. Fat tissue builds up toward the center of the body, including around the internal organs.
Skin and Hair: With age skin becomes thinner, less elastic, loses fat, and no longer looks plump and smooth. Veins and bones can be seen more easily and scratches, cuts, and bumps can take longer to heal. Years exposed to the sun may lead to wrinkles, dryness, age spots, and cancer. Older people may bruise more easily, and it can take longer for these bruises to heal. Some medicines or illnesses may also cause bruising. Gravity can cause skin to sag and wrinkle, and smoking can wrinkle the skin. Also, seen in older adults are age spots, previously called “liver spots”. They look like flat, brown spots and are often caused by years in the sun. Skin tags are small, usually flesh-colored growths of skin that have a raised surface. They become common as people age, especially for women, but both age spots and skin tags are harmless (NIA, 2015f).
Nearly everyone has hair loss as they age, and the rate of hair growth slows down as many hair follicles stop producing new hairs. The loss of pigment and subsequent graying begun in middle adulthood continues in late adulthood.
Sarcopenia is the loss of muscle tissue as a natural part of aging. Sarcopenia is most noticeable in men, and physically inactive people can lose as much as 3% to 5% of their muscle mass each decade after age 30, but even when active muscle loss still occurs (Webmd, 2016). Symptoms include a loss of stamina and weakness, which can decrease physical activity and subsequently further shrink muscles. Sarcopenia typically happens faster around age 75, but it may also speed up as early as 65 or as late as 80. Factors involved in sarcopenia include a reduction in nerve cells responsible for sending signals to the muscles from the brain to begin moving, a decrease in the ability to turn protein into energy, and not receiving enough calories or protein to sustain adequate muscle mass. Any loss of muscle is important because it lessens strength and mobility, and sarcopenia is a factor in frailty and the likelihood of falls and fractures in older adults. Maintaining strong leg and heart muscles are important for independence. Weight-lifting, walking, swimming, or engaging in other cardiovascular exercises can help strengthen the muscles and prevent atrophy.
Height and Weight: The tendency to become shorter as one ages occurs among all races and both sexes. Height loss is related to aging changes in the bones, muscles, and joints. People typically lose almost one-half inch every 10 years after age 40, and height loss is even more rapid after age 70. A total of 1 to 3 inches in height is lost with aging. Changes in body weight vary for men and woman. Men often gain weight until about age 55, and then begin to lose weight later in life, possibly related to a drop in the male sex hormone testosterone. Women usually gain weight until age 65, and then begin to lose weight. Weight loss later in life occurs partly because fat replaces lean muscle tissue, and fat weighs less than muscle. Diet and exercise are important factors in weight changes in late adulthood (National Library of Medicine, 2014).
Sensory Changes in Late Adulthood
Vision: In late adulthood, all the senses show signs of decline, especially among the oldest-old. In the last chapter, you read about the visual changes that were beginning in middle adulthood, such as presbyopia, dry eyes, and problems seeing in dimmer light. By later adulthood these changes are much more common. Three serious eyes diseases are more common in older adults: Cataracts, macular degeneration, and glaucoma. Only the first can be effectively cured in most people.
Cataracts are a clouding of the lens of the eye. The lens of the eye is made up of mostly water and protein. The protein is precisely arranged to keep the lens clear, but with age some of the protein starts to clump. As more of the protein clumps together the clarity of the lens is reduced. While some adults in middle adulthood may show signs of cloudiness in the lens, the area affected is usually small enough to not interfere with vision. More people have problems with cataracts after age 60 (NIH, 2014b) and by age 75, 70% of adults will have problems with cataracts (Boyd, 2014). Cataracts also cause a discoloration of the lens, tinting it more yellow and then brown, which can interfere with the ability to distinguish colors such as black, brown, dark blue, or dark purple.
Risk factors besides age include certain health problems such as diabetes, high blood pressure, and obesity, behavioral factors such as smoking, other environmental factors such as prolonged exposure to ultraviolet sunlight, previous trauma to the eye, long-term use of steroid medication, and a family history of cataracts (NEI, 2016a; Boyd, 2014). Cataracts are treated by removing and replacing the lens of the eye with a synthetic lens. In developed countries, such as the United States, cataracts can be easily treated with surgery. However, in developing countries, access to such operations are limited, making cataracts the leading cause of blindness in late adulthood in Third World nations (Resnikoff, Pascolini, Mariotti & Pokharel, 2004). As shown in Figure 9.15, areas of the world with limited medical treatment for cataracts often results in people living more years with a serious disability. For example, of those living in the darkest red color on the map, more than 990 out of 100,00 people have a shortened lifespan due to the disability caused by cataracts.
Older adults are also more likely to develop age-related macular degeneration, which is the loss of clarity in the center field of vision, due to the deterioration of the macula, the center of the retina. Macular degeneration does not usually cause total vision loss, but the loss of the central field of vision can greatly impair day-to-day functioning. There are two types of macular degeneration: dry and wet. The dry type is the most common form and occurs when tiny pieces of a fatty protein called drusen form beneath the retina. Eventually the macular becomes thinner and stops working properly (Boyd, 2016). About 10% of people with macular degeneration have the wet type, which causes more damage to their central field of vision than the dry form. This form is caused by an abnormal development of blood vessels beneath the retina. These vessels may leak fluid or blood causing more rapid loss of vision than the dry form.
The risk factors for macular degeneration include smoking, which doubles your risk (NIH, 2015a); race, as it is more common among Caucasians than African Americans or Hispanics/Latinos; high cholesterol; and a family history of macular degeneration (Boyd, 2016). At least 20 different genes have been related to this eye disease, but there is no simple genetic test to determine your risk, despite claims by some genetic testing companies (NIH, 2015a). At present, there is no effective treatment for the dry type of macular degeneration. Some research suggests that certain patients may benefit from a cocktail of certain antioxidant vitamins and minerals, but the results are mixed at best. They are not a cure for the disease nor will they restore the vision that has been lost. This “cocktail” can slow the progression of visual loss in some people (Boyd, 2016; NIH, 2015a). For the wet type medications that slow the growth of abnormal blood vessels, and surgery, such as laser treatment to destroy the abnormal blood vessels may be used. Only 25% of those with the wet version may see improvement with these procedures (Boyd, 2016).
A third vision problem that increases with age is glaucoma, which is the loss of peripheral vision, frequently due to a buildup of fluid in eye that damages the optic nerve. As you age the pressure in the eye may increase causing damage to the optic nerve. The exterior of the optic nerve receives input from retinal cells on the periphery, and as glaucoma progresses more and more of the peripheral visual field deteriorates toward the central field of vision. In the advanced stages of glaucoma, a person can lose their sight. Fortunately, glaucoma tends to progresses slowly (NEI, 2016b).
Glaucoma is the most common cause of blindness in the U.S. (NEI, 2016b). African Americans over age 40, and everyone else over age 60 has a higher risk for glaucoma. Those with diabetes, and with a family history of glaucoma also have a higher risk (Owsley et al., 2015). There is no cure for glaucoma, but its rate of progression can be slowed, especially with early diagnosis. Routine eye exams to measure eye pressure and examination of the optic nerve can detect both the risk and presence of glaucoma (NEI, 2016b). Those with elevated eye pressure are given medicated eye drops. Reducing eye pressure lowers the risk of developing glaucoma or slow its progression in those who already have it.
Hearing: As you read in Chapter 8, our hearing declines both in terms of the frequencies of sound we can detect and the intensity of sound needed to hear as we age. These changes continue in late adulthood. Almost 1 in 4 adults aged 65 to 74 and 1 in 2 aged 75 and older have disabling hearing loss (NIH, 2016). Table 9.4 lists some common signs of hearing loss.
Table 9.4: Common Signs of Hearing Loss
Have trouble hearing over the telephone
Find it hard to follow conversations when two or more people are talking
Often ask people to repeat what they are saying
Need to turn up the TV volume so loud that others complain
Have a problem hearing because of background noise
Think that others seem to mumble
Can't understand when women and children speak to you
Adapted from NIA, 2015c
Presbycusis is a common form of hearing loss in late adulthood that results in a gradual loss of hearing. It runs in families and affects hearing in both ears (NIA, 2015c). Older adults may also notice tinnitus, a ringing, hissing, or roaring sound in the ears. The exact cause of tinnitus is unknown, although it can be related to hypertension and allergies. It may come and go or persist and get worse over time (NIA, 2015c). The incidence of both presbycusis and tinnitus increase with age and males have higher rates of both around the world (McCormak, Edmondson-Jones, Somerset, & Hall, 2016).
Your auditory system has two jobs: To help you to hear, and to help you maintain balance. Your balance is controlled by the brain receiving information from the shifting of hair cells in the inner ear about the position and orientation of the body. With age this function of the inner ear declines which can lead to problems with balance when sitting, standing, or moving (Martin, 2014).
Taste and Smell: Our sense of taste and smell are part of our chemical sensing system. Our sense of taste, or gustation, appears to age well. Normal taste occurs when molecules that are released by chewing food stimulate taste buds along the tongue, the roof of the mouth, and in the lining of the throat. These cells send messages to the brain, where specific tastes are identified. After age 50 we start to lose some of these sensory cells. Most people do not notice any changes in taste until ones 60s (NIH: Senior Health, 2016b). Given that the loss of taste buds is very gradual, even in late adulthood, many people are often surprised that their loss of taste is most likely the result of a loss of smell.
Table 9.5: Types of Smell Disorders
Presbyomia Smell loss due to aging
Hyposmia Loss of only certain odors
Anosmia Total loss of smell
Dysomia Change in the perception of odors. Familiar odors are distorted.
Phantosmia Smell odors that are not present
Adapted from NIH Senior Health: Problems with Smell
Our sense of smell, or olfaction, decreases more with age, and problems with the sense of smell are more common in men than in women. Almost 1 in 4 males in their 60s have a disorder with the sense of smell, while only 1 in 10 women do (NIH: Senior Health, 2016b). This loss of smell due to aging is called presbyosmia. Olfactory cells are located in a small area high in the nasal cavity. These cells are stimulated by two pathways; when we inhale through the nose, or via the connection between the nose and the throat when we chew and digest food. It is a problem with this second pathway that explains why some foods such as chocolate or coffee seem tasteless when we have a head cold. There are several types of loss of smell. Total loss of smell, or anosmia, is extremely rare.
Problems with our chemical senses can be linked to other serious medical conditions such as Parkinson’s, Alzheimer’s, or multiple sclerosis (NIH: Senior Health, 2016a). Any sudden change should be checked out. Loss of smell can change a person’s diet, with either a loss of enjoyment of food and eating too little for balanced nutrition, or adding sugar and salt to foods that are becoming blander to the palette.
Touch: Research has found that with age, people may experience reduced or changed sensations of vibration, cold, heat, pressure, or pain (Martin, 2014). Many of these changes are also aligned with a number of medical conditions that are more common among the elderly, such as diabetes. However, there are changes in the touch sensations among healthy older adults. The ability to detect changes in pressure have been shown to decline with age, with it being more pronounced by the 6th decade and diminishing further with advanced age (Bowden & McNelty, 2013). Yet, there is considerable variability, with almost 40% showing sensitivity that is comparable to younger adults (Thornbury & Mistretta, 1981). However, the ability to detect the roughness/smoothness or hardness/softness of an object shows no appreciable change with age (Bowden & McNulty, 2013). Those who show increasing insensitivity to pressure, temperature, or pain are at risk for injury (Martin, 2014).
Pain: According to Molton and Terrill (2014), approximately 60%-75% of people over the age of 65 report at least some chronic pain, and this rate is even higher for those individuals living in nursing homes. Although the presence of pain increases with age, older adults are less sensitive to pain than younger adults (Harkins, Price, & Martinelli, 1986).
Farrell (2012) looked at research studies that included neuroimaging techniques involving older people who were healthy and those who experienced a painful disorder. Results indicated that there were age-related decreases in brain volume in those structures involved in pain. Especially noteworthy were changes in the prefrontal cortex, brainstem, and hippocampus. Women are more likely to identify feeling pain than men (Tsang et al., 2008). Women have fewer opioid receptors in the brain, and women also receive less relief from opiate drugs (Garrett, 2015). Because pain serves an important indicator that there is something wrong, a decreased sensitivity to pain in older adults is a concern because it can conceal illnesses or injuries requiring medical attention. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.05%3A_Physical_Changes_of_Aging.txt |
A healthy diet is necessary for older adults to increase mental acuteness, resistance to illness and disease, boost energy levels, improve immune system strength, recuperation speed, and have greater effectiveness in the management of chronic health problems (Mayer, 2016). The new MyPlate for Older Adults, a website from Tufts University, suggests that older adults should strive for 50% of their diet being fruits and vegetables; 25% grains, many of which should be whole grains; and 25% protein-rich foods, such as nuts, beans, fish, lean meat, poultry, and fat-free and low-fat Unfortunately, changes in sensory functions, such as smell and taste, along with loss of teeth, can derail an older adult’s ability to eat right. Older adults are likely to use salt and sugar to flavor foods that no longer taste the way they once did. Several government websites provide older adults with alternatives to the salt shaker to make foods more palatable.
9.07: Chronic Conditions
Chronic illnesses are illnesses that are ongoing, generally incurable conditions that require continuing medical attention and affect daily life. As individuals live longer, diseases that affect older individuals will become more prevalent, and the burden of chronic illness grows with age. Less than 50% of adults 50-64 have a chronic condition, yet 90% aged 75 and up do (Cohen, 2011). Older women are more likely to have a chronic condition than are older men (83% vs. 88%) (CDC, 2009). Table 9.6 lists the percentage of older adults who have certain chronic illnesses based on the National Health Survey conducted in 2014. Other studies place the figure of diabetes in older adults at 26% (CDC, 2014).
Table 9.6: Percentage of Older Adults with Chronic Conditions
High Cholesterol 58.2
Hypertension 56.7
Arthritis 48.7
Cancer 23.1
Diabetes 20.5
Heart disease 17.9
Ulcers 11.3
Stroke 7.2
Asthma 6.9
Kidney disease 5.1
Chronic bronchitis 5.0
Emphysema 4.0
Adapted from CDC National Health Interview 2014
Cancer and Major Cardiovascular Disease: As discussed in chapter 8, cancer and cardiovascular disease are the overall leading causes of death, and they are especially high reasons for death in middle and late adults. Table 9.7 identifies the percentages of deaths due to cancer and cardiovascular disease for selected age groups in 2013; the most recent year for data (Xu, Murphy, Kochanek, & Bastian, 2016).
Table 9.7 Death Percentages for Cancer and Cardiovascular Disease for Selected Age Groups
Groups
2013 Causes of Death 45-54 55-64 65-74 75-84 85+
Cancer 6.4% 13.7% 24.9% 24.5% 12%
Major Cardiovascular Disease 24.3% 26.5% 27.7% 31.6% 38.9%
Adapted from Xu, Murphy, Kochanek, & Bastian (2016)
Cancer: Advancing age is a significant risk factor for cancer, with persons over 65 accounting for 60% of newly diagnosed cancer and 70% of all cancer deaths (Berger et al., 2006). Additionally, more than 70% of the mortality associated with many cancers, including prostate, bladder, colon, uterus, pancreas, stomach, rectum and lung occur in patients 65 and older. Other conditions that affect the elderly can occur with cancer, including anemia, coronary artery diseases, congestive heart failure, chronic obstructive pulmonary diseases, renal insufficiency, cerebrovascular diseases, neurovascular complications of diabetes mellitus, and arthritis that restricts mobility (Balducci & Extermann, 2000). Comorbidity will complicate treatment.
Balducci and Extermann (2000) examined several concerns of cancer treatment in the elderly. With aging, there is a decline in multiple organ systems that can adversely affect the ability of medications to treat the cancer. Chemotherapy has been found to compromise the cognitive function of those being treated for cancer, and it may further exacerbate dementia and elderly cognitive declines. Frail individuals, defined as having limited life expectancy and near-to- exhausted functional reserves, are also not considered candidates for more toxic forms of chemotherapy. With cancer, the prevalence and risk of malnutrition are higher, and diminished visual and hearing function makes elderly cancer patients more susceptible to environmental injury. Screening for depression is also recommended because depression is associated with weight loss, failure to thrive, and may reduce the motivation to receive treatment. Consequently, depression has been associated with decreased survival rates in the elderly. Due to the projected increase in the total number of older patients with cancer, it is recommended that physicians and caretakers have expertise in both oncology and geriatrics (Berger et al., 2006).
Heart Disease: There are changes to the heart that happen with age, and some may increase a person’s risk of heart disease. These include stiffening blood vessels and valves, which may result in leaks or problems pumping blood out of the heart (NIA, 2012). As previously stated, heart disease is the leading cause of death for those in late adulthood (CDC, 2016b). There are different types of heart disease, and as already discussed in chapter 8, the most common is atherosclerosis, the buildup of fatty deposits or plaques in the walls of arteries. As plaque builds up, blood is unable to flow normally and bring oxygen throughout the body, including to the heart. Depending on where the buildup is, atherosclerosis can cause a heart attack, leg pain, or a stroke. However, Atherosclerosis is not part of normal aging. Many of the problems older people have with their heart and blood vessels are caused by disease and not by aging. For example, an older heart can normally pump blood as strong as a younger heart, while less ability to pump blood is caused by disease. Therefore, leading a heart-healthy lifestyle is most important to keeping one’s heart strong in late adulthood.
Arthritis: Arthritis and other rheumatic conditions are the most common cause of disability among US adults, and have been the most common cause of disability among US adults for the past 15 years (NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2014). According to the NIH, approximately 62% of adults with arthritis are 65 years old and up. Almost 1 in 2 older adults with arthritis have some degree of mobility limitations, such as climbing stairs, walking, and grasping objects. The pain and other limitations of arthritis can also increase the risk of depression and other forms of mental distress.
Osteoarthritis is the most common type of arthritis. “When the cartilage, the slick, cushioning surface on the ends of bones wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic” (Arthritis Foundation, 2017, para 3). Common risk factors for osteoarthritis include genetics, obesity, age, previous injury, and other medical conditions.
Osteoporosis and Kyphosis: Osteoporosis is a disease that thins and weakens bones to the point that they become fragile and break easily. After age 50, 1 in 2 women and 1 in 4 men will experience an osteoporosis related fracture in their lifetime, often leading to hip, spine, and wrist fractures (Dailey & Cravedi, 2006). Broken hips are a very serious problem as we age. They greatly increase the risk of death, especially during the year after they break (NIH Senior Health, 2015). In the U.S., more than 53 million adults either already have osteoporosis or at a high risk due to low bone mass (NIH Senior Health, 2015). As bones weaken in the spine, adults gradually lose height and their posture becomes hunched over, which is called Kyphosis. Over time a bent spine can make it hard to walk or even sit up. Adults can prevent the loss of bone mass by eating a healthy diet with enough calcium and vitamin D, regularly exercising, limiting alcohol, and not smoking (National Osteoporosis Foundation, 2016).
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease in which the airways become damaged making it difficult to breathe. COPD includes problems such as emphysema and chronic bronchitis (NIH Senior Health, 2013). COPD kills more than 120,000 people every year, making it one of the leading causes of death.
Figure 9.20 compares healthy to damaged lungs due to COPD. As COPD develops slowly, people may not notice the early signs, and may attribute the shortness of breath to age or lack of physical exercise. Most people are not diagnosed until midlife or late adulthood. There is no cure as the damage cannot be reversed. Treatments aim at slowing further damage.
Cigarette smoking is the leading cause of COPD, but other types of tobacco smoking, such as a pipe or cigar, can cause COPD, especially if the smoke is inhaled. Heavy or long-term exposure to second hand smoke can also lead to COPD (NIH Senior Health, 2013). COPD can also occur in people who have long term exposure to other environmental irritants, such as chemical fumes, and dust from the environment and workplace.
About 1 in every 1,600 to 5,000 people have a risk for COPD because of a recessive genetic condition known as alpha-1 antitrypsin (AAT) deficiency (NIH, 2011). AAT is a protein made in the liver that protects organs, especially the lungs, from the effects of other harmful proteins. In those with the genetic defect, the AAT protein created is the wrong shape and cannot leave the liver. This can lead to a heightened risk for lung disease, and even liver disease, as the excess of the AAT protein can lead to cirrhosis, which is a disease in which the liver becomes scarred and does not function properly. While some people with ATT deficiency are not affected and live a normal life, COPD is more likely to occur in such individuals if their lungs are exposed to environmental irritants.
Shingles: According to the National Institute on Aging (2015e), shingles is a disease that affects your nerves. Shingles is caused by the same virus as chicken pox, the varicella-zoster virus (VZV). After you recover from chickenpox, the virus continues to live in some of your nerve cells. It is usually inactive, and most adults live with VZV in their body and never get shingles. However, the virus will become active in one in three adults. Instead of causing chickenpox again, it produces shingles. A risk factor for shingles includes advanced age as people have a harder time fighting off infections as they get older. About half of all shingles cases are in adults age 60 or older, and the chance of getting shingles becomes much greater by age 70. Other factors that weaken an individual’s ability to fight infections, such as cancer, HIV infections, or other medical conditions, can put one at a greater risk for developing shingles.
Shingles results in pain, burning, tingling, or itching in the affected area, as well as a rash and blisters. Typically, shingles develops only on one side of the body or face and in a small area rather than all over. Most cases of shingles last 3 to 5 weeks. After the shingles rash goes away, some people may be left with ongoing pain, called post-herpetic neuralgia (PHN) in the area where the rash had been (NIA, 2015e). The older one is when getting shingles, the greater the chance of developing PHN. Some people with PHN find it hard to go about their daily activities, like dressing, cooking, and eating. They can also suffer from depression, anxiety and sleeplessness. Medicines can help with pain and usually PHN will disappear. Unfortunately, the blisters from shingles may become infected or leave a scar. Blisters near or in the eye can cause lasting eye damage or blindness. A brief paralysis of the face, hearing loss, and very rarely, swelling of the brain (encephalitis) can also occur. There is a shingles vaccine recommended for those aged 60 and older. Shingles is not contagious, but one can catch chickenpox from someone with shingles. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.06%3A_Nutrition.txt |
Research has demonstrated that the brain loses 5% to 10% of its weight between 20 and 90 years of age (Fjell & Walhovd, 2010). This decrease in brain volume appears to be due to the shrinkage of neurons, lower number of synapses, and shorter length of axons. According to Garrett (2015), the normal decline in cognitive ability throughout the lifespan has been associated with brain changes, including reduced activity of genes involved in memory storage, synaptic pruning, plasticity, and glutamate and GABA (neurotransmitters) receptors. There is also a loss in white matter connections between brain areas. Without myelin, neurons demonstrate slower conduction and impede each other’s actions. A loss of synapses occurs in specific brain areas, including the hippocampus (involved in memory) and the basal forebrain region. Older individuals also activate larger regions of their attentional and executive networks, located in the parietal and prefrontal cortex, when they perform complex tasks. This increased activation correlates with a reduced performance on both executive tasks and tests of working memory when compared to those younger (Kolb & Whishaw, 2011).
Despite these changes the brain exhibits considerable plasticity, and through practice and training, the brain can be modified to compensate for age-related changes (Erber & Szuchman, 2015). Park and Reuter-Lorenz (2009) proposed the Scaffolding Theory of Aging and Cognition which states that the brain adapts to neural atrophy (dying of brain cells) by building alternative connections, referred to as scaffolding. This scaffolding allows older brains to retain high levels of performance. Brain compensation is especially noted in the additional neural effort demonstrated by those individuals who are aging well. For example, older adults who performed just as well as younger adults on a memory task used both prefrontal areas, while only the right prefrontal cortex was used in younger participants (Cabeza, Anderson, Locantore, & McIntosh, 2002). Consequently, this decrease in brain lateralization appears to assist older adults with their cognitive skills.
Can we improve brain functioning? Many training programs have been created to improve brain functioning. ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly), a study conducted between 1999 and 2001 in which 2,802 individuals age 65 to 94, suggests that the answer is "yes". These racially diverse participants received 10 group training sessions and 4 follow up sessions to work on tasks of memory, reasoning, and speed of processing. These mental workouts improved cognitive functioning even 5 years later. Many of the participants believed that this improvement could be seen in everyday tasks as well (Tennstedt et al., 2006). However, programs for the elderly on memory, reading, and processing speed training demonstrate that there is improvement on the specific tasks trained, but there is no generalization to other abilities (Jarrett, 2015). Further, these programs have not been shown to delay or slow the progression of Alzheimer’s disease. Although these programs are not harmful, “physical exercise, learning new skills, and socializing remain the most effective ways to train your brain” (p. 207). These activities appear to build a reserve to minimize the effects of primary aging of the brain.
Parkinson’s disease is characterized by motor tremors, loss of balance, poor coordination, rigidity, and difficulty moving (Garrett, 2015). Parkinson’s affects approximately 1% of those over the age of 60, and it appears more frequently in family members in a little less than 10% of cases. Twenty-eight chromosomal areas have been implicated in Parkinson’s disease, but environmental factors have also been identified and include brain injury. Being knocked unconscious once increases the risk by 32%, and being knocked out several times increases the risk by 174% (Garrett, 2015). Other environmental influences include toxins, industrial chemicals, carbon monoxide, herbicides and pesticides (Olanow & Tatton, 1999). The symptoms are due to the deterioration of the substantia nigra, an area in the midbrain whose neurons send dopamine-releasing axons to the basal ganglia which affects motor activity.
Treatment typically includes the medication levodopa (L-dopa), which crosses the blood-brain barrier and is converted into dopamine in the brain. Deep brain stimulation, which involves inserting an electrode into the brain that provides electrical stimulation, has resulted in improved motor functioning (Garrett, 2015).
Sleep: Similar to other adults, older adults need between 7 to 9 hours of sleep per night, but they tend to go to sleep earlier and get up earlier than those younger. This pattern is called advanced sleep phase syndrome and is based on changes in circadian rhythms (National Sleep Foundation, 2009).There are sleep problems in older adults, and insomnia is the most common problem in those 60 and older (NIA, 2016). People with insomnia have trouble falling asleep and staying asleep. There are many reasons why older people may have insomnia, including certain medications, being in pain, having a medical or psychiatric condition, and even worrying before bedtime about not being able to sleep. Using over the counter sleep aids or medication may only work when used for a short time. Consequently, sleep problems should be discussed with a health care professional.
Also, common in older adults are sleep disorders, including sleep apnea, restless legs syndrome, periodic limb movement disorder, and rapid eye movement sleep behavior disorder (NIA, 2016). Sleep apnea refers to repeated short pauses in breathing, while an individual sleeps, that can lead to reduced oxygen in the blood. Snoring is a common symptom of sleep apnea and it often worsens with age. Untreated sleep apnea can lead to impaired daytime functioning, high blood pressure, headaches, stroke, and memory loss. Restless legs syndrome feels like there is tingling, crawling, or pins and needles in one or both legs, and this feeling is worse at night. Periodic limb movement disorder causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Rapid eye movement sleep behavior disorder occurs when one’s muscles can move during REM sleep and sleep is disrupted.
According to the National Sleep Foundation (2009), there are many medical conditions that affect sleep and include gastroesophageal reflux disease, diabetes mellitus, renal failure, respiratory diseases such as asthma, and immune disorders. Diseases such as Parkinson's disease and multiple sclerosis also commonly cause problems sleeping. Lastly, Alzheimer’s disease can interfere with sleeping patterns. Individuals may wake up many times during the night, wander when up, and yell which can alter the amount of time they sleep. Both minor and significant sleep problems in older adults can lead to increased risk of accidents, falls, chronic fatigue, decreased quality of life, cognitive decline, reduced immune function, and depression (Buman, 2013).
Because of sleep problems experienced by those in late adulthood, research has looked into whether exercise can improve their quality of sleep. Results show that 150 minutes per week of exercise can improve sleep quality (Buman, 2013). This amount of exercise is also recommended to improve other health areas including lowering the risk for heart disease, diabetes, and some cancers. Aerobic activity, weight training, and balance programs are all recommended. For those who live in assisted living facilities even light exercise, such as stretching and short walks, can improve sleep. High intensity activity is not necessary to see improvements. Overall, the effects of exercise on sleep may actually be even larger for older adults since their sleep quality may not be ideal to start. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.08%3A_Brain_Functioning.txt |
According to Kane (2008), older men and women are often viewed as genderless and asexual. There is a stereotype that elderly individuals no longer engage in sexual activity and when they do, they are perceived to have committed some kind of offense. These ageist myths can become internalized, and older people have a more difficult time accepting their sexuality (Gosney, 2011). Additionally, some older women indicate that they no longer worry about sexual concerns anymore once they are past the child bearing years.
In reality, many older couples find greater satisfaction in their sex life than they did when they were younger. They have fewer distractions, more time and privacy, no worries about getting pregnant, and greater intimacy with a lifelong partner (NIA, 2013). Results from the National Social Life Health, and Aging Project indicated that 72% of men and 45.5% of women aged 52 to 72 reported being sexually active (Karraker, DeLamater, & Schwarz, 2011). Additionally, the National Survey of Sexual Health data indicated that 20%-30% of individuals remain sexually active well into their 80s (Schick et al., 2010). However, there are issues that occur in older adults that can adversely affect their enjoyment of healthy sexual relationships.
Causes of Sexual Problems
According to the National Institute on Aging (2013), chronic illnesses including arthritis (joint pain), diabetes (erectile dysfunction), heart disease (difficulty achieving orgasm for both sexes), stroke (paralysis), and dementia (inappropriate sexual behavior) can all adversely affect sexual functioning. Hormonal changes, physical disabilities, surgeries, and medicines can also affect a senior’s ability to participate in and enjoy sex. How one feels about sex can also affect performance. For example, a woman who is unhappy about her appearance as she ages may think her partner will no longer find her attractive. A focus on youthful physical beauty for women may get in the way of her enjoyment of sex. Likewise, most men have a problem with erectile dysfunction (ED) once in a while, and some may fear that ED will become a more common problem as they age. If there is a decline in sexual activity for a heterosexual couple, it is typically due to a decline in the male’s physical health (Erber & Szuchman, 2015).
Overall, the best way to experience a healthy sex life in later life is to keep sexually active while aging. However, the lack of an available partner can affect heterosexual women’s participation in a sexual relationship. Beginning at age 40 there are more women than men in the population, and the ratio becomes 2 to 1 at age 85 (Karraker et al., 2011). Because older men tend to pair with younger women when they become widowed or divorced, this also decreases the pool of available men for older women (Erber & Szuchman, 2015). In fact, a change in marital status does not result in a decline in the sexual behavior of men aged 57 to 85 years-old, but it does result in a decline for similar aged women (Karraker et al., 2011
Concluding Thoughts
Key players in improving the quality of life among older adults will be those adults themselves. By exercising, reducing stress, stopping smoking, limiting use of alcohol, and consuming more fruits and vegetables, older adults can expect to live longer and more active lives (He et al., 2005). Stress reduction, both in late adulthood and earlier in life, is also crucial. The reduction of societal stressors can promote active life expectancy. In the last 40 years, smoking rates have decreased, but obesity has increased, and physical activity has only modestly increased. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.09%3A_Sexuality.txt |
Learning Objectives: Cognitive Development in Late Adulthood
• Describe how memory changes for those in late adulthood
• Describe the theories for why memory changes occur
• Describe how cognitive losses in late adulthood are exaggerated
• Explain the pragmatics and mechanics of intelligence
• Define what is a neurocognitive disorder
• Explain Alzheimer’s disease and other neurocognitive disorders
• Describe work and retirement in late adulthood
• Explain how those in late adulthood use strategies to compensate for losses
How Does Aging Affect Information Processing?
There are numerous stereotypes regarding older adults as being forgetful and confused, but what does the research on memory and cognition in late adulthood reveal? Memory comes in many types, such as working, episodic, semantic, implicit, and prospective. There are also many processes involved in memory, thus it should not be a surprise that there are declines in some types of memory and memory processes, while other areas of memory are maintained or even show some improvement with age. In this section, we will focus on changes in memory, attention, problem solving, intelligence, and wisdom, including the exaggeration of losses stereotyped in the elderly.
Memory
Changes in Working Memory: As discussed in chapter 4, working memory is the more active, effortful part of our memory system. Working memory is composed of three major systems: The phonological loop that maintains information about auditory stimuli, the visuospatial sketchpad, that maintains information about visual stimuli, and the central executive, that oversees working memory, allocating resources where needed and monitoring whether cognitive strategies are being effective (Schwartz, 2011). Schwartz reports that it is the central executive that is most negatively impacted by age. In tasks that require allocation of attention between different stimuli, older adults fair worse than do younger adults. In a study by Göthe, Oberauer, and Kliegl (2007) older and younger adults were asked to learn two tasks simultaneously. Young adults eventually managed to learn and perform each task without any loss in speed and efficiency, although it did take considerable practice. None of the older adults were able to achieve this. Yet, older adults could perform at young adult levels if they had been asked to learn each task individually. Having older adults learn and perform both tasks together was too taxing for the central executive. In contrast, working memory tasks that do not require much input from the central executive, such as the digit span test, which uses predominantly the phonological loop, we find that older adults perform on par with young adults (Dixon & Cohen, 2003).
Changes in Long-term Memory: As you should recall, long-term memory is divided into semantic (knowledge of facts), episodic (events), and implicit (procedural skills, classical conditioning and priming) memories. Semantic and episodic memory are part of the explicit memory system, which requires conscious effort to create and retrieve. Several studies consistently reveal that episodic memory shows greater age-related declines than semantic memory (Schwartz, 2011; Spaniol, Madden, & Voss, 2006). It has been suggested that episodic memories may be harder to encode and retrieve because they contain at least two different types of memory, the event and when and where the event took place. In contrast, semantic memories are not tied to any particular time line. Thus, only the knowledge needs to be encoded or retrieved (Schwartz, 2011). Spaniol et al. (2006) found that retrieval of semantic information was considerably faster for both younger and older adults than the retrieval of episodic information, with there being little difference between the two age groups for semantic memory retrieval. They note that older adults’ poorer performance on episodic memory appeared to be related to slower processing of the information and the difficulty of the task. They found that as the task became increasingly difficult, the gap between each age groups’ performance increased for episodic memory more so than for semantic memory.
Studies which test general knowledge (semantic memory), such as politics and history (Dixon, Rust, Feltmate, & See, 2007), or vocabulary/lexical memory (Dahlgren, 1998) often find that older adults outperform younger adults. However, older adults do find that they experience more “blocks” at retrieving information that they know. In other words, they experience more tip-of- the-tongue (TOT) events than do younger adults (Schwartz, 2011).
Implicit memory requires little conscious effort and often involves skills or more habitual patterns of behavior. This type of memory shows few declines with age. Many studies assessing implicit memory measure the effects of priming. Priming refers to changes in behavior as a result of frequent or recent experiences. If you were shown pictures of food and asked to rate their appearance and then later were asked to complete words such as s_ _ p, you may be more likely to write soup than soap, or ship. The images of food “primed” your memory for words connected to food. Does this type of memory and learning change with age? The answer is typically “no” for most older adults (Schacter, Church, & Osowiecki, 1994).
Prospective memory refers to remembering things we need to do in the future, such as remembering a doctor’s appointment next week, or to take medication before bedtime. It has been described as “the flip-side of episodic memory” (Schwartz, 2011, p. 119). Episodic memories are the recall of events in our past, while the focus of prospective memories is of events in our future. In general, humans are fairly good at prospective
memory if they have little else to do in the meantime. However, when there are competing tasks that are also demanding our attention, this type of memory rapidly declines. The explanation given for this is that this form of memory draws on the central executive of working memory, and when this component of working memory is absorbed in other tasks, our ability to remember to do something else in the future is more likely to slip out of memory (Schwartz, 2011). However, prospective memories are often divided into time-based prospective memories, such as having to remember to do something at a future time, or event-based prospective memories, such as having to remember to do something when a certain event occurs. When age-related declines are found, they are more likely to be time-based, than event-based, and in laboratory settings rather than in the real-world, where older adults can show comparable or slightly better prospective memory performance (Henry, MacLeod, Phillips & Crawford, 2004; Luo & Craik, 2008). This should not be surprising given the tendency of older adults to be more selective in where they place their physical, mental, and social energy. Having to remember a doctor’s appointment is of greater concern than remembering to hit the space-bar on a computer every time the word “tiger” is displayed.
Recall versus Recognition: Memory performance often depends on whether older adults are asked to simply recognize previously learned material or recall material on their own. Generally, for all humans, recognition tasks are easier because they require less cognitive energy. Older adults show roughly equivalent memory to young adults when assessed with a recognition task (Rhodes, Castel, & Jacoby, 2008). With recall measures, older adults show memory deficits in comparison to younger adults. While the effect is initially not that large, starting at age 40 adults begin to show declines in recall memory compared to younger adults (Schwartz, 2011).
The Age Advantage: Fewer age differences are observed when memory cues are available, such as for recognition memory tasks, or when individuals can draw upon acquired knowledge or experience. For example, older adults often perform as well if not better than young adults on tests of word knowledge or vocabulary. With age often comes expertise, and research has pointed to areas where aging experts perform quite well. For example, older typists were found to compensate for age- related declines in speed by looking farther ahead at printed text (Salthouse, 1984). Compared to younger players, older chess experts focus on a smaller set of possible moves, leading to greater cognitive efficiency (Charness, 1981). Accrued knowledge of everyday tasks, such as grocery prices, can help older adults to make better decisions than young adults (Tentori, Osheron, Hasher, & May, 2001). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.10%3A_Cognitive_Development_in_Late_Adulthood.txt |
Changes in Attention in Late Adulthood: Changes in sensory functioning and speed of processing information in late adulthood often translates into changes in attention (Jefferies et al., 2015). Research has shown that older adults are less able to selectively focus on information while ignoring distractors (Jefferies et al., 2015; Wascher, Schneider, Hoffman, Beste, & Sänger, 2012), although Jefferies and her colleagues found that when given double time, older adults could perform at young adult levels. Other studies have also found that older adults have greater difficulty shifting their attention between objects or locations (Tales, Muir, Bayer, & Snowden, 2002). Consider the implication of these attentional changes for older adults.
How do changes or maintenance of cognitive ability affect older adults’ everyday lives? Researchers have studied cognition in the context of several different everyday activities. One example is driving. Although older adults often have more years of driving experience, cognitive declines related to reaction time or attentional processes may pose limitations under certain circumstances (Park & Gutchess, 2000). In contrast, research on interpersonal problem solving suggested that older adults use more effective strategies than younger adults to navigate through social and emotional problems (Blanchard-Fields, 2007). In the context of work, researchers rarely find that older individuals perform poorer on the job (Park & Gutchess, 2000). Similar to everyday problem solving, older workers may develop more efficient strategies and rely on expertise to compensate for cognitive decline.
Problem Solving: Problem solving tasks that require processing non-meaningful information quickly (a kind of task that might be part of a laboratory experiment on mental processes) declines with age. However, many real-life challenges facing older adults do not rely on speed of processing or making choices on one’s own. Older adults resolve everyday problems by relying on input from others, such as family and friends. They are also less likely than younger adults to delay making decisions on important matters, such as medical care (Strough, Hicks, Swenson, Cheng & Barnes, 2003; Meegan & Berg, 2002).
What might explain these deficits as we age? The processing speed theory, proposed by Salthouse (1996, 2004), suggests that as the nervous system slows with advanced age our ability to process information declines. This slowing of processing speed may explain age differences on many different cognitive tasks. For instance, as we age, working memory becomes less efficient (Craik & Bialystok, 2006). Older adults also need longer time to complete mental tasks or make decisions. Yet, when given sufficient time older adults perform as competently as do young adults (Salthouse, 1996). Thus, when speed is not imperative to the task healthy older adults do not show cognitive declines.
In contrast, inhibition theory argues that older adults have difficulty with inhibitory functioning, or the ability to focus on certain information while suppressing attention to less pertinent information tasks (Hasher & Zacks, 1988). Evidence comes from directed forgetting research. In directed forgetting people are asked to forget or ignore some information, but not other information. For example, you might be asked to memorize a list of words, but are then told that the researcher made a mistake and gave you the wrong list, and asks you to “forget” this list. You are then given a second list to memorize. While most people do well at forgetting the first list, older adults are more likely to recall more words from the “forget-to-recall” list than are younger adults (Andrés, Van der Linden, & Parmentier, 2004).
Cognitive losses exaggerated: While there are information processing losses in late adulthood, overall loss has been exaggerated (Garrett, 2015). One explanation is that the type of tasks that people are tested on tend to be meaningless. For example, older individuals are not motivated to remember a random list of words in a study, but they are motivated for more meaningful material related to their life, and consequently perform better on those tests. Another reason is that the research is often cross-sectional. When age comparisons occur longitudinally, however, the amount of loss diminishes (Schaie, 1994). A third reason is that the loss may be due to a lack of opportunity in using various skills. When older adults practiced skills, they performed as well as they had previously. Although diminished performance speed is especially noteworthy in the elderly, Schaie (1994) found that statistically removing the effects of speed diminished the individual’s performance declines significantly. In fact, Salthouse and Babcock (1991) demonstrated that processing speed accounted for all but 1% of age-related differences in working memory when testing individuals from 18 to 82. Finally, it is well established that our hearing and vision decline as we age. Longitudinal research has proposed that deficits in sensory functioning explain age differences in a variety of cognitive abilities (Baltes & Lindenberger, 1997).
9.12: Intelligence and Wisdom
When looking at scores on traditional intelligence tests, tasks measuring verbal skills show minimal or no age-related declines, while scores on performance tests, which measure solving problems quickly, decline with age (Botwinick, 1984). This profile mirrors crystalized and fluid intelligence. As you recall from last chapter, crystallized intelligence encompasses abilities that draw upon experience and knowledge. Measures of crystallized intelligence include vocabulary tests, solving number problems, and understanding texts. Fluid intelligence refers to information processing abilities, such as logical reasoning, remembering lists, spatial ability, and reaction time. Baltes (1993) introduced two additional types of intelligence to reflect cognitive changes in aging. Pragmatics of intelligence are cultural exposure to facts and procedures that are maintained as one ages and are similar to crystalized intelligence. Mechanics of intelligence are dependent on brain functioning and decline with age, similar to fluid intelligence. Baltes indicated that pragmatics of intelligence show little decline and typically increase with age. Additionally, pragmatics of intelligence may compensate for the declines that occur with mechanics of intelligence. In summary, global cognitive declines are not typical as one ages, and individuals compensate for some cognitive declines, especially processing speed.
Wisdom is the ability to use the accumulated knowledge about practical matters that allows for sound judgment and decision making. A wise person is insightful and has knowledge that can be used to overcome obstacles in living. Does aging bring wisdom? While living longer brings experience, it does not always bring wisdom. Paul Baltes and his colleagues (Baltes & Kunzmann, 2004; Baltes & Staudinger, 2000) suggest that wisdom is rare. In addition, the emergence of wisdom can be seen in late adolescence and young adulthood, with there being few gains in wisdom over the course of adulthood (Staudinger & Gluck, 2011). This would suggest that factors other than age are stronger determinants of wisdom. Occupations and experiences that emphasize others rather than self, along with personality characteristics, such as openness to experience and generativity, are more likely to provide the building blocks of wisdom (Baltes & Kunzmann, 2004). Age combined with a certain types of experience and/or personality brings wisdom. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.11%3A_Attention_and_Problem_Solving.txt |
Historically, the term dementia was used to refer to an individual experiencing difficulties with memory, language, abstract thinking, reasoning, decision making, and problem-solving (Erber & Szuchman (2015). However, in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) (American Psychiatric Association, 2013) the term dementia has been replaced by neurocognitive disorder. A Major Neurocognitive Disorder is diagnosed as a significant cognitive decline from a previous level of performance in one or more cognitive domains and interferes with independent functioning, while a Minor Neurocognitive Disorder is diagnosed as a modest cognitive decline from a previous level of performance in one of more cognitive domains and does not interfere with independent functioning. There are several different neurocognitive disorders that are typically demonstrated in late adulthood, and determining the exact type can be difficult because the symptoms may overlap with each other. Diagnosis often includes a medical history, physical exam, laboratory tests, and changes noted in behavior. Alzheimer’s disease, Vascular Neurocognitive Disorder and Neurocognitive Disorder with Lewy bodies will be discussed below.
Alzheimer’s disease: Probably the most well-known and most common neurocognitive disorder for older individuals is Alzheimer’s disease. In 2016 an estimated 5.4 million Americans were diagnosed with Alzheimer’s disease (Alzheimer’s Association, 2016), which was approximately one in nine aged 65 and over. By 2050 the number of people age 65 and older with Alzheimer's disease is projected to be 13.8 million if there are no medical breakthroughs to prevent or cure the disease. Alzheimer’s disease is the 6th leading cause of death in the United States, but the 5th leading cause for those 65 and older. Among the top 10 causes of death in America, Alzheimer's disease is the only one that cannot be prevented, cured, or even slowed. Current estimates indicate that Alzheimer disease affects approximately 50% of those identified with a neurocognitive disorder (Cohen & Eisdorfer, 2011).
Alzheimer’s disease has a gradual onset with subtle personality changes and memory loss that differs from normal age-related memory problems occurring first. Confusion, difficulty with change, and deterioration in language, problem-solving skills, and personality become evident next. In the later stages, the individual loses physical coordination and is unable to complete everyday tasks, including self-care and personal hygiene (Erber & Szuchman, 2015). Lastly, individuals lose the ability to respond to their environment, to carry on a conversation, and eventually to control movement (Alzheimer’s Association, 2016). On average people with Alzheimer’s survive eight years, but some may live up to 20 years. The disease course often depends on the individual’s age and whether they have other health conditions.
The greatest risk factor for Alzheimer’s disease is age, but there are genetic and environmental factors that can also contribute. Some forms of Alzheimer’s are hereditary, and with the early onset type, several rare genes have been identified that directly cause Alzheimer's. People who inherit these genes tend to develop symptoms in their 30s, 40s and 50s. Five percent of those identified with Alzheimer’s disease are younger than age 65. When Alzheimer's disease is caused by deterministic genes, it is called familial Alzheimer's disease (Alzheimer’s Association, 2016). Traumatic brain injury is also a risk factor, as well as obesity, hypertension, high cholesterol, and diabetes (Carlson, 2011).
According to Erber and Szuchman (2015) the problems that occur with Alzheimer’s disease are due to the “death of neurons, the breakdown of connections between them, and the extensive formation of plaques and tau, which interfere with neuron functioning and neuron survival” (p. 50). Plaques are abnormal formations of protein pieces called beta-amyloid. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells. Because beta-amyloid is sticky, it builds up into plaques (Alzheimer’s Association, 2016). These plaques appear to block cell communication and may also trigger an inflammatory response in the immune system, which leads to further neuronal death.
Tau is an important protein that helps maintain the brain’s transport system. When tau malfunctions, it changes into twisted strands called tangles that disrupt the transport system. Consequently, nutrients and other supplies cannot move through the cells and they eventually die. The death of neurons lead to the brain shrinking and affecting all aspects of brain functioning. For example, the hippocampus is involved in learning and memory, and the brain cells in this region are often the first to be damaged. This is why memory loss is often one of the earliest symptoms of Alzheimer's disease. Figures 9.30 and 9.31 illustrate the difference between an Alzheimer’s brain and a healthy brain.
Vascular Neurocognitive Disorder is the second most common neurocognitive disorder affecting 0.2% in the 65-70 years age group and 16% of individuals 80 years and older (American Psychiatric Association, 2013). Vascular neurocognitive disorder is associated with a blockage of cerebral blood vessels that affects one part of the brain rather than a general loss of brain cells seen with Alzheimer’s disease. Personality is not as affected in vascular neurocognitive disorder, and more males are diagnosed than females (Erber and Szuchman, 2015). It also comes on more abruptly than Alzheimer’s disease and has a shorter course before death. Risk factors include smoking, diabetes, heart disease, hypertension, or a history of strokes.
Neurocognitive Disorder with Lewy bodies: According to the National Institute on Aging (2015a), Lewy bodies are microscopic protein deposits found in neurons seen postmortem. They affect chemicals in the brain that can lead to difficulties in thinking, movement, behavior and mood. Neurocognitive Disorder with Lewy bodies is the third most common form and affects more than 1 million Americans. It typically begins at age 50 or older, and appears to affect slightly more men than women. The disease lasts approximately 5 to 7 years from the time of diagnosis to death, but can range from 2 to 20 years depending on the individual’s age, health, and severity of symptoms. Lewy bodies can occur in both the cortex and brain stem which results in cognitive as well as motor symptoms (Erber & Szuchman, 2015). The movement symptoms are similar to those with Parkinson’s disease and include tremors and muscle rigidity. However, the motor disturbances occur at the same time as the cognitive symptoms, unlike with Parkinson’s disease when the cognitive symptoms occur well after the motor symptoms. Individuals diagnosed with Neurocognitive Disorder with Lewy bodies also experience sleep disturbances, recurrent visual hallucinations, and are at risk for falling. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.13%3A_Neurocognitive_Disorders.txt |
Older adults are just as capable as younger adults at the workplace. In fact, jobs that require social skills, accumulated knowledge, and relevant experiences favor older adults (Erber & Szuchman, 2015). Older adults also demonstrate lower rates of absenteeism and greater investment in their work. In 2015, 8.8 million adults aged 65 or older were employed or actively seeking employment. This constitute about 5.6% of the U.S. labor force (AOA, 2016).
Transitioning into Retirement: For most Americans, retirement is a process and not a one-time event (Quinn & Cahill, 2016). Sixty percent of workers transition straight to bridge jobs, which are often part-time, and occur between a career and full retirement. About 15% of workers get another job after being fully retired. This may be due to not having adequate finances after retirement or not enjoying their retirement. Some of these jobs may be in encore careers, or work in a different field from the one in which they retired. Approximately 10% of workers begin phasing into retirement by reducing their hours. However, not all employers will allow this due to pension regulations.
Retirement age changes: Looking at retirement data, the average age of retirement declined from more than 70 in 1910 to age 63 in the early 1980s. However, this trend has reversed and the current average age is now 65. Additionally, 18.5% of those over the age of 65 continue to work (US Department of Health and Human Services, 2012) compared with only 12% in 1990 (U. S. Government Accountability Office, 2011). With individuals living longer, once retired the average amount of time a retired worker collects social security is approximately 17-18 years (James, Matz-Costa, & Smyer, 2016).
When to retire: Laws often influence when someone decides to retire. In 1986 the Age Discrimination in Employment Act (ADEA) was amended, and mandatory retirement was eliminated for most workers (Erber & Szuchman, 2015). Pilots, air traffic controllers, federal law enforcement, national park rangers, and fire fighters continue to have enforced retirement ages. Consequently, for most workers they can continue to work if they choose and are able. Social security benefits also play a role. For those born before 1938, they can receive full social security benefits at age 65. For those born between 1943 and 1954, they must wait until age 66 for full benefits, and for those born after 1959 they must wait until age 67 (Social Security Administration, 2016). Extra months are added to those born in years between. For example, if born in 1957, the person must wait until 66 years and 6 months. The longer one waits to receive social security, the more money will be paid out. Those retiring at age 62, will only receive 75% of their monthly benefits. Medicare health insurance is another entitlement that is not available until one is aged 65.
Delayed Retirement: Older adults primarily choose to delay retirement due to economic reasons (Erber & Szchman, 2015). Financially, continuing to work provides not only added income, but also does not dip into retirement savings which may not be sufficient. Historically, there have been three parts to retirement income; that is, social security, a pension plan, and individual savings (Quinn & Cahill, 2016). With the 2008 recession, pension plans lost value for most workers. Consequently, many older workers have had to work later in life to compensate for absent or minimal pension plans and personal savings. Social security was never intended to replace full income, and the benefits provided may not cover all the expenses, so elders continue to work. Unfortunately, many older individuals are unable to secure later employment, and those especially vulnerable include persons with disabilities, single women, the oldest- old, and individuals with intermittent work histories.
Some older adults delay retirement for psychological reasons, such as health benefits and social contacts. Recent research indicates that delaying retirement has been associated with helping one live longer. When looking at both healthy and unhealthy retirees, a one-year delay in retiring was associated with a decreased risk of death from all causes (Wu, Odden, Fisher, & Stawski, 2016). When individuals are forced to retire due to health concerns or downsizing, they are more likely to have negative physical and psychological consequences (Erber & Szuchman, 2015).
Retirement Stages: Atchley (1994) identified several phases that individuals ago through when they retire:
• Remote pre-retirement phase includes fantasizing about what one wants to do in retirement
• Immediate pre-retirement phase when concrete plans are established
• Actual retirement
• Honeymoon phase when retirees travel and participate in activities they could not do while working
• Disenchantment phase when retirees experience an emotional let-down
• Reorientation phase when the retirees attempt to adjust to retirement by making less hectic plans and getting into a regular routine
Not everyone goes through every stage, but this model demonstrates that retirement is a process.
Post-retirement: Those who look most forward to retirement and have plans are those who anticipate adequate income (Erber & Szuchman, 2015). This is especially true for males who have worked consistently and have a pension and/or adequate savings. Once retired, staying active and socially engaged is important. Volunteering, caregiving and informal helping can keep seniors engaged. Kaskie, Imhof, Cavanaugh and Culp (2008) found that 70% of retirees who are not involved in productive activities spent most of their time watching TV, which is correlated with negative affect. In contrast, being productive improves well-being.
Elder Education: Attending college is not just for the young as discussed in the previous chapter. There are many reasons why someone in late adulthood chooses to attend college. PNC Financial Services surveyed retirees aged 70 and over, and found that 58% indicated that they had retired before they had planned (Holland, 2014). Many of these individuals chose to pursue additional training to improve skills to return to work in a second career. Others may be looking to take their career in a new direction. For some older students who are no longer focused on financial reasons, returning to school is intended to enable them to pursue work that is personally fulfilling. Attending college in late adulthood is also a great way for seniors to stay young and keep their minds sharp.
Even if an elder chooses not to attend college for a degree, there are many continuing education programs on topics of interest available. In 1975, a nonprofit educational travel organization called Elderhostel began in New Hampshire with five programs for several hundred retired participants (DiGiacomo, 2015). This program combined college classroom time with travel tours and experimental learning techniques. In 2010, the organization changed its name to Road Scholar, and it now serves over 100,000 people per year in the U. S. and in 150 countries. Academic courses, as well as practical skills such as computer classes, foreign languages, budgeting, and holistic medicines, are among the courses offered. Older adults who have higher levels of education are more likely to take continuing education. However, offering more educational experiences to a diverse group of older adults, including those who are institutionalized in nursing homes, can bring enhance the quality of life. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.14%3A_Work_and_Retirement.txt |
Learning Objectives: Psychosocial Development in Late Adulthood
• Explain the stereotypes of those in late adulthood and how it impacts their lives
• Summarize Erikson’s eighth psychosocial task of integrity vs despair
• Explain how self-concept and self-esteem affect those in late adulthood
• Identify sources of despair and regret
• Describe paths to integrity, including the activity, socioemotional selectivity, and convoy theories
• Describe the continuation of generativity in late adulthood
• Describe the relationships those in late adulthood have with their children and other family members
• Describe singlehood, marriage, widowhood, divorce, and remarriage in late adulthood
• Describe the different types of residential living in late adulthood
• Describe friendships in late life
• Explain concerns experienced by those in late adulthood, such as abuse and mental health issues
Ageism
Stereotypes of people in late adulthood lead many to assume that aging automatically brings poor physical health and mental decline. These stereotypes are reflected in everyday conversations, the media, and even in greeting cards (Overstreet, 2006). Age is not revered in the United States, and so laughing about getting older in birthday cards is one way to get relief. The negative attitudes people have about those in late adulthood are examples of ageism, or prejudice based on age. The term ageism was first used in 1969, and according to Nelson (2016), ageism remains one of the most institutionalized forms of prejudice today.
Nelson (2016) reviewed the research on ageism and concluded that when older individuals believed their culture’s negative stereotypes about those who are old, their memory and cognitive skills declined. In contrast, older individuals in cultures, such as China, that held more positive views on aging did not demonstrate cognitive deficits. It appears that when one agrees with the stereotype, it becomes a self-fulfilling prophecy, or the belief in one’s ability results in actions that make it come true.
Being the target of stereotypes can adversely affect individuals’ performance on tasks because they worry they will confirm the cultural stereotypes. This is known as stereotype threat, and it was originally used to explain race and gender differences in academic achievement (Gatz et al., 2016). Stereotype threat research has demonstrated that older adults who internalize the aging stereotypes will exhibit worse memory performance, worse physical performance, and reduced self-efficacy (Levy, 2009).
In terms of physically taking care of themselves, those who believe in negative stereotypes are less likely to engage in preventative health behaviors, less likely to recover from illnesses, and more likely to feel stress and anxiety, which can adversely affect immune functioning and cardiovascular health (Nelson, 2016). Additionally, individuals who attribute their health problems to their age, had a higher death rate. Similarly, doctors who believe that illnesses are just natural consequence of aging are less likely to have older adults participate in clinical trials or receive life-sustaining treatment. In contrast, those older adults who possess positive and optimistic views of aging are less likely to have physical or mental health problems and are more likely to live longer. Removing societal stereotypes about aging and helping older adults reject those notions of aging is another way to promote health and life expectancy among the elderly.
Minority status: Older minority adults accounted for approximately 21% of the U. S. population in 2012, but are expected to reach 39% of the population in 2050 (U. S. Census Bureau, 2012). Unfortunately, racism is a further concern for minority elderly already suffering from ageism. Older adults who are African American, Mexican American, and Asian American experience psychological problems that are often associated with discrimination by the White majority (Youdin, 2016). Ethnic minorities are also more likely to become sick, but less likely to receive medical intervention. Older, minority women can face ageism, racism, and sexism, often referred to as triple jeopardy (Hinze, Lin, & Andersson, 2012), which can adversely affect their life in late adulthood.
Poverty rates: According to Quinn and Cahill (2016), the poverty rate for older adults varies based on gender, marital status, race, and age. Women aged 65 or older were 70% more likely to be poor than men, and older women aged 80 and above have higher levels of poverty than those younger. Married couples are less likely to be poor than nonmarried men and women, and poverty is more prevalent among older racial minorities. In 2012 the poverty rates for White older men (5.6%) and White older women (9.6%) were lower than for Black older men (14%), Black older women (21%), Hispanic older men (19%), and Hispanic older women (22%). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.15%3A_Psychosocial_Development_in_Late_Adulthood.txt |
Do those in late adulthood primarily live alone? No. In 2014, of those 65 years of age and older, approximately 72% of men and 46% of women lived with their spouse (Vespa & Schondelmyer, 2015). Between 1900 and 1990 the number of older adults living alone increased, most likely due to improvements in health and longevity during this time (see Figure 9.35). Since 1990 the number of older adults living alone has declined, because of older women more likely to be living with their spouse or children (Stepler, 2016c).
Women continue to make up the majority of older adults living alone in the U.S., although that number has dropped from those living alone in 1990 (Stepler, 2016a). Older women are more likely to be unmarried, living with children, with other relatives or non-relatives. Older men are more likely to be living alone than they were in 1990, although older men are more likely to reside with their spouse. The rise in divorce among those in late adulthood, along with the drop-in remarriage rate, has resulted in slightly more older men living alone today than in the past (Stepler, 2016c).
Older adults who live alone report feeling more financially strapped than do those living with others (Stepler, 2016d). According to a Pew Research Center Survey, only 33% of those living alone reported they were living comfortably, while nearly 49% of those living with others said they were living comfortably. Similarly, 12% of those living alone, but only 5% of those living with others, reported that they lacked money for basic needs (Stepler, 2016d).
Do those in late adulthood primarily live with family members? No. There are significantly fewer older adults living in multigenerational housing; that is three generations living together, than in previous generations (Erber & Szuchman, 2015). According to the Pew Research Center (2011), nearly 17% of the population lived in a house with at least two adult generations based on the 2010 census results. However, ethnic differences are noted in the percentage of multigenerational households with Hispanic (22%), Black (23%), and Asian (25%) families living together in greater numbers than White families (13%). Consequently, with the exception of some cultural groups, the majority of older adults wish to live independently for as long as they are able.
Do those in late adulthood move after retirement? No. According to Erber and Szuchman (2015), the majority of those in late adulthood remain in the same location, and often in the same house, where they lived before retiring. Although some younger late adults (65-74 years) may relocate to warmer climates, once they are older (75-84 years) they often return to their home states to be closer to adult children (Stoller & Longino, 2001). Despite the previous trends, however, the recent housing crisis has kept those in late adulthood in their current suburban locations because they are unable to sell their homes (Erber & Szuchman, 2015).
Do those in late adulthood primarily live in institutions? No. Only a small portion (3.2%) of adults older than 65 lived in an institution in 2015 (United States Department of Health and Human Services, 2015). However, as individuals increase in age the percentage of those living in institutions, such as a nursing home, also increases. Specifically: 1% of those 65-74, 3% of those 75-84, and 10% of those 85 years and older lived in an institution in 2015. Due to the increasing number of baby boomers reaching late adulthood, the number of people who will depend on long-term care is expected to rise from 12 million in 2010 to 27 million in 2050 (United States Senate Commission on Long-Term Care, 2013). To meet this higher demand for services, a focus on the least restrictive care alternatives has resulted in a shift toward home and community-based care instead of placement in a nursing home (Gatz et al., 2016). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.16%3A_Living_Arrangements.txt |
How do people cope with old age? According to Erikson, the last psychosocial stage is Integrity vs. Despair. This stage includes, “a retrospective accounting of one’s life to date; how much one embraces life as having been well lived, as opposed to regretting missed opportunities,” (Erikson, 1982, p. 112). Those in late adulthood need to achieve both the acceptance of their life and the inevitability of their death (Barker, 2016). This stage includes finding meaning in one’s life and accepting one’s accomplishments, but also acknowledging what in life has not gone as hoped. It is also feeling a sense of contentment and accepting others’ deficiencies, including those of their parents. This acceptance will lead to integrity, but if elders are unable to achieve this acceptance, they may experience despair. Bitterness and resentments in relationships and life events can lead one to despair at the end of life. According to Erikson (1982), successful completion of this stage leads to wisdom in late life.
Erikson’s theory was the first to propose a lifespan approach to development, and it has encouraged the belief that older adults still have developmental needs. Prior to Erikson’s theory, older adulthood was seen as a time of social and leisure restrictions and a focus primarily on physical needs (Barker, 2016). The current focus on aging well by keeping healthy and active, helps to promote integrity. There are many avenues for those in late adulthood to remain vital members of society, and they will be explored next.
Staying Active: Many older adults want to remain active and work toward replacing opportunities lost with new ones. Those who prefer to keep themselves busy demonstrate the Activity Theory, which states that greater satisfaction with one’s life occurs with those who remain active (Lemon, Bengston, & Peterson, 1972). Not surprisingly, more positive views on aging and greater health are noted with those who keep active than those who isolate themselves and disengage with others. Community, faith-based, and volunteer organizations can all provide those in late adulthood with opportunities to remain active and maintain social networks. Erikson’s concept of generativity applies to many older adults, just as it did in midlife.
9.18: Generativity in Late Adulthood
Research suggests that generativity is not just a concern for midlife adults, but for many elders, concerns about future generations continue into late adulthood. As previously discussed, some older adults are continuing to work beyond age 65. Additionally, they are volunteering in their community, and raising their grandchildren in greater numbers.
Volunteering
Many older adults spend time volunteering. Hooyman and Kiyak (2011) found that religious organizations are the primary settings for encouraging and providing opportunities to volunteer. Hospitals and environmental groups also provide volunteer opportunities for older adults. While volunteering peaks in middle adulthood, it continues to remain high among adults in their 60s, with about 40% engaging in volunteerism (Hooyman & Kiyak, 2011). While the number of older adults volunteering their time does decline with age, the number of hours older adults volunteer does not show much decline until they are in their late 70s (Hendricks & Cutler, 2004). African-American older adults volunteer at higher levels than other ethnic groups (Taylor, Chatters, & Leving, 2004). Taylor and colleagues attribute this to the higher involvement in religious organizations by older African-Americans.
Volunteering aids older adults as much as it does the community at large. Older adults who volunteer experience more social contact, which has been linked to higher rates of life satisfaction, and lower rates of depression and anxiety (Pilkington, Windsor, & Crisp, 2012).
Longitudinal research also finds a strong link between health in later adulthood and volunteering (Kahana, Bhatta, Lovegreen, Kahana, & Midlarsky, 2013). Lee and colleagues found that even among the oldest-old, the death rate of those who volunteer is half that of non-volunteers (Lee, Steinman, & Tan, 2011). However, older adults who volunteer may already be healthier, which is why they can volunteer compared to their less healthy age mates.
New opportunities exist for older adults to serve as virtual volunteers by dialoguing online with others from around the world and sharing their support, interests, and expertise. These volunteer opportunities range from helping teens with their writing to communicating with ‘neighbors’ in villages of developing countries. Virtual volunteering is available to those who cannot engage in face-to-face interactions, and it opens-up a new world of possibilities and ways to connect, maintain identity, and be productive.
Grandparents raising Grandchildren
According to the 2014 American Community Survey (U.S. Census, 2014a), over 5.5 million children under the age of 18 were living in families headed by a grandparent. This was more than a half a million increase from 2010. While most grandparents raising grandchildren are between the ages of 55 and 64, approximately 25% of grandparents raising their grandchildren are 65 and older (Office on Women’s Health, 2010a).
For many grandparents, parenting a second time can be harder. Older adults have far less energy, and often the reason why they are now acting as parents to their grandchildren is because traumatic events. A survey by AARP (Goyer, 2010) found that grandparents were raising their grandchildren because the parents had problems with drugs and alcohol, had a mental illness, were incarcerated, had divorced, had a chronic illness, were homeless, had neglected or abused the child, were deployed in the military, or had died. While most grandparents state they gain great joy from raising their grandchildren, they also face greater financial, health, education, and housing challenges that often derail their retirement plans than do grandparents who do not have primary responsibility for raising their grandchildren. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.17%3A_Erikson_-_Integrity_vs._Despair.txt |
A person’s social network consists of the people with whom one is directly involved, such as family, friends, and acquaintances (Fischer, 1982). As individuals age, changes occur in these social networks, and The Convoy Model of Social Relations and Socioemotional Selectivity Theory address these changes (Wrzus, Hanel, Wagner, & Neyer, 2013). Both theories indicate that less close relationships will decrease as one ages, while close relationships will persist. However, the two theories differ in explaining why this occurs.
The Convoy Model of Social Relations suggests that the social connections that people accumulate differ in levels of closeness and are held together by exchanges in social support (Antonucci, 2001; Kahn & Antonucci, 1980). According to the Convoy Model, relationships with a spouse and family members, people in the innermost circle of the convoy, should remain stable throughout the lifespan. In contrast, coworkers, neighbors, and acquaintances, people in the periphery of the convoy, should be less stable. These peripheral relationships may end due to changes in jobs, social roles, location, or other life events. These relationships are more vulnerable to changing situations than family relationships. Therefore, the frequency, type, and reciprocity of the social exchanges with peripheral relationships decrease with age.
The Socioemotional Selectivity Theory focuses on changes in motivation for actively seeking social contact with others (Carstensen, 1993; Carstensen, Isaacowitz & Charles, 1999). This theory proposes that with increasing age, our motivational goals change based on how much time one has left to live. Rather than focusing on acquiring information from many diverse social
relationships, as noted with adolescents and young adults, older adults focus on the emotional aspects of relationships. To optimize the experience of positive affect, older adults actively restrict their social life to prioritize time spent with emotionally close significant others. In line with this theory, older marriages are found to be characterized by enhanced positive and reduced negative interactions and older partners show more affectionate behavior during conflict discussions than do middle-aged partners (Carstensen, Gottman, & Levenson, 1995). Research showing that older adults have smaller networks compared to young adults, and tend to avoid negative interactions, also supports this theory.
Relationship with adult children: Many older adults provide financial assistance and/or housing to adult children. There is more support going from the older parent to the younger adult children than in the other direction (Fingerman & Birditt, 2011). In addition to providing for their own children, many elders are raising their grandchildren. Consistent with socioemotional selectivity theory, older adults seek, and are helped by, their adult children providing emotional support (Lang & Schütze, 2002). Lang and Schütze, as part of the Berlin Aging Study (BASE), surveyed adult children (mean age 54) and their aging parents (mean age 84). They found that the older parents of adult children who provided emotional support, such as showing tenderness toward their parent, cheering the parent up when he or she was sad, tended to report greater life satisfaction. In contrast, older adults whose children provided informational support, such as providing advice to the parent, reported less life satisfaction. Lang and Schütze found that older adults wanted their relationship with their children to be more emotionally meaningful. Daughters and adult children who were younger, tended to provide such support more than sons and adult children who were older. Lang and Schütze also found that adult children who were more autonomous rather than emotionally dependent on their parents, had more emotionally meaningful relationships with their parents, from both the parents’ and adult children’s point of view.
Friendships: Friendships are not formed in order to enhance status or careers, and may be based purely on a sense of connection or the enjoyment of being together. Most elderly people have at least one close friend. These friends may provide emotional as well as physical support. Being able to talk with friends and rely on others is very important during this stage of life. Bookwala, Marshall, and Manning (2014) found that the availability of a friend played a significant role in protecting the health from the impact of widowhood. Specifically, those who became widowed and had a friend as a confidante, reported significantly lower somatic depressive symptoms, better self-rated health, and fewer sick days in bed than those who reported not having a friend as a confidante. In contrast, having a family member as a confidante did not provide health protection for those recently widowed.
Loneliness or solitude? Loneliness is the discrepancy between the social contact a person has and the contacts a person wants (Brehm, Miller, Perlman, & Campbell, 2002). It can result from social or emotional isolation. Women tend to experience loneliness due to social isolation; men from emotional isolation. Loneliness can be accompanied by a lack of self-worth, impatience, desperation, and depression. Being alone does not always result in loneliness. For some, it means solitude. Solitude involves gaining self-awareness, taking care of the self, being comfortable alone, and pursuing one’s interests (Brehm et al., 2002). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.19%3A__Social_Networks_in_Late_Adulthood.txt |
Marriage: As can be seen in Figure 9.40, the most common living arrangement for older adults in 2015 was marriage (AOA, 2016). Although this was more common for older men.
Widowhood: Losing one’s spouse is one of the most difficult transitions in life. The Social Readjustment Rating Scale, commonly known as the Holmes-Rahe Stress Inventory, rates the death of a spouse as the most significant stressor (Holmes & Rahe, 1967). The loss of a spouse after many years of marriage may make an older adult feel adrift in life. They must remake their identity after years of seeing themselves as a husband or wife. Approximately, 1 in 3 women aged 65 and older are widowed, compared with about 1 in 10 men.
Loneliness is the biggest challenge for those who have lost their spouse (Kowalski & Bondmass, 2008). However, several factors can influence how well someone adjusts to this life event. Older adults who are more extroverted (McCrae & Costa, 1988) and have higher self-efficacy, (Carr, 2004b) often fare better. Positive support from adult children is also associated with fewer symptoms of depression and better overall adjustment in the months following widowhood (Ha, 2010).
The context of the death is also an important factor in how people may react to the death of a spouse. The stress of caring for an ill spouse can result in a mixed blessing when the ill partner dies (Erber & Szchman, 2015). The death of a spouse who died after a lengthy illness may come as a relief for the surviving spouse, who may have had the pressure of providing care for someone who was increasingly less able to care for themselves. At the same time, this sense of relief may be intermingled with guilt for feeling relief at the passing of their spouse. The emotional issues of grief are complex and will be discussed in more detail in chapter 10.
Widowhood also poses health risks. The widowhood mortality effect refers to the higher risk of death after the death of a spouse (Sullivan & Fenelon, 2014). Subramanian, Elwert, and Christakis (2008) found that widowhood increases the risk of dying from almost all causes. However, research suggests that the predictability of the spouse’s death plays an important role in the relationship between widowhood and mortality. Elwert and Christakis (2008) found that the rate of mortality for windows and widowers was lower if they had time to prepare for the death of their spouse, such as in the case of a terminal illness like Parkinson’s or Alzheimer’s. Another factor that influences the risk of mortality is gender. Men show a higher risk of mortality following the death of their spouse if they have higher health problems (Bennett, Hughes, & Smith, 2005). In addition, widowers have a higher risk of suicide than do widows (Ruckenhauser, Yazdani, & Ravaglia, 2007).
Divorce: As noted in Chapter 8, older adults are divorcing at higher rates than in prior generations. However, adults age 65 and over are still less likely to divorce than middle-aged and young adults (Wu & Schimmele, 2007). Divorce poses a number of challenges for older adults, especially women, who are more likely to experience financial difficulties and are more likely to remain single than are older men (McDonald & Robb, 2004).
Figure 9.41. Source.
However, in both America (Lin, 2008) and England (Glaser, Stuchbury, Tomassini, & Askham, 2008) studies have found that the adult children of divorced parents offer more support and care to their mothers than their fathers. While divorced, older men may be better off financially and are more likely to find another partner, they may receive less support from their adult children.
Dating: Due to changing social norms and shifting cohort demographics, it has become more common for single older adults to be involved in dating and romantic relationships (Alterovitz & Mendelsohn, 2011). An analysis of widows and widowers ages 65 and older found that 18 months after the death of a spouse, 37% of men and 15% of women were interested in dating (Carr, 2004a). Unfortunately, opportunities to develop close relationships often diminish in later life as social networks decrease because of retirement, relocation, and the death of friends and loved ones (de Vries, 1996). Consequently, older adults, much like those younger, are increasing their social networks using technologies, including e-mail, chat rooms, and online dating sites (Fox, 2004; Wright & Query, 2004).
Interestingly, older men and women parallel online dating information as those younger. Alterovitz and Mendelsohn (2011) analyzed 600 internet personal ads from different age groups, and across the life span, men sought physical attractiveness and offered status related information more than women. With advanced age, men desired women increasingly younger than themselves, whereas women desired older men until ages 75 and over, when they sought men younger than themselves. Research has previously shown that older women in romantic relationships are not interested in becoming a caregiver or becoming widowed for a second time (Carr, 2004a). Additionally, older men are more eager to repartner than are older women (Davidson, 2001; Erber & Szuchman, 2015). Concerns expressed by older women included not wanting to lose their autonomy, care for a potentially ill partner, or merge their finances with someone (Watson & Stelle, 2011).
Older dating adults also need to know about threats to sexual health, including being at risk for sexually transmitted diseases, including chlamydia, genital herpes, and HIV. Nearly 25% of people living with HIV/AIDS in the United States are 50 or older (Office on Women’s Health, 2010b). Githens and Abramsohn (2010) found that only 25% of adults 50 and over who were single or had a new sexual partner indicated that they have used a condom the last time they had sex. Robin (2010) stated that 40% of those 50 and over have never been tested for HIV. These results indicated that educating all individuals, not just adolescents, on healthy sexual behavior is important.
Remarriage and Cohabitation: Older adults who remarry often find that their remarriages are more stable than those of younger adults. Kemp and Kemp (2002) suggest that greater emotional maturity may lead to more realistic expectations regarding marital relationships, leading to greater stability in remarriages in later life. Older adults are also more likely to be seeking companionship in their romantic relationships. Carr (2004a) found that older adults who have considerable emotional support from their friends were less likely to seek romantic relationships. In addition, older adults who have divorced often desire the companionship of intimate relationships without marriage. As a result, cohabitation is increasing among older adults, and like remarriage, cohabitation in later adulthood is often associated with more positive consequences than it is in younger age groups (King & Scott, 2005). No longer being interested in raising children, and perhaps wishing to protect family wealth, older adults may see cohabitation as a good alternative to marriage. In 2014, 2% of adults age 65 and up were cohabitating (Stepler, 2016b). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.20%3A_Late_Adult_Lifestyles.txt |
Approximately 3 million older adults in the United States identify as lesbian or gay (Hillman & Hinrichsen, 2014). By 2025 that number is expected to rise to more than 7 million (National Gay and Lesbian Task Force, 2006). Despite the increase in numbers, older lesbian and gay adults are one of the least researched demographic groups, and the research there is portrays a population faced with discrimination. According to the Centers for Disease Control and Prevention (2011), compared to heterosexuals, lesbian and gay adults experience both physical and mental health differences. More than 40% of lesbian and gay adults ages 50 and over suffer from at least one chronic illness or disability, and compared to heterosexuals they are more likely to smoke and binge drink (Hillman & Hinrichsen, 2014). Additionally, gay older adults have an increased risk of prostate cancer (Blank, 2005) and infection from HIV and other sexually transmitted illnesses (Centers for Disease Control and Prevention, 2008). When compared to heterosexuals, lesbian and gay elders have less support from others as they are twice as likely to live alone and four times less likely to have adult children (Hillman & Hinrichsen, 2014).
Lesbian and gay older adults who belong to ethnic and cultural minorities, conservative religions, and rural communities may face additional stressors. Ageism, heterocentrism, sexism, and racism can combine cumulatively and impact the older adult beyond the negative impact of each individual form of discrimination (Hillman & Hinrichsen, 2014). David and Knight (2008) found that older gay black men reported higher rates of racism than younger gay black men and higher levels of perceived ageism than older gay white men.
Although lesbian and gay older adults face many challenges, more than 80% indicate that they engage in some form of wellness or spiritual activity (Fredrickson-Goldsen et al., 2011). They also gather social support from friends and “family members by choice” rather than legal or biological relatives (Hillman & Hinrichsen, 2014). This broader social network provides extra support to gay and lesbian elders.
An important consideration when reviewing the development of gay and lesbian older adults is the cohort in which they grew up (Hillman & Hinrichsen, 2014). The oldest lesbian and gay adults came of age in the 1950s when there were no laws to protect them from victimization. The baby boomers, who grew up in the 1960s and 1970s, began to see states repeal laws that criminalized homosexual behavior. Future lesbian and gay elders will have different experiences due to the legal right for same-sex marriage and greater societal acceptance. Consequently, just like all those in late adulthood, understanding that gay and lesbian elders are a heterogeneous population is important when understanding their overall development.
9.22: Elder Abuse
Current research indicates that at least 1 in 10, or approximately 4.3 million, older Americans are affected by at least one form of elder abuse per year (Roberto, 2016). Those between 60 and 69 years of age are more susceptible than those older. This may be because younger older adults more often live with adult children or a spouse, two groups with the most likely abusers. Cognitive impairment, including confusion and communication deficits, is the greatest risk factor for elder abuse, while a decline in overall health resulting in greater dependency on others is another. Having a disability also places an elder at a higher risk for abuse (Youdin, 2016). Definitions of elder abuse typically recognize five types of abuse as shown in Table 9.8
Consequences of elder abuse are significant and include injuries, new or exacerbated health conditions, hospitalizations, premature institutionalization, and early death (Roberto, 2016). Psychological and emotional abuse is considered the most common form, even though it is underreported and may go unrecognized by the elder. Continual emotional mistreatment is very damaging as it becomes internalized and results in late-life emotional problems and impairment. Financial abuse and exploitation is increasing and costs seniors nearly 3 billion dollars per year (Lichtenberg, 2016). Financial abuse is the second most common form after emotional abuse, and affects approximately 5% of elders. Abuse and neglect occurring in a nursing home is estimated to be 25%-30% (Youdin, 2016). Abuse of nursing home residents is more often found in facilities that are run down and understaffed.
Table 9.8: Types of Elder Abuse
Type Description
Physical abuse Physical force resulting in injury, pain, or impairment
Sexual abuse Nonconsensual sexual contact
Psychological and emotional abuse Infliction of distress through verbal or nonverbal acts such as yelling, threatening, or isolating
Financial abuse and exploitation Improper use of an elder's finances, property, or assets
Neglect and abandonment Intentional or unintentional refusal or failure to fulfill caregiving duties to an elder
Adapted from Roberto (2016)
Older women are more likely to be victims than men, and one reason is due to women living longer. Additionally, a family history of violence makes older women more vulnerable, especially for physical and sexual abuse (Acierno et al., 2010). However, Kosberg (2014) found that men were less likely to report abuse. Recent research indicated no differences among ethnic groups in abuse prevalence, however, cultural norms regarding what constitutes abuse differ based on ethnicity. For example, Dakin and Pearlmutter found that working class White women did not consider verbal abuse as elder abuse, and higher socioeconomic status African American and White women did not consider financial abuse as a form of elder abuse (as cited in Roberto, 2016, p. 304).
Perpetrators of elder abuse are typically family members and include spouses/partners and older children (Roberto, 2016). Children who are abusive tend to be dependent on their parents for financial, housing, and emotional support. Substance use, mental illness, and chronic unemployment increase dependency on parents, which can then increase the possibility of elder abuse. Prosecuting a family member who has financially abused a parent is very difficult. The victim may be reluctant to press charges and the court dockets are often very full resulting in long waits before a case is heard. According to Tanne, family members abandoning older family members with severe disabilities in emergency rooms is a growing problem as an estimated 100,000 are dumped each year (as cited in Berk, 2007). Paid caregivers and professionals trusted to make decisions on behalf of an elder, such as guardians and lawyers, also perpetuate abuse. When elders feel they have social support and are engaged with others, they are less likely to suffer abuse. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.21%3A_Gay_and_Lesbian_Elders.txt |
Alcohol and drug problems, particularly prescription drug abuse, have become a serious health concern among older adults. Although people 65 years of age and older make up only 13% of the population, they account for almost 30% of all medications prescribed in the United States. According to the National Council on Alcoholism and Drug Dependence (NCADD) (2015), the following statistics illustrate the significance of substance abuse for those in late adulthood:
• There are 2.5 million older adults with an alcohol or drug problem.
• Six to eleven percent of elderly hospital admissions, 14 percent of elderly emergency room admissions, and 20 percent of elderly psychiatric hospital admissions are a result of alcohol or drug problems.
• Widowers over the age of 75 have the highest rate of alcoholism in the U.S.
• Nearly 50 percent of nursing home residents have alcohol related problems.
• Older adults are hospitalized as often for alcoholic related problems as for heart attacks.
• Nearly 17 million prescriptions for tranquilizers are prescribed for older adults each year. Benzodiazepines, a type of tranquilizing drug, are the most commonly misused and abused prescription medications.
Risk factors for psychoactive substance abuse in older adults include social isolation, which can lead to depression (Youdin, 2016). This can be caused by the death of a spouse/partner, family members and/or friends, retirement, moving, and reduced activity levels. Additionally, medical conditions, chronic pain, anxiety, and stress can all lead to the abuse of substances.
Diagnosis Difficulties: Using criteria from the Diagnostic and Statistical Manual of Disorder-5th Edition (American Psychiatric Association, 2013), diagnosing older adults with a substance use disorder can be difficult (Youdin, 2016). For example, compared to adolescents and younger adults, older adults are not looking to get high, but rather become dependent by accident. Additionally, stereotypes of older adults, which include memory deficits, confusion, depression, agitation, motor problems, and hostility, can result in a diagnosis of cognitive impairment instead of a substance use disorder. Further, a diagnosis of a substance use disorder involves impairment in work, school, or home obligations, and because older adults are not typically working, in school or caring for children, these impairments would not be exhibited. Lastly, physicians may be biased against asking those in late adulthood if they have a problem with drugs or alcohol (NCADD, 2015).
Abused Substances: Drugs of choice for older adults include alcohol, benzodiazepines, opioid prescription medications and marijuana. The abuse of prescription medications is expected to increase significantly. Siriwardena, Qureshi, Gibson, Collier, and Lathamn (2006) found that family physicians prescribe benzodiazepines and opioids to older adults to deal with psychosocial and pain problems rather than prescribe alternatives to medication such as therapy. Those in late adulthood are also more sensitive to the effects of alcohol than those younger because of an age-related decrease in the ratio between lean body mass and fat (Erber & Szuchman, 2015).
Additionally, “liver enzymes that metabolize alcohol become less efficient with age and central nervous system sensitivity to drugs increase with age” (p.134). Those in late adulthood are also more likely to be taking other medications, and this can result in unpredictable interactions with the psychoactive substances (Youdin, 2016).
Cannabis Use: Blazer and Wu (2009) found that adults aged 50-64 were more likely to use cannabis than older adults. These “baby boomers” with the highest cannabis use included men, those unmarried/unpartnered, and those with depression. In contrast to the negative effects of cannabis, which include panic reactions, anxiety, perceptual distortions and exacerbation of mood and psychotic disorders, cannabis can provide benefit to the older adult with medical conditions (Youdin, 2016). For example, cannabis can be used in the treatment for multiple sclerosis, Parkinson’s disease, chronic pain, and the fatigue and nausea from the effects of chemotherapy (Williamson & Evans, 2000).
Future Substance Abuse Concerns: There will be an increase in the number of seniors abusing substances in the future because the baby boomer generation has a history of having been exposed to, and having experienced, psychoactive substance use over their adult life. This is a significant difference from the current and previous generations of older adults (National Institutes of Health, 2014c). Efforts will be needed to adequately address these future substance abuse issues for the elderly due to both the health risks for them and the expected burden on the health care system.
9.24: Successful Aging
Although definitions of successful aging are value-laden, Rowe and Kahn (1997) defined three criteria of successful aging that are useful for research and behavioral interventions. They include:
• Relative avoidance of disease, disability, and risk factors, like high blood pressure, smoking, or obesity
• Maintenance of high physical and cognitive functioning
• Active engagement in social and productive activities
For example, research has demonstrated that age-related declines in cognitive functioning across the adult life span may be slowed through physical exercise and lifestyle interventions (Kramer & Erickson, 2007).
Another way that older adults can respond to the challenges of aging is through compensation. Specifically, selective optimization with compensation is used when the elder makes adjustments, as needed, in order to continue living as independently and actively as possible (Baltes & Dickson, 2001). When older adults lose functioning, referred to as loss-based selection, they may first use new resources/technologies or continually practice tasks to maintain their skills. However, when tasks become too difficult, they may compensate by choosing other ways to achieve their goals. For example, a person who can no longer drive needs to find alternative transportation, or a person who is compensating for having less energy, learns how to reorganize the daily routine to avoid over-exertion. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/09%3A_Late_Adulthood/9.23%3A_Substance_Abuse_and_the_Elderly.txt |
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Learning Objectives: Death and Dying
• Define death
• Describe what characterizes physical and social death
• Compare the leading causes of death in the United States with those of developing countries
• Explain where people die
• Describe how attitudes about death and death anxiety change as people age
• Explain the philosophy and practice of palliative care
• Describe the roles of hospice and family caregivers
• Explain the different types of advanced directives
• Describe cultural differences in end of life decisions
• Explain the different types of euthanasia and their controversies
• Describe funeral rituals in different religions
• Differentiate among grief, bereavement, and mourning
• List and describe the stages of loss based on Kübler-Ross’s model and describe the criticisms of the model
• Explain the dual-process model of grief
• Identify the impact of losing a child and parent
• Identify the four tasks of mourning
• Explain the importance of support groups for those in grief
We have now reached the end of the lifespan. While it is true that death occurs more commonly at the later stages of age, death can occur at any point in the life cycle. Death is a deeply personal experience evoking many different reactions, emotions, and perceptions. Children and young adults in their prime of life may perceive death differently from adults dealing with chronic illness or the increasing frequency of the death of family and friends. If asked, most people envision their death as quick and peaceful. However, except for a handful of illnesses in which death does often quickly follow diagnosis, or in the case of accidents or trauma, most deaths come after a lengthy period of chronic illness or frailty (Institute of Medicine (IOM), 2015). While modern medicine and better living conditions have led to a rise in life expectancy around the world, death will still be the inevitable final chapter of our lives.
• 10.1: Death and Dying
According to the Uniform Determination of Death Act (UDDA) (Uniform Law Commissioners, 1980), death is defined clinically as the following: An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.
• 10.2: Most Common Causes of Death
The United States: In 1900, the most common causes of death were infectious diseases, which brought death quickly. Today, the most common causes of death are chronic diseases in which a slow and steady decline in health ultimately results in death. In 2015, heart disease, cancer, and chronic lower respiratory diseases were the leading causes of death (see Figure 10.2, CDC, 2016).
• 10.3: Where Do People Die?
Gathering statistics on the location of death is not a simple matter. Those with terminal illnesses may be going through the process of dying at home or in a nursing home, only to be transported to a hospital in the final hours of their life. Thus, it should not be a surprise that in the United States, more Americans die in hospitals than in any other settings. However, as can be seen in figure 10.4, there has been a decline in the number of people dying in hospital in the last decade (Hall, Lev
• 10.4: Developmental Perceptions of Death and Death Anxiety
The concept of death changes as we develop from early childhood to late adulthood. Cognitive development, societal beliefs, familial responsibilities, and personal experiences all shape an individual’s view of death.
• 10.5: Curative, Palliative, and Hospice Care
Ill individuals need to make choices about the treatment they wish to receive. One’s age, type of illness, and personal beliefs about dying affect the type of treatment chosen: (1) Curative care is designed to overcome and cure disease and illness, (2) Palliative care focuses on providing comfort and relief from physical and emotional pain to patients throughout their illness and (3) Hospice care that involves providing terminally ill patients with medical, psychological, and spiritual support.
• 10.6: Advanced Directives
Advance directives include documents that mention a health care agent and living wills. These are initiated by the patient. Living wills are written or video statements that outline the health care initiates the person wishes under certain circumstances. Durable power of attorney for health care names the person who should make health care decisions in the event that the patient is incapacitated. In contrast, medical orders are crafted by a medical professional on behalf of a seriously ill patie
• 10.7: Cultural Differences in End-of-Life Decisions
Cultural factors strongly influence how doctors, other health care providers, and family members communicate bad news to patients, the expectations regarding who makes the health care decisions, and attitudes about end-of-life care. In the United States, doctors take the approach that patients should be told the truth about their health. Outside the US and among certain racial & ethnic groups within the United States, doctors and family members may conceal the full nature of a terminal illness.
• 10.8: Euthanasia
Euthanasia is defined as intentionally ending one’s life when suffering from a terminal illness or severe disability (Youdin, 2016). Euthanasia is further separated into active euthanasia, which is intentionally causing death, usually through a lethal dose of medication, and passive euthanasia occurs when life-sustaining support is withdrawn. This can occur through the removal of a respirator, feeding tube, or heart-lung machine.
• 10.9: Religious Practices After Death
Funeral rites are expressions of loss that reflect personal and cultural beliefs about the meaning of death and the afterlife. Ceremonies provide survivors a sense of closure after a loss. These rites and ceremonies send the message that the death is real and allow friends and loved ones to express their love and duty to those who die.
• 10.10: Grief, Bereavement, and Mourning
Grief is the normal process of reacting to a physical loss, such as a death, or a social loss including a relationship or job. Bereavement is the period after a loss during which grief and mourning occurs. The time spent in bereavement for the loss of a loved one depends on the circumstances of the loss and the level of attachment to the person who died. Mourning is the process by which people adapt to a loss. Mourning is greatly influenced by cultural beliefs, practices, and rituals
• 10.R: Death and Dying (References)
10: Death and Dying
One way to understand death and dying is to look more closely at what defines physical death and social death.
Death Defined: According to the Uniform Determination of Death Act (UDDA) (Uniform Law Commissioners, 1980), death is defined clinically as the following:
An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.
The UDDA was approved for the United States in 1980 by a committee of national commissioners, the American Medical Association, the American Bar Association, and the President’s Commission on Medical Ethics. This act has since been adopted by most states and provides a comprehensive and medically factual basis for determining death in all situations.
Death Process: For those individuals who are terminal and death is expected, a series of physical changes occur. Bell (2010) identifies some of the major changes that occur in the weeks, days, and hours leading up to death:
• Weeks Before Passing
• Minimal appetite; prefer easily digested foods o Increase in the need for sleep
• Increased weakness
• Incontinence of bladder and/or bowel
• Restlessness or disorientation
• Increased need for assistance with care
• Days Before Passing
• Decreased level of consciousness
• Pauses in breathing
• Decreased blood pressure
• Decreased urine volume and urine color darkens o Murmuring to people others cannot see
• Reaching in air or picking at covers
• Need for assistance with all care
• Days to Hours Before Passing
• Decreased level of consciousness or comatose-like state
• Inability to swallow
• Pauses in breathing become longer
• Shallow breaths
• Weak or absent pulse
• Knees, feet, and/or hands becoming cool or cold
• Knees, feet, and/or hand discoloring to purplish hue
• Noisy breathing due to relaxed throat muscles, often called a “death rattle”
• Skin coloring becoming pale, waxen (pp. 5, 176-177)
Social death begins much earlier than physical death (Pattison, 1977). Social death occurs when others begin to dehumanize and withdraw from someone who is terminally ill or has been diagnosed with a terminal illness (Glaser & Strauss, 1966). Dehumanization includes ignoring them, talking about them if they were not present, making decisions without consulting them first, and forcing unwanted procedures. Sweeting and Gilhooly (1997) further identified older people in general, and people with a loss of personhood, as having the characteristics necessary to be treated as socially dead. More recently, the concept has been used to describe the exclusion of people with HIV/AIDS, younger people living with terminal illness, and the preference to die at home (Brannelly, 2011). Those diagnosed with conditions such as AIDS or cancer may find that friends, family members, and even health care professionals begin to say less and visit less frequently. Meaningful discussions may be replaced with comments about the weather or other topics of light conversation. Doctors may spend less time with patients after their prognosis becomes poor.
Why do others begin to withdraw? Friends and family members may feel that they do not know what to say or that they can offer no solutions to relieve suffering. They withdraw to protect themselves against feeling inadequate or from having to face the reality of death. Health professionals, trained to heal, may also feel inadequate and uncomfortable facing decline and death. People in nursing homes may live as socially dead for years with no one visiting or calling. Social support is important for quality of life, and those who experience social death are deprived from the benefits that come from loving interaction with others (Bell, 2010).
Why would younger or healthier people dehumanize those who are incapacitated, older, or unwell? One explanation is that dehumanization is the result of the healthier person placing a protective distance between themselves and the incapacitated, older, or unwell person (Brannelly, 2011). This keeps the well person from thinking of themselves as becoming ill or in need of assistance. Another explanation is the repeated experience of loss that paid caregivers experience when working with terminally ill and older people requires a distance which protects against continual grief and sadness, and possibly even burnout. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.01%3A_Death_and_Dying.txt |
The United States: In 1900, the most common causes of death were infectious diseases, which brought death quickly. Today, the most common causes of death are chronic diseases in which a slow and steady decline in health ultimately results in death. In 2015, heart disease, cancer, and chronic lower respiratory diseases were the leading causes of death (see Figure 10.2, CDC, 2016).
The causes of death vary by age (see Tables 10.1 and 10.2; adapted from CDC, 2015). In infancy, congenital problems and other birth complications are the largest contributors to infant mortality. Accidents, known as unintentional injury, become the leading cause of death throughout childhood and early adulthood. In middle and late adulthood cancer and heart disease become the leading killers.
Table 10.1: Top Five Causes of Death in the United States in 2013 by Age (birth to 24)
< 1 1 - 4 5 - 9 10 - 14 14 - 24
congenital abnormalities unintentional injury unintentional injury unintentional injury unintentional injury
premature birth congenital abnormalities malignant neoplasms malignant neoplasms homicide
maternal pregnancy complications homicide congenital abnormalities suicide suicide
SIDS malignant neoplasms homicide congenital abnormalities malignant neoplasms
unintentional injury heart disease chronic lower respiratory disease homicide heart disease
Table 10.2: Top Five Causes of Death in the United States by Age
25 - 34 35 - 44 45 - 54 55 - 64 65+
unintentional injury unintentional injury malignant neoplasms malignant neoplasms heart disease
suicide malignant neoplasms heart disease heart disease malignant neoplasms
homicide heart disease unintentional injury unintentional injury chronic lower respiratory disease
malignant neoplasms suicide liver disease chronic lower respiratory disease cerebrovascular disease
heart disease homicide suicide diabetes mellitus Alzheimer's disease
The world: The most recent statistics analyzed by the World Health Organization were in 2012, and non- communicable deaths; that is, those not passed from person- to-person, were responsible for 68% of deaths (WHO, 2016). The four most common noncommunicable diseases were cardiovascular disease, cancer, diabetes, and chronic lung diseases. In contrast, communicable diseases, such as HIV and other infectious diseases, neonatal and maternal mortality, and nutritional problems caused 23% of the deaths, and injuries caused the remaining 9% of the deaths.
Tobacco use is attributed as one of the top killers, and is often the hidden cause behind many of the diseases that result in death, such as heart disease and chronic lung diseases (WHO, 2016).
These statistics hide the differences in the causes of death among high versus low income nations. In high-income countries, defined as having a per capita annual income of \$12,476 or more, 70% of deaths are among people aged 70 and older. Only 1% of deaths occur in children under 15 years of age. People predominantly die of chronic diseases, such as cardiovascular disease, cancers, dementia, or diabetes. Lower respiratory infections remain the only leading infectious cause of death in such nations. In contrast, in low-income countries, defined as having a per capital annual income of \$1025 or less, almost 40% of deaths are among children under age 15, and only 20% of deaths are among people aged 70 years and older. People predominantly die of infectious diseases such as lower respiratory infections, HIV/AIDS, diarrheal diseases, malaria and tuberculosis. These account for almost one third of all deaths in these countries. Complications of childbirth due to prematurity, birth asphyxia, and birth trauma are among the leading causes of death for newborns and infants in the poorest of nations (WHO, 2016).
10.03: Where Do People Die
Gathering statistics on the location of death is not a simple matter. Those with terminal illnesses may be going through the process of dying at home or in a nursing home, only to be transported to a hospital in the final hours of their life. Thus, it should not be a surprise that in the United States, more Americans die in hospitals than in any other settings. However, as can be seen in figure 10.4, there has been a decline in the number of people dying in hospital in the last decade (Hall, Levant, & DeFrances, 2013). This decline can be tied to two changes in the U.S. health care system: Medicare, and other private insurance plans, covering the cost of hospice care, and Medicare paying hospitals to encourage less use of inpatient hospital care (IOM, 1997).
Internationally, 54% of deaths in over 45 nations occurred in hospitals, with the most frequent occurring in Japan (78%) and the least frequent occurring in China (20%), according to a study by Broad et al. (2013). They also found that for older adults, 18% of deaths occurred in some form of residential care, such as nursing homes, and that for each decade after age 65, the rate of dying in a such settings increased 10%. In addition, the number of women dying in residential care was considerably higher than for males. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.02%3A_Most_Common_Causes_of_Death.txt |
The concept of death changes as we develop from early childhood to late adulthood. Cognitive development, societal beliefs, familial responsibilities, and personal experiences all shape an individual’s view of death (Batts, 2004; Erber & Szuchman, 2015; National Cancer Institute, 2013).
• Infancy: Certainly infants do not comprehend death, however, they do react to the separation caused by death. Infants separated from their mothers may become sluggish and quiet, no longer smile or coo, sleep less, and develop physical symptoms such as weight loss.
• Early Childhood: As you recall from Piaget’s preoperational stage of cognitive development, young children experience difficulty distinguishing reality from fantasy. It is therefore not surprising that young children lack an understanding of death. They do not see death as permanent, assume it is temporary or reversible, think the person is sleeping, and believe they can wish the person back to life. Additionally, they feel they may have caused the death through their actions, such as misbehavior, words, and feelings.
• Middle Childhood: Although children in middle childhood begin to understand the finality of death, up until the age of 9 they may still participate in magical thinking and believe that through their thoughts they can bring someone back to life. They also may think that they could have prevented the death in some way, and consequently feel guilty and responsible for the death.
• Late Childhood: At this stage, children understand the finality of death and know that everyone will die, including themselves. However, they may also think people die because of some wrong doing on the part of the deceased. They may develop fears of their parents dying and continue to feel guilty if a loved one dies.
• Adolescence: Adolescents understand death as well as adults. With formal operational thinking, adolescents can now think abstractly about death, philosophize about it, and ponder their own lack of existence. Some adolescents become fascinated with death and reflect on their own funeral by fantasizing on how others will feel and react. Despite a preoccupation with thoughts of death, the personal fable of adolescence causes them to feel immune to the death. Consequently, they often engage in risky behaviors, such as substance use, unsafe sexual behavior, and reckless driving thinking they are invincible.
• Early Adulthood: In adulthood, there are differences in the level of fear and anxiety concerning death experienced by those in different age groups. For those in early adulthood, their overall lower rate of death is a significant factor in their lower rates of death anxiety. Individuals in early adulthood typically expect a long life ahead of them, and consequently do not think about, nor worry about death.
• Middle Adulthood: Those in middle adulthood report more fear of death than those in either early and late adulthood. The caretaking responsibilities for those in middle adulthood is a significant factor in their fears. As mentioned previously, middle adults often provide assistance for both their children and parents, and they feel anxiety about leaving them to care for themselves.
• Late Adulthood: Contrary to the belief that because they are so close to death, they must fear death, those in late adulthood have lower fears of death than other adults. Why would this occur? First, older adults have fewer caregiving responsibilities and are not worried about leaving family members on their own. They also have had more time to complete activities they had planned in their lives, and they realize that the future will not provide as many opportunities for them. Additionally, they have less anxiety because they have already experienced the death of loved ones and have become accustomed to the likelihood of death. It is not death itself that concerns those in late adulthood; rather, it is having control over how they die. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.04%3A__Developmental_Perceptions_of_Death_and_Death_Anxiety.txt |
When individuals become ill, they need to make choices about the treatment they wish to receive. One’s age, type of illness, and personal beliefs about dying affect the type of treatment chosen (Bell, 2010).
Curative care is designed to overcome and cure disease and illness (Fox, 1997). Its aim is to promote complete recovery, not just to reduce symptoms or pain. An example of curative care would be chemotherapy. While curing illness and disease is an important goal of medicine, it is not its only goal. As a result, some have criticized the curative model as ignoring the other goals of medicine, including preventing illness, restoring functional capacity, relieving suffering, and caring for those who cannot be cured.
Palliative care focuses on providing comfort and relief from physical and emotional pain to patients throughout their illness, even while being treated (NIH, 2007). In the past, palliative care was confined to offering comfort for the dying. Now it is offered whenever patients suffer from chronic illnesses, such as cancer or heart disease (IOM, 2015). Palliative care is also part of hospice programs.
Hospice emerged in the United Kingdom in the mid-20th century as a result of the work of Cicely Saunders. This approach became popularized in the U.S. by the work of Elizabeth Kübler-Ross (IOM, 2015), and by 2012 there were 5,500 hospice programs in the U.S. (National Hospice and Palliative Care Organization (NHPCO), 2013).
Hospice care whether at home, in a hospital, nursing home, or hospice facility involves a team of professionals and volunteers who provide terminally ill patients with medical, psychological, and spiritual support, along with support for their families (Shannon, 2006). The aim of hospice is to help the dying be as free from pain as possible, and to comfort both the patients and their families during a difficult time. In order to enter hospice, a patient must be diagnosed as terminally ill with an anticipated death within 6 months (IOM, 2015). The patient is allowed to go through the dying process without invasive treatments. Hospice workers try to inform the family of what to expect and reassure them that much of what they see is a normal part of the dying process.
According to Shannon (2006), the basic elements of hospice include:
• Care of the patient and family as a single unit
• Pain and symptom management for the patient
• Having access to day and night care
• Coordination of all medical services
• Social work, counseling, and pastoral services
• Bereavement counseling for the family up to one year after the patient’s death
In 2013, an estimated 1.5 million people received hospice care (NHPCO, 2014). The majority of patients on hospice are cancer patients and typically do not enter hospice until the last few weeks prior to death. The median length of stay was 18 days, and one out of three patients were on hospice for less than a week.
Although hospice care has become more widespread, these new programs are subjected to more rigorous insurance guidelines that dictate the types and amounts of medications used, length of stay, and types of patients who are eligible to receive hospice care (Weitz, 2007). Thus, more patients are being served, but providers have less control over the services they provide, and lengths of stay are more limited.
Not all racial and ethnic groups feel the same way about hospice care. African-American families may believe that medical treatment should be pursued on behalf of an ill relative as long as possible and that only God can decide when a person dies. Chinese-American families may feel very uncomfortable discussing issues of death or being near the deceased family member's body. The view that hospice care should always be used is not held by everyone, and health care providers need to be sensitive to the wishes and beliefs of those they serve (Coolen, 2012).
Family Caregivers
According to the Institute of Medicine (2015), it is estimated that 66 million Americans, or 29% of the adult population, are caregivers for someone who is dying or chronically ill. Two- thirds of these caregivers are women. This care takes its toll physically, emotionally, and financially. Family caregivers may face the physical challenges of lifting, dressing, feeding, bathing, and transporting a dying or ill family member. They may worry about whether they are performing all tasks safely and properly, as they receive little training or guidance. Such caregiving tasks may also interfere with their ability to take care of themselves and meet other family and workplace obligations. Financially, families may face high out of pocket expenses (IOM, 2015).
As can be seen in Table 10.3, most family caregivers are employed, are providing care by themselves with little professional intervention, and there are high costs in lost productivity. As the prevalence of chronic disease rises, the need for family caregivers is growing. Unfortunately, the number of potential family caregivers is declining as the large baby boomer generation enters into late adulthood (Redfoot, Feinberg, & Houser, 2013).
Table 10.3 Characteristics of Family Caregivers in the United States
Characteristic
No home visits by health care professionals 69%
Caregivers are also employed 72%
Caregivers for the elderly 67%
Duration of employed workers who have been caregiving for 3+ years 55%
Annual cost of lost productivity due to absenteeism from working due to providing care \$25.2 billion
Adapted from IOM, 2015. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.05%3A_Curative_Palliative_and_Hospice_Care.txt |
Advanced care planning refers to all documents that pertain to end-of-life care. These include advance directives and medical orders. Advance directives include documents that mention a health care agent and living wills. These are initiated by the patient. Living wills are written or video statements that outline the health care initiates the person wishes under certain circumstances. Durable power of attorney for health care names the person who should make health care decisions in the event that the patient is incapacitated. In contrast, medical orders are crafted by a medical professional on behalf of a seriously ill patient. Unlike advanced directives, as these are doctor’s orders, they must be followed by other medical personnel. Medical orders include Physician Orders for Life-sustaining Treatment (POLST), do-not-resuscitate, do- not-incubate, or do-not-hospitalize. In some instances, medical orders may be limited to the facility in which they were written. Several states have endorsed POLST so that they are applicable across heath care settings (IOM, 2015).
10.07: Cultural Differences in End-of-Life Decisions
According to Searight and Gafford (2005a), cultural factors strongly influence how doctors, other health care providers, and family members communicate bad news to patients, the expectations regarding who makes the health care decisions, and attitudes about end-of-life care. In the United States, doctors take the approach that patients should be told the truth about their health. Outside the United States and among certain racial and ethnic groups within the United States, doctors and family members may conceal the full nature of a terminal illness as revealing such information is viewed as potentially harmful to the patient, or at the very least, is seen as disrespectful and impolite. Holland, Geary, Marchini and Tross (1987) found that many doctors in Japan and in numerous African nations used terms such as “mass,” “growth,” and “unclean tissue” rather than referring to cancer when discussing the illness to patients and their families. Family members actively protect terminally ill patients from knowing about their illness in many Hispanic, Chinese, and Pakistani cultures (Kaufert & Putsch, 1997; Herndon & Joyce, 2004).
In the United States, we view the patient as autonomous in health care decisions (Searight & Gafford, 2005a), while in other nations the family or community plays the main role, or decisions are made primarily by medical professionals, or the doctors in concert with the family make the decisions for the patient. For instance, in comparison to European Americans and African Americans, Koreans and Mexican-Americans are more likely to view family members as the decision makers rather than just the patient (Berger, 1998; Searight & Gafford, 2005a). In many Asian cultures, illness is viewed as a “family event”, not just something that impacts the individual patient (Candib, 2002). Thus, there is an expectation that the family has a say in the health care decisions. As many cultures attribute high regard and respect for doctors, patients and families may defer some of the end-of-life decision making to the medical professionals (Searight & Gafford, 2005b).
According to a Pew Research Center Survey (Lipka, 2014), while death may not be a comfortable topic to ponder, 37% of their survey respondents had given a great deal of thought about their end-of-life wishes, with 35% having put these in writing. Yet, over 25% had given no thought to this issue. Lipka (2014) also found that there were clear racial and ethnic differences in end-of-life wishes (see Figure 10.10). Whites are more likely than Blacks and Hispanics to prefer to have treatment stopped if they have a terminal illness. While the majority of Blacks (61%) and Hispanics (55%) prefer that everything be done to keep them alive. Searight and Gafford (2005a) suggest that the low rate of completion of advanced directives among non-whites may reflect a distrust of the U.S. health care system as a result of the health care disparities non-whites have experienced. Among Hispanics, patients may also be reluctant to select a single family member to be responsible for end-of- life decisions out of a concern of isolating the person named and of offending other family members, as this is commonly seen as a “family responsibility” (Morrison, Zayas, Mulvihill, Baskin, & Meier, 1998). | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.06%3A_Advanced_Directives.txt |
Euthanasia is defined as intentionally ending one’s life when suffering from a terminal illness or severe disability (Youdin, 2016). Euthanasia is further separated into active euthanasia, which is intentionally causing death, usually through a lethal dose of medication, and passive euthanasia occurs when life-sustaining support is withdrawn. This can occur through the removal of a respirator, feeding tube, or heart-lung machine.
Physician-assisted suicide is a form of active euthanasia whereby a physician prescribes the means by which a person can die. The United States federal government does not legislate physician-assisted suicide as laws are handled at the state level (ProCon.org, 2016). Six states currently allow physician-assisted suicide. The person seeking physician-assisted suicide must be: (1) at least 18 years of age, (2) have six or less months until expected death, and (3) obtain two oral (or least 15 days apart) and one written request from a physician (ProCon.org, 2016). Table 10.4 lists the states that allow physician-assisted suicide and the date the act was passed.
Table 10.4 Six States with Legal Physician-Assisted Suicide
State Date Passed
Oregon Passed November 8, 1994, but enacted October 27, 1997
Washington November 4, 2008
Montana December 31, 2009
Vermont May 20, 2013
California October 5, 2015
Colorado November 8, 2016
Source.
Since 1997 when the law was passed in Oregon, 1545 people had lethal prescriptions written and 991 patients had died from the medication by the end of 2015 (Oregon Public Health Division, 2016). Canada and several European countries, including Switzerland, Belgium, Luxembourg, and the Netherlands, also allow physician-assisted suicide. As of 2014, Belgium is the only country that allows the right to die to those under the age of 18. Stricter conditions were put in place for children, including parental consent, the child must be suffering from a serious and incurable disease, the child must understand what euthanasia means, and the child’s death must be expected in the near future (Narayan, 2016).
The practice of physician-assisted euthanasia is certainly controversial with religious, legal, ethical, and medical experts weighing in with opinions. The main areas where there is disagreement between those who support physician-assisted euthanasia and those who do not include:
1. whether a person has the legal right to die,
2. whether active euthanasia would become a “slippery slope” and start a trend to legalize deaths for individuals who may be disabled or unable to give consent,
3. how to interpret the Hippocratic Oath and what it exactly means for physicians to do no harm,
4. whether the government should be involved in end-of-life decisions, and
5. specific religious restrictions against deliberately ending a life (ProCon.org, 2016).
Not surprisingly, there are strong opinions on both sides of this topic. According to a 2013 Pew Research Center survey, 47% of Americans approve and 49% disapprove of laws that would allow a physician to prescribe lethal doses of drugs that a terminally ill patient could use to commit suicide (Pew Research Center, 2013). Attitudes on physician-assisted suicide were roughly the same in 2005, when 46% approved and 45% disapproved.
10.09: Religious Practices After Death
Funeral rites are expressions of loss that reflect personal and cultural beliefs about the meaning of death and the afterlife. Ceremonies provide survivors a sense of closure after a loss. These rites and ceremonies send the message that the death is real and allow friends and loved ones to express their love and duty to those who die. Under circumstances in which a person has been lost and presumed dead or when family members were unable to attend a funeral, there can continue to be a lack of closure that makes it difficult to grieve and to learn to live with loss. Although many people are still in shock when they attend funerals, the ceremony still provides a marker of the beginning of a new period of one's life as a survivor. The following are some of the religious practices regarding death, however, individual religious interpretations and practices may occur (Dresser & Wasserman, 2010; Schechter, 2009).
Hindu: The Hindu belief in reincarnation accelerates the funeral ritual, and deceased Hindus are cremated as soon as possible. After being washed, the body is anointed, dressed, and then placed on a stand decorated with flowers ready for cremation. Once the body has been cremated, the ashes are collected and, if possible, dispersed in one of India’s holy rivers.
Judaism: Among the Orthodox, the deceased is first washed and then wrapped in a simple white shroud. Males are also wrapped in their prayer shawls. Once shrouded the body is placed into a plain wooden coffin. The burial must occur as soon as possible after death, and a simple service consisting of prayers and a eulogy is given. After burial the family members typically gather in one home, often that of the deceased, and receive visitors. This is referred to as “sitting shiva”.
Muslim: In Islam the deceased are buried as soon as possible, and it is a requirement that the community be involved in the ritual. The individual is first washed and then wrapped in a plain white shroud called a kafan. Next, funeral prayers are said followed by the burial. The shrouded dead are placed directly in the earth without a casket and deep enough not to be disturbed. They are also positioned in the earth, on their right side, facing Mecca, Saudi Arabia.
Roman Catholic: Before death an ill Catholic individual is anointed by a priest, commonly referred to as the Anointing of the Sick. The priest recites a prayer and applies consecrated oil to the forehead and hands of the ill person. The individual also takes a final communion consisting of consecrated bread and wine. The funeral rites consist of three parts. First is the wake that usually occurs in a funeral parlor. The body is present and prayers and eulogies are offered by family and friends. The funeral mass is next which includes an opening prayer, bible readings, liturgy, communion, and a concluding rite. The funeral then moves to the cemetery where a blessing of the grave, scripture reading, and prayers conclude the funeral ritual. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.08%3A_Euthanasia.txt |
The terms grief, bereavement, and mourning are often used interchangeably, however, they have different meanings. Grief is the normal process of reacting to a loss. Grief can be in response to a physical loss, such as a death, or a social loss including a relationship or job. Bereavement is the period after a loss during which grief and mourning occurs. The time spent in bereavement for the loss of a loved one depends on the circumstances of the loss and the level of attachment to the person who died. Mourning is the process by which people adapt to a loss. Mourning is greatly influenced by cultural beliefs, practices, and rituals (Casarett, Kutner, & Abrahm, 2001).
Grief Reactions: Typical grief reactions involve mental, physical, social and/or emotional responses. These reactions can include feelings of numbness, anger, guilt, anxiety, sadness and despair. The individual can experience difficulty concentrating, sleep and eating problems, loss of interest in pleasurable activities, physical problems, and even illness. Research has demonstrated that the immune systems of individuals grieving is suppressed and their healthy cells behave more sluggishly, resulting in greater susceptibility to illnesses (Parkes & Prigerson, 2010). However, the intensity and duration of typical grief symptoms do not match those usually seen in severe grief reactions, and symptoms typically diminish within 6-10 weeks (Youdin, 2016).
Complicated Grief: After the loss of a loved one, however, some individuals experience complicated grief, which includes atypical grief reactions (Newson, Boelen, Hek, Hofman, & Tiemeier, 2011). Symptoms of complicated grief include: Feelings of disbelief, a preoccupation with the dead loved one, distressful memories, feeling unable to move on with one’s life, and a yearning for the deceased. Additionally, these symptoms may last six months or longer and mirror those seen in major depressive disorder (Youdin, 2016).
According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), distinguishing between major depressive disorder and complicated grief requires clinical judgment. The psychologist needs to evaluate the client’s individual history and determine whether the symptoms are focused entirely on the loss of the loved one and represent the individual’s cultural norms for grieving, which would be acceptable. Those who seek assistance for complicated grief usually have experienced traumatic forms of bereavement, such as unexpected, multiple and violent deaths, or those due to murders or suicides (Parkes & Prigerson, 2010).
Disenfranchised Grief: Grief that is not socially recognized is referred to as disenfranchised grief (Doka, 1989). Examples of disenfranchised grief include death due to AIDS, the suicide of a loved one, perinatal deaths, abortions, the death of a pet, lover, or ex-spouse, and psychological losses, such as a partner developing Alzheimer’s disease. Due to the type of loss, there is no formal mourning practices or recognition by others that would comfort the grieving individual. Consequently, individuals experiencing disenfranchised grief may suffer intensified symptoms due to the lack of social support (Parkes & Prigerson, 2010).
Anticipatory Grief: Grief that occurs when a death is expected and survivors have time to prepare to some extent before the loss is referred to as anticipatory grief. This expectation can make adjustment after a loss somewhat easier (Kübler-Ross & Kessler, 2005). A death after a long-term, painful illness may bring family members a sense of relief that the suffering is over, and the exhausting process of caring for someone who is ill is also completed.
Models of Grief
There are several theoretical models of grief, however, none is all encompassing (Youdin, 2016). These models are merely guidelines for what an individual may experience while grieving. However, if individuals do not fit a model, it does not mean there is something “wrong” with the way they experience grief. It is important to remember that there is no one way to grieve, and people move through a variety of stages of grief in various ways.
Five Stages of Grief: Kübler-Ross (1969, 1975) describes five stages of loss experienced by someone who faces the news of their impending death. These "stages" are not really stages that a person goes through in order or only once; nor are they stages that occur with the same
intensity. Indeed, the process of death is influenced by a person's life experiences, the timing of their death in relation to life events, the predictability of their death based on health or illness, their belief system, and their assessment of the quality of their own life. Nevertheless, these stages help us to understand and recognize some of what a dying person experiences psychologically, and by understanding, we are more equipped to support that person as they die.
• Denial is often the first reaction to overwhelming, unimaginable news. Denial, or disbelief or shock, protects us by allowing such news to enter slowly and to give us time to come to grips with what is taking place. The person who receives positive test results for life-threatening conditions may question the results, seek second opinions, or may simply feel a sense of disbelief psychologically even though they know that the results are true.
• Anger also provides us with protection in that being angry energizes us to fight against something and gives structure to a situation that may be thrusting us into the unknown. It is much easier to be angry than to be sad, in pain, or depressed. It helps us to temporarily believe that we have a sense of control over our future and to feel that we have at least expressed our rage about how unfair life can be. Anger can be focused on a person, a health care provider, at God, or at the world in general. It can be expressed over issues that have nothing to do with our death; consequently, being in this stage of loss is not always obvious.
• Bargaining involves trying to think of what could be done to turn the situation around. Living better, devoting self to a cause, being a better friend, parent, or spouse, are all agreements one might willingly commit to if doing so would lengthen life. Asking to just live long enough to witness a family event or finish a task are examples of bargaining.
• Depression or sadness is appropriate for such an event. Feeling the full weight of loss, crying, and losing interest in the outside world is an important part of the process of dying. This depression makes others feel very uncomfortable and family members may try to console their loved one. Sometimes hospice care may include the use of antidepressants to reduce depression during this stage.
• Acceptance involves learning how to carry on and to incorporate this aspect of the life span into daily existence. Reaching acceptance does not in any way imply that people who are dying are happy about it or content with it. It means that they are facing it and continuing to make arrangements and to say what they wish to say to others. Some terminally ill people find that they live life more fully than ever before after they come to this stage.
According to Kübler-Ross (1969), behind these five stages focused on the identified emotions, there is a sense of hope. Kübler-Ross noted that in all the 200 plus patients she and her students interviewed, a little bit of hope that they might not die was always in the back of their minds.
Criticisms of Kübler-Ross’s Five Stages of Grief: Some researchers have been skeptical of the validity of there being stages to grief among the dying (Friedman & James, 2008). As Kübler- Ross notes in her own work, it is difficult to empirically test the experiences of the dying. “How do you do research on dying,...? When you cannot verify your data and cannot set up experiments?” (Kübler-Ross, 1969, p. 19). She and four students from the Chicago Theology Seminary in 1965 decided to listen to the experiences of dying patients, but her ideas about death and dying are based on the interviewers’ collective “feelings” about what the dying were experiencing and needed (Kübler-Ross, 1969). While she goes on to say in support of her approach that she and her students read nothing about the prior literature on death and dying, so as to have no preconceived ideas, a later work revealed that her own experiences of grief from childhood undoubtedly colored her perceptions of the grieving process (Kübler-Ross & Kessler, 2005). Kübler-Ross is adamant in her theory that the one stage that all those who are dying go through is anger. It is clear from her 2005 book that anger played a central role in “her” grief, and did so for many years (Friedman & James, 2008).
There have been challenges to the notion that denial and acceptance are beneficial to the grieving process (Telford, Kralik, & Koch, 2006). Denial can become a barrier between the patient and health care specialists, and reduce the ability to educate and treat the patient. Similarly, acceptance of a terminal diagnosis may also lead patients to give up and forgo treatments to alleviate their symptoms. In fact, some research suggests that optimism about one’s prognosis may help in one’s adjustment and increase longevity (Taylor, Kemeny, Reed, Bower & Gruenewald, 2000).
A third criticism is not so much of Kübler-Ross’s work, but how others have assumed that these stages apply to anyone who is grieving. Her research focused only on those who were terminally ill. This does not mean that others who are grieving the loss of someone would necessarily experience grief in the same way. Friedman and James (2008) and Telford et al. (2006) expressed concern that mental health professionals, along with the general public, may assume that grief follows a set pattern, which may create more harm than good.
Lastly, the Yale Bereavement Study, completed between January 2000 and January 2003, did not find support for Kübler-Ross’s five stage theory of grief (Maciejewski, Zhang, Block, & Prigerson, 2007). Results indicated that acceptance was the most commonly reported reaction from the start, and yearning was the most common negative feature for the first two years. The other variables, such as disbelief, depression, and anger, were typically absent or minimal.
Although there is criticism of the Five Stages of Grief Model, Kübler-Ross made people more aware of the needs and concerns of the dying, especially those who were terminally ill. As she notes,
...when a patient is severely ill, he is often treated like a person with no right to an opinion. It is often someone else who makes the decision if and when and where a patient should be hospitalized. It would take so little to remember that the sick person has feelings, has wishes and opinions, and has – most important of all – the right to be heard. (1969, p. 7-8).
Dual-Process Model of Grieving: The dual-process model takes into consideration that bereaved individuals move back and forth between grieving and preparing for life without their loved one (Stroebe & Schut, 2001; Stroebe, Schut, & Stroebe, 2005). This model focuses on a loss orientation, which emphasizes the feelings of loss and yearning for the deceased and a restoration orientation, which centers on the grieving individual reestablishing roles and activities they had prior to the death of their loved one. When oriented toward loss grieving individuals look back, and when oriented toward restoration they look forward. As one cannot look both back and forward at the same time, a bereaved person must shift back and forth between the two. Both orientations facilitate normal grieving and interact until bereavement has completed.
Grief: Loss of Children and Parents
Loss of a Child: According to Parkes and Prigerson (2010), the loss of a child at any age is considered “the most distressing and long-lasting of all griefs” (p. 142). Bereaved parents suffer an increased risk to both physical and mental health and exhibit an increased mortality rate. Additionally, they earn higher scores on inventories of grief compared to other types of bereavement. Of those recently diagnosed with depression, a high percentage had experienced the death of child within the preceding six months, and 8 percent of women whose child had died attempted or committed suicide. Archer (1999) found that the intensity of grief increased with the child’s age until the age of 17, when it declined. Archer explained that women have a greater chance of having another child when younger, and thus with added age comes greater grief as fertility declines. Certainly, the older the child the more the mother has bonded with the child and will experience greater grief.
Even when children are adults, parents may experience intense grief, especially when the death is sudden. Adult children dying in traffic accidents was associated with parents experiencing more intense grief and depression, greater symptoms on a health check list, and more guilt than those parents whose adult children died from cancer (Parkes & Prigerson, 2010). Additionally, the deaths of unmarried adult children still residing at home and those who experienced alcohol and relationship problems were especially difficult for parents. Overall, in societies in which childhood deaths are statistically infrequent, parents are often unprepared for the loss of their daughter or son and suffer high levels of grief.
Loss of Parents in Adulthood: In contrast to the loss of a child, the loss of parents in adult life is much more common and results in less suffering. In their literature review, Moss and Moss (1995) found that the loss of a parent in adult life is “rarely pathological.” Those adult children who appear to have the most difficulty dealing with the loss of a parent are adult men who remain unmarried and continue to live with their mothers. In contrast, those who are in satisfying marriages are less likely to require grief assistance (Parkes & Prigerson, 2010). To determine the effects of gender on parental death, Marks, Jun and Song (2007) analyzed longitudinal data from the National Survey of Families and Households that assessed multiple dimensions of psychological well-being in adulthood including depression, happiness, self-esteem, mastery, psychological wellness, alcohol abuse, and physical health. Findings indicated that a father’s death led to more negative effects for sons than daughters, and a mother’s death lead to more negative effects for daughters.
Loss of Parents in Childhood: Parental deaths in childhood have been associated with adjustment problems that may last into adulthood. Ellis, Dowrick and Lloyd-Williams (2013) identified several negative outcomes associated with childhood grief including increased chance of substance abuse, greater susceptibility to depression, higher chance of criminal behavior, school underachievement, and lower employment rates. Typically, professional help is not required in helping children and teens who are dealing with the death of a loved one. However, Worden (2002) identified ten “red flags” displayed by grieving children that may indicate the need for professional assistance:
• Persistent difficulty in talking about the dead person
• Persistent or destructive aggressive behavior
• Persisting anxiety, clinging, or fears
• Somatic complaints (stomachaches, headaches)
• Sleeping difficulties
• Eating disturbance
• Marked social withdrawal
• School difficulties or serious academic reversal
• Persistent self-blame or guilt
• Self-destructive behavior
As parents may also be dealing with funeral arrangements and other end of life matters, they may not always have the time to address questions and concerns that children may have. When explaining death to children it is important to use real words, such as died and death (Dresser & Wasserman, 2010). Children do not understand the meanings of such phrases as “passed away”, “left us”, or “lost”, and they can become confused as to what happened. Saying a loved one died of a disease called cancer, is preferable to saying he was “very sick”. The child may become worried when others become sick that they too will die. Consequently, it is important that children have someone who will listen to, and accurately address their concerns.
Mourning
As a society, are we given the tools and time to adequately mourn? Not all researchers agree that we do. The "death-denying, grief-dismissing world" is the modern world (Kübler-Ross & Kessler, 2005, p. 205). We often grieve privately, quickly, and medicate our suffering with substances or activities. Employers grant 3 to 5 days for bereavement, if the loss is that of an immediate family member, and such leaves are sometimes limited to no more than one per year. Yet grief takes much longer and the bereaved are seldom ready to perform well on the job after just a few days. Obviously life does have to continue, but we need to acknowledge and make more caring accommodations for those who are in grief.
Four Tasks of Mourning: Worden (2008) identified four tasks that facilitate the mourning process. Worden believes that all four tasks must be completed, but they may be completed in any order and for varying amounts of time. These tasks include:
• Acceptance that the loss has occurred
• Working through the pain of grief
• Adjusting to life without the deceased
• Starting a new life while still maintaining a connection with the deceased
Support Groups: Support groups are helpful for grieving individuals of all ages, including those who are sick, terminal, caregiving, or mourning the loss of a loved one. Support groups reduce isolation, connect individuals with others who have similar experiences, and offer those grieving a place to share their pain and learn new ways of coping (Lynn & Harrold, 2011). Support groups are available through religious organizations, hospitals, hospice, nursing homes, mental health facilities, and schools for children.
Viewing death as an integral part of the lifespan will benefit those who are ill, those who are bereaved, and all of us as friends, caregivers, partners, family members and humans in a global society. | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.10%3A_Grief_Bereavement_and_Mourning.txt |
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Parkes, C. M., & Prigerson, H. G. (2010). Bereavement: Studies of grief in adult life. New York: Routledge.
Pattison, E. M. (1977). The experience of dying. Englewood Cliffs, N. J.: Prentice-Hall.
Pew Research Center. (2013). Views on end-of-life medical treatment. Retrieved from http://www.pewforum.org/2013/11/21/v...al-treatments/
ProCon.org. (2016). State-by-state guide to physician-assisted suicide. Retrieved from http://euthanasia.procon.org/view.re...ourceID=000132
Redfoot, D., Feinberg, L., & Houser, A. (2013). The aging of the baby boom and the growing care gap: A look at future declines in the availability of family caregivers. AARP. Retrieved from http://www.aarp.org/content/dam/aarp...RP-ppi-ltc.pdf
Schechter, H. (2009). The whole death catalog. New York: Ballantine Books.
Searight, H. R., & Gafford, J. (2005a). Cultural diversity at end of life: Issues and guidelines for family physicians. American Family Physician, 71(3), 515-522.
Searight, H. R., & Gafford, J. (2005b). “It’s like playing with your destiny”: Bosnian immigrants’ views of advance directives and end-of-life decision-making. Journal or Immigrant Health, 7(3), 195-203.
Shannon, J. B. (2006). Death and dying sourcebook. Detroit, MI: Omnigraphics.
Stroebe, M. S., & Schut, H. (2001). Meaning making in the duel process model of coping with bereavement. In R. A. Neimeyer (Ed.), Meaning, reconstruction and the experience of loss (pp. 55-73). Washington, DC: American Psychological Association.
Stroebe, M. S., Schut, H., & Stroebe, W. (2005). Attachment in coping with bereavement: A theoretical integration. Review of General Psychology, 9, 48-66.
Sweeting, H., & Gilhooly, M. (1997). Dementia and the phenomenon of social death. Sociology of Health and Illness, 19, 93– 117.
Taylor, S. E., Kemeny, M. E., Reed, G. M., Bower, J. E., & Gruenewald, T. L. (2000). Psychological resources, positive illusions, and health. American Psychologist, 55(1), 99-109.
Telford, K., Kralik, D., & Koch, T. (2006). Acceptance and Denial: Implications for People Adapting to chronic illness: Literature review. Journal of Advanced Nursing, 55, 457-464.
Uniform Law Commissioners. (1980). Defining death: medical, legal and ethical issues in the definition of death. Washington, DC: US Government Printing Office, 1981159–166.166
Weitz, R. (2007). The sociology of health, illness, and health care: A critical approach (4th ed.). Belmont, CA: Thomson/Wadsworth.
Worden, J. W. (2002). Children and grief: When a parent dies. London: Guilford Press.
Worden, J. W. (2008). Grief counseling and grief therapy: A handbook for the mental health practitioner (4th ed.). New York: Springer Publishing company.
World Health Organization. (2016). The top ten causes of death. Retrieved from http://www.who.int/mediacentre/facts...en/index2.html
Youdin, R. (2016). Psychology of aging 101. New York: Springer Publishing Company.
11.01: OER Attribution Information
Chapter 1
Parts of the Introduction "African Virtual University" by John T. Phiri is licensed under CC BY 2.5
Throughout Chapter "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Parts of Theorists and Research Methods "Introducing to Psychology [Adapted from Charles Stangor, Introduction to Psychology]" by Martha Lally and Suzanne Valentine-French is licensed under CC BY 3.0/ A derivative of the original work
Chapter 2
Throughout Chapter "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Chapter 3
Throughout Chapter "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Parts of Language Section "Introducing to Psychology [Adapted from Charles Stangor, Introduction to Psychology]" by Martha Lally and Suzanne Valentine-French is licensed under CC BY 3.0/ A derivative of the original work
Parts of Parenting "The Developing Parent" by NOBA is licensed under CC BY 3.0.
Chapter 4
Throughout Chapter "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Theory of Mixed "Theory of Mind" by NOBA is licensed under CC BY 4.0
Chapter 5
Throughout Chapter "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Education Topics "Educational Psychology" by Kelvin Seifert is licensed under CC BY 3.0
Intelligence and Moral Development "Introducing to Psychology [Adapted from Charles Stangor, Introduction to Psychology]" by Martha Lally and Suzanne Valentine-French is licensed under CC BY 3.0/ A derivative of the original work
Chapter 6
Peers and Romantic Relationships "Adolescent Development" by NOBA is licensed under CC BY 3.0
Chapter 7
Sexual Responsiveness Peak, Friendships, Love, and Tacit Knowledge "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Parenthood "The Developing Parent" by NOBA is licensed under CC BY 3.0
Chapter 8
Mechanics of Cognition, Aspects of Midlife Crisis, and Aspects of Family Relationships "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Intelligence "Introducing to Psychology [Adapted from Charles Stangor, Introduction to Psychology]" by Martha Lally and Suzanne Valentine-French is licensed under CC BY 3.0/ A derivative of the original work
Aspects of Physical Aging "Psychology" by Boundless is licensed under CC BY 3.0
Stress "The Healthy Life" by NOBA is licensed under CC BY-SA 3.0
Friendship "Love, Friendship, and Social Support" by NOBA is licensed under CC BY 3.0
Chapter 9
Aspects of Aging "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0
Successful Aging and Social Networks "Aging" by NOBA is licensed under CC BY 3.0
Chapter 10
Aspects of Death, Kubler-Ross Model, and Anticipatory Grief "Psyc 200 Lifespan Psychology" by Laura Overstreet is licensed under CC BY 3.0 | textbooks/socialsci/Psychology/Developmental_Psychology/Lifespan_Development_-_A_Psychological_Perspective_(Lally_and_Valentine-French)/10%3A_Death_and_Dying/10.R%3A_Death_and_Dying_%28References%29.txt |
This book is about exceptional students and will discuss the role of teachers and clinicians who work together to support exceptional students in various clinical settings, including public schools in the United States.
Exceptional students are children and adolescents whose educational needs are not met by traditional educational programs and include students who are at risk for delayed development and those with specific disabilities. Exceptional students also include those who are capable of performing at higher levels than others of the same age. These students are referred to as gifted and talented and may also experience the need for additional support. Gifted and talented students may also have specific disabilities. These students are referred to as twice exceptional.
The Individuals with Disabilities Education Act (IDEA) defines a child with a disability as having an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, any other health impairment, a specific learning disability, deaf–blindness, or multiple disabilities, and who needs special education and related services. We will discuss each of these disability categories in future chapters.
In addition, throughout this book we will discuss the different federal and state laws governing the education of exceptional students. It is important for educators and clinicians who work with exceptional students to understand how federal and state laws are made and how these laws influence their work.
• 1.1: How Federal Laws Are Made
Congress is the legislative branch of the federal government in the United States and makes laws for the nation. Congress has two legislative bodies or chambers: the United States Senate and the United States House of Representatives.
• 1.2: Special Education and Related Services
Special education is instruction specifically designed to meet the individual needs of exceptional students. IDEA defines special education as instruction and related services specifically designed, at no cost to parents, to meet the unique needs of a child with a disability, including instruction conducted in the classroom, the home, hospitals, institutions, and other settings and includes instruction in physical education.
• 1.3: The Individuals with Disabilities Education Act
In 1975, President Gerald Ford signed the Education for All Handicapped Children Act (EHA), which guaranteed a free and appropriate public education for children with disabilities in the United States. In 1990, the law was reauthorized and renamed the Individuals with Disabilities Education Act (IDEA).
• 1.4: The Pre-Referral Process
Students are identified for special education and related services through a system of referrals beginning with the pre-referral process. Many schools have established school-based student assistance teams (SATs) to facilitate the assessment and identification of exceptional students. The SAT is a team of educators, specialists, and clinicians who monitor the progress of students that may require special education and related services.
• 1.5: The Referral Process
If the tiered interventions do not result in improvement, a formal referral is made for evaluation to determine eligibility for special education and related services. At this point, parents must be notified and give their consent for the evaluation. IDEA specifies that a child must be evaluated within 60 days of receiving parental consent or within any period established by the state.
• 1.6: Multi-Tiered System of Support
Another proactive instructional model or framework for preventing both academic and non-academic issues is called a Multi-Tiered System of Support (MTSS).
• 1.7: Early Childhood Intervention Services
Early intervention services incorporate education, health care, and social services and are provided to infants and toddlers (under age 3) who have a disability or are exhibiting developmental delays, as well as their families. Children who are considered at risk for developmental delays also receive early intervention services.
• 1.8: The Individualized Education Program
The multidisciplinary team (MDT) is required to develop an IEP for each student receiving special education and related services. The purpose of an IEP is to provide an appropriate education that meets the specialized needs of each student.
• 1.9: Transition from School to Post-School Activities
The IDEA requires transition planning and transition services for students 16 to 22 years of age. In Illinois, transition planning must begin at age 14 ½. Transition services facilitate the transition from school to post-school activities including postsecondary education, vocational education, employment, continuing and adult education, and independent living.
• 1.10: Chapter Questions and References
01: Introduction and Foundations of Special Education
Congress is the legislative branch of the federal government in the United States and makes laws for the nation. Congress has two legislative bodies or chambers: the United States Senate and the United States House of Representatives. Anyone elected to either body can propose a new law. A bill is a proposal for a new law. Either chamber then follows these steps:
1. Once a bill is introduced, it is assigned to a committee whose members research, discuss, and make changes to the bill.
2. The bill is then put before that chamber to be voted on.
3. If the bill passes one body of Congress, it goes to the other body to undergo a similar process of research, discussion, changes, and voting.
4. Once both bodies vote to accept a bill, they must work out any differences between the two versions. Both chambers then vote on the same bill and, if it passes, they present it to the president.
5. The president then considers the bill. The president can approve the bill and sign it into law or veto the bill.
6. If the president chooses to veto a bill, in most cases Congress can vote to override that veto and the bill becomes a law. However, if the president pocket vetoes a bill after Congress has adjourned, the veto cannot be overridden.
The United States Code contains our federal laws. New federal laws appear in each edition of the United States Statutes at Large. There is a new edition for each session of Congress.
In addition, laws that appropriate (i.e., assign to a particular recipient, purpose, or use) funding include provisions that require Congress to decide, after a set period, whether the legislation should be reauthorized. To do this, a new bill must be introduced that reauthorizes the provisions of the law, makes any necessary changes to the original law, and sets a new timeline for future reauthorizations.
For example, in 1965 President Lyndon B. Johnson signed into law the Elementary and Secondary Education Act (ESEA), the federal law governing public education in the United States. ESEA has been reauthorized six times. In 2015, President Barack Obama signed the most recent reauthorization of the law, the Every Student Succeeds Act (ESSA). The purpose of ESSA is to ensure public schools provide a quality education to all students, including exceptional students.
IDEA is the federal law that ensures all students with disabilities receive an appropriate education through special education and related services in the United States. We will talk more about these and other laws that impact the education of exceptional students later in this chapter.
In addition, individual states also pass laws that impact the education of exceptional students. Illinois, like Congress, has two bodies, the Senate and the House of Representatives, which together are called the Illinois General Assembly. A bill becomes a law in Illinois when it passes both houses of the Illinois General Assembly with a majority vote in each house and is signed by the governor.
The Illinois Compiled Statutes contain our state laws. State laws must meet the requirements of federal laws and may add to the federal requirements (e.g., providing additional services). In addition, state education agencies, such as the Illinois State Board of Education, are tasked with writing administrative rules. Administrative rules interpret the law and guide the actions of those affected (e.g., state agency staff, educators and clinicians, school boards). | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/01%3A_Introduction_and_Foundations_of_Special_Education/1.01%3A_How_Federal_Laws_Are_Made.txt |
Special education is instruction specifically designed to meet the individual needs of exceptional students. IDEA defines special education as instruction and related services specifically designed, at no cost to parents, to meet the unique needs of a child with a disability, including instruction conducted in the classroom, the home, hospitals, institutions, and other settings and includes instruction in physical education.
In addition to the general education classroom, special education may occur partially within the general education classroom, in a separate classroom for students with disabilities, or in a separate school that includes just students with disabilities. In addition, some students require residential facilities as well as home- or hospital-based instruction. However, special education should be provided in the least restrictive environment, which, whenever possible, is the general education classroom; and the student should participate in the general education curriculum with appropriate adaptations and modifications.
Special education may be implemented by different professionals, including special education teachers specifically trained to support students with disabilities or a general education teacher who teaches in a classroom that includes children with and without disabilities. Special education teachers, specialists, and clinicians collaborate with the general education teacher to plan and assist in instruction.
Related services enable a student with a disability to receive a free and appropriate public education. Related services are based on individual student needs and may include the following services.
Early Identification and Assessment
Early childhood screening and assessment is often provided by local health services to determine if a child is experiencing developmental or cognitive delays. Appropriate interventions can then be implemented to mediate the effects of an existing disability or reduce the risks associated with other conditions such as malnourishment or low birth weight.
Social Work Services
Social workers act as advocates for students with disabilities and their families. Social workers help students and their families access the community resources they need (e.g., housing, supplemental nutrition assistance, medical care) to ensure their health and safety.
Speech–Language Services
Speech and language pathologists work with students who have communication disorders. These clinicians perform assessments and evaluations, monitor student progress, and provide appropriate interventions.
Audiology Services
Audiologists are clinicians who assess the degree and type of hearing loss a student may be experiencing. Audiologists also fit, adjust, and maintain assistive listening devices such as hearing aids. In some cases, audiologists may provide counseling to students who have experienced hearing loss as well as make recommendations for adaptations and assistive technology that can aid students.
Interpreting Services
Interpreters work with students who use sign language to communicate. Interpreters accompany students to provide sign language interpretation to other educators, specialists, or clinicians who may not use sign language.
Psychological Services
School psychologists support student behavior, development, learning, and mental health. They perform psychological assessments and observe students in classroom settings to determine if a student is eligible for special education.
Physical Therapy
Physical therapists work with students with physical disabilities or health impairments to help restore function and improve mobility.
Occupational Therapy
Occupational therapists work with students with disabilities to improve and maintain skills needed for everyday activities (e.g., gross and fine motor skills). Occupational therapists also provide information for students who may have sensory needs such as sensitivity to light or sounds.
School Counseling Services
School counselors provide academic and career counseling. In addition, school counselors provide short-term individual and small group counseling. They support students with disabilities by helping them recognize their strengths and develop self-advocacy skills.
Rehabilitation Counseling Services
Rehabilitation counselors help students with disabilities transition from school to employment and independent living. Rehabilitation counselors can also assist schools in accommodating the individual needs of students.
Orientation and Mobility Services
Orientation and mobility specialists teach students with vision loss how to navigate within environments and from one environment to another. They assist students in traveling independently and can work with students on the use of canes, guide dogs, wheelchairs, and public transportation.
School-Based Health Services
Some students with health impairments or multiple disabilities require services such as tube feeding and catheterization. School nurses may provide these services or may train school staff to carry out such services when special medical knowledge and training is not required.
Parent Training and Counseling Services
Parent training and counseling services provide families with information about the special needs of their student, providing information about resources available to them to support their student’s progress.
Therapeutic Recreational Services
Therapeutic recreation focuses on leisure skills and includes assessing individuals’ leisure functioning, developing and implementing recreation programs in schools and community agencies, and working with others to implement leisure education.
In Illinois, the law also provides for transportation as a related service. Transportation services ensure student access to an appropriate education. For example, a student with a physical disability may require a wheelchair lift. Other students may require transportation to a special education program located outside of their home school or district. In addition, while not included in the IDEA definition of non-academic services, students may also receive art and music therapy.
Necessary related services are determined by the team responsible for developing a student’s individualized education program (IEP), an overall plan for the student’s education that IDEA requires and that this chapter discusses later. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/01%3A_Introduction_and_Foundations_of_Special_Education/1.02%3A_Special_Education_and_Related_Services.txt |
In 1975, President Gerald Ford signed the Education for All Handicapped Children Act (EHA), which guaranteed a free and appropriate public education for children with disabilities in the United States. In 1990, the law was reauthorized and renamed the Individuals with Disabilities Education Act (IDEA). Before EHA, many children with disabilities were denied a public education in the United States. Since the signing of EHA, significant progress has been made toward meeting the goal of providing a free and appropriate public education for children with disabilities. In 2021, approximately 7.2 million or 15% of all public-school students received special education and related services (NCES, 2022). IDEA includes the following foundational requirements.
Free Appropriate Public Education
Students with disabilities must be given a free appropriate public education (FAPE). FAPE includes education services designed to meet the individual education needs of students with disabilities as adequately as the needs of nondisabled students at no cost to the family.
Child Find
States are required to develop procedures for identifying and tracking the number of students who are at risk for delayed development and those with disabilities.
Nondiscriminatory Evaluation
A nondiscriminatory evaluation is an evaluation that does not discriminate on the basis of language, culture, and student background and must be provided for each student identified for special education.
Individualized Education Program
An IEP is a plan developed to meet the special education needs of students with disabilities.
Least Restrictive Environment
The least restrictive environment is the setting most like that of students without disabilities that also meets each student’s educational needs.
Due Process
Due process guarantees the right to an impartial hearing if appropriate procedures outlined in the law are not followed and parents or schools believe that special education programs do not meet the student’s educational needs.
Parent Participation
Parent participation and shared decision making must be included in all aspects of the identification and education of students with disabilities.
The Disability Rights Movement
In the 1960s, the civil rights movement began to take shape, and disability rights advocates saw an opportunity to join forces with other minority groups to demand equal access and equal opportunity for people with disabilities. At the forefront of this fight were parent advocates demanding that their children have the opportunity to attend public schools and have the same opportunities to learn as children who were not disabled.
In the 1970s, these activists lobbied Congress and marched on Washington to include civil rights language for people with disabilities into the Rehabilitation Act. In 1973, the Rehabilitation Act was passed, and for the first time in history, the civil rights of people with disabilities were protected by law.
The Rehabilitation Act (Section 504) provided equal opportunity for employment within the federal government and in federally funded programs, prohibiting discrimination on the basis of either physical or mental disability. Section 504 of the Rehabilitation Act also mandated equal access to public services (e.g., public housing and public transportation) for people with disabilities and the allocation of money for vocational training.
In 1975, the Education for All Handicapped Children Act (EHA) was passed to guarantee equal access to public education for children with disabilities. This act of legislation specified that every child had a right to an education.
In the 1980s, disability rights activists lobbied for a consolidation of various pieces of legislation under one civil rights law that would protect the rights of people with disabilities. The Civil Rights Act of 1964 prohibited discrimination on the basis of race, religion, national origin, or gender, but people with disabilities were not included in this law.
In 1990, the Americans with Disabilities Act (ADA) was passed, ensuring the equal treatment and equal access of people with disabilities to employment opportunities and public accommodations. The ADA prohibits discrimination on the basis of disability in employment, services rendered by state and local governments, places of public accommodation, transportation, and telecommunications services. Unfortunately, people with disabilities still face barriers in our society, but the disability rights movement continues to work toward their empowerment and self-determination (Smiley et al., 2022).
Activity \(1\): Virtual Tour of the Patient No More Exhibit
Directions: Take a virtual tour of the Patient No More exhibit at the Paul K. Longmore Institute on Disability website. This exhibit explores the 1977 "Section 504 Sit-In," when people with disabilities occupied a government building to demand civil rights. This protest paved the way for the ADA and profoundly changed the lives of Americans with and without disabilities. Why do you think it is important to know the history and requirements of federal and state laws concerning people with disabilities?
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/01%3A_Introduction_and_Foundations_of_Special_Education/1.03%3A_The_Individuals_with_Disabilities_Education_Act.txt |
Students are identified for special education and related services through a system of referrals beginning with the pre-referral process. Many schools have established school-based student assistance teams (SATs) to facilitate the assessment and identification of exceptional students. The SAT is a team of educators, specialists, and clinicians who monitor the progress of students that may require special education and related services. This team helps teachers by suggesting appropriate research-based instructional or behavioral interventions as well as reasonable accommodations or modifications to see if the student can succeed in the general education classroom. This process allows the team to identify whether the student requires additional instruction or special education and related services. The pre-referral process is part of a larger schoolwide system called response to intervention (Smiley et al., 2022).
Response to Intervention
Response to intervention (RTI) is a proactive instructional model or framework for preventing academic issues in the early elementary grades and a remediation framework for improving outcomes in academics and behavior in upper elementary and secondary grades. The components of RTI include the following.
• Screening refers to academic and behavioral assessments that are administered to all students two to three times throughout the school year.
• Progress monitoring refers to more frequent assessments given to students to determine which strategies or interventions are most effective.
• Tier 1 includes research-based whole class instruction. Tier 1 strategies meet the needs of most students, but if a student is not making adequate progress, they will receive Tier 2 interventions.
• Tier 2, or secondary interventions, are for students who are not making adequate progress under Tier 1. These students are provided with additional academic instruction or behavioral interventions.
• Tier 3, or intensive individualized interventions, are for students who did not make adequate progress under Tier 2. These students are provided with additional academic instruction or behavioral interventions that occur more frequently and for longer periods. At this point, if students continue to fail to make adequate progress, their parents are contacted to consent to the special education referral process (Smiley et al., 2022)
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
1.05: The Referral Process
If the tiered interventions do not result in improvement, a formal referral is made for evaluation to determine eligibility for special education and related services. At this point, parents must be notified and give their consent for the evaluation. IDEA specifies that a child must be evaluated within 60 days of receiving parental consent or within any period established by the state. Students must meet eligibility criteria to receive special education and related services related to one or more of the disabilities categories identified in IDEA.
In addition, IDEA includes a special rule for eligibility determination that states a child cannot be considered to have a disability if the determining factor is lack of appropriate instruction in reading, including the essential components of reading instruction; a lack of instruction in math; or limited English proficiency. In other words, these factors must be ruled out as a primary determinant of the child’s difficulties in school.
Next, a multidisciplinary team (MDT) conducts evaluation procedures to determine if the child meets eligibility criteria. Most students are administered educational and psychological tests. Traditionally, the MDT uses norm-referenced tests (i.e., tests designed to compare and rank test takers in relation to one another) are used to help make eligibility decisions. It may also use other procedures such as interviews, developmental histories, checklists, and behavior rating scales.
Two areas frequently evaluated using norm-referenced tests are intelligence and academic achievement. Intelligence tests are used to determine a student’s intelligence quotient (IQ), which can be used to help make decisions regarding the most appropriate disability category for a student if the category includes IQ as a criterion. Achievement test scores are often used as one eligibility criterion, typically to document the student’s academic performance in reading and math. The specific methods of identifying exceptional students are discussed in chapters focusing on specific disabilities (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/01%3A_Introduction_and_Foundations_of_Special_Education/1.04%3A_The_Pre-Referral_Process.txt |
Another proactive instructional model or framework for preventing both academic and non-academic issues is called a Multi-Tiered System of Support (MTSS). RTI is a model for identifying and addressing academic issues. MTSS has a broader scope, addressing academic and non-academic issues such as social and emotional problems, including behavior. RTI may be included in the MTSS framework.
1.07: Early Childhood Intervention Services
Early intervention services incorporate education, health care, and social services and are provided to infants and toddlers (under age 3) who have a disability or are exhibiting developmental delays, as well as their families. Children who are considered at risk for developmental delays also receive early intervention services. A child may be considered at risk if they are experiencing homelessness, have a primary caregiver who abuses drugs or alcohol, have a primary caregiver who is diagnosed with a chronic illness or psychological disorder, or are a victim of abuse or neglect.
Children who receive early intervention services have an individualized family service plan (IFSP) supervised by a state appointed case manager. Unlike the IEP, the IFSP also includes services for the child’s family (e.g., counseling). IFSPs must also be developed by a multidisciplinary team and should include the following:
• A description of the child’s gross motor skills, fine motor skills, speech and language, cognitive and intellectual development, and social and emotional development.
• An assessment of the family and their needs as they relate to supporting the child’s development.
• A description of the goals or outcomes expected for the child and the family.
• A description of the early intervention services required.
• Procedures for measuring progress, including timelines, objectives, and evaluation procedures.
• A description of the environments in which the early intervention services will be provided.
• A transition plan from to a preschool program after age 3.
Special education and related services are also provided to children in preschool (ages 3 to 5). In preschool, an IEP will replace the IFSP (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
1.08: The Individualized Education Program
The multidisciplinary team (MDT) is required to develop an IEP for each student receiving special education and related services. The purpose of an IEP is to provide an appropriate education that meets the specialized needs of each student. The MDT includes a representative of the local education agency, the classroom teacher, the special education teacher, parents or guardians, a person who can interpret the instructional implications of evaluation or assessment results, and, when appropriate, the student.
Depending on the student’s needs, the MDT also includes professionals from related services (e.g., social workers, speech and language pathologists, psychologists, and occupational therapists) and may include other professionals or specialists, such as doctors. Each IEP must include the following information:
• The student’s present levels of academic achievement and functional performance, including how the disability affects the student’s involvement in the general education curriculum.
• Measurable annual goals, including short-term benchmarks or objectives.
• Special education and related services to be provided to the student, as well as any modifications or other supports. This may include additional school personnel such as paraprofessionals.
• An explanation of the extent, if any, to which the student will participate with nondisabled students in the general education classroom and in other school settings or activities.
• Individual modifications for the administration of statewide or districtwide assessments or an explanation of why those assessments are inappropriate for the student and what alternative methods will be used to assess the student.
• A projected date for the beginning of services and their anticipated frequency, location, and duration.
• In Illinois, by age 14 1/2, the IEP must contain transition services designed to help the student prepare for postsecondary education, vocational education, employment, continuing and adult education, and independent living (Smiley et al., 2022).
Activity \(1\): Exploring IEP Forms
Directions: Most states provide teachers with IEP template forms. Explore the forms on the Illinois State Board of Education website. Why do you think this documentation is important?
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
1.09: Transition from School to Post-School Activities
The IDEA requires transition planning and transition services for students 16 to 22 years of age. In Illinois, transition planning must begin at age 14 ½. Transition services facilitate the transition from school to post-school activities including postsecondary education, vocational education, employment, continuing and adult education, and independent living. An important component of transition services are individualized transition plans (ITPs,) which are incorporated into IEPs. ITPs include the designation of appropriate and measurable postsecondary goals based on age-appropriate transition assessments related to training, education, employment, and independent living skills. ITPs are also based on the student’s preferences and interests as well as their needs. ITPs include a coordinated effort between state agencies, service providers, and vocational and rehabilitation services (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
1.10: Chapter Questions and References
1. Who are exceptional students?
2. What are special education and related services?
3. What federal laws govern special education?
4. What are the pre-referral process and the referral process?
5. What information does an individualized education plan include? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/01%3A_Introduction_and_Foundations_of_Special_Education/1.06%3A_Multi-Tiered_System_of_Support.txt |
• 2.1: What is Collaboration?
Collaboration is a necessity when working with exceptional students. Exceptional students may receive instruction in a general education classroom with the support of a special educator and paraprofessional while also receiving related services from different clinicians throughout the school day.
• 2.2: Collaboration Among Teachers
Teachers use different co-teaching models. When co-teaching, general and special education teachers or other specialized teachers (e.g., reading specialists) work together to plan and facilitate lessons for a class that includes students with disabilities.
• 2.3: Collaboration with Paraprofessionals
Teachers and clinicians regularly collaborate with paraprofessionals, who are sometimes referred to as paraeducators, aides, or education support professionals. Paraprofessionals provide specific classroom or student support and are supervised by teachers.
• 2.4: Collaboration with Clinicians
Teachers and clinicians collaborate when students receive related services. The Individuals with Disabilities Education Act (IDEA) ensures that related services are delivered in a student’s least restrictive environment.
• 2.5: Collaboration with Teams
In addition to collaborating with individuals, teachers and clinicians collaborate on teams, specifically on multidisciplinary teams (MDTs) that require the meaningful involvement of students and families.
• 2.6: Collaborations with Families
The IDEA ensures students and their families are involved in the education process. For example, states must provide Parent Training and Information Centers and Community Parent Resource Centers. These centers help students with disabilities and their families understand their rights and connect them with appropriate services.
• 2.7: Increasing Student Involvement
It is important for students to participate actively in their IEP meetings beginning in elementary school and to be actively involved in their transition planning in high school. Student participation in IEP meetings can be improved by ensuring families know their child is invited to participate.
• 2.9: Collaboration with Communities
Future teachers and clinicians will work with community organizations when students transition from early intervention to preschool to school-age programs and when they transition from high school to postsecondary education, employment, and independent living. Identifying the best practices associated with community collaboration is essential.
• 2.10: Chapter Questions and References
02: Working Collaboratively
Collaboration is a necessity when working with exceptional students. Exceptional students may receive instruction in a general education classroom with the support of a special educator and paraprofessional while also receiving related services from different clinicians throughout the school day. All these professionals work together to support the student's needs by providing different types of knowledge and expertise. In special education, collaboration also includes different models that educators, clinicians, and paraprofessionals might use to structure their interactions (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.02: Collaboration Among Teachers
Teachers use different co-teaching models. When co-teaching, general and special education teachers or other specialized teachers (e.g., reading specialists) work together to plan and facilitate lessons for a class that includes students with disabilities. Co-teaching allows each teacher to utilize their expertise to meet individual student needs and promote student learning. The following are different co-teaching models. Each model has strengths and weaknesses; it is up to the collaborating teachers to determine what model will work best for their specific circumstances.
One Teach, One Observe
In the one teach, one observe model, one teacher teaches while the other observes during instruction. For example, while the general education teacher is instructing the class, the special education teacher is observing a student with a disability to ensure they are grasping the concepts taught in the lesson.
One Teach, One Assist
In one teach, one assist, one teacher assumes greater responsibility for planning and facilitating instruction. The assisting teacher observes and provides support to students as needed. The one teach, one assist model extends the one teach, one observe model and works well when co-planning time is limited.
Station Teaching
In station teaching, teachers divide a lesson into parts, and each teacher instructs a small group of students at a station. The groups then rotate between stations. This model is often used at the elementary level. For example, when teaching a math lesson, one teacher might instruct a group on using manipulatives to solve a problem while the other teacher instructs a group on solving the same problem using mathematical computation.
Parallel Teaching
In parallel teaching, each teacher presents the same lesson to a small group of students. The primary benefit of this model is the smaller teacher-to-student ratio. This model is best for reviewing material that has already been taught.
Supplemental or Alternative Teaching
In supplemental teaching, one teacher works with students at their expected grade level, while the other works with students requiring remediation (i.e., re-teaching) or enrichment. For example, one teacher may work with a group of students who have fallen behind because of repeated absences.
Teaming
In teaming, teachers take equal responsibility for planning and instruction. This model is the most collaborative of all the co-teaching models. Teachers regularly change roles, each taking the lead and assisting when needed (Friend et al., 2010; Smiley et al., 2022).
Friend, M., Cook., L., Hurley-Chamberlain, D., & Shamberger, C. (2010). Co-teaching: An illustration of the complexity of collaboration in special education. Journal of Educational and Psychological Consultation, 20(1), 9–27.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.03: Collaboration with Paraprofessionals
Teachers and clinicians regularly collaborate with paraprofessionals, who are sometimes referred to as paraeducators, aides, or education support professionals. Paraprofessionals provide specific classroom or student support and are supervised by teachers. For example, a paraprofessional assigned to a classroom might tutor students or assist the teacher with classroom management and instructional material organization. When a paraprofessional is hired to support an individual student, they will accompany that student to their classes and school-related activities to provide assistance and instructional support. It’s important for teachers, clinicians, and paraprofessionals to build positive, trusting relationships to best support students. Administrators should provide a time for teachers and paraprofessionals to plan and train together (Smiley et al., 2022).
Activity \(1\): Teacher and Paraprofessional Collaboration
Directions: Read Working With Paraeducators: Tools and Strategies for Planning, Performance Feedback, and Evaluation. How can teachers incorporate paraprofessionals into instructional planning and delivery effectively?
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/02%3A_Working_Collaboratively/2.01%3A_What_is_Collaboration.txt |
Teachers and clinicians collaborate when students receive related services. The Individuals with Disabilities Education Act (IDEA) ensures that related services are delivered in a student’s least restrictive environment. For example, if speech services can be delivered effectively in the general education classroom, that should be where services are delivered. If a student’s needs require an environment free from distractions and individualized instruction, services should be delivered in a separate setting. Many clinicians and related service personnel serve students in various schools in a district. For example, a speech–language pathologist may be assigned to work with students in multiple elementary schools in a district. Working in multiple schools can sometimes hinder collaboration because time and resources are limited. Depending on the situation, collaboration with clinicians may occur primarily during individualized education program (IEP) meetings or through scheduled consultations throughout the school year (Downing, 2004; Smiley et al., 2022).
Downing, J.A. (2004). Related services for students with disabilities: Introduction to the special issue. Intervention in School and Clinic, 39(4), 195–208.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.05: Collaboration with Teams
In addition to collaborating with individuals, teachers and clinicians collaborate on teams, specifically on multidisciplinary teams (MDTs) that require the meaningful involvement of students and families. Effective teams clearly define each member’s role and responsibilities, set clear goals defined by students’ needs, and value each team member’s expertise (Friend & Cook, 2013). For example, a middle school student with a learning disability is enrolled in general education courses during the school day. Therefore, her teachers need to collaborate to ensure they are all familiar with the accommodations she needs and how to implement them. This team of teachers would meet regularly to review how this student is progressing academically.
Another example might be an elementary school student with an intellectual disability and a communication disorder who spends a significant portion of the school day with his special education teacher and paraprofessional. The special education teacher and paraprofessional collaborate with the general education teacher and other specialized teachers (e.g., physical education teacher) to ensure the student is included as often as possible with his peers. In addition, a speech–language pathologist works with the student twice weekly and communicates with the special education teacher and paraprofessional about appropriate interventions. The special education teacher and paraprofessional also collaborate daily to meet the student’s needs. Each quarter, the team meets to review the student’s progress (Smiley et al., 2022).
Friend, M., & Cook., L. (2013). Interactions: Collaboration skills for school professionals (7th ed). Pearson.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.06: Collaborations with Families
The IDEA ensures students and their families are involved in the education process. For example, states must provide Parent Training and Information Centers and Community Parent Resource Centers. These centers help students with disabilities and their families understand their rights and connect them with appropriate services. Formal collaboration with families usually occurs during the IEP process. However, sometimes families are not as involved as educators and clinicians would like, but it’s important to remember that there are many possible reasons for limited involvement. For example, some parents may have jobs that limit their ability to participate in IEP meetings during the school day. Others may have limited options for transportation or may not have reliable internet access to participate in remote IEP meetings. Whatever the reason, the school needs to engage in ongoing communication with families and accommodate their needs to encourage participation in their child’s education (Smiley et al., 2022). Importantly, some families may be hesitant to talk with or ask questions of teachers or clinicians. Communicating with families outside of the mandated meetings is critical. Informal daily or weekly communication can help build a relationship between the family, teachers, and clinicians.
Activity \(1\): Explore Parent Training and Information Centers
Directions: Illinois is home to two Parent Training and Information Centers: the Family Resource Center on Disabilities, which serves the Chicago Metro area, and Family Matters Parent Training and Information, which serves the 94 counties in Illinois outside the Chicago area. Explore the resources and services that these centers provide. How might parents and families of children with disabilities benefit from access to these centers?
Culturally and Linguistically Diverse Families
Cultural and linguistic differences between families, teachers, and clinicians may impact the success of collaboration. Educators and clinicians need to use effective communication techniques and work to develop positive and trusting relationships with families (Friend & Cook, 2013). This includes initiating communication, using a communication format and language that accommodates the family's needs, and using translators and interpreters. In addition, educators and clinicians should demonstrate a willingness to learn about the cultures of families whose backgrounds are different from their own (Smiley et al., 2022).
Recognizing implicit bias is critical when working with culturally diverse families and students. Implicit bias is a form of bias that occurs automatically and unintentionally and affects judgments, decisions, and behaviors. When a teacher or clinician interacts with a student or family member from a different background or culture, their implicit biases may impact their conclusions. It is important for teachers and clinicians to assume personal responsibility to better understand and address their own biases.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.07: Increasing Student Involvement
It is important for students to participate actively in their IEP meetings beginning in elementary school and to be actively involved in their transition planning in high school. Student participation in IEP meetings can be improved by ensuring families know their child is invited to participate. Students may feel more empowered to participate when the IEP process is explained to them and when they are invited to take an active role in developing and implementing their IEP. Framing the conversations to build on a student’s strengths and providing a safe environment for students to practice advocating for themselves by asking questions helps make students partners in their own education. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/02%3A_Working_Collaboratively/2.04%3A_Collaboration_with_Clinicians.txt |
Future teachers and clinicians will work with community organizations when students transition from early intervention to preschool to school-age programs and when they transition from high school to postsecondary education, employment, and independent living. Identifying the best practices associated with community collaboration is essential. Community personnel may include early childhood educators, health service professionals, higher education professionals, and other community agency employees such as social workers, employers, and vocational rehabilitation workers. Collaboration with community organizations should facilitate a seamless transition between services and programs (Smiley et al., 2022).
Collaboration in Early Childhood
Collaborative teams in early childhood programs may involve medical and social service professionals (e.g., nurses and social workers), clinicians (e.g., psychologists and speech-language pathologists), early childhood educators and other specialized teachers, and family members. All team members must work together to ensure the student’s needs are met.
As discussed earlier, effective teams clearly define each member’s role and responsibilities, set clear goals determined by the needs of students, and value each team member’s expertise (Friend & Cook, 2013). In addition, teams should be flexible regarding planning and service delivery. For example, services may be delivered in a child’s home, in a preschool or early childhood center, in a medical office, or at another location, such as a community center. Therefore, interagency collaboration and flexibility are necessary to ensure the student's needs are met. Early childhood intervention services may reduce or even prevent the need for special education and related services (Smiley et al., 2022).
Transition to Postsecondary Education, Employment, and Independent Living
The transition from high school to adult living is an important process that involves collaboration with community organizations. The IDEA requires that transition planning begin no later than age 16. In Illinois, transition planning must begin when the student turns 14 1⁄2. Collaboration between school and community organizations supports a smooth transition from high school to postsecondary education, employment, and independent living. Community organizations may help students find employment or housing or participate in community life (e.g., recreational and leisure programming). Colleges and universities may also provide vocational training, certificates, and degree programs for interested students. Interagency agreements are often used to guide these programs (Smiley et al., 2022).
Transition Services
Transition services are a coordinated set of activities within a results-oriented process that promote transition from school to adult living and include the following:
• Instruction (i.e., postsecondary, vocational, and adult education)
• Related services
• Community experiences
• Employment
• Independent living
Transition plans should be based on a student’s interests and preferences. Students may need help identifying postsecondary or vocational interests, applying for jobs, finding appropriate housing, acquiring daily living skills (e.g., budgeting, using public transportation), or learning how to participate in community recreational and leisure opportunities (Friend & Cook, 2013). Classroom learning and related services should support the transitional needs of each student (Smiley et al., 2022).
Planning and Programming
Planning and programming for the transition process involve the IEP team. During transition planning, this team may be expanded to include vocational rehabilitation counselors, vocational evaluators, school counselors, and community organizations that provide employment services, housing, and recreational and leisure opportunities for adults with disabilities. Interagency agreements may also facilitate collaboration with other community organizations (Smiley et al., 2022). In addition, community organizations often develop collaborative relationships with local businesses to provide programming for students with disabilities.
Interagency Agreements
An interagency agreement is a written agreement to which agencies commit that outlines their shared responsibilities for student learning and school, community, and family participation in achieving positive outcomes for students with disabilities. Interagency agreements can be at local or state levels and are required under the IDEA. Schools may invite personnel from other agencies to attend IEP meetings when transition planning and programming will be discussed. Plans are developed as needed to ensure collaboration among agencies and clearly define roles and responsibilities.
Interagency agreements enable agencies to collaborate and function more effectively. For example, an interagency agreement might specify that a school district will provide students with vocational assessments that identify their interests, aptitudes, and current skills. In turn, a vocational rehabilitation agency may assist students in obtaining and maintaining employment in an identified area. Some states also provide what are referred to as wraparound services, where a state agency coordinates and oversees transition services (Smiley et al., 2022).
Activity \(1\): Exploring Transition Services in Illinois
Directions: Equip for Equality is an advocacy group that works to protect the civil and human rights of people with disabilities. They have developed a comprehensive Transition Planning FAQ. Why are advocacy groups like this important for people with disabilities?
Friend, M., & Cook., L. (2013). Interactions: Collaboration skills for school professionals (7th ed). Pearson.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
2.10: Chapter Questions and References
1. What are the six models of co-teaching?
2. What are the characteristics of effective teams?
3. Why is collaboration with community organizations important?
4. What are transition services? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/02%3A_Working_Collaboratively/2.09%3A_Collaboration_with_Communities.txt |
• 3.1: Definitions of Learning Disabilities
The federal definition included in the Individuals with Disabilities Education Act (IDEA) is the most common definition of specific learning disability used in educational settings.
• 3.2: The Illinois Definition of Specific Learning Disability
Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.
• 3.3: Types of Learning Disabilities
Learning disabilities represent a group of disorders that cause students to exhibit unexpected difficulty or low performance in one or more academic areas and ineffective or inefficient information processing.
• 3.4: The History of Learning Disabilities
There has been considerable debate about how to define or categorize learning disabilities. Often, as demonstrated by the definitions at the beginning of this chapter, a learning disability is defined by what it is not.
• 3.5: Prevalence of Learning Disabilities
Among students receiving special education services, 33% are identified as having a specific learning disability, the most common category of disability (National Center for Education Statistics, 2022).
• 3.6: Causes of Learning Disabilities
Among students receiving special education services, 33% are identified as having a specific learning disability, the most common category of disability (National Center for Education Statistics, 2022).
• 3.7: Identifying Students with Learning Disabilities
Students are identified for special education and related services through a system of referrals beginning with the pre-referral process previously discussed in Chapter 1. The pre-referral process is part of a larger schoolwide system called response to intervention (RTI).
• 3.8: Chapter Questions and References
03: Students with Learning Disabilities
The federal definition included in the Individuals with Disabilities Education Act (IDEA) is the most common definition of specific learning disability used in educational settings. However, there are other organizational definitions for specific learning disabilities, as well as state definitions. The IDEA defines learning disabilities as the following.
Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.
Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage (Individuals With Disabilities Education Act [IDEA], Part B, Subpart A § 300.8(c)(10)(2004)).
The NJCLD Definition
In addition to the IDEA definition of learning disabilities, teachers and clinicians should be aware of the definition proposed by the National Joint Committee on Learning Disabilities (2022):
Learning disabilities is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the lifespan. Problems in self-regulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although learning disabilities may occur concomitantly with other disabilities (for example, sensory impairment, intellectual disabilities, emotional disturbance), or with extrinsic influences (such as cultural or linguistic differences, insufficient or inappropriate instruction), they are not the result of those conditions or influences.
Note that this definition attributes learning disabilities to central nervous system dysfunction. The central nervous system comprises the brain and the spinal cord and helps regulate and coordinate the body’s activities. The central nervous system can be damaged by trauma, infections, degeneration, structural defects, tumors, blood flow disruption, and autoimmune disorders that may result in language impairment (Johns Hopkins Medicine, 2022).
The APA Definition
The definition included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association broadly defines learning disabilities and is based on the individual’s family and medical history, as well as observations, interviews, and educational and psychological assessments.
1. Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties:
1. Inaccurate or slow and effortful word reading (e.g., reading single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
2. Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand the sequence, relationship, inferences, or deeper meanings of what is read).
3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants).
4. Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity).
5. Difficulties mastering number sense, number facts, or calculations (e.g., has poor understanding of numbers, their magnitude, and relationships; counts on fingers to add single-digit numbers instead of recalling the math facts as peers do; gets lost in the midst of arithmetic computation and may switch procedures).
6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems).
2. The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment. For individuals age 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment.
3. The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual’s limited capacities (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads).
4. The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction (DSM-5-TR, 2022, p. 76–77).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(10)(2004).
Johns Hopkins Medicine. (2022, September 1). Overview of nervous system disorders. https://www.hopkinsmedicine.org/health/conditions-and-diseases/overview-of-nervous-system-disorders
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. text revision). https://doi.org/10.1176/appi.books.9780890425596 | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/03%3A_Students_with_Learning_Disabilities/3.01%3A_Definitions_of_Learning_Disabilities.txt |
“Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage" (Illinois State Board of Education, 2022).
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, NJCLD, APA, and Illinois definitions of specific learning disability. Consider the differences and similarities between inclusion and exclusion criteria. Which definition resonates with you? Why?
Illinois State Board of Education. (2022, September 1). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx#:~:text=Specific%20learning%20disability%20means%20a,do%20mathematical%20calculations%2C%20including%20conditions
3.03: Types of Learning Disabilities
Learning disabilities represent a group of disorders that cause students to exhibit unexpected difficulty or low performance in one or more academic areas and ineffective or inefficient information processing. Frequently used terms that categorize patterns of learning disabilities include dyslexia, dyscalculia, and dysgraphia.
Dyslexia is a specific learning disability that affects reading and related language-based processing skills. Dyslexia is the most common learning disability. Common characteristics include
• Difficulty with phonemic awareness (the ability to notice, think about, and work with individual sounds in words).
• Phonological processing (detecting and discriminating differences in phonemes or speech sounds).
• Difficulties with word decoding, fluency, rate of reading, rhyming, spelling, vocabulary, comprehension, and written expression.
Dyscalculia is a specific learning disability that affects a person’s ability to understand numbers and learn math facts. Common characteristics include
• Difficulty with counting, learning number facts, and doing math calculations.
• Difficulty with measurement, telling time, counting money, and estimating number quantities.
• Trouble with mental math and problem-solving strategies.
Dysgraphia is a specific learning disability affecting a person’s handwriting and fine motor skills. Features of learning disabilities in writing are often seen in students diagnosed with dyslexia and dyscalculia and vary from person to person and at different ages and stages of development. Common characteristics include
• Tight, awkward pencil grip and body position.
• Tiring quickly while writing and avoiding writing or drawing tasks.
• Trouble forming letter shapes as well as inconsistent spacing between letters or words.
• Difficulty writing or drawing on a line or within margins.
• Trouble organizing thoughts on paper.
• Trouble keeping track of thoughts already written down.
• Difficulty with syntax structure and grammar.
• A large gap between written ideas and understanding demonstrated through speech (Cortiella & Horowitz, 2014).
Associated Deficits and Disorders
The following deficits and disorders are not designated as specific categories of learning disabilities but are commonly associated with learning disabilities. For example, some students with learning disabilities may also experience deficits in information processing. Information processing deficits may impact a student’s ability to engage socially and academically.
Auditory processing deficit or auditory processing disorder are the terms used to describe a deficit in the ability to understand and use auditory information. Common characteristics include
• Auditory discrimination (the ability to notice, compare, and distinguish the distinct and separate sounds in words).
• Auditory figure–ground discrimination (the ability to pick out important sounds from a noisy background).
• Auditory memory (short-term and long-term abilities to recall information presented orally).
• Auditory sequencing (the ability to understand and recall the order of sounds and words).
• Spelling, reading, and written expression.
Visual processing deficit or visual processing disorder are the terms used to describe deficits in the ability to understand and use visual information. Common characteristics include
• Visual discrimination (the ability to notice and compare the features of different items and to distinguish one item from another).
• Visual figure–ground discrimination (the ability to distinguish a shape or printed character from its background).
• Visual sequencing (the ability to see and distinguish the order of symbols, words, or images).
• Visual motor processing (using visual feedback to coordinate body movement).
• Visual memory (the ability to engage in short-term and long-term recall of visual information).
• Visual closure (the ability to know what an object is when only parts of it are visible).
• Spatial relationships (the ability to understand how objects are positioned in space).
Non-verbal learning disabilities is the term used to describe the characteristics of students who have unique learning and behavioral deficits that may have similarities with dyslexia, dyscalculia, and dysgraphia but that differ in significant ways. For example, these students often excel in areas such as verbal expression, vocabulary, reading, comprehension, auditory memory, and attention to detail. However, they may struggle with math computation and problem solving, visual and spatial tasks, motor coordination, and reading body language and social cues.
Executive functioning deficits is the term used to describe deficits in the ability to plan, organize, strategize, remember details, and manage time and space efficiently. These are common characteristics in individuals with attention deficit/hyperactivity disorder (ADHD) and are often seen in those with learning disabilities.
Attention deficit/hyperactivity disorder (ADHD) is a brain-based disorder that results in significant inattention, hyperactivity, distractibility, or a combination of these characteristics. As many as one-third of those with learning disabilities are estimated to have ADHD as well. However, unlike learning disabilities, characteristics of ADHD are attributed to neurochemical imbalances that can be treated effectively with a combination of behavioral therapy and medication (Cortiella & Horowitz, 2014). We will learn more about ADHD in Chapter 11.
The IDEA and Illinois definitions of specific learning disability also include a disorder called developmental dysphasia. Developmental dysphasia is a language disorder with genetic risk factors. Common characteristics of the disorder include difficulty speaking and understanding spoken words (Genetic and Rare Diseases Information Center, 2022).
Cortiella, C., & Horowitz, S.H. (2014). The state of learning disabilities: Facts, trends and emerging issues. National Center for Learning Disabilities.
Genetic and Rare Diseases Information Center. (2022, September 1). Developmental dysphasia familial. https://rarediseases.info.nih.gov/diseases/1823/developmental-dysphasia-familial | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/03%3A_Students_with_Learning_Disabilities/3.02%3A_The_Illinois_Definition_of_Specific_Learning_Disability.txt |
There has been considerable debate about how to define or categorize learning disabilities. Often, as demonstrated by the definitions at the beginning of this chapter, a learning disability is defined by what it is not. For example, the Illinois definition states that “specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage” (Illinois State Board of Education, 2022).
Wiederholt (1974) identifies four periods in the history of learning disabilities. The foundational phase (1800–1930) emphasized basic scientific research related to the brain. During this period, the relationship of injury to specific brain areas and the corresponding loss of specific functions, such as language or perceptual skills, was investigated. Researchers such as Kurt Goldstein, who studied patients who suffered head injuries during World War I, found that many patients displayed characteristics that would later be associated with learning disabilities. These characteristics include perseveration, in which an individual starts an activity but has difficulty stopping or changing it; hyperactivity; and figure–ground problems, in which an individual cannot perceptually shift from foreground to background as when viewing Rubin’s Vase (see Figure \(1\)). This research period emphasized the perceptual problems associated with learning disabilities (Smiley et al., 2022).
The transition phase (1930–1960) began the application of brain research to the study of children. For example, Heinz Werner and Alfred Strauss noticed similarities between the characteristics of children with learning problems and those of adults who had suffered a brain injury. This observation led to terms such as minimal brain injury and minimal brain dysfunction, which were early labels used for learning disabilities.
The integration phase (1930–1974) included the origination of the term learning disability and the recognition of learning disabilities within education. In 1963, Samuel Kirk, a professor at the University of Illinois Urbana–Champaign, delivered a speech to the Learning Disabilities Association of America (LDA) that popularized the term learning disability. Perceptual skills were emphasized during this phase through the work of researchers such as William Cruickshank, Newell Kephart, and Marianne Frostig. While the views about the perceptual nature of learning disabilities developed during this period were later disproven, this period generated significant research and interest in learning disabilities.
Activity \(1\): Dr. Samuel Kirk
Directions: Visit the Dr. Samuel Kirk website at the Illinois Distributed Museum to learn more about his work with children with learning disabilities at the University of Illinois Urbana–Champaign. What other unique contributions did Dr. Kirk make to the field of special education?
The current phase (1975 to present) emphasizes interventions focusing on academic, behavioral, cognitive, and language development. Most research today examines interventions that help students with learning disabilities achieve academically in the general education classroom (Smiley et al., 2022).
Illinois State Board of Education. (2022, September 1). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx#:~:text=Specific%20learning%20disability%20means%20a,do%20mathematical%20calculations%2C%20including%20conditions
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
3.05: Prevalence of Learning Disabilities
Among students receiving special education services, 33% are identified as having a specific learning disability, the most common category of disability (National Center for Education Statistics, 2022). However, the number of students identified as having a specific learning disability has decreased over time. This may be due to better mechanisms for identifying students with learning disabilities and other categories of disabilities (e.g., RTI/MTSS), as well as a focus on early childhood interventions (Cortiella & Horowitz, 2014; Lerner & Johns, 2015).
In 2022, 42% of students who received special education services for specific learning disabilities were female, and 31% were male (NCES, 2022). This contrasts with the historical trend of males as the predominant gender identified with learning disabilities (Cortiella & Horowitz, 2014). Changes in this trend may be due to reduced bias regarding special education referrals for male students.
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
Cortiella, C., & Horowitz, S.H. (2014). The state of learning disabilities: Facts, trends and emerging issues. National Center for Learning Disabilities.
Lerner, J., & Johns, B. (2015). Learning disabilities and related disabilities (13th ed.). Cengage Learning. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/03%3A_Students_with_Learning_Disabilities/3.04%3A_The_History_of_Learning_Disabilities.txt |
Among students receiving special education services, 33% are identified as having a specific learning disability, the most common category of disability (National Center for Education Statistics, 2022). However, the number of students identified as having a specific learning disability has decreased over time. This may be due to better mechanisms for identifying students with learning disabilities and other categories of disabilities (e.g., RTI/MTSS), as well as a focus on early childhood interventions (Cortiella & Horowitz, 2014; Lerner & Johns, 2015).
In 2022, 42% of students who received special education services for specific learning disabilities were female, and 31% were male (NCES, 2022). This contrasts with the historical trend of males as the predominant gender identified with learning disabilities (Cortiella & Horowitz, 2014). Changes in this trend may be due to reduced bias regarding special education referrals for male students.
Causes of Learning Disabilities
Researchers do not know all the possible causes of learning disabilities, but they have identified risk factors for developing a learning disability. These risk factors are grouped into neurological, genetic, and environmental risk factors and may not apply to all categories of learning disabilities (Smiley et al., 2022).
Neurological Risk Factors
Neurological risk factors for developing a learning disability could include deficits related to brain injury, brain development, or brain structure. For example, there is evidence that individuals with dyslexia have a smaller planum temporale, a section of the temporal lobe of the brain, than individuals without dyslexia (Miller et al., 2003). In addition, researchers have found evidence that indicates distinct patterns of white matter pathways, which are disrupted in math and reading disabilities (Ashkenazi et al., 2013). Research on functional and structural differences in the brains of those with and without learning disabilities indicates support for the existence of neurological risk factors for developing a learning disability (Peterson & Pennington, 2015; Smiley et al., 2022).
Genetic Risk Factors
There is also evidence of genetics as a risk factor for developing a learning disability. Much of this evidence is based on twin studies (Galaburda, 2005). For example, reading disabilities are reported more frequently between identical twins than between fraternal twins (Wadsworth et al., 2000). There is also research that indicates the prevalence of dyscalculia is ten times higher in families of individuals with the disability than would be expected from the general population (Shalev et al., 2001), and genetics is also a risk factor for the development of word recognition problems (Harlaar et al., 2005; Smiley et al., 2022).
Environmental Risk Factors
Environmental factors may also cause learning disabilities. Environmental factors are grouped by those that occur prenatally, perinatally, and postnatally. Prenatal risk factors that cause harm to a fetus include maternal drug use, alcohol consumption, and smoking during pregnancy. For example, mothers who smoke during pregnancy are more likely to have premature babies who are subsequently at risk for developing a learning disability (Dooley, 2009).
Perinatal factors that cause learning disabilities occur at birth or very shortly thereafter. Complications during birth, such as the umbilical cord becoming twisted, could lead to anoxia, the loss of oxygen, a risk factor for developing a learning disability. Brain injuries that occur at birth may also lead to the development of learning disabilities (Zhang, 2007).
Postnatal factors that cause learning disabilities occur after the child is born. For example, medical conditions such as meningitis may contribute to learning disabilities. The ingestion of certain substances, such as lead-based paint, which is known to cause brain injury, may result in the development of a learning disability.
Activity \(1\): Preventing Lead Poisoning
Directions: In the United States, lead-based paint is banned, but lead is still found in some water pipes. Learn more about preventing lead poisoning in children by exploring the Centers for Disease Control and Prevention website on Childhood Lead Poisoning Prevention. Consider what populations are at high risk of lead poisoning and how prevention programs work to reduce this risk.
Although cultural and economic factors are excluded as causes from the IDEA definition of learning disabilities, environmental factors such as poor nutrition and adverse childhood experiences are associated with learning disability development (Arends, 2007; Cortiella & Horowitz, 2015; Lacour & Tissington, 2011; Smiley et al., 2022).
Activity \(2\): Adverse Childhood Experiences
Directions: Learn more about preventing adverse childhood experiences by exploring the Centers for Disease Control and Prevention website on adverse childhood experiences. Consider the risk factors and protective factors associated with adverse childhood experiences and what teachers and clinicians can do to help students at risk of learning difficulties.
Cortiella, C., & Horowitz, S.H. (2014). The state of learning disabilities: Facts, trends and emerging issues. National Center for Learning Disabilities.
Lerner, J., & Johns, B. (2015). Learning disabilities and related disabilities (13th ed.). Cengage Learning.
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Miller, C., Sanchez, J., & Hynd, G. (2003). Neurological correlates of reading disabilities. In H.L. Swanson, K. Harris, & S. Graha, (Eds.), Handbook of learning disabilities (pp. 242–255). Guilford Press.
Ashkenazi, S., Black, J.M., Abrams, D.A., Hoeft, F., & Menon, V. (2013). Neurobiological underpinnings of math and reading learning disabilities. Journal of Learning Disabilities, 46(6), 549–569. http://dx.doi.org/10.1177/0022219413483174
Peterson, R.L., & Pennington, B.F. (2015). Developmental dyslexia. Annual Review of Clinical Psychology, 11, 283–307. http://dx.doi.org/10.1146/annurev-clinpsy-032814-112842
Shalev, R., Manor, O., Kerem, B., Ayali, M., Bidici, N., Friedlander, Y., & Gross-Tsur, V. (2001). Developmental dyscalculia is a familiar learning disability. Journal of Learning Disabilities, 34(1), 59–65.
Harlaar, N., Spinath, F., Dale, P., & Plomin, R. (2005). Genetic influences on early word recognition abilities and disabilities: A study of 7-year-old twins. Journal of Child Psychology and Psychiatry, 46(4), 373–384. http://dx.doi.org/10.1111/j.1469-7610.2004.00358.x
Dooley, P. A. (2009). Examining individual and neighborhood-level risk factors for delivering preterm [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1242748346
Zhang, J. (2007). Perinatal brain injury, visual–motor integration, and poor school performance among low-birth weight survivors in central New Jersey [Doctoral dissertation, University of Pennsylvania]. Dissertations available from ProQuest. AAI3261012. https://repository.upenn.edu/dissertations/AAI3261012
Arends, R. (2007). Learning to teach (7th ed.). McGraw Hill.
Lacour, M., & Tissington, L. (2011). The effects of poverty on academic achievement. Educational Research and Reviews, 6(7), 522–526. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/03%3A_Students_with_Learning_Disabilities/3.06%3A_Causes_of_Learning_Disabilities.txt |
Students are identified for special education and related services through a system of referrals beginning with the pre-referral process previously discussed in Chapter 1. The pre-referral process is part of a larger schoolwide system called response to intervention (RTI). RTI is a proactive instructional model or framework for preventing academic issues in the early elementary grades and a remediation framework for improving outcomes in academics and behavior in upper elementary and secondary grades. The components of RTI include the following.
• Universal screening refers to academic and behavioral assessments administered to all students two to three times throughout the school year.
• Progress monitoring refers to more frequent assessments given to students to determine which strategies or interventions are most effective.
• Tier 1 includes research-based whole-class instruction. Tier 1 strategies meet the needs of most students, but if a student is not making adequate progress, they will receive Tier 2 interventions.
• Tier 2, or secondary, interventions are for students who are not making adequate progress under Tier 1. These students receive additional academic instruction or behavioral interventions.
• Tier 3, or intensive individualized, interventions are for students who did not make adequate progress under Tier 2. These students receive additional academic instruction or behavioral interventions that occur more frequently and for longer periods. At this point, if students continue to fail to make adequate progress, their parents will be contacted to consent to the special education referral process.
If the interventions fail, a formal referral is made for evaluation to determine eligibility for special education and related services. The IDEA includes regulations that guide the identification of students with specific disabilities, including learning disabilities. The RTI process helps educators and clinicians identify students with learning disabilities before they experience significant academic setbacks. However, it is important that students receive a comprehensive evaluation conducted by a multidisciplinary team, utilizing multiple measures and assessments, as part of the referral process to rule out other possible reasons for lack of academic progress.
Activity \(1\): IDEA Regulations: Identification of Specific Learning Disabilities
Directions: Read the IDEA Regulations for the Identification of Specific Learning Disabilities. Identify who needs to be involved in the identification process and what data needs to be collected.
Illinois’ Identification Process
“In accordance with 23 Illinois Administrative Code 226.130, Illinois districts are required to use a process that determines how a child responds to scientific, research-based interventions as part of the evaluation procedures, as described in 34 CFR 300.304, to determine special education eligibility under the category of specific learning disability (SLD). While this requirement is specific to SLD, districts also have the option of using such a process as part of the evaluation procedures for other disability categories. The documents below address Illinois’ procedures and criteria for special education eligibility and entitlement decisions in an RTI framework” (Illinois State Board of Education, 2022).
Illinois Special Education Eligibility and Entitlement Procedures and Criteria within a Response to Intervention (RtI) Framework: A Guidance Document
Frequently Asked Questions about Special Education Eligibility and Entitlement within a Response to Intervention (RtI) Framework
The multidisciplinary team might include teachers, audiologists, occupational therapists, physical therapists, school psychologists, and speech–language pathologists. In addition, a comprehensive evaluation must be based on multiple reliable and valid data sources, including information related to the student and the learning environment (Smiley et al., 2022).
For example, a student may take intelligence tests (e.g., Wechsler Intelligence Scale), achievement tests (e.g., Woodcock–Johnson Tests of Achievement, Wechsler Individual Achievement Test, and Kaufman Test of Educational Achievement), visual–motor integration tests (e.g., Beery–Buktenica Developmental Test of Visual–Motor Integration), or language tests (e.g., Clinical Evaluation of Language Fundamentals). An observation of the student in their learning environment must also be conducted. The multidisciplinary team may also consider districtwide or statewide standardized achievement test scores, observational data, portfolios of the student’s classwork, and transcripts from interviews with the students’ caregivers before making a determination.
Illinois State Board of Education. (2022, September 1). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx#:~:text=Specific%20learning%20disability%20means%20a,do%20mathematical%20calculations%2C%20including%20conditions
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
3.08: Chapter Questions and References
1. What is the IDEA definition of a specific learning disability (SLD)?
2. What is the NJCLD definition of SLD?
3. What are the differences between dyslexia, dyscalculia, and dysgraphia?
4. What percentage of students receiving special education services are identified as having an SLD?
5. What are the risk factors for developing a learning disability? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/03%3A_Students_with_Learning_Disabilities/3.07%3A_Identifying_Students_with_Learning_Disabilities.txt |
• 4.1: Definitions of Intellectual Disabilities
There are three primary definitions of intellectual disabilities. These include definitions from the Individuals with Disabilities Education Act (IDEA), the American Association on Intellectual and Developmental Disabilities (AAIDD), and the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association.
• 4.2: The History of Intellectual Disabilities
Before the passage of Rosa’s Law (Office of the Federal Register, 2010), this disability category was referred to as “mental retardation.” Rosa’s Law replaced this term with “intellectual disabilities” in the Rehabilitation Act, the Higher Education Act, the Elementary and Secondary Education Act, and the IDEA.
• 4.3: Prevalence and Causes of Intellectual Disabilities
Among students receiving special education services, 6% percent are identified as having an intellectual disability (National Center for Education Statistics, 2022).
• 4.4: Prevention of Intellectual Disabilities
Efforts have been made to reduce the prevalence of intellectual disabilities. The AAIDD has identified three levels of intervention.
• 4.5: Characteristics of Students with Intellectual Disabilities
Students with intellectual disabilities experience academic challenges resulting from their deficits in intellectual functioning and adaptive behavior. Students may experience academic challenges related to attention, memory, generalization, and language.
• 4.6: Identifying Students with Intellectual Disabilities
As identified earlier in this chapter, children may be diagnosed with an intellectual disability resulting from genetic or other environmental causes before they reach school age.
• 4.7: Chapter Questions and References
04: Students with Intellectual Disabilities
There are three primary definitions of intellectual disabilities. These include definitions from the Individuals with Disabilities Education Act (IDEA), the American Association on Intellectual and Developmental Disabilities (AAIDD), and the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. The IDEA defines intellectual disabilities as the following.
Intellectual disability means significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance (IDEA, Part B, Subpart A § 300.8(c)(6)(2004)).
Subaverage general intellectual functioning is defined as a score on a standardized intelligence test below 68 (significantly below an average score of 100). In addition, the developmental period refers to the time between birth and 18 years of age (Smiley et al., 2022).
The AAIDD Definition
The AAIDD is an advocacy group that promotes the rights of people with intellectual and developmental disabilities. The AAIDD publishes a manual titled Intellectual Disability: Definition, Diagnosis, Classification, and Systems of Supports. This manual defines intellectual disability as the following.
Intellectual disability is a disability characterized by significant limitations in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical skills. This disability originates during the developmental period, defined operationally as before the individual attains age 22 (Schalock et al., 2021).
The IDEA and AAIDD definitions refer to adaptive behavior. Adaptive behaviors are “learned behaviors that reflect an individual’s social and practical competence to meet the demands of everyday living” (AAIDD, 2022). AAIDD refers to adaptive behavior as a collection of conceptual, social, and practical skills. Conceptual skills include memory, language, reading, writing, math reasoning, acquisition of practical knowledge, problem solving, and judgment in novel situations. Social skills include empathy, interpersonal communication skills, friendship abilities, social judgment, and awareness of others’ thoughts, feelings, and experiences. Practical skills involve learning and self-management across life settings, including personal care, job responsibilities, money management, recreation, self-management of behavior, and school and work task orientation (DSM-5-TR, 2022, p. 42).
Although the IDEA and AAIDD definitions provide criteria to support the identification of students with an intellectual disability, it is important to recognize that adaptive behaviors are malleable. With appropriate interventions, students with intellectual disabilities can improve their adaptive behaviors.
The APA Definition
The definition included in the DSM refers to intellectual disability as “a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains” (DSM-5-TR, 2022, p. 37). The following three criteria must be met for a child to be diagnosed with an intellectual disability.
1. Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing.
2. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more daily life activities, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.
3. Onset of intellectual and adaptive deficits during the developmental period (DSM-5-TR, 2022, p. 37).
The diagnosis of intellectual disability must also be based on “both clinical assessment and standardized testing of intellectual functions, standardized neuropsychological tests, and standardized tests of adaptive functioning” (DSM-5-TR, 2022, p. 38). In addition, the DSM specifies four severity levels of intellectual disability: mild, moderate, severe, and profound, which are diagnosed on the basis of adaptive functioning. Schalock et al. (2021) indicate that a classification is considered an optional post-diagnosis organizing scheme that helps educators and clinicians provide appropriate interventions for students.
The Illinois Definition of Intellectual Disability
“Intellectual Disability means significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance” (Illinois State Board of Education, 2022).
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, AAIDD, APA, and Illinois definitions of intellectual disabilities. Consider the differences and similarities between diagnostic criteria.
The AAIDD has also published guidance on how to classify the severity of an intellectual disability, as well as the Supports Intensity Scale (SIS), which allows professionals to measure the support needs of students with intellectual disabilities across categories of adaptive behavior. The SIS changes the focus from the individual’s deficits to the support they need to succeed in different settings.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(6)(2004).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Schalock, R. L., Luckasson, R.., & Tassé, M. J. (2021). Intellectual disability: Definition, diagnosis, classification, and systems of supports (12th ed.). American Association on Intellectual and Developmental Disabilities.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Illinois State Board of Education. (2022, September 27). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx
4.02: The History of Intellectual Disabilities
Before the passage of Rosa’s Law (Office of the Federal Register, 2010), this disability category was referred to as “mental retardation.” Rosa’s Law replaced this term with “intellectual disabilities” in the Rehabilitation Act, the Higher Education Act, the Elementary and Secondary Education Act, and the IDEA. However, before advocacy organizations were established, beginning in 1951 with The National Association for Retarded Children (now called The ARC) in 1951, people with intellectual disabilities were often institutionalized, segregated from society, and even sterilized (Richards et al., 2015). The ARC led the human rights movement to deinstitutionalize people with intellectual disabilities and advocated for “normalization” or providing a life for people with disabilities in community settings. In 1975, the Education for All Handicapped Children Act 94-142 was passed, which required all public schools to provide equal access to an education for all students with disabilities. Today, the Rehabilitation Act and Americans with Disabilities Act secure the rights of individuals with intellectual disabilities to equal opportunity and equal protection under the law.
Office of the Federal Register, National Archives and Records Administration. (2010, October 4). Public Law 111-256 – Rosa’s Law. [Government]. U.S. Government Printing Office. https://www.govinfo.gov/app/details/PLAW-111publ256 | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/04%3A_Students_with_Intellectual_Disabilities/4.01%3A_Definitions_of_Intellectual_Disabilities.txt |
Among students receiving special education services, 6% percent are identified as having an intellectual disability (National Center for Education Statistics, 2022). Genetic and environmental factors may cause intellectual disabilities, but what causes an intellectual disability is not always known. In addition, causes may be prenatal, perinatal, or postnatal.
Genetic Causes
Educators and clinicians should have a basic knowledge of chromosomal disorders to provide appropriate interventions and treatment for students whose intellectual disability is caused by a chromosomal disorder. The two most common genetic causes of intellectual disabilities are Down syndrome and fragile X syndrome.
Down syndrome occurs in approximately one in every 700 babies (Mai et al., 2019). There are different types of Down syndrome. The most common type of Down syndrome, which accounts for approximately 95% of cases, is called trisomy 21, in which a person has an extra chromosome called chromosome 21. Mosaicism, or mosaic Down syndrome, which accounts for approximately 2% of cases, is diagnosed when there is a mixture of two types of cells, some containing the usual 46 chromosomes and some containing an extra chromosome (i.e., chromosome 21). Finally, translocation, which accounts for approximately 3% of cases, is diagnosed when an additional full or partial copy of chromosome 21 attaches to another chromosome, usually chromosome 14 (National Down Syndrome Society, 2022). The extra chromosome leads to the physical features and developmental challenges that can concur among people with Down syndrome. Students with Down syndrome usually have an IQ in the mildly-to-moderately low range and are slower to speak than other children. Students with Down syndrome may also experience hearing loss, ear infections, eye diseases, and heart defects. Down syndrome is not genetically inherited. However, women who are 35 years or older are more likely to have a pregnancy affected by Down syndrome (CDCa, 2022).
Fragile X syndrome is caused by the mutation of a single gene, fragile X messenger ribonucleoprotein 1 (FMR1), and is genetically inherited. People who have fragile X syndrome do not make this protein. A female carrier has a 50% chance of passing the mutation to each of her children, whereas a male carrier will pass it to all of his daughters but none of his sons. Fragile X syndrome occurs in both sexes. However, females often have milder symptoms than males. The exact number of people with fragile X syndrome is unknown, but studies indicate that approximately 1 in 7,000 males and 1 in 11,000 females have fragile X syndrome. The severity of intellectual disability varies between individuals, but males are usually diagnosed with more severe forms of intellectual disability than females. Autism spectrum disorder also occurs more frequently in students with fragile X syndrome. Students with fragile X syndrome may also experience ear infections, strabismus (i.e., crossed eyes), seizures, sensory processing challenges, speech and language delays, and motor delays (CDCb, 2022; National Fragile X Foundation, 2022).
Less common genetic disorders may also result in intellectual disability. These include Smith–Magenis syndrome, Angelman syndrome, Smith–Lemli–Opitz syndrome, Cornelia de Lange syndrome, Rett syndrome, Cri-du-Chat syndrome, and Sotos syndrome.
• Smith–Magenis syndrome is caused by a deletion of genetic material from chromosome 17. The prevalence of Smith–Magenis syndrome is approximately one in 25,000 people. Students with Smith–Magenis syndrome have mild-to-moderate intellectual disabilities.
• Angelman syndrome is caused by the loss of a gene located on chromosome 15. Angelman syndrome affects one in every 15,000 people. Students with Angelman syndrome have profound intellectual disabilities.
• Smith–Lemli–Opitz syndrome is caused by a defective gene on chromosome 7 that is responsible for the production of cholesterol, which is essential to cells in the body. Smith–Lemli–Opitz syndrome affects an estimated one in 20,000 to 60,000 people. Symptoms vary widely, but severe cases may involve profound intellectual disability.
• Cornelia de Lange syndrome is caused by a mutation in one of a few different genes located on the X chromosome or on chromosomes 5 or 10. Cornelia de Lange syndrome occurs in about one in every 10,000 to 30,000 people. Students with Cornelia de Lange syndrome typically have mild to profound intellectual disabilities, with most falling in the mild-to-moderate range.
• Rett syndrome is caused by mutations to a gene on the X chromosome. It affects approximately one in every 10,000 to 23,000 female births. Rett syndrome in boys is extremely rare. Students with Rett syndrome typically have severe to profound intellectual disabilities.
• Cri-du-Chat syndrome is caused by missing genes on chromosome 5. It affects approximately one in every 20,000 to one in 50,000 people. Students with Cri-du-Chat syndrome have severe intellectual disabilities.
• Sotos syndrome is caused by a defect on chromosome 5 and is reported to occur in one in 10,000 or 14,000 people. Students with Sotos syndrome may or may not have an intellectual disability (Kennedy Krieger Institute, 2022).
Environmental Causes
Environmental causes of intellectual disability may occur prenatally, perinatally, or postnatally and can result in medical problems that affect a child’s development. An example of a prenatal cause is the use of alcohol by the pregnant mother, which puts babies at risk for developing fetal alcohol spectrum disorders (FASD). FASDs include fetal alcohol syndrome, alcohol-related neurodevelopmental disorders, alcohol-related birth defects, and neurobehavioral disorder associated with prenatal alcohol exposure. In addition, maternal use of drugs or tobacco can also cause birth defects and potential intellectual disabilities (CDCc, 2022).
Examples of perinatal causes of intellectual disabilities include difficulties with the birthing process such as anoxia (i.e., temporary oxygen deprivation) or other birth-related injuries. Childhood diseases such as measles that cause damage to the brain are examples of postnatal causes of intellectual disabilities. In addition, childhood head injuries and exposure to environmental toxins such as lead and mercury may cause intellectual disabilities (ARC, 2022).
Risk Factors
Several factors may contribute to the risk of developing an intellectual disability. A primary risk factor is living in poverty. Children who live in poverty are at higher risk for experiencing malnutrition, exposure to environmental toxins, and inadequate health care. In addition, experiencing child abuse and neglect is also a risk factor that may contribute to the development of an intellectual disability (Smiley et al., 2022).
National Center for Education Statistics. (2022). Students with disabilities. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg
Mai, C.T., Isenburg, J.L., Canfield, M.A., Meyer, R.E., Correa, A., Alverson, C.J., Lupo, P.J., Riehle‐Colarusso, T., Cho, S.J., Aggarwal, D., & Kirby, R.S. (2019). National population‐based estimates for major birth defects, 2010–2014. Birth Defects Research, 111(18), 1420–1435.
National Down Syndrome Society. (2022, September 27). About Down syndrome. https://ndss.org/about#p_336
Centers for Disease Control and Prevention. (2022b, September 27). What is fragile x syndrome? https://www.cdc.gov/ncbddd/fxs/facts.html
National Fragile X Foundation. (2022, September 27). Fragile x 101. https://fragilex.org/understanding-fragile-x/fragile-x-101/
Kennedy Krieger Institute. (2022, September 27). Genetic, metabolic, and chromosomal disorders. https://www.kennedykrieger.org/patient-care/conditions/genetic-metabolic-chromosomal-disorders
Centers for Disease Control and Prevention. (2022c, S
eptember 27). Fetal alcohol spectrum disorders. https://www.cdc.gov/ncbddd/fasd/index.html
The ARC. (2011). Causes and prevention of intellectual disabilities. http://www.thearc.org/wp-content/uploads/forchapters/Causes%20and%20Prevention%20of%20ID.pdf
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/04%3A_Students_with_Intellectual_Disabilities/4.03%3A_Prevalence_and_Causes_of_Intellectual_Disabilities.txt |
Efforts have been made to reduce the prevalence of intellectual disabilities. The AAIDD has identified three levels of intervention. Primary prevention uses strategies such as vaccinations to prevent childhood diseases that cause intellectual disabilities. Another example of primary prevention is providing counseling and addiction treatment services for mothers who use drugs, alcohol, or tobacco.
Secondary prevention uses strategies that prevent the development of symptoms of disability in individuals with an existing disease or condition. For example, testing newborns for phenylketonuria (PKU), an inherited disorder that can damage the brain and nervous system, and providing appropriate medical treatment can help prevent damage to the brain and nervous system.
Tertiary prevention includes strategies to reduce the outcome of a disability on a child’s everyday functioning. For example, this might include providing early intervention services to a child diagnosed with an FASD (Smiley et al., 2022).
Activity \(1\): The Abecedarian Project
Directions: The Abecedarian Project was one of the first research projects to demonstrate the positive impact that early intervention services can have on a child’s development. Explore The Abecedarian Project website. Who participated in The Abecedarian Project? What early interventions did they test? What were their findings?
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
4.05: Characteristics of Students with Intellectual Disabilities
Students with intellectual disabilities experience academic challenges resulting from their deficits in intellectual functioning and adaptive behavior. Students may experience academic challenges related to attention, memory, generalization, and language.
Attention characteristics
Generally, students with intellectual disabilities find attending to tasks challenging. However, attending skills may be improved through early intervention and instruction that use real-life tasks and materials (e.g., coins) that are relevant to the student. Real-life tasks improve all students’ motivation to attend but are especially helpful for students with intellectual disabilities.
Academic characteristics
Students with intellectual disabilities tend to have below grade-level reading, writing, and math skills. However, academic skills can be improved, and students with mild intellectual disabilities benefit from academically inclusive settings.
Memory characteristics
Students with intellectual disabilities often perform poorly on working memory tasks compared with their peers without intellectual disabilities (Henry & MacLean, 2002). Working memory holds information for short periods and is used for reasoning and decision-making.
Generalization characteristics
Students with intellectual disabilities experience challenges when attempting to repeat a learned behavior or skill in a new situation. For example, a student may learn how to use a calculator to solve simple mathematics equations effectively in the classroom but may struggle to apply this skill in other settings, such as creating a budget and shopping for groceries. This means that students will need instruction on how to apply skills in different situations and settings.
Language characteristics
Students with intellectual disabilities may experience a delay in their language development. For example, students with intellectual disabilities may experience delays in learning vocabulary or engaging in conversation. Working memory deficits may contribute to experiencing a delay in language development such that students may not remember the order of events or may omit information they do not remember. Speech disorders are also common among students with intellectual disabilities, including deficits in articulation and fluency.
Adaptive behavior characteristics
Students with intellectual disabilities may experience challenges in developing adaptive behaviors. Adaptive behaviors include conceptual, social, and practical skills (DSM-5-TR, 2022, p. 42). Students may experience deficits in acquiring new skills or struggle with performing a learned skill in a new environment (e.g., expressing empathy with a new friend). Educators and clinicians should focus on students’ strengths and abilities rather than just their limitations. Students with intellectual disabilities can live and work in their communities with appropriate support (Smiley et al., 2022).
Henry, L.A., & MacLean, M. (2002). Working memory performance in children with and without intellectual disabilities. American Journal on Mental Retardation, 107(6), 421–432.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
4.06: Identifying Students with Intellectual Disabilities
As identified earlier in this chapter, children may be diagnosed with an intellectual disability resulting from genetic or other environmental causes before they reach school age. However, once students enter school, response to intervention is used to identify students for special education and related services. Educators and clinicians may use intelligence tests, adaptive behavior skills assessments, or other academic skills assessments to identify students.
Example intelligence tests include the Stanford-Binet Intelligence Scale and the Wechsler Intelligence Scale for Children. An example of adaptive behavior skills assessment is the Vineland Adaptive Behavior Scales. In addition, the AAIDD advocates for the use of the Supports Intensity Scale, which allows professionals to measure the support needs of students with intellectual disabilities across categories of adaptive behavior. Academic skills assessments may include standardized and curriculum-based assessments and examples of students’ coursework.
The AAIDD also suggests that needed support should be assessed using self-reports from the students and their parents or guardians. Direct observation of a student’s behavior may also help determine their level of functioning compared with that of their peers and in different environments (e.g., home, school, community). Finally, determining the needs of the student means considering the goals of the student and their parents or guardians (Smiley et al., 2022). Person-centered planning (PCP) has become an important process enabling the person with a disability, and people significant to them, to be fully involved in developing plans for the future (National Parent Center on Transition and Employment, 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
National Parent Center on Transition and Employment. (2022, October 19). Person-centered planning. https://www.pacer.org/transition/learning-center/independent-community-living/person-centered.asp
4.07: Chapter Questions and References
1. What is the IDEA definition of intellectual disability?
2. What is the prevalence of intellectual disabilities?
3. What are the most common genetic disorders associated with intellectual disabilities?
4. What are some ways in which intellectual disabilities can be prevented?
5. What are the intellectual and academic characteristics of students with intellectual disabilities? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/04%3A_Students_with_Intellectual_Disabilities/4.04%3A_Prevention_of_Intellectual_Disabilities.txt |
Emotional and behavioral disorders is an umbrella term that includes psychological disorders impacting students’ behavior, emotions, and moods. The terminology used to describe this disability category is subject to debate. The term emotional disturbance is used in the Individuals with Disabilities Education Act (IDEA). Illinois uses the term emotional disability, and other states use various terms. However, many professionals advocate using the term emotional or behavioral disorders (Smiley et al., 2022).
The IDEA Definition
The IDEA of 2004 defines emotional disturbances thus:
1. Emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:
1. An inability to learn that cannot be explained by intellectual, sensory, or health factors.
2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
3. Inappropriate types of behavior or feelings under normal circumstances.
4. A general pervasive mood of unhappiness or depression.
5. A tendency to develop physical symptoms or fears associated with personal or school problems.
Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted unless it is determined that they have an emotional disturbance (IDEA, Part B, Subpart A § 300.8(c)(4)(2004))
The IDEA definition is often referred to as vague (Theodore et al., 2004) and lacking any mention of specific negative behaviors (e.g., aggression) (Smiley et al., 2022).
The Council for Children with Behavioral Disorders Definition
The Council for Children with Behavioral Disorders (CCBD) is a Special Interest Division of the Council for Exceptional Children (CEC). The CCBD is an advocacy group for children with emotional and behavioral disorders and uses the following characteristics to define students with emotional disturbance:
• Hyperactivity (short attention span, impulsiveness)
• Aggression or self-injurious behavior (acting out, fighting)
• Withdrawal (not interacting socially with others, excessive fear or anxiety)
• Immaturity (inappropriate crying, temper tantrums, poor coping skills)
• Learning difficulties (academically performing below grade level) (CCBD, 2022)
The CCBD also points to general categories of psychological disorders, including schizophrenia spectrum disorder, bipolar disorder, depressive disorders, anxiety disorders, obsessive–compulsive disorders, eating disorders, and disruptive, impulse-control, and conduct disorders as causes of this disability category.
The APA Definition
The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association defines each of the psychological disorders associated with the term emotional and behavioral disorders. This includes schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive–compulsive disorders, feeding and eating disorders, and disruptive, impulse-control, and conduct disorders. There are too many specific psychological disorders to define and describe their diagnostic criteria for the purposes of this chapter. However, general definitions are included below.
Schizophrenia Spectrum and Other Psychotic Disorders
Schizophrenia spectrum and other psychotic disorders include schizophrenia, other psychotic disorders, and schizotypal (personality disorder). They are defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia (i.e., inability to move normally), and negative symptoms (e.g., diminished emotional expression and decreased motivation) (DSM-5-TR, 2022, p. 101).
Bipolar and Related Disorders
Bipolar and related disorders include bipolar I disorder, bipolar II disorder, cyclothymic disorder, substance/medication-induced bipolar and related disorders, bipolar and related disorder due to another medical condition, other specific bipolar and related disorder, and unspecified bipolar and related disorder. Depending on the specific disorder, students may experience episodes of mania or hypomania (i.e., periods of overactive and excited behavior), major depressive episodes, and instability of moods (DSM-5-TR, 2022, p. 139).
Depressive Disorders
Depressive disorders include disruptive mood dysregulation disorder, major depressive disorder (including major depressive episodes), persistent depressive disorder, premenstrual dysphoric disorder, substance/medication-induced depressive disorder, depressive disorder due to another medical condition, other specified depressive disorder, and unspecified depressive disorder. The common feature of all these disorders is the presence of sad, empty, or irritable mood, accompanied by related changes that significantly affect the individual’s capacity to function (e.g., somatic and cognitive changes in major depressive disorder and persistent depressive disorder). What differs among them are issues of duration, timing, or presumed etiology (i.e., cause) (DSM-5-TR, 2022, p. 177).
Anxiety Disorders
Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety, or avoidance behavior. Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persisting beyond developmentally appropriate periods. In addition, many anxiety disorders develop in childhood and tend to persist if not treated (DSM-5-TR, 2022, p. 215).
Obsessive–Compulsive Disorders
Obsessive–compulsive disorders include obsessive–compulsive disorder (OCD), body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, substance/medication-induced obsessive–compulsive and related disorder, obsessive–compulsive and related disorder due to another medical condition, other specified obsessive–compulsive and related disorder (e.g., nail biting, lip biting, check chewing, obsessional jealousy, olfactory reference disorder), and unspecified obsessive and related disorder.
OCD is characterized by the presence of obsession, compulsion, or both. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. Some other obsessive–compulsive and related disorders are characterized primarily by recurrent body-focused repetitive behaviors (e.g., hair pulling) and repeated attempts to decrease or stop the behaviors (DSM-5-TR, 2022, p. 263).
Feeding and Eating Disorders
Feeding and eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. Disorders include pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge-eating disorder (DSM-5-TR, 2022, p. 371).
Disruptive, Impulse-Control, and Conduct Disorders
Disruptive, impulse-control, and conduct disorders include conditions involving problems in the self-control of emotions and behaviors. While other psychological disorders may also involve problems in emotional or behavioral regulation, these disorders are unique in that they are manifested in behaviors that violate the rights of others (e.g., aggression, destruction of property) or that bring the individual into significant conflict with societal norms or authority figures. Disorders include oppositional defiant disorder, intermittent explosive disorder, conduct disorder, antisocial personality disorder, pyromania, kleptomania, and other specific and unspecified disruptive, impulse-control, and conduct disorders (DSM-5-TR, 2022, p. 521).
This is the primary classification system used for students with emotional or behavioral disorders. Although clinicians such as clinical psychologists, school psychologists, psychiatrists, and social workers have training in this medical classification system, students are often referred to clinical psychologists or psychiatrists to receive an official medical diagnosis. Educators are not trained to diagnose or treat psychological disorders.
The Illinois Definition of Emotional Disability
“Emotional Disability (includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance) means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:
• An inability to learn that cannot be explained by intellectual, sensory, or health factors;
• An inability to build or maintain satisfactory interpersonal relationships with peers and teachers;
• Inappropriate types of behavior or feelings under normal circumstances;
• A general pervasive mood of unhappiness or depression; or
• A tendency to develop physical symptoms or fears associated with personal or school problems” (Illinois State Board of Education, 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(4)(2004).
The Council for Children with Behavioral Disorders. (2022, October 2). Behavior disorders: Definitions, characteristics & related Information. https://debh.exceptionalchildren.org/behavior-disorders-definitions-characteristics-related-information
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Illinois State Board of Education. (2022, September 27). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/05%3A_Students_with_Emotional_and_Behavioral_Disorders/5.01%3A_Definitions_of_Emotional_and_Behavioral_Disorders.txt |
Before the twentieth century, people with serious emotional and behavioral disorders were often institutionalized and segregated from society. With the twentieth century came the development of professional organizations such as the CEC and the American Orthopsychiatric Association, which advocated for the rights of people with emotional and behavioral disorders. In addition, mental health interventions for children with emotional and behavioral disorders became increasingly available through programs such as Project Re-Ed (Hobbs, 1966). However, it was not until the 1997 reauthorization of the IDEA that emotional disturbance was included as a disability classification. Before this time, students with emotional and behavioral disorders were not eligible for special education or related services.
Hobbs, N. (1966). Helping the disturbed child: Psychological and ecological strategies. American Psychologist, 21(12), 1105–1115.
5.03: Prevalence of Emotional and Behavioral Disorders
Among students receiving special education services, 5% are identified as having an intellectual disability (National Center for Education Statistics, 2022). In addition, national data on children’s mental health indicate that the number of children who experience anxiety and depressive disorders has increased over time (Bitsko et al., 2013) and that these disorders often co-occur with disruptive, impulse-control, and conduct disorders (Ghandour et al., 2018). The number of children identified for special education and related services in this disability category is considered significantly lower than the actual number of children estimated to need these services. Experts believe that the negative stigma associated with the term emotional disturbance may be one reason for fewer referrals, especially for younger children. In addition, not all students diagnosed with these psychological disorders perform poorly or are disruptive to the educational environment (Smiley et al., 2022).
Gender and race may also influence referrals for special education and related services. Research suggests that males are more likely to have externalizing disorders, which are characterized by poor impulse control that may contribute to rule-breaking, aggression, impulsivity, and inattention. Females are more likely to have internalizing disorders, which are characterized by anxiety, depressive, and somatic symptoms (e.g., physical pain) (Romano et al., 2001; Sachs-Ericsson & Ciarlo, 2000). Externalizing disorders may be more noticeable in a classroom setting, resulting in more referrals for these students. In addition, Black students are twice as likely to be identified as having an emotional or behavioral disorder than all other racial groups combined (National Center for Education Statistics, 2022).
Bitsko, R.H., Claussen, A.H., Lichstein, J., et al. (2022). Mental health surveillance among children — United States, 2013–2019. Morbidity and Mortality Weekly Report, 71(2), 1–42. http://dx.doi.org/10.15585/mmwr.su7102a1
Ghandour, R.M., Sherman, L.J., Vladutiu, C.J., Ali, M.M., Lynch, S.E., Bitsko, R.H., & Blumberg, S.J. (2018). Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 206, 256–267.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Romano, E.L., Tremblay, R., Vitaro, F., Zoccolillo, M., & Pagani, L. (2001). Prevalence of psychiatric diagnoses and the role of perceived impairment: Findings from an adolescent community sample. Journal of Child Psychology and Psychiatry, 42(4), 451–461.
Sachs-Ericsson, N., & Ciarlo, J.A. (2000). Gender, social roles, and mental health: An epidemiological perspective. Sex Roles, 42(9/10), 605–628.
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/05%3A_Students_with_Emotional_and_Behavioral_Disorders/5.02%3A_A_Brief_History_of_Emotional_and_Behavioral_Disorders.txt |
Research indicates that both environmental and genetic factors play a role in the development of emotional and behavioral disorders. Environmental factors include adverse childhood experiences. Adverse childhood experiences are potentially traumatic events that occur in childhood, including abuse, neglect, and household dysfunction (e.g., violence in the home). These traumatic childhood experiences have been linked to the development of anxiety and depression (Elmore & Crouch, 2020). In addition, negative school experiences such as bullying and the systematic oppression of specific racial or ethnic groups may also lead to the development of emotional or behavioral disorders (CDC, 2015).
Certain emotional and behavioral disorders are linked to genetics. For example, children of a parent with a depressive, bipolar, or schizoaffective disorder are at a higher risk for developing anxiety, depressive, or schizoaffective disorders than the general public (DSM-5-TR, 2022). However, these genetic and environmental factors only increase a student’s risk of developing an emotional or behavioral disorder. Experiencing one or more of these factors does not mean a student will develop an emotional or behavioral disorder. In addition, environmental and genetic factors are often interrelated, making it difficult for clinicians to identify a single cause (Kauffman & Landrum, 2018).
Elmore, A.L., & Crouch, E. (2020). The association of adverse childhood experiences with anxiety and depression for children and youth, 8 to 17 years of age. Academic Pediatrics, 20(5), 600–608.
Centers for Disease Control and Prevention. (2015). Fact sheet: Understanding bullying. Retrieved October 2, 2022, from https://www.cdc.gov/violenceprevention/pdf/bullying-factsheet508.pdf
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Kauffman, J.M., & Landrum, T.J. (2018). Characteristics of emotional and behavioral disorders of children and youth (11th ed.). Pearson.
5.05: Characteristics of Students with Emotional and Behavioral Disorders
Students with emotional and behavioral disorders exhibit a wide range of characteristics. This has important implications for educators and clinicians, who must be aware of characteristics that typically go unnoticed, such as social withdrawal. Most of these characteristics fall into the following categories.
Externalizing Characteristics
Externalizing characteristics of emotional and behavioral disorders are those that can be observed and that directly affect others. For example, individuals may exhibit irritable mood, aggression, defiance, destruction of property, deceitfulness, and vindictiveness.
Internalizing Characteristics
Internalizing characteristics of emotional and behavioral disorders are often not directly observable or do not directly affect others. For example, anxiety and social withdrawal are not always visible to external observers. In addition, students with obsessive–compulsive disorders may experience recurrent unwanted thoughts and repetitive behaviors (e.g., hair pulling).
Intellectual Characteristics
The IDEA definition of emotional disturbance includes “an inability to learn that cannot be explained by intellectual, sensory, or health factors.” This statement implies that students with emotional and behavioral disorders should demonstrate average levels of intelligence. However, research indicates that these students typically score in the low-to-average range of intelligence. In addition, students with severe disorders tend to have lower levels of intelligence (Kauffman and Landru, 2018; Smiley et al., 2022).
Kauffman, J.M., & Landrum, T.J. (2018). Characteristics of emotional and behavioral disorders of children and youth (11th ed.). Pearson.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/05%3A_Students_with_Emotional_and_Behavioral_Disorders/5.04%3A_Causes_of_Emotional_and_Behavioral_Disorders.txt |
In school, the response to intervention (RTI) system is used to identify students for special education and related services. Students are provided with interventions to support their educational success before the student’s eligibility for special education services has been determined. Educators and clinicians use multiple measures to determine whether a student has an emotional or behavioral disorder. Data collection may include observations, behavior rating scales, and behavior assessment systems (Smiley et al., 2022). Outside of school, clinical psychologists and psychiatrists will use the diagnostic criteria included in the DSM to determine whether a student has an emotional or behavioral disorder.
Observation
Observation may be used to document the type, frequency, and duration of problem behaviors. Observational data provides valuable information that helps educators and clinicians make eligibility decisions. Observations are also used when conducting a functional behavior assessment (FBA). An FBA is used to determine the function of a behavior. FBAs help teachers and clinicians understand the reasons (i.e., the functions) for a student’s behavior. The teacher or clinician documents what happened immediately before the behavior (i.e., antecedents) and what happened immediately after the behavior (i.e., consequences) to develop a hypothesis about the function of the behavior. Teachers and clinicians can then use this information to design an appropriate intervention for the student. This information also contributes to the evidence required to make an eligibility decision as part of the RTI process (Smiley et al., 2022).
Behavior Rating Scales
Behavior rating scales are used to document the nature and severity of certain observable behaviors. Behavior rating scales include a list of behaviors such as “has temper tantrums” and “argues a lot” that are grouped together to measure different emotional and behavior problems, such as aggressive behavior. Each item is rated using a scale. For example, the behavior never, occasionally, or frequently occurs. The Devereux Behavior Rating Scale (DBRS-SF) is an example of a behavior rating scale. The DBRS-SF has two forms, one for ages 5 to 12 and one for ages 13 to 18. It may be used by educators, school psychologists, guidance counselors, or other clinicians and includes 40 items grouped according to four factors: interpersonal problems, inappropriate behaviors/feelings, depression, and physical symptoms/fears. These are the same areas included in the IDEA definition (Smiley et al., 2022).
Behavior Assessment Systems
Behavior rating scales may also be used as part of a behavior assessment system. For example, behavior assessment systems might include an educator rating scale, a parent/guardian rating scale, a peer rating scale, a self-report scale, an observational component, and an interview component. The advantage of behavior assessment systems is that they provide ratings of the student from multiple people who are familiar with the student’s behavior in different settings. Frequently used behavior assessment systems include the Achenbach System of Empirically Based Assessment (ASEBA) and the Behavior Assessment System for Children–Third Edition (BASC-3). The ASEBA measures areas such as anxiety and depression, thought problems, and aggression. The BASC-3 includes areas such as depression, interpersonal relations, and attention problems (Smiley et al., 2022).
In addition to the RTI system, the school may engage additional services from mental health professionals (e.g., psychiatrists) in their community to provide additional evidence that may be used to determine a student’s eligibility for special education and related services. School social workers may also connect students and their families to additional community resources to support the health of the family as a whole (e.g., family counseling).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
5.07: Chapter Questions and References
1. What is the IDEA definition of emotional disturbance?
2. What is the prevalence of emotional and behavioral disorders?
3. What are some environmental factors associated with emotional and behavioral disorders?
4. What are some examples of externalizing and internalizing characteristics of emotional and behavioral disorders?
5. How are students with emotional and behavioral disorders typically identified? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/05%3A_Students_with_Emotional_and_Behavioral_Disorders/5.06%3A_Identifying_Students_with_Emotional_and_Behavioral_Disorders.txt |
Communication is the expression of thoughts, including ideas, feelings, and opinions, between two or more people using language and speech. Language is a rule-governed system of symbols that people use to communicate. Speech is the physical ability to articulate language. Language may also be expressed using sign languages such as American Sign Language. Speech consists of five integrated systems:
• Respiration (i.e., the breathing that supports speech);
• Voicing (i.e., the sound powered by the vocal folds and chords);
• Resonance (i.e., the means by which sound is changed as it travels through the cavities of the neck and head); and
• Articulation (i.e., the formulation of speech sounds by the lips, tongue, and other structures).
Fluent speech also requires the use of concepts such as stress, pitch, timing, and loudness to impart meaning. For example, in American English, there is usually a rise in pitch at the end of a question (Smiley et al., 2022).
Language also has five components: phonology, morphology, syntax, semantics, and pragmatics. These concepts are defined below in the American Speech–Language–Hearing Association (ASHA) definition of language disorders. However, a few additional definitions in relation to these concepts are also important. For example, phonology is the sound system of a language and the rules that govern sound combinations (ASHA, 1993). The smallest unit of speech that distinguishes one word from another is the phoneme. An example of a phoneme is a consonant such as “p” or “b” that distinguishes “tap” from “tab” (Smiley et al., 2022). Each of these words is the same except for the final phoneme.
Morphology is the system that governs the structure of words and the construction of word forms (ASHA, 1993). A morpheme is the smallest meaningful unit in the grammar of a language. Morphemes may be free or bound. Free morphemes have meaning on their own and may not be broken into smaller units and still maintain their meaning (e.g., dog). A bound morpheme has meaning only when attached to another morpheme. For example, “s” alone has no meaning, but when it is attached to “dog,” as in “dogs,” it means more than one (Smiley et al., 2022).
In addition, language also includes nonlinguistic cues such as gestures, body posture, proximity, eye contact, and facial expressions. Communication requires using both linguistic and nonlinguistic components of language. In school, a student must also learn about the rules governing the use of language in different settings (e.g., in the classroom versus on the playground). For example, cheering and clapping is an appropriate way to communicate praise when a teammate makes a goal, but cheering and clapping is not appropriate when a peer answers a math question correctly. Culture also plays a role in communication and may influence both linguistic and nonlinguistic components of language. For example, in certain cultures making eye contact with a teacher is a sign of disrespect. Educators and clinicians need to be aware of these cultural differences to assess the student appropriately and help the student master the communication rules used in school (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
• 6.1: Definitions of Communication Disorders
The Individuals with Disabilities Education Act (IDEA) defines a speech or language impairment as the following:
• 6.2: The History of Communication Disorders
In 1925, the American Academy of Speech Correction, ASHA’s original predecessor, was founded at an informal meeting of the National Association of Teachers of Speech. This organization was originally composed of teachers working in the areas of rhetoric, debate, and theater, and its members were becoming increasingly interested in the scientific study of speech correction.
• 6.3: Prevalence and Causes of Communcation Disorders
Among students receiving special education services, 19% are identified as having a speech or language impairment (National Center for Education Statistics, 2022).
• 6.4: Characteristics of Students with Communication Disorders
The characteristics of students with communication disorders vary depending on the components of language or speech that are affected. A speech disorder is an impairment of the articulation of speech sounds, fluency, voice, or all three.
• 6.5: Identifying Students with Communication Disorders
School-age children should be screened for communication disorders in the early grades; however, universal screenings may not identify all existing problems. Therefore, classroom teachers and other professionals who work with students play a significant role in the identification and referral of students with possible communication disorders.
• 6.6: Chapter Questions and References
06: Students with Communication Disorders
The Individuals with Disabilities Education Act (IDEA) defines a speech or language impairment as the following:
Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance (Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(11)(2004)).
This definition is used to determine whether a student with a communication disorder is eligible for special education and related services. However, many professionals also use the following definitions from the ASHA. ASHA provides the following more detailed definition of communication disorder.
A communication disorder is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal and graphic symbol systems. A communication disorder may be evident in the processes of hearing, language, and/or speech. A communication disorder may range in severity from mild to profound. It may be developmental or acquired. Individuals may demonstrate one or any combination of communication disorders. A communication disorder may result in a primary disability, or it may be secondary to other disabilities (ASHA, 1993).
ASHA also provides detailed definitions of the different types of communication disorders, including speech disorders, language disorders, and central auditory processing disorders.
A speech disorder is an impairment of the articulation of speech sounds, fluency and/or voice.
• An articulation disorder is the atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility.
• A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words, and phrases. This may be accompanied by excessive tension, struggle behavior, and secondary mannerisms.
• A voice disorder is characterized by the abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration, which is inappropriate for an individual’s age and/or sex.
A language disorder is impaired comprehension and/or use of spoken, written and/or other symbol systems. The disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics) in any combination.
• Form of Language
• Phonology is the sound system of a language and the rules that govern the sound combinations.
• Morphology is the system that governs the structure of words and the construction of word forms.
• Syntax is the system governing the order and combination of words to form sentences, and the relationships among the elements within a sentence.
• Content of Language
• Semantics is the system that governs the meanings of words and sentences.
• Function of Language
• Pragmatics is the system that combines the above language components in functional and socially appropriate communication.
Central auditory processing disorders (CAPD) are deficits in the information processing of audible signals not attributed to impaired peripheral hearing sensitivity or intellectual impairment. This information processing involves perceptual, cognitive, and linguistic functions that, with appropriate interaction, result in effective receptive communication of auditorily presented stimuli. Specifically, CAPD refers to limitations in the ongoing transmission, analysis, organization, transformation, elaboration, storage, retrieval, and use of information contained in audible signals. CAPD may involve the listener’s active and passive (e.g., conscious and unconscious, mediated and unmediated, controlled and automatic) ability to do the following:
• attend, discriminate, and identify acoustic signals;
• transform and continuously transmit information through both the peripheral and central nervous systems;
• filter, sort, and combine information at appropriate perceptual and conceptual levels;
• store and retrieve information efficiently; restore, organize, and use retrieved information;
• segment and decode acoustic stimuli using phonological, semantic, syntactic, and pragmatic knowledge; and
• attach meaning to a stream of acoustic signals through use of linguistic and nonlinguistic contexts (ASHA, 1993).
Finally, ASHA differentiates a communication disorder from communication variations including communication difference/dialect and augmentative/alternative communication.
Communication difference/dialect is a variation of a symbol system used by a group of individuals that reflects and is determined by shared regional, social, or cultural/ethnic factors. A regional, social, or cultural/ethnic variation of a symbol system should not be considered a disorder of speech or language.
Augmentative/alternative communication systems attempt to compensate and facilitate, temporarily or permanently, for the impairment and disability patterns of individuals with severe expressive and/ or language comprehension disorders. Augmentative/alternative communication may be required for individuals demonstrating impairments in gestural, spoken, and/or written modalities (ASHA, 1993).
APA Definition
In addition, the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association includes disorders of communication which include language disorder, speech sound disorder, childhood-onset fluency disorder (stuttering), social (pragmatic) communication disorders, and unspecified communication disorders. The diagnostic criteria for each are included below.
Language Disorder
1. Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:
1. Reduced vocabulary (word knowledge and use).
2. Limited sentence structure (ability to put words and word endings together to form sentences based on the rules of grammar and morphology).
3. Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).
2. Language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination.
3. Onset of symptoms is in the early developmental period.
4. The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual developmental disorder (intellectual disability) or global developmental delay (DSM-5-TR, 2022, p. 47).
Speech Sound Disorder
1. Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication or messages.
2. The disturbance causes limitation in effective communication that interferes with social participation, academic achievement, or occupational performance, individually or in any combination.
3. Onset of symptoms in the early developmental period.
4. The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions (DSM-5-TR, 2022, p. 50).
Childhood-Onset Fluency Disorder (Stuttering)
1. Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following:
1. Sound and syllable repetitions.
2. Sound prolongations of consonants as well as vowels.
3. Broken words (e.g., pauses within a word).
4. Audible or silent blocking (filled or unfilled pauses in speech).
5. Circumlocutions (word substitutions to avoid problematic words).
6. Words produced with an excess of physical tension.
7. Monosyllabic whole-word repetitions (e.g., “I-I-I-I see him”).
2. The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination.
3. The onset of symptoms is in the early developmental period.
4. The disturbance is not attributable to a speech-motor or sensory deficit, disfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder (DSM-5-TR, 2022, p. 51-52).
Social (Pragmatic) Communication Disorder
1. Persistent difficulties in the social use of verbal and nonverbal communication as manifest by all of the following:
1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.
2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding the use of overly formal language.
3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.
4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral and ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).
2. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.
3. The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).
4. The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual developmental disorder (intellectual disability), global developmental delay, or another mental disorder (DSM-5-TR, 2022, p. 54).
The Illinois Definition of Speech or Language Impairment
Speech or Language Impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance (ISBE, 2022).
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, ASHA, APA, and Illinois definitions of communication disorders. Consider the differences and similarities between diagnostic criteria.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(11)(2004).
American Speech-Language-Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. https://www.asha.org/policy/rp1993-00208/
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Illinois State Board of Education. (2022, October 7). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/06%3A_Students_with_Communication_Disorders/6.01%3A_Definitions_of_Communication_Disorders.txt |
In 1925, the American Academy of Speech Correction, ASHA’s original predecessor, was founded at an informal meeting of the National Association of Teachers of Speech. This organization was originally composed of teachers working in the areas of rhetoric, debate, and theater, and its members were becoming increasingly interested in the scientific study of speech correction. The American Academy of Speech Correction went through several name changes before settling on the American Speech–Language–Hearing Association (ASHA).
Beginning in 1910, “speech correctionists” were hired to work in Chicago Public Schools. That same year, two speech centers opened in Detroit Public Schools. Many large school districts followed suit, and by the 1950s, “speech correctionists” were common in elementary schools (Hulit et al., 2015). In the 1970s, knowledge of language development increased, and “speech therapists” learned to identify and treat communication disorders. Today, speech–language pathologists (SLP) work closely with special education and general education teachers to provide services to students with communication disorders and are also part of the referral and IEP process when appropriate (Smiley et al., 2022).
Example \(1\): The Early Years of Language, Speech, and Hearing Services
Directions: Learn more about the history of communication disorders by reading The Early Years of Language, Speech, and Hearing Services in U.S. Schools by Judith Felson Duchan. How do these services help students improve their quality of life?
Hulit, L.M., Fahey, K.R., & Howard, M.R. (2015). Born to talk: An introduction to speech and language development (6th ed.). Pearson.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
6.03: Prevalence and Causes of Communcation Disorders
Among students receiving special education services, 19% are identified as having a speech or language impairment (National Center for Education Statistics, 2022). Communication disorders may be caused by congenital conditions (e.g., Down syndrome) or acquired after birth (e.g., traumatic brain injury). In addition, communication disorders are also classified as organic or functional. Organic communication disorders result from an abnormal structure or neuromuscular malfunction in the speech organs (e.g., cleft palate). Functional communication disorders have no organic cause but are presumed to result from environmental risk factors. Determining the cause of a functional communication disorder is difficult. However, environmental risk factors include lack of adequate prenatal care, living in poverty, lack of stimulation during childhood, and hearing loss. Recent research indicates that genetics may also be a risk factor for developing a communication disorder (Flax et al., 2003; Smiley et al., 2022).
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
Flax, J., Realpe-Bonilla, T., Herschm, L.S., Brzustowic, L.M., Bartlett, C., & Tallal, P. (2003). Specific language impairment: Co-occurrence in families. Journal of Speech, Language, and Hearing Research, 46(3), 530–543.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
6.04: Characteristics of Students with Communication Disorders
The characteristics of students with communication disorders vary depending on the components of language or speech that are affected. A speech disorder is an impairment of the articulation of speech sounds, fluency, voice, or all three.
Articulation Disorder
An articulation disorder is the atypical production of speech sounds characterized by substitutions, omissions, additions, or distortions that may interfere with intelligibility. For example, students may substitute one speech sound for another or distort a speech sound (e.g., a whistling “s”). Students may also add an additional sound or omit a sound. Students with an articulation disorder usually have difficulty with only one or two specific sounds.
Fluency Disorder
A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words, and phrases. This may be accompanied by excessive tension, struggle behavior, and secondary mannerisms. For example, a student may interject unnecessary words or phrases, use incomplete phrases, use broken words (i.e., include pauses within words), prolong sounds, or repeat sounds of syllables, words, or phrases. The most common fluency disorder is stuttering, which involves the repetition of sounds or syllables or prolonged sounds as primary speech characteristics. Fluency disorders affect students most commonly between the ages of 2 and 10. In addition, boys are more commonly affected than girls. However, many children experience periods of dysfluency lasting about 6 months, usually between ages 2 and 6.
Voice Disorder
A voice disorder is characterized by abnormal production or absence of vocal quality, pitch, loudness, resonance, and/or duration that is inappropriate for an individual’s age and/or sex. For example, students with voice disorders may have a hoarse voice, speak in a high pitch, speak with no changes in pitch, or speak excessively loudly or softly (ASHA, 1993; Smiley et al., 2022).
Characteristics of language disorders are determined by whether they are primary (i.e., the disorder does not arise from an underlying medical condition) or secondary (i.e., the disorder can be attributed to another disability). Characteristics of secondary language disorders are associated with the identified primary disability (Smiley et al., 2022). Language disorders include difficulties with the form of language (i.e., phonology, morphology, or syntax), the content of language (i.e., semantics), or the function of language (i.e., pragmatics).
Form of Language
Students with language disorders that involve the form of language may experience difficulty with phonology or the sound system of a language and the rules that govern the sound combinations. For example, students may substitute one consonant sound for another or omit certain consonant sounds entirely. Students may also struggle with morphology or the system that governs the structure of words and the construction of word forms. For example, students may omit a specific morpheme such as the “s” that makes nouns plural.
Finally, some students may not experience language difficulties until they reach school age and encounter more complex syntax or the system governing the order and combination of words to form sentences, and the relationships among the elements within a sentence. For example, students may have difficulty understanding when to use commas.
Content of Language
Students with language disorders that involve the content of language experience difficulty with semantics or the system that governs the meanings of words and sentences. For example, students may have difficulty understanding metaphors.
Function of Language
Students with language disorders that involve the function of language experience difficulty with pragmatics or the system that combines form of language and content of language into functional and socially appropriate communication. For example, students may have difficulty participating in a conversation.
In addition, educators and clinicians must be aware of regional, social, and cultural or ethnic variations in the use of language. Any difference in language use that can be attributed to these variations is not considered a language disorder. Language disorders may also impact a student’s ability to read and write. For example, a student who is experiencing phonological difficulties may have problems understanding the sound–symbol associations necessary to encode and decode written words. Students with secondary language disorders caused by other disabilities, such as intellectual disabilities, may progress through a normal sequence of linguistic development but at a slower rate than their nondisabled peers. Identifying the characteristics of each student with a communication disorder can facilitate developing appropriate interventions (Smiley et al., 2022).
American Speech-Language-Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. https://www.asha.org/policy/rp1993-00208/
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/06%3A_Students_with_Communication_Disorders/6.02%3A_The_History_of_Communication_Disorders.txt |
School-age children should be screened for communication disorders in the early grades; however, universal screenings may not identify all existing problems. Therefore, classroom teachers and other professionals who work with students play a significant role in the identification and referral of students with possible communication disorders. Importantly, some areas of difficulty, such as articulation, have a developmental trajectory. ASHA has developed a chart that identifies the Age of Customary Consonant Production to identify age-appropriate articulation errors. Similarly, ASHA has developed a chart of Grammatical Morphemes in Order of Acquisition that identifies when children should produce correct grammatical morphemes.
Educators and clinicians may use a variety of procedures in different settings to identify students for special education and related services. Speech–language pathologists (SLP), audiologists, and occupational and physical therapists may be involved in this process (Smiley et al., 2022). ASHA’s Preferred Practice Patterns for the Professions of Speech–Language Pathology (2004) indicates that a comprehensive speech–language pathology assessment should include the following components:
• Case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds and information from teachers and other related service providers.
• Student and family interviews.
• Review of auditory, visual, motor, and cognitive status.
• Standardized and/or non-standardized measures of specific aspects of speech, spoken and non-spoken language, cognitive–communication, and swallowing function, including observations and analysis of work samples.
• Selection of standardized measures for speech, language, cognitive–communication, and/or swallowing assessment with consideration for documented ecological validity and cultural sensitivity.
• Identification of potential for effective intervention strategies and compensations.
• Follow-up services to monitor communication and swallowing status and ensure appropriate intervention and support for individuals with identified speech, language, cognitive–communication, and/or swallowing disorders (ASHA, 2022).
In addition, the SLP consults other members of the multidisciplinary team, such as parents and psychologists, to determine how the disorder may impact other areas of a student’s life. The SLP may also conduct observations in different classroom settings, during different activities, and with different conversational partners to assess the impact the communication disorder has on the child’s ability to learn and identify the appropriate interventions. Assessment procedures are dependent on a student’s age and the aspect of language being assessed.
Assessment procedures should also take into account linguistically diverse student populations and use appropriate alternative assessment procedures that reduce the bias inherent in some norm-referenced standardized tests. For English learners, information about their native language and English language proficiency is needed to determine whether they should be assessed in their native language. Finally, SLPs should also assess conversational and academic language skills in both languages. Students who are learning a second language generally acquire conversational language skills in 1–3 years but may need 5–7 years to acquire academic language skills (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
American Speech-Language-Hearing Association. (2022, October 7). Assessment and evaluation of speech–language disorders in schools. https://www.asha.org/slp/assessment-and-evaluation-of-speech-language-disorders-in-schools/
6.06: Chapter Questions and References
1. What are the systems that are required for speech?
2. What are the components of language?
3. What is the IDEA definition of speech or language impairment?
4. What are the differences between speech and language disorders?
5. What is the prevalence of communication disorders? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/06%3A_Students_with_Communication_Disorders/6.05%3A_Identifying_Students_with_Communication_Disorders.txt |
Definitions of deaf and hard of hearing are based on the type and degree of hearing loss. Hearing depends on a series of steps that change sound waves in the air into electrical signals. Our auditory nerve then carries these signals to the brain.
First, sound waves enter the outer ear and travel through the ear canal, which leads to the eardrum. Next, the eardrum vibrates from the incoming sound waves and sends these vibrations to the bones in the middle ear. The bones in the inner ear amplify the sound vibrations and send them to the cochlea, a snail-shaped structure filled with fluid, in the inner ear. Hair cells on the cochlea then turn the sound waves into electrical signals carried through the auditory nerve to the brain (National Institute on Deafness and Other Communication Disorders, 2022).
Sound is described in terms of loudness and frequency. Loudness refers to the intensity of a sound and is measured in decibels (dB). The larger the dB number, the louder the sound. Zero dB represents the lowest level of sound that a typically hearing person can perceive.
The frequency of sound waves is measured in cycles per second, or hertz (Hz). The ear can detect frequencies from 20 Hz to 20,000 Hz, but most speech occurs in the 200–6,000 Hz range, most occurring between 300 and 3,000 Hz. However, hearing loss can occur at various frequencies, affecting how well an individual hears different sounds. Hearing loss is described in relation to the age of onset. Audiologists may administer a speech reception threshold test to determine an individual’s specific ability to hear and understand speech (Scheetz, 2012; Smiley et al., 2022).
Types of Hearing Loss
The type of hearing loss is often associated with a physiological or neurological problem with the transmission of sound. There are three types of hearing loss, which are described below.
• A conductive hearing loss happens when sounds cannot get to the inner ear. This type of hearing loss may be caused by infection, fluid, earwax, or benign tumors or other problems that block access to the inner ear.
• A sensorineural hearing loss happens when there is damage to the inner ear. Problems with the nerve pathways from the inner ear to the brain can also cause sensorineural hearing loss. This type of hearing loss may be caused by illness, aging, injury, or genetic predisposition to hearing loss.
• A mixed hearing loss is a problem with the outer or middle ear and the inner ear. For example, there may be damage to the outer or middle ear and damage to the inner ear or nerve pathways to the brain. Anything that causes a conductive hearing loss or a sensorineural hearing loss can lead to mixed hearing loss (ASHA, 2022b).
In addition, hearing loss can be unilateral (i.e., affecting only one ear) or bilateral (i.e., affecting both ears), and can be stable or progress over time (Smiley et al., 2022).
Degree of Hearing Loss
Degree of hearing loss is described on a scale from slight to profound and is based on decibels. For example, students who can hear sounds only at 30 dB have a mild hearing loss. Students who can hear only sounds closer to 50 dB have a moderate hearing loss. Table \(1\) lists hearing loss classifications.
Table \(1\): Hearing Loss Classifications
Degree of Hearing Loss
Hearing Loss Range (dB HL)
Normal
-10 to 15
Slight
16 to 25
Mild
26 to 40
Moderate
41 to 55
Moderately Severe
71 to 90
Profound
91+
Educators and clinicians should keep in mind that the type or degree of hearing loss does not necessarily describe a student’s ability to engage in classroom learning. For example, the student might utilize their residual hearing or use amplification devices to hear the teacher and the other students in the class. A functional hearing assessment is necessary to determine how a student’s learning and communication abilities may be affected (ASHA, 2022a; Smiley et al., 2022).
Age of Onset
Hearing loss may also be described based on age of onset. Students with congenital hearing loss had hearing loss at birth. Students with adventitious hearing loss experienced hearing loss after birth. Prelingual hearing loss occurs before the development of speech and language, and postlingual hearing loss occurs after the development of speech and language. Speech and oral language development may be influenced by age of onset as well as the type and degree of hearing loss. Therefore, hearing loss must be identified early to avoid developmental issues (Smiley et al., 2022). The Joint Committee on Infant Hearing (2007) suggests that “all infants should have access to hearing screening using a physiologic measure at no later than 1 month of age.”
The IDEA Definition
The Individuals with Disabilities Education Act (IDEA) uses the term hearing impairment. Some people in the Deaf community consider this term offensive because it focuses on what a student cannot do. This term should not be used to refer to a student who is deaf or hard of hearing. The IDEA defines deafness and hearing impairment as the following.
Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance (IDEA, Part B, Subpart A § 300.8(c)(3)(2004)).
Hearing impairment means an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but that is not included under the definition of deafness in this section (IDEA, Part B, Subpart A § 300.8(c)(5)(2004)).
The ASHA Definition
The American Speech–Language–Hearing Association (ASHA) definitions of communication disorders include the following definition of a hearing disorder.
A hearing disorder is the result of impaired auditory sensitivity of the physiological auditory system. A hearing disorder may limit the development, comprehension, production, and/or maintenance of speech and/or language. Hearing disorders are classified according to difficulties in detection, recognition, discrimination, comprehension, and perception of auditory information. Individuals with hearing impairment may be described as deaf or hard of hearing.
• Deaf is defined as a hearing disorder that limits an individual’s aural/oral communication performance to the extent that the primary sensory input for communication may be other than the auditory channel.
• Hard of hearing is defined as a hearing disorder, whether fluctuating or permanent, which adversely affects an individual’s ability to communicate. The hard of hearing individual relies on the auditory channel as the primary sensory input for communication (ASHA, 1993).
The Illinois Definition of Deafness and Hearing Impairments
Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance.
Hearing Impairments means an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but that is not included under the definition of deafness (ISBE, 2022).
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, ASHA, and Illinois definitions of communication disorders. Consider the differences and similarities between diagnostic criteria.
National Institute on Deafness and Other Communication Disorders. (2022). How do we hear? Retrieved October 17, 2022 from https://www.nidcd.nih.gov/health/how-do-we-hear
Sheetz, N.A. (2012). Deaf education in the 21st century: Topics and trends. Pearson.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
American Speech–Language–Hearing Association. (2022b, October 17). Types of hearing loss. https://www.asha.org/public/hearing/types-of-hearing-loss/
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(3)(2004).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(5)(2004).
American Speech–Language–Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. https://www.asha.org/policy/rp1993-00208/
Illinois State Board of Education. (2022, September 1). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx#:~:text=Specific%20learning%20disability%20means%20a,do%20mathematical%20calculations%2C%20including%20conditions | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/07%3A_Students_Who_Are_Deaf_or_Hard_of_Hearing/7.01%3A_Definitions_of_Deaf_and_Hard_of_Hearing.txt |
In 1817, the American School for the Deaf was founded as the first permanent school for the deaf in the United States. In 1865, Gallaudet University was founded; it provides a collegiate-level education to individuals who are deaf or hard of hearing. In 1880, the National Association of the Deaf (NAD) was founded. NAD advocates for the civil rights of individuals who are deaf or hard of hearing. Before IDEA, most students who were deaf or hard of hearing were educated in residential or special day schools. Today, many students who are deaf or hard of hearing are educated in public schools with their hearing peers. However, some members of the Deaf community prefer to attend state-funded residential and special day schools such as the Illinois School for the Deaf.
7.03: Prevalence and Causes of Deafness and Hard of Hearing
Among students receiving special education services, 1% are identified as having a hearing impairment (National Center for Education Statistics, 2022). However, not all students who have experienced hearing loss qualify for special education and related services. In addition, as identified earlier in this chapter, causes of hearing loss include conductive, sensorineural, and mixed hearing loss.
However, the cause of hearing loss is not always identifiable. Genetic or environmental factors can also cause hearing loss. For example, approximately 30% of all cases of sensorineural hearing loss are genetic (Smith & Robin, 2002). Usher syndrome is a rare genetic disease that affects both hearing and vision. Other genetic disorders that cause hearing loss include Pendred syndrome and Waardenburg syndrome. Environmental causes of sensorineural hearing loss are aging, medications that cause hearing loss, exposure to noise, and infections. Maternal viruses or infections such as cytomegalovirus, toxoplasmosis, and syphilis can also cause sensorineural hearing loss in children (Smiley et al., 2022).
National Center for Education Statistics. (2022). Students with disabilities. Condition of education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
Smith, R.H., & Robin, N.H. (2002). Genetic testing for deafness – GJB2 and SLC26A4 as causes of deafness. Journal of Communication Disorders, 35(4), 367–377. https://doi.org/10.1016/s0021-9924(02)00091-6
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
7.04: Characteristics of Students Who Are Deaf or Hard of Hearing
Characteristics of students who are deaf or hard of hearing vary based on the type, degree, and age of onset of the hearing loss. Although there are no significant differences related to the intelligence of students who are deaf or hard of hearing and their hearing peers, academic achievement is often impacted, with students who are deaf or hard of hearing scoring significantly below same-age peers in reading and math (Hrastinski & Wilbur, 2016; Qi & Mitchell, 2011). There may also be significant cultural differences as well as differences related to students’ use of speech and language.
Cultural Characteristics
American Deaf culture centers on the use of American Sign Language (ASL) and the identification and unity of other people who are Deaf. ASL is a visual/gestural language with no vocal component and is a complete, grammatically complex language. Dr. Barbara Kannapel, a sociologist who is Deaf, developed a definition of American Deaf culture that includes a set of values, behaviors, and traditions that include the following:
• Promoting an environment that supports vision as the primary sense used for communication at school, in the home, and in the community, as vision offers individuals who are deaf access to information about the world and the independence to drive, travel, work, and participate in every aspect of society.
• Valuing children who are deaf as the future of deaf people and Deaf culture. Deaf culture therefore encourages the use of ASL, in addition to any other communication modalities the child may have.
• Support for bilingual ASL/English education of children who are deaf, so they are competent in both languages.
• Inclusion of specific rules of behavior in communication in addition to the conventional rules of turn taking. For example, consistent eye contact and visual attention during a conversation are expected. In addition, a person using sign language has the floor during a conversation until they provide a visual indicator (pause, facial expression, etc.) that they are finished.
• Perpetuation of Deaf culture through a variety of traditions, including films, folklore, literature, athletics, poetry, celebrations, clubs, organizations, theaters, and school reunions. Deaf culture also includes some of its own “music” and poetry as well as dance.
• Inclusion of unique strategies for gaining a person’s attention, such as gently tapping a person on the shoulder if they are not within the line of sight, waving if the person is within the line of sight, or flicking a light switch a few times to gain the attention of a group of people in a room (Laurent Clerc National Deaf Education Center, 2022).
Educators and clinicians need to acknowledge that ASL is a legitimate language and provide opportunities for students who are deaf or hard of hearing to learn ASL. Some students who are hard of hearing may struggle with their identity and feel they are not quite members of the hearing or Deaf community. This can be avoided by educating students who are hard of hearing as bilingual–bicultural students, focusing on both ASL and English language skills, and actively promoting both Deaf and hearing cultures (Smiley et al., 2022).
Speech and Language Characteristics
Speech and language characteristics vary widely among students who are deaf or hard of hearing. These characteristics are affected by variables such as the age of onset of the hearing loss, type and degree of hearing loss, and language experiences. For example, a student whose parents are also deaf may have very different speech and language characteristics than another student whose family uses spoken language as their primary mode of communication.
Depending on the degree of hearing loss and the use of assistive listening devices (e.g., hearing aids) or cochlear implants, students who are deaf or hard of hearing may experience delayed speech development. However, early intervention and direction instruction allows many students who are deaf or hard of hearing to develop age-appropriate speech (Blamey, 2003). In addition, it is important for children who are deaf or hard of hearing to be exposed to a fully accessible language (e.g., ASL) to avoid language delays and develop the school readiness skills needed when learning to read and write (Smiley et al., 2022).
Hrastinski, I., & Wilbur, R.B. (2016). Academic achievement of deaf and hard-of-hearing students in an ASL/English bilingual program. The Journal of Deaf Studies and Deaf Education, 21(2), 156–170. https://academic.oup.com/jdsde/article/21/2/156/2404366
Qi, S., & Mitchell, R. E. (2011). Large-scale academic achievement testing of deaf and hard-of-hearing students: Past, present, and future. The Journal of Deaf Studies and Deaf Education, 17(1), 1–18. https://academic.oup.com/jdsde/article/17/1/1/359085
Laurent Clerc National Deaf Education Center (2022, October 17). American Deaf culture. https://clerccenter.gallaudet.edu/national-resources/info/info-to-go/deaf-culture/american-deaf-culture.html
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/07%3A_Students_Who_Are_Deaf_or_Hard_of_Hearing/7.02%3A_The_History_of_Deafness_and_Hard_of_Hearing.txt |
Babies are usually subjected to a newborn hearing screening. Children are also screened for hearing problems at regular intervals during their well-child visits. If a pediatrician identifies a hearing problem, the child will often be referred to an audiologist for additional testing, diagnosis, and treatment. ASHA has identified the role of an audiologist in its Scope of Practice in Audiology document. If hearing loss is determined to be congenital, the child’s family may choose to undergo genetic testing to determine a possible cause (Smith & Robin, 2002; Smiley et al., 2022).
Symptomatic behavior of a student who may be experiencing hearing loss includes the following.
• Complaints about the ears
• Frequent infections of the ear, nose, or throat
• Speech articulation problems
• Embarrassment about participating in school activities that require speaking and listening
• Frequent requests to have a verbal message repeated or said more loudly
• Problems attending to the conversation of others
Other possible symptoms that may be observed include turning up the volume on auditory devices, social withdrawal, inattentiveness, and not following directions (Smiley et al., 2022).
Scheetz (2012) identifies four types of testing used to evaluate students who may be experiencing hearing loss. Pure-tone tests are usually conducted once a hearing loss is suspected. Pure-tone tests help to determine the degree and type of hearing loss present. There are two types of pure-tone tests. In a pure-tone air test, or pure-tone audiogram, sounds of different pitches and loudness are transmitted, usually through earphones, directly into the ear. This test is often used to determine whether there may be a conductive, sensorineural, or mixed hearing loss. Speech reception threshold and speech discrimination threshold tests help to determine at what dB a student can hear speech and, once loud enough, how well the student can understand the speech. Audiologists may also determine if an amplification device is appropriate and how amplification might influence a student’s ability to communicate in different environments (Smiley et al., 2022).
Assessment of the Effect on Educational Performance
Identifying students under IDEA requires evidence that hearing loss adversely affects educational performance. In addition to audiologic testing, the multidisciplinary team (MDT) may conduct intelligence tests and other tests of academic abilities. However, there are several problems with these types of assessments. Many of these assessments have not been validated for use with students who are experiencing hearing loss. In addition, few assessments have normative comparison groups for students who are deaf or hard of hearing. The administration and interpretation of these types of assessments require a professional who is well versed in the norms of this particular student population (Smiley et al., 2022).
Smith, R.H., & Robin, N.H. (2002). Genetic testing for deafness – GJB2 and SLC26A4 as causes of deafness. Journal of Communication Disorders, 35(4), 367–377. https://doi.org/10.1016/s0021-9924(02)00091-6
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Sheetz, N.A. (2012). Deaf education in the 21st century: Topics and trends. Pearson.
7.06: Chapter Questions and References
1. What are the different types of hearing loss?
2. What are the IDEA definitions of deafness and hearing impairments?
3. What percentage of students receiving special education services are identified as having a hearing impairment?
4. What are the main types of causes of hearing loss?
5. What is the Deaf culture, and what role does it play in the lives of many individuals who are deaf and hard of hearing? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/07%3A_Students_Who_Are_Deaf_or_Hard_of_Hearing/7.05%3A_Identifying_Students_Who_Are_Deaf_or_Hard_of_Hearing.txt |
• 8.1: Definitions of Blindness and Low Vision
The Individuals with Disabilities Education Act (IDEA) uses the term visual impairment and defines it as the following.Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness (IDEA, Part B, Subpart A § 300.8(c)(13)(2004)).
• 8.2: The History of Blindness and Low Vision
In the United States, the education of students who were blind or had low vision began in the early 19th century. The Perkins School for the Blind, founded in 1829, was the first school for the blind in the United States.
• 8.3: Prevalence of Blindness and Low Vision
Among students receiving special education services, less than 1% are identified as having a visual impairment (National Center for Education Statistics, 2020).
• 8.4: Causes of Blindness and Low Vision
Blindness and low vision have many different causes affecting different parts and functions of the eye, including optical defects, ocular motility disturbance, and external and internal problems of the eye (Smiley et al., 2022).
• 8.5: Characteristics of Students who are Blind or Have Low Vision
The characteristics of students who are blind or have low vision vary based on age of onset and severity of vision loss. For example, children born with congenital blindness may experience developmental delays without appropriate intervention.
• 8.6: Identifying Students Who Are Blind or Have Low Vision
Different professionals are involved in identifying vision loss and treating vision problems, including ophthalmologists, optometrists, and opticians. Ophthalmologists are medical doctors who identify and treat eye problems, prescribe medication, and perform surgery.
• 8.7: Chapter Questions and References
08: Students Who Are Blind or Have Low Vision
The Individuals with Disabilities Education Act (IDEA) uses the term visual impairment and defines it as the following.
Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness (IDEA, Part B, Subpart A § 300.8(c)(13)(2004)).
Educators and clinicians should note that while the IDEA definition uses the term “partial sight,” the more commonly used term is “low vision.”
In addition to the IDEA definition, state laws often include definitions for blindness. These laws are associated with visual acuity. Typically, a standard distance of 20 feet is used as a base measure of visual acuity. For example, an individual with 20/20 vision must be able to identify letters or objects at a distance of 20 feet. Visual acuity of 20/200 means that an individual can identify letters or objects at a distance of 20 feet that a typically sighted individual could see at 200 feet. In addition, these definitions take into account the use of corrective lenses and the eye with the best vision using corrective lenses.
Legal definitions are used for determining eligibility for government services (e.g., vocational rehabilitation for adults) rather than eligibility for special education and related services. In Illinois, the Bureau for the Blind Act defines blindness as
any person whose central visual acuity does not exceed 20/200 in the better eye with corrective lenses or a visually impaired person whose vision with best correction is 20/60 in the better eye, or with a field restriction of 105 degrees if monocular vision; 140 degrees if binocular vision (Bureau for the Blind Act, 20 ILCS 2410/2(e)).
The Illinois State Board of Education has an additional definition of visual impairment that is used to determine eligibility for special education and related services.
The Illinois Definition of Visual Disability
“Visual Impairment means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness” (Illinois State Board of Education, 2022).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(13)(2004).
Bureau for the Blind Act, 20 ILCS 2410/2(e).
Illinois State Board of Education. (2022, October 25). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx
8.02: The History of Blindness and Low Vision
In the United States, the education of students who were blind or had low vision began in the early 19th century. The Perkins School for the Blind, founded in 1829, was the first school for the blind in the United States. In 1837, Ohio established the Ohio State School for the Blind, the first state-supported residential school for the blind. In 1849, Illinois founded the Illinois School for the Visually Impaired. However, it was not until 1879 that the American Printing House for the Blind (APH) received federal funding to supply braille books and apparatus for blind students nationwide. In 1936, APH obtained permission to publish books for children in the Talking Book format (i.e., audiobooks). The National Federation of the Blind and the American Foundation for the Blind have advocated for the civil rights of people who are blind or have low vision. In 1995, The National Agenda for the Education of Children and Youths with Visual Impairments, Including Those with Multiple Disabilities, which identifies specific educational goals for students who are blind or have low vision, was published. This document was revised in 2004 and has had a profound impact on the education of children who are blind or have low vision.
Activity \(1\): The National Agenda
Directions: Read The National Agenda for the Education of Children and Youths with Visual Impairments, Including Those with Multiple Disabilities. How do the goals outlined in this document support the education of students who are blind or have low vision?
8.03: Prevalence of Blindness and Low Vision
Among students receiving special education services, less than 1% are identified as having a visual impairment (National Center for Education Statistics, 2020). It is important for educators and clinicians to know that some students who experience vision loss do not require special education and related services because their vision loss does not impact their educational performance.
National Center for Education Statistics. (2020). Digest of education statistics. https://nces.ed.gov/programs/digest/d19/tables/dt19_204.30.asp | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/08%3A_Students_Who_Are_Blind_or_Have_Low_Vision/8.01%3A_Definitions_of_Blindness_and_Low_Vision.txt |
Blindness and low vision have many different causes affecting different parts and functions of the eye, including optical defects, ocular motility disturbance, and external and internal problems of the eye (Smiley et al., 2022). Vision relies on an interaction between the eye and the brain. First, light passes through the cornea, which is the clear front layer of the eye. The cornea is shaped like a dome and bends light to help the eye focus. Some of this light enters the eye through an opening called the pupil. The iris, the colored part of the eye, controls how much light the pupil lets in. Next, light passes through the lens, a clear inner part of the eye. The lens works with the cornea to focus light correctly on the retina. When light hits the retina, a light-sensitive layer of tissue at the back of the eye, special cells called photoreceptors turn the light into electrical signals. These electrical signals travel from the retina through the optic nerve to the brain. The brain then turns the signals into images (National Eye Institute, 2022a).
Optical Defects
There are three major optical defects: myopia, hyperopia, and astigmatism. These are refraction errors. Refractive errors are a type of vision problem that makes it hard to see clearly. Refraction errors happen when the shape of the eye keeps light from focusing correctly on the retina.
• Myopia (i.e., nearsightedness) makes faraway objects look blurry.
• Hyperopia (i.e., farsightedness) makes nearby objects look blurry.
• Astigmatism can make faraway and nearby objects look blurry or distorted.
Symptoms of refraction errors include double vision, hazy vision, or a glare or halo around bright lights. Students may also experience headaches or eye strain or have trouble focusing when reading or looking at electronic devices (National Eye Institute, 2022b). Astigmatism is usually present at birth. However, myopia and hyperopia can develop throughout the lifespan (Smiley et al., 2022).
Ocular Motility Disturbance
Ocular motility disturbance refers to any abnormal eye alignment or difficulty controlling eye movements. These conditions involve the brain and the muscles that control eye movement and include strabismus, nystagmus, and amblyopia. Strabismus is a condition where the eyes are not facing in the same direction. It is a relatively common condition in children and may be present at birth. Symptoms of strabismus may include eyes that do not point in the same direction, double vision, and poor depth perception.
Amblyopia is a condition in which the brain fails to process the information from one eye. This may occur because one eye is misaligned (strabismus) and incorporating that information would cause double vision. It may also occur if one eye has much better vision than the other, and the brain selects the clearer image. Nystagmus is characterized by fast, uncontrollable eye movements. This may be present at birth (Houston Methodist, 2022).
Types of External Eye Problems
External eye problems may affect the orbit, eyelids, and cornea. Orbital problems may include protruding, recessed, or abnormally small eyeballs. Abnormalities of the eyelids include drooping of the upper eyelids, outward or inward rolling of the eyelids, eyelids that do not close completely, and inflammation of the lids or glands around the eye (Smiley et al., 2022). Students may also experience corneal problems such as growths, thinning of the cornea, and inflammation of the cornea, which can lead to problems with vision, pain, and tearing of the cornea (National Eye Institute, 2022c).
Types of Internal Eye Problems
There are also several conditions that may affect the internal components of the eye, such as retinopathy of prematurity (ROP). ROP is an eye disease that may occur in babies who are premature or who weigh less than 3 pounds at birth. ROP happens when abnormal blood vessels grow in the retina. Some babies with ROP have mild cases and get better without treatment. But some babies need treatment to protect their vision and prevent blindness (National Eye Institute, 2022d).
In addition, retinitis pigmentosa (RP), a group of rare eye diseases that affect the retina, causes cells in the retina to break down slowly over time, causing vision loss. RP is genetic, with symptoms beginning in childhood, resulting in significant vision loss (National Eye Institute, 2022e). Cortical visual impairment (CVI) is a disorder caused by damage to the parts of the brain that process vision. A child with CVI has vision problems caused by their brain that cannot be explained by a problem with their eyes. Normally, the eyes send electrical signals to the brain, and the brain turns those signals into images. Children with CVI have trouble processing and understanding these signals. CVI is caused by an injury to the brain. These injuries usually happen before, during, or shortly after birth (National Eye Institute, 2022f). Finally, traumatic brain injury may also cause vision problems in children (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
National Eye Institute. (2022a). How the eyes work. https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/how-eyes-work
National Eye Institute. (2022b). Refraction errors. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors
Houston Methodist. (2022). Ocular motility disturbances. https://www.houstonmethodist.org/neurology/neuro-ophthalmology-diseases/ocular-motility-disturbances/
National Eye Institute. (2022c). Corneal conditions. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/corneal-conditions
National Eye Institute. (2022d). Retinopathy of prematurity. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity
National Eye Institute. (2022e). Retinitis pigmentosa. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinitis-pigmentosa
National Eye Institute. (2022f). Cerebral visual impairment. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cerebral-visual-impairment-cvi | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/08%3A_Students_Who_Are_Blind_or_Have_Low_Vision/8.04%3A_Causes_of_Blindness_and_Low_Vision.txt |
The characteristics of students who are blind or have low vision vary based on age of onset and severity of vision loss. For example, children born with congenital blindness may experience developmental delays without appropriate intervention. Vision influences development for young children by providing reasons for movement and exploration of one’s environment (e.g., seeing a novel object and crawling toward it) and interaction with others. For young children who are blind or have low vision, it is important for adults to encourage their interaction with their environment, including interactions with other children.
In addition, children who are blind or have low vision may have problems associating words with concepts and generating various word meanings. For example, if a child has never seen a particular animal (e.g., bird), it may be difficult for them to describe the animal or its specific features (e.g., feathers) and what they do. Therefore, hands-on learning activities (e.g., touching a feather) are helpful when learning about new concepts or word meanings.
Finally, some students who are blind or have low vision may have trouble with proprioception or their awareness of their body in space, which is directly related to motor development. This is an important skill for students to learn because proprioception is needed for orientation (i.e., the process of using sensory input to know one’s position in their environment) and mobility (i.e., moving about an environment safely and efficiently). Students who are blind or have low vision can successfully learn orientation and mobility skills when training is provided beginning in early childhood. Technology such as global positioning systems may also assist individuals with blindness or low vision to better navigate their environment (Smiley et al., 2022).
When working with students who are blind or have low vision, educators and clinicians need to arrange their classrooms or offices to optimize the use of a student’s residual vision and other senses for learning. Special educators must be licensed specifically to teach students with low vision and blindness.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
8.06: Identifying Students Who Are Blind or Have Low Vision
Different professionals are involved in identifying vision loss and treating vision problems, including ophthalmologists, optometrists, and opticians. Ophthalmologists are medical doctors who identify and treat eye problems, prescribe medication, and perform surgery. Optometrists examine eyes for defects and problems in refraction and prescribe corrective lenses. Opticians make or sell optical devices and instruments. A low-vision specialist is an ophthalmologist or optometrist who specializes in assessing and treating individuals with 20/70 vision or worse.
When appropriate screenings and medical care are provided, most children with blindness or low vision are identified before four months of age. In addition, periodic vision screenings are usually required for school-age children. However, once a student is identified as having blindness or low vision, a comprehensive assessment that includes the components of functional vision, learning media assessment, and orientation and mobility skills is required (Smiley et al., 2022).
Functional Vision Assessment
Functional vision is the use of any residual vision to obtain information from the environment. For example, a student who is blind or has low vision may use residual vision to read printed materials with magnification and to navigate their environment safely. Assessing how well students can use their residual vision in functional ways is critical for providing special education and related services to these students. Functional vision assessment examines visual and behavioral skills (Smiley et al., 2022). The Perkins School for the Blind has developed a Functional Vision Assessment Template for educators and clinicians. Functional vision assessments are conducted by educators or clinicians who are specially trained to perform them and interpret the results.
Learning Media Assessment
A learning media assessment is used to help educators and clinicians select appropriate learning media and assistive technology (Smiley et al., 2022). For example, some students are able to use printed materials with magnification or enlarged print, whereas other students may use braille (i.e., a system of raised dots that can be read with the fingers). In addition, some students may also use screen readers (i.e., software programs that allow users to read the text that is displayed on a computer screen with a speech). The National Reading Media Assessment is a helpful tool for conducting learning media assessments.
Orientation and Mobility Skills Assessment
Assessments of orientation and mobility skills address concepts such as spatial orientation and special physical education needs and can determine how familiar the student is with their classroom, school, home, and community environments. An orientation and mobility specialist may also assess a student’s use of special devices (e.g., a cane) (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
8.07: Chapter Questions and References
1. What is the IDEA definition of visual impairments?
2. What is the prevalence of students receiving special education services who are blind or have low vision?
3. What are the optical defects that cause vision loss?
4. What are the ocular motility conditions that cause vision loss?
5. What are the components of a comprehensive assessment? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/08%3A_Students_Who_Are_Blind_or_Have_Low_Vision/8.05%3A_Characteristics_of_Students_who_are_Blind_or_Have_Low_Vision.txt |
Students with physical or health disabilities include those with orthopedic impairments, other health impairments, and traumatic brain injury under the Individuals with Disabilities Education Act (IDEA). The IDEA defines orthopedic impairment (OI) as the following.
Orthopedic impairment means a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures) (IDEA, Part B, Subpart A § 300.8(c)(8)(2004)).
Under IDEA, for a student to receive special education and related services, the OI must adversely affect their educational performance.
The IDEA defines other health impairment (OHI) as the following.
Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—
• Is due to chronic or acute health problems such as asthma, attention-deficit disorder or attention-deficit/hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and
Adversely affects a child’s educational performance (IDEA, Part B, Subpart A § 300.8(c)(9)(2004)).
• The final category included in this chapter is traumatic brain injury. The IDEA defines traumatic brain injury (TBI) as the following.
Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma (IDEA, Part B, Subpart A § 300.8(c)(12)(2004)).
The Illinois Definitions of Physical and Health Disabilities
“Orthopedic Impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., Poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).
Other Health Impairment means having limited strength, vitality or alertness, including a heightened sensitivity to environmental stimuli, that results in limited alertness with respect to the educational environment that
• is due to chronic or acute health problems such as asthma, attention-deficit disorder or attention-deficit/hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, or sickle cell anemia; and
• adversely affects a child's educational performance.
Traumatic Brain Injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; psychosocial functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative or to brain injuries induced by birth trauma” (Illinois State Board of Education, 2022).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(8)(2004).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(9)(2004).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(12)(2004).
Illinois State Board of Education. (2022, October 25). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/09%3A_Students_with_Physical_or_Health_Disabilities/9.01%3A_Definitions_or_Physical_and_Health_Disabilities.txt |
Each physical and health disability category has a unique history. However, it was not until the 19th century that physicians began to understand the underlying causes of disorders such as cerebral palsy and epilepsy and the impact of viruses such as polio that resulted in physical and health disabilities. Before IDEA, many children with physical and health disabilities were denied access to a public education or segregated from their peers. Most school buildings could not accommodate wheelchairs or students with limited mobility. However, in 1975, the passage of the Education for All Handicapped Children Act guaranteed a free and appropriate public education for children with disabilities in the United States. This law included the concept of educating students in the least restrictive environment that also meets each student’s educational needs. This law laid the groundwork for the programs we see in public schools today. Moreover, these disability categories continue to evolve as we learn more about different diseases and as new viruses emerge (e.g., human immunodeficiency virus, Zika, and coronavirus) that may result in the development of physical and health disabilities in children.
Activity \(1\): Disability Services at the University of Illinois
Directions: Read about the history of Disability Services at the University of Illinois. The University of Illinois was the first post-secondary institution to provide a support service program enabling students with disabilities to attend. What new opportunities did this program provide to students with physical and health disabilities?
9.03: University of Illinois Alumni Spotlight
“If you think the UI’s admissions standards are tough now, imagine having to endure what future famed Springfield attorney Saul Morse did in the late 1960s.
‘I am disabled and have always used a wheelchair. School in Philadelphia was for me an experience in quasi segregation as I was required to attend a school limited to students with disabilities,’ he says.
‘An uncle had read about the program for people with disabilities, the first and at the time one of the only ones in the country, in the American Medical Association Journal. He passed it on to my parents, and soon we were headed to Champaign for a preliminary interview.
‘Others from all over the country were applying for one of the approximately 25 slots allotted to those with disabilities.
‘I was provisionally admitted, the provisional part being that I had never bathed or dressed myself since no one thought I would ever be independent and thus did not need to know how. At Illinois, the program at the time required that you be totally independent and never need or accept assistance. I was given one week before new student week to prove I should stay.
‘Seeing ramps at street corners was a new experience since they did not exist anywhere else I had been, including major cities where I or my family lived. At the corner of Fourth and Gregory, I crossed the street with no help, no curb, along with everyone else, regardless of their abilities.
‘It was a lasting taste of freedom I have never forgotten.
‘My education, both as an undergraduate and as a law student, has served me much better than I had a right to expect, and the friendships have lasted a lifetime. The entire campus carries great meaning and memories, but I come back to that corner whenever I am in town for a fond remembrance of possibilities previously not thought to exist’” (The News-Gazette, 2022).
The News-Gazette. (2022, November 1). Saul Morse. University of Illinois: 150 years and beyond. https://uofi150.news-gazette.com/people/saul-morse | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/09%3A_Students_with_Physical_or_Health_Disabilities/9.02%3A_The_History_of_Physical_and_Health_Disabilities.txt |
Physical and health disabilities have many different causes and characteristics. Students with OIs often experience motor movement deficits that stem from damage to the central nervous system or loss of a limb. Students with OHIs may have contracted a virus or have another disease or disorder that impacts the operation of different organs. Students with TBIs may have different characteristics depending on the injury type, location, and severity (Smiley et al., 2022).
Orthopedic Impairments
Educators and clinicians working with students who have OIs are most likely to encounter cerebral palsy, spina bifida, and muscular dystrophy.
Cerebral Palsy
Cerebral palsy is a group of disorders that affect a person’s ability to move and maintain balance and posture. Cerebral palsy is the most common orthopedic impairment in children and is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control their muscles. The damage, which typically occurs before, during, or shortly after birth, does not progress over time.
The symptoms of cerebral palsy vary. A person with severe cerebral palsy might need to use special equipment to walk or might not be able to walk and need to use a wheelchair. Some people with cerebral palsy may also need an augmentative communication device to communicate with others. A person with mild cerebral palsy might not need any special equipment to walk. However, all people with cerebral palsy have problems with movement and posture. Many also have related conditions such as intellectual disability; seizures; problems with vision, hearing, or speech; changes in the spine (e.g., scoliosis); or joint problems (e.g., contractures).
Physicians classify cerebral palsy according to the main type of movement disorder and the location of the brain damage. This includes stiff muscles (i.e., spasticity), uncontrollable movements (i.e., dyskinesia), and poor balance and coordination (i.e., ataxia). There are four main types of cerebral palsy: spastic, dyskinetic, ataxic, and mixed cerebral palsy (CDC, 2022a).
Spina Bifida
Spina bifida, which affects the spine and is usually apparent at birth, is a type of neural tube defect. Spina bifida may occur anywhere along the spine if the neural tube does not close completely. When the neural tube does not close, the backbone that protects the spinal cord does not form and close as it should. This often results in damage to the spinal cord and nerves.
Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on the opening’s size and location in the spine and whether it affects part of the spinal cord and nerves. The three most common types of spina bifida are spina bifida occulta, meningocele, and myelomeningocele.
Spina bifida occulta occurs when an opening exists in one or more of the spinal column vertebrae but there is no damage to the spinal cord itself. Meningocele occurs when the membranes surrounding the spinal cord, called meninges, protrude through a hole in the vertebrae, causing the development of a meningocele sac. As with spina bifida occulta, the meningocele does not damage the spinal cord.
The most severe and commonly diagnosed type of spina bifida is myelomeningocele, in which the spinal cord itself protrudes through the back so that the nerves themselves are exposed. Depending on where this sac is located, various degrees of neurological problems may result. The higher the sac forms, the more serious the neurological problem. Spina bifida may be diagnosed during pregnancy or after the baby is born. However, spina bifida occulta might not be diagnosed until late childhood or adulthood or may never be diagnosed (CDC, 2022b).
Muscular Dystrophy
Muscular dystrophies are a group of muscle diseases caused by mutations in a person’s genes that result in muscle weakness and decreased mobility. There are different kinds of muscular dystrophy, each affecting specific muscle groups. Muscular dystrophy may be inherited, or a person may be the first in their family to have muscular dystrophy. There may be several different genetic types within each kind of muscular dystrophy, and people with the same kind of muscular dystrophy may experience different symptoms (CDC, 2022c).
Duchenne muscular dystrophy is the most prevalent kind of muscular dystrophy. Duchenne muscular dystrophy is usually inherited from the mother, who has a defective gene that regulates dystrophin, which is responsible for maintaining muscle fiber (Smiley et al., 2022). Duchenne muscular dystrophy usually affects the upper legs and upper arms first and may cause problems with the heart, lungs, throat, stomach, intestines, and spine (CDC, 2022c).
Other Health Impairments
Various health conditions may require special education or related services, including epilepsy, asthma, cystic fibrosis, and diabetes. Students with attention-deficit/hyperactivity disorder, discussed in Chapter 11, are also often provided services under this category.
Epilepsy
Epilepsy is a central nervous system disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, or loss of awareness. There are two types of seizures: focal seizures and generalized seizures.
Focal seizures result from abnormal activity in just one area of the brain. Generalized seizures involve all areas of the brain. There are two types of focal seizures: focal seizures without loss of consciousness and focal seizures with impaired awareness.
• Focal seizures without loss of consciousness. These seizures do not cause a loss of consciousness, but they may alter emotions or change how things look, smell, feel, taste, or sound. This type of seizure may also result in involuntary jerking of one body part (e.g., arm or leg) and spontaneous sensory symptoms such as tingling, dizziness, and flashing lights.
• Focal seizures with impaired awareness. These seizures involve a change or loss of consciousness or awareness. During a focal seizure with impaired awareness, a person may stare into space and not respond normally to their environment or perform repetitive movements such as hand rubbing, chewing, swallowing, or walking in circles.
There are six types of generalized seizures: absence seizures, tonic seizures, atonic seizures, clonic seizures, myoclonic seizures, and tonic–clonic seizures.
• Absence seizures. Absence seizures typically occur in children. They are characterized by staring into space with or without subtle body movements such as eye blinking and last between 5 and 10 seconds. These seizures may occur in clusters, happening as often as 100 times per day, and cause a brief loss of awareness.
• Tonic seizures. Tonic seizures cause stiff muscles and may affect consciousness. These seizures usually affect muscles in a person’s back, arms, and legs and may cause them to fall to the ground.
• Atonic seizures. Atonic seizures cause a loss of muscle control. Because this most often affects the legs, it often causes a person to suddenly collapse or fall down.
• Clonic seizures. Clonic seizures are associated with repeated or rhythmic jerking muscle movements. These seizures usually affect the neck, face, and arms.
• Myoclonic seizures. Myoclonic seizures usually appear as sudden, brief jerks or twitches and usually affect the upper body, arms, and legs.
• Tonic–clonic seizures. Tonic–clonic seizures are the most serious type of epileptic seizure. They can cause an abrupt loss of consciousness, body stiffening, twitching, and shaking (Mayo Clinic, 2022a).
When dealing with a student who is having a tonic–clonic seizure, remove all nearby furniture and objects, lay the individual down, and turn their head to the side to help prevent breathing problems. It is also a good idea to put a soft folded object (e.g., a towel or jacket) under the student’s head to prevent injuries. Do not put anything inside the student’s mouth (Smiley et al., 2022).
For many children, epilepsy is controlled with medication and does not impact their educational performance (CDC, 2022d). However, epilepsy may be associated with different risk factors such as intellectual disabilities, concussions, abnormal areas in the brain, and bleeding in the brain (Smiley et al., 2022).
Asthma
Asthma is a condition in which a person’s airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, wheezing, and shortness of breath. For some students, asthma is a minor health concern that is easily controlled with medication. For others, it may be a major health concern that interferes with daily activities and may lead to a life-threatening asthma attack. Children may experience one of two types of asthma: exercise-induced asthma or allergy-induced asthma triggered by airborne substances such as pollen, mold spores, cockroach waste, or pet dander (Mayo Clinic, 2022b).
Asthma, food allergies, and high risk of anaphylaxis (i.e., severe allergic reaction) frequently co-occur, and asthma increases the risk of fatal anaphylaxis. Therefore, students who have severe asthma may carry adrenaline or epinephrine kits that can be self-administered. Educators and clinicians working with students with severe asthma should also be familiar with administering these kits (Smiley et al., 2022).
Cystic Fibrosis
Cystic fibrosis is an inherited disorder that causes severe damage to different organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat, and digestive juices. These secreted fluids are normally thin and slippery, but in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as lubricants, the secretions block tubes, ducts, and passageways, especially in the lungs and pancreas. Cystic fibrosis is a progressive disease that requires medication and physical therapy to thin and dislodge mucus from airways in the lungs (Mayo Clinic, 2022c; Smiley et al., 2022).
Diabetes
Diabetes refers to a group of diseases that affect how the body uses blood sugar (i.e., glucose). Glucose is an important energy source for the cells that make up muscles and other tissues within the body. It's also the brain's main source of fuel. The main cause of diabetes varies by type and leads to excess sugar in the blood, which may cause serious health complications such as nerve damage.
Chronic diabetes conditions include Type 1 diabetes and Type 2 diabetes. Type 1 diabetes is often diagnosed in children. Type 2 diabetes may develop at any age. Children may have a genetic predisposition to develop diabetes, and certain environmental risk factors, such as diet, may contribute to the disease’s development. The symptoms of diabetes include increased hunger, thirst, urination, and blurred vision. Both types of diabetes may be controlled with medication, diet, and exercise (Mayo Clinic, 2022d).
Traumatic Brain Injury
TBI usually results from a violent blow to the head or body. An object that goes through brain tissue may also cause TBI. Mild TBI may affect the brain’s cells temporarily. However, moderate to severe TBI may result in bruising, torn tissues, bleeding, and other physical damage to the brain. These injuries may result in long-term complications or death.
TBIs have different physical and psychological effects. For example, some signs or symptoms may appear immediately after the traumatic event, whereas others may appear days or weeks later. The signs and symptoms of mild TBI may include the following:
• Headache
• Nausea or vomiting
• Fatigue or drowsiness
• Problems with speech
• Dizziness or loss of balance
• Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth, or changes in the ability to smell
• Sensitivity to light or sound
• Cognitive, behavioral, or mental symptoms
• Loss of consciousness for a few seconds to a few minutes
• No loss of consciousness, but a state of being dazed, confused, or disoriented
• Memory or concentration problems
• Mood changes or mood swings
• Feeling depressed or anxious
• Difficulty sleeping
• Sleeping more than usual
Moderate to severe TBI may include any of the signs and symptoms of mild injury, as well as the following symptoms that may appear within the first hours to days after the head injury.
• Loss of consciousness from several minutes to hours
• Persistent headache or headache that worsens
• Repeated vomiting or nausea
• Convulsions or seizures
• Dilation of one or both pupils of the eyes
• Clear fluids draining from the nose or ears
• Inability to awaken from sleep
• Weakness or numbness in fingers and toes
• Loss of coordination
• Cognitive or mental symptoms
• Profound confusion
• Agitation, combativeness, or other unusual behavior
• Slurred speech
• Coma and other disorders of consciousness
Infants and young children with TBI might be unable to communicate headaches, sensory problems, or confusion. Educators and clinicians may observe the following behaviors in a child with TBI.
• Change in eating or nursing habits
• Unusual or easy irritability
• Persistent crying and inability to be consoled
• Change in ability to pay attention
• Change in sleep habits
• Seizures
• Sad or depressed mood
• Drowsiness
• Loss of interest in favorite toys or activities (Mayo Clinic, 2022e)
Students with TBI may also experience cognitive symptoms such as changes in attention, information processing, and memory that may affect educational performance. Students with TBI may also experience behavioral symptoms such as irritability, aggression, lack of self-control, and hyperactivity (Smiley et al., 2022).
9.05: Prevalence or Physical and Health Disabilities
Among students receiving special education services, 15% are identified as having an OHI (National Center for Education Statistics, 2022). Less than 1% are identified as having an OI or a TBI (National Center for Education Statistics, 2020). The prevalence of TBI may also be underreported, as it is often diagnosed as attention-deficit/hyperactivity disorder or a specific learning disability. In addition, many students who have physical or health disabilities may never receive special education or related services because their disability does not adversely affect their educational performance (Smiley et al., 2022).
National Center for Education Statistics. (2022). Students with disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
National Center for Education Statistics. (2020). Digest of education statistics. https://nces.ed.gov/programs/digest/d19/tables/dt19_204.30.asp
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
9.06: Identifying Students with Physical or Health Disabilities
Most students with OIs or OHIs are identified by physicians before or after birth. For example, amniocentesis (i.e., removal of a small amount of amniotic fluid), chorionic villus sampling (i.e., removal of tissue samples from the placental), and ultrasound (i.e., bouncing of sound waves off the fetus to produce a “picture”) are all prenatal procedures that can detect various physical or health disabilities before a child is born. In addition, physicians may use a variety of other medical tests to diagnose OIs and OHIs (e.g., blood tests, electromyography, computerized tomography, and magnetic resonance imaging) after a child is born. TBI is identified through medical procedures such as brain imaging and by observing the student’s physical symptoms (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
9.07: Chapter Questions and References
1. Which categories under IDEA comprise the area of physical and health disabilities?
2. What is the prevalence of students receiving special education services in each IDEA category comprising the area of physical and health disabilities?
3. What are the types and characteristics of the various types of cerebral palsy?
4. What are the names and characteristics of the different types of seizures?
5. What prenatal procedures can be used to identify many physical and health disabilities? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/09%3A_Students_with_Physical_or_Health_Disabilities/9.04%3A_Causes_and_Characteristics_of_Physical_and_Health_Disabilities.txt |
Autism spectrum disorder (ASD) is a developmental disability that causes social, communication, and behavioral challenges. Before the most recent publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM), there were various related diagnoses, including Asperger syndrome (or disorder) and pervasive developmental disorder–not otherwise specified (PDD–NOS). These diagnoses were removed in the current edition and were replaced with ASD. We will discuss the history of ASD later in this chapter.
• 10.1: Definitions of ASD
The Individuals with Disabilities Education Act (IDEA) of 2004 provides the following definition of autism but does not currently define ASD. Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance.
• 10.2: The History of ASD
In 1980, the APA officially acknowledged autism as a disorder. In 1990, the IDEA included autism as a disability category.
• 10.3: Prevalence of ASD
Among students receiving special education services, 12% are identified as having autism (National Center for Education Statistics [NCES], 2022).
• 10.4: Causes of ASD
The cause of ASD is unknown. However, evidence supports that there may be both genetic and environmental causes.
• 10.5: Characteristics of Autism Spectrum Disorder
Students with ASD exhibit a wide range of characteristics. However, students with ASD often exhibit problems with social communication and interaction and exhibit restricted or repetitive behaviors.
• 10.6: University of Illinois Alumni Spotlight
“Mary Temple Grandin graduated with a Ph.D. from the College of Agricultural, Consumer, and Environmental Sciences at the University of Illinois Urbana-Champaign in 1989.
• 10.7: Identifying Students with Autism Spectrum Disorders
Diagnosing ASD can be difficult because there are no medical tests (e.g., blood tests) that are used to diagnose the disorder. A medical professional examines a child’s developmental history and behavior to make a diagnosis.
• 10.8: Chapter Questions and References
10: Students with Autism Spectrum Disorder
The Individuals with Disabilities Education Act (IDEA) of 2004 provides the following definition of autism but does not currently define ASD.
Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.
• Autism does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance.
• A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria of this section are satisfied (Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(1)(2004)).
The American Psychiatric Association (APA) Definition
The APA DSM defines ASD as the following.
1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history (examples are illustrative, not exhaustive; see text):
1. Deficits in social–emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absences of interest in peers.
2. Restrictive, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive, see text):
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take [the] same route or eat [the] same food every day).
3. Highly restricted, fixed interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
3. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies later in life).
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. These disturbances are not better explained by intellectual developmental disorder (intellectual disability) or global developmental delay. Intellectual developmental disorder and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual developmental disorder, social communication should be below that expected for general developmental level.
Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder–not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder (DSM-5-TR, 2022, p. 56–57).
Within the note in this definition, the authors of the DSM have included a new disorder called social (pragmatic) communication disorder. This disorder includes children with only language and social impairments. In addition, students diagnosed with ASD may also be classified using severity specifiers that describe the level of support the student may require.
The Illinois Definition of ASD
“Autism Spectrum Disorder (ASD) is a developmental disability that affects an individual’s ability to communicate (e.g., the ability to use language to express one’s needs) and the ability to engage in social interaction (e.g., the ability to engage in joint attention). This disability significantly affects verbal/nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance. Often other characteristics associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance. The child’s performance, strengths, skills, deficits, and challenges associated with ASD will vary greatly from child to child.
Characteristics of Autism Spectrum Disorder (ASD)
• Intense reactions to sounds, smells, tastes, textures, lights, and/or colors
• Resistance to minor changes in routine or surroundings
• Delayed language development
• Loss of previously acquired speech or social skills
• Persistent repetition of words or phrases (echolalia)
• Difficulty understanding other people’s feelings
• Avoidance of eye contact
• Persistent preference for solitude” (Illinois State Board of Education, 2022)
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, APA, and Illinois definitions of autism and ASD. Consider the differences and similarities between the criteria included in each definition.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(1)(2004)
American Academy of Pediatrics. (2021, April 20). Autism spectrum disorder. https://www.aap.org/en/patient-care/autism/
Illinois State Board of Education. (2022, September 27). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/10%3A_Students_with_Autism_Spectrum_Disorder/10.01%3A_Definitions_of_ASD.txt |
In 1980, the APA officially acknowledged autism as a disorder. In 1990, the IDEA included autism as a disability category. However, multiple editions of the APA DSM since 1980 have significantly changed the diagnosis of autism and related disorders over time. In 1980, the DSM-III established the diagnosis of autism. However, based on a growing body of research, this diagnosis was eventually expanded to include related disorders such as Asperger’s syndrome, PDD–NOS, childhood disintegrative disorder, and Rhett syndrome.
In the 1990s, researchers attempted to find specific sets of genes that contributed to each of these disorders. Instead, they found hundreds of genes that contributed to autism symptoms. Therefore, the DSM-IV changed the diagnosis of autism and related disorders to an all-inclusive diagnosis of autism with symptoms that ranged from mild to severe. Finally, the DSM-V introduced the term autism spectrum disorder (ASD) and removed all related disorders. This was a controversial change, and many individuals diagnosed with related disorders such as Asperger’s syndrome were afraid of losing their identities and the medical and behavioral health benefits their diagnoses provided (Zeldovich, 2018; Smiley et al., 2022).
Activity \(1\): The Problematic History of Hans Asperger
Directions: The Austrian pediatrician Hans Asperger has long been recognized as a pioneer in the study of autism. However, it is now indisputable that Asperger collaborated in the murder of children with disabilities in Nazi-era Vienna. Read Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna by Herwig Czech.
Zeldovich, L. (2018, May 9). The evolution of “autism” as a diagnosis, explained. Spectrum. https://www.spectrumnews.org/news/evolution-autism-diagnosis-explained/
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
10.03: Prevalence of ASD
Among students receiving special education services, 12% are identified as having autism (National Center for Education Statistics [NCES], 2022). The Centers for Disease Control and Prevention (CDC) reports that males are four times more likely to be diagnosed with ASD than females (CDC, 2022). However, not all students with ASD require special education and related service; therefore, the prevalence may be higher than reported by the NCES.
National Center for Education Statistics. (2022). Students with disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved August 30, 2022, from https://nces.ed.gov/programs/coe/indicator/cgg.
Centers for Disease Control and Prevention. (2022, March 2). Data and statistics on autism spectrum disorder. https://www.cdc.gov/ncbddd/autism/data.html
10.04: Causes of ASD
The cause of ASD is unknown. However, evidence supports that there may be both genetic and environmental causes. It is generally accepted that ASD is a result of abnormalities in brain structure or brain function and that genetic and environmental factors may cause these abnormalities.
For example, there is evidence that the brains of children with ASD are larger than those of their peers without ASD, but as they age, the difference in size is reduced. This is referred to as the “growth dysregulation hypothesis” and may be caused by genetic defects in brain growth factors. In addition, twin studies have indicated that an identical twin of an individual with ASD is also likely to have ASD, and parents who have a child with ASD are also more likely to have another child with ASD. Researchers believe that ASD is a complex disorder that most likely results from multiple gene abnormalities (Autism Speaks, 2022; Smiley et al., 2022).
In addition, there is evidence that environmental factors may influence the development of the disorder in genetically susceptible children during vulnerable periods of development. Environmental factors that have been identified as possible causes include problems during pregnancy and delivery (e.g., oxygen deprivation at birth), viral infections (e.g., rubella, measles, mumps, polyomaviruses, cytomegalovirus, and influenza), and metabolic imbalances (e.g., purine and pyrimidine disorders). However, extensive research has proven that vaccines do not cause autism (Smiley et al., 2022).
Autistic Self-Advocacy Network (2022). About autism. https://autisticadvocacy.org/about-asan/about-autism/
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill. | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/10%3A_Students_with_Autism_Spectrum_Disorder/10.02%3A_The_History_of_ASD.txt |
Students with ASD exhibit a wide range of characteristics. However, students with ASD often exhibit problems with social communication and interaction and exhibit restricted or repetitive behaviors. Examples of problems with social communication and interaction include the following.
• Inability to make or keep eye contact
• Decreased facial recognition
• Limited ability to share interests or achievements
• Difficulty initiating social interactions or maintaining friendships
Deviations in language development may also contribute to problems with social communication. For example, some students with ASD may have limited speech or may not speak. In addition, some students may display characteristics such as echolalia, the repetition of words and phrases said to them. Echolalia may be immediate or delayed, where the child repeats a previously heard word or phrase hours, days, or weeks later. Other less prevalent language characteristics are palilalia, when a student repeats their own words; echopraxia, the repetition of others’ gestures and movements; and the use of neologisms (i.e., made-up words). Students with ASD may also use inappropriate pronouns or sentences that are less complex than those used by their peers without ASD (Smiley et al., 2022).
Examples of restricted or repetitive behaviors include the need for a routine, engaging in repetitive motor movements (e.g., rocking back and forth, hand flapping, hand wringing), repetitive play (e.g., repeatedly spinning the wheels on a truck), an unusual attachment to particular objects or toys, and obsession with particular topic areas (e.g., baseball statistics) or interests (e.g., dinosaurs). Deficits in executive functioning—the skills that enable individuals to plan, focus attention, and remember—may also contribute to these types of behaviors.
Students with ASD may also display characteristics related to sensory and motor functions, such as an abnormal response to sensory stimuli, including response to sound, smell, taste, tactile input, or visual stimuli; reduced sensitivity to pain, heat, or cold; and abnormal eating and sleeping behaviors. For example, a student with ASD may be overresponsive or underresponsive to loud noises or hypersensitive to smells in the environment.
Students with ASD may also experience developmental delays as well as co-occurring disorders such as learning disabilities, intellectual disabilities, and emotional or behavioral disorders (e.g., depressive disorders, anxiety disorders, and schizophrenia spectrum disorders). Some students may also experience health disorders such as seizure disorders, gastrointestinal disorders, and attention deficit hyperactivity disorder (Autistic Self-Advocacy Network, 2022; Smiley et al., 2022).
Finally, it is important to note that students with ASD may also have significant strengths. For example, it is generally accepted that students with ASD have strong visual processing skills (Smiley et al., 2022). Educators and clinicians must remember that students with ASD may exhibit a wide range of characteristics that require individualized instruction and intervention.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Autistic Self-Advocacy Network (2022). About autism. https://autisticadvocacy.org/about-asan/about-autism/
10.06: University of Illinois Alumni Spotlight
“Mary Temple Grandin graduated with a Ph.D. from the College of Agricultural, Consumer, and Environmental Sciences at the University of Illinois Urbana-Champaign in 1989. Dr. Grandin is a well-known professor of animal sciences, but she is best known for being one of the first individuals with ASD to speak out about her experience. She has authored several books and articles about her personal experiences as well as research regarding livestock. In 2010, Dr. Grandin was named one of Time Magazine’s most influential people in the world. She has received numerous awards and honorary degrees, and in February 2017, she was named to the National Women’s Hall of Fame” (University of Illinois Urbana-Champaign, 2022).
University of Illinois Urbana-Champaign. (2022). Mary Temple Grandin. Retrieved December 6, 2022, from https://gec150.web.illinois.edu/1980s/mary-temple-grandin/#illinois%20#wggpillinoa
10.07: Identifying Students with Autism Spectrum Disorders
Diagnosing ASD can be difficult because there are no medical tests (e.g., blood tests) that are used to diagnose the disorder. A medical professional examines a child’s developmental history and behavior to make a diagnosis. By age two, a diagnosis by an experienced medical professional is considered reliable. However, many children do not receive a diagnosis until they are much older, which delays their ability to access appropriate special education and related services.
Medical professionals should monitor a child’s development at well-child visits and screen children for ASD at 18 and 24 months (American Association of Pediatrics, 2021). Screening instruments are designed to help identify young children who warrant further attention. One example is the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F, Robins et al., 2009). With its use, medical professionals classify a child’s risk of having autism as low, medium, or high based on caregivers’ answers to 20 questions (Smiley et al., 2022).
At these visits, medical professionals should also be asking caregivers about typical developmental milestones, or skills that most children reach by a certain age. The CDC has developed a collection of resources on their Learn the Signs. Act Early. web page, which outlines typical developmental milestones and includes an app that helps caregivers monitor their child’s development.
For a medical professional or psychologist to make a diagnosis, specific criteria must be met (see the APA definition). Additional medical screening may also be required to exclude other developmental disabilities or conditions such as communication disorders, hearing impairment, or intellectual disability. In addition, specific tests have been designed to identify ASD, including the Autism Diagnostic Observation Schedule, Second Edition (Lord et al., 2012), and the Autism Diagnostic Interview–Revised (Rutter et al., 2003). However, the tests that are used depend on the child’s age. While many students with ASD are identified before they begin school, educators and clinicians play a significant role in identifying ASD and supporting students with ASD, which may include but is not limited to special education, speech and language instruction, occupational therapy, and physical therapy (Smiley et al., 2022).
American Academy of Pediatrics. (2021, April 20). Autism spectrum disorder. https://www.aap.org/en/patient-care/autism/
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Lord, C., Rutter, M., DiLavore, P., & Risi, S. (2012). Autism diagnostic observation schedule (2nd ed.). Pearson.
Rutter, M., LeConteur, A., & Lord, C. (2003). The autism diagnostic manual, revised. Western Psychological Services.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
10.08: Chapter Questions and References
1. What is the IDEA definition of autism?
2. What is the prevalence of AS?
3. What role do genetics play in ASD?
4. What are the common characteristics of ASD?
5. When are children usually screened for ASD? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/10%3A_Students_with_Autism_Spectrum_Disorder/10.05%3A_Characteristics_of_Autism_Spectrum_Disorder.txt |
Attention-deficit/hyperactivity disorder (ADHD) is not considered a separate disability category under the Individuals with Disabilities Education Act (IDEA). However, it is classified under Other Health Impairment (OHI) when special education and related services are required.
Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—
• Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and
• Adversely affects a child’s educational performance (Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(9)(2004)).
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(9)(2004)
11: Students With Attention-Deficit Hyperactivity Disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association defines attention-deficit/hyperactivity disorder as the following.
1. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: (Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.)
1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
2. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
3. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
5. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
7. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
8. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
9. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: (Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.)
1. Often fidgets with or taps hands or feet or squirms in seat.
2. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
3. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless).
4. Often unable to play or engage in leisure activities quietly.
5. Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
6. Often talks excessively.
7. Often blurts out an answer before a question has been completed (e.g., completes other people’s sentences; cannot wait for turn in conversation).
8. Often has difficulty waiting his or her turn (e.g., waiting in line).
9. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
2. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
3. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
4. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
5. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal) (DSM-5-TR, 2022, p. 68–69).
The DSM also defines ADHD as mild, moderate, or severe based on the following criteria.
Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning.
Moderate: Symptoms or functional impairment between “mild” and “severe” are present.
Severe: Many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning (DSM-5-TR, 2022, p. 70).
The Illinois Definitions of Physical and Health Disabilities
“Other Health Impairment means having limited strength, vitality or alertness, including a heightened sensitivity to environmental stimuli, that results in limited alertness with respect to the educational environment that
• is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, or sickle cell anemia; and
• adversely affects a child’s educational performance” (Illinois State Board of Education, 2022).
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Illinois State Board of Education. (2022, September 27). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/11%3A_Students_With_Attention-Deficit_Hyperactivity_Disorder/11.01%3A_Definitions_of_Attention-Deficit_Hyperactivity_Disorder.txt |
ADHD has gained attention in recent years, but the condition was first described in 1902 by George F. Still, a British physician. He presented a series of papers to the Royal College of Physicians describing children with a variety of characteristics, including attention problems and hyperactivity. In the 20th century, professionals began recognizing what would eventually become ADHD as a specific disorder and that students with this disorder had unique educational needs.
In the 1960s, the second edition of the DSM defined the term hyperkinetic reaction disorder of childhood. In the 1970s, professionals shifted their research interest from hyperactivity to attention problems, which resulted in the introduction of the term attention deficit disorders with or without hyperactivity in the third edition of the DSM. In 1987, the DSM removed the hyperactivity option and replaced it with undifferentiated attention deficit disorder. In 1994, the current term, attention-deficit/hyperactivity disorder, was introduced (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
11.03: Prevalence of Attention-Deficit Hyperactivity Disorder
Among children aged 3 to 17 years, approximately 9% are identified as having ADHD. Improved education and awareness have increased the disorder’s prevalence significantly in recent years (CDC, 2022). Although ADHD is not included as a separate disability category under IDEA, it is included under OHI.
Centers for Disease Control and Prevention. (2002, November 5). Attention deficit hyperactivity disorder. https://www.cdc.gov/nchs/fastats/adhd.htm
11.04: Causes of Attention-Deficit Hyperactivity Disorder
ADHD is generally accepted as a neurological disorder. Research has shown that the prefrontal lobe, the basal ganglia, and the cerebellum are impacted in individuals with ADHD (Krain & Castellanos, 2006). The prefrontal lobe plays a central role in cognitive control functions, influencing attention and impulse inhibition. The basal ganglia and cerebellum are associated with motor behavior and may play a role in controlling hyperactivity. There is also evidence that ADHD may be genetic. It is estimated that between 40 to 60% of children of a parent with ADHD will also have ADHD (National Institute of Mental Health, 2022; Smiley et al., 2022).
Krain, A., & Castellanos, F.X. (2006). Brain development and ADHD. Clinical Psychology Review, 26, 433-444.
National Institute of Mental Health. (2022, September). Attention-deficit/hyperactivity disorder. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
11.05: Characteristics of Attention-Deficit Hyperactivity Disorder
The DSM includes specific characteristics that are used to diagnose an individual with ADHD. The characteristics associated with ADHD vary by age. Young children typically demonstrate excessive gross motor behavior associated with hyperactivity, such as the inability to stay seated in the classroom. They may also seem fidgety or restless and may be unable to complete tasks. In addition, some students may appear to be engaged but are not attending to the task. These students, more often girls, are underdiagnosed in the early elementary grades (Quinn & Madhoo, 2014). During adolescents, signs of hyperactivity become less common, but students may still experience restlessness or impatience (DSM-5-TR, 2022). Research has shown that as children age, the hyperactivity–impulsivity characteristics tend to decrease, but the inattentive characteristics remain. This results in academic challenges as students are required to engage in more challenging and independent work as they age. In addition, some students with ADHD may experience relationship difficulties. For example, students with ADHD may experience difficulty regulating their emotions or identifying emotions in others, which inhibits relationship building (Smiley et al., 2022).
Coexistence With Other Exceptionalities
The coexistence, or comorbidity, of ADHD with other exceptionalities is well documented. These include psychological disorders such as oppositional defiant disorder, conduct disorder, disruptive mood dysregulation disorder, and anxiety and depressive disorders. In addition, approximately 20 to 30% of students with ADHD also have a specific learning disability (LDA, 2022).
Quinn, P. O. & Madoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis. https://www.psychiatrist.com/pcc/neurodevelopmental/adhd/review-attention-deficit-hyperactivity-disorder-women/
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed. Text Revision). https://doi.org/10.1176/appi.books.9780890425596
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Learning Disabilities Association of America. (2022). Affects focus, attention and behavior and can make learning challenging. https://ldaamerica.org/disabilities/adhd/
11.06: Identifying Students with Attention-Deficit Hyperactivity Diso
The identification of individuals with ADHD is a comprehensive process that involves multiple measures such as interviews, academic testing, and observation. If a student is exhibiting ADHD symptoms, the first step is a medical evaluation to rule out other medical problems that might be causing the inattention, hyperactivity, or impulsivity (Smiley et al., 2022).
If students are exhibiting symptoms of ADHD before they enter school, they will most likely be diagnosed by their primary healthcare provider (e.g., pediatrician) or a mental health professional (e.g., psychologist or psychiatrist). Once a child enters school, a teacher may identify them for the school’s pre-referral process. If the pre-referral interventions are not successful, a formal referral is made for evaluation to determine eligibility for special education and related services. The pre-referral and referral process may include the students’ teachers, the special education teacher, and the school psychologist, as well as the student’s pediatrician or primary care physician.
Often, parents and teachers are interviewed by a clinician, such as a school psychologist. Parent and teacher interviews provide information about the student’s current behavior across multiple settings. When appropriate, the student may also be interviewed about their perspective regarding their behavior, which gives the clinician an opportunity to observe the student. The school psychologist may also use ADHD-specific rating scales such as the Attention-Deficit/Hyperactivity Disorder Test (Gilliam, 2015) and the Conners Rating Scale-Revised (Conners, 2008). Finally, both educators and school psychologists may directly observe a student’s behavior in different settings to document the frequency of problematic behaviors and the duration of behaviors. For example, a classroom teacher may document how long a student is able to focus on a task (Smiley et al., 2022).
It is important to note that medication is the primary intervention for students with ADHD. However, students should also receive behavioral interventions that promote the use of self-regulation strategies in and outside of school.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Gilliam, J. (2015). Attention-deficit/hyperactivity test (2nd ed.). Pro-Ed.
Conners, C. (2008). Conners rating scale–Revised (3rd ed.). Multi-Health Systems.
11.07: Chapter Questions and References
1. What is the APA definition of ADHD?
2. What are the three types of ADHD?
3. What is the prevalence of ADHD?
4. What areas of the brain are thought to be involved in ADHD?
5. Who is involved in the identification of a student with ADHD? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/11%3A_Students_With_Attention-Deficit_Hyperactivity_Disorder/11.02%3A_The_History_of_Attention-Deficit_Hyperactivity_Disorder.txt |
• 12.1: The Illinois Definition of Severe Disabilities
Severe disabilities include two disability categories, multiple disabilities and deaf–blind, as well as other combinations of disability categories.
• 12.2: The History of Severe Disabilities
The history of the treatment of people with severe disabilities is similar to that of the treatment of people with intellectual disabilities (see Chapter 4). Before the establishment of advocacy organizations (e.g., The ARC), many people with severe disabilities were institutionalized.
• 12.3: Prevalence of Severe Disabilities
Among students receiving special education services, 2% are identified as having multiple disabilities, and less than 1% are identified as deaf–blind (National Center for Education Statistics [NCES], 2022).
• 12.4: Causes and Characteristics of Severe Disabilities
The causes and characteristics of severe disabilities vary by student. This section of the chapter will provide an overview of common causes and characteristics but does not provide a comprehensive list.
• 12.5: Identifying Students with Severe Disabilities
Severe disabilities, especially those disabilities that are congenital (i.e., present at birth), are usually identified by medical professionals before a child begins school. Assessments to identify young children with severe disabilities include neonatal screening, medical evaluations, and developmental assessments.
• 12.6: Chapter Questions and References
12: Students with Severe Disabilities
Severe disabilities include two disability categories, multiple disabilities and deaf–blind, as well as other combinations of disability categories. The Individuals with Disabilities Education Act (IDEA) defines multiple disabilities as “concomitant impairments (such as intellectual disability–blindness or intellectual disability–orthopedic impairment), the combination of which causes such severe educational needs that cannot be accommodated in special education programs solely for one of the impairments. Multiple disabilities does not include deaf–blindness” (IDEA, Part B, Subpart A § 300.8(c)(7)(2004)). This definition states that the presence of multiple disabilities requires additional special education or related services. Deaf–blindness is a separate category.
The IDEA defines deaf–blindness as “concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness” (IDEA, Part B, Subpart A § 300.8(c)(2)(2004)). For a student to qualify for services in this category, their visual and hearing challenges need not meet the threshold for legal deafness or blindness. However, the combination of the two disabilities increases the student’s educational needs.
The Illinois Definition of Severe Disabilities
The Illinois State Board of Education does not have a specific definition for severe disabilities. It does, however, include the following definitions for multiple disabilities and deaf–blindness.
• “Multiple Disabilities means concomitant impairments (such as intellectual disability–blindness or intellectual disability–orthopedic impairment), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments. Multiple disabilities does not include deaf–blindness.
• Deaf–Blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness” (ISBE, 2022).
Note that the federal definition and the Illinois definition are exactly the same.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(2)(2004)
Individuals With Disabilities Education Act, Part B, Subpart A § 300.8(c)(7)(2004)
Illinois State Board of Education. (2022, September 27). Special education disability areas. https://www.isbe.net/Pages/Special-Education-Disability-Areas.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/12%3A_Students_with_Severe_Disabilities/12.01%3A_The_Illinois_Definition_of_Severe_Disabilities.txt |
The history of the treatment of people with severe disabilities is similar to that of the treatment of people with intellectual disabilities (see Chapter 4). Before the establishment of advocacy organizations (e.g., The ARC), many people with severe disabilities were institutionalized. In 1975, the Education for All Handicapped Children Act 94-142 was passed, which required all public schools to provide equal access to an education for all students with disabilities. Today, the Rehabilitation Act and Americans with Disabilities Act secure the rights of individuals with severe disabilities to equal opportunity and equal protection under the law.
One driving factor that specifically spurred action for children with severe disabilities was a rubella outbreak in the 1960s. This outbreak resulted in a large number of children with severe disabilities, which rallied parental support around the movement to deinstitutionalize individuals with severe disabilities and to pass the Education for All Handicapped Children Act 94-142 (Smiley et al., 2022). However, many people with severe disabilities continue to fight for equal access to an inclusive education. Advocacy organizations such as The Association for Persons with Severe Handicaps (now called TASH) continue to play an important role in ensuring the rights of people with severe disabilities.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
12.03: Prevalence of Severe Disabilities
Among students receiving special education services, 2% are identified as having multiple disabilities, and less than 1% are identified as deaf–blind (National Center for Education Statistics [NCES], 2022). In 2021, The National Center on Deaf–Blindness reported that 10,336 children receiving special education services were categorized as deaf–blind in the United States (National Center on Deaf–Blindness, 2022).
12.04: Causes and Characteristics of Severe Disabilities
The causes and characteristics of severe disabilities vary by student. This section of the chapter will provide an overview of common causes and characteristics but does not provide a comprehensive list. Severe disabilities may be caused by both genetic and environmental factors, including chromosomal disorders (e.g., Hurler syndrome, Tay–Sachs disease); prenatal (e.g., the use of drugs or alcohol by the pregnant mother), perinatal (e.g., anoxia and other birth-related injuries), or postnatal trauma (e.g., childhood diseases and infections); and childhood head injuries and exposure to environmental toxins. In addition, the lack of early intervention or appropriate health-related services may contribute to a mild disability becoming more severe as a child develops.
Intellectual disability is often one of the disabilities experienced by students with severe disabilities. However, that may not always be the case. For example, a student may experience severe physical and health disabilities and demonstrate above-average intellectual abilities. In addition, students with severe disabilities may experience developmental delays impacting motor function, speech and language, cognition, and social and emotional development (Smiley et al., 2022). Students with severe disabilities may require a wider range of related services, including nursing and other health-related services in school. However, it is important to ensure that these students experience an inclusive education and that educators and clinicians work to actively facilitate the development of relationships between students with and without disabilities
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
12.05: Identifying Students with Severe Disabilities
Severe disabilities, especially those disabilities that are congenital (i.e., present at birth), are usually identified by medical professionals before a child begins school. Assessments to identify young children with severe disabilities include neonatal screening, medical evaluations, and developmental assessments. In addition, a social worker may be employed to evaluate the needs of a family with a child who has severe disabilities (e.g., health care, child care, food assistance). However, some genetic conditions (e.g., Tay–Sachs disease) are not evident at birth and may develop over time. In addition, a physical or sensory disability could lead to a secondary disability, such as a communication disorder, if a child does not receive appropriate early intervention services. Therefore, multiple and severe disabilities may emerge as a child develops.
Once a child enters school, the child and family will be engaged in the special education referral process, which may include multiple assessments based on the student’s needs. The focus for students with severe disabilities is often on their ability to function in various environments (e.g., school, home, community) and what interventions they need to function as independently as possible (e.g., augmentative or alternative communication systems, orientation and mobility assistance, and school-based health services) (Smiley et al., 2022). See Chapters 7 and 8 for a discussion on the identification of students who are blind or have low vision and for students who are deaf or hard of hearing.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
12.06: Chapter Questions and References
1. What two federal categories can be considered severe disabilities?
2. What is the prevalence of severe disabilities?
3. What are the causes of severe disabilities?
4. When are most students with severe disabilities identified?
5. What are some ways severe disabilities are identified in young children? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/12%3A_Students_with_Severe_Disabilities/12.02%3A_The_History_of_Severe_Disabilities.txt |
In Chapter 1, we learned that early intervention services are provided to infants and toddlers under the age of 3 who have a disability or are exhibiting developmental delays. These children are considered at-risk infants and toddlers. In this chapter, we will discuss the federal and state definitions of at-risk and how at-risk students are identified.
• 13.1: Definitions of At-Risk
The Individuals with Disabilities Education Act (IDEA) defines an at-risk infant or toddler as an individual under three years of age who would be at risk of experiencing a substantial developmental delay if early intervention services were not provided to the individual.
• 13.2: The History of Head Start and At-Risk Programming
In the 1960s, Lyndon B. Johnson’s administration, influenced by research on the effects of poverty on children, assembled a group of experts to develop a program that supported the needs of young children living in poverty who were at risk of school failure.
• 13.3: Prevalence of At-Risk Students
In 2020, approximately 3% of all children from birth through age 3 received early intervention services under IDEA Part C, the Program for Infants and Toddlers with Disabilities (IDEA Section 618 Data Products, 2022).
• 13.4: At-Risk Factors
There are a number of factors that indicate a student might be at risk for academic failure (i.e., risk factors). Risk factors are not causes of academic failure but may contribute to the likelihood of academic failure.
• 13.5: Identifying At-Risk Students
Under IDEA, states must identify and provide services for at-risk infants and toddlers. Medical professionals are the first to refer families for early intervention services immediately after birth.
• 13.6: Chapter Questions and References
13: At-Risk Students
The Individuals with Disabilities Education Act (IDEA) defines an at-risk infant or toddler as
an individual under three years of age who would be at risk of experiencing a substantial developmental delay if early intervention services were not provided to the individual. At the state’s discretion, at-risk infant or toddler may include an infant or toddler who is at risk of experiencing developmental delays because of biological or environmental factors that can be identified (including low birth weight, respiratory distress as a newborn, lack of oxygen, brain hemorrhage, infection, nutritional deprivation, a history of abuse or neglect, and being directly affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure). (IDEA, Part B, Subpart A § 3005.5(2004)).
As stated in the IDEA definition, states have the authority to identify eligibility criteria. In Illinois, the Illinois General Assembly has defined at-risk infants or toddlers as the following:
1. “Eligible infants and toddlers” means infants and toddlers under 36 months of age with any of the following conditions:
1. Developmental delays.
2. A physical or mental condition which typically results in developmental delay.
3. Being at risk of having substantial developmental delays based on informed clinical opinion.
Either (A) having entered the program under any of the circumstances listed in paragraphs (1) through (3) of this subsection but no longer meeting the current eligibility criteria under those paragraphs, and continuing to have any measurable delay, or (B) not having attained a level of development in each area, including (i) cognitive, (ii) physical (including vision and hearing), (iii) language, speech, and communication, (iv) social or emotional, or (v) adaptive, that is at least at the mean of the child’s age equivalent peers; and, in addition to either item (A) or item (B), (C) having been determined by the multidisciplinary individualized family service plan team to require the continuation of early intervention services in order to support continuing developmental progress, pursuant to the child’s needs and provided in an appropriate developmental manner. The type, frequency, and intensity of services shall differ from the initial individualized family services plan because of the child’s developmental progress, and may consist of only service coordination, evaluation, and assessments.
“Eligible infants and toddlers” includes any child under the age of 3 who is the subject of a substantiated case of child abuse or neglect as defined in the federal Child Abuse Prevention and Treatment Act.
1. “Developmental delay” means a delay in one or more of the following areas of childhood development as measured by appropriate diagnostic instruments and standard procedures: cognitive; physical, including vision and hearing; language, speech, and communication; social or emotional; or adaptive. The term means a delay of 30% or more below the mean in function in one or more of those areas.
2. “Physical or mental condition which typically results in developmental delay” means
1. a diagnosed medical disorder or exposure to a toxic substance bearing a relatively well known expectancy for developmental outcomes within varying ranges of developmental disabilities; or
2. a history of prenatal, perinatal, neonatal or early developmental events suggestive of biological insults to the developing central nervous system and which either singly or collectively increase the probability of developing a disability or delay based on a medical history.
3. “Informed clinical opinion” means both clinical observations and parental participation to determine eligibility by a consensus of a multidisciplinary team of 2 or more members based on their professional experience and expertise. (Early Intervention Services System Act, 2022)
In addition, once a child enters school, they may be considered at risk of academic failure because of additional environmental risk factors such as living in poverty or suffering adverse childhood experiences such as abuse or neglect. The Illinois State Board of Education has a broader definition of at-risk that applies to all school-age students.
The Illinois State Board of Education Definition for At Risk
The Illinois State Board of Education states that “risk factors are those variables found in individuals, families, communities, schools, and peers that put youth at greater risk of participating in delinquent and risky behaviors or developing mental, emotional, physical or behavioral disorders. For example, a youth exposed to physical and emotional abuse is more likely to develop mental, emotional, physical or behavioral problems than a youth who has not experienced trauma” (ISBE, 2022).
Activity \(1\): Compare and Contrast
Directions: Compare and contrast the IDEA, Illinois General Assembly, and Illinois State Board of Education definitions for at-risk.
States provide different early intervention services that are funded by both federal and state money. For example, Head Start is one federally funded program that provides comprehensive early childhood education, health, nutrition, and other social services to at-risk children and their families.
Illinois’ Early Intervention Services
In addition to Head Start programs, Illinois also provides at-risk infants and toddlers and their families access to the following programs:
• Preschool for All and The Prevention Initiative, which provide funds for preschool, home visits, and center-based infant and toddler care for at-risk children.
• Title I Preschool, which provides funding for preschools associated with K–12 schools and other local education agencies with a concentration of low-income children.
• The Child Care Assistance Program, which provides childcare subsidies to low-income working families and those engaged in education or training activities to pay for childcare.
• The Illinois Early Intervention Program, which provides resources and supports to infants and toddlers with diagnosed disabilities or developmental issues.
Individuals With Disabilities Education Act, Part B, Subpart A § 300.5(2004)
Early Intervention Services System Act, 325 ILCS 20. (2022) https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1463&ChapterID=32
Illinois State Board of Education. (2022, December 15). Risk factors. https://www.isbe.net/Pages/Risk-Factors.aspx | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/13%3A_At-Risk_Students/13.01%3A_Definitions_of_At-Risk.txt |
In the 1960s, Lyndon B. Johnson’s administration, influenced by research on the effects of poverty on children, assembled a group of experts to develop a program that supported the needs of young children living in poverty who were at risk of school failure. This program was called Head Start, and it promoted the school readiness of young children from low-income families through agencies in their local community. Currently, Head Start grants are administered by the United States Department of Health and Human Services, Administration for Children and Families (U.S. Department of Health and Human Services Office of Head Start, 2022a).
Since Head Start’s inception, researchers have continued to examine factors that contribute to a child’s being identified as at-risk for developmental delay and school failure. In 1994, the Carnegie Foundation published a report, “Starting Points: Meeting the Needs of Our Youngest Children,” that highlighted the importance of the first 3 years of life for subsequent healthy development and cited factors that were contributing to a “quiet crisis” that included rising rates of child abuse and neglect (Carnegie Corporation of New York, 1994).
In 2000, the National Research Council and the Institute of Medicine of the National Academies published a report, “From Neurons to Neighborhoods: The Science of Early Childhood Development,” that concluded there are “striking disparities in what children know and can do [which] are evident well before they enter kindergarten. These differences are strongly associated with social and economic circumstances, and they are predictive of subsequent academic performance” (National Research Council and Institute of Medicine Committee on Integrating the Science of Early Childhood Development, 2000). These two reports spurred policymakers to support Head Start and other early childhood programs focused on early intervention services for at-risk children.
Activity \(1\): Head Start in Illinois
Directions: Learn more about Head Start programs in Illinois by visiting the Illinois Head Start Association. Search for a local Head Start program near you. What services does Head Start provide to children and their families?
U.S. Department of Health and Human Services Office of Head Start. (2022a). Head Start history. https://www.acf.hhs.gov/ohs/about/history-head-start
Carnegie Corporation of New York. (1994). Starting points: Meeting the needs of our youngest children. https://www.carnegie.org/publications/starting-points-meeting-the-needs-of-our-youngest-children/
National Research Council and Institute of Medicine Committee on Integrating the Science of Early Childhood Development. (2000). From neurons to neighborhoods: The science of early childhood. https://pubmed.ncbi.nlm.nih.gov/25077268/
13.03: Prevalence of At-Risk Students
In 2020, approximately 3% of all children from birth through age 3 received early intervention services under IDEA Part C, the Program for Infants and Toddlers with Disabilities (IDEA Section 618 Data Products, 2022). In addition, in 2020, Head Start served 839,116 children and families in the United States. Illinois-specific Head Start programs served 29,117 children and families (U.S. Department of Health and Human Services Office of Head Start, 2022b). However, children of all ages may be at risk for school failure, and educators and clinicians play an important role in identifying these students.
IDEA Section 618 Data Products. (2022, December 15). Static tables part C: Child count and settings table 1. https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c-child-count-and-settings-table-1/resources
U.S. Department of Health and Human Services Office of Head Start. (2022b). Head Start program facts: Fiscal year 2021. https://eclkc.ohs.acf.hhs.gov/about-us/article/head-start-program-facts-fiscal-year-2021 | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/13%3A_At-Risk_Students/13.02%3A_The_History_of_Head_Start_and_At-Risk_Programming.txt |
There are a number of factors that indicate a student might be at risk for academic failure (i.e., risk factors). Risk factors are not causes of academic failure but may contribute to the likelihood of academic failure. The more risk factors a student has, the more likely that the child might experience academic failure. Risk factors include premature birth; low birth weight; prenatal, perinatal, and postnatal trauma and other health issues (e.g., failure to thrive); diagnosed disability; poverty; and homelessness (Smiley et al., 2022). Adverse childhood experiences are also considered risk factors. Adverse childhood experiences are potentially traumatic events that occur before a child turns 18. These include physical, emotional, and sexual abuse, physical and emotional neglect, and living in a household with a parent or caregiver experiencing substance abuse, mental illness, divorce, domestic violence, or incarceration. Children may also experience potentially traumatic events in their community, including bullying, violence, and discrimination (Centers for Disease Control and Prevention, 2022).
Teenage pregnancy is another factor that puts adolescents at risk for academic failure. In addition, children of adolescent mothers face higher risks of low birth weight, preterm birth, and neonatal conditions, which put them at risk for developmental delay (World Health Organization, 2022). English learners may face academic challenges that put them at risk for academic failure (Smiley et al., 2022). Therefore, it is important for educators and clinicians to acknowledge these risk factors and create environments that are sensitive to the challenges these students are facing. Protective factors that guard against the negative effects of these risk factors include access to a safe and nurturing educational environment and the development of meaningful and positive connections with school staff. Students benefit a great deal from knowing someone cares about their well-being and academic success.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Centers for Disease Control and Prevention. (2022, April 6). Fast facts: Preventing adverse childhood experiences. https://www.cdc.gov/violenceprevention/aces/fastfact.html
World Health Organization. (2022, December 15). Adolescent pregnancy. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy#:~:text=Adolescent%20mothers%20
13.05: Identifying At-Risk Students
Under IDEA, states must identify and provide services for at-risk infants and toddlers. Medical professionals are the first to refer families for early intervention services immediately after birth. Medical professionals also conduct appropriate screenings and assessments to determine whether a child has a developmental delay at well-child visits. Parents and caregivers may also seek out early intervention services through programs such as Child Find, a program that develops public awareness about federal- and state-funded early childhood services.
In addition, mandated reporters (e.g., childcare workers, teachers, clinicians, and other school personnel) must report any incidents of suspected child abuse or neglect to the appropriate state agency, which may result in referral to early intervention services as well as other social services the family may need.
Reporting Child Abuse and Neglect in Illinois
The Illinois Department of Children and Family Services has the primary responsibility of protecting children through the investigation of suspected abuse or neglect. As a mandated reporter, you must report suspected child abuse or neglect.
As discussed in Chapter 1, schools also conduct academic and behavioral assessments using the Response to Intervention (RTI) framework. RTI is a proactive instructional framework for preventing academic issues in the early elementary grades and a remediation framework for improving outcomes in academics and behavior in upper elementary and secondary grades to prevent academic failure. Finally, educators and clinicians may refer students to their school’s social worker for access to mental health care and other social services (Smiley et al., 2022).
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
13.06: Chapter Questions and References
1. How does IDEA define an at-risk infant or toddler?
2. Who else might be considered at risk? Why?
3. What services does the Head Start program provide?
4. How are at-risk children identified?
5. What is the role of mandated reporters? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/13%3A_At-Risk_Students/13.04%3A_At-Risk_Factors.txt |
There are no mandates for gifted education at the federal level, nor is there an official definition of gifted and talented students. Therefore, it is up to states and school districts to identify gifted and talented students, develop gifted and talented programs, and meet the unique needs of these students.
• 14.1: Definition of Gifted and Talented Students
In 1972, a federal report, “Education of the Gifted and Talented,” provided the following definition of gifted and talented students, also referred to as the Marland Definition in reference to the then commissioner of education Sidney P. Marland, Jr.
• 14.2: The History of Gifted and Talented Students
In the United States, gifted education did not begin in earnest until the twentieth century with the passage of the Jacob K. Javits Gifted and Talented Students Education Act (1987).
• 14.3: Prevalence of Gifted and Talented Students
It is difficult to estimate the number of gifted and talented students in the United States. In 2014, the National Center for Education Statistics reported that approximately 7% of public school students were identified as being serviced in gifted and talented education programs (NCES, 2018).
• 14.4: Causes of Gifted and Talented Students
The development of gifts and talents cannot be attributed to a single factor such as genetics or environment. Intelligence is thought to be a result of both genetics and environment. Twin studies suggest that the environment plays an active role in how genes are expressed.
• 14.5: Characteristics of Gifted and Talented Students
The characteristics of gifted and talented students vary by student. This section of the chapter will provide an overview of common characteristics associated with above-average intelligence.
• 14.6: Identifying Gifted and Talented Students
The process of identifying gifted and talented students varies between states and school districts. However, intelligence tests and academic achievement tests are commonly used (e.g., Wechsler Intelligence Scale for Children-V).
• 14.7: Chapter Questions and References
14: Gifted and Talented Students
In 1972, a federal report, “Education of the Gifted and Talented,” provided the following definition of gifted and talented students, also referred to as the Marland Definition in reference to the then commissioner of education Sidney P. Marland, Jr.
Gifted and talented children are those identified by professionally qualified persons who by virtue of outstanding abilities, are capable of high performance. These are children who require differentiated educational programs and/or services beyond those normally provided by the regular school program in order to realize their contribution to self and society. Children capable of high performance include those with demonstrated achievement and/or potential ability in any of the following areas, singly or in combination:
1. General intellectual ability
2. Specific academic aptitude
3. Creative or productive thinking
4. Leadership ability
5. Visual and performing arts
6. Psychomotor ability (Marland, 1972)
This definition serves as the foundation for many of the definitions of gifted and talented students that are used today. Modified versions of this definition were proposed by the United States Department of Education in 1978 as part of the Gifted and Talented Act (Public Law 95-516) and in 1981 by the Education Consolidation and Improvement Act. These subsequent definitions were similar but eliminated psychomotor ability (i.e., superior athleticism) as one of the possible criteria (Smiley et al., 2022).
In 1993, a report, “National Excellence: A Case for Developing America’s Talent,” identified concerns about the underidentification of culturally and linguistically diverse students as gifted and talented. The report introduced the following definition.
Children and youth with outstanding talent perform or show the potential for performing at remarkably high levels of accomplishment when compared with others of their age, experience, or environment.
These children and youth exhibit high-performance capability in intellectual, creative, and/or artistic areas, possess an unusual leadership capacity, or excel in specific academic fields. They require services or activities not ordinarily provided by the schools.
Outstanding talents are present in children and youth from all cultural groups, across all economic strata, and in all areas of human endeavor. (Ross, 1993, p. 11)
In 1998, Joseph Renzulli, an educational psychologist at the University of Connecticut, developed what he called the three ring concept of giftedness. The three rings include above-average ability, creativity, and task commitment. Students who possess a combination of these three traits exhibit gifted behavior (Renzulli, 1998). Renzulli’s model indicates that gifts and talents may emerge in students of varying abilities who may excel in one or more areas and are motivated to learn.
Example \(1\): Renzulli’s Models
Directions: Explore “The Three Ring Conception of Giftedness” as well as the related “The Enrichment Triad Model” and “The Schoolwide Enrichment Model” on Renzulli’s Research-Based Learning System web page. How might these models benefit students who are gifted and talented? How can these models be used to develop the strengths and talents of all students?
To date, the Every Student Succeeds Act identifies gifted and talented as “students, children, and youth who illustrate high achievement capabilities in areas such as intellectual, creative, artistic, or leadership capacity, or in specific academic fields, and who need services and activities that are not typically available to fully develop their capabilities” (USDOE, 2015, p. 398). In addition, a survey conducted by the National Association for Gifted Children (NAGC, 2015) indicated that most states use a version of the Marland definition. However, the results demonstrate a lack of consensus regarding an operational definition of gifted and talented students (Smiley et al., 2022).
The Illinois Definition of Gifted and Talented Students
The Illinois State Board of Education does not have a definition of gifted and talented students. However, the state does have laws and rules related to accelerated placement and educational programs for gifted and talented students. While educators providing gifted education within Illinois are not required by the state to hold a special endorsement, Illinois educators may add a gifted education teacher endorsement or a gifted education specialist endorsement to their license. Learn more about the state’s role in gifted and talented education at the Illinois State Board of Education Advanced Learners web page.
Marland, S.P. (1972). Education of the gifted and talented — Volume 1: Report to the Congress of the United States by the U. S. Commissioner of Education. https://eric.ed.gov/?id=ED056243
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Ross, O.R. (1993). National excellence: A case for developing America’s talent. U.S. Department of Education Office of Educational Research and Improvement. https://files.eric.ed.gov/fulltext/ED359743.pdf
Renzulli, J.S. (1998). The three ring conception of giftedness. In Baum, S. M., Reis, S. M., & Maxfield, L. R. (Eds.). Nurturing the gifts and talents of primary grade students. Creative Learning Press.
United States Department of Education (2015). The Every Student Succeeds Act. https://www.congress.gov/bill/114th-congress/senate-bill/1177/text
National Association for Gifted Children. (2015). 2014–2015: State of the states in gifted education: Policy and practice data. https://www.nagc.org/resources-publications/gifted-state/2014-2015-state-states-gifted-education | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/14%3A_Gifted_and_Talented_Students/14.01%3A_Definition_of_Gifted_and_Talented_Students.txt |
In the United States, gifted education did not begin in earnest until the twentieth century with the passage of the Jacob K. Javits Gifted and Talented Students Education Act (1987). This act directed the Department of Education to make grants and contracts available for programs or projects designed to meet the educational needs of gifted and talented children. It also established the National Center for Research and Development in the Education of Gifted and Talented Children and Youth. In 1998, the National Association for Gifted Children published Gifted Programming Standards, which provides guidance for school districts interested in developing gifted and talented programs. In 2004, the Institute for Research and Policy on Acceleration (now called The Acceleration Institute) published a report, “A Nation Deceived,” that highlighted the disparities between the benefits of acceleration for gifted and talented students and the lack of accelerated programs across the United States (Acceleration Institute, 2015).
Acceleration Institute. (2015). A nation deceived. https://www.accelerationinstitute.org/nation_deceived/
14.03: Prevalence of Gifted and Talented Students
It is difficult to estimate the number of gifted and talented students in the United States. In 2014, the National Center for Education Statistics reported that approximately 7% of public school students were identified as being serviced in gifted and talented education programs (NCES, 2018). The lack of a commonly implemented definition of “gifted and talented” impacts the integrity of related data collection.
Data routinely indicate that several groups of students are underrepresented in gifted and talented programs, including females, students with disabilities, and culturally, linguistically, and racially diverse students (Smiley et al., 2022). It is critical that states and school districts consider issues of equitable access, particularly as it pertains to the identification of students.
National Center on Educational Statistics. (2018). Percentage of public school students enrolled in gifted and talented programs, by sex, race/ethnicity, and state. https://nces.ed.gov/programs/digest/d17/tables/dt17_204.90.asp
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
14.04: Causes of Gifted and Talented Students
The development of gifts and talents cannot be attributed to a single factor such as genetics or environment. Intelligence is thought to be a result of both genetics and environment. Twin studies suggest that the environment plays an active role in how genes are expressed. Clark (2013) states, “It is misleading to think of either genes or the environment as being more important—genes can express themselves only in an environment, and an environment has no effect except by evoking genotypes already present” (p. 26). Educators and clinicians should consider how to develop educational environments that support the development of all students’ gifts and talents.
Clark, B. (213). Growing up gifted (8th ed.). Pearson Education.
14.05: Characteristics of Gifted and Talented Students
The characteristics of gifted and talented students vary by student. This section of the chapter will provide an overview of common characteristics associated with above-average intelligence. However, it is important for educators and clinicians to remember that students may demonstrate above-average levels of creativity and aptitude in any area of academic study.
Historically, above-average intelligence has been the primary indicator of gifted and talented students despite efforts to broaden the definition (e.g., the three ring conception of giftedness). Often, it is the only criterion used to determine eligibility for gifted and talented programs (Smiley et al., 2022). The intelligence quotient cutoff point commonly used for eligibility into gifted programs is 130; this score indicates that a student scored higher than approximately 96% of their peers. In the 1980s, Howard Gardner, a developmental psychologist at Harvard University, introduced his theory of multiple intelligences. This theory proposed that there are eight different types of intelligence, including linguistic, logical/mathematical, spatial, bodily-kinesthetic, musical, interpersonal, intrapersonal, and naturalist (Gardner, 1983). This theory gained popularity and led to a related theory that students have different learning styles (e.g., visual, auditory, tactile/kinesthetic). However, researchers have found “virtually no evidence” supporting the idea that “instruction is best provided in a format that matches the preference of the learner” (Pashler et al., 2008, p. 105; Ragosky et al., 2014). Therefore, educators should focus on research-based instructional methods rather than student preference.
Activity \(1\): Learning Styles Debunked
Directions: Further explore the concept of learning styles and why matching instruction to students’ preferred learning styles does not improve learning on Vanderbilt University’s Center for Teaching Learning Styles web page. Why do you think the concept of learning styles continues to be so popular in educational communities? What can be done to educate teachers about research-based instructional methods?
Other intellectual characteristics associated with gifted and talented students include rapid comprehension (i.e., an advanced ability to learn and process information), the ability to think abstractly and problem-solve, and intellectual curiosity (Smiley et al., 2022). However, gifted and talented students may also be perfectionists and may believe that they should excel in everything that they do. This can lead to frustration when they are presented with a task they find challenging. Therefore, it is important to promote the development of a growth mindset or the belief that one’s intelligence can be developed (Dweck, 2006) and continue presenting students with challenging yet achievable goals.
Activity \(2\): Developing A Growth Mindset
Directions: Explore the educational resources on the Mindset Kit web page to learn more about how to develop a growth mindset in yourself and your future students or clients.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
Gardner, H. (1983). Frames of mind: A theory of multiple intelligences. Basic Books.
Pashler, H., McDaniel, M., Rohrer, D., & Bjork, R. (2008). Learning styles: Concepts and evidence. Psychological Science in the Public Interest, 9(3), 105–119. https://doi.org/10.1111/j.1539-6053.2009.01038.x
Rogowsky, B. A., Calhoun, B. M., & Tallal, P. (2015). Matching learning style to instructional method: Effects on comprehension. Journal of Educational Psychology, 107(1), 64–78. https://doi.org/10.1037/a0037478
Dweck, C. S. (2006). Mindset: The new psychology of success. Random House.
14.06: Identifying Gifted and Talented Students
The process of identifying gifted and talented students varies between states and school districts. However, intelligence tests and academic achievement tests are commonly used (e.g., Wechsler Intelligence Scale for Children-V). Additional assessments may also be used that specifically measure a student’s potential for learning, otherwise known as aptitude (e.g., Cognitive Abilities Test [CogAT]), or their creativity (e.g., Torrance Test of Creative Thinking). Some school districts also employ educator rating scales such as the Scale for Rating Behavioral Characteristics of Superior Students (Renzulli et al., 2010). However, each of these methods has limitations, and additional steps should be taken to identify students who are members of underrepresented groups.
For example, females face negative stereotypes and other barriers to achievement that result in attributing their achievements to hard work or luck rather than ability. In addition, negative stereotypes related to math and science achievement may also bias educators and clinicians, thus limiting their referrals of females for gifted assessment. In addition, twice-exceptional students (i.e., students with disabilities who are also gifted and talented) are often identified only by their disability, and their gifts and talents are overlooked. Finally, gifted and talented students from culturally, linguistically, and racially diverse backgrounds are significantly underrepresented in gifted and talented programs. Alternative approaches should be used to identify students from these underrepresented groups, including nonverbal tests (e.g., Naglieri Nonverbal Ability Test) that avoid language barriers, portfolio assessments, and other performance-based tasks that allow students to demonstrate their unique abilities (Smiley et al., 2022).
Renzulli, J.S. (1998). The three ring conception of giftedness. In Baum, S. M., Reis, S. M., & Maxfield, L. R. (Eds.). Nurturing the gifts and talents of primary grade students. Creative Learning Press.
Smiley, L. R., Richards, S.B., & Taylor, R. (2022). Exceptional students: Preparing teachers for the 21st century (4th ed.). McGraw Hill.
14.07: Chapter Questions and References
1. In the Marland definition, what six areas were included in which students could demonstrate high performance?
2. How does Renzulli’s definition of giftedness differ from other definitions? What are the similarities?
3. Why is it important to develop a growth mindset in all students?
4. Which groups of students are underrepresented in gifted and talented programs?
5. Why is it important to use alternative methods for identifying gifted and talented students? | textbooks/socialsci/Psychology/Developmental_Psychology/The_Psychology_of_Exceptional_Children_(Zaleski)/14%3A_Gifted_and_Talented_Students/14.02%3A_The_History_of_Gifted_and_Talented_Students.txt |
Psychology is a relatively young science with its experimental roots in the nineteenth century, compared, for example, to human physiology, which dates much earlier. Anyone interested in exploring issues related to the mind generally did so in a philosophical context prior to the nineteenth century. Two men, working in the nineteenth century, are generally credited as being the founders of psychology as a science and academic discipline that was distinct from philosophy. Their names were Wilhelm Wundt and William James. This section will provide an overview of the shifts in paradigms that have influenced psychology from Wundt and James through today.
1.02: Wundt And Structuralism
Wilhelm Wundt (1832–1920) was a German scientist who was the first person to be referred to as a psychologist. His famous book entitled Principles of Physiological Psychology was published in 1873. Wundt viewed psychology as a scien- tific study of conscious experience, and he believed that the goal of psychology was to identify components of conscious- ness and how those components combined to result in our conscious experience. Wundt used introspection (he called it “internal perception”), a process by which someone exam- ines their own conscious experience as objectively as possible, making the human mind like any other aspect of nature that a scientist observed. Wundt’s version of introspection used only very specific experimental conditions in which an external stimulus was designed to produce a scientifically observable (repeatable) experience of the mind (Danziger, 1980). The first stringent requirement was the use of “trained” or prac- ticed observers, who could immediately observe and report a reaction. The second requirement was the use of repeatable stimuli that always produced the same experience in the sub- ject and allowed the subject to expect and thus be fully atten- tive to the inner reaction. These experimental requirements were put in place to eliminate “interpretation” in the report- ing of internal experiences and to counter the argument that there is no way to know that an individual is observing their mind or consciousness accurately, since it cannot be seen by any other person. This attempt to understand the structure or characteristics of the mind was known as structuralism. Wundt established his psychology laboratory at the Univer- sity at Leipzig in 1879 (Figure \(1\)). In this laboratory, Wundt and his students conducted experiments on, for example, reaction times. A subject, sometimes in a room isolated from the scientist, would receive a stimulus such as a light, image, or sound. The subject’s reaction to the stimulus would be to push a button, and an apparatus would record the time to reaction. Wundt could measure reaction time to one-thou- sandth of a second (Nicolas & Ferrand, 1999).
However, despite his efforts to train individuals in the process of introspection, this process remained highly subjec- tive, and there was very little agreement between individuals. As a result, structuralism fell out of favor with the passing of Wundt’s student, Edward Titchener, in 1927 (Gordon, 1995).
1.03: James And Functionalism
William James (1842–1910) was the first American psychologist who espoused a different perspective on how psychology should operate (Figure \(1\)). James was introduced to Darwin’s theory of evolution by natural selection and accepted it as an explanation of an organism’s characteristics. Key to that theory is the idea that natural selection leads to organisms that are adapted to their environment, including their behavior. Adaptation means that a trait of an organism has a function for the survival and reproduction of the individual, because it has been naturally selected. As James saw it, psychology’s purpose was to study the function of behavior in the world, and as such, his perspective was known as functionalism. Functionalism focused on how mental activities helped an organism fit into its environment. Functionalism has a second, more subtle meaning in that functionalists were more interested in the operation of the whole mind rather than of its individual parts, which were the focus of structuralism. Like Wundt, James believed that introspection could serve as one means by which someone might study mental activities, but James also relied on more objective measures, including the use of various recording devices, and examinations of concrete products of mental activities and of anatomy and physiology (Gordon, 1995). | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.01%3A_Introduction.txt |
Perhaps one of the most influential and well-known figures in psychology’s history was Sigmund Freud (Figure \(1\)). Freud (1856–1939) was an Austrian neurologist who was fascinated by patients suffering from “hysteria” and neurosis. Hysteria was an ancient diagnosis for disorders, primarily of women with a wide variety of symptoms, including physi- cal symptoms and emotional disturbances, none of which had an apparent physical cause. Freud theorized that many of his patients’ problems arose from the unconscious mind. In Freud’s view, the unconscious mind was a repository of feelings and urges of which we have no awareness. Gaining access to the unconscious, then, was crucial to the successful resolution of the patient’s problems. According to Freud, the unconscious mind could be accessed through dream analysis, by examinations of the first words that came to people’s minds, and through seemingly innocent slips of the tongue. Psychoanalytic theory focuses on the role of a person’s unconscious, as well as early childhood experiences, and this particular perspective dominated clinical psychology for several decades (Thorne & Henley, 2005).
Freud’s ideas were influential, and you will learn more about them when you study lifespan development, person- ality, and therapy. For instance, many therapists believe strongly in the unconscious and the impact of early child- hood experiences on the rest of a person’s life. The method of psychoanalysis, which involves the patient talking about their experiences and selves, while not invented by Freud, was certainly popularized by him and is still used today. Many of Freud’s other ideas, however, are controversial. Drew Westen (1998) argues that many of the criticisms of Freud’s ideas are mis- placed, in that they attack his older ideas without taking into account later writings. Westen also argues that critics fail to consider the success of the broad ideas that Freud introduced or developed, such as the importance of childhood experi- ences in adult motivations, the role of unconscious versus conscious motivations in driving our behavior, the fact that motivations can cause conflicts that affect behavior, the effects of mental representations of ourselves and others in guiding our interactions, and the development of personality over time. Westen identifies subsequent research support for all of these ideas.
More modern iterations of Freud’s clinical approach have been empirically demonstrated to be effective (Knekt et al., 2008; Shedler, 2010). Some current practices in psychother- apy involve examining unconscious aspects of the self and relationships, often through the relationship between the therapist and the client.
Freud’s historical significance and contributions to clinical practice merit his inclusion in a discussion of the histori- cal movements within psychology.
1.05: Wertheimer Koffka Kohler Aad Gestalt Psychology
Max Wertheimer (1880–1943), Kurt Koffka (1886–1941), and Wolfgang Kohler (1887–1967) were three German psy- chologists who immigrated to the United States in the early twentieth century to escape Nazi Germany. These men are credited with introducing psychologists in the United States to various Gestalt principles. The word Gestalt roughly trans- lates to “whole;” a major emphasis of Gestalt psychology deals with the fact that although a sensory experience can be bro- ken down into individual parts, how those parts relate to each other as a whole is often what the individual responds to in perception. For example, a song may be made up of individ- ual notes played by different instruments, but the real nature of the song is perceived in the combinations of these notes as they form the melody, rhythm, and harmony. In many ways, this particular perspective would have directly contradicted Wundt’s ideas of structuralism (Thorne & Henley, 2005).
Unfortunately, in moving to the United States, these men were forced to abandon much of their work and were unable to continue to conduct research on a large scale. These fac- tors along with the rise of behaviorism (described next) in the United States prevented principles of Gestalt psychology from being as influential in the United States as they had been in their native Germany (Thorne & Henley, 2005). Despite these issues, several Gestalt principles are still very influential today. Considering the human individual as a whole rather than as a sum of individually measured parts became an important foundation in humanistic theory late in the cen- tury. The ideas of Gestalt have continued to influence research on sensation and perception.
Structuralism, Freud, and the Gestalt psychologists were all concerned in one way or another with describing and understanding inner experience. But other researchers had concerns that inner experience could be a legitimate sub- ject of scientific inquiry and chose instead to exclusively study behavior, the objectively observable outcome of mental processes. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.04%3A_Freud_And_Psychoanalytic_Theory.txt |
Early work in the field of behavior was conducted by the Russian physiologist Ivan Pavlov (1849–1936). Pavlov studied a form of learning behavior called a conditioned reflex, in which an animal or human produced a reflex (unconscious) response to a stimulus and, over time, was conditioned to produce the response to a different stimulus that the experimenter associated with the original stimulus. The reflex Pavlov worked with was salivation in response to the presence of food. The salivation reflex could be elicited using a second stimulus, such as a specific sound, that was presented in association with the initial food stimulus several times. Once the response to the second stimulus was “learned,” the food stimulus could be omitted. Pavlov’s “classical conditioning” is only one form of learning behavior studied by behaviorists.
John B. Watson (1878–1958) was an influential American psychologist whose most famous work occurred during the early twentieth century at Johns Hopkins University (Figure \(1\)). While Wundt and James were concerned with under- standing conscious experience, Watson thought that the study of consciousness was flawed. Because he believed that objective analysis of the mind was impossible, Watson preferred to focus directly on observable behavior and try to bring that behavior under control. Watson was a major proponent of shifting the focus of psychology from the mind to behavior, and this approach of observing and controlling behavior came to be known as behaviorism. A major object of study by behaviorists was learned behavior and its interaction with inborn qualities of the organism. Behaviorism commonly used animals in experiments under the assumption that what was learned using animal models could, to some degree, be applied to human behavior. Indeed, Tolman (1938) stated, “I believe that everything important in psychology (except . . . such matters as involve society and words) can be investigated in essence through the continued experimental and theoretical analysis of the determiners of rat behavior at a choice-point in a maze.”
Behaviorism dominated experimental psychology for several decades, and its influence can still be felt today (Thorne & Henley, 2005). Behaviorism is largely responsible for establishing psychology as a scientific discipline through its objective methods and especially experimentation. In addition, it is used in behavioral and cognitive-behavioral therapy. Behavior modification is commonly used in classroom settings. Behaviorism has also led to research on environmental influences on human behavior.
B. F. Skinner (1904–1990) was an American psychologist (Figure \(2\)). Like Watson, Skinner was a behaviorist, and he concentrated on how behavior was affected by its con- sequences. Therefore, Skinner spoke of reinforcement and punishment as major factors in driving behavior. As a part of his research, Skinner developed a chamber that allowed the careful study of the principles of modifying behavior through reinforcement and punishment. This device, known as an operant conditioning chamber (or more familiarly, a Skinner box), has remained a crucial resource for researchers studying behavior (Thorne & Henley, 2005). The Skinner box is a chamber that isolates the subject from the external environment and has a behavior indicator such as a lever or a button. When the animal pushes the button or lever, the box is able to deliver a positive reinforcement of the behavior (such as food) or a punishment (such as a noise) or a token conditioner (such as a light) that is correlated with either the positive reinforcement or punishment.
Skinner’s focus on positive and negative reinforcement of learned behaviors had a lasting influence in psychology that has waned somewhat since the growth of research in cognitive psychology. Despite this, conditioned learning is still used in human behavioral modification. Skinner’s two widely read and controversial popular science books about the value of operant conditioning for creating happier lives remain as thought-provoking arguments for his approach (Greengrass, 2004). | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.06%3A_Pavlov_Watson_Skinner_And_Behaviorism.txt |
During the early twentieth century, American psychology was dominated by behaviorism and psychoanalysis. How- ever, some psychologists were uncomfortable with what they viewed as limited perspectives being so influential to the field. They objected to the pessimism and determinism (all actions driven by the unconscious) of Freud. They also disiked the reductionism, or simplifying nature, of behaviorism. Behaviorism is also deterministic at its core, because it sees human behavior as entirely determined by a combination of genetics and environment. Some psychologists began to form their own ideas that emphasized personal control, intentionality, and a true predisposition for “good” as important for our self-concept and our behavior. Thus, humanism emerged. Humanism is a perspective within psychology that emphasizes the potential for good that is innate to all humans. Two of the most well-known proponents of humanistic psychology are Abraham Maslow and Carl Rogers (O’Hara, n.d.).
Abraham Maslow (1908–1970) was an American psychologist who is best known for proposing a hierarchy of human needs in motivating behavior (Figure \(1\)). Although this concept will be discussed in more detail in a later chapter, a brief overview will be provided here. Maslow asserted that so long as basic needs necessary for survival were met (e.g., food, water, shelter), higher-level needs (e.g., social needs) would begin to motivate behavior. According to Maslow, the highest-level needs relate to self-actualization, a process by which we achieve our full potential. Obviously, the focus on the positive aspects of human nature that are characteristic of the humanistic perspective is evident (Thorne & Henley, 2005). Humanistic psychologists rejected, on principle, the research approach based on reductionist experimentation in the tradition of the physical and biological sciences, because it missed the “whole” human being. Beginning with Maslow and Rogers, there was an insistence on a humanistic research program. This program has been largely qualitative (not measurement-based), but there exist a number of quantitative research strains within humanistic psychology, including research on happiness, self-concept, meditation, and the out- comes of humanistic psychotherapy (Friedman, 2008).
Carl Rogers (1902–1987) was also an American psychologist who, like Maslow, emphasized the potential for good that exists within all people (Figure \(2\). Rogers used a therapeutic technique known as client-centered therapy in helping his clients deal with problematic issues that resulted in their seeking psychotherapy. Unlike a psychoanalytic approach in which the therapist plays an important role in interpreting what conscious behavior reveals about the unconscious mind, client-centered therapy involves the patient taking a lead role in the therapy session. Rogers believed that a therapist needed to display three features to maximize the effectiveness of this particular approach: unconditional positive regard, genuine- ness, and empathy. Unconditional positive regard refers to the fact that the therapist accepts their client for who they are, no matter what he or she might say. Provided these factors, Rogers believed that people were more than capable of dealing with and working through their own issues (Thorne & Henley, 2005).
Humanism has been influential to psychology as a whole. Both Maslow and Rogers are well-known names among students of psychology (you will read more about both men later in this text), and their ideas have influenced many scholars. Furthermore, Rogers’ client-centered approach to therapy is still commonly used in psychotherapeutic settings today (O’Hara, n.d.)
LINK TO LEARNING
View a brief video of Carl Rogers describing his therapeutic approach. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.07%3A_Maslow_Rogers_And_Humanism.txt |
Behaviorism’s emphasis on objectivity and focus on external behavior had pulled psychologists’ attention away from the mind for a prolonged period of time. The early work of the humanistic psychologists redirected attention to the individual human as a whole, and as a conscious and self-aware being. By the 1950s, new disciplinary perspectives in linguistics, neuroscience, and computer science were emerging, and these areas revived interest in the mind as a focus of scientific inquiry. This particular perspective has come to be known as the cognitive revolution (Miller, 2003). By 1967, Ulric Neisser published the first textbook entitled Cognitive Psychology, which served as a core text in cognitive psychology courses around the country (Thorne & Henley, 2005).
Although no one person is entirely responsible for starting the cognitive revolution, Noam Chomsky was very influential in the early days of this movement (Figure \(1\)). Chomsky (1928– ), an American linguist, was dissatisfied with the influence that behaviorism had had on psychology. He believed that psychology’s focus on behavior was short-sighted and that the field had to re-incorporate mental functioning into its purview if it were to offer any meaningful contributions to understanding behavior (Miller, 2003).
European psychology had never really been as influenced by behaviorism as had American psychology; and thus, the cognitive revolution helped reestablish lines of communication between European psychologists and their American counterparts. Furthermore, psychologists began to cooperate with scientists in other fields, like anthropology, linguistics, computer science, and neuroscience, among others. This interdisciplinary approach often was referred to as the cognitive sciences, and the influence and prominence of this particular perspective resonates in modern-day psychology (Miller, 2003).
1.09: Multicultural Psychology
Culture has important impacts on individuals and social psychology, yet the effects of culture on psychology are under-studied. There is a risk that psychological theories and data derived from white, American settings could be assumed to apply to individuals and social groups from other cultures and this is unlikely to be true (Betancourt & López, 1993). One weakness in the field of cross-cultural psychology is that in looking for differences in psychological attributes across cultures, there remains a need to go beyond simple descriptive statistics (Betancourt & López, 1993). In this sense, it has remained a descriptive science, rather than one seeking to determine cause and effect. For example, a study of characteristics of individuals seeking treatment for a binge eating disorder in Hispanic American, African American, and Caucasian American individuals found significant differences between groups (Franko et al., 2012). The study concluded that results from studying any one of the groups could not be extended to the other groups, and yet potential causes of the differences were not measured.
This history of multicultural psychology in the United States is a long one. The role of African American psychologists in researching the cultural differences between African American individual and social psychology is but one example. In 1920, Cecil Sumner was the first African American to receive a PhD in psychology in the United States. Sumner established a psychology degree program at Howard University, leading to the education of a new generation of African American psychologists (Black et al., 2004). Much of the work of early African American psychologists (and a general focus of much work in first half of the twentieth century in psychology in the United States) was dedicated to testing and intelligence testing in particular (Black et al., 2004). That emphasis has continued, particularly because of the importance of testing in determining opportunities for children, but other areas of exploration in African American psychology research include learning style, sense of community and belonging, and spiritualism (Black et al., 2004).
The American Psychological Association has several ethnically based organizations for professional psychologists that facilitate interactions among members. Since psychologists belonging to specific ethnic groups or cultures have the most interest in studying the psychology of their communities, these organizations provide an opportunity for the growth of research on the impact of culture on individual and social psychology. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.08%3A_The_Cognitive_Revolution.txt |
Feminist Psychology
The science of psychology has had an impact on human wellbeing, both positive and negative. The dominant influence of Western, white, and male academics in the early history of psychology meant that psychology developed with the biases inherent in those individuals, which often had negative consequences for members of society that were not white or male. Women, members of ethnic minorities in both the United States and other countries, and individuals with sexual orientations other than heterosexual had difficulties entering the field of psychology and therefore influencing its development. They also suffered from the attitudes of white, male psychologists, who were not immune to the nonscientific attitudes prevalent in the society in which they developed and worked. Until the 1960s, the science of psychology was largely a “womanless” psychology (Crawford & Marecek, 1989), meaning that few women were able to practice psychology, so they had little influence on what was studied. In addition, the experimental subjects of psychology were mostly men, which resulted from underlying assumptions that gender had no influence on psychology and that women were not of sufficient interest to study.
An article by Naomi Weisstein, first published in 1968 (Weisstein, 1993), stimulated a feminist revolution in psychology by presenting a critique of psychology as a science. She also specifically criticized male psychologists for constructing the psychology of women entirely out of their own cultural biases and without careful experimental tests to verify any of their characterizations of women. Weisstein used, as examples, statements by prominent psychologists in the 1960s, such as this quote by Bruno Bettleheim: “We must start with the realization that, as much as women want to be good scientists or engineers, they want first and foremost to be womanly companions of men and to be mothers.” Weisstein’s critique formed the foundation for the subsequent development of a feminist psychology that attempted to be free of the influence of male cultural biases on our knowledge of the psychology of women and, indeed, of both genders.
Crawford and Marecek (1989) identify several feminist approaches to psychology that can be described as feminist psychology. These include re-evaluating and discovering the contributions of women to the history of psychology, studying psychological gender differences, and questioning the male bias present across the practice of the scientific approach to knowledge.
INK TO LEARNING
Read a news story about the influence of an African American’s psychology research on the historic Brown v. Board of Education civil rights case.
REFERENCES
Betancourt, H., & López, S. R. (1993). The study of culture, ethnicity, and race in American psychology. American Psychologist, 48, 629–637. https://doi.org/10.1037/0003-066X.48.6.629
Black, S. R., Spence, S. A., & Omari, S. R. (2004). Contributions of African Americans to the field of psychology. Journal of Black Studies, 35, 40–64. https://doi.org/10.1177/0021934704263124
Crawford, M., & Marecek, J. (1989). Psychology reconstructs the female: 1968–1988. Psychology of Women Quarterly, 13, 147–165. doi. org/10.1111/j.1471-6402.1989.tb00993.x
Danziger, K. (1980). The history of introspection reconsidered. Journal of the History of the Behavioral Sciences, 16, 241–262. doi. org/10.1002/1520-6696(198007)16:3%3C241::AID- JHBS2300160306%3E3.0.CO;2-O
Franko, D. L., Thompson-Brenner, H., Thompson, D. R., Boisseau, C. L., Davis, A., Forbush, K. T., Roehrig, J. P., Bryson, S. W., Bulik, C. M., Crow, S. J., Devlin, M. J., Gorin, A. A., Grilo, C. M., Kristeller, J. L., Masheb, R. M., Mitchell, J. E., Peterson, C. B., Safer, D. L., Striegel, R. H., . . . Wilson, G. T. (2012). Racial/ethnic differences in adults in randomized clinical trials of binge eating disorder. Journal of Consulting and Clinical Psychology, 80, 186–195. doi. org/10.1037/a0026700
Friedman, H. (2008). Humanistic and positive psychology: The methodological and epistemological divide. The Humanistic
HISTORy OF PSyCHOlOGy 7 Psychologist, 36, 113–126. doi.org/10.1080/
08873260802111036
Gordon, O. E. (1995). A brief history of psychology. web.archive. org/web/20160502035954/www.psych.utah.edu/gordon/ Classes/Psy4905Docs/PsychHistory/index.html
Greengrass, M. (2004). 100 years of B.F. Skinner. Monitor on Psychology, 35, 80. www.apa.org/monitor/mar04/skinner
Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M., & Renlund, C. (2008). Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38, 689–703. https://doi.org/10.1017/S003329170700164X
Miller, G. A. (2003). The cognitive revolution: A historical perspective. Trends in Cognitive Sciences, 7, 141–144. doi.org/10.1016/ S1364-6613(03)00029-9
Nicolas, S., & Ferrand, L. (1999). Wundt’s laboratory at Leipzig in 1891. History of Psychology, 2, 194–203. doi.org/10.1037/ 1093-4510.2.3.194
O’Hara, M. (n.d.). Historic review of humanistic psychology. www. ahpweb.org/index.php?option=com_k2&view=item&layout= item&id=14&Itemid=24
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. doi.org/10.1037/ a0018378
Thorne, B. M., & Henley, T. B. (2005). Connections in the history and systems of psychology (3rd ed.). Houghton Mifflin Company.
Tolman, E. C. (1938). The determiners of behavior at a choice point. Psychological Review, 45, 1–41. https://doi.org/10.1037/h0062733
Weisstein, N. (1993). Psychology constructs the female: Or, the fantasy life of the male psychologist (with some attention to the fantasies of his friends, the male biologist and the male anthropologist). Feminism and Psychology, 3, 195–210. https://doi.org/ 10.1177%2F0959353593032005
Westen, D. (1998). The scientific legacy of Sigmund Freud, toward a psychodynamically informed psychological science. Psychological Bulletin, 124, 333–371. https://doi.org/10.1037/0033-2909.124.3.333 | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/01%3A_History_of_Psychology/1.10%3A_Dig_Deeper.txt |
Contemporary psychology is a diverse field that is influenced by all of the historical perspectives described in the preceding section. Reflective of the discipline’s diversity is the diversity seen within the American Psychological Association (APA). The APA is a professional organization rep- resenting psychologists in the United States. The APA is the largest organization of psychologists in the world, and its mission is to advance and disseminate psychological knowledge for the betterment of people. There are 54 divisions within the APA, representing a wide variety of specialties that range from Societies for the Psychology of Religion and Spirituality to Exercise and Sport Psychology to Behavioral Neuroscience and Comparative Psychology. Reflecting the diversity of the field of psychology itself, members, affiliate members, and associate members span the spectrum from students to doctoral-level psychologists, and come from a variety of places including educational settings, criminal justice, hospitals, the armed forces, and industry (APA, 2020).
The Association for Psychological Science (APS) was founded in 1988 and seeks to advance the scientific orientation of psychology. Its founding resulted from disagreements between members of the scientific and clinical branches of psychology within the APA (Association for Psychological Science, n.d.). The APS publishes six research journals and engages in education and advocacy with funding agencies. A significant proportion of its members are international, although the majority is located in the United States. Other organizations provide networking and collaboration opportunities for professionals of several ethnic or racial groups working in psychology, such as the National Latina/o Psychological Association (NLPA), the Asian American Psychological Association (AAPA), the Association of Black Psychologists (ABPsi), and the Society of Indian Psychologists (SIP). Most of these groups are also dedicated to studying psychological and social issues within their specific communities.
This section will provide an overview of the major subdivisions within psychology today. This is not meant to be an exhaustive listing, but it will provide insight into the major areas of research and practice of modern-day psychologists.
LINK TO LEARNING
Please visit this website to learn about the divisions within the APA. Student resources are also provided by the APA.
2.02: Biopsychology And Evolutionary Psychology
As the name suggests, biopsychology explores how our biology influences our behavior. While biological psychology is a broad field, many biological psychologists want to under- stand how the structure and function of the nervous system is related to behavior (Figure \(1\)). As such, they often combine the research strategies of both psychologists and physiologists to accomplish this goal (as discussed in Carlson, 2013).
The research interests of biological psychologists span a number of domains including, but not limited to, sensory and motor systems, sleep, drug use and abuse, ingestive behavior, reproductive behavior, neurodevelopment, plasticity of the nervous system, and biological correlates of psychological disorders. Given the broad areas of interest falling under the purview of biological psychology, it will probably come as no surprise that individuals from all sorts of backgrounds are involved in this research, including biologists, medical professionals, physiologists, and chemists. This interdisciplinary approach is often referred to as neuroscience, of which bio- logical psychology is a component (Carlson, 2013).
While biopsychology typically focuses on the immediate causes of behavior based in the physiology of a human or other animal, evolutionary psychology seeks to study the ultimate biological causes of behavior. To the extent that a behavior is impacted by genetics, a behavior, like any anatomical characteristic of a human or animal, will demonstrate adaption to its surroundings. These surroundings include the physical environment and, since interactions between organisms can be important to survival and reproduction, the social environment. The study of behavior in the context of evolution has its origins with Charles Darwin, the co-discoverer of the theory of evolution by natural selection. Darwin was well aware that behaviors should be adaptive and wrote books titled The Descent of Man (1871) and The Expression of the Emotions in Man and Animals (1872) to explore this field.
Evolutionary psychology—specifically, the evolutionary psychology of humans—has enjoyed a resurgence in recent decades. To be subject to evolution by natural selection, a behavior must have a significant genetic cause. In general, we expect all human cultures to express a behavior if it is caused genetically, since the genetic differences among human groups are small. The approach taken by most evolutionary psychologists is to predict the outcome of a behavior in a particular situation based on evolutionary theory and then to make observations, or conduct experiments, to determine whether the results match the theory. It is important to recognize that these types of studies are not strong evidence that a behavior is adaptive, since they lack information that the behavior is in some part genetic and not entirely cultural (Endler, 1986). Demonstrating that a trait, especially in humans, is naturally selected is extraordinarily difficult; perhaps for this reason, some evolutionary psychologists are content to assume the behaviors they study have genetic determinants (Confer et al., 2010).
One other drawback of evolutionary psychology is that the traits we possess now evolved under environmental and social conditions far back in human history, and we have a poor understanding of what these conditions were. This makes predictions about what is adaptive for a behavior difficult. Behavioral traits need not be adaptive under current conditions, only under the conditions of the past when they evolved, about which we can only hypothesize.
There are many areas of human behavior for which evolution can make predictions. Examples include memory, mate choice, relationships between kin, friendship and cooperation, parenting, social organization, and status (Confer et al., 2010).
Evolutionary psychologists have had success in finding experimental correspondence between observations and expectations. In one example, in a study of mate preference differences between men and women that spanned 37 cultures, Buss (1989) found that women valued earning potential factors greater than men, and men valued potential reproductive factors (youth and attractiveness) greater than women in their prospective mates. In general, the predictions were in line with the predictions of evolution, although there were deviations in some cultures. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/02%3A_Contemporary_Psychology/2.01%3A_Introduction.txt |
Scientists interested in both the physiological aspects of sensory systems and the psychological experience of sensory information work within the area of sensation and perception (Figure \(1\)). As such, sensation and perception research is also quite interdisciplinary. Imagine walking between buildings as you move from one class to another. You are inundated with sights, sounds, touch sensations, and smells. You also experience the temperature of the air around you and maintain your balance as you make your way. These are all factors of interest to someone working in the domain of sensation and perception.
Our experience of our world is not as simple as the sum total of all of the sensory information (or sensations) together. Rather, our experience (or perception) is complex and is influenced by where we focus our attention, our previous experiences, and even our cultural backgrounds.
2.04: Cognitive Psychology
As mentioned in the previous section, the cognitive revolution created an impetus for psychologists to focus their attention on better understanding the mind and mental processes that underlie behavior. Thus, cognitive psychology is the area of psychology that focuses on studying cognitions, or thoughts, and their relationship to our experiences and our actions. Like biological psychology, cognitive psychology is broad in its scope and often involves collaborations among people from a diverse range of disciplinary backgrounds. This has led some to coin the term cognitive science to describe the interdisciplinary nature of this area of research (Miller, 2003).
Cognitive psychologists have research interests that span a spectrum of topics, ranging from attention to problem solving to language to memory. The approaches used in studying these topics are equally diverse.
Given such diversity, various concepts related to cognitive psychology will be covered in relevant portions of the chapters in this text on sensation and perception, thinking and intelligence, memory, lifespan development, social psychology, and therapy.
LINK TO LEARNING
View a brief video recapping some of the major concepts explored by cognitive psychologists.
2.05: Developmental Pstchology
Developmental psychology is the scientific study of development across a lifespan. Developmental psychologists are interested in processes related to physical maturation. However, their focus is not limited to the physical changes associated with aging, as they also focus on changes in cognitive skills, moral reasoning, social behavior, and other psychological attributes.
Early developmental psychologists focused primarily on changes that occurred through reaching adulthood, providing enormous insight into the differences in physical, cognitive, and social capacities that exist between very young children and adults. For instance, research by Jean Piaget (Figure \(1\)) demonstrated that very young children do not demonstrate object permanence. Object permanence refers to the understanding that physical things continue to exist, even if they are hidden from us. If you were to show an adult a toy, and then hide it behind a curtain, the adult knows that the toy still exists. However, very young infants act as if a hidden object no longer exists. The age at which object permanence is achieved is somewhat controversial (Munakata et al., 1997).
While Piaget was focused on cognitive changes during infancy and childhood as we move to adulthood, there is an increasing interest in extending research into the changes that occur much later in life. This may be reflective of changing population demographics of developed nations as a whole. As more and more people live longer lives, the number of people of advanced age will continue to increase. Indeed, it is estimated that there were just over 49 million people aged 65 or older living in the United States in 2016 (Roberts et al., 2018). However, by 2030—the year the last of the baby boomers has reached age 65—this number is expected to increase to about 73 million. By the year 2050, it is estimated that nearly 86 million people in this country will be 65 or older (U.S. Census Bureau, 2017).
2.06: Personality Psychology
Personality psychology focuses on patterns of thoughts and behaviors that make each individual unique. Several individuals (e.g., Freud and Maslow) that we have already discussed in our historical overview of psychology, as well as the American psychologist Gordon Allport, contributed to early theories of personality. These early theorists attempted to explain how an individual’s personality develops from his or her given perspective. For example, Freud proposed that personality arose as conflicts between the conscious and unconscious parts of the mind were carried out over the lifespan. Specifically, Freud theorized that an individual went through various psychosexual stages of development. According to Freud, adult personality would result from the resolution of various conflicts that centered on the migration of erogenous (or sexual pleasure–producing) zones from the oral (mouth) to the anal to the phallic to the genital. Like many of Freud’s theories, this particular idea was controversial and did not lend itself to experimental tests (Person, 1980).
More recently, the study of personality has taken on a more quantitative approach. Rather than explaining how personality arises, research is focused on identifying personality traits, measuring these traits, and determining how these traits interact in a particular context to determine how a person will behave in any given situation. Personality traits are relatively consistent patterns of thought and behavior, and many have proposed that five trait dimensions are sufficient to capture the variations in personality seen across individuals. These five dimensions are known as the “Big Five” or the Five-Factor model, and include dimensions of openness, conscientiousness, extraversion, agreeableness, and neuroticism (OCEAN) (Figure \(1\)). Each of these traits has been demonstrated to be relatively stable over the lifespan (e.g., McCrae & Costa, 2008; Rantanen et al., 2007; Soldz & Vaillant, 1999) and is influenced by genetics (e.g., Jang et al., 1996). | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/02%3A_Contemporary_Psychology/2.03%3A_Sensation_And_Perception.txt |
Social psychology focuses on how we interact with and relate to others. Social psychologists conduct research on a wide variety of topics that include differences in how we explain our own behavior versus how we explain the behaviors of others, prejudice, and attraction, and how we resolve inter- personal conflicts. Social psychologists have also sought to determine how being among other people changes our own behavior and patterns of thinking.
There are many interesting examples of social psychological research, and you will read about many of these in a later chapter of this textbook. Until then, you will be introduced to one of the most controversial psychological studies ever conducted. Stanley Milgram was an American social psychologist who is most famous for research that he conducted on obedience. After the holocaust, in 1961, a Nazi war criminal, Adolf Eichmann, who was accused of committing mass atrocities, was put on trial. Many people wondered how German soldiers were capable of torturing prisoners in concentration camps, and they were unsatisfied with the excuses given by soldiers that they were simply following orders. At the time, most psychologists agreed that few people would be willing to inflict such extraordinary pain and suffering, simply because they were obeying orders. Milgram decided to conduct research to determine whether or not this was true (Figure \(1\)). As you will read later in the text, Milgram found that nearly two-thirds of his participants were willing to deliver what they believed to be lethal shocks to another person, simply because they were instructed to do so by an authority figure (in this case, a man dressed in a lab coat). This was in spite of the fact that participants received payment for simply showing up for the research study and could have chosen not to inflict pain or more serious consequences on another per- son by withdrawing from the study. No one was actually hurt or harmed in any way; Milgram’s experiment was a clever ruse that took advantage of research confederates, those who pretend to be participants in a research study who are actually working for the researcher and have clear, specific directions on how to behave during the research study (Hock, 2009). Milgram’s and others’ studies that involved deception and potential emotional harm to study participants catalyzed the development of ethical guidelines for conducting psychological research that discourage the use of deception of research subjects, unless it can be argued not to cause harm and, in general, requiring informed consent of participants.
2.08: Industrial-Organizational Psychology
Industrial-Organizational psychology (I-O psychology) is a subfield of psychology that applies psychological theories, principles, and research findings in industrial and organiza- tional settings. I-O psychologists are often involved in issues related to personnel management, organizational structure, and workplace environment. Businesses often seek the aid of I-O psychologists to make the best hiring decisions as well as to create an environment that results in high levels of employee productivity and efficiency. In addition to its applied nature, I-O psychology also involves conducting scientific research on behavior within I-O settings (Riggio, 2013).
2.09: Health Psychology
Health psychology focuses on how health is affected by the interaction of biological, psychological, and sociocultural factors. This particular approach is known as the biopsychosocial model (Figure \(1\)). Health psychologists are interested in helping individuals achieve better health through public policy, education, intervention, and research. Health psychologists might conduct research that explores the relationship between one’s genetic makeup, patterns of behavior, relation- ships, psychological stress, and health. They may research effective ways to motivate people to address patterns of behavior that contribute to poorer health (MacDonald, 2013).
2.10: Sport And Exercise Psychology
Researchers in sport and exercise psychology study the psychological aspects of sport performance, including motivation and performance anxiety, and the effects of sport on mental and emotional wellbeing. Research is also conducted on similar topics as they relate to physical exercise in general. The discipline includes topics that are broader than sport and exercise but that are related to interactions between mental and physical performance under demanding conditions, such as fire fighting, military operations, artistic performance, and surgery (APA, 2014).
2.11: Clinical Psychology
Clinical psychology is the area of psychology that focuses on the diagnosis and treatment of psychological disorders and other problematic patterns of behavior. As such, it is generally considered to be a more applied area within psychology; how- ever, some clinicians are also actively engaged in scientific research. Counseling psychology is a similar discipline that focuses on emotional, social, vocational, and health-related outcomes in individuals who are considered psychologically healthy.
As mentioned earlier, both Freud and Rogers provided perspectives that have been influential in shaping how clinicians interact with people seeking psychotherapy. While aspects of the psychoanalytic theory are still found among some of today’s therapists who are trained from a psychodynamic perspective, Rogers’s ideas about client-centered therapy have been especially influential in shaping how many clinicians operate. Furthermore, both behaviorism and the cognitive revolution have shaped clinical practice in the forms of behavioral therapy, cognitive therapy, and cognitive-behavioral therapy (Figure \(1\)). Issues related to the diagnosis and treatment of psychological disorders and problematic patterns of behavior will be discussed in detail in later chapters of this textbook.
By far, this is the area of psychology that receives the most attention in popular media, and many people mistakenly assume that all psychology is clinical psychology. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/02%3A_Contemporary_Psychology/2.07%3A_Social_Psychology.txt |
Forensic psychology is a branch of psychology that deals with questions of psychology as they arise in the context of the justice system. For example, forensic psychologists (and forensic psychiatrists) will assess a person’s competency to stand trial, assess the state of mind of a defendant, act as consultants on child custody cases, consult on sentencing and treatment recommendations, and advise on issues such as eyewitness testimony and children’s testimony (American Board of Forensic Psychology, 2014). In these capacities, they will typically act as expert witnesses, called by either side in a court case to provide their research- or experience-based opinions. As expert witnesses, forensic psychologists must have a good understanding of the law and provide information in the context of the legal system rather than just within the realm of psychology. Forensic psychologists are also used in the jury selection process and witness preparation. They may also be involved in providing psychological treatment within the criminal justice system. Criminal profilers are a relatively small proportion of psychologists that act as consultants to law enforcement.
LINK TO LEARNING
The APA provides career information about various areas of psychology.
REFERENCES
American Board of Forensic Psychology. (2019). About. https://abfp.com/ about/
American Psychological Association. (2014). Graduate training and career possibilities in exercise and sport psychology. www. apadivisions.org/division-47/about/resources/training
American Psychological Association. (2020). APA divisions. www. apa.org/about/division/
Association for Psychological Science. (n.d.). Who we are. www. psychologicalscience.org/about/who-we-are
Buss, D. M. (1989). Sex differences in human mate preferences: Evolutionary hypotheses tested in 37 cultures. Behavioral and Brain Sciences, 12, 1–49. https://doi.org/10.1017/S0140525X00023992
Carlson, N. R. (2013). Physiology of behavior (11th ed.). Pearson.
Confer, J. C., Easton, J. A., Fleischman, D. S., Goetz, C. D., Lewis, D. M. G.,
Perilloux, C., & Buss, D. M. (2010). Evolutionary psychology. Controversies, questions, prospects, and limitations. American Psychologist, 65, 100–126. https://doi.org/10.1037/a0018413
Endler, J. A. (1986). Natural selection in the wild. Princeton University Press.
Hock, R. R. (2009). Forty studies that changed psychology: Explorations into the history of psychological research (pp. 308–317). Pearson.
Jang, K. L., Livesley, W. J., & Vernon, P. A. (1996). Heritability of the Big Five personality dimensions and their facets: A twin study. Journal of Personality, 64, 577–591. doi.org/10.1111/j.1467-6494.1996. tb00522.x
MacDonald, C. A. (2013). Health Psychology Center presents: What is health psychology? healthpsychology.org/what-is-health- psychology/
McCrae, R. R. & Costa, P. T. (2008). Empirical and theoretical status of the five-factor model of personality traits. In G. J. Boyle, G. Matthews, & D. H. Saklofske (Eds.), The Sage handbook of personality theory and assessment: Personality theories and models (Vol. 1). Sage.
Miller, G. A. (2003). The cognitive revolution: A historical perspective. Trends in Cognitive Sciences, 7, 141–144. doi.org/10.1016/ S1364-6613(03)00029-9
Munakata, Y., McClelland, J. L., Johnson, M. H., & Siegler, R. S. (1997). Rethinking infant knowledge: Toward an adaptive process account of successes and failures in object permanence tasks. Psychological Review, 104, 689–713. https://doi.org/10.1037/0033-295X.104.4.686
Person, E. S. (1980). Sexuality as the mainstay of identity: Psychoanalytic perspectives. Signs: Journal of Women in Culture and Society, 5, 605–630. https://doi.org/10.1086/493755
Rantanen, J., Metsäpelto, R. L., Feldt, T., Pulkkinen, L., & Kokko, K. (2007). Long-term stability in the Big Five personality traits in adulthood. Scandinavian Journal of Psychology, 48, 511–518. https:// doi.org/10.1111/j.1467-9450.2007.00609.x
Riggio, R. E. (2013, March 18). What is industrial/organizational psychology? Psychology Today. https://www.psychologytoday.com/ us/blog/cutting-edge-leadership/201303/what-is- industrialorganizational-psychology
Roberts, A. W., Ogunwole, S. U., Blakeslee, L., & Rabe, M. A. (2018, October). The population 65 years and older in the United States: 2016. U.S. Census Bureau. www.census.gov/content/dam/ Census/library/publications/2018/acs/ACS-38.pdf
Soldz, S., & Vaillant, G. E. (1999). The Big Five personality traits and the life course: A 45-year longitudinal study. Journal of Research in Personality, 33, 208–232. https://doi.org/10.1006/jrpe.1999.2243
U.S. Census Bureau. (2017). Table 2: Projected age groups and sex composition of the population. www.census.gov/data/ tables/2017/demo/popproj/2017-summary-tables.html | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/02%3A_Contemporary_Psychology/2.12%3A_Forensic_Psychology.txt |
Here is the abstract of a 2014 article in the journal Psychological Science.
Taking notes on laptops rather than in longhand is increasingly common. Many researchers have suggested that laptop note taking is less effective than longhand note taking for learning. Prior studies have primarily focused on students’ capacity for multitasking and distraction when using laptops. The present research suggests that even when laptops are used solely to take notes, they may still be impairing learning because their use results in shallower processing. In three studies, we found that students who took notes on laptops performed worse on conceptual questions than students who took notes longhand. We show that whereas taking more notes can be beneficial, lap- top note takers’ tendency to transcribe lectures verbatim rather than processing information and reframing it in their own words is detrimental to learning. (Mueller & Oppenheimer, 2014, p. 1159)
In this abstract, the researcher has identified a research question—about the effect of taking notes on a laptop on learning—and identified why it is worthy of investigation— because the practice is ubiquitous and may be harmful to learning. In this chapter, we give you a broad overview of the various stages of the research process. These include finding a topic of investigation, reviewing the literature, refining your research question and generating a hypothesis, designing and conducting a study, analyzing the data, coming to conclusions, and reporting the results.
3.02: A Model Of Scientific Research In Psychology
Figure \(1\) presents a simple model of scientific research in psychology. The researchers formulate a research question, conduct an empirical study designed to answer the question, analyze the resulting data, draw conclusions about the answer to the question, and publish the results so that they become part of the research literature (i.e., all the published research in that field). Because the research literature is one of the primary sources of new research questions, this process can be thought of as a cycle. New research leads to new questions, which lead to new research, and so on. Figure \(1\) also indicates that research questions can originate outside of this cycle either with informal observations or with practical problems that need to be solved. But even in these cases, the researcher would start by checking the research literature to see if the question had already been answered and to refine it based on what previous research had already found.
The research by Matthias Mehl and his colleagues is described nicely by this model. Their research question— whether women are more talkative than men—was suggested to them both by people’s stereotypes and by claims published in the research literature about the relative talkativeness of women and men. When they checked the research literature, however, they found that this question had not been adequately addressed in scientific studies. They then conducted a careful empirical study, analyzed the results (finding very little difference between women and men), formed their conclusions, and published their work so that it became part of the research literature. The publication of their article is not the end of the story, however, because their work suggests many new questions (about the reliability of the result, about potential cultural differences, etc.) that will likely be taken up by them and by other researchers inspired by their work.
VIDEO CLIP
View a brief video about using the scientific method to study distracted drivers.
As another example, consider that as cell phones became more widespread during the 1990s, people began to wonder whether, and to what extent, cell phone use had a negative effect on driving. Many psychologists decided to tackle this question scientifically (e.g., Collet et al., 2010). It was clear from previously published research that engaging in a simple verbal task impairs performance on a perceptual or motor task carried out at the same time, but no one had studied the effect specifically of cell phone use on driving. Under carefully controlled conditions, these researchers compared people’s driving performance while using a cell phone with their performance while not using a cell phone, both in the lab and on the road. They found that people’s ability to detect road hazards, react quickly, and maintain control of the vehicle were all impaired by cell phone use. Each new study was published and became part of the growing research literature on this topic. For instance, other research teams subsequently demonstrated that cell phone conversations carry a greater risk than conversations with a passenger who is aware of driving conditions, which often become a point of conversation (e.g., Drews et al., 2004). | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.01%3A_Introduction.txt |
Good research must begin with a good research question. Yet coming up with good research questions is something that novice researchers often find difficult and stressful. One reason is that this is a creative process that can appear mysterious—even magical—with experienced researchers seeming to pull interesting research questions out of thin air. However, psychological research on creativity has shown that it is neither as mysterious nor as magical as it appears. It is largely the product of ordinary thinking strategies and persistence (Weisberg, 1993). This section covers some fairly simple strategies for finding general research ideas, turning those ideas into empirically testable research questions, and finally evaluating those questions in terms of how interesting they are and how feasible they would be to answer.
Finding inspiration
Research questions often begin as more general research ideas—usually focusing on some behavior or psychological characteristic: talkativeness, learning, depression, bungee jumping, and so on. Before looking at how to turn such ideas into empirically testable research questions, it is worth looking at where such ideas come from in the first place. Three of the most common sources of inspiration are informal observations, practical problems, and previous research.
Informal observations include direct observations of our own and others’ behavior as well as secondhand observations from non-scientific sources such as newspapers, books, blogs, and so on. For example, you might notice that you always seem to be in the slowest moving line at the grocery store. Could it be that most people think the same thing? Or you might read in a local newspaper about people donating money and food to a local family whose house has burned down and begin to wonder about who makes such donations and why. Some of the most famous research in psychology has been inspired by informal observations. Stanley Milgram’s famous research on obedience to authority, for example, was inspired in part by journalistic reports of the trials of accused Nazi war criminals—many of whom claimed that they were only obeying orders. This led him to wonder about the extent to which ordinary people will commit immoral acts simply because they are ordered to do so by an authority figure (Mil- gram, 1963).
Practical problems can also inspire research ideas, leading directly to applied research in such domains as law, health, education, and sports. Does taking lecture notes by hand improve students’ exam performance? How effective is psychotherapy for depression compared to drug therapy? To what extent do cell phones impair people’s driving ability? How can we teach children to read more efficiently? What is the best mental preparation for running a marathon?
Probably the most common inspiration for new research ideas, however, is previous research. Recall that science is a kind of large-scale collaboration in which many different researchers read and evaluate each other’s work and conduct new studies to build on it. Of course, experienced researchers are familiar with previous research in their area of expertise and probably have a long list of ideas. This suggests that novice researchers can find inspiration by consulting with a more experienced researcher (e.g., students can consult a faculty member). But they can also find inspiration by picking up a copy of almost any professional journal and reading the titles and abstracts. In one typical issue of Psychological Science, for example, you can find articles on the perception of shapes, anti-Semitism, police lineups, the meaning of death, second-language learning, people who seek negative emotional experiences, and many other topics. If you can narrow your interests down to a particular topic (e.g., memory) or domain (e.g., health care), you can also look through more specific journals, such as Memory & Cognition or Health Psychology.
VIDEO CLIP
View a video showing how to develop a good research topic.
Reviewing the Research Literature
Once again, one of the most common sources of inspiration is previous research. Therefore, it is important to review the literature early in the research process. The research literature in any field is all the published research in that field. Reviewing the research literature means finding, reading, and summarizing the published research relevant to your topic of interest. In addition to helping you discover new research questions, reviewing the literature early in the research process can help you in several other ways.
• It can tell you if a research question has already been answered.
• It can help you evaluate the interestingness of a research question.
• It can give you ideas for how to conduct your own study.
• It can tell you how your study fits into the research literature.
The research literature in psychology is enormous— including millions of scholarly articles and books dating to the beginning of the field—and it continues to grow. Although its boundaries are somewhat fuzzy, the research literature definitely does not include self-help and other pop psychology books, dictionary and encyclopedia entries, web- sites, and similar sources that are intended mainly for the general public. These are considered unreliable because they are not reviewed by other researchers and are often based on little more than common sense or personal experience. Wikipedia contains much valuable information, but because its authors are anonymous and may not have any formal training or expertise in that subject area, and its content continually changes, it is unsuitable as a basis of sound scientific research. For our purposes, it helps to define the research literature as consisting almost entirely of two types of sources: articles in professional journals and scholarly books in psychology and related fields.
Professional Journals
Professional journals are periodicals that publish original research articles. There are thousands of professional journals that publish research in psychology and related fields. They are usually published monthly or quarterly in individual issues, each of which contains several articles. The issues are organized into volumes, which usually consist of all the issues for a calendar year. Some journals are published in hard copy only, others in both hard copy and electronic form, and still others in electronic form only.
Most articles in professional journals are one of two basic types: empirical research reports and review articles. Empirical research reports describe one or more new empirical studies conducted by the authors. They introduce a research question, explain why it is interesting, review previous research, describe their method and results, and draw their conclusions. Review articles summarize previously published research on a topic and usually present new ways to organize or explain the results. When a review article is devoted primarily to presenting a new theory, it is often referred to as a theoretical article. When a review article provides a statistical summary of all of the previous results, it is referred to as a meta-analysis.
Most professional journals in psychology undergo a process of double-blind peer review. Researchers who want to publish their work in the journal submit a manuscript to the editor—who is generally an established researcher too—who in turn sends it to two or three experts on the topic. Each reviewer reads the manuscript, writes a critical but constructive review, and sends the review back to the editor along with recommendations about whether the manuscript should be published or not. The editor then decides whether to accept the article for publication, ask the authors to make changes and resubmit it for further consideration, or reject it outright. In any case, the editor forwards the reviewers’ written comments to the researchers so that they can revise their manuscript accordingly. This entire process is double-blind, as the reviewers do not know the identity of the researcher(s) and vice versa. Double-blind peer review is helpful because it ensures that the work meets basic standards of the field before it can enter the research literature. However, in order to increase transparency and accountability, some newer open access journals (e.g., Frontiers in Psychology) utilize an open peer review process wherein the identities of the reviewers (which remain concealed during the peer review process) are published alongside the journal article.
Scholarly Books
Scholarly books are books written by researchers and practitioners mainly for use by other researchers and practitioners. A monograph is written by a single author or a small group of authors and usually gives a coherent presentation of a topic, much like an extended review article. Edited volumes have an editor or a small group of editors who recruit many
authors to write separate chapters on different aspects of the same topic. Although edited volumes can also give a coherent presentation of the topic, it is not unusual for each chapter to take a different perspective or even for the authors of different chapters to openly disagree with each other. In general, schol- arly books undergo a peer review process similar to that used by professional journals.
Literature Search Strategies
Using APA PsycINFO and Other Databases
The primary method used to search the research literature involves using one or more electronic databases. These include Academic Search Premier and JSTOR for all academic disciplines, ERIC for education, and PubMed for medicine and related fields. The most important for our purposes, however, is APA PsycINFO (formerly known simply as PsycINFO), which is produced by the American Psychological Association (APA). APA PsycINFO is so comprehensive—covering thousands of professional journals and scholarly books going back more than 100 years—that for most purposes its con- tent is synonymous with the research literature in psychology. Like most such databases, APA PsycINFO is usually available through your university library.
APA PsycINFO consists of individual records for each article, book chapter, or book in the database. A computer interface allows entering one or more search terms and returns any records that contain those search terms. (These interfaces are provided by different vendors and therefore can look somewhat different depending on the library you use.) Each record includes basic publication information, an abstract or summary of the work (like the one presented at the start of this chapter), a list of other works cited by that work, and a list of keywords that describe the content of the work, and a list of index terms. The index terms are especially helpful because they are standardized. Research on differences between females and males, for example, is always indexed under “Human Sex Differences.” Research on note-taking is always indexed under the term “Learning Strategies.” If you do not know the appropriate index terms, APA PsycINFO includes a thesaurus that can help you find them.
Given that there are nearly four million records in APA PsycINFO, you may have to try a variety of search terms in different combinations and at different levels of specificity before you find what you are looking for. Imagine, for example, that you are interested in the question of whether males and females differ in terms of their ability to recall experiences from when they were very young. If you were to enter the search term “memory,” it would return far too many records to look through individually. This is where the thesaurus helps. Entering “memory” into the thesaurus provides several more specific index terms—one of which is “early memories.” While searching for “early memories” among the index terms still returns too many to look through individually—combining it with “human sex differences” as a second search term returns fewer articles, many of which are highly relevant to the topic.
Depending on the vendor that provides the interface to APA PsycINFO, you may be able to save, print, or e-mail the relevant APA PsycINFO records. The records might even contain links to full-text copies of the works themselves. (APA PsycARTICLES, formerly called simply PsycARTICLES, is a database that provides full-text access to articles in all journals published by the APA.) If not, and you want a copy of the work, you will have to find out if your library carries the journal or has the book and the hard copy on the library shelves. Be sure to ask a librarian if you need help.
VIDEO CLIP
View a video illustrating how to do an APA PsycINFO search.
Using Other Search Techniques
In addition to entering search terms into APA PsycINFO and other databases, there are several other techniques you can use to search the research literature. First, if you have one good article or book chapter on your topic—a recent review article is best—you can look through the reference list of that article for other relevant articles, books, and book chapters. In fact, you should do this with any relevant article or book chapter you find. You can also start with a classic article or book chapter on your topic, find its record in APA PsycINFO (by entering the author’s name or the article’s title as a search term), and link from there to a list of other works in APA PsycINFO that cite that classic article. This works because other researchers working on your topic are likely to be aware of the classic article and cite it in their own work. You can also do a general Internet search using search terms related to your topic or the name of a researcher who conducts research on your topic. This might lead you directly to works that are part of the research literature (e.g., articles in open-access journals or posted on researchers’ own websites). The search engine Google Scholar is especially useful for this purpose. A general Internet search might also lead you to websites that are not part of the research literature but might provide references to works that are. Finally, you can talk to people (e.g., your instructor or other faculty members in psychology) who know something about your topic and can suggest relevant articles and book chapters.
VIDEO CLIP
View a video showing how to do a search using Google Scholar.
What to Search For
When you do a literature review, you need to be selective. Not every article, book chapter, and book that relates to your research idea or question will be worth obtaining, reading, and integrating into your review. Instead, you want to focus on sources that help you do four basic things: (a) refine your research question, (b) identify appropriate research methods, (c) place your research in the context of previous research, and (d) write an effective research report. Several basic principles can help you find the most useful sources.
First, it is best to focus on recent research, keeping in mind that what counts as recent depends on the topic. For newer topics that are actively being studied, “recent” might mean published in the past year or two. For older topics that are receiving less attention right now, “recent” might mean within the past 10 years. You will get a feel for what counts as recent for your topic when you start your literature search. A good general rule, however, is to start with sources published in the past five years. The main exception to this rule would be classic articles that turn up in the reference list of nearly every other source. If other researchers think that this work is important, even though it is old, then, by all means, you should include it in your review.
Second, you should look for review articles on your topic because they will provide a useful overview of it—often discussing important definitions, results, theories, trends, and controversies—giving you a good sense of where your own research fits into the literature. You should also look for empirical research reports addressing your question or similar questions, which can give you ideas about how to measure your variables and collect your data. As a general rule, it is good to use methods that others have already used success- fully unless you have good reasons not to. Finally, you should look for sources that provide information that can help you argue for the interestingness of your research question. For a study on the effects of cell phone use on driving ability, for example, you might look for information about how wide- spread cell phone use is, how frequent and costly motor vehicle crashes are, and so on.
How many sources are enough for your literature review? This is a difficult question because it depends on how extensively your topic has been studied and also on your own goals. One study found that across a variety of professional journals in psychology, the average number of sources cited per article was about 50 (Adair & Vohra, 2003). This gives a rough idea of what professional researchers consider to be adequate. As a student, you might be assigned a much lower minimum number of references to include, but the principles for selecting the most useful ones remain the same. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.03%3A__Finding_A_Research_Topic.txt |
Generating Empirically Testable Research Questions
Once you have a research idea, you need to use it to generate one or more empirically testable research questions, that is, questions expressed in terms of a single variable or relation- ship between variables. One way to do this is to look closely at the discussion section in a recent research article on the topic. This is the last major section of the article, in which the researchers summarize their results, interpret them in the context of past research, and suggest directions for future research. These suggestions often take the form of specific research questions, which you can then try to answer with additional research. This can be a good strategy because it is likely that the suggested questions have already been identified as interesting and important by experienced researchers.
But you may also want to generate your own research questions. How can you do this? First, if you have a particular behavior or psychological characteristic in mind, you can simply conceptualize it as a variable and ask how frequent or intense it is. How many words on average do people speak per day? How accurate are our memories of traumatic events? What percentage of people have sought professional help for depression? If the question has never been studied scientifically—which is something that you will learn when you con- duct your literature review—then it might be interesting and worth pursuing.
If scientific research has already answered the question of how frequent or intense the behavior or characteristic is, then you should consider turning it into a question about a relationship between that behavior or characteristic and some other variable. One way to do this is to ask yourself the following series of more general questions and write down all the answers you can think of.
• What are some possible causes of the behavior or characteristic?
• What are some possible effects of the behavior or characteristic?
• What types of people might exhibit more or less of the behavior or characteristic?
• What types of situations might elicit more or less of the behavior or characteristic?
In general, each answer you write down can be conceptualized as a second variable, suggesting a question about a relationship. If you were interested in talkativeness, for example, it might occur to you that a possible cause of this psychological characteristic is family size. Is there a relationship between family size and talkativeness? Or it might occur to
you that people seem to be more talkative in same-sex groups than mixed-sex groups. Is there a difference in the average level of talkativeness of people in same-sex groups and people in mixed-sex groups? This approach should allow you to generate many different empirically testable questions about almost any behavior or psychological characteristic.
If through this process you generate a question that has never been studied scientifically—which again is something that you will learn in your literature review—then it might be interesting and worth pursuing. But what if you find that it has been studied scientifically? Although novice researchers often want to give up and move on to a new question at this point, this is not necessarily a good strategy. For one thing, the fact that the question has been studied scientifically and the research published suggests that it is of interest to the scientific community. For another, the question can almost certainly be refined so that its answer will still contribute something new to the research literature. Again, asking your- self a series of more general questions about the relationship is a good strategy.
• Are there other ways to define and measure the variables?
• Are there types of people for whom the relationship might be stronger or weaker?
• Are there situations in which the relationship might be stronger or weaker—including situations with practical importance?
For example, research has shown that women and men speak about the same number of words per day—but this was when talkativeness was measured in terms of the number of words spoken per day among university students in the United States and Mexico. We can still ask whether other ways of measuring talkativeness—perhaps the number of different people spoken to each day—produce the same result. Or we can ask whether studying elderly people or people from other cultures produces the same result. Again, this approach should help you generate many different research questions about almost any relationship.
Evaluating Research Questions
Researchers usually generate many more research questions than they ever attempt to answer. This means they must have some way of evaluating the research questions they generate so that they can choose which ones to pursue. In this section, we consider two criteria for evaluating research questions: the interestingness of the question and the feasibility of answering it.
Interestingness
How often do people tie their shoes? Do people feel pain when you punch them in the jaw? Are women more likely to wear
makeup than men? Do people prefer vanilla or chocolate ice cream? Although it would be a fairly simple matter to design a study and collect data to answer these questions, you probably would not want to because they are not interesting. We are not talking here about whether a research question is interesting to us personally but whether it is interesting to people more generally and, especially, to the scientific community. But what makes a research question interesting in this sense? Here we look at three factors that affect the interestingness of a research question: the answer is in doubt, the answer fills a gap in the research literature, and the answer has important practical implications.
First, a research question is interesting to the extent that its answer is in doubt. Obviously, questions that have been answered by scientific research are no longer interesting as the subject of new empirical research. But the fact that a question has not been answered by scientific research does not necessarily make it interesting. There has to be some reasonable chance that the answer to the question will be something that we did not already know. But how can you assess this before actually collecting data? One approach is to try to think of reasons to expect different answers to the question—especially ones that seem to conflict with common sense. If you can think of reasons to expect at least two different answers, then the question might be interesting. If you can think of reasons to expect only one answer, then it probably is not. The question of whether women are more talkative than men is interesting because there are reasons to expect both answers. The existence of the stereotype itself suggests the answer could be yes, but the fact that women’s and men’s verbal abilities are fairly similar suggests the answer could be no. The question of whether people feel pain when you punch them in the jaw is not interesting because there is absolutely no reason to think that the answer could be anything other than a resounding yes.
A second important factor to consider when deciding if a research question is interesting is whether answering it will fill a gap in the research literature. Again, this means in part that the question has not already been answered by scientific research. But it also means that the question is in some sense a natural one for people who are familiar with the research literature. For example, the question of whether taking lecture notes by hand can help improve students’ exam performance would be likely to occur to anyone who was familiar with research on note taking and the ineffectiveness of shallow processing on learning.
A final factor to consider when deciding whether a research question is interesting is whether its answer has important practical implications. Again, the question of whether taking notes by hand improves learning has important implications
for education, including classroom policies concerning technology use. The question of whether cell phone use impairs driving is interesting because it is relevant to the personal safety of everyone who travels by car and to the debate over whether cell phone use should be restricted by law.
Feasibility
A second important criterion for evaluating research questions is the feasibility of successfully answering them. There are many factors that affect feasibility, including time, money, equipment and materials, technical knowledge and skill, and access to research participants. Clearly, researchers need to take these factors into account so that they do not waste time and effort pursuing research they cannot complete successfully.
Looking through a sample of professional journals in psychology will reveal many studies that are complicated and difficult to carry out. These include longitudinal designs in which participants are tracked over many years, neuroimaging studies in which participants’ brain activity is measured while they carry out various mental tasks, and complex non-experimental studies involving several variables and complicated statistical analyses. Keep in mind, though, that such research tends to be carried out by teams of highly trained researchers whose work is often supported in part by government and private grants. Also, keep in mind that research does not have to be complicated or difficult to produce interesting and important results. Looking through a sample of professional journals will also reveal studies that are relatively simple and easy to carry out—perhaps involving a convenience sample of university students and a paper-and-pencil task.
A final point here is that it is generally good practice to use methods that have already been used successfully by other researchers. For example, if you want to manipulate people’s moods to make some of them happy, it would be a good idea to use one of the many approaches that have been used successfully by other researchers (e.g., paying them a compliment). This is good not only for the sake of feasibility—the approach is “tried and true”—but also because it provides greater continuity with previous research. This makes it easier to compare your results with those of other researchers and to understand the implications of their research for yours, and vice versa. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.04%3A_Generating_Good_Research_Questions.txt |
Theories and Hypotheses
Before describing how to develop a hypothesis, it is important to distinguish between a theory and a hypothesis. A theory is a coherent explanation or interpretation of one or more phenomena. Although theories can take a variety of forms, one thing they have in common is that they go beyond the phenomena they explain by including variables, structures, processes, functions, or organizing principles that have not been observed directly. Consider, for example, Zajonc’s theory of social facilitation and social inhibition (1965). He pro- posed that being watched by others while performing a task creates a general state of physiological arousal, which increases the likelihood of the dominant (most likely) response. So for highly practiced tasks, being watched increases the tendency to make correct responses, but for relatively unpracticed tasks, being watched increases the tendency to make incorrect responses. Notice that this theory—which has come to be called drive theory—provides an explanation of both social facilitation and social inhibition that goes beyond the phenomena themselves by including concepts such as “arousal” and “dominant response,” along with processes such as the effect of arousal on the dominant response.
Outside of science, referring to an idea as a theory often implies that it is untested—perhaps no more than a wild guess. In science, however, the term theory has no such implication. A theory is simply an explanation or interpretation of a set of phenomena. It can be untested, but it can also be extensively tested, well supported, and accepted as an accurate description of the world by the scientific community. The theory of evolution by natural selection, for example, is a theory because it is an explanation of the diversity of life on earth—not because it is untested or unsupported by scientific research. On the contrary, the evidence for this theory is overwhelmingly positive and nearly all scientists accept its basic assumptions as accurate. Similarly, the “germ theory” of disease is a theory because it is an explanation of the origin of various diseases, not because there is any doubt that many diseases are caused by microorganisms that infect the body.
A hypothesis, on the other hand, is a specific prediction about a new phenomenon that should be observed if a particular theory is accurate. It is an explanation that relies on just a few key concepts. Hypotheses are often specific predictions about what will happen in a particular study. They are developed by considering existing evidence and using reasoning to infer what will happen in the specific context of interest. Hypotheses are often but not always derived from theories. So a hypothesis is often a prediction based on a theory but some hypotheses are atheoretical and only after a set of observations has been made is a theory developed. This is because theories are broad in nature and explain larger bodies of data. So if our research question is really original then we may need to collect some data and make some observations before we can develop a broader theory.
Theories and hypotheses always have this if-then relation- ship. “If drive theory is correct, then cockroaches should run through a straight runway faster and through a branching runway more slowly when other cockroaches are present.” Although hypotheses are usually expressed as statements, they can always be rephrased as questions. “Do cockroaches run through a straight runway faster when other cockroaches are present?” Thus, deriving hypotheses from theories is an excellent way of generating interesting research questions.
But how do researchers derive hypotheses from theories? One way is to generate a research question using the techniques discussed in this chapter and then ask whether any theory implies an answer to that question. For example, you might wonder whether expressive writing about positive experiences improves health as much as expressive writing about traumatic experiences. Although this question is an interesting one on its own, you might then ask whether the habituation theory—the idea that expressive writing causes people to habituate to negative thoughts and feel- ings—implies an answer. In this case, it seems clear that if the habituation theory is correct, then expressive writing about positive experiences should not be effective because it would not cause people to habituate to negative thoughts and feelings. A second way to derive hypotheses from theories is to focus on some component of the theory that has not yet been directly observed. For example, a researcher could focus on the process of habituation—perhaps hypothesizing that people should show fewer signs of emotional distress with each new writing session.
Among the very best hypotheses are those that distinguish between competing theories. For example, Norbert Schwarz and his colleagues considered two theories of how people make judgments about themselves, such as how assertive they are (Schwarz et al., 1991). Both theories held that such judgments are based on relevant examples that people bring to mind. However, one theory was that people base their judgments on the number of examples they bring to mind and the other was that people base their judgments on how easily they bring those examples to mind. To test these theories, the researchers asked people to recall either six times when they were assertive (which is easy for most people) or 12 times (which is difficult for most people). Then they asked them to judge their own assertiveness. Note that the number-of-examples theory implies that people who recalled 12 examples should judge themselves to be more assertive because they recalled more examples, but the ease-of-examples theory implies that participants who recalled six examples should judge themselves as more assertive because recalling the examples was easier. Thus the two theories made opposite predictions so that only one of the predictions could be confirmed. The surprising result was that participants who recalled fewer examples judged them- selves to be more assertive—providing particularly convincing evidence in favor of the ease-of-retrieval theory over the number-of-examples theory.
Theory Testing
The primary way that scientific researchers use theories is some- times called the hypothetico-deductive method (although this term is much more likely to be used by philosophers of science than by scientists themselves). Researchers begin with a set of phenomena and either construct a theory to explain or interpret the phenomena or choose an existing theory to work with. They then make a prediction about some new phenomenon that should be observed if the theory is correct. Again, this pre- diction is called a hypothesis. The researchers then conduct an empirical study to test the hypothesis. Finally, they reevaluate the theory in light of the new results and revise it if necessary. This process is usually conceptualized as a cycle because the researchers can then derive a new hypothesis from the revised theory, conduct a new empirical study to test the hypothesis, and so on. As Figure \(1\) shows, this approach meshes nicely with the model of scientific research in psychology presented earlier in the textbook—creating a more detailed model of “theoretically motivated” or “theory-driven” research.
As an example, let us consider Zajonc’s research on social facilitation and inhibition. He started with a somewhat contradictory pattern of results from the research literature. He then constructed his drive theory, according to which being watched by others while performing a task causes physiological arousal, which increases an organism’s tendency to make the dominant response. This theory predicts social facilitation for well-learned tasks and social inhibition for poorly learned tasks. He now had a theory that organized previous results in a meaningful way—but he still needed to test it. He hypothesized that if his theory was correct, he should observe that the presence of others improves performance in a simple laboratory task but inhibits performance in a difficult version of the very same laboratory task. To test this hypothesis, one of the studies he conducted used cockroaches as subjects (Zajonc, Heingartner, & Herman, 1969). The cockroaches ran either down a straight runway (an easy task for a cockroach) or through a cross-shaped maze (a difficult task for a cock- roach) to escape into a dark chamber when a light was shined on them. They did this either while alone or in the presence of other cockroaches in clear plastic “audience boxes.” Zajonc found that cockroaches in the straight runway reached their goal more quickly in the presence of other cockroaches, but cockroaches in the cross-shaped maze reached their goal more slowly when they were in the presence of other cock- roaches. Thus he confirmed his hypothesis and provided support for his drive theory. (Zajonc also showed that drive theory existed in humans [Zajonc & Sales, 1966] in many other studies afterward).
Incorporating Theory into Your Research
When you write your research report or plan your presentation, be aware that there are two basic ways that researchers usually include theory. The first is to raise a research question, answer that question by conducting a new study, and then offer one or more theories (usually more) to explain or interpret the results. This format works well for applied research questions and for research questions that existing theories do not address. The second way is to describe one or more existing theories, derive a hypothesis from one of those theories, test the hypothesis in a new study, and finally reevaluate the theory. This format works well when there is an existing theory that addresses the research question—especially if the resulting hypothesis is surprising or conflicts with a hypothesis derived from a different theory.
To use theories in your research will not only give you guidance in coming up with experiment ideas and possible projects, but it lends legitimacy to your work. Psychologists have been interested in a variety of human behaviors and have developed many theories along the way. Using established theories will help you break new ground as a researcher, not limit you from developing your own ideas.
Characteristics of a Good Hypothesis
There are three general characteristics of a good hypothesis. First, a good hypothesis must be testable and falsifiable. We must be able to test the hypothesis using the methods of science, and it must be possible to gather evidence that will disconfirm the hypothesis if it is indeed false. Second, a good hypothesis must be logical. As described above, hypotheses are more than just a random guess. Hypotheses should be informed by previous theories or observations and logical reasoning. Typically, we begin with a broad and general theory and use deductive reasoning to generate a more specific hypothesis to test based on that theory. Occasionally, how- ever, when there is no theory to inform our hypothesis, we use inductive reasoning which involves using specific observations or research findings to form a more general hypothesis. Finally, the hypothesis should be positive. That is, the hypothesis should make a positive statement about the existence of a relationship or effect, rather than a statement that a relationship or effect does not exist. As scientists, we don’t set out to show that relationships do not exist or that effects do not occur so our hypotheses should not be worded in a way to suggest that an effect or relationship does not exist. The nature of science is to assume that something does not exist and then seek to find evidence to prove this wrong, to show that it really does exist. That may seem backward to you but that is the nature of the scientific method. The underlying reason for this is beyond the scope of this chapter but it has to do with statistical theory. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.05%3A_Developing_A_Hypothesis.txt |
Identifying and Defining the Variables and Population
Variables and Operational Definitions
Part of generating a hypothesis involves identifying the variables you want to study and operationally defining those variables so they can be measured. Research questions in psychology are about variables. A variable is a quantity or quality that varies across people or situations. For example, the height of the students enrolled in a university course is a variable because it varies from student to student. The chosen major of the students is also a variable as long as not everyone in the class has declared the same major. Almost everything in our world varies, so thinking of examples of constants (things that don’t vary) is far more difficult. A rare example of a constant is the speed of light. Variables can be either quantitative or categorical. A quantitative variable is a quantity, such as height, that is typically measured by assigning a number to each individual. Other examples of quantitative variables include people’s level of talkativeness, how depressed they are, and the number of siblings they have. A categorical variable is a quality, such as chosen major, and is typically measured by assigning a category label to each individual (e.g., Psychology, English, Nursing, etc.). Other examples include people’s nationality, their occupation, and whether they are receiving psychotherapy.
After the researcher generates their hypothesis and selects the variables they want to manipulate and measure, theresearcher needs to find ways to actually measure the variables of interest. This requires an operational definition—a definition of the variable in terms of precisely how it is to be measured. Most variables that researchers are interested in studying cannot be directly observed or measured, and this poses a problem because empiricism (observation) is at the heart of the scientific method. Operationally defining a variable involves taking an abstract construct like depression that cannot be directly observed and transforming it into something that can be directly observed and measured. Most variables can be operationally defined in many different ways. For example, depression can be operationally defined as people’s scores on a paper-and-pencil depression scale such as the Beck Depression Inventory, the number of depressive symptoms they are experiencing, or whether they have been diagnosed with major depressive disorder. Researchers are wise to choose an operational definition that has been used extensively in the research literature.
Sampling and Measurement
In addition to identifying which variables to manipulate and measure, and operationally defining those variables, researchers need to identify the population of interest. Researchers in psychology are usually interested in drawing conclusions about some very large group of people. This is called the population. It could be all American teenagers, children with autism, professional athletes, or even just human beings— depending on the interests and goals of the researcher. But they usually study only a small subset or sample of the population. For example, a researcher might measure the talkative- ness of a few hundred university students with the intention of drawing conclusions about the talkativeness of men and women in general. It is important, therefore, for researchers to use a representative sample—one that is similar to the population in important respects.
One method of obtaining a sample is simple random sampling, in which every member of the population has an equal chance of being selected for the sample. For example, a pollster could start with a list of all the registered voters in a city (the population), randomly select 100 of them from the list (the sample), and ask those 100 whom they intend to vote for. Unfortunately, random sampling is difficult or impossible in most psychological research because the populations are less clearly defined than the registered voters in a city. How could a researcher give all American teenagers or all children with autism an equal chance of being selected for a sample? The most common alternative to random sampling is convenience sampling, in which the sample consists of individuals who happen to be nearby and willing to participate (such as introductory psychology students). Of course, the obvious problem with convenience sampling is that the sample might not be representative of the population and therefore it may be less appropriate to generalize the results from the sample to that population.
Experimental vs. Non-Experimental Research
The next step a researcher must take is to decide which type of approach they will use to collect the data. As you will learn in your research methods course there are many different approaches to research that can be divided in many different ways. One of the most fundamental distinctions is between experimental and non-experimental research.
Experimental Research
Researchers who want to test hypotheses about causal relationships between variables (i.e., their goal is to explain) need to use an experimental method. This is because the experimental method is the only method that allows us to deter- mine causal relationships. Using the experimental approach, researchers first manipulate one or more variables while attempting to control extraneous variables, and then they measure how the manipulated variables affect participants’ responses.
The terms independent variable and dependent variable are used in the context of experimental research. The independent variable is the variable the experimenter manipulates (it is the presumed cause) and the dependent variable is the variable the experimenter measures (it is the presumed effect).
Extraneous variables are any variable other than the dependent variable. Confounds are a specific type of extraneous variable that systematically varies along with the variables under investigation and therefore provides an alter- native explanation for the results. When researchers design an experiment they need to ensure that they control for con- founds; they need to ensure that extraneous variables don’t become confounding variables because in order to make a causal conclusion they need to make sure alternative explanations for the results have been ruled out.
As an example, if we manipulate the lighting in the room and examine the effects of that manipulation on workers’ productivity, then the lighting conditions (bright lights vs. dim lights) would be considered the independent variable and the workers’ productivity would be considered the dependent variable. If the bright lights are noisy then that noise would be a confound since the noise would be present whenever the lights are bright and the noise would be absent when the lights are dim. If noise is varying systematically with light then we wouldn’t know if a difference in worker productivity across the two lighting conditions is due to noise or light. So confounds are bad, they disrupt our ability to make causal conclusions about the nature of the relationship between
variables. However, if there is noise in the room both when the lights are on and when the lights are off then noise is merely an extraneous variable (it is a variable other than the indepen- dent or dependent variable), and we don’t worry much about extraneous variables. This is because, unless a variable varies systematically with the manipulated independent variable, it cannot be a competing explanation for the results.
Non-Experimental Research
Researchers who are simply interested in describing characteristics of people, describing relationships between variables, and using those relationships to make predictions can use non-experimental research. Using the non-experimental approach, the researcher simply measures variables as they naturally occur, but they do not manipulate them. For instance, if I just measured the number of traffic fatalities in America last year that involved the use of a cell phone but I did not actually manipulate cell phone use then this would be categorized as non-experimental research. Alternatively, if I stood at a busy intersection and recorded drivers’ genders and whether or not they were using a cell phone when they passed through the intersection to see whether men or women are more likely to use a cell phone when driving, then this would be non-experimental research. It is important to point out that non-experimental does not mean nonscientific. Non-experimental research is scientific in nature. It can be used to fulfill two of the three goals of science (to describe and to predict). However, unlike with experimental research, we cannot make causal conclusions using this method; we cannot say that one variable causes another variable using this method.
Laboratory vs. Field Research
The next major distinction between research methods is between laboratory and field studies. A laboratory study is a study that is conducted in the laboratory environment. In contrast, a field study is a study that is conducted in the real world, in a natural environment.
Laboratory experiments typically have high internal validity. Internal validity refers to the degree to which we can confidently infer a causal relationship between variables. When we conduct an experimental study in a laboratory environment, we have very high internal validity because we manipulate one variable while controlling all other outside extraneous variables. When we manipulate an independent variable and observe an effect on a dependent variable and we control for everything else so that the only difference between our experimental groups or conditions is the one manipulated variable, then we can be quite confident that it is the independent variable that is causing the change in the dependent variable. In contrast, because field studies are conducted in the real world, the experimenter typically has less control over the environment and potential extraneous variables, and this decreases internal validity, making it less appropriate to arrive at causal conclusions.
But there is typically a trade-off between internal and external validity. External validity simply refers to the degree to which we can generalize the findings to other circumstances or settings, like the real-world environment. When internal validity is high, external validity tends to be low; and when internal validity is low, external validity tends to be high. So laboratory studies are typically low in external validity, while field studies are typically high in external validity. Since field studies are conducted in the real-world environment it is far more appropriate to generalize the findings to that real-world environment than when the research is con- ducted in the more artificial sterile laboratory.
Finally, there are field studies, which are non-experimental in nature because nothing is manipulated. But there are also field experiments where an independent variable is manipulated in a natural setting and extraneous variables are controlled. Depending on their overall quality and the level of control of extraneous variables, such field experiments can have high external and high internal validity. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.06%3A_Designing_A_Research_Study.txt |
Drawing Conclusions
Since statistics are probabilistic in nature and findings can reflect Type I or Type II errors, we cannot use the results of a single study to conclude with certainty that a theory is true. Rather, theories are supported, refuted, or modified based on the results of research.
If the results are statistically significant and consistent with the hypothesis and the theory that was used to generate the hypothesis, then researchers can conclude that the theory is supported. Not only did the theory make an accurate pre- diction, but there is now a new phenomenon that the theory accounts for. If a hypothesis is disconfirmed in a systematic empirical study, then the theory has been weakened. It made an inaccurate prediction, and there is now a new phenomenon that it does not account for.
Although this seems straightforward, there are some complications. First, confirming a hypothesis can strengthen a theory but it can never prove a theory. In fact, scientists tend to avoid the word “prove” when talking and writing about theories. One reason for this avoidance is that the result may reflect a Type I error. Another reason for this avoidance is that there may be other plausible theories that imply the same hypothesis, which means that confirming the hypothesis strengthens all those theories equally. A third reason is that it is always possible that another test of the hypothesis or a test of a new hypothesis derived from the theory will be disconfirmed. This difficulty is a version of the famous philosophical “problem of induction.” One cannot definitively prove a general principle (e.g., “All swans are white.”) just by observing confirming cases (e.g., white swans)—no matter how many. It is always possible that a disconfirming case (e.g., a black swan) will eventually come along. For these reasons, scientists tend to think of theories—even highly successful ones—as subject to revision based on new and unexpected observations.
A second complication has to do with what it means when a hypothesis is disconfirmed. According to the strictest version of the hypothetico-deductive method, disconfirming a hypothesis disproves the theory it was derived from. In for- mal logic, the premises “if A then B” and “not B” necessarily lead to the conclusion “not A.” If A is the theory and B is the hypothesis (“if A then B”), then disconfirming the hypothesis (“not B”) must mean that the theory is incorrect (“not A”). In practice, however, scientists do not give up on their theories so easily. One reason is that one disconfirmed hypothesis could be a missed opportunity (the result of a Type II error) or it could be the result of a faulty research design. Perhaps the researcher did not successfully manipulate the independent variable or measure the dependent variable.
A disconfirmed hypothesis could also mean that some unstated but relatively minor assumption of the theory was not met. For example, if Zajonc had failed to find social facilitation in cockroaches, he could have concluded that drive theory is still correct but it applies only to animals with sufficiently complex nervous systems. That is, the evidence from a study can be used to modify a theory. This practice does not mean that researchers are free to ignore disconfirmations of their theories. If they cannot improve their research designs or modify their theories to account for repeated disconfirmations, then they eventually must abandon their theories and replace them with ones that are more successful.
The bottom line here is that because statistics are probabilistic in nature and because all research studies have flaws, there is no such thing as scientific proof, there is only scientific evidence.
Reporting the Results
The final step in the research process involves reporting the results. As described in the section on Reviewing the Research Literature in this chapter, results are typically reported in peer-reviewed journal articles and at conferences.
The most prestigious way to report one’s findings is by writing a manuscript and having it published in a peer-reviewed scientific journal. Manuscripts published in psychology journals typically must adhere to the writing style of the American Psychological Association (APA style). You will likely be learning the major elements of this writing style in this course.
Another way to report findings is by writing a book chapter that is published in an edited book. Preferably the editor of the book puts the chapter through peer review, but this is not always the case, and some scientists are invited by editors to write book chapters.
A fun way to disseminate findings is to give a presentation at a conference. This can either be done as an oral presentation or a poster presentation. Oral presentations involve get- ting up in front of an audience of fellow scientists and giving a talk that might last anywhere from 10 minutes to 1 hour (depending on the conference) and then fielding questions from the audience. Alternatively, poster presentations involve summarizing the study on a large poster that provides a brief overview of the purpose, methods, results, and discussion. The presenter stands by their poster for an hour or two and discusses it with people who pass by. Presenting one’s work at a conference is a great way to get feedback from one’s peers before attempting to undergo the more rigorous peer-review process involved in publishing a journal article. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.07%3A_Drawing_Conclusions_And_Reporting_The_Results.txt |
• Research in psychology can be described by a simple cyclical model. A research question based on the research literature leads to an empirical study, the results of which are published and become part of the research literature.
• The research literature in psychology is all the published research in psychology, consisting primarily of articles in professional journals and scholarly books.
• Early in the research process, it is important to conduct a review of the research literature on your topic to refine your research question, identify appropriate research methods, place your question in the context of other research, and prepare to write an effective research report.
• There are several strategies for finding previous research on your topic. Among the best is using APA PsycINFO, a computer database that catalogs millions of articles, books, and book chapters in psychology and related fields.
• Research questions expressed in terms of variables and relation- ships between variables can be suggested by other researchers or generated by asking a series of more general questions about the behavior or psychological characteristic of interest.
• It is important to evaluate how interesting a research question is before designing a study and collecting data to answer it. Factors that affect interestingness are the extent to which the answer is in doubt, whether it fills a gap in the research literature, and whether it has important practical implications.
• It is also important to evaluate how feasible a research question will be to answer. Factors that affect feasibility include time, money, technical knowledge and skill, and access to special equipment and research participants.
• A theory is broad in nature and explains larger bodies of data. A hypothesis is more specific and makes a prediction about the outcome of a particular study.
• Working with theories is not “icing on the cake.” It is a basic ingredient of psychological research.
• Like other scientists, psychologists use the hypothetico-deductive method. They construct theories to explain or interpret phenomena (or work with existing theories), derive hypotheses from their theories, test the hypotheses, and then reevaluate the theories in light of the new results.
• Variables vary across people or situations and may be quantitative (e.g., age) or categorical (e.g., course subject).
• A sample is a small subset of a larger population that is selected to participate in the research study. There are many different ways of sampling participants, including convenience sampling and simple random sampling.
• Experimental research involves manipulating an independent variable to observe the effects on a measured dependent variable, whereas non-experimental research involves measuring variables as they naturally occur (i.e., without manipulating anything).
• Research can be conducted in the field or the lab. Laboratory experiments tend to have high internal validity (allowing us to make strong causal conclusions), whereas field studies often have more external validity (allowing us to generalize to the real world).
• The mean, median, and mode are measures of central tendency used to describe the typical, average, or center scores in a distribution. The range, standard deviation, and variance are measures of how dispersed or spread apart the scores are. Measures of central tendency and dispersion are important descriptive statistics.
• Inferential statistics allow researchers to determine whether their findings are statistically significant, that is, whether they are unlikely to be due to chance alone and therefore are likely to represent a real effect in the population.
• Since statistics are probabilistic in nature, we never know if our conclusions are correct. We can make Type I errors (concluding an effect is real when it is not) or Type II errors (concluding there is no effect when there actually is a real effect in the population).
• Theories can be supported but not proved. Similarly, disconfirming a hypothesis does not necessarily mean that theory has been disproved.
• The final step of the research process involves reporting results at scientific conferences, in journal articles, and/or in books.
REFERENCES
Adair, J. G., & Vohra, N. (2003). The explosion of knowledge, references, and citations: Psychology’s unique response to a crisis. American Psychologist, 58, 15–23. https://doi.org/10.1037/0003-066X.58.1.15
Collet, C., Guillot, A., & Petit, C. (2010). Phoning while driving I: A review of epidemiological, psychological, behavioral and physiological studies. Ergonomics, 53, 589–601. doi.org/10.1080/ 00140131003672023
Drews, F. A., Pasupathi, M., & Strayer, D. L. (2004). Passenger and cell-phone conversations in simulated driving. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 48, 2210–2212. https://doi.org/10.1177/154193120404801901
Milgram, S. (1963). Behavioral study of obedience. Journal of Abnormal and Social Psychology, 67, 371–378. doi.org/10.1037/ h0040525
Mueller, P. A., & Oppenheimer, D. M. (2014). The pen is mightier than the keyboard: Advantages of longhand over laptop note taking.
Psychological Science, 25(6), 1159–1168. doi.org/10.1177/ 0956797614524581
Schwarz, N., Bless, H., Strack, F., Klumpp, G., Rittenauer-Schatka, H., & Simons, A. (1991). Ease of retrieval as information: Another look at the availability heuristic. Journal of Personality and Social Psychology, 61, 195–202. https://doi.org/10.1037/0022-3514.61.2.195
Weisberg, R. W. (1993). Creativity: Beyond the myth of genius. Freeman. Zajonc, R. B. (1965). Social facilitation. Science, 149, 269–274. https://
doi.org/10.1126/science.149.3681.269
Zajonc, R. B., Heingartner, A., & Herman, E. M. (1969). Social enhancement and impairment of performance in the cockroach. Journal of Personality and Social Psychology, 13, 83–92. doi. org/10.1037/h0028063
Zajonc, R. B., & Sales, S.M. (1966). Social facilitation of dominant and subordinate responses. Journal of Experimental Social Psychology, 2, 160–168. https://doi.org/10.1016/0022-1031(66)90077-1
3.09: Exercises
1. Find a description of an empirical study in a professional journal or in one of the scientific psychology blogs. Then write a brief description of the research in terms of the cyclical model presented here. One or two sentences for each part of the cycle should suffice.
2. Watch this TED Ed video, in which David H. Schwartz provides an introduction to two types of empirical studies along with some methods that scientists use to increase the reliability of their results.
3. Use the techniques discussed in this chapter to find 10 journal articles and book chapters on one of the following research ideas: memory for smells, aggressive driving, the causes of narcissistic personality disorder, the functions of the intraparietal sulcus, or prejudice against the physically handicapped.
4. Watch this video clip produced by UBCiSchool about how to read an academic paper (without losing your mind).
5. Generate three research ideas based on each of the following: informal observations, practical problems, and topics discussed in recent issues of professional journals.
6. Generate an empirical research question about each of the following behaviors or psychological characteristics: long-distance running, getting tattooed, social anxiety, bullying, and memory for early childhood events.
7. Evaluate each of the research questions you generated in Exercise 6 in terms of its interestingness based on the criteria discussed in this chapter.
8. Find an issue of a journal that publishes short empirical research reports (e.g., Psychological Science, Psychonomic Bulletin and Review, Personality and Social Psychology Bulletin). Pick three studies, and rate each one in terms of how feasible it would be for you to replicate it with the resources available to you right now. Use the following rating scale: (1) You could replicate it essentially as reported. (2) You could replicate it with some simplifications. (3) You could not replicate it. Explain each rating.
9. Find a recent empirical research report in a professional journal. Read the introduction and highlight in different colors descriptions of theories and hypotheses.
10. Using the research article you found in a professional journal identify whether the study was experimental or non-experimental. If it was experimental, identify the independent and dependent variables.
11. Using the research article you found in a professional journal, identify which descriptive statistics were reported.
12. Describe why theories can be supported but not proved. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/03%3A_Overview_of_the_Scientific_Method/3.08%3A_Key_Takeways.txt |
Psychologists test research questions using a variety of methods. Most research relies on either correlations or experiments. With correlations, researchers measure variables as they naturally occur in people and compute the degree to which two variables go together. With experiments, researchers actively make changes in one variable and watch for changes in another variable. Experiments allow researchers to make causal inferences. Other types of methods include longitudinal and quasi-experimental designs. Many factors, including practical constraints, determine the type of meth- ods researchers use. Often researchers survey people even though it would be better—but more expensive and time consuming—to track them longitudinally.
4.02: Research Designs
In the early 1970s, a man named Uri Geller tricked the world: he convinced hundreds of thousands of people that he could bend spoons and slow watches using only the power of his mind. In fact, if you were in the audience, you would have likely believed he had psychic powers. Everything looked authentic—this man had to have paranormal abilities! So, why have you probably never heard of him before? Because when Uri was asked to perform his miracles in line with scientific experimentation, he was no longer able to do them. That is, even though it seemed like he was doing the impossible, when he was tested by science, he proved to be nothing more than a clever magician.
When we look at dinosaur bones to make educated guesses about extinct life, or systematically chart the heavens to learn about the relationships between stars and planets, or study magicians to figure out how they perform their tricks, we are forming observations—the foundation of science. Although we are all familiar with the saying “seeing is believing,” conducting science is more than just what your eyes perceive. Science is the result of systematic and intentional study of the natural world. And psychology is no different. In the movie Jerry Maguire, Cuba Gooding Jr. became famous for using the phrase, “Show me the money!” In psychology, as in all sciences, we might say, “Show me the data!”
One of the important steps in scientific inquiry is to test our research questions, otherwise known as hypotheses. However, there are many ways to test hypotheses in psychological research. Which method you choose will depend on the type of questions you are asking, as well as what resources are available to you. All methods have limitations, which is why the best research uses a variety of methods.
Most psychological research can be divided into two types: experimental and correlational research.
4.03: Experimental Research
If somebody gave you \$20 that absolutely had to be spent today, how would you choose to spend it? Would you spend it on an item you’ve been eyeing for weeks, or would you donate the money to charity? Which option do you think would bring you the most happiness? If you’re like most people, you’d choose to spend the money on yourself (duh, right?). Our intuition is that we’d be happier if we spent the money on ourselves.
Knowing that our intuition can sometimes be wrong, Professor Elizabeth Dunn (2008) at the University of British Columbia set out to conduct an experiment on spending and happiness. She gave each of the participants in her experiment \$20 and then told them they had to spend the money by the end of the day. Some of the participants were told they must spend the money on themselves, and some were told they must spend the money on others (either charity or a gift for someone). At the end of the day she measured participants’ levels of happiness using a self-report questionnaire. (But wait, how do you measure something like happiness when you can’t really see it? Psychologists measure many abstract concepts, such as happiness and intelligence, by beginning with operational definitions of the concepts. See the Noba modules on Intelligence and Happiness for more information on specific measurement strategies.)
In an experiment, researchers manipulate, or cause changes, in the independent variable and observe or mea- sure any impact of those changes in the dependent variable. The independent variable is the one under the experimenter’s control, or the variable that is intentionally altered between groups. In the case of Dunn’s experiment, the independent variable was whether participants spent the money on them- selves or on others. The dependent variable is the variable that is not manipulated at all, or the one where the effect happens. One way to help remember this is that the dependent variable “depends” on what happens to the independent variable. In our example, the participants’ happiness (the dependent variable in this experiment) depends on how the participants spend their money (the independent variable). Thus, any observed changes or group differences in happiness can be attributed to whom the money was spent on. What Dunn and her colleagues found was that, after all the spending had been done, the people who had spent the money on others were happier than those who had spent the money on themselves. In other words, spending on others causes us to be happier than spending on ourselves. Do you find this surprising?
But wait! Doesn’t happiness depend on a lot of different factors—for instance, a person’s upbringing or life circumstances? What if some people had happy childhoods and that’s why they’re happier? Or what if some people dropped their toast that morning and it fell jam-side down and ruined their whole day? It is correct to recognize that these factors and many more can easily affect a person’s level of happiness. So how can we accurately conclude that spending money on others causes happiness, as in the case of Dunn’s experiment?
The most important thing about experiments is random assignment. Participants don’t get to pick which condition they are in (e.g., participants didn’t choose whether they were supposed to spend the money on themselves versus others). The experimenter assigns them to a particular condition based on the flip of a coin or the roll of a die or any other random method. Why do researchers do this? With Dunn’s study, there is the obvious reason: you can imagine which condition most people would choose to be in, if given the choice. But another equally important reason is that random assignment makes it so the groups, on average, are similar on all characteristics except what the experimenter manipulates.
By randomly assigning people to conditions (self-spending versus other-spending), some people with happy child- hoods should end up in each condition. Likewise, some people who had dropped their toast that morning (or experienced some other disappointment) should end up in each condition. As a result, the distribution of all these factors will generally be consistent across the two groups, and this means that on average the two groups will be relatively equivalent on all these factors. Random assignment is critical to experimentation because if the only difference between the two groups is the independent variable, we can infer that the independent variable is the cause of any observable difference (e.g., in the amount of happiness they feel at the end of the day).
Here’s another example of the importance of random assignment: Let’s say your class is going to form two basket- ball teams, and you get to be the captain of one team. The class is to be divided evenly between the two teams. If you get to pick the players for your team first, whom will you pick? You’ll probably pick the tallest members of the class or the most athletic. You probably won’t pick the short, uncoordinated people, unless there are no other options. As a result, your team will be taller and more athletic than the other team. But what if we want the teams to be fair? How can we do this when we have people of varying height and ability? All we have to do is randomly assign players to the two teams. Most likely, some tall and some short people will end up on your team, and some tall and some short people will end up on the other team. The average height of the teams will be approximately the same. That is the power of random assignment!
Other Considerations
In addition to using random assignment, you should avoid introducing confounds into your experiments. Confounds are things that could undermine your ability to draw causal inferences. For example, if you wanted to test if a new happy pill will make people happier, you could randomly assign participants to take the happy pill or not (the independent variable) and compare these two groups on their self-re- ported happiness (the dependent variable). However, if some participants know they are getting the happy pill, they might develop expectations that influence their self-reported happiness. This is sometimes known as a placebo effect. Some- times a person’s knowledge that he or she is receiving special treatment or something new is enough to actually cause changes in behavior or perception: In other words, even if the participants in the happy pill condition were to report being happier, we wouldn’t know if the pill was actually making them happier or if it was the placebo effect—an example of a confound. A related idea is participant demand. This occurs when participants try to behave in a way they think the experimenter wants them to behave. Placebo effects and participant demand often occur unintentionally. Even experimenter expectations can influence the outcome of a study. For example, if the experimenter knows who took the happy pill and who did not, and the dependent variable is the experimenter’s observations of people’s happiness, then the experimenter might perceive improvements in the happy pill group that are not really there.
One way to prevent these confounds from affecting the results of a study is to use a double-blind procedure. In a double-blind procedure, neither the participant nor the experimenter knows which condition the participant is in. For example, when participants are given the happy pill or the fake pill, they don’t know which one they are receiving. This way the participants shouldn’t experience the placebo effect and will be unable to behave as the researcher expects (participant demand). Likewise, the researcher doesn’t know which pill each participant is taking (at least in the beginning—later, the researcher will get the results for data-analysis purposes), which means the researcher’s expectations can’t influence his or her observations. Therefore, because both parties are “blind” to the condition, neither will be able to behave in a way that introduces a confound. At the end of the day, the only difference between groups will be which pills the participants received, allowing the researcher to determine if the happy pill actually caused people to be happier. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/04%3A_Research_Designs/4.01%3A_Introduction.txt |
When scientists passively observe and measure phenomena it is called correlational research. Here, we do not intervene and change behavior, as we do in experiments. In correlational research, we identify patterns of relationships, but we usually cannot infer what causes what. Importantly, with correlational research, you can examine only two variables at a time, no more and no less.
So, what if you wanted to test whether spending on others is related to happiness, but you don’t have \$20 to give to each participant? You could use a correlational design—which is exactly what Professor Dunn did, too. She asked people how much of their income they spent on others or donated to charity, and later she asked them how happy they were. Do you think these two variables were related? Yes, they were! The more money people reported spending on others, the happier they were.
More Details about the Correlation
To find out how well two variables correspond, we can plot the relation between the two scores on what is known as a scatterplot (Figure \(1\)). In the scatterplot, each dot represents a data point. (In this case it’s individuals, but it could be some other unit.) Importantly, each dot provides us with two pieces of information—in this case, information about how good the person rated the past month (x-axis) and how happy the per- son felt in the past month (y-axis). Which variable is plotted on which axis does not matter.
The association between two variables can be summarized statistically using the correlation coefficient (abbreviated as r). A correlation coefficient provides information about the direction and strength of the association between two variables. For the example above, the direction of the association is positive. This means that people who perceived the past month as being good reported feeling more happy, whereas people who perceived the month as being bad reported feeling less happy.
With a positive correlation, the two variables go up or down together. In a scatterplot, the dots form a pattern that extends from the bottom left to the upper right (just as they do in Figure \(1\)). The r value for a positive correlation is indicated by a positive number (although, the positive sign is usually omitted). Here, the r value is .81.
A negative correlation is one in which the two variables move in opposite directions. That is, as one variable goes up, the other goes down. Figure \(2\) shows the association between the average height of males in a country (y-axis) and the pathogen prevalence, or commonness of disease (x-axis), of that country. In this scatterplot, each dot represents a country. Notice how the dots extend from the top left to the bot- tom right. What does this mean in real-world terms? It means that people are shorter in parts of the world where there is more disease. The r value for a negative correlation is indicated by a negative number—that is, it has a minus (−) sign in front of it. Here, it is −.83.
The strength of a correlation has to do with how well the two variables align. Recall that in Professor Dunn’s correlational study, spending on others positively correlated with happiness: The more money people reported spending on others, the happier they reported being. At this point you may be thinking to yourself, I know a very generous person who gave away lots of money to other people but is miserable! Or maybe you know of a very stingy person who is happy as can be. Yes, there might be exceptions. If an association has many exceptions, it is considered a weak correlation. If an association has few or no exceptions, it is considered a strong correlation. A strong correlation is one in which the two variables always, or almost always, go together. In the example of happiness and how good the month has been, the association is strong. The stronger a correlation is, the tighter the dots in the scatterplot will be arranged along a sloped line.
The r value of a strong correlation will have a high absolute value. In other words, you disregard whether there is a negative sign in front of the r value and just consider the size of the numerical value itself. If the absolute value is large, it is a strong correlation. A weak correlation is one in which the two variables correspond some of the time, but not most of the time. Figure \(3\) shows the relation between valuing happiness and grade point average (GPA). People who valued happiness more tended to earn slightly lower grades, but there were lots of exceptions to this. The r value for a weak correlation will have a low absolute value. If two variables are so weakly related as to be unrelated, we say they are uncorrelated, and the r value will be zero or very close to zero. In the previous example, is the correlation between height and pathogen prevalence strong? Compared to Figure \(3\), the dots in Figure \(2\) are tighter and less dispersed. The absolute value of −.83 is large. Therefore, it is a strong negative correlation.
Can you guess the strength and direction of the correlation between age and year of birth? If you said this is a strong negative correlation, you are correct! Older people always have lower years of birth than younger people (e.g., 1950 vs. 1995), but at the same time, the older people will have a higher age (e.g., 65 vs. 20). In fact, this is a perfect correlation because there are no exceptions to this pattern. I challenge you to find a 10-year-old born before 2010! You can’t.
Problems with the Correlation
If generosity and happiness are positively correlated, should we conclude that being generous causes happiness? Similarly, if height and pathogen prevalence are negatively correlated, should we conclude that disease causes shortness? From a correlation alone, we can’t be certain. For example, in the first case it may be that happiness causes generosity, or that generosity causes happiness. Or, a third variable might cause both happiness and generosity, creating the illusion of a direct link between the two. For example, wealth could be the third variable that causes both greater happiness and greater generosity. This is why correlation does not mean causation—an often repeated phrase among psychologists. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/04%3A_Research_Designs/4.04%3A_Correlational_Designs.txt |
Just as correlational research allows us to study topics we can’t experimentally manipulate (e.g., whether you have a large or small income), there are other types of research designs that allow us to investigate these harder-to-study topics. Qualitative designs, including participant observation, case studies, and narrative analysis are examples of such methodologies. Although something as simple as “observation” may seem like it would be a part of all research methods, participant observation is a distinct methodology that involves the researcher embedding himself or herself into a group in order to study its dynamics. For example, Festinger et al. (1956) were very interested in the psychology of a particular cult. However, this cult was very secretive and wouldn’t grant interviews to outsiders. So, in order to study these people, Festinger and his colleagues pretended to be cult members, allowing them access to the behavior and psychology of the cult. Despite this example, it should be noted that the people being observed in a participant observation study usually know that the researcher is there to study them.
Another qualitative method for research is the case study, which involves an intensive examination of specific individuals or specific contexts. Sigmund Freud, the father of psychoanalysis, was famous for using this type of methodology; however, more current examples of case studies usually involve brain injuries. For instance, imagine that researchers want to know how a very specific brain injury affects people’s experience of happiness. Obviously, the researchers can’t conduct experimental research that involves inflicting this type of injury on people. At the same time, there are too few people who have this type of injury to conduct correlational research. In such an instance, the researcher may examine only one person with this brain injury, but in doing so, the researcher will put the participant through a very extensive round of tests. Hopefully, what is learned from this one person can be applied to others; however, even with thorough tests, there is the chance that something unique about this individual (other than the brain injury) will affect his or her happiness. But with such a limited number of possible participants, a case study is really the only type of methodology suitable for researching this brain injury.
The final qualitative method to be discussed in this section is narrative analysis. Narrative analysis centers around the study of stories and personal accounts of people, groups, or cultures. In this methodology, rather than engaging with participants directly, or quantifying their responses or behaviors, researchers will analyze the themes, structure, and dialogue of each person’s narrative. That is, a researcher will examine people’s personal testimonies in order to learn more about the psychology of those individuals or groups. These stories may be written, audio-recorded, or video-recorded and allow the researcher not only to study what the participant says but how he or she says it. Every person has a unique perspective on the world, and studying the way he or she conveys a story can provide insight into that perspective.
4.06: Quasi-Experimental Designs
What if you want to study the effects of marriage on a variable? For example, does marriage make people happier? Can you randomly assign some people to get married and others to remain single? Of course not. So how can you study these important variables? You can use a quasi-experimental design.
A quasi-experimental design is similar to experimental research, except that random assignment to conditions is not used. Instead, we rely on existing group memberships (e.g., married vs. single). We treat these as the independent variables, even though we don’t assign people to the conditions and don’t manipulate the variables. As a result, with quasi-experimental designs causal inference is more difficult. For example, married people might differ from unmarried people on a variety of characteristics. If we find that married participants are happier than single participants, it will be hard to say that marriage causes happiness, because the people who got married might have already been happier than the people who have remained single.
Because experimental and quasi-experimental designs can seem pretty similar, let’s use another example to distinguish them. Imagine you want to know who is a better professor: Dr. Smith or Dr. Khan. To judge their ability, you’re going to look at their students’ final grades. Here, the independent variable is the professor (Dr. Smith vs. Dr. Khan) and the dependent variable is the students’ grades. In an experimental design, you would randomly assign students to one of the two professors and then compare the students’ final grades. How- ever, in real life, researchers can’t randomly force students to take one professor over the other; instead, the researchers would just have to use the preexisting classes and study them as-is (quasi-experimental design). Again, the key difference is random assignment to the conditions of the independent variable. Although the quasi-experimental design (where the students choose which professor they want) may seem random, it’s most likely not. For example, maybe students heard Dr. Smith sets low expectations, so slackers prefer this class, whereas Dr. Khan sets higher expectations, so smarter students prefer that one. This now introduces a confounding variable (student intelligence) that will almost certainly have an effect on students’ final grades, regardless of how skilled the professor is. So, even though a quasi-experimental design is similar to an experimental design (i.e., it has a manipulated independent variable), because there’s no random assignment, you can’t reasonably draw the same conclusions that you would with an experimental design. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/04%3A_Research_Designs/4.05%3A_Qualitative_Designs.txt |
Another powerful research design is the longitudinal study. Longitudinal studies track the same people over time. Some longitudinal studies last a few weeks, some a few months, some a year or more. Some studies that have contributed a lot to psychology followed the same people over decades. For example, one study followed more than 20,000 Germans for two decades. From these longitudinal data, psychologist Rich Lucas (2003) was able to determine that people who end up getting married indeed start off a bit happier than their peers who never marry. Longitudinal studies like this provide valu- able evidence for testing many theories in psychology, but they can be quite costly to conduct, especially if they follow many people for many years.
4.08: Surveys
A survey is a way of gathering information using old-fashioned questionnaires or the Internet. Compared to a study conducted in a psychology laboratory, surveys can reach a larger number of participants at a much lower cost. Although surveys are typically used for correlational research, this is not always the case. An experiment can be carried out using surveys as well. For example, King and Napa (1998) presented participants with different types of stimuli on paper: either a survey completed by a happy person or a survey completed by an unhappy person. They wanted to see whether happy people were judged as more likely to get into heaven compared to unhappy people. Can you figure out the independent and dependent variables in this study? Can you guess what the results were? Happy people (vs. unhappy people; the independent variable) were judged as more likely to go to heaven (the dependent variable) compared to unhappy people!
Likewise, correlational research can be conducted without the use of surveys. For instance, psychologists LeeAnn Harker and Dacher Keltner (2001) examined the smile intensity of women’s college yearbook photos. Smiling in the photos was correlated with being married 10 years later!
4.09: Tradeoffs In Research
Even though there are serious limitations to correlational and quasi-experimental research, they are not poor cousins to experiments and longitudinal designs. In addition to select- ing a method that is appropriate to the question, many prac- tical concerns may influence the decision to use one method over another. One of these factors is simply resource avail- ability—how much time and money do you have to invest in the research? (Tip: If you’re doing a senior honor’s thesis, do not embark on a lengthy longitudinal study unless you are prepared to delay graduation!) Often, we survey people even though it would be more precise—but much more difficult— to track them longitudinally. Especially in the case of explor- atory research, it may make sense to opt for a cheaper and faster method first. Then, if results from the initial study are promising, the researcher can follow up with a more intensive method.
Beyond these practical concerns, another consideration in selecting a research design is the ethics of the study. For example, in cases of brain injury or other neurological abnor- malities, it would be unethical for researchers to inflict these impairments on healthy participants. Nonetheless, study- ing people with these injuries can provide great insight into human psychology (e.g., if we learn that damage to a particular region of the brain interferes with emotions, we may be able to develop treatments for emotional irregularities). In addition to brain injuries, there are numerous other areas of research that could be useful in understanding the human mind but that pose challenges to a true experimental design—such as the experiences of war, long-term isolation, abusive parenting, or prolonged drug use. However, none of these are conditions we could ethically experimentally manipulate and randomly assign people to. Therefore, ethical considerations are another crucial factor in determining an appropriate research design.
4.10: Research Methods- Why You Need Them
Just look at any major news outlet and you’ll find research routinely being reported. Sometimes the journalist understands the research methodology, sometimes not (e.g., correlational evidence is often incorrectly represented as causal evidence). Often, the media are quick to draw a conclusion for you. After reading this module, you should recognize that the strength of a scientific finding lies in the strength of its methodology. Therefore, in order to be a savvy consumer of research, you need to understand the pros and cons of different methods and the distinctions among them. Plus, understanding how psychologists systematically go about answering research questions will help you to solve problems in other domains, both personal and professional, not just in psychology.
REFERENCES
Chiao, J. (2009). Culture–gene coevolution of individualism—collectivism and the serotonin transporter gene. Proceedings of the Royal Society B: Biological Sciences, 277(1681), 529–537. doi.org/10.1098/ rspb.2009.1650
Dunn, E. W., Aknin, L. B., & Norton, M. I. (2008). Spending money on others promotes happiness. Science, 319(5870), 1687–1688. https:// doi.org/10.1126/science.1150952
Festinger, L., Riecken, H. W., & Schachter, S. (1956). When prophecy fails. University of Minnesota Press.
Harker, L. A., & Keltner, D. (2001). Expressions of positive emotion in women’s college yearbook pictures and their relationship to personality and life outcomes across adulthood. Journal of Personality and Social Psychology, 80, 112–124. https://doi.org/ 10.1037/0022-3514.80.1.112
King, L. A., & Napa, C. K. (1998). What makes a life good? Journal of Personality and Social Psychology, 75, 156–165. https://doi.org/ 10.1037/0022-3514.75.1.156
Lucas, R. E., Clark, A. E., Georgellis, Y., & Diener, E. (2003). Reexamining adaptation and the set point model of happiness: Reactions to changes in marital status. Journal of Personality and Social Psychology, 84, 527–539. doi.org/10.1037/ 0022-3514.84.3.527 | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/04%3A_Research_Designs/4.07%3A_Longitudinal_Studies.txt |
We are bombarded every day with claims about how the world works, claims that have a direct impact on how we think about and solve problems in society and our personal lives. This module explores important considerations for evaluating the trustworthiness of such claims by contrasting between scientific thinking and everyday observations (also known as “anecdotal evidence”).
INTRODUCTION
Why are some people so much happier than others? Is it harmful for children to have imaginary companions? How might students study more effectively?
Even if you’ve never considered these questions before, you probably have some guesses about their answers. Maybe you think getting rich or falling in love leads to happiness. Perhaps you view imaginary friends as expressions of a dangerous lack of realism. What’s more, if you were to ask your friends, they would probably also have opinions about these questions—opinions that may even differ from your own.
A quick internet search would yield even more answers. We live in the “Information Age,” with people having access to more explanations and answers than at any other time in history. But, although the quantity of information is continually increasing, it’s always good practice to consider the quality of what you read or watch: Not all information is equally trustworthy. The trustworthiness of information is especially important in an era when “fake news,” urban myths, misleading “click-bait,” and conspiracy theories compete for our attention alongside well-informed conclusions grounded in evidence. Determining what information is well-informed is a crucial concern and a central task of science. Science is a way of using observable data to help explain and understand the world around us in a trustworthy way.
In this module, you will learn about scientific thinking. You will come to understand how scientific research informs our knowledge and helps us create theories. You will also come to appreciate how scientific reasoning is different from the types of reasoning people often use to form personal opinions.
5.02: Scientific Versus Everyday Reasoning
Each day, people offer statements as if they are facts, such as, “It looks like rain today,” or, “Dogs are very loyal.” These conclusions represent hypotheses about the world: best guesses as to how the world works. Scientists also draw conclusions, claiming things like, “There is an 80% chance of rain today,” or, “Dogs tend to protect their human companions.” You’ll notice that the two examples of scientific claims use less certain language and are more likely to be associated with probabilities. Understanding the similarities and differences between scientific and everyday (non-scientific) statements is essential to our ability to accurately evaluate the trustworthiness of various claims.
Scientific and everyday reasoning both employ induction: drawing general conclusions from specific observations. For example, a person’s opinion that cramming for a test increases performance may be based on her memory of passing an exam after pulling an all-night study session. Similarly, a researcher’s conclusion against cramming might be based on studies comparing the test performances of people who studied the material in different ways (e.g., cramming versus study sessions spaced out over time). In these scenarios, both scientific and everyday conclusions are drawn from a limited sample of potential observations.
The process of induction, alone, does not seem suitable enough to provide trustworthy information, given the contradictory results. What should a student who wants to perform well on exams do? One source of information encourages her to cram, while another suggests that spacing out her studying time is the best strategy. To make the best decision with the information at hand, we need to appreciate the differences between personal opinions and scientific statements, which requires an understanding of science and the nature of scientific reasoning.
There are generally agreed-upon features that distinguish scientific thinking—and the theories and data generated by it—from everyday thinking. A short list of some of the commonly cited features of scientific theories and data is shown in Figure \(1\).
One additional feature of modern science not included in this list but prevalent in scientists’ thinking and theorizing is falsifiability, a feature that has so permeated scientific practice that it warrants additional clarification. In the early twentieth century, Karl Popper (1902–1994) suggested that science can be distinguished from pseudoscience (or just everyday reasoning) because scientific claims are capable of being falsified. That is, a claim can be conceivably demonstrated to be untrue. For example, a person might claim that “all people are right handed.” This claim can be tested and—ultimately—thrown out because it can be shown to be false: There are people who are left-handed. An easy rule of thumb is to not get confused by the term falsifiable but to understand that—more or less— it means testable.
On the other hand, some claims cannot be tested and falsified. Imagine, for instance, that a magician claims that he can teach people to move objects with their minds. The trick, he explains, is to truly believe in one’s ability for it to work. When his students fail to budge chairs with their minds, the magician scolds, “Obviously, you don’t truly believe.” The magician’s claim does not qualify as falsifiable because there is no way to disprove it. It is unscientific.
Popper was particularly irritated about nonscientific claims because he believed they were a threat to the science of psychology. Specifically, he was dissatisfied with Freud’s explanations for mental illness. Freud believed that when a person suffers a mental illness it is often due to problems stemming from childhood. For instance, imagine a person who grows up to be an obsessive perfectionist. If she was raised by messy, relaxed parents, Freud might argue that her adult perfection- ism is a reaction to her early family experiences—an effort to maintain order and routine instead of chaos. Alternatively, imagine the same person being raised by harsh, orderly parents. In this case, Freud might argue that her adult tidiness is simply her internalizing her parents’ way of being. As you can see, according to Freud’s rationale, both opposing scenarios are possible; no matter what the disorder, Freud’s theory could explain its childhood origin—thus failing to meet the principle of falsifiability.
Popper argued against statements that could not be falsified. He claimed that they blocked scientific progress: There was no way to advance, refine, or refute knowledge based on such claims. Popper’s solution was a powerful one: If science showed all the possibilities that were not true, we would be left only with what is true. That is, we need to be able to articulate—beforehand—the kinds of evidence that will disprove our hypothesis and cause us to abandon it.
This may seem counterintuitive. For example, if a scientist wanted to establish a comprehensive understanding of why car accidents happen, she
would systematically test all potential causes: alcohol consumption, speeding, using a cell phone, fiddling with the radio, wearing sandals, eating, chatting with a passenger, etc. A complete understanding could only be achieved once all possible explanations were explored and either falsified or not. After all the testing was concluded, the evidence would be evaluated against the criteria for falsification, and only the real causes of accidents would remain. The scientist could dismiss certain claims (e.g., sandals lead to car accidents) and keep only those supported by research (e.g., using a mobile phone while driving increases risk). It might seem absurd that a scientist would need to investigate so many alternative explanations, but it is exactly how we rule out bad claims. Of course, many explanations are complicated and involve multiple causes—as with car accidents, as well as psychological phenomena.
TEST YOURSELF 1: CAN IT BE FALSIFIED?
Which of the following hypotheses can be falsified? For each, be sure to consider what kind of data could be collected to demonstrate that a statement is not true.
A. Chocolate tastes better than pasta.
B. We live in the most violent time in history.
C. Time can run backward as well as forward.
D. There are planets other than Earth that have water on them.
[See answer at end of this module.]
Although the idea of falsification remains central to scientific data and theory development, these days it’s not used strictly the way Popper originally envisioned it. To begin with, scientists aren’t solely interested in demonstrating what isn’t. Scientists are also interested in providing descriptions and explanations for the way things are. We want to describe different causes and the various conditions under which they occur. We want to discover when young children start speaking in complete sentences, for example, or whether people are happier on the weekend, or how exercise impacts depression. These explorations require us to draw conclusions from limited samples of data. In some cases, these data seem to fit with our hypotheses and in others they do not. This is where interpretation and probability come in. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/05%3A_Thinking_like_a_Psychological_Scientist/5.01%3A_Introduction.txt |
Imagine a researcher wanting to examine the hypothesis—a specific prediction based on previous research or scientific theory—that caffeine enhances memory. She knows there are several published studies that suggest this might be the case, and she wants to further explore the possibility. She designs an experiment to test this hypothesis. She randomly assigns some participants a cup of fully caffeinated tea and some a cup of herbal tea. All the participants are instructed to drink up, study a list of words, then complete a memory test. There are three possible outcomes of this proposed study:
1. The caffeine group performs better (support for the hypothesis).
2. The no-caffeine group performs better (evidence against the hypothesis).
3. There is no difference in the performance between the two groups (also evidence against the hypothesis).
Let’s look, from a scientific point of view, at how the researcher should interpret each of these three possibilities.
First, if the results of the memory test reveal that the caffeine group performs better, this is a piece of evidence in favor of the hypothesis: It appears, at least in this case, that caffeine is associated with better memory. It does not, however, prove that caffeine is associated with better memory. There are still many questions left unanswered. How long does the memory boost last? Does caffeine work the same way with people of all ages? Is there a difference in memory performance between people who drink caffeine regularly and those who never drink it? Could the results be a freak occurrence? Because of these uncertainties, we do not say that a study—especially a single study—proves a hypothesis. Instead, we say the results of the study offer evidence in support of the hypothesis. Even if we tested this across 10 thousand or 100 thousand people, we still could not use the word proven to describe this phenomenon. This is because inductive reasoning is based on probabilities. Probabilities are always a matter of degree; they may be extremely likely or unlikely. Science is better at shedding light on the likelihood—or probability—of something than at proving it. In this way, data are still highly useful even if they doesn’t fit Popper’s absolute standards.
The science of meteorology helps illustrate this point. You might look at your local weather forecast and see a high likelihood of rain. This is because the meteorologist has used inductive reasoning to create her forecast. She has taken current observations—lots of dense clouds coming toward your city—and compared them to historical weather patterns associated with rain, making a reasonable prediction of a high probability of rain. The meteorologist has not proven it will rain, however, by pointing out the oncoming clouds.
Proof is more associated with deductive reasoning. Deductive reasoning starts with general principles that are applied to specific instances (the reverse of inductive reasoning). When the general principles, or premises, are true, and the structure of the argument is valid, the conclusion is, by definition, proven; it must be so. A deductive truth must apply in all relevant circumstances. For example, all living cells contain DNA. From this, you can reason—deductively—that any specific living cell (of an elephant, or a person, or a snake) will therefore contain DNA. Given the complexity of psychological phenomena, which involve many contributing factors, it is nearly impossible to make these types of broad statements with certainty.
Exercise \(1\)
Inductive of Deductive?
1. The stove was on, and the water in the pot was boiling over. The front door was standing open. These clues suggest the homeowner left unexpectedly and in a hurry.
2. Gravity is associated with mass. Because the moon has a smaller mass than the Earth, it should have weaker gravity.
3. Students don’t like to pay for high-priced textbooks. It is likely that many students in the class will opt not to purchase a book.
4. To earn a college degree, students need 100 credits. Janine has 85 credits, so she cannot graduate.
Answer
See answer at end of this module
The second possible result from the caffeine-memory study is that the group who had no caffeine demonstrates better memory. This result is the opposite of what the researcher expects to find (her hypothesis). Here, the researcher must admit the evidence does not support her hypothesis. She must be careful, however, not to extend that interpretation to other claims. For example, finding increased memory in the no-caffeine group would not be evidence that caffeine harms memory. Again, there are too many unknowns. Is this finding a freak occurrence, perhaps based on an unusual sample? Is there a problem with the design of the study? The researcher doesn’t know. She simply knows that she was not able to observe support for her hypothesis.
There is at least one additional consideration: The researcher originally developed her caffeine-benefits-memory hypothesis based on conclusions drawn from previous research. That is, previous studies found results that suggested caffeine boosts memory. The researcher’s single study should not outweigh the conclusions of many studies. Perhaps the earlier research employed participants of different ages or who had different baseline levels of caffeine intake. This new study simply becomes a piece of fabric in the overall quilt of studies of the caffeine-memory relationship. It does not, on its own, definitively falsify the hypothesis.
Finally, it’s possible that the results show no difference in memory between the two groups. How should the researcher interpret this? How would you? In this case, the researcher once again has to admit that she has not found support for her hypothesis.
Interpreting the results of a study—regardless of out- come—rests on the quality of the observations from which those results are drawn. If you learn, say, that each group in a study included only four participants, or that they were all over 90 years old, you might have concerns. Specifically, you should be concerned that the observations, even if accurate, aren’t representative of the general population. This is one of the defining differences between conclusions drawn from personal anecdotes and those drawn from scientific observations. Anecdotal evidence—derived from personal experience and unsystematic observations (e.g., “common sense,”)—is limited by the quality and representativeness of observations and by memory shortcomings. Well-designed research, on the other hand, relies on observations that are systematically recorded, of high quality, and representative of the population it claims to describe. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/05%3A_Thinking_like_a_Psychological_Scientist/5.03%3A_The_Interpretation_of_Research_Results.txt |
It’s worth delving a bit deeper into why we ought to trust the scientific inductive process, even when it relies on limited samples that don’t offer absolute “proof.” To do this, let’s examine a widespread practice in psychological science: null-hypothesis significance testing.
To understand this concept, let’s begin with another research example. Imagine, for instance, a researcher is curious about the ways maturity affects academic performance. She might have a hypothesis that mature students are more likely to be responsible about studying and completing home- work and, therefore, will do better in their courses. To test this hypothesis, the researcher needs a measure of maturity and a measure of course performance. She might calculate the correlation—or relationship—between student age (her measure of maturity) and points earned in a course (her mea- sure of academic performance). Ultimately, the researcher is interested in the likelihood—or probability—that these two variables closely relate to one another. Null-hypothesis significance testing (NHST) assesses the probability that the collected data (the observations) would be the same if there were no relationship between the variables in the study. Using our example, the NHST would test the probability that the researcher would find a link between age and class performance if there were, in reality, no such link.
Now, here’s where it gets a little complicated. NHST involves a null hypothesis, a statement that two variables are not related (in this case, that student maturity and academic performance are not related in any meaningful way). NHST also involves an alternative hypothesis, a statement that two variables are related (in this case, that student maturity and academic performance go together). To evaluate these two hypotheses, the researcher collects data. The researcher then compares what she expects to find (probability) with what she actually finds (the collected data) to determine whether she can falsify, or reject, the null hypothesis in favor of the alternative hypothesis.
How does she do this? By looking at the distribution of the data. The distribution is the spread of values—in our example, the numeric values of students’ scores in the course. The researcher will test her hypothesis by comparing the observed distribution of grades earned by older students to those earned by younger students, recognizing that some distributions are more or less likely. Your intuition tells you, for example, that the chances of every single person in the course getting a perfect score are lower than their scores being distributed across all levels of performance.
The researcher can use a probability table to assess the likelihood of any distribution she finds in her class. These tables reflect the work, over the past 200 years, of mathematicians and scientists from a variety of fields. You can see, in Figure \(2\)(a), an example of an expected distribution if the grades were normally distributed (most are average, and relatively few are amazing or terrible). In Figure \(2\)(b), you can see possible results of this imaginary study and can clearly see how they differ from the expected distribution.
In the process of testing these hypotheses, there are four possible outcomes. These are determined by two factors: (1) reality, and (2) what the researcher finds (see Figure \(3\)). The best possible outcome is accurate detection. This means that the researcher’s conclusion mirrors reality. In our example, let’s pretend the more mature students do perform slightly better. If this is what the researcher finds in her data, her analysis qualifies as an accurate detection of reality. Another form of accurate detection is when a researcher finds no evidence for a phenomenon, but that phenomenon doesn’t actually exist anyway! Using this same example, let’s now pretend that maturity has nothing to do with academic performance. Perhaps academic performance is instead related to intelligence or study habits. If the researcher finds no evidence for a link between maturity and grades and none actually exists, she will have also achieved accurate detection.
There are a couple of ways that research conclusions might be wrong. One is referred to as a Type I error—when the researcher concludes there is a relationship between two variables but, in reality, there is not. Back to our example: Let’s now pretend there’s no relationship between maturity and grades, but the researcher still finds one. Why does this happen? It may be that her sample, by chance, includes older students who also have better study habits and perform better: The researcher has “found” a relationship (the data appearing to show age as significantly correlated with academic performance), but the truth is that the apparent relationship is purely coincidental—the result of these specific older students in this particular sample having better-than-average study habits (the real cause of the relationship). They may have always had superior study habits, even when they were young.
Another possible outcome of NHST is a Type II error, when the data fail to show a relationship between variables that actually exists. In our example, this time pretend that maturity is—in reality—associated with academic performance, but the researcher doesn’t find it in her sample. Perhaps it was just her bad luck that her older students are just having an off day, suffering from test anxiety, or were uncharacteristically careless with their homework: The peculiarities of her particular sample, by chance, prevent the researcher from identifying the real relationship between maturity and academic performance.
These types of errors might worry you, that there is just no way to tell if data are any good or not. Researchers share your concerns, and address them by using probability values (p-values) to set a threshold for Type I or Type II errors. When researchers write that a particular finding is “significant at a p < .05 level,” they’re saying that if the same study were repeated 100 times, we should expect this result to occur—by chance—fewer than five times. That is, in this case, a Type I error is unlikely. Scholars sometimes argue over the exact threshold that should be used for probability. The most common in psychological science are .05 (5% chance), .01 (1% chance), and .001 (1/10 of 1% chance). Remember, psycho- logical science doesn’t rely on definitive proof; it’s about the probability of seeing a specific result. This is also why it’s so important that scientific findings be replicated in additional studies.
It’s because of such methodologies that science is generally trustworthy. Not all claims and explanations are equal; some conclusions are better bets, so to speak. Scientific claims are more likely to be correct and predict real outcomes than “common sense” opinions and personal anecdotes. This is because researchers consider how to best prepare and mea- sure their subjects, systematically collect data from large and—ideally—representative samples, and test their findings against probability. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/05%3A_Thinking_like_a_Psychological_Scientist/5.04%3A_Why_Should_I_Trust_Science_If_It_Can%27t_Prove_Anything.txt |
The knowledge generated from research is organized according to scientific theories. A scientific theory is a comprehensive framework for making sense of evidence regarding a particular phenomenon. When scientists talk about a theory, they mean something different from how the term is used in everyday conversation. In common usage, a theory is an educated guess—as in, “I have a theory about which team will make the playoffs,” or, “I have a theory about why my sister is always running late for appointments.” Both of these beliefs are liable to be heavily influenced by many untrustworthy factors, such as personal opinions and memory biases. A scientific theory, however, enjoys support from many research studies, collectively providing evidence, including, but not limited to, that which has falsified competing explanations. A key component of good theories is that they describe, explain, and predict in a way that can be empirically tested and potentially falsified.
Theories are open to revision if new evidence comes to light that compels reexamination of the accumulated, relevant data. In ancient times, for instance, people thought the Sun traveled around the Earth. This seemed to make sense and fit with many observations. In the sixteenth century, however, astronomers began systematically charting visible objects in the sky, and, over a 50-year period, with repeated testing, critique, and refinement, they provided evidence for a revised theory: The Earth and other cosmic objects revolve around the Sun. In science, we believe what the best and most data tell us. If better data come along, we must be willing to change our views in accordance with the new evidence.
5.06: Is Science Objective
Thomas Kuhn (2012), a historian of science, argued that science, as an activity conducted by humans, is a social activity. As such, it is—according to Kuhn—subject to the same psychological influences as all human activities. Specifically, Kuhn suggested that there is no such thing as objective theory or data; all of science is informed by values. Scientists cannot help but let personal/cultural values, experiences, and opinions influence the types of questions they ask and how they make sense of what they find in their research. Kuhn’s argument highlights a distinction between facts (information about the world), and values (beliefs about the way the world is or ought to be). This distinction is an important one, even if it is not always clear.
To illustrate the relationship between facts and values, consider the problem of global warming. A vast accumulation of evidence (facts) substantiates the adverse impact that human activity has on the levels of greenhouse gases in Earth’s atmosphere leading to changing weather patterns. There is also a set of beliefs (values), shared by many people, that influences their choices and behaviors in an attempt to address that impact (e.g., purchasing electric vehicles, recycling, bicycle commuting). Our values—in this case, that Earth as we know it is in danger and should be protected— influence how we engage with facts. People (including scientists) who strongly endorse this value, for example, might be more attentive to research on renewable energy.
The primary point of this illustration is that (contrary to the image of scientists as outside observers to the facts, gathering them neutrally and without bias from the natural world) all science—especially social sciences like psychology— involves values and interpretation. As a result, science functions best when people with diverse values and backgrounds work collectively to understand complex natural phenomena.
Indeed, science can benefit from multiple perspectives. One approach to achieving this is through levels of analysis. Levels of analysis is the idea that a single phenomenon may be explained at different levels simultaneously. Remember the question concerning cramming for a test versus studying over time? It can be answered at a number of different levels of analysis. At a low level, we might use brain scanning technologies to investigate whether biochemical processes differ between the two study strategies. At a higher level—the level of thinking—we might investigate processes of decision making (what to study) and ability to focus, as they relate to cramming versus spaced practice. At even higher levels, we might be interested in real world behaviors, such as how long people study using each of the strategies. Similarly, we might be interested in how the presence of others influences learning across these two strategies. Levels of analysis suggests that one level is not more correct— or truer—than another; their appropriateness depends on the specifics of the question asked. Ultimately, levels of analysis would suggest that we cannot understand the world around us, including human psychology, by reducing the phenomenon to only the biochemistry of genes and dynamics of neural networks. But, neither can we understand humanity without considering the functions of the human nervous system.
5.07: Science In Context
There are many ways to interpret the world around us. People rely on common sense, personal experience, and faith, in combination and to varying degrees. All of these offer legitimate benefits to navigating one’s culture, and each offers a unique perspective, with specific uses and limitations. Science provides another important way of understanding the world and, while it has many crucial advantages, as with all methods of interpretation, it also has limitations. Under- standing the limits of science—including its subjectivity and uncertainty—does not render it useless. Because it is systematic, using testable, reliable data, it can allow us to determine causality and can help us generalize our conclusions. By understanding how scientific conclusions are reached, we are better equipped to use science as a tool of knowledge.
Answer—TEST YOURSELF 1: CAN IT BE FALSIFIED?
Answer explained: There are 4 hypotheses presented. Basically, the question asks, “Which of these could be tested and demonstrated to be false?” We can eliminate answers A, B, and C. A is a matter
of personal opinion. C is a concept for which there are currently no existing measures. B is a little trickier. A person could look at data on wars, assaults, and other forms of violence to draw a conclusion about which period is the most violent. The problem here is that we do not have data for all time periods, and there is no clear guide as to which data should be used to address this hypothesis. The best answer is D, because we have the means to view other planets and to determine whether there is water on them (for example, Mars has ice).
Answer—TEST YOURSELF 2: INDUCTIVE OR DEDUCTIVE
Answer explained: This question asks you to consider whether each of 5 examples represents inductive or deductive reasoning.
(1) Inductive: It is possible to draw the conclusion—the homeowner left in a hurry—from specific observations, such as the stove being on and the door being open. (2) Deductive: Starting with a general principle (gravity is associated with mass), we draw a conclusion about the moon having weaker gravity than does the Earth because it has smaller mass. (3) Deductive: Starting with a general principle (students do not like to pay for textbooks), it is possible to make
a prediction about likely student behavior (they will not purchase textbooks). Note that this is a case of prediction rather than using observations. (4) Deductive: Starting with a general principle (students need 100 credits to graduate), it is possible to draw a conclusion about Janine (she cannot graduate because she has fewer than the 100 credits required).
REFERENCES
Kuhn, T. S. (2011). Objectivity, value judgment, and theory choice. In T. S. Kuhn (Ed.), The essential tension: Selected studies in scientific tradition and change (pp. 320–339). University of Chicago Press.
Kuhn, T. S. (2012). The structure of scientific revolutions: 50th anniversary edition. University of Chicago Press. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/05%3A_Thinking_like_a_Psychological_Scientist/5.05%3A_Scientific_Theories.txt |
This module on the biological basis of behavior provides an overview of the basic structure of neurons and their means of communication. Neurons, cells in the central nervous system, receive information from our sensory systems (vision, audition, olfaction, gustation, and somatosensation) about the world around us; in turn, they plan and execute appropriate behavioral responses, including attending to a stimulus, learning new information, speaking, eating, mating, and evaluating potential threats. The goal of this module is to become familiar with the anatomical structure of neurons and to understand how neurons communicate by electrochemical signals to process sensory information and produce complex behaviors through networks of neurons. Having a basic knowledge of the fundamental structure and function of neurons is a necessary foundation as you move forward in the field of psychology.
INTRODUCTION
Imagine trying to string words together into a meaningful sentence without knowing the meaning of each word or its function (i.e., Is it a verb, a noun, or an adjective?). In a similar fashion, to appreciate how groups of cells work together in a meaningful way in the brain as a whole, we must first understand how individual cells in the brain function. Much like words, brain cells, called neurons, have an underlying structure that provides the foundation for their functional purpose. Have you ever seen a neuron? Did you know that the basic structure of a neuron is similar whether it is from the brain of a rat or a human? How do the billions of neurons in our brain allow us to do all the fun things we enjoy, such as texting a friend, cheering on our favorite sports team, or laughing?
Our journey in answering these questions begins more than 100 years ago with a scientist named Santiago Ramón y Cajal. Ramón y Cajal (1911) boldly concluded that discrete individual neurons are the structural and functional units of the nervous system. He based his conclusion on the numerous drawings he made of Golgi-stained tissue, a stain named after the scientist who discovered it, Camillo Golgi. Scientists use several types of stains to visualize cells. Each stain works in a unique way, which causes them to look differently when viewed under a microscope. For example, a very common Nissl stain labels only the main part of the cell (i.e., the cell body; see left and middle panels of Figure \(1\)). In contrast, a Golgi stain fills the cell body and all the processes that extend outward from it (see right panel of Figure \(1\)). A more notable characteristic of a Golgi stain is that it only stains approximately 1–2% of neurons (Pasternak & Woolsey, 1975; Smit & Colon, 1969), permitting the observer to distinguish one cell from another. These qualities allowed Cajal to examine the full anatomical structure of individual neurons for the first time. This significantly enhanced our appreciation of the intricate networks their processes form. Based on his observation of Golgi-stained tissue, Cajal suggested neurons were distinguishable processing units rather than continuous structures. This was in opposition to the dominant theory at the time proposed by Joseph von Gerlach, which stated that the nervous system was composed of a continuous network of nerves (for review, see López-Muñoz et al., 2006). Camillo Golgi himself had been an avid supporter of Gerlach’s theory. Despite their scientific disagreement, Cajal and Golgi shared the Nobel Prize for Medicine in 1906 for their combined contribution to the advancement of science and our understanding of the structure of the nervous system. This seminal work paved the pathway to our current understanding of the basic structure of the nervous system described in this module (for review, see De Carlos & Borrell, 2007; Grant, 2007).
Before moving forward, there will be an introduction to some basic terminology regarding the anatomy of neurons in the section called The Structure of the Neuron. Once we have reviewed this fundamental framework, the remainder of the module will focus on the electrochemical signals through which neurons communicate. While the electrochemical process might sound intimidating, it will be broken down into digestible sections. The first subsection, Resting Membrane Potential, describes what occurs in a neuron at rest, when it is theoretically not receiving or sending signals. Building upon this knowledge, we will examine the electrical conductance that occurs within a single neuron when it receives signals. Finally, the module will conclude with a description of the electrical conductance, which results in communication between neurons through a release of chemicals. At the end of the module, you should have a broad concept of how each cell and large groups of cells send and receive information by electrical and chemical signals.
A note of encouragement: This module introduces a vast amount of technical terminology that at times may feel overwhelming. Do not get discouraged or bogged down in the details. On your first read of this module, I suggest focusing on the broader concepts and functional aspects of the terms instead of trying to commit all the terminology to memory. That is right, I said read first! I highly suggest reading this module at least twice, once prior to and again following the course lecture on this material. Repetition is the best way to gain clarity and commit to memory the challenging concepts and detailed vocabulary presented here. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/06%3A_Neurons/6.01%3A_Introduction.txt |
Basic Nomenclature
There are approximately 100 billion neurons in the human brain (Williams & Herrup, 1988). Each neuron has three main components: dendrites, the soma, and the axon (see Figure \(1\)). Dendrites are processes that extend outward from the soma, or cell body, of a neuron and typically branch several times. Dendrites receive information from thousands of other neurons and are the main source of input of the neuron. The nucleus, which is located within the soma, contains genetic information, directs protein synthesis, and supplies the energy and the resources the neuron needs to function. The main source of output of the neuron is the axon. The axon is a process that extends far away from the soma and carries an important signal called an action potential to another neuron. The place at which the axon of one neuron comes in close contact with the dendrite of another neuron is a synapse (see Figure \(1\) and Figure \(2\)). Typically, the axon of a neuron is covered with an insulating substance called a myelin sheath that allows the signal and communication of one neuron to travel rapidly to another neuron.
The axon splits many times, so that it can communicate, or synapse, with several other neurons (see Figure \(1\)). At the end of the axon is a terminal button, which forms synapses with spines, or protrusions, on the dendrites of neurons. Synapses form between the presynaptic terminal button (neuron sending the signal) and the postsynaptic membrane (neuron receiving the signal) (see Figure \(2\)). Here we will focus specifically on synapses between the terminal button of an axon and a dendritic spine; however, synapses can also form between the terminal button of an axon and the soma or the axon of another neuron.
A very small space called a synaptic gap or a synaptic cleft, approximately 5 nm (nanometers), exists between the presynaptic terminal button and the postsynaptic dendritic spine. To give you a better idea of the size, a dime is 1.35 mm (millimeter) thick. There are 1,350,000 nm in the thickness of a dime. In the presynaptic terminal button, there are synaptic vesicles that package together groups of chemicals called neurotransmitters (see Figure \(2\)). Neurotransmitters are released from the presynaptic terminal button, travel across the synaptic gap, and activate ion channels on the postsynaptic spine by binding to receptor sites. We will discuss the role of receptors in more detail later in the module.
Types of Cells in the Brain
Not all neurons are created equal! There are neurons that help us receive information about the world around us, sensory neurons. There are motor neurons that allow us to initiate movement and behavior, ultimately allowing us to interact with the world around us. Finally, there are interneurons, which process the sensory input from our environment into meaningful representations, plan the appropriate behavioral response, and connect to the motor neurons to execute these behavioral plans.
There are three main categories of neurons, each defined by its specific structure. The structures of these three different types of neurons support their unique functions. Unipolar neurons are structured in such a way that is ideal for relaying information forward, so they have one neurite (axon) and no dendrites. They are involved in transmission of physiological information from the body’s periphery such as communicating body temperature through the spinal cord up to the brain. Bipolar neurons are involved in sensory perception such as perception of light in the retina of the eye. They have one axon and one dendrite which help acquire and pass sensory information to various centers in the brain. Finally, multi- polar neurons are the most common and they communicate sensory and motor information in the brain. For example, their firing causes muscles in the body to contract. Multipolar neurons have one axon and many dendrites, which allows them to communicate with other neurons. One of the most prominent neurons is a pyramidal neuron, which falls under the multipolar category. It gets its name from the triangular or pyramidal shape of its soma (for examples see, Furtak et al., 2007).
In addition to neurons, there is a second type of cell in the brain called glia cells. Glia cells have several functions, just a few of which we will discuss here. One type of glia cell, called oligodendroglia, forms the myelin sheaths mentioned above (Simons & Trotter, 2007; see Figure \(1\)). Oligodendroglia wrap their dendritic processes around the axons of neurons many times to form the myelin sheath. One cell will form the myelin sheath on several axons. Other types of glia cells, such as microglia and astrocytes, digest debris of dead neurons, carry nutritional support from blood vessels to the neurons, and help to regulate the ionic composition of the extracellular fluid. While glial cells play a vital role in neuronal support, they do not participate in the communication between cells in the same fashion as neurons do. | textbooks/socialsci/Psychology/Introductory_Psychology/General_Psychology_for_Honors_Students_(Votaw)/06%3A_Neurons/6.02%3A_The_Structure_Of_The_Neuron.txt |
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