National Seminar on Women in Panchayat Raj held on 27-29th April 1995 at Bangalore
Item
- Title
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National Seminar on
Women in Panchayat Raj
held on 27-29th April 1995 at Bangalore - extracted text
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(’ ■ J-
A CLASSIFICATION SYSTEM FOR CATEGORISING
PROBLEMS IN CHILDHOOD SOCIAL
FUNCTIONING
RIKA SWANZEN
SOCHARA
Community Health
Library and Information Centre (CLIC)
Community Health Cell
85/2,1st Main, Maruthi Nagar,
Madiwala, Bengaluru - 560 068.
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email: clic@sochara.org / chc@sochara.org
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ex
TO MY HEAVENLY FATHER:
You have bestowed gifts on me and have given me
strength. Your grace has carried me over mountains, and through Your attention to the
details in my life, You have filled the gaps.
I give this back to You so You may be
glorified.
To my husband, without whom I could never have completed this study, to my mother, for
instilling in me the discipline to never give up, and to my two boys for giving me
something more meaningful than work.
To Dr. Wim Roestenburg, my study promoter, thank you for the fine balance between
allowing creative freedom and stem discipline. To Prof. James Karls, my other mentor,
thank you for your advice and for placing the interests of the profession above your own.
To all the role players that were integral to making this thesis a possibility:
the
University’s bursary department for my merit bursary, and to Fanie Lewies from ULYSSIS
for further financial assistance with nothing to gain from it. Also to Gert Jonker from The
Bethany House Trust for financial support on the ‘last leg’ of this study.
To Annelien van der Westhuizen, thank you for being a problem-solver. Thank you to
Judith Ferreira for reading the first chapters, and for being so thorough in providing
feedback. To Cynthia Reed, for being willing to give so much of your time. And thanks to
Trish Cooper for the final editing. Thank you, Nicolette, for the fast and accurate typing.
To my colleagues from practice, Elsabe Aucamp, Annelie Olivier, Antoinette Struwig,
Elsabe van Heerden and Yolandi Viljoen, for being excited about my first attempts and for
testing it for me. To those behind the scenes, Mrs Mitchell and Mrs Jansen at the Faculty
of Humanities, and Riette Eiselen at STATCON, for oiling the ‘machinery’.
And lastly, to Prof van Delft, from the Department of Social Work at UNISA. Your positive
feedback on the value of this study encouraged me to give even more to the continuing
development of the ‘product’.
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INDEX
PAGE
CHAPTER 1
MOTIVATION TO THE STUDY
1.1.
Introduction
1
1.2.
Motivation for the study
3
1.3.
Research problem
5
1.4.
Aim of the study
8
1.5.
Value of the study
9
1.6.
Research methodology
10
1.7.
Research design
12
1.8.
Definition of concepts
16
1.8.1. Child client
17
1.8.2. Ecometrics
17
1.8.3. Classification system
17
1.8.4. Person-in-environment (pie) classification system
18
1.9.
Limitations of the study
18
1.10. Chapter layout
19
1.11. Summary
19
CHAPTER 2
RESEARCH METHODOLOGY
2.1.
Introduction
21
2.2.
Research design
22
2.2.1.
Step 1: Problem analysis
25
2.2.2.
Step 2: Determine feasibility
26
2.2.3.
Step 3: Establish requirements for the new technology
28
2.2.3.1. Step 3 a: Requirements for a measurement tool
29
2.2.3.1.1. The rationale for measuring
29
2.2.3.1.2. Types of measurement tools
30
2.2.3.2. Step 3 b: Requirements for classification systems
33
2.2.3.2.1. Diagnosis versus classification
33
2.2.3.2.2. Accurate use of classification systems
34
2.2.3.2.3. Guidelines concerning classification of children
35
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2.2.4.
Step 4: Specify boundaries of domain of design and development
37
2.2.5.
Step 5: Identify and describe the theoretical framework in which
39
the technology is developed
2.2.6.
Step 6: Establish a method of information gathering with regard to
41
literature use
2.2.6.1. Literature survey
41
2.2.6.2. Organising the literature
46
2.2.7.
2.2.8.
Step 7: Identify the operational assessment areas that will be
measured by the new technology
48
Step 8: Draft the appearance of the new technology
51
2.2.8.1. The purpose of the technology
52
2.2.8.2. The length of the new technology
54
2.2.8.3. The selection, scaling and ordering of items
55
2.2.9.
Step 9: Determine role of users
56
2.2.10. Step 10: Prepare user-ready innovation for consumers
56
2.2.11. Step 11: Facilitate feedback on development thus far
57
2.2.12. Step 12: Determine the developmental research procedure
58
2.2.12.1. Design and development competencies
59
2.2.12.2. Interrater testing
60
2.2.12.3. Data management
2.2.13. Step 13: Select sample and apply
66
2.2.14. Step 14: Technical analysis (validity & reliability)
67
2.2.14.1. Validity and reliability used with the adult PIE
67
2.2.14.2. Validation methods
69
2.2.14.3. Reliability testing methods
72
2.2.15. Step 15: Identify and address design problems
74
2.2.16. Step 16: Advanced development
74
2.2.17. Step 17: Proposal for approval of product from accreditation committee 75
2.2.18. Step 18: Develop the marketing plan
76
2.2.19. Step 19: Addressing dissemination barriers
77
2.2.20. Step 20: Start training workshops
78
2.3.
79
Summary
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CHAPTER 3
THEORETICAL MODEL
3.1.
Introduction
3.2.
The history of social work in South Africa
3.3.
3.4.
Accepted definitions of social work
An understanding of social functioning
88
90
3.5.
Moving towards an integrated approach for 21st century social work
91
80
82
3.5.1. The advantage of finding an integrated approach for social work
92
3.5.2. Obstacles to finding an integrated approach for social work
3.5.5. The PIE classification system as integrated model?
92
93
95
97
Finding a unifying construct for social work
101
3.6.1. Early origins of the psychosocial approach
101
3.6.2. Early origins of ecology
103
3.6.3. Measuring ecology in social work
3.6.5. The Person-in-environment construct
104
104
107
3.7.
109
3.5.3. Previous efforts at integration
3.5.4. Where does social development fit into an integrated model?
3.6.
3.6.4. Human ecology
The child-in-environment
3.7.1. Ecology and childhood
110
3.7.1.1.
A time-context
110
3.7.1.2.
Transactions with children
111
3.7.2. Childhood social functioning
112
115
3.7.3. The child’s social environment
3.7.4. Childhood social functioning in a South African context
3.8.
Previous attempts at classifying social problems in children
3.9.
A conceptual framework
3.9.1. Diagrammatic illustration of conceptual process
3.9.2. Concepts that describe childhood social functioning
3.10. Summary
CHAPTER 4
4.1.
118
120
120
121
120
124
CHILDHOOD SOCIAL FUNCTIONING
Introduction
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125
4.2.
4.3.
4.4.
Decision process for inclusion
126
128
Consideration of childhood development
130
Restricting the concepts for this study
4.4.1. Developmental stages
131
4.4.2. Milestones
133
134
4.4.3. Cognitive development
4.4.3.1.
Context of development
135
4.4.3.2.
Child variables in development
136
Routine
137
4.5.1. Sleep problems
4.5.2. Bedwetting or enuresis
139
140
4.5.3. Soiling or encopresis
142
4.5.4. Eating problems
Behavioural adjustment
143
147
4.6.1. Choice of terms for categories
149
4.6.2. Elements of behavioural maladjustment
151
4.6.3. Oppositional Defiant Behaviour
4.5.
4.6.
4.6.3.1.
Temper tantrums
153
154
4.6.3.2.
Lying
155
4.6.3.3.
4.6.3.4.
Aggressiveness
156
159
161
163
166
Devotion to a cult
4.6.4. Conduct disturbances
4.6.4.1.
School attendance problems
4.6.4.2.
Running away
4.6.4.3.
Substance abuse
4.6.4.4.
Stealing/theft
4.6.4.5.
Vandalism
169
171
172
4.6.4.6.
Serious assault
173
4.7.
Performance
4.7.1. The role of achievement
4.7.2. The role of expectation
4.7.3. The role of satisfaction
4.7.4. Understanding frustration
4.7.5. Goal-directedness
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174
175
177
179
181
183
4.7.6. Creativeness
184
Stress
185
187
4.8.
4.8.1. Understanding stress
4.8.2. Emotional effects of stress
4.8.2.1.
Fear
4.8.2.2.
Helplessness
189
189
190
4.8.3. Statutory intervention
192
4.8.4. Early recollections
194
195
196
4.8.5. Grieving
4.8.6. Teenage pregnancies
4.8.7. Abortion
4.9.
Socialisation
198
201
4.9.1. Elements in socialisation
201
4.9.2 Social awareness
204
4.9.3. Childhood gender roles
205
4.9.4 Age and pro-social behaviour
206
208
209
211
4.9.5. Social skills
4.9.6. Play
4.9.7. Peer group
4.9.8. School relations
4.9.9. Friendships
4.9.10. Self-concept
4.10. Parenting
4.10.1
Behaviour management
4.10.1.1. Discipline
213
213
215
216
217
4.10.1.2. Parental styles
218
219
4.10.1.3. Family atmosphere
220
4.10.2.
224
Relations within the family
4.10.2.1. Bonding
4.10.2.2. Family constellation / birth order
4.10.2.3. Child Abuse
4.10.3.
Disrupted family system
4 10.3.1. Divorced families
4.10.3.2. Stepfamilies
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224
229
232
237
237
239
4.10.3.3. Single parent families
243
4.10.3.4. Child-headed families
4.10.3.5. Children raised by grandparents
245
246
4.10.3.6. Domestic violence
248
4.10.3.7. Impact of poverty on families
249
4.11. Operationalisation of concepts
251
4.12. Summary
256
CHAPTER 5
DESIGN OF THE NEW TECHNOLOGY
5.1.
Introduction
260
5.2.
Conceptual definitions
5.3.
5.4.
Indicators for operational definitions
261
264
Design decisions
5.4.2. A problem focus
273
273
274
5.4.2.1.
Operationalisation and classification systems
275
5.4.2.2.
The role of the user
275
5.4.2.3.
The volume of included material
276
5.4.2.4.
5.4.2.5.
The theoretical construct perceived to be supported at face value
277
Underlying principles of the design
279
5.4.1. Name of the new technology
5.4.3. Utilising the PIE framework
5.4.4. Perceived needs of the practitioner
5.4.5. Validity and reliability considerations
279
284
284
5.4.5.1.
Narrowing down the area for testing
284
5.4.5.2.
The pilot study
5.5.
Description of the ChildPIE©
285
287
287
5.6.
Summary
288
5.4.6. Cultural sensitivity
CHAPTER 6 DATA RESULTS & INTERPRETATION
6.1.
Introduction
289
6.2.
Data sets utilised in the study
290
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6.3.
6.4.
Selected sample
6.5.
Data results
Overview of data analysis
6.5.1. Feedback assemblage
6.5.2. Results from qualitative data
6.5.3. Feedback from an expert
6.5.4. Feedback from the questionnaire
293
295
297
298
301
303
308
6.5.5.1.
Results from the first pilot test
311
312
6.5.5.2.
Results from the second pilot test
318
6.6.
Adjustments made from test results
323
6.7.
Summary
324
6.5.5. Interrater reliability
CHAPTER 7
THE CHILDPIE©
7.1.
Introduction
327
7.2.
Instructions for use
328
7.3.
7.4.
Benefits for practice
328
329
7.5.
7.6.
The ChildPIE©
Use by practitioners
Category definitions
7.6.1. Childhood Social Roles
7.6.2. Indexes
7.6.2.1. Developmental stage
330
331
332
341
341
7.6.2.2.
Problem Types
7.6.2.3.
Child abuse types
7.6.2.4.
7.6.2.5.
Duration of the problem
342
350
354
Coping strengths
354
7.6.2.6.
Priority code
7.7.
7.8.
Intervention plan
Practical example
355
355
357
357
7.9.
Summary
358
7.6.3. Coding
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CHAPTER 8
CONCLUSIONS & RECOMMENDATIONS
8.1.
Introduction
359
8.2.
Conclusions on the development
360
8.2.1. Method of information gathering
361
8.2.2. Design and Development competencies
361
8.2.3. Meeting measurement criteria
362
8.2.4. Meeting validation criteria for a classification system
364
8.2.5. Finding a unifying construct
364
8.2.6. Validation guidelines
365
8.2.7. Limitations of the study
368
8.2.8. Discrepancies in process
368
8.3.
Recommendations
369
8.4.
Value of the ChildPIE©
371
8.5.
Summary
371
GLOSSARY OF TERMS
374
BIBLIOGRAPHY
394
ANNEXURE1
EMAIL CORRESPONDENCE FROM JAMES KARLS
ANNEXURE 1A.
CLASSIFICATION SYSTEMS THAT HELPED SHAPED
THE RESEARCHER’S DECISIONS
ANNEXURE 2
422
430
ASSESSMENT AIDS THAT ASSIST IN THE
CLASSIFICATION OF SOCIAL FUNCTIONING
PROBLEMS IN CHILDREN
ANNEXURE 3
455
DOCUMENTS UTILISED DURING THE PRESENTATION
AND DATA GATHERING PROCESS
479
LIST OF TABLES
TABLE 1.1. APPLICATIONS OF THE PIE AND FORESEEN BENEFITS
FOR NEW TECHNOLOGY
9
TABLE 2.1. TYPES OF MEASUREMENT TOOLS
31
TABLE 3.1. ENVIRONMENTAL SYSTEMS AND FUNCTIONS
117
TABLE 4.1. FOCUS AREAS FROM CONCEPTUAL FRAMEWORK
127
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TABLE 4.2. MINNESOTA CLASSIFICATION’S CATEGORIES FOR STAGES
132
TABLE 4.3. ABUSIVE PARENTAL BEHAVIOURS
234
TABLE 4.4. CATEGORY DEFINITIONS OF CHILDHOOD SOCIAL
FUNCTIONING
253
TABLE 5.1. THE BASIC STRUCTURE OF THE PIE
280
TABLE 5.2. ROLE TYPES
281
TABLE 5.3. PROBLEM TYPES
282
TABLE 6.1. SAMPLE PROFILE
296
TABLE 6.2. FEEDBACK ASSEMBLAGE
299
TABLE 6.3. SUMMARY OF FEEDBACK
301
TABLE 6.4. RESULTS FROM QUESTIONNAIRE
308
TABLE 6.5. CODING OF 1 ST INTERRATER STUDY
316
TABLE 6.6. FREQUENCY ANALYSIS
317
TABLE 6.7. SECOND INTERRATER STUDY CODES
321
TABLE 6.8. FREQUENCY TABLE FOR SOCIAL ROLE (2ND
1 RATER STUDY)
322
T ABLE 6.9. FREQUENCY TABLE FOR PROBLEM TYPE (21ND RATER STUDY) 322
LIST OF FIGURES
FIGURE 1.1. COMBINED SCHEMA OF ROTHMAN’S SOCIAL RESEARCH
& DEVELOPMENT MODEL & THOMAS’ RESEARCH PARADIGM 14
FIGURE 1.2. RESEARCH PROCESS OF SCALE DEVELOPMENT
IN ECOMETRICS
15
FIGURE 1.3. STEPS IN THE CONSTRUCTION OF A PSYCHOLOGICAL TEST 16
FIGURE 2.1. THE ADAPTED DESIGN AND DEVELOPMENT MODEL
FOR DEVELOPING A CLASSIFICATION SYSTEM
24
FIGURE 2.2. THE BOUNDARIES OF THE DOMAIN OF THE ADAPTED
DESIGN & DEVELOPMENT MODEL
38
FIGURE 2.3. THE OPERATIONAL PROCESS
49
FIGURE 3.1. THE HUMAN ECOSYSTEM
106
FIGURE 3.2. THE CONCEPTUAL PROCESS
122
FIGURE 3.3. A PERSON-IN-ENVIRONMENT CONCEPTUAL
FRAMEWORK FOR CHILDHOOD SOCIAL FUNCTIONING
FIGURE 4.1. PYRAMID OF DISRUPTIVE BEHAVIOURS
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123
151
I
FIGURE 4.2. OPERATIONALISATION PROCESS FOR NEW TECHNOLOGY
256
FIGURE 5.1. THE PROGRESSION OF THE CONCEPTUAL DEVELOPMENT
261
FIGURE 5.2. THE SEVEN BROAD CATEGORIES OF CHILDHOOD SOCIAL
FUNCTIONING
262
FIGURE 5.3. CHILDHOOD SOCIAL FUNCTIONING
CONCEPTS AND SUB CATEGORIES
263
FIGURE 5.4. INDICATORS OF THE CONCEPT: DEVELOPMENT
265
FIGURE 5.5. INDICATORS OF THE CONCEPT: ROUTINE
266
FIGURE 5.6. INDICATORS OF THE CONCEPT: BEHAVIOURAL
ADJUSTMENT
267
FIGURE 5.7. INDICATORS OF THE CONCEPT: PERFORMANCE
268
FIGURE 5.8. INDICATORS OF THE CONCEPT: STRESS
269
FIGURE 5.9. INDICATORS OF THE CONCEPT: SOCIALISATION
270
FIGURE 5.10. INDICATORS OF THE CONCEPT: PARENTING
271
FIGURE 5.10. INDICATORS OF THE CONCEPT: PARENTING (continued)
272
FIGURE 6.1. THREE DATA SETS OBTAINED THROUGH PILOT STUDY
292
FIGURE 6.2. OVERVIEW OF DATA ANALYSIS
294
FIGURE 6.3. E-MAIL CORRESPONDENCE FROM EXPERT
304
FIGURE 6.4. ChildPIE USED IN 1 ST INTERRATER STUDY
(psycho-social listing)
314
FIGURE 6.5. ChildPIE USED IN 2'ND INTERRATER STUDY
(social role)
320
FIGURE 6.6. RESEARCHER’S PROCESS
326
FIGURE 7.1. THE CHILDPIE©
330
FIGURE 7.2. CHILDPIE© CODING
356
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Chapter 1
Motivation for the study
“Discovery consists of seeing what everyone else has seen and thinking what no one else has
thought.”
- Albert von Szent-Gyorgyi Nagyrapolt (Scientist and Noble laureate) -
1.1
Introduction
To not care means to take no responsibility and to ultimately turn your back on society
and social engagement. To care, on the other hand, means to accept a host of moral
responsibilities for your own and for others' well-being - it is to accept that people
matter (Bretchin, 1998:1).
Care "implies attending, physically, mentally, and
emotionally, to the needs of another and giving a commitment to the nurturance,
growth, and healing of that other" (Davies, 1998:126).
The above statements form a particularly apt introduction to the aim of this study. Many
social workers really want to care for their clients and find themselves overwhelmed by
the implications of this. This study aims to provide a clearer understanding of what
caring for social work clients means.
Care tends to be idealised as something that occurs spontaneously within families and
kinship systems.
Shared assumptions about the family’s responsibility for their own
young, old, sick or disabled members are common across cultural boundaries.
The capacity of families to care will be subject to the range of influences that affect
lifestyles and relationships in general - the social, cultural, and economic environment,
including wealth distribution, the community, the neighbourhood and friendship networks,
in the context of high geographical mobility, as well as the prevailing political, policy, and
belief structures.
Bretchin, 1998:2.
Families and their cultures and communities are central to social work.
All of the
influences on lifestyles and relationships mentioned above are part of this focus area. It
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is necessary to understand the intentions of the social worker in her approach to the
domain of families, cultures, communities, and even society.
The social work profession has its origins in the charity movement of the late 19th
Century which started in Great Britain and the United .States of America.
This
movement committed itself to the improvement of the conditions under which the poor
and disadvantaged of society lived. Together with the provision of basic needs, such as
food, clothing, and shelter, the movement also attempted to relieve the distress of the
clients and their families, and to address the external forces responsible for the
conditions in which they lived.
The first social workers became concerned, friendly
home visitors. This led to helpers leaving their offices and moving away from the
‘doctor-patient model’ (Nichols en Schwartz, 1995:18).
Although this was an exemplary move to deal effectively with real challenges faced by
families, it started the notion that social work is charity work.
Unfortunately social work has never fully succeeded in getting rid of its ‘charity’ label and
many professionals have regarded it as a soft science. One of the central issues in the
debate regarding the professional status of the profession, is the importance of an
empirical knowledge base for the profession. Many researchers and academics within the
profession are of the opinion that social work will not be able to claim itself as a profession
if the activities of practitioners are based on intuition and ‘practice wisdom’, and not on a
knowledge base that is grounded in empirical evidence.
Faul, 1995:1.
Siegel, (1994 in Faul, 1995:2) argues that a profession is a systemic body of knowledge
and theory and that, to be valid, knowledge must be well grounded, sound, cogent
(forceful), and convincing. It must be supported by objective truth or generally accepted
authority, be based on flawless reasoning and on solid grounds, and have the power of
overcoming doubt. In terms of these criteria, knowledge refers to what seems to be
established by the highest standards of objectivity and rationality of which people are
capable. Fisher and Hudson (1983, in Faul 1995:2) propose that "measurement is a
fundamental part of increasing precision and control, which contributes to the advance
of any science".
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From early on social work found its meaning in caring for people through providing for
their most basic needs. This has given the profession the reputation of providing charity
- a label which forces us to question whether we have a systematic body of knowledge
that is characteristic of a profession.
Social work moved from being a charity
organisation to a profession and a science. Its methods have become more rigorous,
and this study continues in this tradition.
1.2
Motivation for the study
Through her own observations the researcher has found that many social workers do
not use measurements, and so cannot state objectively whether their practice efforts
are meeting service objectives. The significance of basing this study within the domain
of social work lies in determining what constitutes good social practice. This enables
social workers to establish exactly what needs to be measured in order to assess their
success in solving their clients' problems. A unifying construct of the profession needs
to be identified in order to develop a technology that will increase the precision of the
assessment and intervention process, to the advancement of the profession as a whole.
The technology to be developed is a classification system that aims to provide social
workers with a 'unifying language'.
It will become clear in subsequent chapters that the one requirement of a profession is
to be able to show evidence of what it does.
Based on the researcher's belief that
social work contributes significantly to society as a whole, the motivation for this thesis
is to provide the means through which social workers can be united and earn the
respect of our clients and other professions. The underlying objective of this study is
therefore to show how the social work profession cares in a way that distinguishes it
from other caring professions.
From its earliest beginnings, two concepts stand out as integral components of social
work’s efforts to become professionally and scientifically credible: its domain of practice
and its methods of practice. A field can be identified as a science on two grounds:
firstly, if it has a domain that helps distinguish it from other fields of science, and,
secondly, if it has methods of inquiry by which its findings can be tested. Social work
has a broad-based orientation that embraces general as well as specialised
approaches. It includes both direct and indirect strategies designed to help people with
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social functioning problems.
It requires that members of the profession should unite
around an agreed-upon domain of practice, values, and ethics, and agree to establish
particular modes of professional activity to work within the boundaries of the defined
domain. Activities that meet these characteristics are called paradigms. The conscious
use of self in the practice relationship .suggests the domain of the practitioner as
another component of social work practice (Ramsay, 1994:182-183).
The benefit of developing a measurement tool for use in social work is that it would
address the fiscal, professional, and ethical issues of accountability. A measurement
tool would lead to the "enhancement of our knowledge base for the conduct of practice,
and ... to an improved quality of service delivery" (Hudson, 1987 in Faul, 1995:4).
We need to recognize that present diagnostic, legal, and social labels do not describe how
people function.
Without a consistent vocabulary we can never get to a reasonable
application of the case management objective. So long as the definitions of problems are
made unilaterally by each helping agent, there can be no clarity of boundaries of rational
and workable assignment of responsibilities.
It is important for social work to find a
unifying perspective that will provide greater cohesiveness to social work practice and to
bind together social workers who are all doing different things to carry out the same
purposes.
Karls and Wandrei, 1994:4-5.
In 1984 pioneers helped to provide a unifying construct for social workers in order to
explain to other professions and society in general what the profession entails. By 1994
the Person-in-Environment Classification System (PIE), developed by James Karls and
Karin Wandrei, was published. PIE was intended to provide social work with a unifying
language.
... PIE creates uniform statements of social role; environmental, mental, and physical
health problems; and client strengths.
The system seeks to balance problems and
strengths; it delineates problems pertinent to both person and the environment and
qualifies them according to their duration, severity, and the client’s ability to solve or cope
with them.
Karls and Wandrei, 1994:3.
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Attention will be given to the structure of PIE in Chapter 5 where it serves as a guideline
for the new development.
In the course of her Master’s study the researcher investigated the applicability of the
PIE system within a South African psychiatric setting. The intention, in conducting this
study, is to further the researcher’s interest in the PIE.
It is also the intention of this
study to provide the social work profession with the means to truly care for their clients and child clients in particular - as mentioned at the beginning of this chapter.
1.3
Research problem
In South Africa the state as subsidy agent and the community as donor and source of
voluntary workforce, are placing pressure on the social work profession to account for
its activities and the outcomes of these activities. Accountability has become a goal that
must be achieved in every social work organisation in South Africa if it is to survive the
lack of funds and to maintain the goodwill of the community.
South African social
workers have not fallen behind in this era of accountability, and as the pressure has
increased, so has the need for measurement tools.
Social workers realise that in order to describe a client’s problem in more precise terms,
they need quantitative data to measure the problem and plan for the correct intervention
strategy and to evaluate their practice.
Francisco-la Grange and Joubert, 1988 in Faul, 1995:10.
The profession has realised that there is a need for measurement technology, although
there are certain restrictions on the technology available to social workers in South
Africa. The Social and Associated Workers Act of 1978 (Act 110, Government Gazette
1988) forbade social workers to apply psychometric tests with a view to diagnosis and
therapy, and for years this has discouraged practitioners from using standardised
measurement tools to assess clients' problems. Van Zyl (1986 in Faul, 1995:11) has
changed this situation somewhat with his validation of the Heimler Scale for Social
Functioning (HSSF).
I would argue that the measurement tools that have been developed for social work are
under-utilised and poorly represented in the curriculum of tertiary institutions. A further
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factor influencing the use of measurement technology is the current focus of the South
African Council for Social Service Professions (SACSSP) on scales and measurement
tools in social work.
The SACSSP organised a work group, which has become a
recognised sub-committee of the council, and which is currently attending to the
following issues:
■
The finalisation of a definition of ecometric tests.
■
The question of whether non social workers should be permitted to use ecometric
tests.
■
The compilation of a database of tests with which social workers are involved.
■
Criteria for the practical application of different tests.
■
Specifying education and training.
■
Investigating the nature of control and drafting the regulations required for social
workers to utilise the different tests.
SACSSP, 2001:13.
However, although the reality of social work practice in South Africa seems to allow for
the adoption of a system like PIE, which is specifically designed for the social work
profession, a problem exists in directly implementing the system as it is. While PIE
addresses the need for integration in the knowledge base of social work, some of the
limitations of PIE that complicate its application to the South African welfare system
were highlighted by Roestenburg (1999:137-138):
■
Some of the categories are not relevant to South Africa, such as illegal
immigrants, which are not necessarily a problem social workers in South Africa
deal with.
(This issue was questioned in the researcher’s Master’s study
however.)
■
The PIE cannot be used for children under 18; this causes problems when social
workers need to comply with existing policies in South Africa, which
focus
heavily on children and on the youth.
■
PIE was field tested for reliability on a small scale and is thus only a prototype to
be refined through research.
■
As a classification system PIE addresses only one component of social work
practice, namely the assessment of social functioning problems.
It does not
direct the social worker to problem solving processes.
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■
The movement by the developers of PIE away from assumptions of mechanical
determinism and narrow specialization may complicate causality measurement to
some extent.
Although these arguments were generally confirmed in a previous study (Oosthuizen,
1999), the researcher disagrees that the fourth point is a shortcoming.
She would
argue that, as a classification system, it serves as an assessment tool, but that its
purpose lies beyond mere assessment.
Its primary contribution lies in integrating all
aspects of the domain of social work. The researcher believes that PIE does this, and
that it gives direction to problem-solving processes through pointing the social worker
towards social functioning problems on which she should focus her intervention.
The researcher does agree, however, that the language used in PIE is more
appropriate to America than South Africa (especially the computerised version,
CompuPIE). South African social workers need to identify with a classification system
before they will consider adopting it.
Roberts (1990:243) warned practitioners to be
wary of social work theory developed in another country. Even importing theory within
western countries can pose problems, and this is magnified when ideas are imported
from highly developed and industrialized countries to third world countries.
Although it is recognised that social work needs to be more accountable, cognisance
needs to be given to the limited applicability of a system like PIE.
The researcher
therefore has to address some of its shortcomings in order to motivate its adoption by
social workers in South Africa.
The researcher was of the opinion that she could
contribute either by field testing the existing PIE in South Africa to determine its
reliability and validity, and then suggest changes to the system, or by considering a new
development that would address the fact that PIE is not applicable to the whole range of
social work clients as it cannot be used on children.
In the researcher’s opinion it is more useful to explore what is required for a social work
classification system for children for two reasons: firstly, she cannot justify testing a
system that has already been found to have limitations within South Africa. Secondly, it
has been ten years since the last publication of the PIE, and the designer, Professor
James Karls, has indicated that he is currently revising the existing version. It therefore
makes more sense to be involved in the validation and reliability study of the renewed
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version, particularly with the addition of a child-orientated application.
By developing a
version for the classification of childhood functioning in South Africa, it will gain
recognition as an indigenous development, thereby making it more acceptable to the
South African social worker.
The research problem then can be stated as the profession’s failure to adopt a unifying
language among social workers in South Africa because of a lack of an adequate
measurement tool that either supports the objectives of the profession, or increases the
accountability of social workers’ professional activities. Part of the problem is that the
available technology is not applicable within the South African system.
1.4
Aim of the study
In addressing the research problem of finding a unifying construct for social work, the
researcher has two goals. One is to increase the likelihood of social workers adopting a
classification system such as the PIE through highlighting the need for one and through
clarifying what the unifying construct of social work is. The other goal is to resolve an
inherent shortcoming within the existing PIE, that is, it cannot be used for children; in
doing so, the likelihood of the adoption of a classification system is further increased.
To accomplish these goals, this doctoral thesis has as its goal the provision of the first
working draft for classifying social functioning problems in children. The aim of this
working draft is to enhance practice in all social work spheres dealing with children.
The aim of this research is to develop a classification system for the categorisation of
childhood social functioning problems.
It has as its objectives:
■
To develop a conceptual framework that will identify the focus area of social
work in dealing with children.
■
To conduct a literature study directed by the conceptual framework and
strategies to ensure validity of content.
■
To apply the steps of the Adapted Design and Development Model that guide
the development of a classification system in accordance with established
requirements.
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■
To do an initial pilot test on the first draft.
■
To incorporate
the findings and
make
recommendations for further
developments.
1.5
Value of the study
Apart from the benefits to the profession that accompany the adoption of a classification
system (see Chapter 2), this study introduces new ideas to the academic domain of
social work, thereby contributing to a rise in the standards of the profession, and further
distinguishing it from the other helping professions.
In addition, certain improvements in practice should result when a classification system
is used. Since the benefits highlighted by the developers of PIE (Karls and Wandrei,
1995:1819;1825) are also indirectly applicable to the new development, the researcher
has listed the benefits to be gained from the childhood version, in juxtaposition to those
of the existing classification system. Table 1.1 outlines the anticipated benefits of the
new technology next to the applications of the existing counterpart.
TABLE 1.1 APPLICATIONS OF PIE AND ANTICIPATED BENEFITS OF THE NEW
TECHNOLOGY
Anticipated benefits of the new technology
Applications of PIE
E
K
provides
a
method
of describing
the
PIE helps sort out the often complex
This tool
array of problems that the client brings to
functioning of the family and community of the child in a
the social work practitioner.
standardised manner, rather than in terms of vague
It permits a non-judgemental description
suggestions.
of
the
problems
that
the
client
is
It provides assistance with the description of service
experiencing.
delivery and programme evaluation. (The system can
A uniform method of describing client
give statistical feedback on typical problems addressed
problems enables social workers to plan
by agencies in their service delivery to children, which
interventions more responsibly.
means better planning of interventions.)
Instead
It is a practical way of ensuring that the child’s most
of
social
work
assessment
following the methodological expertise of
important needs are being met.
the practitioner, PIE enables a social
It is an effective way of identifying community resources
worker in one agency to describe a
that should assist the child’s development, or a lack
client’s problems in a way that will be
thereof.
understood by a colleague in a different
It helps to identify possible support structures within the
setting.
family, or the absence of involved supportive systems.
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The client should be able to understand
It focuses on treatment and healing of the whole family
the assessment of the problem, and
(and not just on the patient’s illness).
participate
It is a measurement tool which focuses on both intra
more
fully
in
problem
resolution or reduction.
and inter-personal aspects.
As a teaching tool the PIE is eminently
It focuses on how parental problems might be affecting
useful
helping
in
learn
students
the child client.
the domain of
It serves as a communication tool among social
social work practice, and develop an
workers in different sectors, and so will assist with the
assessment and intervention plan that is
referral of clients.
clear and understandable.
It will provide social work with its own method of
Because this system is essentially a-
defining clients’ problems, and so establish it as a
theoretical, it permits the instructor to use
distinct profession within the multi-disciplinary field of
whatever casework model or behaviour
similar caring professions.
theory has been adopted, and apply it to
It will enable social workers to approach the systems in
the individual case.
the community which are relevant to the child client, like
casework,
understand
For the researcher and administrator PIE
serves
a
as
database
to
aid
the
schools, welfare agencies, and hospitals, with a specific
set of objectives and assessment criteria.
collection, classification, and analysis of
It provides a common tool in terms of which social
social conditions and social interactional
workers can give feedback on success in project
problems
in
which
social
workers
reports.
intervene.
It serves as a community assessment / description tool
Routinely collected data could facilitate
which can be used for needs assessment.
both social programme and social policy
It can be used for appropriate assessments of children
development.
for accurate inclusion into community projects and
resource utilisation.
It enables private practitioners to prove effectiveness
and thereby elicit trust among paying clients.
It provides a more tangible classification of child client
problems.
It serves as a more accurate and scientific assessment,
and so compliments the use of other forensic methods
used in child welfare.
Based on the above list of applications, the researcher is confident that the social work
profession will benefit considerably from a well developed classification system which
social workers will find both user-friendly and reliable.
1.6
Research methodology
The research method used in this study is Applied research, which is the “scientific
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planning of induced change in troublesome situations” (De Vos, Schurink and Strydom,
1998:8).
The primary model used in this study is Design and Development (see
Figure 1.1 on page 15 from Thomas and Rothman, 1994:10-11).
Developmental
research derives from the need for technology, which is the “technical means by which
a profession achieves its objectives” (De Vos, Schurink and Strydom 1998:9).
Therefore this paradigm is best suited to a study of this nature.
According to De Vos (1998:362), the new model of intervention research developed by
Rothman and Thomas (1994), is the second major breakthrough in a practical
combination of qualitative and quantitative approaches in the caring professions’
research fields. This model was used in developing the research design for this study,
which is based on both qualitative and quantitative data. Creswell’s (1994, in De Vos
1998:360) mixed methodology, which refers to using both qualitative and quantitative
approaches, best describes the research approach of this study.
In the course of this study, the researcher considers both how well the developed part
of the classification system is working (quantitative), as well as what practitioners think
of how well the system seems to fit in to the social work paradigm (qualitative). To get
to these two sets of data, the researcher needs to identify the appropriate
representatives that can use and evaluate the new technology.
In field-testing the classification on social workers with the necessary expertise, she will
gather a sample through snowball sampling. To do this, she enquires from colleagues
who they think might be interested and able to participate. She would then approach
each individually with a short proposal of what would be expected of them and what
would be gained through their participation. After training them in the system, they will
administer the measurement tool on case studies in practice.
Their findings will be
compared to determine interrater reliability. In other words, the agreement among the
ratings will be statistically determined.
After the system has been implemented, a
questionnaire will be administered to each user, enabling them to offer suggestions and
feedback that will be used to refine the new technology. The purpose behind this is to
determine the integrity of the new technology.
Schurink (in De Vos, 1998) describes Grounded Theory design as a systematic
procedure of sampling and of data analysis through which a theory system is developed
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from data, often utilising other research designs and strategies. Since a classification
system is a broad system to be used by social workers across different settings, it is
crucial that it is supported by a strong theoretical model from which the eventual
categories for the classification system will be abstracted.
Bailey (1987:54) sees
grounded theory as theory that is discovered or generated through entering the field
without a hypothesis, describing what happens, and formulating explanations as to why
it happens on the basis of observation. It will become clear throughout the study why a
strong conceptual framework and unifying construct is needed, and why, in order to
arrive at this, the researcher needed to approach the study in the manner described by
grounded theory. Grounded theory is relevant to this study because of the inherent risk
in re-conceptualising
and
re-categorising theory in order to come to a new
understanding of the underlying concepts within this study.
1.7
Research design
Several designs are commonly used for the development of interventions or
technologies in the Human services. Some of these designs originate from the field of
Psychometrics, such as Smit’s (1991) model. In social work, the D&D approach to
technology development was introduced by Rothman and Thomas (1994). This
framework has been used in several local studies to develop either interventions or
technologies, such as Roestenburg's development of social welfare indicators (1999).
Faul (1995) has specifically developed methodology to be used in the development of
measurement scales in social work in South Africa. This work has contributed
significantly to the structuring of scale development processes.
Based on an analysis of the above mentioned structured approaches to assessment
technology development, the researcher has formulated a combined approach -
incorporating elements of the different approaches - to be applied to this study.
The researcher introduces the three designs in this chapter to indicate how the structure
of this study was influenced, and to serve as reference for the Adjusted Design and
Development model that will be the focus of Chapter 2.
Although the Design and Development model serves as a guideline for the new
technology developed in this study, there are also other considerations to be taken into
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account. These considerations are based on the two concerns mentioned earlier in this
chapter.
The first is that South African social workers should be wary of theory developed in
other countries (Roberts, 1990). With this in mind, the researcher wanted to ensure that
she would meet the methodological requirements for a South African study with regard
to the development of measurement technology. Faul (1995:12) used a unique process
in the development and validation of measurement tools for the social work profession
in the United States, and formally described this as part of a research process which
she introduced and evaluated in South Africa in order to create a foundation for the
development of a battery of validated scales that can be used by social workers in
South Africa. The implemented process of development by Faul (1995:35) involves the
steps given in Figure 1.2 on page 15.
The second consideration raised by the research problem is that the implication exists
that social work measurement is different from psychological measurement.
With
ecometric scales being under evaluation by the Ecometrics committee of the Council,
the process of development of psychological measurement technology is directly
relevant to this study. Smit’s (1991:148) steps for developing a psychometric test are
regarded as the result of years of experience in developing standardised psychological
tests.
This author’s steps are given in Figure 1.3 on page 16.
Since the aim of
conducting measurements in social work differs from that of psychology, and since this
study does not aim to develop a standardised test, only the steps found to be relevant
to the development of a classification system are added to the Adapted Design and
Development model to be described in the next chapter.
The suitability of this framework as a proposed design for this study is based on the fact
that the candidate does not intend to develop a measurement scale but a structured
classification framework. Based on this difference, existing frameworks had to be
adapted to fulfil this goal.
The figures on the following three pages illustrate the three models discussed above.
The proposed design for this study will receive attention in the next chapter.
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A: PROJECT ANALYSIS & PLANNING
B: INFORMATION GATHERING & SYNTHESIS
>
C: DESIGN
D: EARLY DEVELOPMENT & PILOT TESTING
E: EVALUATION & ADVANCED DEVELOPMENT
>
F: DISSEMINATION
1. Identify &
6. Identify & select
12. Identify design problems &
20. Develop plan for trial use
30. Plan evaluation
35. Assess need and points of
analyse key
existing type of info
intervention requirements
21. Create limited operational
in light of degree of
access of potential consumers
model of intervention for trial
interventional
problems
>
use in pilot site
development
2. Initiate state-of-
7. Identify relevant
13. Specify boundaries of
22. Determine the
31. Select
36. Formulate dissemination plan
the-art review
info sources
domain of design &
developmental research
evaluation methods
37. Design & develop appropriate
8. Establish retrieval
development
medium &/or procedure
(non-experimental
implementation procedures
procedures
14. Determine design
23. Determine developmental
procedures)
participants & role of users
& monitoring instruments
3. Determine
9. Gather, process &
15. Select development site
24. Identify & address design
32. Conduct pilot
38. Prepare user-ready
feasibility:
store data
16. Use disciplined problems
problems
evaluation
innovation for consumers
technical: financial,
solving & creativity
25. Revise intervention as
33. Carryout
39. Develop means & media to
political, etc.
17. Generate, select &
necessary
systematic
reach consumers
assemble solution alternatives
26. Continue proceduralisation
evaluation
40. Test use of innovation
& implementation of model
4. Prepare project
10. Collect & analyse
18. Formulate an initial
27. Plan field test & select site
34. Revise
41. Monitor & evaluate use
plan
original data as
intervention or other
28. Expand trial test as
intervention as
42. Revise innovation
informed by the pilot
necessary
43. Conduct on large scale
appropriate
5. Set a
11. Synthesize data &
development goal
formulate conclusions
19. Initiate proceduralisation
29. Implement field test &
44. Repeat above steps as
revise intervention as
necessary
necessary
Figure 1.1 Combined schema of Rothman’s Social Research & Development Model and Thomas’ Research Paradigm
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PHASES
FDEVELOPMENT
PRE-
STEPS
MAIN MOMENTS
A: PROBLEM IDENTIFICATION
1. Problem analysis
2. Aims of study
B: THEORY FORMULATION
3. Identify and describe the theoretical framework
in which the scale is developed
4. Identify the operational assessment area(s)
that will be measured by the scale
5. Define construct(s) to be measured
DEVELOPMENT
C: DESIGN SCALE
6. Design items
7. Determine scale length
8. Scale the items
9. Develop a scoring formula
10. Write instructions for respondents
VALIDATION
D: DESIGN VALIDATION STUDY
11. Formulate research problem
12. Select the sampling technique
L_
13. Determine the sample size
14. Prepare the research package
E: COLLECT DATA
15. Administer research package to sample
F: INVESTIGATE RELIABILITY
16. Compute coefficient Alpha
17. Compute standard error of measurement
G: INVESTIGATE VALIDITY
18. Judge face validity
19. Judge content validity
20. Investigate content validity
21. Investigate construct validity
22. Investigate criterion validity
H: ESTABLISH CLINICAL
23. Establish clinical cutting scores
CUTTING SCORES
UTILISATION
I: DISSEMINATION OF
24. Write a manual
INFORMATION
25. Write a journal article
FIGURE 1.2 RESEARCH PROCESS OF SCALE DEVELOPMENT IN ECOMETRICS
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g-* Select & arrange items
1.
Specify the purpose of
the test
...
2.
3.
I- - -... —
Define the purpose in
operational terms
Write the items of the test
* Applying
procedures
* Instructions
* Time
* Reviewing
7.
Standardisation with
regard to:
8.
Technical analysis
* Reliability
* Validity
* Norms
9.
4.
Apply to sample
5.
Item analysis
Review
* Discrimination value
* Difficulty value
* Response analysis
FIGURE 1.3 STEPS IN THE CONSTRUCTION OF A PSYCHOLOGICAL TEST
Theoretical formulation followed by empirical testing and validation underlies all of the
existing approaches studied. It is therefore essential to state that the combined model will
also contain these two key elements. Due to the nature of the intended technology,
several key validation steps had to be included in this adapted model. These are
explained in Chapter 2. The three designs which the Adapted Design and Development
model are based on are given in this chapter as a background to the design that will be
the focus of the rest of this study. Only the steps that were taken from these designs will
be discussed in the next chapter.
Selected steps from all three models will be discussed in the Research Methodology
chapter, and reference will be made to what step is used. For instance, Smit’s 8th step will
be S8 in the Adapted Design and Development model.
The researcher will now give a description of the key concepts of this study.
1.8
Definition of concepts
The most important key concepts to be used are introduced here. A glossary of terms will
also be included at the end of the thesis to clarify some difficult terminology.
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1.8.1 Child client
A person under the age of 18 years (Swanepoel and Wessels, 1991:1). This means that
the study will focus on the dynamics of the infant, pre-schooler, school-going child, and
the adolescent.
1.8.2 Ecometrics
Van Zyl (1995:31) uses the term ecometry to refer to the technology in social work that
has to do with quantifying the person-in-environment fit.
It is the methodology of
measurement of all aspects of social work, and it focuses on the manner in which people
adapt to their environment - referred to as ecology.
Ecology is a form of general systems theory... concerned with the relations among living
entities and between entities and other aspects of their environments. The perspective is
concerned with the growth, development and potentialities of human beings and with the
properties of their environments that support or fail to support the expression of human
potential ... practice is directed toward improving the transactions between people and
environments in order to enhance adaptive capacities and improve environments for all who
function within them.
Germain 1979:17-18.
1.8.3 Classification system
Classification is the process of dividing a number of items or scores into categories or
class intervals (Plug, Meyer, Louwand Gouws 1988:177).
Sartorius (1990:1) regards classification as a way of seeing the world:
It is the reification of an ideological position of an accepted standard of theory and
knowledge. Classifying means creating, defining or confirming boundaries of concepts, and
through these we define ourselves, our future and our past, the territory of our discipline, its
importance and its exclusiveness.
Sartorius 1990:1.
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The author also explains that, should our classifications of things and people in the world
around us collapse, the world would cease to exist as a coherent and organised whole
(Sartorius 1990:1).
1.8.4 The Person-in-Environment (PIE) Classification System
PIE is a classification system that embodies the idea that social work's business is the
interaction between people and their environments.
PIE is meant to capture both the
problems and resources or strengths in (a) social role functioning (the performance of
daily activities in family, intimate, interpersonal, occupational, and special roles, as well as
focusing on the struggles and problems in power relationships, problems of ambivalence,
dependence, isolation, and the like, and (b) environmental problems and supports,
including the economic/needs-meeting, judicial, educational/training, health, welfare, and
safety systems (Saleebey, 2004).
1.9
Limitations of the study
Because of resource constraints and the limited support this development has in practice
as a result of the restricted exposure it will receive initially, this study focuses only on
partial development of the system. In the following chapter the boundaries of the study
will be clarified.
study.
Validity and reliability are also only partially addressed through this
Since it is the researcher’s intention to first find the common construct in social
work and to develop a conceptual framework to guide the development of the
classification system, she will only give attention to procedural validity and reliability. In
other words, she will control variables during the accumulation of literature and its
organisation and operationalisation.
Standardising a measurement technology through
validity and reliability testing requires different procedures and analyses. There is little
use in standardising a partial product. The researcher will therefore merely refer to this
standardisation as a step in the next chapter to be implemented at later stages in the
development of the whole system.
Another limitation of this study is the availability of social workers involved in practice.
The researcher has observed that most practitioners carry heavy case loads and, in the
majority of cases, are not be motivated to give time or attention to a tentative design.
Since the new technology to be developed depends to a considerable extent for its
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success on acceptance by the majority of members of the social work profession (general
acceptance being an inherent requirement for classification systems), the involvement of
practitioners is particularly crucial.
The reference sampling mentioned earlier in this
chapter will be used to encourage participation and to identify the members who show
interest in new developments.
1.10
Chapter layout
This chapter has outlined the motivation for the study. Chapter 2 provides an explanation
of the research design selected to ensure a valid and reliable developmental process.
Chapter 3 shows the development of a conceptual framework, while Chapter 4 examines
the relevant literature on childhood social functioning.
Chapter 5 explains the
developmental process, and Chapter 6 presents the first drafts of the development and
the results of the two pilot tests. Chapter 7 presents the final draft of the classification
system for childhood social functioning problems, and Chapter 8 offers suggestions for
further refinement of the final product. All of these chapters implement the steps outlined
in the Adapted Design and Development model.
1,11
Summary
This study stems from a desire to contribute to the social work profession by introducing a
working classification system. To accomplish this it is essential to remain true to social
work and attempt to improve the developments made to date to increase the chances of
the system being used.
The intention of this study is to combine the issues of
accountability and the use of a common language in services to clients in order to prevent
the profession from being regarded as a lesser science. By offering the first draft of a
system that can be used to identify childhood social functioning problems, the researcher
will stimulate debate and further research in this field. In this South Africa can then join
hands with the United States to present the social work profession with technology aimed
at supporting practice functions and service to the clients in our care.
This study is not based on an assumption that it will give rise to a new development within
the field of social work. It is based on a belief that the profession will benefit from the
improvement of a measurement tool already in existence, with the intention of making it
more visible and useful. To counteract the negative perceptions of the profession based
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on poor integration of our rich knowledge base, the primary aim of this study is a clear
statement of what the focus area of the profession is, leading to a prototype of a
measurement technology to be used in practice.
The researcher believes that it is
essential to build the credibility and resilience of the profession among other ‘people
professions’. Having witnessed the empowerment of social workers through the use of
scientific tools, she would argue that such tools play a significant role in increasing the
social worker’s confidence and effectiveness in practice.
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Chapter 2
Research Methodology
“Ours is a dynamic and growing profession, one that is facing with our colleagues in other
professions the humbling awareness of the deficiencies in our knowledge and the limits of our
interventions. But this awareness draws us on to increase the precision of our understanding of
those persons we serve, an understanding that will ensure that, as effectively as possible, we
make available to them the range of knowledge, skills, resources, and services that make up our
armamentarium of practice”
- Francis J. Turner -
2.1
Introduction
In the previous chapter the researcher outlined the aim of this study as well as the key
processes that have to be followed in the design and development of a classification
framework for child assessment purposes. It was also argued that the research design
required for the development of such technology presents the researcher with a complex
set of activities that must be followed if the resulting classification framework is to be valid
and reliable.
The goal of this chapter is to elaborate on the research design and to
explore the methodology required for the successful completion of this study.
Some of the steps are implemented in this chapter, particularly where decisions do not
require further activity (for example, determining feasibility). Other steps involve activities
that form part of the research process, and so are addressed in subsequent chapters.
It is necessary to clarify that, although the process will be applicable to the development
of the whole classification system for children, only parts of the process will be
implemented within the scope of this study.
To develop the system to a state of full
maturity, where it can be applied in practice, will be a long-term, if not life-long, project.
Such a project falls outside the scope of a doctoral thesis. The discussion of step 4 later
in this chapter will clarify the boundaries of this doctoral study.
The Design and Development Model is very comprehensive, and may be compared to a
big umbrella.
It guides the researcher through the development steps, which include
decisions regarding the research methodology.
It might therefore be confusing to find
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that the description of the research methodology, as one might traditionally understand it,
is only discussed at step 12 (presented later in this chapter).
However, the research
design, which includes the research methodology, is discussed throughout the rest of this
chapter.
To help simplify the discussion of this complex design, the researcher first highlighted the
different phases with in grey boxes (in later chapters she highlighted what phase and step
is applicable in blue on the sides of the relevant pages). Second she highlighted the
intention of each step in blue boxes, and third she highlighted how the steps will be
addressed in this study in red boxes.
Research design
2.2
Chapter 1 presented a short overview of the three designs that were used to arrive at the
researcher’s Adapted Design and Development Model. As mentioned in Chapter 1, the
researcher modified the design in order to address the problem statement, and avoid
applying a model developed in another country to the South African context.
The
researcher therefore included steps from Faul’s (1995) model of scale development as
applied to the South African context.
Since one part of the Design and Development
process is standardisation of the development, the researcher also introduced steps from
Smit’s (1991) guideline for standardising psychological tests.
The study falls within a
Design and Development paradigm, so the combined schemas of Rothman’s Social
Research and Development Model and Thomas’ Research Paradigm, as given in
Chapter 1, serve as the guiding framework for the Adapted Design and Development
Model.
The Adapted Design and Development Model followed in this study is illustrated on page
22.
In the diagram the researcher refers to the steps in the three other designs
mentioned above. She uses the following abbreviations to provide reference to the origin
of the steps: Rothman & Thomas’ Design & Development Model is ‘R & T\ followed by
the phase and step number; Faul’s ecometric scale development design is ‘F, followed
by phase and step number; and Smit’s model for constructing a psychometrical test is ‘S’,
followed by the step number. Those steps without any form of reference were inserted by
the researcher.
The steps she added are crucial to the study as they set guidelines to
ensure responsible action in a somewhat new and unfamiliar process.
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© Rika Swanzen 2003
PRE-DEVELOPMENT
1. Problem analysis (F;A1,/?&7”:A4)
2. Determine feasibility (/?&T:A3)
3. Establish requirements for new
technology
DEVELOPING THE DESIGN
4. Specify the boundaries of the
domain of the design and
development (/?&T:C13; F:B5)
8. Draft & decide on the appea
rance of the new technology
(compare S.lf F.C7f S.3, F.C8)
9. Determine the role of users
(R&7:C14)
5. Identify & describe the theore
tical framework in which the
technology is developed (F:B3)
12. Determine the developmental re
search procedure or medium (/?&7":D22)
10. Prepare user-ready inno
vation for consumers, i.e.
manual (/?&T:F38, F:I24)
6. Establish method of information
gathering with regard to
literature use (/?&T:B6-11)
PRODUCT TESTING &
STANDARDISATION
11. Facilitate feedback on
13. Select sample & apply (F:D12, S:4,
F:E15)
14. Technical analysis (S:8, F:F16-17,
G18- 22)
development thus far
MARKETING &
DISSEMINATION
18. Develop marketing plan
(compare /?<&7":F35)
15. Identify & address design problems
(R&T: D24)
7. Identify the operational assess
ment areas that will be
measured
by the technology (F:B4)
19. Addressing dissemination
16. Advanced development (/?&T:E31)
barriers
17. Proposal for approval of product
20. Start training workshops
from accreditation committee
FIGURE 2.1 THE ADAPTED DESIGN AND DEVELOPMENT MODEL FOR DEVELOPING A CLASSIFICATION SYSTEM
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PRE-DEVELOPMENT
The first phase of the Design and Development Model allows for the chance to consider
the developmental background of the new assessment tool to be developed. This phase
starts with a consideration of the problem that will be addressed through the
development; it considers whether addressing it will be feasible; it further provides a
structure that guides the method of gathering necessary information; it then attempts to
find an appropriate framework of requirements for the new development (i.e. as it is seen
as a measurement tool, what are the requirements for a measurement tool?). As part of
laying the foundation for the development, this phase also describes the theoretical basis
for the new development; it narrows the development down to the appropriate focus area,
and it prescribes a formula for transforming gathered information into a format that can be
measured in practice (as is the aim of the new technology).
2.2.1
Stepl: Problem analysis
The purpose of the first step is to start with a statement of what problem the development
intends to address. The researcher must analyse whether addressing the problem is
appropriate to the study and beneficial to the profession.
It is in part addressed in
Chapter 1, and a final statement regarding the problem area to be addressed is given
here.
The profession of social work lacks a unifying language with which to describe the social
functioning problems of children. The aim of this study is to build on the advancement
made by Karls and Wandrei (1994) that provided a classification system for identifying
problems in the social functioning of the adult clients of social workers. The PIE is still
new to South Africa, but the fact that it does not offer descriptions of the social functioning
problems of children, limits its utility in South Africa, a country whose policies and laws
are formulated with the future of our youth in mind.
Despite extensive investigation into classification systems, the researcher has found that
no similar study has been conducted. After presenting the results of her Master’s study at
a Joint Conference for Social Workers in Quebec, Canada, in 2000, the researcher
established contact with James Karls, one of the developers of the original PIE.
Literature on PIE confirmed that no classification for children exists.
E-mail
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correspondence with Karls reflects his support of this research project. The researcher
has included a few of his e-mails in Annexure 1 to show which suggestions influenced
this study.
From the correspondence it will become clear that this study has inspired
international interest and support, as well as hope that it will offer a long-awaited solution
to the problem of assessment within the field of social work.
2.2.2 Step 2: Determine feasibility
The purpose of this step is to answer the question of whether the study is viable. By
| exploring feasibility the researcher can anticipate possible shortfalls which may render
her unable to address the research problem.
In order to evaluate the feasibility of this study, the researcher referred to Bless and
Higson-Smith’s (1995:21-22) areas in which feasibility should be established:
Workability: To accomplish the aim of this study, which is the development of
an initial draft of a classification system for childhood social functioning
problems, sufficient personal resources for material, time and costs exist to
execute the steps set out by the research design.
Scope of research: The scope of the research falls in the field of person-in-
environment which has long been seen as the cornerstone of social work.
B
Interest:
The researcher has consistently showed interest in the field of
ecometry, both through doing supplementary courses in this area, and through
using it as the field of interest in her Master’s study.
Empirical testability: A new classification system can be tested for reliability
and validity, and its usefulness to practitioners can be evaluated through peer
review.
Theoretical value: In the development of a new technology a new theoretical
framework is developed which may prove more useful to practitioners than
outdated or inadequate ones.
Practical value: The nature of the research design makes provision for testing
the value of the technology in practice, and this study is based on the belief that
it will contribute to the social work profession by making practice more
empirical, and by assisting with assessment and intervention.
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The researcher believes that a possible obstacle to the integration of this study into
practice is that social workers may be unwilling to subscribe to the same framework.
Because of the structure of social work’s service delivery system, social workers carry
highly diverse caseloads. As a profession, social work has not yet committed itself to one
discernable knowledge base (as psychiatrists are committed to the D8MIV, for example).
At the same time our periodical literature remains a principal source of new practice ideas
and trends, but this literature is not easily available to all social workers.
Turner (1983) states that the underlying unifying concept is the “diagnostic component of
practice”. At the time Turner argues that there is still much more conceptualising and
experimentation to be done before we can search for common ground on the operational
components of diagnosis in social work intervention. As long as we are committed to the
ideal that what we do for, with, and to clients is somehow related to our knowledge about
them, we must continue to connect our perceptions of people and our professional
actions with them. The expanding numbers of schools of thought that are influencing
social work practice and the thrust towards a multi-method form of practice have made
the search for more precise diagnostic efforts more difficult.
In conjunction with the already wide array of significant factors in a client’s inner and outer
life affecting his functioning, the diversity of services we have to offer, and the wide range of
client’s requests and expectations, the search for more precise diagnosis appears almost
futile.
Turner, 1983: xxv, xxvi.
The next step includes a discussion on the differences between diagnosis and
classification. This study refers to classification rather than diagnosis because of social
work’s fundamental resistance to a disease-oriented approach. Turner recognised that
the underlying unifying concept is the diagnostic component of practice. The researcher
therefore argues that the underlying unifying concept of social work is the classification
component of practice.
This means that the focus of this study must be to find the
unifying concept of social work.
Karls and Wandrei (1997) responded to Lowery and Mattaini’s (1997) critical review of the
reliability findings on the PIE by stating that, even before the publication of the book and
manual, the PIE system had been adopted from journal articles by practitioners and
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educators in the United States and in several foreign countries (Japan, Netherlands,
Belgium, Italy, Canada, Australia). The considerable interest in the system and reports of
its successful application in a variety of practice settings suggests the likely feasibility and
coverage of the PIE system. The developers inferred from the PIE’s applicability in in
patient and outpatient mental health, public welfare, hospital, family service agency, and
employee assistance programmes (Karls and Wandrei, 1994, chapters 3-8), that PIE
could be used effectively in most settings in which social workers practice (Karls, Lowery,
Mattaini and Wandrei, 1997).
Given the above arguments, the researcher proposes that, even with the apparent
difficulties in finding a unifying concept for social work, the keen interest in the adult PIE
provides endorsement for the adoption of a classification system in this field. This gives
feasibility to this study which has as its aim to address some of the shortcomings of the
adult PIE and thereby increase the likelihood of adopting a more comprehensive
classification system.
The positive response to the PIE system is a further sign that
sufficient interest exists to undertake this study.
The adoption of the PIE in different
countries is also an indication that the system is more likely to be viewed by South African
social workers as applicable to the cultures represented in our country. Apart from the
limitation of doing this research with limited financial resources, this study is certainly
feasible.
2.2.3 Step 3: Establish requirements for the new technology
The purpose of this step is to establish an idea of how the new technology should look.
The new technology to be developed has two characteristics shaping its form: it is a
measurement tool and it is a classification tool. This step will show how classification
forms part of measurement. The information on classification systems is given here to
shape the study; it will be implemented in Chapter 5. The discussion at this stage serves
as preparation for later stages.
One of the early phases of the helping process, namely the assessment phase, gives the
social worker the first opportunity to apply ecological theory of social work practice. In this
phase the social worker must assess the client’s problems in the context of his dynamic
interaction with his environment. Measurement in this phase is something the social work
practitioner must do to describe in quantitative terms the quality of adaptation between the
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client system and its environment. ... Once all the sources used in the assessment phase
have been integrated and the client’s quality of adaptation has been described, the social
work practitioner and the client can decide together on the focus of intervention to increase
the person’s adaptation within his environment.
Faul and Hudson, 1999:14, 15, 16, and 17.
The helping process then progresses to the intervention phase where the social work
practitioner implements strategies decided on in the assessment phase. Measurement is
used in this phase to evaluate the extent to which the social functioning of the client
system has improved as a result of the professional activities of the practitioner.
The client system claiming satisfaction with service delivery is no longer sufficient evidence
of sufficiency. Substantial evidence is necessary to prove the effectiveness of the social
worker in increasing the adaptation between the individual and his environment, evidence
that can be provided with measurement technology.
Faul and Hudson, 1999:14,15, 16, and 17.
The significance of this study has to do with the fact that a measurement technology is to
be developed that will assist the practitioner in assessing the problem, and directing her
to intervention strategies. In focusing on measurement, the study contributes to issues of
accountability in social work. It is therefore necessary to have a good understanding of
what is required of measurement technology.
2.2.3.1
Step 3a: Requirements for a measurement tool
This section provides the general and specific guidelines to be followed when engaging in
measurement.
2.2.3.1.1
The rationale for measuring
The way in which a measurement tool should benefit the practitioner is a very useful
guideline in developing a new one.
Bloom and Fisher (1982, in Faul, 1995:8-9) argue
that if a problem is too subtle or too vague to measure, it is probably too subtle or too
vague to work on. If the problem is not measured, there will be no way of knowing how
well the client is doing with the intervention programme or whether goals are reached.
The use of measurement thus holds the following benefits for the practitioner (Faul, 1995:
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8-9):
■
A measurement tool helps the practitioner to more accurately and thoroughly
describe the personal and social problems of clients.
■
It allows the practitioner to classify and observe events to determine whether,
when, how often, how intensely, or for how long they occur.
■
It leads to empowerment of clients by clearly communicating to them what is being
done, thus demystifying the intervention process and enhancing their future
independence.
■
It facilitates practice decisions and helps to answer questions such as: Is the client
eligible for services? Does the client pose a risk to others? Does the client have
adequate social support? Does he/she have the skills to recognise and utilise the
support? Is the selected intervention working well enough? How close is the client
to achieving goals? Are the client’s gains sufficiently stable to shift to a different
treatment intensity? Is there a risk of relapse?
Repeated measurement of a client’s problem and/or strengths leads to beneficial
feedback and this assists with informed clinical decision making.
■
It adds objectiveness to social work practice, increases the precision of what is
done, and is therefore a key to enhancing the effectiveness and efficiency of the
practice efforts.
2.2.3.1.2 Types of measurement tools
Measurement tools can be classified according to a range of criteria.
Dr Wim
Roestenburg (2003) illustrated the range of criteria for the assessment tools available to
social workers in terms of a functional table that divides the tools according to qualitative
and quantitative properties. For purposes of this study the researcher refers only to some
of these divisions to show the difference between classification systems and scales. She
includes some of the qualitative procedures identified by Roestenburg (2003) to illustrate
what procedures are applied indirectly when using a classification system. For example,
in using a classification system, the processes of interviewing and observation are
applied to gain the information needed to make professional judgements about identified
problems.
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TABLE 2.1 TYPES OF MEASUREMENT TOOLS
QUANTITATIVE TOOLS________________ _______
Assessment
Technology Type
Criterion
referenced scales
Norm referenced
rating scales
______ Description_____
_______ Uses______
Most formal types of interviews
that are used to measure the
frequency of behaviour or
attitudes of candidates.
This type of scale measures a
person against set criteria.
A rating scale, the score of
which numerically compares a
person to a recognised norm.
Usually administered as a test
within a specified time limit.
Used as an objective
measure to quantify and
summarise behaviours.
Uses numerical language
as basis of description.
Used as primary
assessment instrument to
compare scores with the
norm.
Used to confirm
judgements about
candidates.
Accountability
________ issues_______
Ensure the reliability of the
instrument is known as
well as its validity.
Ensure that reliability is
promoted by observing
test conditions._________
Check validity of
instruments before use.
Ensure that test conditions
are applied during
administering to conform
to validity requirements.
QUALltATIVE ASSESSMENT TECHNOLOGIES
Assessment
Technology Type
______ Description
Accountability
_______ Uses_______ ______ Issues______
Naturalistic
observation
Observation of behaviour in a
real context such as the
workplace to assess specific
performance in a task.
To evaluate acquired skills
and knowledge post
intervention.
Recollections
Recalling previous
observations and
interpretations of behaviours
and events such as can be
given by others who deal with
the candidate.
Additional source of
information for other
assessment methods.
Indirect way of assessing.
Interviews
Goal directed interactive
process between two or more
individuals to determine nature
of problem or need.
Can be highly structured or
unstructured.
Sometimes only
assessment and
evaluation tool used.
Preferred method when
quality relationship is
paramount.
Professional
judgements
An assessment made by a
qualified person who is
authorised to form an opinion
or judgement about a person.
Used as additional
information in assessment
situations.
Validity may be influenced
by ‘halo-effect’.
Cost offsets benefit
Validity influenced by
workplace restrictions.
Participant nervousness.
Requires time away form
work.__________________
Large time gap between
behaviour and recalling
process - lower accuracy.
Individuals may be
untruthful and highly
subjective.
Information may be
filtered.________________
More structured type can
be used to compare
individuals with each other.
Less structured type used
for individual assessment
as when a problem is
identified.______________
Ensure person is capable,
conscientious, and
objective.
Can be a valid source, but
also contains risk._______
QUALITATIVE-QUANTITATIVETECHNOLOGIES
Assessment
Technology Type
______ Description_____
_______ Uses______
Rating scales
A scale with quantitative items
and a scaling format to be used
by assessor to rate client
behaviour.
Used in the observation
and rating of individual or
group behaviour.
Repeated observations of
different individuals in
similar circumstances.
Classification
Classifying and categorising a
Qualitative method to
Accountability
______ Issues______
Scale format and item
construction improves
objectivity and reduces
assessor contamination of
data.
Systematic format that
facilitates replication
potential.______________
Requires substantial
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frameworks
candidate according to a set of
behavioural items,
characteristics, or traits that
exist in a framework.
facilitate accurate
judgement based
assessment.
Promotes uniform
classification according to
a set of behavioural or
symptomatic criteria.
training and practice to
facilitate uniform
application.
Framework promotes
replication indifferent
circumstances and by
different assessors.
Uniform application of
framework and coding
promotes cross validation
and inter-rater agreement
on classification._______
Roestenburg, 2003
The purpose of using a classification system among these measurement options is
indicated by the need to have descriptive criteria that will categorise a client in such a way
that another professional familiar with the classification system will recognise the
symptomatic traits that will
facilitate
coordinated
treatment
and
referral
among
professionals. This form of measurement is not exclusive of any of the other assessment
types.
On the contrary, in the language of social work all other assessment should
eventually assist with a more accurate classification of client problems.
The accountability issues which relate to classification systems are significant to this
study.
The researcher would argue that these issues serve to confirm that a common
knowledge base for social work should first be established. A well developed conceptual
framework will make training in the system easier, while increasing the chances of
interrater agreement.
In summary, the aim of this study is to develop a classification tool that will act as a
measurement tool and offer the following benefits to practice:
■
Help the practitioner describe the personal and social problems of the client more
clearly and accurately.
■
Assist in determining whether, when, how often, how intense, or how long
observed events occur.
■
Empower the client through providing clearer feedback.
■
Provide more precise estimates of severity, magnitude, duration, or form of the
client’s problem.
■
Facilitate practice decisions and enhance the effectiveness and efficiency of
practice efforts.
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2.2.3.2 Step 3b: Requirements for classification systems
Social work has had a love-hate relationship with classification systems, being particularly
opposed to systems that label individuals as deviant or that otherwise stigmatise or
stereotype. Nonetheless, social workers have been aware of the usefulness of identifying
categories of psychosocial problems. Since the early 1980s the field of social work has
been moving towards a more scientific approach to testing its theories and interventions,
and many social workers support the classification of problems as a means toward
conscious and deliberate planning of social work interventions. Objections to the use of
classifications are raised more because of classification’s misuse rather than the
classification itself. The client and the social worker each can see that a clear description of
psychosocial problems will aid the client’s well-being.
(Karls and Wandrei, 1995:1819-1820).
2.2.3.2.1
Diagnosis versus classification
The most significant difference between classification systems and self-rating scales
(which in the researcher’s opinion tend to gain greater acceptance from social work
practitioners), is that the former attempts a diagnosis based on the social worker’s
observation of the client within the framework of his of her professional knowledge about
social functioning within the context of an environment.
Diagnosis usually involves a
classification in terms of an illness or abnormality, and describes a myriad of terms that
professionals use to label clients.
Observed behaviour is used as a sign of more
important underlying processes.
Use of diagnostic labels often assumes a trait
conception of behaviour in which consistency of behaviour across situations is assumed
(Faul and Hudson, 1999:31).
Turner (1983: xxi) argues that diagnosis is built on knowledge of individual cases, classes
of cases, and classes of components of the complexity of the bio-psychosocial reality of
social work clients and the range of problems they bring with them.
If one uses the
literature of a profession as a reliable reflector of the reality of the practice of that
profession, then we can conclude that, as our practice is becoming more complex, the
role of diagnosis is also becoming more important. The long-standing criticism of a too
structured approach to diagnosis when classifying patients is rapidly reducing. We are all
aware of the potential misuse of uni-category diagnoses, but equally aware that one
cannot
responsibly
practice
without
well-developed
and
well-tested
systems
of
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classification. The need for precision in diagnostic terminology, the need for a multi-axial
approach to diagnosis, and the role of psychosocial stressors in understanding personsin-situations, have long since been part of the social work tradition (Turner, 1983:xxii).
The researcher has observed that the most significant difference between self-rating
scales and classifications appears to be what they represent to practitioners. Self-rating
scales represent the social work principle that clients participate in their own treatment,
and are therefore empowered from the beginning phase of assessment.
Classification
systems are controlled by the practitioner and are therefore often perceived as problem-
orientated.
Turnbull and Cahalane (1994:49-50) are of the opinion that assessments
which focus on symptoms tend to result in treatment interventions that emphasize
medication.
Understanding that a classification such as PIE is not a diagnostic tool is
therefore crucial if the new technology is ever to gain favour among social workers.
PIE is not a diagnostic tool because it does not offer a cause-and-effect relationship for
the problems identified. It is instead a tool for collecting and ordering relevant information
that can produce a comprehensive assessment of a client's problems in social
functioning.
This in turn also allows for the application of interventions from varying
theoretical positions that might relieve or solve the problem (Karls and Wandrei 1994:3).
However, the dangers of misusing or inappropriately using a system such as PIE are
outlined by Goldstein (1980:46):
In the absence of workable person and environment problem classifications, without
operational concepts to describe the active and natural processes of coping and
adaptations, without action principles derived from these concepts and in the absence of
systematic research on practice effectiveness with specific types of maladaptive
transactions, it is easy to fall back on old, familiar formulations as to what is wrong and how
to correct it.
2.2.3.2.2 Accurate use of classification systems
The most significant guidelines,
principles,
and criteria that should be used in
classification systems in order to minimize the problems of misuse are provided by Karls
and Wandrei (1994:5), Sartorius (1990:5-6), and Wittchen and Essau (1990:113). A
summary of these is outlined below:
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■
Classifications are merely tools that alert the practitioner to major combinations of
relevant factors.
■
Formulating a useful psychosocial assessment requires knowledge beyond that in
the classification.
■
A classification is a means of ascertaining what characteristics a person or family
has in common with others, but also emphasizes what is unique in the person or
family.
■
The social worker should not permit the label to obscure the client's strength or the
value of intervening in a variety of systems to meet the client's needs.
■
The search for understanding is reciprocal between a practitioner and a client - the
client has the right to participate actively.
■
A classification should be based on points of agreement among professionals.
■
It should be sufficiently simple and understandable to allow easy use.
■
It should not compete with or replace regional or local classifications.
It should be somewhat conservative and theoretically un-enterprising so as to
remain attractive to a wide variety of people of different orientations and
knowledge.
It should be stable and abide by the rule that changes can only be introduced
when sufficient data have become available to support the change and facilitate its
acceptance.
■
It should be comprehensive enough to detect a wide spectrum of problems, but
specific enough to allow the professional to act appropriately, and sensitive
enough for early detection of problems.
The researcher will now look at how requirements for the classification of children differ
and will then provide a summary of what the requirements of a classification tool for
children are. This summary will be useful in the design stage described in Chapter 5 of
this thesis, and even more valuable when drawing up guidelines for users to be included
in a manual when the final product is completed (post doctoral development).
2.2.3.2.3 Guidelines concerning the classification of children
Cegelka (2003:65-66) lays down strict guidelines with regard to controversy around the
classification of learning disabilities. These do not necessarily apply directly to the PIE
system for adults, and the researcher has therefore noted these as suggestions for the
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ideal context in which the classification for children should be done:
Where possible a child should only be classified where a team composed of
■
qualified diagnosticians with the skills to assess medical, psychological, social,
educational, and vocational factors, is available to evaluate the case. The team
should assume responsibility for proposing and interpreting an individual plan for
the child’s progress and needs.
Evaluation for the purpose of classification should ideally include the use of
■
individual test procedures that measure a range of skills and that are
appropriate to a child’s linguistic and cultural background - taking into account
reversible environmental factors.
As far as possible the child should be assessed in his/her natural setting, but
■
the behaviour in this setting alone should never be used as sole criterion for
categorising a child.
No assessment of a child should be considered complete unless the parents have
■
been actively involved in the evaluation process as significant observers of the
child and his functioning.
Assistance to parents in the home management of
problems related to optimal development should be offered.
In summary then, the accurate use of a classification system demands that problems
presented by diagnostic systems are avoided.
A classification system should be used as a tool that merely alerts the
practitioner to major combinations of relevant factors, and gives an indication of
how a client’s problem is the same as others and how it is unique.
■
The practitioner needs psychosocial knowledge beyond that in the classification
system. She should also not permit the label to obscure the client’s strengths.
■
A good classification system is based on points of agreement among social
workers, and they should be able to identify with such a system.
■
It should be fairly simple and ‘user-friendly’, be applicable as a tool of information
exchange, and be sensitive enough to allow early detection of childhood
problems.
■
Since children lack the ability to relate to abstract emotions, parents should be
involved where possible, other individual test procedures should be included, and
ideally assessments should be done in the child’s natural setting.
■
The child would also be best served if assessments are discussed in team
conferences.
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Classification differs from diagnosis in that it does not offer a cause-and-effect
relationship for problems, but it is rather a tool for collecting and ordering relevant
information that can produce a comprehensive assessment.
2.2.4 Step 4: Specify boundaries of domain of design and development
The purpose of this step is to ensure that the development stays within the boundaries of
the study’s objective. Before the researcher embarks on a literature search she needs to
narrow down the area of her study.
Following from PIE, with 20 years of development behind the system, four factors can be
identified that need to be developed for the childhood version (illustrations of PIE are
given in Chapter 5). The childhood version should provide child role descriptions for the
different areas of social interaction, with consideration of the intricacies of problems in
these roles together with an indication of the duration and intensity of the problem and the
coping strengths the child may posses. It should consider other influences that may be at
play (such as physical and mental health) and how adequately the environment provides
for the needs of the child.
This is a cumbersome development process and it is
necessary to narrow down the domain to what is specific to this study.
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Steps done in this doctorate
study with regard to developing ;
; the oc al role functioning fecX" ;
PRE-DEVELOPMENT
__
i
1. Problem analysis (E'A1ZR&T:A4)
© Rika Swanzen 2003
2. Determine feasibility (/?&7“:A3)
3. Establish requirements for new
technology
4. Specify the boundaries of the
domain of the design and
development (/?&T:C13; F:B5)
5. Identify & describe the theore
tical framework in which the
technology is developed (F:B3)
6. Establish method of information
gathering with regard to
literature use (/?&T:B6-11)
7. Identify the operational assess
ment areas that will be measured
by the technology (F:B4)
DEVELOPING THE DESIGN
8. Draft & decide on the appea
rance of the new technology
(compare S.lf F.C7, S.37 F.CS')
9. Determine the role of users
(R&7”:C14)
10. Prepare user-ready inno
vation for consumers, i.e.
manual (/?<&T:F38Z F:I24)
11. Facilitate feedback on
development thus far
PRODUCT TESTING &
STANDARDISATION
12. Determine the developmental re
search procedure or medium (R&T:D22)
13. Select sample & apply (F:D12Z S:4Z
F:E15)
14. Technical analysis (S:8Z F:F16-17Z
G18- 22)
MARKETING &
DISSEMINATION
18. Develop marketing plan
(compare R&TttS)
15. Identify & address design problems
(/?&T:D24)
16. Advanced development (/?<&T:E31)
17. Proposal for approval of product
from accreditation committee
19. Addressing dissemination
barriers
20. Start training workshops
FIGURE 2.2 THE BOUNDARIES OF THE DOMAIN OF THE ADAPTED DESIGN & DEVELOPMENT MODEL
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I The study is confined with regard to two things: firstly, with regard to the steps of the
Adapted Design and Development Model to be addressed in this study, and secondly,
with regard to the parts of the classification system (new technology) to be developed.
It will not be appropriate to implement all the phases and steps of the Adapted Design
and Development Model until the whole classification system has been developed. The
diagram of this model (Figure 2.2 on the previous page) highlights the phases that will be
addressed in this study.
(The highlighted steps in the standardisation phase will also
| include the initial pilot testing, to test interest and to check the process of testing - this will
|j be clarified later in this chapter when these steps are discussed).
With regard to the parts of the classification system, the development has been narrowed
down to the first factor, which is the social role functioning factor. What this entails will
become clear as the study progresses. The development will only focus on the social
functioning problems of children (since a classification system for adults already exists);
this implies a child from birth to 18 years (based on a clinical definition of child and not
policy definitions in current South African Welfare which have extended the description of
youth to include the young adult phase). This development of the classification system
also only focuses on social functioning problems as applied to social work (to be clarified
in Chapter 3).
2.2.5 Step 5: Identify and describe the theoretical framework in which the
technology is developed
pAny development is based on certain beliefs and principles that place it within the context
| of a profession. This step gives shape to the development within the context of social
work.
The reason for this step as a pre-requisite to the development of the new technology lies
in the dual vision of this study. The study is embedded in the Design and Development
model, but the need for an additional theoretical model made the introduction of
Grounded Theory essential. Grounded theory construction is the development of theory
from data through the general method of comparative analysis.
Theory-building
approaches try to discover more than simply what something is - they attempt to find out
why it is. Seeking explanations is the same as theorising. It begins with attempting to
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establish links between/among the elements in the literature which the researcher has
identified and classified. The first goal is to find the entities to analyse. The entire point
of theory construction is to produce concepts from the literature that seem to fit the data
(Tesch, 1991:19, 23).
In grounded theory construction the entities to analyse are called categories.
In 1967,
Glaser and Strauss coined the term constant comparison to describe the process of
progressive category clarification and definition. When the researcher then discerns that
two or more categories are conceptually related, rather than claiming that any theory has
been derived, all that has been achieved has been to construct hypotheses and the
attempt to demonstrate support for those hypotheses.
Although not strictly seeking generalisations, grounded theory is theory building in the sense
that it aims to strip away the particulars and to arrive at some underlying principle that is
likely to apply to similar situations.
Tesch, 1991:24.
In this step and in others where to the researcher was required to make decisions based
on her own judgement, she used the following five-step procedure set out by Earl Baby in
1986:
■
observe the way things are;
■
ask why they are this way;
■
suggest an explanation;
■
then ask, if this explanation is true, what else might be true;
■
look to see if it is true.
The primary difficulty in this sort of thinking is getting into the habit of following the steps
carefully (Erickson and Nosanchuk, 1992:74-75).
In Chapter 3 the researcher describes a theoretical approach, shows that it is integral to
social work, and develops a conceptual framework that will guide the selection of topics
for the relevant literature survey. This will then begin to give shape to the classification
system for childhood social functioning problems to be developed. The five guidelines
above that should be implemented when depending on one's own judgement of what to
explore and include, will be applied at every stage of this study.
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2,2.6
Step 6: Establish a method of information gathering with regard to literature
use
The categories that form the foundation of the new technology are derived from literature
on the social functioning of children. The literature on this subject is very diverse, so a
filter is needed to direct what should be included and what excluded. This step describes
how the literature was accessed, reviewed and handled to ensure a comprehensive
inclusion of all relevant information.
The following quote from Hayes (1994:101) explains why this step is necessary:
There is concern about the apparently overwhelming amount of information that might be of
value, possibly without adequate means for separating that which is relevant, gaining
access to it, or analysing and organizing it.
Challenging factors in information gathering are, firstly, identifying the existence and
relevance of potentially important information materials, and then determining their
availability and the means of accessing them. Certain sources of information, such as
those that are computer-based, require sophisticated technology to gain access to them
(Hayes, 1994:105-106).
2.2.6.1
Literature survey
For a study such as this, it is necessary to explore an extensive range of literature in
order to develop an idea of what concepts are related to social role functioning in
children. A basic understanding of the literature review process is necessary in order to
orientate the researcher to finding and managing relevant literature.
The fact that reviews are tied to a finite universe of problems does not mean the activity of
research synthesis is any less creative
Instead, the creativity in research review enters
when the reviewers are asked to make sense of many related but not identical theories or
studies.
More often than not, the cumulative results of studies are many times more
complex than envisioned by the separate researchers who conducted them. The reviewer’s
instinct for uncovering variables that influence a relation and ability to generate divergent
schemes are important ingredients in the research synthesis process.
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Cooper, 1989:19.
The gathering process involves the following steps (Cooper, 1989: 39-47; 54; 57-62):
■
Firstly, the researcher starts with a precise definition of the target population,
which will allow for a list of its constituent (basic) elements.
■
Secondly, studies are to be located from:
-
Informal channels which include the researcher’s own research; the
‘invisible college’, that is, scientists working on similar problems who are aware of
each other; students and their lecturers who share ideas and pass on papers and
articles they find of mutual interest; attendance at professional meetings; and
convention papers. The personal biases within these channels are obvious and
the researcher should not rely solely on information gained from such sources.
Primary channels, involving publications which form the initial link between
the reviewer and the formal communication system.
Two methods of gaining
access to primary works are the use of personal libraries or journals carried by
institutional libraries, and the ancestry approach.
The latter involves retrieving
information by tracking down the research cited in already-obtained relevant
research. The limitation of this channel is the tendency of journal reviewers to look
less favourably on studies that conflict with conventional wisdom than those which
support it.
Secondary channels should form the backbone of any systematic,
comprehensive literature survey since they contain the information most closely
approximating all publicly available research.
Bibliographies are non-evaluative
listings of books and articles that are relevant to particular topics. Making use of
bibliographies prepared by others is time-effective for the reviewer. These lists
extend beyond the reviewer’s field of interest, but they need constant updating.
The sources of information most likely to prove fruitful are the indexing and
abstracting services associated with the social sciences. The service will focus on
a topic and define its scope as an explicit number of primary publication outlets.
The limitation of this service is the long time lag, often three to four years, between
when a study is completed and when it appears in the system. There may also be
restrictions on what is allowed to enter the system based on topical or disciplinary
guidelines.
More than one secondary source will be required for the literature
search to be exhaustive. The system is entered through keywords associated with
pieces of research. For this the Thesaurus can be valuable in ensuring that the
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)
researcher accesses all the literature on the topic. Computer searches can access
thousands of documents from a wide variety of sources. Their exhaustiveness,
coupled with the explosion in social science research, commonly results in the
problem of information overload. Nevertheless, the effort is still far less than that
required for many hours of manual searching.
■
Thirdly, the researcher should determine the adequacy of the literature survey.
The question of which and how many sources of information to use has no fixed
answer. As a rule the researcher should always employ multiple channels so that
the chances of a strong unidentified bias distinguishing included from unincluded
studies is minimized. Although informal sources carry the risk of bias, their benefit
lies in containing the most recent findings. Even though unpublished research may
not have undergone rigorous methodological appraisal by established researchers,
it may produce valid findings which contradict conventional wisdom.
•
Fourthly, the researcher should protect validity during the study retrieval process.
The researcher should ask how the studies under investigation might differ from
other studies, and how elements contained in the studies might differ from other
elements of interest. The first threat to validity in the literature study is that the
review may not include all studies pertinent to the topic of interest. The second
threat occurs during the retrieval process where individuals or elements in the
studies may not represent all individuals or elements in the target population. The
researcher has an obligation to describe missing populations carefully and to
qualify any conclusions based on over-represented samples.
The target population of this study is children, and the constituent elements involve those
relevant to the child’s social functioning, to be clarified in Chapter 3.
In the course of this study, the researcher makes use of all the information channels. She
uses findings from her Master’s study (1999), and material from the doctoral thesis,
articles, and training notes of her promoter, as well as dissertations by other students. In
addition, she refers to articles obtained from the developer of the adult PIE (James Karls),
as well as his training notes, e-mail correspondence and advice.
In the process of
reading, she takes note of studies cited by authors she will refer to throughout her thesis,
regarding these studies as additional support of their statements and opinions. In making
use of informal literature such as news letters from supportive community groups, she
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also tries to identify current client-friendly terminology, with the idea that this should
contribute to cultural sensitivity (including those aspects relevant to the community).
The indexes and abstracts of the university library from the education, psychology,
psychiatry, sociology and social work disciplines provided the major source of relevant
literature. The researcher will make use of her internet account to access ‘Proquest’, an
online data base for social science topics. This reduces travelling and this means the
computer can be used to search through text instead of the researcher having to scan
through pages of information herself.
She will also examine unpublished information
brochures and the websites of recognised organisations in South Africa such as Autism
S. A. and the Depression and Anxiety Support Group. As a member of the Council of
Social Service Professions in South Africa and the South African Association of Social
Workers in Private Practice, she receives their quarterly newsletters, and so is able to
stay abreast of developments in the profession. The researcher will attend all training
workshops related to her field of study, such as diagnosis in children, augmentative
communication, and autism.
In this way, she ensures access to sufficient information
channels to avoid bias and so can contribute to the protection of the validity of the
literature she is including in this thesis.
Since so many topics need to be covered in the development of a comprehensive
measuring tool such as a classification system, there exists a perceived threat to
protecting validity through including all relevant literature on the topic. In the process of
compiling the literature survey the researcher had to decide what literature to include and
what to omit. The best way to address the perceived threat in this process seemed to be
to develop a list of requirements that have to be met when deciding on the inclusion or
exclusion of a particular literature source. The following aspects have been identified to
act as a filter for the literature review:
■
Include only the literature on the target group, that is, children from birth to 18
years.
■
Look in general at needs to be met for optimal social functioning.
■
Search for literature focussing on categories or integrated models or frameworks.
■
Avoid exploratory studies that work inductively towards a theory, and look for
deductive explanatory or intervention studies.
■
Refer to articles evaluating previous studies and giving collective findings
(reviews).
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■
Only quote relationships already proven between variables, or when it is stated
that, although the relationship was unproven, a significant relationship between
facts had been shown.
■
Focus on relevant literature with themes common to the study, for example,
related problems or similar causes.
■
Include only references that have a social or environmental (systems) approach
to the subject.
•
Focus on facts pertaining to assessment and excluding intervention (the latter to
be addressed in post doctoral study).
■
Examine the content of the study: the accuracy of interpretation; the extent to
which the references are dated; how objective the researcher appears to be; and
how it compares with possible opposing views.
■
Give preference to developmental approaches in explaining the functioning of
children.
■
Include literature which examines the intrapersonal aspects related to children’s
needs and development.
■
Look out for collective terms in literature that may be appropriate to the
classification system. (Beware of terms such as- 'disorder’, and others which
entail a set of requirements before the term can be used).
■
Engage in a broad search to cover all possible problems with social work child
clients, while avoiding specialisation in each category.
■
Refer to a range of sources, including academic journals and text books, website
services, medical and child care magazines, and, to a lesser extent, related non
academic books such as self-help books.
The second threat to validity mentioned previously is the reality of the multi-racial South
African context. In order to address this issue, this study focuses on the degree to which
studies in other countries may be applied to the cultural differences found in S. A. (This is
merely an awareness based on personal practice experience and multi-cultural training.
The researcher is not claiming that she will test the studies for their application to the
South African context.) She also made a point of searching for South African based
research studies. This second threat to validity is one of the principal reasons why it is
not possible to merely accept the frameworks which the PIE was built on. For the
purposes of this study, it was essential to examine more recently developed frameworks
and frameworks which focus on children (including conditions frequently found in South
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I Africa, such as ‘child-headed families’). It will also be crucial to consider the South African
traditions, and the trends we as a profession support. The primary source used to identify
current trends in South Africa was government policy papers (such as the White Paper on
Social Welfare and Social Development).
These threats then are addressed in the
conceptual framework (Chapter 3), and in the literature study following from this
framework (Chapter 4).
2.2.6.2 Organising the literature
Marshal and Rossman (1995:111-112) see analysis as the process of bringing order,
structure and meaning to a mass of collected data. The process is regarded as ongoing,
interactive, commencing from the point where the researcher enters the field of study and
continuing throughout the research process. This is why the researcher has discussed
the organisation and analysis of the literature gathered as conceptual data for the study at
this stage. The method used for the literature survey is explained again in the third phase
when the new assessment technology is tested and the data gained through the testing
process is analysed.
Gathered data must be synthesised in a specific form to allow easy and accurate data
analysis.
Forness and Kavale (1994:117-118) suggest that meta-analysis is an
appropriate method in intervention research (of which design and development forms
part):
Meta-analysis is a method of research synthesis that aggregates findings across a particular
area of research by converting data in each study to a common metric. Its aim is to use this
metric as an inductive synthesis to define the relative effectiveness of a particular procedure
across several studies, to clarify the parameters of the phenomena that appear to govern its
effectiveness, and even to place this relative effectiveness in the context of other
procedures used with similar populations.
An ideal example of this approach, which uses structured protocols in meta-analysis but
includes the flexible integrative qualities of the traditional review, is Systematic Research
Synthesis (SRS).
It is procedurally rigorous, without seeking statistically summative
means of representing conclusions. Its basic features, according to Rothman, Damron| Rodrigues and Shenassa (1994:137-139), are:
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■
The planned structuring of explicit steps and operations in the synthesis. In this
instance a research review is regarded as parallel to a scientific enquiry.
■
It provides conceptual rather than statistical data integration.
SRS creates a
conceptual synthesis of research in a given area - an approximating rather than a
determinant integration.
It entails a degree of invention that makes a new
integrated whole from the parts of a body of research findings.
Conceptual
integration requires qualitative judgements that are subject to reliability questions.
B
It permits a very broad range of evidence on any given issue. Since SRS is not
constrained by statistical strictures, it allows for more comprehensive coverage,
including quantitative and qualitative findings.
With the SRS approach:
•
uniformities and tendencies in the data are discerned,
•
clusters of data comprising a consensus of findings are identified, and
•
appropriate statements constituting generalisations are composed.
Rothman, Damron-Rodriguez and Shenassa, 1994:152.
The approach employs a set of techniques used in qualitative research analysis, one of
which is particularly relevant to the nature of this study. Indexing can be used to look for
markers that comprise different wordings for the same term (thereby disambiguating
terms). The synthesis process often includes finding an intervening variable that explains
and reconciles different conclusions.
Raising or lowering the level of abstraction of a
conceptual category can generate consensus findings. Consensus findings may state the
relationship of variables as they are supported and also include sub-generalisations,
showing inconsistencies among findings as they relate to different circumstances or
groups.
Synthesis can entail the creation of new concepts, or the modification,
transformation, or reorganisation of current ones (Rothman, Damron-Rodriguez and
Shenassa, 1994:152-153).
The inclusion of SRS concepts should not be confused with a methodological design.
The researcher uses the Adapted Design and Development Model as the methodological
design for this study. In addition, some of the concepts from the SRS approach were
integrated into the design in order to help with the organisation of data from the literature
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search. In Chapter 4 she describes the following process relating to the literature search
based on SRS principles:
■
Organise the literature into headings within each chapter based on uniformities and
tendencies, consensus findings, and generalisations from the relevant literature.
■
Name the headings of the sections in order to initiate a form of synthesis - giving a
name
to
the
concept
described
underneath
conceptualisation is similar in practical intent.
the
heading.
(The term
This is significant as preliminary
work for the later stages.)
■
Because the study draws on literature from different disciplines, it is necessary to
simplify (lower abstractions as mentioned above) or change words (such as
psychiatric terms) where necessary to suit the language of social work, without
changing the meaning. Instances where this seems necessary are typically when
similar facts are relayed through different descriptive words.
■
Remain receptive to debates in the literature and identify inconsistent findings.
Without focusing too much on the different viewpoints, establish points of
agreement that add value to understanding social functioning in children.
■
By using bullet point guidelines throughout, the planned structuring of the process
is emphasized.
An overly complicated plan carries the risk of invalidating the
thesis.
2.2.7
Step 7: Identify the operational assessment areas that will be measured by
the new technology
Having already established the aim of developing a classification system, how to go about
identifying the relevant literature, how literature on social functioning of children will be
handled to eventually become the content of the new technology, and what the
boundaries of the development will be, it is now necessary to describe how to express
this theoretical base in a format that will enable it to be applied in practice through the
new classification system.
Up until this step the literature will undergo a process of
synthesis or organisation. In this step the literature will include a process of reduction and
conceptualisation to produce the items of the new classification system.
This section is about the operational stages.
Operationalisation is one step beyond
conceptualisation (Rubin and Babbie, 1993:700). Step 5 describes how to formulate a
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theory and step 6 discusses how to identify and organise the vast amount of literature
needed for the study.
The remainder of this section explains how to establish more
specific measurable variables that will become the new technology.
The progression of measurement steps from a vague sense of what a term means to
specific measurements in scientific study, can be depicted as follows:
Conceptualisation
Nominal^Definition
Operational Definition
Measurements^in the real world
Ruben and Babbie, 1993:133.
FIGURE 2.3 THE OPERATIONAL PROCESS
Conceptualisation is the process which specifies precisely what is meant when a certain
term is used.
The end product of conceptualisation is the specification of a set of
indicators of what one has in mind, indicating the presence or absence of the concept
being studied. Different mental images can be conjured up by a certain term, and these
images can be grouped together to form dimensions - a specifiable aspect or facet of a
concept. A concept can therefore be subdivided into several sets of dimensions. The
inter-changeability of indicators implies that if several different indicators all represent, to
some degree, the same concept, then all of them will behave in the same way as the
concept would behave if it were observable (Rubin and Babbie, 1993:129-130).
Bailey (1987:55) defines operationalism as the term referring to operations carried out in
the measurement of a concept - the concept is synonymous with the corresponding set of
operations (that by which something is determined). Rubin and Babbie (1993:37) refer to
operationalisation as the specification of steps, procedures, or operations that you will go
through in actually measuring and identifying the variables you want to observe.
In order to be observed, variables must be translated into observable terms - these
translations are termed operational definitions.
This refers to the operations, or
indicators, which will be used to determine the quantity or qualitative category of a
particular variable when observed. The definition of a concept provides some idea of how
an operational definition might be developed, but it does not specify what indicators will
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be observed.
The operational definition points the way to how a variable will be
measured (Rubin and Babbie, 1993:124).
The real definition is not a stipulation determining the meaning of some expression, but
rather a statement of the essential nature or essential attributes of some entity. Essential
nature is so vague, however, that it cannot be used for rigorous inquiry. The specification
of concepts in scientific inquiry depends on nominal and operational definitions.
A
nominal definition is one that is assigned to a term. When disagreement exists about
what the term really means the researcher specifies a working definition for the purposes
of the inquiry. The specification of nominal definitions focuses our observational strategy
but does not allow us to observe. The next step is then to specify exactly what will be
observed, how this will be done, and how various possible observations will be
interpreted. All of these specifications make up the operational definition of the concept
and spell out precisely how the concept will be measured (Rubin and Babbie, 1993:131,
133).
If one considers that “measurement is a process that results in the consistent assignment
of individual characteristics or objects so they can be classified, ordered, or counted”
(Ottenbacher, 1997:17), then this study sets out to find consistent assignments of
characteristics in children to be classified as social functioning problems.
The
measurement process in clinical environments involves four steps:
■
Identifying a concept to be measured.
■
Specifying an indicator of the concept.
■
Defining operational data necessary for measurement, so they can be quantified or
classified into a variable.
■
Determining reliability and validity of the assessment process.
A concept then is a verbal or symbolic representation of the phenomenon the researcher
or clinician is interested in. Concepts are the building blocks of any language; they are
essential for professional communication and research.
A variable is a "measurable
dimension of a concept and is an indicator of a concept that is translated by means of an
operational definition into one of four levels of measurement: nominal, ordinal, interval or
ration" (Ottenbacher, 1997:18-19).
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The precise and exact naming of variables is important in research. It is both essential to
and a result of good operationalisation. Variable names quite often evolve from an iterative
process of forming a conceptual definition, then an operational definition, then renaming the
concept to better match what can or will be measured. This looping process continues,
resulting in a gradual refinement of the variable name and its measurement until a
reasonable fit is obtained. Sometimes the concept of the variable that you end with is a bit
different from the original one you started with, but at least you are measuring what you are
talking about, if only because you are talking about what you are measuring.
Fisher, 1989 (in Faul, 1995:177).
From the development of the theoretical framework that will be the goal of Chapter 3
| (Step 5), the information gained through the literature survey (Step 6) has to be
condensed into categories for the classification system to be developed. This will take
place through the process of operationalisation, in which the concepts derived from
Chapter 4 are employed.
For each concept, indicators will be developed and these
indicators will be quantified or classified into variables.
L
DEVELOPING THE DESIGN
The information accessed in the retrieval stage is converted into basic action constructs,
and through design processes these basic action constructs are used to formulate more
situational intervention concepts. These resulting concepts form the conceptual plan for
development.
The task of design, then, is creation of a conceptual formulation or plan,
which specifies the general form of an intervention, which satisfies the goal requirements.
Mullen, 1994:172.
2.2.8
Step 8: Draft the format of the new technology
Certain decisions need to be made with regard to the format and nature of the new
technology. Following the guidelines of the three models used in the Adapted Design and
Development Model (as described in Chapter 1), this step considers a few aspects to
|j ensure a workable format, and also ensures that the requirements for a measurement
and classification tool are met.
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"2 Sit.
The best framework to use as an example of how a classification system for social work
should look is the adult PIE. The researcher builds on her previous study on the adult
PIE in a psychiatric setting (for a detailed description of the PIE classification system refer
to this study, Oosthuizen, 1999). Although the classification system developed in the
course of this study will appear similar, it will obviously differ significantly from the adult
PIE. It is therefore necessary to make independent decisions regarding the appearance
of the classification system to be developed. The aspects regarding appearance which
are to be considered in the course of this study are outlined below.
2.2.8.1 The purpose of the technology
The appearance of the system relates directly to what it is intended for. Three classes of
things are measured by social scientists. The first class is direct observables - those
things we can observe rather simply and directly (e.g. selecting the colour of an apple).
Indirect observables include relative, subtler, and complex observations (e.g. the minutes
of a meeting). Thirdly, constructs are theoretical creations based on observations, which
cannot be observed directly or indirectly (e.g. intelligence).
A construct cannot be
observed directly because it does not exist - the researcher created it from a theoretical
framework (Rubin and Babbie, 1993:104).
Guion (1965, in Smit, 1991:148-149) states that test development is the development of
operational definitions. A test consists of operations, namely tasks to be performed, or
questions to be answered.
Smit (1991:149-154) identifies the following aspects in
describing the purpose of the new test (which in this study is a classification system)
being developed:
■
The content of the technology: The content is determined by the goals of the
technology. Two aspects with regard to content are identified, namely:
performance testing - depending on the goal of the test, the developer must
identify and define those (observable) behavioural aspects that manifest to identify
the trait or characteristic to be measured or tested.
predictive testing - a systematic analysis of the performance aspect is
necessary to be able to predict certain behaviour.
■
The test plan refers to the specifications regarding the aspects that should be
covered, the skills4hel-Hw§t be measured, and the relative weight the different
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facets of the behavioural aspect should carry in the final test form. Two aspects
of the test plan are discerned, namely:
the type of items, and
the amount of each type of item to be selected.
The decision on the above will give form to the test format, which can be one of the
following:
Free-response / open-ended items'.
No limits are placed on the
respondent’s reply to the task or question.
The respondent must provide the
answer instead of recognising the appropriate one. This type of item is dependent
on how specific it is, and has a limited coverage of the content. This can influence
its reliability.
This item is applicable to a broad spectrum of
Multiple-choice items'.
content,
namely
defining
terms,
identifying
causes,
consequences
and
association, recognising and identifying faults, etc. The multiple-choice format is a
question or incomplete statement with four or five possible answers. The criteria
for multiple-choice items are that each answer should have high face validity, the
statement must contain most of the wording, negative statements should be
avoided, the item should not ask the opinion of the respondent, the statement
should not be leading in terms of the ‘correct’ answer, the alternatives should be
presented in an ordinary format, and the response ‘none of the above’ must be
used sparingly. Developing a test like this can be very time consuming.
True-untrue items:
This refers to explanatory items to which ‘true’ or
‘untrue’ are possible responses.
This is limiting when specific, and sometimes
only trivial knowledge is tested.
| The new technology will include all three classes of measurables. The practitioner will be
the observer and will be able to report on direct observations, such as presented
behaviour, on indirect behaviour as reported on by others or predicted by the practitioner
based on theoretical knowledge, and on theoretical constructs, like including the tentative
classification of problems and appropriate intervention(s).
The goal of the new
technology will include aspects of both performance and predictive testing. The nature of
the client problem needs to be explained through the assessment and it should include
some prediction in terms of diagnosis and appropriate intervention. When looking at a
I system like PIE, it includes both these goals.
Even though the description of the test
format is not typically applicable (since the classification system cannot be seen as a
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test), the principles laid out for a multiple-choice type format are useful. These principles
relate to face validity, as indicated.
The challenge of using the multiple-choice format in
the development of the new technology is that it would have to contain all the possible
‘correct’ answers. The researcher would have to anticipate all the possible options the
user may need for a very diverse caseload (implying a vast number of topics to be
included in the literature search). The majority of problems should be able to fit into the
category options. The option of ‘other’ or ‘mixed’ should be avoided in principle, since this
would mean that the new technology is not making provision for most cases, or that the
categories are not well defined. The avoidance of the ‘none of the above category’ is
similar to Karls and Wandrei’s concept of ‘coverage’, which states that goodness of fit
between the system and practice is obtained when not many of the clients fall into the
residual category (refer to validity and reliability of the PIE in Step 14 of this chapter).
2.2.8.2 The length of the new technology
This is a further step in designing the new technology.
It is necessary to consider all
aspects of the final product.
Deciding on the length of the classification is critical, since this will influence its appeal to
potential users. The new technology attempts to offer more time-efficient assessment.
An overly lengthy system might discourage practitioners from adopting it.
The
classification system must serve as a comprehensive framework of general social work
practice, in which a considerable amount of information is consolidated. The length will
therefore be dependent on the number of roles identified in the child’s social functioning
and the number of indexes which clarify the problem experienced with the identified social
role. (This will be considered briefly in Chapter 5, but is excluded from the scope of
development of this study.)
The space-saving innovation in the adult PIE (placing
indexes in a text box below the role categories), will also be employed in the new
technology. An effort has also been made to reduce the number of role categories in
order to fit these onto one page (as with Factor 1 of the adult PIE), bearing in mind that
the lengthier part - the environmental systems - is still to be developed in the post
doctoral study.
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2.2.8.3 The selection, scaling and ordering of items
This forms a further step in deciding on aspects of the final product. All of these
systematic decisions will be explained in the course of the description of the new
technology in Chapter 5.
The selection of items is done according to difficulty value, discrimination value, and
information gathered from response-analysis.
Items with the highest combined
correlation with the criteria and low correlation with other items are selected.
Furthermore, items should correlate well with the total test score (Smit, 1991:167-168).
The implementation of the steps up to this point will shape the content of the new
technology. Not all selected items will necessary form part of the new development after
rigorous testing. Although the rigorous testing required for the final design (inclusion of
I items) of the new technology does not lie within the scope of this study, this step served a
purpose in demanding a re-evaluation of the degree of difficulty of those items initially
selected. Correlation tests will only be done after more data are obtained through post-
■ doctoral development.
Scaling items has to do with the development of a specific rule for assigning values to
them.
The reason for this is to obtain an indication of the level or magnitude of the
variable for a specific person. Different approaches exist for assigning values to scale
items (Faul, 1995:50-54), but for the purposes of this study, which involves the
development of a classification system and not a scale, these values do not apply. The
researcher nevertheless borrowed this step from Faul in order to illustrate what coding will
be used in the development of the new technology.
| The adult PIE uses a coding system that quantifies aspects like coping and severity. A
similar coding system will be adopted for this study. Only the meaning of the number will
be altered to reflect childhood dynamics.
The refinement and testing of this coding
system will, however, only be addressed after this study has been completed (it falls out
of the domain of the design for this study).
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In ordering the items, attention is paid to the final appearance of the new product to
ensure a logical flow. This flow will be determined on the basis of age progression and
the level of magnitude of the variable.
2.2.9 Step 9: Determine the role of users
The central aim of this new technology is to bring to practice an empowering mutual
language among social workers dealing with children.
It will not succeed unless
practitioners and academics believe it is workable. For this reason their input into this
project is essential.
Choices must be made in design and these choices are normative. Values enter into the
decision process, and consumers should therefore be involved in this process.
consumer needs are central in design choices distribution is increased.
If
On the other
hand, design can begin with the seed of an idea that grows and is formed by design
methods, and eventually gets adapted to a variety of possible users (Mullen, 1994:190).
Not only does this new technology stem from the ideas of the researcher, but also from
previous attempts of others (see Chapter 4) to quantify and objectively assess the
problems of social work child clients. As mentioned previously, a number of opportunities
for receiving input have been built into the development process. The findings and
suggestions that result from this study will be taken to experts in the domain of assessing
the well-being of children. These users will be asked for suggestions on how to make the
technology more practical. They may therefore be considered partners in the eventual
success of the technology in terms of meeting both academic and practice standards.
2.2.10
Step 10: Prepare user-ready innovation for consumers
The success of the new technology depends strongly on its accurate use and for this
reason a manual providing clear guidelines will be part of the package.
A common mistake in developing a measuring tool is to assume people will know how to
use it.
If respondents do not understand how to answer items, serious errors may be
introduced. Therefore clear instructions and introductory comments should accompany a
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measurement tool. Some guidelines with regard to instructions are to keep them simple,
explain what is being measured, display a response key, explain where to put responses,
and mention that there are no right or wrong answers (Spector, 1992; Mindel, 1982; and
Hudson, 1994 in Faul,1995: 56-57).
in the testing stages of the new development, before the final instruction manual can be
presented, some clear form of instruction is necessary. Faul (1995:63) argues that the
research package to be presented to respondents should include a cover letter that
explains the purpose of the study and introduces the research bodies conducting the
research.
Participation should be stressed as voluntary and anonymous. Secondly, a
background information sheet should accompany the package, used to describe the
characteristics of the sample, which will later be useful in investigating construct validity.
This sheet will consist of questions regarding the age, gender, education, marital status,
or income of the respondent or other information relevant to the study. The measurement
to be validated will comprise the content of the rest of the package.
The latter suggestions were incorporated when approaching and orientating the
! participants in the study.
The final manual will only be developed once the full
development and redesign have been completed. A temporary manual for the purpose of
testing the partial design will be developed for the sample’s use.
Participants will be
informed that the product has not been standardised and may not be used in practice
outside of the study.
2.2 J1
Step 11: Facilitate feedback on current development
! Since not all potential future users can be reached at this early developmental stage,
J participants are needed who will understand that they are required to evaluate a work in
!| progress. They are not being presented with a final product which necessitates either
approval or disapproval.
| Practitioners and academics will be presented with a progress draft on different
occasions, in order to obtain feedback. This feedback will be used to modify the product
; being tested, and to check unforeseen problems in the new technology. In addition, the
i researcher can confirm whether she will be able to meet the requirements set out by the
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research design, as well as the needs of the practice sphere.
Chapter 6 tables the
feedback assemblage that provided opportunities for feedback, with a description of the
people who provided feedback.
PRODUCT TESTING AND STANDARDISATION
Standardisation
refers
to
both the
standardisation
process
that precedes
administration of the test, and the use of test data after application.
the
The aim of
measurement is to acquire objective and accurate information for the evaluation of
behaviour.
This information is the result of close control of factors that may have a
differential effect on the results.
This control has to do with the first function of
standardisation as mentioned above. The second function of standardisation has to do
with the interpretation of findings and the development of norm scores (a quantitative
value or symbol for expected, normal or average behaviour for comparative purposes).
The end result of the latter process is a standard procedure for interpretation.
The
aspects to be checked with regard to standardisation, include the content, the application
procedure, and the interpretation procedure (Smit, 1991:168-169).
This phase is concerned with the procedures to be followed in testing the new technology
in order to ensure that it will eventually be applicable in social work practice spheres.
2.2.12
Step 12: Determine the developmental research procedure
It is necessary to stipulate the plan by which the new technology will be developed and
tested. The analogy of a train can be used to describe this step: the research procedure
can be compared to the tracks that are needed for the train, with the train being the
design of the total study. The data-gathering is like the load that the train picks up and
the destination of the train is the interpretation of results which are applied to the final
development.
According to Bailey (1987:33), ‘methodology’ refers to the philosophy of the research
process. This includes the assumptions and values that serve as a rationale for research
and the standards or the criteria the researcher uses for interpreting data and reaching
conclusions.
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It is necessary to mention again that this initial study involving the partial development of
a classification for children, will only involve a pilot study. A pilot study is a tentative,
small-scale study done to pre-test and modify study design and procedures (McBurney,
1994:185).
In conventional research on practice, one usually concludes a study with implications of the
findings for practice. The researcher hopes that these suggestions will somehow and someday
influence future practice. In contrast, modifications suggested by developmental research are
incorporated directly into the intervention under development.
Reid, 1994:261.
j The above quote is significant to this study. Having as its aim to develop a classification
| system, Chapter 5 will indicate how the development takes place, Chapter 6 will present
| the results, and Chapter 7 will introduce the improved version - the one that will take the
| findings into consideration to modify the first attempt. The ‘true result’ of this study will
j then be an improved prototype of the initial development this study sets out to
| accomplish.
| As a guideline to how the final prototype of the new technology will be developed, at the
I researcher examines what is required when a design and development study are being
i conducted she then considers how the data will be acquired and managed, since this is
I crucial to reporting valid and reliable data.
2.2J2.1
Design and development competencies
Within the framework of this study methodology the new technology, and the process of
developing it, should lead to the following design and developmental competencies:
■
Mastery of theoretical and conceptual background knowledge concerning human
service problems, social science disciplines, and research methodologies.
■
Ability to identify, define and conceptualise major social and behavioural
problems, treatment methods and unresolved issues for intervention modalities.
■
Ability to identify relevant sources of knowledge and information for problem
solution, and to retrieve, assess, order, and synthesize their contributions for
application purposes.
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■
Ability to design innovative intervention strategies and techniques derived from
the diverse sources of knowledge and information.
■
Ability to engage in development processes, that is, to operate intervention
procedures, to submit them to pilot and developmental testing, to revise them as
appropriate and to come up with innovative, field-tested interventions.
■
Ability to employ multiple methodologies in development and evaluation - needs
assessments; quantitative and qualitative approaches; basic research methods;
single-case experimental designs; group- and quasi-experimental designs;
measurement instruments and
practice related to recording procedures;
developmental practice and methods of proceduralisation; diverse techniques,
such as those of human service practice (treatment planning), task analysis and
flow charting; and selected aspects of programme evaluation now employed for
assessing, modifying, and developing interventions in a phased sequence.
■
Ability to work cooperatively in practice settings, to gain the support of
practitioners, and to handle politics of field research and of outcome evaluation.
■
Ability to communicate research results differentially to both the scientific
community and to professional practitioners and administrators (Thomas and
Rothman, 1994:372-373).
The researcher uses the above competencies as a guideline for this study, and will
evaluate herself against these in Chapter 8. Following from the first guideline above, she
sets out to gain a theoretical background of childhood social functioning.
2.2.12.2
Interrater testing
The central research problem is to give social workers dealing with children a
comprehensive and representative model with which to classify social functioning
problems. The methodology of the Design and Development Model has a number of
advantages. Firstly, it is oriented toward creating a specific solution, strategy, or answer
to a specific problem. The primary research question is ‘how to’ (where the focus is on
development) rather than ‘why’ (where the focus is on explanation).
Secondly, this
method actively and meaningfully involves practitioners in all phases of the project.
Clinical judgement, practice wisdom, and subjective evaluation of practitioners are viewed
as valid and important pieces of information (Whittaker et al., 1994: 197).
The best
strategy to address this problem is therefore to ensure a valid theoretical foundation and
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to apply it to practitioners to test its reliability and applicability.
The judgements and
experiences of practitioners would be the main sources of information.
One method of obtaining these judgements and experiences from practitioners is to
establish interrater reliability or agreement amongst raters.
The existence of high
agreement suggests reliability of the classification system. Chapter 6 in this thesis will
elaborate on the interrater testing that will be done through the use of pilot testing. The
manner in which the test will be approached is discussed next.
The researcher will present a case study in either a transcript or written form. The case
study will be presented to various trained practitioners with instructions to study genuine
cases from practice and to use the new technology to classify the social functioning
problems of the child. In reality more than one interview will probably be necessary to
make an accurate assessment, and the case studies will therefore also differ in the
information available (some will be short with intake information, others may include
reports from other disciplines, etc.). The classification system can be used throughout the
helping process, and it is unrealistic to expect all the information to be available by the
first or second contact. The data to be analysed will be the classifications given by the
respondents. The questionnaires administered to elicit their opinions should be geared
towards finding out what their practice needs are, and whether or not these needs can be
met by the classification system.
2.2.12.3
Data management
The mixed methodology approach means that different sets of data are obtained for
analysis - both qualitative and quantitative. The data gathering process will involve the
preparation of a preliminary manual with instructions, definitions and case studies; finding
participants and training them; facilitating the implementation of the classification system
with the case studies; and the completion of the questionnaire on their experiences of the
system. It must be borne in mind that data gathering in this step refers to the data from
the testing done on the classification system. Previous management of data referred to
the method of data gathering and how this would be managed for reduction and re
organisation into a new theoretical construct.
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Data management is even more crucial with the dual qualitative and quantitative
approach. This study will initially use only a small sample. For this reason the researcher
will not have a large amount of data to handle, but will need to have clarity on which data
is to be gathered for quantitative analysis and which for qualitative analysis.
The
organisation of the data in this way will be facilitated by using separate methods for the
different sets of data (see Chapter 6).
She will use Microsoft Excel to clean up and
organise the more quantitative data, which will then be handed over to a student
consultation department that specialises in statistics at the University (STATCON). This
will ensure objective and accurate data processing, and will produce frequency tables that
can be used to determine specific and overall agreement (see Chapter 6). The qualitative
data will also be organised into a table, and answers to open-ended questions will be
presented in Chapter 6.
Stouthamer-Loeber (1995:101-105) highlighted the importance of keeping missing data to
a minimum and using data checking strategies as part of the capturing process. By using
a similar format to the interview schedule on the computer, the researcher can
immediately spot when the instructions were not followed and a wrong skipping-pattern
was used. This is useful information for subsequent testing where the question can be
asked differently. Inconsistent information is also not necessarily a bad thing in research,
as it can provide information on why different answers were given.
Data documentation is an important part of data management.
preserved in an organised fashion.
different kinds of file structures.
Data files need to be
Different types of data require setting up files with
In longitudinal studies it may be more economical to
maintain separate data files for each assessment wave.
Every instrument will not
necessarily be used in all waves, and it may be the case that not all participants agree to
be interviewed at every period.
many empty data cells.
If all information were stored together there would be
Each research project should thus maintain a collection of
different data files that will be part of a data bank (Stouthamer-Loeber, 1995:106-107).
Managing data is an important part of testing the new technology. It would be easiest for
different participants to be included at different testing times; not only to disseminate the
system to a wide variety of practitioners, but also to continuously obtain new perspectives
and ideas on the development. As she continues to test the refined new technology, the
researcher will develop a data bank.
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Each study needs a system to organise its files. There are generally three types of files
according to Stouthamer-Loeber (1995:107-108): The first type contains the assessment
data in a cleaned and coded format. The data in these files are called raw variables and
are the result of the previous data management steps. Each study develops a system of
naming raw variables that makes the names unique and easy to trace. One method of
doing this is to name each variable that starts with the phase identifier followed by the
number of the question.
One of the most valuable features of the PIE classification system is that, because it uses
numerical coding in its framework, it already has a representative code with a variable
name. The data gained from the respondent is therefore received in the form of named
variables. The file to be used to contain this data will take the form of a Microsoft Word
computer file in which a table is created to hold the data.
The second type of file contains derived variables. Raw data is not usually analysed in its
original format but is transformed or combined with other raw variables to create derived
variables (summary scores of added scores from different studies; recoding of variables;
or where missing values have been imputed). Identifying derived variables can be done
in such a way that the name of each variable reflects the content of the data field. This
may eliminate the need for an explanation of the variable names and make analysis
printouts easy to examine. If the creation of derived variables is integrated as a routine
procedure, it will be relatively easy to maintain a catalogue of these variables with
documentation that includes all arithmetic transformations, recoding procedures, value
labelling statements, and internal procedures such as internal reliability testing. Derived
variables that are constructed during the data analysis process are harder to track.
Documentation for these variables may be embedded in files with statistical analysis
procedures or may not exist at all if they were created interactively without the existence
of a log (Stouthamer-Loeber, 1995:108).
| In order to prove that the new technology is reliable and valid, huge-scale testing of the
final product will eventually be necessary.
It is therefore essential to keep files that
contain derived variables. What makes it easy with the new technology is that, because a
classification system is to be developed, the category names are descriptive of the
variable being tested and the latter therefore already has a name that describes the
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content.
These files will only become relevant as more data is gathered to form a
catalogue of the variables that can be used to interpret the validity and reliability of the
new technology (as a post-doctoral study).
To monitor the derived variables, a data bank that is able to retrieve the following
information about each variable, can be used (Stouthamer-Loeber, 1995:109):
a) description of the content; b) the raw variables included in creating the derived variable;
c) the construction data; d) the name of the procedural file that created the variable; e)
the person responsible for constructing the derived variable; and f) the publication(s) in
which the variable was used.
This system facilitates the reconstruction of previously
reported results, since it enables the researcher (or any other user) to search for such
results and existing derived variables in order to avoid duplication.
When errors are
discovered in raw variables, the system permits the identification of all derived variables in
which these flawed raw variables were included.
The third type of file contains information related to the data collection effort such as files
that keep track of the detail about the participants and the study - tracking files.
In
addition, these files should be archived to prevent disaster when buildings go up in
flames, burglars walk off with computers containing hard drives packed with information,
or hard drives crash (Stouthamer-Loeber, 1995:107, 109).
I Back-ups of the data for this study are stored on compact discs, which are kept in a safe
that is theft and fire resistant. This also serves as precaution against any possible forms
of computer failure.
According to Cooper (1989:81), data analysis means the categorisation, ordering,
manipulating and summarising of data to obtain answers to research questions.
The
purpose is to reduce data to intelligible and interpretable form. Cooper (1988:81) also
argues that interpretation takes the results of the analysis, makes inferences pertinent to
the research relations studied, and draws conclusions about these relations.
The data analysis takes form through the implementation of steps 6 and 14 in this thesis.
Firstly with regard to the literature accumulated to provide the content of the new
technology, and secondly to interpret the data gained from testing the new technology to
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determine how good the development is. Reducing the data to intelligible form will take
place throughout Chapters 3 to 7. The focus of this study is the use of literature and
findings to develop a classification system for childhood social functioning.
The final aspect of the research process is critical, namely sharing the findings with
outside researchers and practitioners. This could involve sharing the data acquired in
another study.
Sharing data with researchers outside of the immediate project staff can be a tremendous
benefit to a project. Other researchers may have different points of view from the original
research team or a different expertise that may broaden and increase the yield from a study.
In addition, the original findings of a research team may be verified, refined or even
contradicted by outside researchers.
Stouthamer-Loeber (1995:110).
The researcher believes that this project should be geared towards the application of
funds for the preparation of data sets and for the provision of assistance at a later date.
Researchers are likely to come to the conclusion, however reluctantly, that they must
charge for the use of their data set. As the burden of servicing outside projects becomes
detrimental to the ongoing work of the research group, so requesting contributions
becomes a necessity.
Data sharing with outside researchers requires a clear understanding of how the data will
be used and for what purpose.
To prevent unpleasantness, a data sharing contract
should be drawn up, which specifies who will have access to which part of a data set and
for how long. The contract should include an outline of the questions to be addressed
and an analysis plan to make sure that the data is not misinterpreted or later used for a
different purpose. The investigator may preserve the right to examine the results before
they are disseminated, not to act as a censor, but to ensure that the data have been
interpreted correctly and that there is no unnecessary duplication in reporting.
It can
further specify what kind of help will be offered by the original research group
(Stouthamer-Loeber, 1995:111).
—-------------------------------------------......................................... —
----------------------In the researcher’s case, the sharing of data would serve as a welcome answer to the
problem of how to get sufficient scores from the implementation of the new technology to
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| be able to conduct bigger scale testing (at post-doctoral level)
Data sharing also involves letting others know in more general terms what the findings of
the study are. The purpose of doing this is to inform others who may be interested in the
topic and to build on the. scientific knowledge of the profession.
This involves report
writing.
According to the definition of thesis (see glossary of terms), this study is already a form of
report on the researcher’s arguments and findings.
Apart from this document, the
J researcher will also report on this study in journal articles.
2.2.13
Step 13: Select sample and apply
The purpose of this step is to describe the requirements set out for the selection of a
sample, and to explain the method used to gather the respondents and get them to the
point of participating in the testing of the newly developed classification system.
In the analysis phase of the Design and Development Model, the main tasks involve
identifying and analysing the social problem, and selecting information sources from
which to generate innovations (Whittaker et al., 1994:198).
In extreme or deviant case sampling participants and situations are selected that are
most likely to provide information rich data. Snowball or chain reference sampling is
used to gain a holistic understanding of the meanings of interconnected networks.
Through this technique the researcher is referred to other relevant sources of information
(Schurink, 1998:254 and 255).
The researcher will select the sample based on the following criteria for the purposes of
the testing: firstly, participants should fall within the age category of 30 to 55 to ensure
that the group has adequate experience; they should have some training in assessing
children; and they should be as homogenous as possible in order to control external
influences on the testing environment. This can be achieved through attempting to find a
group that are of the same gender and work in the same area.
The researcher will
approach organisations and individuals who know of social workers specialising in some
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manner with children and who are interested in new developments in social work. She
will identify at least three suitable raters from the references, to test the classification
system’s interrater reliability and to acquire qualitative data on the rating experience. The
participants will have to attend a workshop where they will be trained in the correct use of
the technology - findings derived from a poor understanding of the technology would
obviously not be valid.
2.2.14
Step 14: Technical analysis (validity and reliability)
Since the researcher is developing a classification system, she will examine the elements
used in testing the PIE’s value in practice.
Having taken cognisance of the array of
standardisation strategies, she focused only on those utilised in the study in this section.
The ‘technical analysis’ that is the focus of this step will then only reach its fullest potential
once the whole system has been developed as part of a post-doctoral study.
A
preliminary reliability study will be done on the partial development, to ensure the validity
of the content of the new technology, which forms the foundation of this study.
Krefting (1990) and Agar (1986) (in Poggenpoel, 1998:348) are of the opinion that
qualitative research is often evaluated against criteria appropriate for quantitative
research, although the nature and purpose of the two differ considerably.
A new
language is needed for the assessment of qualitative studies. Terms such as credibility,
accuracy or representation, and authority of the writer, should replace terms like
reliability and validity.
The criteria mentioned by Poggenpoel are significant to this study.
The researcher is
placing a high value on the experience and authority of the developer of the adult PIE,
and will consider his advice on this study as an important indicator of validity and
reliability. It will become apparent in the next section that the developers of the adult PIE
also considered both qualitative and quantitative criteria in the standardisation of their
development.
2.2.14.1
Validity and reliability used with the adult PIE
Efforts to develop what is now known as PIE started in the 1980s through the California
chapter of NA8W, whose president at the time was James Karls. PIE was conceived in
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part as a reaction to DSM III and its perceived limitations for use within social work
practice, and in part as a response to trends and new developments in social work
practice and theory (Wandrei and Karls, 1997:29). American social workers also felt that
they were learning the language of psychiatry to describe their patients, since this was the
only system available to them (Karls and Wandrei, 1992:80).
The original system was established by 1983, and has since had minor modifications in
response to peer reviews, feedback from workshop attendees, feedback from users, and
pilot reliability and validity studies.
PIE can be seen as an on-going work in progress
(Wandrei and Karls, 1997:29).
In 1984 there was a review of the earliest version of the PIE by 16 eminent social workers
throughout the country.
Of these experts, 14 responded favourably to the system.
Additional feedback and suggestions for revisions were obtained from 12 years of the co
authors presenting workshops on the system to several thousand social workers in the
Unites
States
and
other countries.
Responses from participants
have been
overwhelmingly positive (Wandrei and Karls, 1997:32-33).
In 1984 a nation-wide pilot test of the initial version of PIE was conducted. Two chapters
from each of the nine NASW regions were selected, with five members from each chapter
representing different theoretical orientations, direct practice settings, and length of time
in practice. Participants were asked to apply the system to two clients, and then to
complete a questionnaire about their experiences. Sixty-two social workers responded to
the questionnaire. Most indicated they were able to use it with their clients with minimum
difficulty. Eighty-two percent reported that it helped identify when social work intervention
was needed, and 76.4% reported that it clearly and concisely described the client’s
situation and said that the manual was easy to understand. On measuring whether or not
the system would allow communication with other practitioners, 64.7% responded
positively. Furthermore, 64.6% said the systems would be useful in their clinical practice,
and 52,9% reported no problems in using the system. The results of the field test were
then used to revise the system (Karls and Wandrei, 1992:81 and Wandrei and Karls,
1997:33).
A pilot study funded by the NASW was conducted in 1991 in four sites. Using video
taped case material in these tests, a total of 197 ratings were made across 16 video
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tapes, with from 4 to 30 raters per tape. While the size of the study did not give enough
ratings across the range of PIE categories to make definite statements about their
reliability possible, there was high agreement among the social workers using the system
on the identification of the PIE categories. These formal and informal utilisation and pilot
testing suggest that that the PIE system has likely acceptability and feasibility in practice,
and likely reliability (Wandrei and Karls, 1997:33).
For Wandrei and Karls (1997:32-33) it was important to establish the usefulness that the
classification steps would have for practice. They did so with the adult PIE by ensuring
the following:
■
Acceptability, which concerns itself with whether the users agree that the
categories and their definitions have face validity, that is, whether they
encompass the language and ideas of the profession.
■
Feasibility, which indicates whether the system is understandable and easily
applied.
£
Coverage is achieved to the extent that there is goodness of fit of the system in
practice, and that not many clients fall within the residual categories (those
designated ‘unspecified’ or ‘other’).
■
The reliability of a system indicates how well practitioners using the system can
agree with each other on the identification of the categories.
■
The validation of a system is a measure of its usefulness, and reflects how well
it measures what it is supposed to measure.
For the pilot testing of the new technology, the researcher will make use of a qualitative
questionnaire to determine whether her sample agrees on the acceptability, feasibility,
and coverage of the initial development, and to see what changes they suggest.
Determining validity is approached through the guidelines to be used in the literature
study and through the synthesis and operationalisation of the theoretical concepts
discussed in previous steps in this chapter. For reliability at this early stage of testing the
researcher will also use rater reliability as with the adult PIE.
What needs to be
determined through validity and reliability testing is discussed next.
- -
2.2.14.2
Validation methods
A valid instrument measures what it is supposed to measure and yields scores whose
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differences reflect the true differences of the variable being measured rather than random
or constant errors.
Thus a valid instrument actually measures the concept in question
and measures it accurately (Hudson, 1981 in De Vos and Fouche, 1998:83).
Reliability, of course, is only a precondition for good data quality. By itself it does not show
that the data are adequate representations of particular behaviours.
To accomplish this
validity must also be assessed. Validity is the degree to which a set of data represents what
it purports to represent. Validity is more difficult to measure or ‘prove’ than reliability, as it is
inferred from circumstantial evidence that an observed score is or is not a credible
representation of the behaviour of interest. To gather evidence of validity, the existence of a
theory or a reasonable conceptual framework is critical. With a theory at hand, three main
types of evidence of observational data validity can be obtained: content validity, construct
validity, and criterion-related validity.
Lindahl, (2001:27-28).
Proving the latter will not receive attention in this study, but it confirms the researcher’s
decision to work first on a conceptual framework that will be acceptable to most social
workers.
The process by which research data is obtained and handled has an important influence
on how valid the overall study will be.
To ensure valid data that will support the
acceptance of the new technology as a non-biased, scientific measurement, data analysis
forms an important part of the validation process. Since verification involves checking for
the most common biases that can steal into the process of drawing conclusions, it is clear
how this should be used with reference to measurement error (as described at a later
stage). The following summary serves as guideline for the qualitative data analysis task.
This guideline was developed from the work of Huberman & Miles (1994), Marshall &
Rossman (1989), and La Biondo-Wood & Haber (1994), in Poggenpoel (1998:351-352).
Some of the most frequent shortcomings include the following:
a. Data overload in the field, leading to the analyst missing important information,
overweighing some findings, and skewing the analysis.
b. Responding to the most salient (noticeable) first impressions or observations of
highly concrete or dramatic incidents.
c.
Selectivity or overconfidence in some data, especially when trying to confirm a
central finding.
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d. Co-occurrences taken as correlations or even as casual relationships.
e
False base-rate proportions; extrapolation of the number of total instances from
those observed.
f.
Unreliability of information from some sources.
g. Over-accommodation
of information
that questions
outright
the
tentative
hypothesis.
Tactics used to ward off obvious biases are:
h. Checking for adequate representation.
i.
Checking for researcher reactivity.
j.
Triangulation (comparison of results of two or more methods) and weighing of
evidence.
Tactics for the testing of viability of patterns centre around:
k. The active search for contrasts.
l.
Comparisons.
m. Outliers and extreme cases.
More elaborate tests of conclusions attempt to:
n. Rule out spurious conclusions.
o. Replicate key findings.
p. Check out rival explanations.
q. Look out for negative evidence.
r. Obtain feedback from respondents can be used at any point in the cycle.
s. Make use of a more general and comprehensive approach such as auditing, which
is a systemic review of a given study on the part of an external examiner.
A minimum set of expectations is required for the verification of qualitative research,
giving information regarding the following:
t.
Sampling decisions made within and across cases.
u. Instrumentation and data collection operations.
v. Database summary, size, how produced.
w. Software used, if any.
x. Overview of analytic strategies followed.
y. Inclusion of key data displays supporting data.
z. The following questions are asked in this regard:
•
Are findings grounded in data?
•
Are inferences (conclusions) logical?
•
Can enquiry decisions and methodological shifts be justified?
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•
What is the degree of researcher bias (premature closure, unexplored data in
field notes, lack of search for negative cases, feelings of empathy)?
•
What strategies were used to increase credibility (second readers, feedback to
informants, peer review, adequate time in field)?
The researcher termed all these steps or suggestions, the ‘a to z’, and will use these as
guidelines during the data gathering, analysis, and interpretation phases, whilst also
guarding against making this validation process too extensive. The new technology will in
essence classify observed or reported behaviour that will give an indication of where
problems might lie in terms of the child’s social functioning within his/her environmental
context.
The validation of the technology will therefore have a strong foundation in its
theoretical, conceptual framework. This framework will be influenced by ecological and
ecometric theory, but will have as its focus the use of the most popular, holistic theories in
social work with a strong inclination towards practical and useful intervention.
In this
initial phase the researcher will make use of her own judgement and practical experience
to discern which theories to use, but will build in an assessment of their relevance in the
actual data gathering phase, as well as during the doctoral presentations throughout the
study to peers and colleagues.
Reflections on the validation strategies used are
presented in Chapter 8.
2.2.14.3
Reliability testing methods
Reliability of an instrument refers to its accuracy - the degree of consistency or
agreement between two independently derived sets of scores, and the extent to which
independent administrations of the same instrument yield the same or similar results
under comparable conditions (Hudson, 1981 in De Vos and Fouche, 1998: 83 and 85).
Most measurements in the behavioural sciences involve measurement error, but
judgements made by humans are especially prone to this problem ... a reliable instrument is
one with [a] small error of measurement, and one that shows consistency and stability of
scores on the behaviour being evaluated ... With respect to observational data, reliability is
most commonly thought of in terms of the extent to which two observers, working
independently, agree on what behaviours are occurring.
Lindahl 2001:25-26.
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Test-retest reliability means the repeated application of the same measure. A reliable
measurement tool will show a change in the value of the characteristic being measured
and should not show a change when none occurs (Bailey, 1987:72-73). The same test is
used and a difference in values is attributed to a change in that being measured.
Rubin
and Babbie (1993:168-169), however, highlight the problem with reliability testing.
Should the measuring tool be incorrect it will still give similar readings and would
therefore be viewed as reliable, although it is not. They also see other problems, such as
the fact that how we feel when we do the measuring is likely to colour what we see, which
means we may misinterpret what we see.
The type of measurement reliability that is most relevant to a particular study varies
according to the purpose and design of the study. If the study involves judgements made
by observers or raters, for example, then we need to assess the extent of agreement, or
consistency, between observers or raters.
This is called inter-observer reliability or
interrater reliability (agreement).
Rubin and Babbie, 1993: 170.
Rubin and Babbie (1993:170) further state that, to assess interrater agreement, two raters
are trained and shown the same case studies in order to independently implement the
same measurement (the classification system in the case of this study).
If they show
agreement of 80% or more (70% might be acceptable) in their ratings, one can assume
the amount of random error in the measurement is not excessive. Instead of calculating
the percent of agreement, the correlation between two sets of ratings can be calculated.
This means judging whether both used high or low scores and whether they went in the
same direction (both up or both down), even if they did not agree on the exact
number/score.
Correlations can range form 0 (no relationship) to 1.0 (a perfect
relationship with no random error).
This strategy for testing the reliability of the classification system actually fits both
meanings of standardisation given at the beginning of this phase. The conditions under
which the raters implement the technology can have a crucial influence on the agreement
in ratings. Control of differences among study respondents and consideration for external
influences such as fatigue, work pressure, motivation, etc. all received attention in the
selection and administration of the sample.
In an attempt to prevent errors and possible
bias during the test procedure, the researcher will make use of genuine practice case
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studies, provided by an independent social worker in private practice. Obtaining scores
on how many raters agreed on the same case study, falls under the second meaning of
standardisation where accurate interpretation of the result needs careful consideration.
2.2.15
Step 15: Identify and address design problems
Data obtained from the interrater study and qualitative feedback serve as ‘evidence’ to be
used to make alterations to the development. In addressing the problems that become
evident during the developmental process, certain aspects need to be addressed. These
are considered below.
Developmental work begins with trials of the intervention in a series of case studies. The
case study provides preliminary data about the intervention under study: how it is actually
carried out, what problems practitioners experience in applying it, how well it appears to
achieve its immediate goals, and what apparent longer range effects it has. Answers to
these questions help identify areas for improvement (Reid, 1994:247). Reid (1994) also
mentions a number of tools and structures that facilitate the pursuit of these answers,
although these will not be discussed at this stage. The immediate implementation of
findings naturally forms part of developmental research. A formal step such as this one
will become necessary as the development of the classification system progresses. For
example, aggregate analysis can only be performed when a significant number of single
case studies have been accumulated.
2.2.16
Step 16: Advanced development
The purpose of this step is to determine whether what has been learned through the trial
tests is sufficiently positive to justify further development. This has considerable bearing
on a possible post-doctoral study.
According to Thomas (1994:267), an integral part of the innovation process is that
evaluation should provide the necessary results to determine whether an innovation
should be retained and utilised as it was designed, or whether should it be redesigned
and developed further.
Satisfactory results in evaluation generally provide a basis for
moving ahead into dissemination.
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Advanced development presupposes that initial design and pilot testing have been
carried out with the intervention and that what has been learned in the earlier trial use is
sufficiently positive to justify more systematic appraisal of intervention outcomes
(Thomas, 1994:268).
Evaluation and advanced design and development have three related requirements
(Thomas, 1994:272-274):
■
The evaluation should constitute a fair test of the outcomes of intervention.
Ideally a control group, which received the intervention versus a no-treatment
group, can provide valuable comparison to strengthen the design.
■
A service requirement in which the intervention being evaluated should provide
the human service for which objectives of the intervention were intended. The
intervention should not be evaluated against what it was not intended for.
■
Advancement of the intervention calls for implementing the intervention in the
evaluation so that development of the intervention is furthered beyond that
which was accomplished in the earlier pilot testing.
The scope of the
development should not be exceeded, however.
The areas of advanced development need to be coordinated with those of initial
development as well as with the requirements of service, evaluation, and advanced
development, while also bringing the three together in a complementary relationship.
Thomas (1994:275) also mentions a number of tasks related to evaluation. These will be
addressed when necessary - towards the finalisation of the whole classification system
(post-doctoral).
2.2.17
Step 17: Proposal for approval of product from accreditation committee
Because of the uniquely South African context in which social work assessments are
currently scrutinised for accreditation, the researcher included this step as a necessary
part of receiving endorsement for the development from the South African Council for
Social Service Professions (SACSSP).
The Ecometric Paper presented by the committee established by the SACSSP for
accreditation of ecometric assessment as a specialised field in social work, will be used
as a guideline for applying for accreditation of the new technology as an approved
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ecometric tool for social workers in South Africa. This step will be implemented outside
the scope of this doctoral study.
MARKETING AND DISSEMINATION
The purpose of development research is to offer an intervention for practice. The new
technology should therefore be marketed and disseminated to the target group it is
intended for (i.e. social workers). This phase will only be executed when the development
of the new technology has been completed and has undergone sufficient testing and
advanced development. Important elements of the steps in this phase will be highlighted
but will not be discussed in this chapter, since it falls out of the scope of this research
study.
2.2.18
Step 18: Develop the marketing plan
A new assessment tool is only as good as the extent to which it is used by the
practitioners it is intended for. One major influence in the probability of the tool being
used is how effectively it is marketed.
Practitioners need to know of its existence first
before anyone will know to use it. This step also forms part of the blueprint of the next
phase to follow in the design and development process.
Fawcett, et al. (1994:39-43) outline the following operations to help make the process of
dissemination and adaptation more successful:
■
Prepare the product for dissemination:
Several issues emerge in this
process: choosing a brand name, establishing the price, and setting standards
for the intervention’s use.
■
Identifying potential markets for the intervention:
To do this the following
questions need to be asked: Which people can benefit from the intervention?
Who, with the use of the intervention, can contribute most to problem solving? Is
the goal of dissemination broad-based adoption or restricted to selected
practitioners? Which market segments would most likely adopt and benefit from
the intervention if they were aware of it? Which media approach - public service
announcement, direct mail, or other - would be most appropriate and feasible to
inform the market segment? It may also be helpful to identify ‘early adopters’
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whose use of the product might encourage others in the selected market
segments to adopt the intervention.
■
Creating a demand for the intervention:
Potential purchasers must be
convinced that they will really benefit from the intervention. Strategies used in
marketing of innovations include modelling, sampling, and advertising.
■
Encouraging appropriate adaptation:
Reinvention of an innovation occurs
when adopters modify the intervention to fit local conditions after its original
development.
There exists tension between permitting reinvention and
preserving the quality of the intervention.
Encouraging adaptation may
accelerate adoption, but some changes may result in loss of effectiveness,
dependability and other valued attributes of the innovation.
■
Providing technical support for users: Support might be needed to adapt the
intervention to the specific needs of the implementers.
Providing support is
important in order to maintain long-term client satisfaction.
2.2.19
Step 19: Addressing dissemination barriers
Certain obstacles can be anticipated. This step discuses possible barriers as a means of
highlighting awareness of their existence.
The barriers that may be anticipated in dissemination are outlined below (Corrigan, et al.,
1994: 318-325):
■
Innovation-related barriers: A split between scientist and practitioners exists in
terms of published and validated treatment methods and their use by clinicians.
The rigorous methods and conservative inferences that guide clinical research do
not readily yield meaningful clinical products. Statistical significance may have
little in common with clinical significance. There may be little correspondence
between treatment effects on the average patient and real effects on the
everyday patient.
■
Institutional constraints:
Introducing innovative programmes into existing
organisations requires targeting two populations for acceptance and use of the
innovation: the patients for whom the treatment was developed, and the change
agents responsible for carrying out the intervention. To motivate clinicians to
change their treatment approaches and gain competence and comfort in using
innovations may require control over rewards that affect staff behaviour.
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■
Practitioner barriers:
Using the innovation may clash with professional role
identity. Differences in therapeutic language may lead to the innovation being
judged as inappropriate. Specific problems include developed treatment plans
that are inconsistent with perceptions of client skills, frequent staff turnover
preventing consistent implementation, and staff with low morale having little
motivation or competence to faithfully carry out innovations.
2.2.20
Step 20: Start training workshops
How the innovation will be presented to participants will determine future use. The new
product may be good but if it is not received well by the trainees, this can detract from the
success of its implementation.
This step looks at strategies to be considered in the
training workshops through which future users will be trained.
Glaser and his colleagues (1983 in Corrigan, et al., 1994:329-331) outlined five strategies
that facilitate implementation as innovators introduce a new programme into treatment
settings. These assist in presenting the product in a more acceptable way:
a. Staff more readily accept innovations if they are able to observe a
demonstration of the intervention.
b. Innovators should clearly communicate the relevance of the technique to the
resolution of problems in treatment settings.
c. The relative advantage of implementing new interventions in place of or
through existing programmes should be highlighted, especially in terms of difficult
client issues.
d. Staff members more readily accept innovations that are easily understood. The
pre-packaged and highly prescribed nature of modules facilitates this goal.
Innovators should be aware that the modules may be implemented by persons of
a wide range of educational levels, and must key their introductory discussions
appropriately.
e. Implementation is facilitated when innovations can be ‘phased in’ with evidence
of incremental success along the way. Seasoned staff members are wary of
ambitious programmes that seek to rewrite existing positions and practices.
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2.3
Summary
The process outlined in this chapter is comprehensive.
It is intended to guide the
development of a new technology - ensuring that it produces a standardised technology
and that all the requirements for implementing the technology in practice are considered.
Throughout each step, the intent of the step is highlighted in blue, while the method
through which the step will be implemented is highlighted in red. In the chapters that
follow, the researcher has indicated what steps are being addressed at each stage.
Because of the boundaries set for this study (as discussed in step 4 in this chapter), not
all the steps of the Adapted Design and Development Model will be addressed in this
thesis.
The developmental process followed in this study, which forms the research design for
the study, should not be confused with the research methodology.
The research
methodology has to do with how data will be obtained through tests done on the new
development, and how the data will be analysed and interpreted. The research design
sets out the total process followed in developing a new technology. Its phases guide the
research with regard to pre-development, design, testing, and dissemination.
The
research procedure (methodology) is one step in this process. The procedure attempts to
address the research problem through a research goal, a research objective, a research
approach, and a systematic plan for gathering data, from a selected sample, and through
organising and analysing the data obtained (discussed in Chapter 1 and in steps 12 and
13 of this chapter).
Chapter 3 will consider what the common construct for social workers should be. This will
form the foundation of the new technology to be developed.
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Chapter 3
Theoretical Model
"The meaning of life is not what happens to people - it’s what happens between people."
- Martha Beck (author and motivational speaker) -
3.1
Introduction
In the researcher’s opinion, the reason social work has not adopted a classification
system to date is firstly because social workers do not understand the possible benefits of
such a system, and secondly because of a reluctance to commit to one unifying
construct. The assumption seems to be that committing to a unifying construct will inhibit
the social worker's freedom to use their own method of choice in practice.
The
developers of the PIE however, after consulting with a task team over two years,
determined that social workers should utilise theoretical and methodological knowledge
beyond that of the classification system (see Chapter 2, step 3b).
Objections to the
developers’ intentions did arise, however (as set out by Roestenburg, 1999, in Chapter 1,
and Lowery and Mattaini, 1997 in Chapter 7). It is therefore a necessary part of this study
to motivate for the approach by the developers, that is, to promote the adoption of a
universal language among social workers.
To illustrate this point, Rubin and Babbie (1993: 46) argue that social work is a practice
profession which tends to apply existing social science theories in an effort to alleviate
problems in social welfare.
Its practice paradigms therefore tend to be based on the
synthesis of existing theories. This study will explore the different practice paradigms that
have been employed throughout the history of social work in South Africa.
This chapter involves the implementation of step 5, namely to identify and describe the
theoretical framework in terms of which the technology has been developed. It may be
argued that trying to provide a broad construct for all social workers is an attempt to limit
the choices of practice models available to them. For the purposes of this research, the
challenge of finding a theoretical model for a classification system applicable to all social
workers, means finding a system which no social worker can argue does not form part of
her professional approach to client problems. In other words, the researcher advocates
that, no matter what method social workers use in practice, they should recognise that it
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k >
falls under the umbrella of social work practice. Without a conceptual and formal alliance
to the underlying principles of the profession, social workers will feel threatened by a
unifying concept they have not seen the need for. For this reason, this step is extremely
important for the success of this study.
The aim of a classification system is to simplify the language and transactions between
one social worker and another, between the social worker and the client, and between the
social worker and other professionals in the referral and case management process. The f|2|
model should therefore incorporate the underlying theories that set social work apart from
other helping professions and which bind the profession across practice spheres. At the
same time, the model should not specialise to the extent that a variety of practice
approaches is excluded. Speciality fields in child practice should be able to classify the
child’s problems and assess the child as part of a treatment plan, according to the
practitioner’s own model.
/A
I
I
The ideal, then, is to find a common construct that can be applied to all practice methods,
1
W
j
which supports the values underlying social work in a comprehensive but concise fashion.
In the course of this chapter the researcher will show that the person-in-environment
approach meets these requirements. To do this she provides an overview of the history
of social work in South Africa together with the most recent developments.
These U
developments not only support the construct, but demand the adoption of a system that g
i
will support government initiatives for social development strategies. She also uses the S
elements gained through the construct together with a consideration of how it applies to
the child, to build the first ‘entities to analyse', called categories. A process of constant
comparison for the sake of progressive category clarification and definition leads to the
first ‘construct hypotheses’ of this study (refer to Chapter 2).
This study is based on the premise that, to classify child-client problems in social work,
social functioning is assessed and described through ecological theory. This theory states
1
that transactions between the individual’s role in society and the degree of adequacy ofTC^^
his environment to meet his needs exist, and determine the well-being of the individual.
The categories to be derived from this theoretical framework should support the role and f?
environmental system divisions (similar to the adult PIE). This study attempts to derive a
simpler theory from vast ecological and person-in-environment principles that support the
new technology’s application within the social work context.
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r
■■■
3.2
The history of social work in South Africa
The fabric of South Africa’s history is coloured by wars, famines, the discovery of incredibly
rich mineral deposits, internecine struggles and sudden, rapid urbanisation, but its dominant
pattern from the time that white men and the native inhabitants of the sub-continent first
encountered each other, has been that of the relationships between groups of different
racial origin.
The heterogeneity of South Africa’s peoples and the ways in which these
groups of peoples have regarded each other, competed with each other and depended
upon each other, is the pre-eminent influence that has moulded South Africa’s society,
tempered the development and nature of its economic system, and fashioned by the
philosophy of human welfare.
McKendrick, 1990: 5-6.
Some idea of the development of the profession in South Africa may be formed through
events in history described by McKendrick (1990). International trends (especially those
in the USA) were taken from Ramsay’s (1990:172-176) account of the highlights in social
work development through history. Mason (1990: 51-53; 62-63) outlines the approaches
found suitable for social workers internationally, and how these differed from the South
African during the 1980s. Midgley (2001: 267-278) offers his view on the post-apartheid
regime’s influence on social welfare.
Brandell and Ringel (2004: 549-553) give a
historical view on the relationship between social work and psychodynamic theory. The
researcher has combined these sources to illustrate the influences on and progression of
the social work profession in South Africa.
In the early 1650s, the Dutch East India Company established itself in the Cape of Good
Hope. Since this served as a mid-station for fresh supplies, the first white people were
brought to the southern point of Africa as employees, and the foundations of modern
South Africa were laid. Within the first 10 years, the Cape experienced three events that
are still relevant to the present day: race conflict, racial intermingling, and poverty. The
company felt sufficient responsibility to raise money for poor relief through the Dutch
Reformed Church in Holland, and eventually the church became established in South
Africa in 1665.
Although the Boers and Africans saw each other as conspicuously
dissimilar, they had in common the customary way in which they met their human welfare
needs: the keystones of welfare were the family and kinship group. From 1795 the Cape
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underwent a series of occupations by the British, who finally acquired sovereignty over
the colony in 1814.
Resentment and a tradition of freedom from official interference
prompted progressive immigrations of Boers north and east to land occupied by African
tribes.
On the international front, social work in the 19th Century was characterised by a range of
voluntary philanthropy in the form of charity organisations, settlement houses, social
reform movements, and women’s liberation advocates. The need for an organisational
form of ‘socialisation’ work was forged during the Industrial Revolution when exploitation
of individuals and puritanical beliefs about people in poverty were commonplace. During
the same period religious organisations begun establishing institutional welfare services
in South Africa, such as the first orphanage, founded in 1814. Of the 17 institutions for
children known to have been established between 1864 and 1899, only one - a
reformatory - was for members of the non-white group. With the discovery of diamonds
at Kimberley in 1870 and gold on the Witwatersrand in 1885, the focus shifted suddenly
and unexpectedly from rural to urban communities.
Many Whites did not have the
educational and trade skills to compete with overseas immigrants, and similarly were
unable to compete with Africans in the area of unskilled labour since they were neither
disposed to manual labour nor willing to accept such low wages, and so the ‘poor white
problem’ had begun. African migrants experienced different problems, with public policy
denying them permanent residence in town and cities, forcing them to become ‘temporary
sojourners’.
Partly as a consequence of the newfound riches in the Transvaal, a war broke out in 1899
between Britain and the two Boer Republics of the Transvaal and the Orange Free State.
The war ended in 1902 but the consequences of the damage inflicted (such as the
burning of farms) lasted many years.
Charity volunteers were initially trained to be
‘friendly visitors’, providing moral reform and help to the poor. Social reform and women’s
liberation volunteers were community activists who took issue with those in power and set
out to improve the social well-being of those deprived or denied basic human rights and
equal opportunities.
Settlement house volunteers were live-in neighbours helping the
poor and working class immigrants to participate in the democratic process and to press
for social change.
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During this period a number of pioneers emerged who took social work to a different
level. Charity organisations in the Unites States, influenced by the strong leadership of
Mary Richmond, focused on reforming individuals and families in poverty. At the same
time, with the support of Jane Adams and other pioneers of social justice, settlement
house and reform work focused on changing the social conditions of poor housing, child
labour, and sweatshop environments in factories.
Afrikaans women’s organisations in
South Africa sprang up to aid poor whites at the local community level and the church
organised successive conferences to seek means of ameliorating white poverty. After the
Union in 1910, the state became involved through provisional relief schemes designed to
mitigate the situation of poor whites. In other countries social work as a human service
profession emerged
philanthropy.
from efforts to replace voluntary philanthropy with
scientific
Greater emphasis was placed on the specialised training required for
thorough social investigations on the assumption that, by gathering sufficient facts, a
remedy could be prescribed.
The 1917 publication of Richmond’s Social Diagnosis
presented social casework, with an emphasis on thorough investigation, diagnosis, and
treatment as social work’s teachable scientific method. The fact-finding, case method of
study was the profession’s first explicitly stated conceptual framework.
Poverty in South Africa continued to grow with the depression of the late 1920s. At the
instigation of the Dutch Reformed Church, the Carnegie Corporation of New York was
persuaded to fund a scientific investigation into the causes of white poverty. The report of
the Carnegie Commission of Inquiry had a dramatic impact on South African social
welfare.
Two of the major recommendations
of the Commission,
which were
subsequently enforced, were for the establishment of a state bureau responsible for
people’s social welfare, and for the preparation of skilled, university-trained social
workers, well versed in the social sciences. These recommendations were seminal to the
creation of a state Department of Social Welfare in 1937, the rapid development of
courses in social work training at universities, and the establishment of a social work
profession (although social workers were only officially registered after the mid-1970s).
On the international front, however, a split in social work occurred. In her campaign for
volunteers to be trained and paid for social work services, Mary Richmond identified the
broad-based ‘man in his environment’ perspective as a unified concept for the new
profession. On the other hand, Addams argued that, as the causes of personal social
problems were embedded in the environment, this reinforced the need for the profession
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to have a social environment focus.
However, the few efforts to conceptualise social
work with an integrated person-in-environment domain and a social interaction focus
received little support. The rivalry between Richmond and Addams became so great that
the two resorted to denouncing each other’s perspective.
The pressure to become
scientific pushed social work in the direction of Richmond’s method specialisation
perspective.
After World War I, social casework services were extended to people not living in poverty.
Post-war needs introduced social work to Freudian Psychology, and with the eventual
incorporation of this theory, social casework switched almost exclusively to an individual
unit of study. Social casework specialities soon emerged in different fields of practice. In
the 1930s and 1940s, social casework evolved into two rival schools of thought: the
diagnostic and the functional. The functional school differed from the social diagnosis
model in that it rejected scientific determinism, and suggested greater participatory
involvement in the caseworker-client relationship, guided by the function of the
organisation.
The World War of 1939-1945, in which South Africa was a combatant, also brought social
welfare challenges to the country. The publication of the Atlantic Charter emphasised the
four freedoms, including freedom from want. The South African government still rejected
an institutional approach to social welfare - reaffirming the traditional standpoint that the
individual was primarily responsible for ensuring his own well-being. A second challenge
brought by the war was the increased influx of black Africans to towns in search of
employment in the cash economy.
This aggravated the already existing housing
shortage, and led to the growth of squatter settlements. These concomitants of African
urbanisation had detrimental effects on family life and social interaction. Migrant labour
dislocated the family system and contributed to prostitution, illegitimacy, alcoholism,
juvenile delinquency and other indices of social disorganisation. The final event of major
significance during this period in South Africa was the coming to power in 1948 of the
white Nationalist Party government.
The clarion call of the new government was
‘Apartheid’, and their policy was to implement separate development in all areas of life,
including that of social welfare. During this time the South African social welfare system
was stretched in attempts to accommodate the two conflicting influences of modern social
work practice and apartheid ideology.
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By the mid-20th Century it had become apparent in the United States that efforts to
conceptualise the profession by method specialisations were problematic.
The work
done by Werner Boehm and Harriet Hartlett addressed the importance of a common
domain of practice across all method specialisations, and the need for a holistic
conception of the entire profession. Out of these efforts came the generic term social
work practice, as a replacement for specialised practice terms such as casework, group
work, and community practice.
Bartlett’s 1970s publication of The Common Base of
Social Work proposed that three core components were needed for a holistic conception
of social work: a social functioning focus, a broad-based practice orientation, and a
repertoire of intervention methods.
In South Africa social welfare services became increasingly oriented towards the
rehabilitation of persons in social need, rather than being centred on palliative or calming
measures. This prompted the beginnings of a movement towards community care, rather
than reliance upon residential institutions; the start of refocusing concern on causes,
rather than consequences; and the growth of specialised welfare agencies which
addressed their efforts to particular areas of need. The response of black Africans to the
different levels and ranges of services available to them as compared to those available
to the white population, was to develop a variety of voluntary associations, for example,
burial societies.
Many of these had mutual aid or welfare functions.
Stokfels and
Mahodisana societies served to circulate sums of money amongst members. Although
proponents of racially segregated services justified separation by noting that separate did
not mean unequal and by arguing that the separation was based on cultural sensitivity,
opponents argued that all people have important common needs whatever their cultural
outlook.
Approaches used by social workers during the 1980s included the behavioural approach
as a reaction to the psychodynamic emphasis in case-work; behaviour modification, with
its range of techniques based on empirical evidence illustrating their effectiveness; the
systems approach, which is more of an overarching theory developed by von Bertalannfy
during the late 1960s and first applied to social work by Hearn; Family therapy
approaches, with concepts of sub-systems and boundaries fundamental to the structural
understanding of the family; and the generalist or eclectic approach, which describes the
different roles of the social worker, from clinician / behaviour changer to consultant /
educator or broker / advocate.
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The reality of South Africa’s legacy influenced the contemporary approaches which social
workers found helpful. Often presented as a first world / third world dichotomy, casework
is unproductive in the face of poverty, disease, and unequal distribution of material
resources.
These social workers called rather for more community work and macro
systems change.
Because of cultural differences, black social workers called for the
extended family to be the unit of analysis and not the nuclear family. The use of social
networks is more beneficial in the promotion of mental health and the prevention of
mental illness. A change in terminology occurred during this time, with the more general
term ‘assessment’ replacing the more medical term ‘diagnosis’ and ‘intervention’
replacing ‘treatment’.
South Africa’s transformation from a society permeated by an
official policy of racism to an open liberal democracy was one of the major political events
of the last decade. Even more surprising was the liberation government’s commitment to
reconciliation. At the time of transition to majority rule, South Africa was a relatively highsncome developing country with a modernised and technologically advanced economy,
but with high levels of poverty being starkly incompatible with its economic development
achievements.
The new government therefore adopted a developmental strategy
that focused on meeting basic needs, eradicating poverty and investing in human
capacities - a commitment finding expression in the Reconstruction and Development
Programme or RDP. The country’s economic and fiscal difficulties, however, impede the
realisation of the RDP’s goals.
In short then it is clear that social work had its start in addressing poverty and injustice.
The first move away from this was driven by a need for the social work profession to
become more scientific, hence the rise of psychotherapy after World War I. Around the
1930s, early attempts to conceptualise social work within a person-in-environment
framework failed. Social work in South Africa was only formalised during 1937, with the
establishment of the Department of Social Welfare and the development of training
courses at universities. After World War II, social welfare in South Africa was stretched in
attempts to accommodate modern social work theories and the Apartheid ideology of
separate development.
Social
work was
conceptualised
specialisation, which had become problematic by the 1950s.
in
terms of method
In response, Bartlett
attempted to find a common construct for social work. She identified three core elements
of the field: a social functioning focus, a broad-based practice orientation, and a repertoire
of intervention methods.
During this period, there was a general movement back to
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I
community-based care, which influenced social work in South Africa. The resilience of
the African people at this time led to the establishment of informal mutual aid societies.
During the 1980s social work was still influenced by other approaches, such as the
behavioural and family therapy approaches.
systems thinking in the 1960s.
Social work first became influenced by
Social work in South Africa, faced with needing to
eradicate the injustices of the past, generally finds case work unproductive.
The researcher believes that Bartlett’s recognition of a need for a common construct for
social work still applies today. If one considers the definition of a science in the glossary
of terms (since the pressure to become more scientific forced social work into a
diagnostic model), she would argue that Barlett's work was the result of her perception
that Richmond’s diagnostic method seemed more empirical and objective (although she
did recognise the 'man in his environment' as a unifying concept for social work). The
person-in-environment construct for social work was probably too vague to be accepted
at that time. This does not mean that the person-in-environment approach, as a unifying
construct for social work, has been discarded. The fact that the 1980s and 1990s saw
authors like Turner, Karls and Wandrei, Goldstein and Ramsay, call for a return to finding
a unifying construct in social functioning is some proof of this.
Accepted definitions of social work
3.3
The researcher compared the most commonly used definitions for social work to
statements made about the focus of social work practice. If the definition of social work at
different periods has the same underlying theme, and if this correlates well with the trends
found throughout history, she will have established a basis for her assumptions regarding
the need for a unifying construct for social work.
Hepworth and Larsen (1990) based their work on the definition published by the National
Association of Social Workers (NASW) in 1973, which defined social work as the
professional activity of helping individuals, groups, or communities to enhance their
capacity for social functioning, and to create conditions favourable to their goals.
The NASW (1973: 4-5) claimed that social work practice consists of applying social work
values, principles, and techniques to the following ends:
■
Helping people obtain tangible services.
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■
Counselling and psychotherapy with individuals, families and groups.
■
Helping communities or groups provide or improve social and health services.
■
Participating in relevant legislative processes.
Hepworth and Larsen (1990) viewed the purpose of social work as:
■
Restoring and promoting mutually beneficial interaction between individuals and
society.
■
Enhancing social functioning, which involves addressing common human needs to
enable productive functioning.
■
Requiring ecological study; identifying the resources in the community and the
individual’s ability to access these. This is a reference to adult ability and maturity.
Within the context of South Africa in the 1990s, a generally accepted definition was that
social work as a profession involves itself with enhancing, restoring, or maintaining the
social functioning of individuals, groups or communities. These activities and the various
professional roles social workers take on, involve them in bi-directional interactions
between an individual and his environment. The socio-political context includes, among
others, the interaction of law, government organisation, societal institutions, family, as
well as formal and informal social networks, which regulate and interact with the various
components of the social service system. As Bartlett noted more than thirty years ago;
social work is not practiced in a vacuum or through the choice of social workers alone.
The South African socio-political context determines who receives service, what type of
service is given, how the delivery of service is structured, how services are paid for, how
social work services are regulated, and even what type of education is available for social
workers as well as who is educated.
The socio-political context is embedded in the
community, culture, and nation concentric circles (see Figure 3.1) (Welch, 1990: 156157).
The more recent internationally accepted definition of social work is:
The social work profession promotes social change, problem solving in human relationships
and the empowerment and liberation of people to enhance well-being. Utilising theories of
human behaviour and social systems, social work intervenes at the point where people
interact with their environments.
Principles of human rights and social justice are
fundamental to social work.
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South African Council for Social Service Professions - SACSSP, 2001: 1.
In the service delivery model for developmental social services in South Africa, the
definition taken from the Social Service Professions Act 110 of 1978 states that social
work means a professional service, performed by a social worker, aimed at the
improvement in the social functioning of people.
Social functioning means the role performance of an individual in its entirety, at all levels of
his existence, in interaction with other individuals, families, group, communities, and
situations in his environment.
Department of Social Development, 2004: 14.
The following summary highlights the most relevant common concepts found across all
the definitions:
■
Help individuals, groups or communities to
■
enhance capacity for social functioning
■
Conduct counselling and therapy with
Help people obtain services, and help the
community improve services
■
Participate in relevant legislative procedures
■
Enhance social functioning by addressing
individuals, families and groups
■
Restore and promote mutually beneficial
common human needs
interaction between individual and society
■
Requires ecological study of the resources in
■
the community and individual’s ability to
Exists within a socio-political context, which
influences social service delivery
access these
■
Promote social change; problem-solving in
■
Social functioning is the role performance of
human relationships and empowerment and
an individual in interaction with other
liberation to enhance well-being
individuals, families, group, communities,
and situations in his environment
3.4
An understanding of social functioning
Social functioning is central to the formulation of one of the primary goals of the
profession, and therefore social work has a responsibility to define clearly what is meant
by social functioning, and to develop methods to measure it effectively (Faul, 1995: 11).
Social functioning is defined by Lantz (1987: 3) as referring to the interactions between
and including the person and their social environment. He sees social functioning as a
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complicated process and not a static state of being, but rather constantly changing
throughout the human life cycle. Social dysfunction includes intense human pain and is
signalled by anger, rage, depression, anxiety, physical illness, hallucinations, delusions,
anomie,
emptiness,
suicidal
thinking,
drug
addiction,
alcoholism,
de-realization
experiences, starvation and homicide (Lantz 1987: 3).
One of the earliest definitions of functional assessment is "any systematic attempt to
measure objectively the level at which a person is functioning, in any variety of areas
such as physical health, quality of self-maintenance, quality of role activity, intellectual
status, social activity, attitude toward the world and self, and emotional status" (Dittmar,
1997: 1).
Karls and Wandrei (1994: 24) define social functioning as a successful ecological
transaction:
Social functioning in the PIE refers to a person's performance in his or her social roles. ....
A person's role can be defined in terms of fulfilling a recognized and regulated position in
Although the major functions of these roles remain generally the same across
society
cultures, the way the functions are accomplished may vary from culture to culture ..."
The similarity to the ‘niche’ described in ecological theory is obvious. The researcher
would argue, therefore, that she is justified in her assumption that the two concepts of
ecology
and
person-in-environment
have
undergone
an
amalgamation
in
the
understanding of them in practice, and have found their pinnacle in defining what social
functioning is.
3.5
Moving towards an integrated approach to 21st Century social work
The previous section outlined the development of social work as a profession to where it
is today. Its ethics and knowledge base had to find shape within a practice approach.
This section considers the development and description of this approach in practice.
Welch’s (1990: 155-156) statement should be noted with reference to current integration
efforts within the South African context:
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An integrated model of practice for South Africa must begin with an acute awareness of the
situation created by apartheid and of the total socio-political context of practice. Social work
in South Africa, as elsewhere, is practiced in a socio-political context. While some social
workers develop specialised skills that leave them not as directly in touch with the socio
political context realities (i.e. work in specialised fields of practice, with particular problem
areas, or in specific treatment modalities), these specialisations are secondary to the
primary purpose of social work. The primary purpose of social work is to enable individuals,
families and groups to deal with their problems in living through the utilisation of society’s
resources in the context of their social environment.
3.5.1 The advantage of finding an integrated approach for social work
Welch (1990:154) quoted Baker (1980) on the following six advantages that will accrue
from the development of an integrated practice base. An integrated base can:
■
provide a set of practice principles (ethical and process) which can guide the social
worker in a disciplined and principled manner in novel situations;
■
help make explicit the values, knowledge bases, processes, roles and necessary
skills which help answer the question ’what does a social worker do?’;
■
serve as an organising device providing continuity in a constantly changing world;
■
allow for evaluation of the impact of various core components on one another, as
they individually and in combination affect outcome, and how process and
outcome are affected by context variables;
■
provide a common occupational identity and language base which allow social
workers to communicate; and
■
allow social workers to move from the general questions of ‘who am I and what do
I do?’ to the development of more specific guidelines for training and practice.
3.5.2 Obstacles to finding an integrated approach to social work
Goldstein (1983, in Welch, 1990:157) made the following observations concerning the
development of a knowledge base for social work, and, according to the researcher,
these have contributed to the inability of the profession to adopt an integrated approach:
■
The knowledge base of social work reflects both a borrowing of theory from other
disciplines and a refinement of specific interventive technology.
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"
There has been a tendency to unquestioningly accept certain theories and
methods.
■
Social work’s unfortunate tendency to separate people-helping and society
changing aspects of the profession has had a negative consequence.
■
There is poor integration of research and practice.
3.5.3 Previous efforts at integration
As early as the 1970s, the need to find a ‘common base’ for social work was addressed.
Social work required an area of central concern that is common to the profession as a
whole; meaningful in terms of the profession’s values and goals; practical in terms of
available and attainable knowledge and techniques; and sufficiently distinctive that it does
not duplicate what other professions are doing.
Social functioning interactions, where
individuals and their social environments meet, were identified as the central focus of the
profession. The common domain included three essential concepts: people, interactions,
and environment, abbreviated into person-in-environment.
In practice this meant the
primary focus of social work was on the interaction between the coping efforts of
individuals, singly or in groups, and the environmental demands they experienced over
time. Underpinning the broad orientation to the concept of social work practice would be
a common set of values about the nature of human relationships, a body of knowledge,
and intervention approaches familiar to all social workers, whether generalists or
specialists. This re-conceptualisation was the forerunner of several general social work
practice conceptualisations, aided by the introduction of general systems and ecological
theories.
These theories provided the theoretical foundations for social workers, to
describe the holistic patterns of interaction between the elements of the person-inenvironment domain (Ramsay, 1994: 175-176).
Social work has historically had the dual mission of people-helping and society changing.
The tendency to polarize these two perspectives has inhibited the development of an
integrated practice format that incorporates all social work methods (case-, group-, and
community work as well as community organisation). Several social work theorists have
advocated an ending to the artificial dichotomy, calling instead for the use of theories that
focus on person-environment transactions (Welch, 1990: 152).
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Historically, social work has been influenced by behaviourist frameworks in psychology,
the structural-functional approaches in sociology and psycho-analytic orientations in
therapy.
As a profession we have been through various theories and practice
methodologies, shifting emphasis from individual to system and back to the individual
many times. In 1983 Germain argued that the commitment to person-in-situation is one
of the primary thematic threads in the historical development of social work practice
(Welch, 1990: 153).
For over twenty years, Schwartz has defined and refined the reciprocal approach - this
approach is generic, and applicable to all aspects of social work practice.
Working
together with Shulman from the late sixties to the late seventies, Schwartz offered an
original social work contribution to interactional theory. They paralleled Blumer’s (1969)
social internationalism, to develop a comprehensive approach, integrating knowledge of
social reality, basic assumptions about social work values and goals of practice, and the
formulation of integrated principles of action (Welch, 1990: 153).
Welch (1990) looked at a number of attempts at integration. In an interesting attempt at
conceptual unity, Baker (1980) combined a generic base (e.g. knowledge, values,
process, purpose, roles and principles) with a bio-social model, a multi-role practitioner
model, an interpersonal process model and a social change model.
One of the most
influential generic approaches is by Pincus and Minahan (1973). They utilised a systems
theory perspective as a foundation for social work practice. They employ the systems
theory concept of interdependence, which states that all elements of a system affect one
another: change one, and you impact all the other elements.
Further credit for the
general systems theory approach to social work goes to Hearn (1958), Lutz (1956),
Meyer (1970; 1976), Goldstein (1973) and Siporin (1975).
The most productive and
promising suggested model of integrated practice came from a blending of general
systems theory (Lazio, 1972) and human ecology (Theodorson, 1961).
While general ecology utilized systems theory to understand the relationship
between living organisms and their environment, human ecology focuses on the
human ecosystem as the basic unit of analysis. The human ecosystem functions
in terms of change and stability, with the central questions relating to how humans
maintain themselves in continually changing yet restricted surroundings.
Welch, 1990:153-154.
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In a more recent writing on the profession of social work, Saleeby (2004) states that:
The profession of social work has long claimed its niche as that space where the
traffic between the environment and individuals, families, and groups occurs.
Person-environment is a code for this transactional space.
The reign of the
ecological/systems model of understanding and practice, and that staple of
curriculum, human behaviour and the social environment, all stake out in one way
or another, this conceptual and practical habitat for the profession. It is, in fact,
one of the distinguishing marks of the helping that social workers do, that we must
always understand human problems, suffering, possibility, capacities, and need in
terms of their context; we must understand how the environment promotes
challenges and offers resources; and we must understand how the individual or
family interacts with those factors. But there is a sense of the environment that
social work has, to a significant degree, ignored - that is, the immediate, proximal,
often small environment where people play out much of their lives. Were we need
to attend to elements of this aspect of the environment, some of the ways that we
think about human problems and possibilities might be reshaped.
Saleebey, 2004:7.
3.5.4 Where does social development fit into an integrated model?
The consideration of social development in this chapter is motivated by two things: firstly
the researcher heeds the historical concerns that the social work profession has had with
regard to the adoption of models that are not adaptable to South African circumstances.
She therefore has to consider what the focus area in social work service delivery is
currently.
Secondly Professor Leila Patel (Head of the Social Work Department at the
University of Johannesburg) attended one of the researcher’s panel discussions
(discussed in Chapter 6) while she was busy with the pre-development phase of the
Adapted Design and Development model of this study.
Prof. Patel, who is also
recognised as one of the specialists in this field, suggested that the researcher gives
more consideration to the social development approach in her framework (see feedback
assemblage in Chapter 6).
Key aspects of social development, as highlighted by Midgley (1995, in Fouche and
Delport, 1999: 135), are:
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■
The process of social development is inextricably linked to economic development.
■
Social development has an inter-disciplinary focus, which draws on the insights of
the various sciences.
■
It invokes a sense of process, involving a dynamic concept with the explicit notion
of growth.and change.
■
The process of development is progressive in nature.
■
The process is also interventionist - organised efforts are needed to bring about
improvements in social welfare.
■
Social development goals are fostered through various strategies and supported
by different beliefs and ideologies about how these goals can best be attained.
■
It is inclusive or universalistic in scope.
Patel (1992) elaborates more on the goals of a developmental social paradigm and these
are summarised by Fouche and Delport (1999: 135) as follows:
B
Improving people’s material conditions of life.
■
Maximising the development of human capacity to create productive, contributing
members of society.
■
Promoting individual and collective self-reliance in an enabling social, economic
and political environment, to promote social and emotional well-being, worth,
dignity and self-identity.
■
Assisting individuals and groups at various stages of their development in different
circumstances, and helping those in need of protection, care, support and material
assistance to achieve their optimal development.
■
Building a grass-roots democracy through the empowerment of the people to press
for social policies and programmes to meet their needs, to promote their rights, as
well as to contribute to and benefit from the fruits of social and economic progress.
The elements of social development, such as people-driven, multifaceted, empowerment,
self-reliance, inclusiveness, integration of social and economic efforts, capacity building,
and multi-sectoral integration, implicitly refer to the well-being of individuals, groups,
families and communities (Fouche and Delport, 1999:135). Potgieter (1998, in Fouche
and Delport, 1999:136) sees individuals, married couples, families, small groups,
organisations, and communities as the vehicle for change. The author emphasises that a
social developmental approach is inclusive of helping groups, families and communities,
but in a different manner, i.e. to develop human resources (including capacity building
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and empowerment) and where possible, facilitate and enhance economic development
(Lombard, 1996, in Fouche and Delport, 1999:136).
The researcher would go so far as to argue that the social development approach is a
practical language for promoting a person-in-environment fit. She will be discussing the
latter approach later in this chapter in order to establish the degree to which these two
approaches are compatible.
3.5.5 The PIE classification system as integrated model?
The task force that developed the adult PIE, identified social well-being as a sound basis
on which to build a social work classification system. Social well-being is different and
separate from mental and physical well-being. Human behaviour is seen as the result of
intra-personal and inter-personal forces in dynamic interaction.
The source of these
forces are social performance expectations generated from an individual’s personal life
experience or from the social context, which consists of the family, community, culture,
and so forth. This social role construct has been studied and described in social role
theory by Sarbin (1954), Thomas and Feldman (1967), and Turner (1954). The concepts
were adopted by the task force as the foundation for describing the problems of social
work clients. A corollary to this social work construct - ‘role functioning’ - was used as a
unifying construct to catalogue problems of social functioning (Karls and Wandrei, 1992:
81).
Similarly the environment was seen as a product of forces within and between social
institutions.
The general categorising of social institutions follows Warren’s (1963)
conceptualisation of the basic functions to be performed by social units and systems in a
community.
On the basis of the five spheres in Warren’s conceptualisation, the
environment was further defined as the result of personal and societal efforts to meet
these functions.
The problems in the environment are the barriers that impede
achievement of social institution functions (Karls and Wandrei, 1992: 81).
The same
definition of environmental problems will be utilised in the post-doctoral development of
the new technology.
At face value the PIE may be seen as meeting the need for an integrated approach: it
provides a way of classifying social functioning problems - looking at the person within
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his environment. Two points of concern raised by the authors below are discussed, and
solutions to these are proposed. The concerns raised are relevant to this study, since the
researcher will probably be questioned on similar points if her development has similar
constructs to the adult PIE.
The PIE is a remarkable attempt at integrating social work, but as with any development it
comes under scrutiny. Lowery and Mattaini (1997, in Karls, Lowery, Mattaini and
Wandrei, 1997) presented the following critique, regarding the use of PIE as a "system
that purports to be applicable for all social work settings":
■
"PIE relies on lists that distinguish issues in the person from those in the environment,
an approach reminiscent of early social work (e.g. Richmond, 1917).
contemporary
ecosystems
perspective (Meyer,
1995),
which
The
recognizes the
transactional nature of clinical phenomena, is a substantive advance over this
approach." The authors pose a crucial question: "can PIE capture those transactional
phenomena in the way that broad-band graphic instruments like ecomaps or other
ecosystemic approaches do?".
■
The PIE does not produce a diagnosis per se, but a complete PIE assessment still
requires a diagnosis based on the Diagnostic and Statistical Manual of Mental
Disorders (DSM). This means that all of the questions raised about DSM must also
be addressed with PIE. “The DSM link also binds social workers using PIE to that
psychiatric system, which is grounded in a different professional stance.” (Karls,
Lowery, Mattaini and Wandrei, 1997)
Transactional phenomena is a crucial concept for Lowery and Mattaini (in Karls,
Lowery, Mattaini and Wandrei, 1997) since most contemporary theoretical approaches to
social work practice are deeply contextualised, viewing issues in transactional terms. For
example, ecological models focus on 'goodness of fit' between person and environment
(e.g. Germain and Gitterman, 1996); family systems models view problems as lying in
family dynamics rather than residing in the person; and eco-behavioural models are
concerned with changes in patterns of events that are embedded indivisibly in the person
and his world (e.g. Mattaini, 1997).
The PIE system separates such problems into
problems of Role Functioning and Environmental Problems, and the question asked is
whether the PIE system could thereby narrow the focus of assessment.
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Drs Karls and Wandrei’s response to this, is that the question actually illustrates the
dilemma we face in social work by not having a unifying theory on which to base our
practice, and it possibly explains why the PIE system took the form it did. The profession
is not yet willing to adopt family systems and eco-behavioural models as the basis for
client or problem assessment. The task force concluded that, if social work were to have
a uniform assessment system, it should accommodate as many contemporary theoretical
approaches as possible.
To do this, it is necessary to avoid advocating any specific
theoretical model, even though almost everyone on the task force had a favourite. The
developers believe that the PIE system accommodates this diversity. Once the problems
in social functioning as well as the environmental, mental health, and physical health
problems are identified, an ecological model (or behaviourist model, psychoanalytic
model, feminist model, strengths model, etc.) can be used to explain the probable case
dynamics. To the extent that these models produce certain kinds of interventions, PIE
could provide an ongoing mechanism for testing the efficacy of these models in treatment
or intervention. If the interventions are effective, the problems identified in PIE should
either be reduced or eliminated by the approach advocated in the model or theory (Karls,
Lowery, Mattaini and Wandrei, 1997).
PIE seems to rely heavily on role theory as an underlying theoretical perspective even
though many contemporary social work approaches rely on alternative theoretical models
(e.g. psychodynamic and developmental, cognitive-behavioural, stress and coping, the
strengths perspective) as primary organising frameworks. Over the two-year period in
which the task force developed the initial PIE system, it reviewed a large number of
relevant concepts and theories from the behavioural and social sciences. The debate
about what might constitute a social work classification system covered everything from
Erikson's life cycle model through Perlman and Hollis and a score of others.
It also
critically examined Mary Richmond's system for social diagnosis. The task force noted
that most social casework models used the term social functioning, and considered
enhancement of social functioning the primary goal of social work intervention.
To
develop a schema for describing and categorising social functioning, the task force chose
to borrow ideas and terminology from sociology. It did not consider that it was relying on
role theory as its underlying theoretical perspective. The major contribution made by role
theory, or perhaps more properly the field of sociology, was the identification of social
roles that were incorporated in Factor 1 (Karls, Lowery, Mattaini and Wandrei, 1997).
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It seems, from both practice and literature, that, despite the attempts of the last thirty
years to find a ‘common base’ for social work, the members of the profession still resist
the adoption of a unifying theoretical base - a resistance which the researcher finds
perplexing. She has observed in social work practice a similar phenomenon pointed out
by Goldstein (1983, in Welch, 1990): social workers tend to adjust their practice method
to whatever new and seemingly applicable model they receive training in. Many of these
are directly applicable to social work practice, but there seems to be no agreed upon
practice guideline through which workshops and models are filtered.
A concern the researcher has with regard to motivating for the PIE to be the agreed upon
practice guideline, is that the developers admit that the categories of social role
functioning were derived from concepts in sociology. The concern raised by Lowery and
Mattaini (1997) about the reference to a psychiatric diagnosis is based on a similar
concern.
According to Goldstein (1983, in Welch, 1990) the borrowing from other
disciplines can be an obstacle to accepting it as social work’s ‘common base’.
A further concern relates to the criticism of the PIE’s apparent lack of inclusion of the
transactional nature of relationships.
Lowery and Mattaini (1997) suggested the
contemporary ecosystems approach as a more applicable model for social work. The
developers of PIE have the presence of mind not to be pressured into adopting the
current contemporary favourites, and thereby risking the PIE becoming unsuitable when a
change in preference takes place.
For this reason the researcher will also take the
current focus on social development in South African Welfare into consideration, but she
will not attempt to use it as the unifying construct in the development of the new
technology.
The researcher is concerned, however, that the profession does not seem willing to adopt
one perspective that describes its domain, even if variation takes place within its
implementation in practice.
This phenomenon is not uncommon to any of the other
helping professions, but diversity did not stop them from accepting advances in the
science of their profession. For this reason, the researcher will press on to suggest one
system that will be applicable to approaches, has proved itself popular, and has stayed
part of the profession despite major societal and political changes in the last few decades.
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It would be a shame, however, not to benefit from the 20 years of development that has
shaped the PIE. For this reason, the researcher will not attempt to explore the number of
theoretical constructs and concepts already investigated by the task force and
developers. She will only attempt to provide motivation to support the argument that the
construct of person-in-environment is broad enough to be accepted as the unifying
construct for social work. She will also show that the PIE format can be a practical tool
through which the adoption of the unifying construct could take place. (To provide a visual
idea of what the PIE looks like, the researcher will put Factor 1 of the adult PIE into
Annexure 1A - this study only focuses on developing a Factor 1 for the child, so for now
she will not include the rest of the MiniPIE.)
3.6
Finding a unifying construct for social work
Building from Goldstein’s (1983, in Welch, 1990) statement in the previous section that an
unfortunate tendency to separate people-helping and society-changing aspects exists in
the social work profession, the researcher recognises the necessity of establishing links
such as these in her attempt to motivate for the adoption of a classification system. Four
concepts were introduced when the focus of social work was described in the previous
section. These are social functioning, ecology, person-in-environment (interaction
between person and his environment), and well-being.
The researcher feels it is
necessary to create one term that will incorporate these concepts and therefore needs to
explore these concepts in order to find an acceptable unifying term. Social functioning
will receive separate attention, since the aim of this study is to develop a system that will
classify the social functioning problems of children. A thorough understanding of social
functioning and how it relates to children is not only necessary for adoption as a unifying
construct, but is also necessary to guide the literature search.
3.6.1 Early origins of the psychosocial approach
The researcher found that any search for literature on person-in-environment is bound to
produce literature on the psychosocial approach as well.
To work through her own
overlapping use of the two concepts, and to clarify these for the reader, the researcher
starts the discussion on the related concepts stemming from social work’s purpose with a
short discussion on the roots of the psychosocial approach. She does not intend to form
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an opinion on the approach and its current use in practice. She merely intends to clarify
the significance it has in terms of person-in-environment theory.
Generally speaking, services to individuals and families have been termed social
casework from the early beginnings of professional social work. As Mason (1990: 47)
found, casework can be regarded as one approach of the social work profession, with its
defining characteristic being the provision of individualised service. Social workers used
many different approaches based on theoretical orientations. Especially after the First
World War, this became more apparent with the development of the speciality of
psychiatric and medical social work (in response to the demand for treatment for ‘shellshocked’ soldiers and their families).
Diagnosis’ in 1917.
Mary Richmond published her book ‘Social
Influenced by the medical model, with its emphasis on single
causation and a linear relationship between cause and effect, she adapted the disease
model of medicine to social diagnosis and treatment. The Milford Conference held in
1929 in the U.S.A, attempted to identify generic rather than specific components of
casework practice. This was a period of growth which saw an increased preoccupation
with the method or techniques of social casework. It was also a period which focused on
individual defects rather than on the shortcomings of the social system. Caseworkers
began to regard themselves no longer as dispensers of charity but rather as ‘social
physicians’, concerned with psychological maladjustment rather than with material need
(Mason, 1990: 48).
Growing out of the diagnostic casework of the 1930s, Hamilton (1951, in Mason, 1990:
49) introduced the notion of the person-in-situation configuration, which was later
developed by Florence Hollis (1964, in Mason, 1990: 49) as the Psychosocial Approach.
These views incorporated the ideas of Gestalt psychology and multiple rather than linear
causality.
Hollis classified casework procedure as either direct or indirect (or
environmental) treatment. By 1970, Hollis was describing the Psychosocial Approach as
a system theory approach to individual and family problems. The person to be helped
must be seen in the context of his interactions or transactions with the external world.
Although treatment was still individualised, the systems within which the individual existed
were recognised (Mason, 1990: 50).
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3,6.2 Early origins of ecology
The term ecology was first used by Ernst Haeckel in 1868 to refer to interdependencies
among organisms in the natural world.
In conventional usage, ecology means the
interdisciplinary scientific study of the living conditions of organisms in interaction with
each other and with the surroundings, organic as well as inorganic.
There is a
comfortable fit between the science of ecology and a profession like social work, which
has as its expressed purpose the fostering of healthy and interdependent transactions
between people and their environments. The earliest ecological model of social work
practice challenged the individualistic casework orientation, popular in the early and
middle twentieth century. As Carol Meyer (in Ungar, 2002) notes:
The movement from casework to social work was more than semantic; it meant ultimately
that family, group, community, and organizational approaches to intervention were to be
included under the heading of social work practice, and that new efforts were to be made to
intervene in the client's environment.
In an early review of ecological theory, Geoffrey Greif and Arthur Lynch (1983, in Ungar,
2002) trace social workers' understanding of ecology to biological theories that explain
the adaptation of organisms to their environments. In human terms, this means that, as a
person enters each new situation, he or she usually adapts to its demands and, by his or
her presence, changes the situation at least structurally. A person is constantly creating,
restructuring, and adapting to the environment, even as the environment affects the
person. Although these early formulations emphasize goodness of fit through adaptation,
they practically ignore the position of the observer (social worker) vis-a-vis the client and
the relative power of each part of the helping system.
Early ecological models were
based on systems theories and were most commonly used by social workers to explain
the interactional processes between family members. These systems-based models of
practice did not deconstruct the standpoints of those who decide which adaptations are
best.
Implicit in these early models is the naive assumption that all family members
benefit equally from a system that establishes balance in ways amenable to those in
power.
Despite these shortcomings in systems theory, social workers still found the
ecological perspective, based on a broadened view of systems theory, intriguing and
more synchronous with their mission, than the individualising psychoanalytic models of
intervention popular in the 1950s and 1960s (Ungar, 2002).
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3.6.3 Measuring ecology in social work
Van Zyl (1995, in Faul, 1995: 17) coined the term ecometrics, which refers to
measurement in the context of ecology .(the study of the delicate balance between living
organisms and their environment).
The following two concepts within the ecological theory are important for the social work
profession:
■
Habitat, which refers to the places where people live, and consists of the physical
and social setting within particular cultural contexts.
When habitats are rich in
resources required for growth and development, humans tend to thrive, but when
they are deficient in vital resources, development and ongoing functioning may be
adversely affected.
■
Niche, which refers to the status or role occupied by a member of the community.
One milestone required in achieving maturity is finding one’s role in society, which
is essential if the individual is to achieve self-respect and a stable sense of identity
(Van Zyl, 1995: 34).
This definition of ecometrics compares well with the format of the PIE. The PIE is a
classification system that is a form of measurement (refer to Table 2.1 in step 3). It has
as its aim the ‘measurement’ of the role the client occupies in society (niche), as well as
problems in the environment that impede its ability to meet the needs of clients (habitat).
Based on this clear resemblance, the researcher draws the conclusion that the PIE is an
ecometric tool.
This further implies that ecology and person-in-environment are
compatible enough to unite within a classification system such as the PIE.
3.6.4 Human ecology
Referring back to Karls and Wandrei’s (1992) explanation of the process that lead to the
adoption of social role functioning as a unifying construct, the task force started with what
social well-being meant. Using the word ‘human’, they referred to behaviour as the result
of intra- and interpersonal forces in dynamic interaction.
A similar framework that
incorporates these forces is human ecology, as described by Welch in 1990.
The
researcher makes reference to these interacting forces as a result of impressions gained
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from the results of her Master's study. One of the findings drawn from implementing the
adult PIE in a psychiatric setting was that it did not give enough focus to intra-personal
aspects, which are very relevant to psychiatric social work. It is therefore interesting to
observe the deductive reasoning that lead to the concepts of social role functioning (as
. incorporative of intra- and inter personal aspects).
The researcher understands the logical reasoning behind the developers’ deduction as:
* intra- and interpersonal forces are in interaction;
* the forces come from
social performance expectations;----- ► these expectations come from the person’s
experience within his social environment; ----- ►
this construct comes from role theory
resulting in the adoption of 'role functioning' used to catalogue problems of social
functioning.
In order to accept this premise, the researcher has to explore the assumptions it is based
on. She does this by examining the definition of social functioning later in this chapter,
and by comparing it to another model that incorporates Karls and Wandrei’s view of social
well-being, namely 'human ecology'. In order to promote the adoption of the PIE system,
the researcher will need more than a superficial understanding of what the system is
based on. She should know about opposing views and aspects of the system that may
not be compatible in making it the unifying construct in social work.
Ungar’s (2002) statement that the emphasis within Germain and Gitterman's (1996) life
model on contextualization, power, and privilege reflects advances in cultural sensitivity,
the politics of location, and the understanding of the mutual dependency among people
and their environment, serves as further motivation for the discussion of human ecology.
As can be seen from the history of social work in South Africa, advocacy and political
activism have been an integral part of social work practice. The socio-political context is
therefore a huge consideration in the South African client’s environment, and with the
current focus on social development, it incorporates the socio-economic influences.
The researcher found that this approach gives cognisance to all of these levels of
interaction between the person and his environment.
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In human ecology, the person-in-environment orientation constitutes the totality of
The key to understanding the
relationships among individuals and their environments.
basics of human ecology is the notion of interaction.
"The interaction of the system’s
components taken together has a greater total effect than the sum of their individual
effects." (Welch, 199Q: 1-55-.)
The following figure illustrates Welch’s (1990: 156; 159; 171) description of human
ecology as a meta-theory for social work, with a consideration of typical social work
problems and interventions on each level.
The examples given in blocks next to the
spirals allow for recognition of the meaning of the components in everyday practice.
Figure 3.1 therefore gives an overview of all the levels relevant to a client’s functioning,
together with how this would translate into practice.
Person-in-environment is still a
related concept, but to the researcher human ecology highlights the elements involved in
the interaction of the person and his environment.
Physical environment
Nation
PRIMARY PROBLEMS:
P ’ POSSIBLE SOCIAL WORK
INTERVENTIONS:
Social policy not suppd
population group /
nter,
Conflict of valued Bre;
turally defined roles
m of cul-,.-isibUiff'es
______________________________
,1,
,
,
/
;
Culture
| Politic^ actlvishi. legal advocacy
........
. .......................
based
Loss of support networks, zL'ack of
community consciousness
—----- Family or small groups
tasis.
Family
Disrupted family hoi'
'
ssors/
reactions to externa
Loss of anchoring
tion, alienation, cDepressed mood agitation,^
hopelessness, loss of self-esteem'
__ _____-____ -______________
oq, action, research
Community
Devefop social suppc networks,
commuriity education & organisation
therapy‘ ^ropp work, self-help
I
\
■
//
____
^thttf^persopal;
........
Intft-persohal A
rehearsal
FIGURE 3.1 THE HUMAN ECOSYSTEM
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The focus on aspects within the individual reminds one again of the psycho-social
approach.
The researcher is of the opinion that Karls and Wandrei’s attempt at
combining the concepts of intra-personal and inter-personal forces with the person-inenvironment and social functioning approaches represents adequate consideration of all
the transactions occurring within the person’s ecology. The researcher points again to
the fact that, with a classification system, knowledge beyond that of the system itself is
necessary. She will therefore not go into an in-depth discussion of these concepts at this
stage, but would like to emphasise that broader knowledge gained from the literature in
the next chapter will involve concepts of both intra- and interpersonal forces at work in the
social functioning of the child.
3.6.5 The Person-in-environment construct
Ramsay (1994: 171) states that:
Person-in-environment is the concept commonly used to describe the social work domain of
practice, and it comes from the profession’s long-standing efforts to develop a common
conceptual description of the core components of the discipline.
Person-in-environment practice is an emergent model of direct practice that makes strategic
use of time to accomplish three things: (1) Improving a client’s sense of mastery in dealing
with stressful life situations, meeting environmental challenges, and making full use of
environmental resources; (2) Achieving this end through active assessment, engagement,
and intervention in the environment, considered multi-dimensionally, with particular
emphasis on mobilization of the personal social network; (3) Linking individual concerns in
ways that promote social empowerment through collective action.
Kemp, Whittaker and Tracy, 1997: 2-3.
The building blocks of person-in-environment practice are:
■
Partnership: Clients and professionals meet on common ground and as a unified
team.
■
Mutuality: Creating an atmosphere where clients and professionals communicate
openly about their most sensitive concerns in a relationship built on openness,
mutual respect, and trust.
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■
Reciprocity: Operating on the ‘helper principle’ where giving and receiving help
go both ways among all of the key players: professional to client, client to
professional, and client to client.
■
Social assets: Assessment begins not by looking at what is going wrong in clients
(deficits), but at what is going right (strengths).
■
Resilience: Always being alert for those protective factors and mechanisms that
blunt and divert the effects of known risk factors and permit individuals, families,
and groups to overcome extraordinarily difficult life situations.
■
Optimisation: Establish a goal to create conditions within which each individual,
each client family, group, and neighbourhood reaches the upper limit of its
developmental potential.
■
Natural helping: Search for those approaches to change that draw fully on the
ability of clients and communities to aid themselves through ritual, spiritual
practice, celebration, and reflection.
■
Social integration: Social workers work with ‘private troubles’ of individual clients
in the context of raising public concerns about the critical integrating function of
individuals, families, small groups, and neighbourhoods in maintaining social order
and promoting public safety.
This function is often best realised after external
social/environmental change has occurred. Imparting skills to cope with harmful
and dangerous environments is often an important proximate goal but cannot
define the real objective of practice: to remove risk and change the environment.
■
Coherence: The process through which individuals, families, and groups discern
a sense of meaning beyond the struggles of day-to-day existence.
K
Hope:
Fostering hope that things can change for the better, that the power to
change resides within, and that someone is listening and cares.
Kemp, Whittaker and Tracy, 1997: 4-6.
Current person-in-environment thinking treats macro and micro realities as more-or-less
separate arenas of human activity that "interface”.
Constructionist theorizing also conceives of macrostructures as somehow "other" than -
although influencing - the immediate arenas in which individuals construct identities,
relationships, and meanings in their everyday interactions ... social structure is both
medium and outcome of the patterned activity of individuals over time brings micro and
macro realities conceptually together.
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Laird, 1993 and Giddens, 1979; 1984, in Kondrat, 2002.
The heaviest emphasis in the life model is on environmental pressures and stresses
(anything from unemployment to natural disasters), and how the individual, family, or
community adapts to and copes with them. The coping and adaptation can be salubrious
or, at the other end of the spectrum, unsuccessful, harmful, and, perhaps, debilitating.
Germain and Gitterman (1996) advocate for ‘life-modelled’ community: practise assessing
community needs and strengths, recruiting residents to participate in the development of
programmes, marshalling informal resources, and strengthening networks of supportive
relationships to meet needs and solve problems, as well as working to augment the
community's ability to withstand stress, whether internally or externally generated
(Saleebey, 2004).
Versions of these ideas are also found in the seminal work of Carol Meyer (1983) and
Harriet Bartlett (1970), especially in her notable attempt to find an essential conceptual
underpinning to social work practice.
More currently, the person-in-environment (PIE)
assessment protocol developed by James Karls and Karin Wandrei (1995) - meant to
amend the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric
Association, 1994) - is underpinned by the idea that the profession's distinctive
orientation must be reflected in the assessments and methods that social workers employ
in understanding and helping.
PIE is another step towards a precise and detailed
account of the factors and forces in the immediate and distant environments of people
and groups (Saleebey, 2004).
The similarities between the Person-in-environment and social development approaches
provide further support for the former approach to be seen as a unifying construct for
social work since it can also accommodate social development frameworks. At the very
least, no contradiction exists between the two approaches.
3.7
The child-in-environment
The point of determining the applicability of the PIE as a common language in social work
through this study is to establish support for the use of a similar format for the
development of a system that classifies the social functioning problems of children. The
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researcher has gained adequate understanding of the concepts underlying the
development, and these can now be applied to the child.
3.7.1 Ecology and childhood
With regard to assessing a child's environment as a causal factor in problems
experienced by the child, Bronfenbrenner (1977, in Eamon, 2001) explains that the
ecology of human development involves the scientific study of the progressive, mutual
accommodation between an active, growing human being and the changing properties of
the immediate settings in which the developing person lives, as this process is affected by
relations between these settings, and by the larger contexts in which the settings are
embedded.
Bronfenbrenner notes that there is now sufficient evidence to hypothesize
that ecological forces at play in the world beyond the family affect a child's development
as much or more than the child's interaction with parents.
Ecological perspectives on
ethnicity, race, and gender in practice situations promise a more critical understanding of
the power implicit in transactional processes.
Germain and Gitterman outlined the
following conceptual areas in their model: vulnerability, oppression, the use or misuse of
power, and social and technological pollution; habitat and niche; and life course, the
trajectory taken by individuals, with attention paid to social and cultural determinants of
these trajectories.
This greater emphasis on contextualization, power, and privilege
reflects advances in cultural sensitivity, the politics of location, and the understanding of
the mutual dependency among all things human and the natural world (Ungar, 2002).
In the researcher’s opinion the PIE successfully places the social problems of the client
within a context through providing Factor 2, 3 and 4 classifications as part of the
comprehensive assessment of the client.
This simultaneously ensures more cultural
sensitivity according to Ungar (2002). This study aims to ensure the same placement of
social problems when it develops a system for children. All the concepts mentioned as
part of the ecology of children are all relevant concepts which the researcher intends to
explore further in post-doctoral development.
3.7.1.1
A time-context
The process-Person-Context-Time model of Bronfenbrenner (1977, in Eamon, 2001)
proposes an ecological systems model of the lifelong progressive accommodations
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individuals make to the changing environments in which they develop. His "bio-ecological
paradigm" rests on two main assumptions that can be investigated within the process
person-context-time model.
First, human development occurs through "processes of
progressively more complex reciprocal interactions" between active, evolving "bio-
psychological" human beings and the individuals, objects, and symbols in the
environment (Eamon, 2001).
If these interactions, or proximal processes, are to be
effective, they must occur with regularity over extended periods of time,
Proximal
processes (interactions) occur between a parent and child and within peer groups,
school, learning, and recreational activities; they are the mechanisms by which genetic
potential for effective psychological functioning is realied. Second, the effectiveness of
proximal processes is determined by the bio-psychological characteristics of the
individual, the immediate and distant environments in which the proximal processes
occur, and the developmental outcome being examined (Eamon, 2001).
3X1.2
Transactions with children
Super and Harkness (1994, in Strelau, 1998: 342) offered a definition of what they call a
developmental niche.
This is defined as consisting of the physical and social setting
children are found in: the culturally regulated customs for child care, socialisation, and
behaviour management; and the psychology of caretakers, including beliefs and values
about the nature of development.
Based on the understanding obtained from previous definitions of ecology, the researcher
is of the opinion that the definition of developmental niche does not describe the roles the
child occupies in his environment, but rather the factors that will influence that role. She
proposes that these describe the transaction between the child and his environment.
This will become clearer in the discussion of the person-in-environment construct later in
this section.
Van Zyl (1995: 34) argues that one milestone of maturity is to find one’s role in society,
and this is essential if the individual is to achieve self-respect and a stable sense of
identity.
The introduction of time-span by Bronfebrenner (1977) is significant in the ecological
study of children.
This is because age is very significant during the trajectory from
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infancy through to early adulthood.
The interactions within relationships become
progressively more complex and the child’s well-being is influenced by how well he
adjusts to the change. (Van Zyl (1995) emphasises that finding one’s role in society is a
milestone for maturity. The significance of time and development will be relayed into the
new technology through the Inclusion of developmental stages!
In doing this the
researcher does not claim the Life Cycle Model as a theoretical construct, but merely
makes reference to the reality of life stages in childhood.
The relevant interactions during childhood are those between the child and parent, the
child and peers, the child and school, and the child and extra-curricular activities (e.g.
sport and recreation).
These will eventually form the social roles (niche) of the new
technology (see Chapter 7).
The interaction that takes place when the child occupies a role within his social
environment, is influenced by culturally regulated customs for child care, the socialisation
of children and how their behaviour is managed, and the personal characteristics of
caretakers, including their beliefs and values about the nature of the child’s development.
The concepts of time and interaction will be considered in the conceptual framework
which this chapter sets out to develop.
3.7.2 Childhood social functioning
A more specific definition of social functioning is called for to start developing a method
for measuring it in children. The researcher is therefore interested in indicators of the
presence or absence of optimal social functioning in her exploration of the literature.
For the purposes of this study, the researcher will maintain a holistic view of what social
functioning in the child is - what should the child accomplish as an adult with regard to
social functioning? In other words, what are the child’s developmental goals for him to be
viewed as an adult with adequate social functioning? The term adult derives from the
Latin word adu/tus, which means 'to grow up'. Age is one attribute of adulthood, while the
other is maturity. The latter "denotes ripeness, or full development within the genetic and
ecological limits established by the species in its particular locale" (Bocknek, 1986: 48).
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\ >
Maturity can be viewed on three levels: as psychological health, as self-actualisation,
and as being functional. The researcher combined a list of the common factors among
these levels given by Bocknek (1986: 49-51):
■
Has a more efficient perception of reality, and is less frightened by the unknown.
■
Has the ability to enter deep, close relationships without fearing loss of identity or
destruction, and has the ability to foster the development of a new generation
through the psycho-social functions of parenthood and teaching.
■
Is able to accept self, others, natural events, processes, and needs.
■
Spontaneity and zestfulness in living, and a sense of humour not hostile in intent.
■
Ability to concentrate, persist and work on objective tasks.
■
Individual creativity when approaching any situation.
■
Ethical certainty, so as to persevere in one’s convictions.
■
Autonomy from mass opinion and an independence of culture and environment.
■
Anticipation of the future in one’s perceptions and thoughts - appreciating limitless
horizons.
»
Abiding by realistic choices and decisions one has made.
■
Acting on plans rather than on impulse.
The relevance of considering this list of attributes of maturity is that it gives the researcher
an idea of what concepts of childhood development are significant for the child to reach
maturity on all three levels.
To summarise it further, the concepts of creativity;
acceptance of self, others, and situations; concentration; developing convictions;
independence; and decision-making, are, in the researcher's opinion, relevant for
childhood social functioning with a view to reaching maturity.
significant towards the end of adolescence.
This becomes more
The researcher will work from the
assumption that the child needs to strive towards these factors of maturity to establish a
foundation for healthy social functioning in adulthood.
She focuses on the literature
surrounding childhood social functioning next, and applies these attributes as appropriate
to the literature.
In a study on stress resilience in children to determine the role of temperament on
behaviour disturbances, the researchers took great care to control the child and
environmental variables. In this study Kyrios and Prior (1990, in Strelau, 1998: 345-346)
viewed these child variables as behavioural adjustment, development history, fine and
gross motor coordination, health history, facility attendance, word knowledge, stress, and
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temperament.
Environmental variables consisted of marital adjustment, parental
psychological functioning, child-rearing practices, parental employment, and social status.
For much older adolescents psychological adjustment can be measured in the following
areas: self-evaluation, family relationships, school functioning, social functioning, sexual
functioning, goals and implementation of goals, coping styles, functioning at work,
communication, emotional expressiveness, and routines (Strelau, 1998: 348). In seeking
to control other aspects that would influence the child, the authors provided certain
‘signposts’ as to what is relevant when looking at the child’s functioning.
Chen, Chen and Kaspar (2001) did a study in which they examined the relevance of
group social functioning to individual social, academic, and psychological adjustment,
based on a sample of 323 elementary and high school students in China. These authors
have used elements from different authors with regard to the social functioning of
children. Those found relevant to social functioning were social preference, leadership,
school-related
competence
and
problems,
academic achievement,
psychological
adjustment, including loneliness, depression, and perceived social competence. It was
also found that social functioning, including sociability, aggression, and shyness
inhibition, of group peers had unique contributions to individual social and school
adjustment and to adjustment problems, over and above the child's self social functioning.
It also was found that the contributions of peer social functioning to individual school
adjustment might depend on the child’s social characteristics, and that the relations
between child social functioning and socio-emotional adjustment might be moderated by
group context.
As an important social context, peer group interactions provide extensive opportunities for
children to learn from others. Social connections and networks that children establish and
maintain with peers may constitute a major source of social support for children to cope
with emotional stress and adjustment difficulties. Moreover, during social interactions,
constant peer evaluations and reactions, based on culturally prescribed group norms and
values, may serve to regulate and direct children's behaviours and, thus affect
developmental
processes
and
pathways.
Furthermore,
children's
pro-social,
cooperative, and sociable behaviours have been found to be associated with indexes of
social status, school-related competence (which involve four overlapping areas: (a)
frustration tolerance, (b) assertive social skills, (c) task orientation, and (d) peer social
skills), and psychological well-being. Pro-social children tend to be liked by peers and
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1
viewed as competent by teachers, and tend to be academically proficient and emotionally
stable. In contrast, aggressive-disruptive behaviour is associated with social and school
problems; aggressive children are often rejected by peers and adults and have difficulties
Interestingly, it seems that since shy-inhibited behaviour is
in academic areas.
considered socially immature and maladaptive, shy and anxious children are also likely io
have problems in peer acceptance and school adjustment (Chen, Chen and Kaspar,
2001).
For the researcher, these identified variables offered a good starting point in identifying
what determines a child’s functioning. In using these variables, one should keep in mind
that the focus of social work falls more strongly on social functioning, which will relate to
those variables that influence the status or role that the child occupies within his
environment.
A first attempt by the researcher at defining social functioning for the purpose of
developing a system for the classification of problems in childhood social functioning is:
the quality or condition of the child’s interaction with others and his/her
environment,
with
a
constant
need
for re-adjustment,
brought
about by
developmental changes. It is viewed within the context of the child’s contribution
to the interaction through behavioural, emotional, and temperament traits,
balanced with an understanding of his/her family’s and community’s ability to meet
needs and the existence of stressors and/or obstacles to healthy development.
When the researcher reinterprets the understanding of social functioning in terms of role
performance (as the developers of the adult PIE did), it will imply all of the aspects
mentioned in this initial definition.
3.7.3 The child's social environment
Caret Germain and Alex Gitterman (1996) wrote widely about the ecological approach or,
in their words, the life model of social work practice.
When they use the word
‘environment’, they typically mean environmental resources and supports or the opposite
- environmental challenges or scarcities. According to these authors in Saleeby (2004),
environmental resources include formal service networks such as public and private
agencies and institutions. Supports also include informal networks of relatives, friends,
neighbours, workmates, and co-religionists. However, some formal and informal support
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systems may be unresponsive or cease to be supportive and the social and physical
environments involved in coping must be assessed as well. Germain and Gitterman also
refer to habitat and niche, terms from ecology that amplify the idea of environment.
Habitat is the place where the individual organism and its group can be found, and niche
is the organisms' place in the local ecosystem (Saleebey, 2004).
The ecological environment, or the context in which human development occurs, can be
seen as a set of ‘nested structures’ and are explained as follows by Eamon (2001):
developmental outcomes are influenced by interactions within microsystems, or the
immediate settings that contain the developing person (home, peer group, and school).
The remaining structures, in order of the distance of their influence on the developing
individual, include mesosystems,
which involve processes among two or more
microsystems - both contain the developing person (relations between the child’s school
or peer group and family).
These are followed by exosystems, which refer to the
processes between two or more settings; only one containing the developing person
(home and parents’ workplace, social support system). Then come macrosystems that
contain influences of the broader cultural and socioeconomic environments (material
resources, opportunity structures, alternatives available throughout the life course,
lifestyles and customs, and shared knowledge and cultural beliefs). And chronosystems,
which include effects of consistency and change over the life course - incorporating the
time dimension (changes such as parental divorce, historical events, or social conditions
occurring within the environment, and changes such as life transitions, within the
developing person).
Social support has a huge significance on childhood functioning. Family and friends offer
various types of support that affect parenting; they may provide financial assistance or
labour (e.g. money or help with child care), encouragement or positive evaluations of
parenting performance, and information such as strategies for achieving a childrearing
goal. When individuals receive social support, they interpret and evaluate it according to
their perceptions of what constitutes support, who should provide it, to whom, and under
what circumstances. The impact of social support is conditioned by how it is evaluated by
the recipient. Those who feel satisfied with their social support are likely to experience a
sense of confidence and emotional well-being stemming from their knowledge that friends
and family members are "on their side".
Of all possible sources of support, it is the
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husband whose supportiveness is most highly related to mothers' parenting self-efficacy
(Holloway, Suzuki, Yamamoto and Behrens, 2005).
Problems in the environment, identified through the adult PIE, refer to the inability of the
environmental system to exercise its function. Table 3.1 gives an idea of what systems
the PIE identified, and what their functions are.
This is significant for the future
development of the environmental systems functioning in the child’s life. Most of these
systems are relevant for the functioning of the family who is responsible for the child’s
well-being. More specifically the ‘nested structures’ and the relevance of social support
on childrearing will be considered together with the PIE’s existing format, when the
system is developed further on a post-doctoral level.
TABLE 3.1 ENVIRONMENTAL SYSTEMS AND FUNCTIONS
ENVIRONMENTAL
FUNCTION OF SYSTEM
SYSTEM
Economic / basic needs
the production, distribution, and consumption functions, that is, the ability of the
system
community to meet the basic needs of its citizens for food, shelter, employment,
and transportation
Educational / training
the ability of the community to nurture intellect, to develop individual skills, and
system
to foster individual potential to its optimal level
L----
’ > ludicial / legal system
; health, safety and social
the criminal justice system's primary function of social control and enforcement
measures by police.
problems exists of the absence of these service delivery systems in the
service system
community or natural disasters
voluntary association
the common ways in which people satisfy needs for social support and
system
interaction outside the family and work place, like participating in informal
community and religious groups. Problems will then entail the absence of the
groups of the client's choice or the lack of the community’s acceptance of the
client's community group of choice
affectional support system
this system enables the social worker to record the situation of clients who
either have under involved or over involved personal environments. It consists
of the network of social relationships of the client with everyone in his personal
social system who has an affectional tie with the client. Problems do not
include the clients ability to access these system (factor I), but rather the
absence of such a system or a excessively involved system
Karls and Wandrei, 1994: 29, 30 and 31.
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The researcher needs to stay within the boundaries she has set out for this study (which
excludes the development of the environmental factor), while still responsibly including all
aspects related to the social functioning of the child (with the initial exclusion of the
environmental systems).
However, the context in which the child functions cannot be
separated from the aspects intrinsic to the child. To keep the balance for the sake of this
study, the researcher will acknowledge the family and the school as the child’s immediate
context (microsystems), although this is not as broad as the rest of the community systems
contained in PIE. She will consider aspects of it within her conceptual framework, but these
two ‘institutions’ will also receive attention as systems within the environment in post
doctoral development.
The researcher is also of the opinion that the family is of more
primary concern to social work than the school, since the latter is an area shared with the
Department of Education and the teaching profession.
None of these contexts can,
however, be excluded in any discussion of the social functioning of a child. The researcher
will bear this in mind in her literature survey in the next chapter, and will keep her focus on
the transactions taking place within these contexts, instead of on the contexts themselves.
3.7.4 Childhood social functioning in a South African context
A similar sentiment with regard to optimal functioning of the child and family, can be found in
policies of South African government, specifically the White Paper for Social Welfare of
1997. Roestenburg (1999) studied the focus areas of the government when he developed
indicators for social welfare.
He claims that, amongst other areas, social welfare
specifically targets individuals and the various contexts within which they perform their roles.
The most important context is that of the family since the family can be regarded as the
basic unit in society that requires strengthening (White Paper for Social Welfare, 1997:20).
■
Roestenburg’s (1999) description of the policy focus can be found in his doctoral
thesis at the University of Johannesburg, but for the purposes of understanding
childhood social functioning within a South African context, the researcher will make
a summary of the key concepts derived from his discussion:
■
The family seeks to care for, nurture and socialise its members
■
Children and youth, persons with chronic illness, physical and mental disabilities, the
elderly and those who are not functioning optimally and have special needs, are
usually members of a family.
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.
1 f
"
The aim of family and child welfare services is to preserve and strengthen families,
so that they can provide a suitable environment for the physical, emotional and social
development of all their members.
■
Welfare policy indicates that the life-cycle perspective will be used to determine
programme focus areas.
This approach refers to the interaction between family
members, the wider social environment, and their social support networks across the
life span.
w
Programmes should therefore make provision for the needs of families during the
different stages in the life cycle. These (family) stages are: early childhood and the
childhood development phase (including the preparation and child-bearing phase);
the school-going and adolescent years; launching stage of young adults, middle
stage; and retirement and old age.
■
Special attention is to be given to families with circumstances that place an extra
burden on their functioning, such as families with children under the age of five years,
single parent families, and families with handicapped or chronically ill members.
Services envisaged for high-risk families are enrichment programmes, parental and
family guidance, and growth related programmes.
*
Concern is expressed in the white paper for children in difficult circumstances.
Factors that affect child development and growth are found in the following child
groups:
O
Pre-school children who do not receive childhood development services.
O
Children requiring out-of-home care or residential services such as foster care
and adoption, and disabled children who are the victims of discrimination, and
are therefore denied access to educational and other facilities.
o
Children with chronic diseases such as HIV/AIDS; abused and neglected
children, street children, children who are employed; children abusing
substances; children whose parents are divorcing; and children who are
under-nourished.
o
Welfare programmes are also focused on the needs of the youth as a
developmental stage in the life cycle, especially the needs of specific target
groups such as juvenile delinquents and youths wandering about aimlessly.
■
Apart from the family, social welfare also has a role to play in alleviating poverty in
rural areas, informal settlements, and parts of urban areas where people are not
integrated into mainstream society.
According to the policy there is a significant
relationship between poverty and family disintegration.
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K >
■
Other social concerns are also on the social welfare agenda, such as promoting
access to services,
removing
discrimination
(promoting
equity),
community
development, rehabilitative services, and protective programmes for groups of people
who suffer from social pathologies such as alcoholism, drug abuse, and other social
phenomena that require rehabilitative interventions.
■
Another focus-area and responsibility of the social welfare system concerns social
security, which incorporates the state’s responsibility to promote subsistence by
providing financial assistance to fulfil basic needs, and social insurance to individuals
who are unable to continue in a paid economic role to maintain their level of well
being. Social security is closely associated with poverty alleviation.
3.8
Previous attempts at classifying social problems in children
In the course of her correspondence with James Karls, the researcher received a copy of
the Classifications and Codes for Children and Youth - Social Work, by Minnesota
Systems Research Incorporated, completed in 1975 and revised in 1977.
It was
developed under the DHEW Maternal and Child Health Training Grant. Prof. Karls does
not know whether there was any formal publication of these codes. A limited internet
search by the researcher also revealed nothing. The search was limited by the fact that
the academic online library of her university did not search as far back as the 70s, and an
internet search on Minnesota classification codes did not produce the desired
classification system. Since Prof. Karls found it significant, she decided to refer to it as
part of guiding her conceptual framework. Annexure 1A holds the codes that were sent to
the researcher by Prof. Karls. Although the codes will not be relevant to the development
of the new technology, the items will be used as guidelines through its incorporation into
the conceptual framework.
3.9
A conceptual framework
At this point it should be made clear that, according to the design and development
process, it is necessary to place a development within its theoretical framework.
However, as with the original PIE, this study will attempt to keep the new technology atheoretical, in order to make it applicable to different social work methodologies
(principles of the a-theoretical system will be explained in Chapter 5).
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The first part of this chapter attempted to illustrate that the social worker and the
profession both function within domains, and for this reason a classification can be
introduced into the paradigm of a profession while still allowing practitioners to follow their
own method of practice. The purpose of this chapter was to identify the role of the new
technology for social work - supporting the notion that social workers should be able to
describe the ecological, person-in-environment fit, as their purpose for intervention.
Karls (Karls, Lowery, Mattaini, and Wandrei, 1997) argues that:
There is a significant difference between using the concepts in a theory and the
theory itself. We think that we sometimes grant theory status to constructs that are
not really theories, and social role theory probably belongs in that category.
Moreover, the role identification system in Factor 1, has appeared to work very well
as a mechanism for identifying client problems and in affirming social work's area
of expertise in enhancing client social functioning.
The way in which role theory concepts were applied will become clear in Chapters 5 and
7. For now it is necessary to understand that the researcher is attempting to establish a
guiding framework that shapes the theory (literature) to be included, to start guiding the
process towards operationalising what will go into the new technology, in order for it to
classify the social functioning problems of children. In order to accomplish this, she uses
concepts of the person-in-environment / ecological theory and not the theory itself.
3.9.1
Diagrammatic illustration of conceptual process
To provide an overview of this chapter and to assist with narrowing down the scope of the
conceptual framework, the following diagram shows where the researcher found the most
significant concepts that will guide the remainder of the development in this study. Figure
3.2 illustrates that the researcher started with investigating what social work’s focus has
been throughout its history and accepted definitions of the profession.
This led to
understanding its focus as enhancing social functioning through looking at a person-inenvironment fit. In attempting to find an integrated model for doing this, and in describing
the concepts of social functioning in childhood, it can be concluded that optimal role
performance in interaction with others with regard to time and social development
provides the context for the conceptual foundation of this study.
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through treatment, ecological sti
, and the promotion of soot
developmental stages & life changes with consideration to self-reliar
inclusiveness, empowerment and integration.
© Copyright Rika Swanzen 2005
FIGURE 3.2 THE CONCEPTUAL PROCESS
It is now necessary to summarise the framework for the content found to be descriptive
and representative of a development that aims to offer a uniquely suited unifying system
to social work, which will classify the social functioning problems during childhood.
3.9.2 Concepts that describe childhood social functioning
To simplify things simple, the researcher will now only consider concepts that are relevant
to social functioning in children.
All of the concepts can be referenced back to
discussions in this chapter and to the Minnesota codes in Annexure 1 A.
Based on Ramsay’s (1994) depiction of person-in-environment as having the three
essential concepts - people, interactions, and environment, the researcher has allocated
the identified concepts as appropriate. The person-component involves aspects of the
child that will influence the interaction the child has with the environment. The interaction
component involves the influences people who interact with the child have on his
functioning. The environment (which will only be mentioned now, but which will receive
more attention at the post-doctoral stage) involves the systems which serve a function in
the child’s life. With regard to the contribution of the Minnesota classification system,
child aspects were linked to the stages of growth and development.
These will be
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d in Chapter 5, when the actual development takes place. The chapter will also
ght other aspects from these sources, which will form part of the factors to be
developed at post-doctoral level (mental and physical well-being), and will not be used as
a guideline for the literature study in the next chapter.
Figure 3.3 illustrates all three parts (as highlighted by Ramsay in the discussion of an
integrated model for social work, earlier in this chapter) of the person-in-environment with
regard to the social functioning of the child.
Figure 3.3 indicates the concepts found
throughout this chapter, with a side box that serves to cross-reference where the
concepts came from.
Strelau (1998), Minnesota
codes (1977),
Bronfenbrenner(1977)
Person-Process-ContextTimw Model), Eamon
(2001) Chronosystems;
Chen, Chen and Kaspar
(2001) Older adolescents,
Bucknek (1986) Maturity
© Copyright
Rika Swanzen
2005
Behaviour adjustment;
developmental history;
fine & gross motor
coordination; facility
attendance; word
knowledge; stress;
temperament; self
evaluation; academic
achievement;
sociability; goals; task
orientation; leadership;
coping styles; routine;
aggression; assertive
skills; life transitions;
emotionally stable;
forming relationships;
decision-making;
independence; creativity
Minnesota codes
(1977), Supers
Harkness (1994), social
setting, Eamon (2001)
Macrosystems, Kondrat
(2002) influencing,
Bronfenbrenner (1977)
mechanisms through
which functioning is
realized
Child rearing; home
management; financial
problems; socialization;
behaviour management;
customs; culturally
regulated customs for child
care; psychology of care
takers; beliefs & values
about nature of
development; parental
divorce / marital adjustment;
recreational activities
Minnesota codes
(1977), Eamon
(2001) Exosystems,
Karls & Wandrei
(1994) factor 2
Inadequate housing;
problems in
neighbourhood; problems
in school setting; social
services inadequate;
mental health services
inadequate; economic
system; judicial / legal
system; social support
system; association
system (recreational); key
words: accessibility &
ooDortunitv
FIGURE 3.3 A PERSON-IN-ENVIRONMENT CONCEPTUAL FRAMEWORK FOR
CHILDHOOD SOCIAL FUNCTIONING
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3.10
Summary
Coming back to the discussion at the beginning of this chapter regarding the paradigm of
social work, South African social work history shows that most psychoanalytic theory has
been found unhelpful in the face of the- huge demands that have to be dealt with in
practice. A lot of these demands, which are related to poverty, have not changed much,
and we will be betraying our profession if we do not start claiming that our focus is on the
level of person-in-environment.
Considering the concepts described in Developmental
Social Welfare, in the glossary of terms, it may be observed that the approach currently
depicted by practice compliments the person-in-environment approach.
If a paradigm
tells you where to look for the answers (see definition in glossary of terms), then do we
really want to claim that, as a profession, we are not looking for answers in the interactive
and dynamic fit the individual has with his environment?
Having an understanding of
person-in-environment as a unifying construct paves the way for the adoption of a
classification system that is applicable to different social work practice methods.
Chapter 4 starts with the applications of the conceptual framework identified in this
chapter. The concepts are further re-categorised as depicted by Tesch (1991, see step 5
in Chapter 2), and Rubin and Babbie (1993, in step 7 of Chapter 2).
This re
categorisation serves to further funnel the concepts involved in the functioning of the child
in his environment, or, in other words, his social functioning. It is essential to bear in mind
throughout this study that it is the concepts of the theory are utilised, and not the theory
itself.
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< /
Chapter 4
Childhood Social Functioning
Life is either a daring adventure or nothing. Security does not exist in nature, nor do the
children of men as a whole experience it. Avoiding danger is no safer in the long run than
exposure.
- Helen Keller (US blind and deaf educator, 1880-1968) -
4.1 Introduction
It is generally accepted that most of the social work practitioners who work with children,
either directly or indirectly, will also treat the parent, whose problems in social functioning
will inevitably influence the child’s upbringing and maturatioixjThe theory explored inthisA
chapter was guided by the framework developed in the previous chapter.
The main
theoretical frameworks used to establish what childhood social functioning will entail,
\
were Bronfenbrenner (1977, in Eamon, 2001) on the ecology of the child (niche - status /
role, and habitat - physical and social setting), the Minnesota classification codes for
children and youth, and the adult PIE (Karls and Wandrei: 1994). Certain terms among
these concepts and codes repeated themselves or complimented each other within the
construct of person-in-environment.
The researcher made use of this construct which
focuses on the variables of the child, the influences on the child through interaction, and
the ability of the environment to meet the child’s needs. The terms identified through the /
conceptual framework are used as key words in the literature study for this chapter.
y
The conceptual framework cannot serve as the structure for the new technology,
It
guided the selection of content, but the content still needs to be developed into a usable
system that will classify the social functioning problems of children. Cooper (1989) points
out that, in gathering information, a precise definition of the target population is needed.
In addition, it is necessary not only to determine where sources of information can be
located and whether the literature search is adequate, but also to protect validity
throughout the process.
This links back to step 6 of the Adapted Design and
Development Model guiding this study. The researcher presented a comprehensive plan
for this step in Chapter 2. The plan now finds its shape in this chapter.
According to Cooper (1989), the purpose of analysing the information is to reduce the
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/
< >
data to an intelligible form.
The synthesis of the literature has as its goal to find
intervening variables that explain and reconcile different conclusions.
The process of
synthesis can also involve the creation of new concepts, or the modification,
transformation, or reorganisation of existing concepts.
Step 6 explains how the
researcher approached the task of staying within the framework, while simultaneously
reducing the literature relating to this field into an understandable format that serves as
the basis of the new technology.
The most difficult aspect of this chapter for the researcher was the question of how much
and what to include. It is impossible to have a comprehensive discussion on each of the
topics. She allowed herself to be guided by the opinion of Karls and Wandrei (1994) that
the social worker needs broader knowledge outside of the classification system. In other
words, the researcher assumes that the users of the classification system to be
developed will have knowledge about the social functioning problems they are assessing
(gained from training in the system and from knowledge of their own practice modelsj-^oj"
With reference to appropriate literature, the researcher’s task is to develop definitions of
the categories and topics/themes she includes in the classification system.
She focuses
on indications of the presence of the problem, possible causes for it, and the
consequences the problem will have on the social functioning of the child. In doing this
the researcher provides the social worker with signs to look out for when identifying the
problem, she justifies why the social worker will need to intervene in the problem, and she RSO
highlights the focus areas for intervention. For example, if poor attachment and poor role
models are some of the contributing factors to substance abuse, the classification system B®
alerts the social worker to the need for the child to develop a secure relationship with a
significant other, who can serve as a positive role model.
4.2
[Bl
Restricting the concepts used in this study
Key concepts identified from the framework developed in the previous chapter, gave
strong description of what the social functioning of the child entails. Table 4.1 sets out^S
the two parts of the conceptual framework that will be the focus of this chapter. It will
become clear throughout this chapter how the concepts relate, and how the researcher f O1
chooses to organise these into a manageable format.
(It should be noted that the
environmental variables have now been left out of the discussion, since they fall outside
the scope of this study.)
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i
A /
TABLE 4.1 FOCUS AREAS FROM THE CONCEPTUAL FRAMEWORK
chiid y-j/iabl-ii
• Behaviour adjustment
• Developmental
history
• Fine & gross motor
coordination
® Facility attendance
• Word knowledge
• Stress
• Temperament
• Assertive skills
• Life transitions
• Self-evaluation
• Academic
achievement
• Sociability
• Goals
• Task orientation
• Leadership
• Coping styles
• Routine
• Aggression
?' I *
• Child rearing
• Home management
• Financial problems
• Socialization
• Behaviour
management
• Culturally regulated
customs for child care
■« 4
• Psychology of care
takers
• Beliefs & values
about nature of
development
• Parental divorce
• Marital adjustment
The researcher started with a very extensive literature study into childhood functioning,
but had to narrow it down to fit into the boundaries of this study.
She initially used
literature which explored all of the variables mentioned above, and placed these within a
psycho-social listing of problem classifications. This explains why emotional and physical
problems as well as concepts such as temperament were initially included in the first draft
of the new technology. To simplify this chapter, however, the researcher excluded these
concepts from the literature survey. This formed part of the continuous re-evaluation of
validity during the initial development. The researcher realised that it was more difficult to
determine validity if the focus was too broad, because of the many interactional dynamics
at play when one addresses the social functioning of the child. With the exception of
neurological and physical aspects (moved to Factors 3 and 4, respectively, as with the
adult PIE, following Prof. Karls' suggestion), she used the same literature and
restructured it into a person-in-environment framework.
The concepts of social functioning in childhood focus on the niche and interaction level,
which refer toThe~sbcial roles a chifdTinds^himseif in, in the growing years, and the
interactions~vi/hich exude influences on the child^performance in that rolej When the
social worker wants to identify social functioning problems, this implies the problems
experienced in the interaction that takes place in relationships. Chapter 3 showed the
reciprocal interaction between the child and his environment as the domain for social
work intervention.
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4.3
Decision process for inclusion
One of the biggest challenges in the gathering of information was to decide what to
include in the literature study and what to exclude. This also influenced what concepts
the researcher decided to include. In step 6 of the Adapted Design and Development
Model in Chapter 2, Rothman, Damron-Rodriguez and Shenassa (1994) stated that
synthesis could entail either the creation of new concepts, or the modification,
transformation, or reorganisation of current ones.
The researcher will reorganise the
concepts identified in the conceptual framework of the previous chapter.
Through an
initial overview of the literature available on the functioning of children, the researcher
gained an idea of how comprehensive the theories on the topic are.
She therefore
needed to decide on what to include and what to exclude from this study. The final
decision was based on two criteria.
Firstly, she directed her search by means of the
points identified in step 6 (under section 2.2.6.2. in Chapter 2). Secondly, she used the
unifying construct of social work, identified in the previous chapter (person-inenvironment), to narrow down the concepts that would be relevant to this study. Having
established what to look for, the researcher could then make decisions on how to modify
or re-organise concepts.
The researcher used the concepts in Table 4.1, and re-categorised it into broader
categories. One reason for this was to simplify the framework by judging what is relevant
for the purpose of a classification system.
The aim of a classification system is to
categorise concepts. Categorisation is possible when a number of concepts are able to fit
under a new heading. The researcher therefore combined some of the concepts under
the same heading, as will become clear in the course of this literature survey.
For
example, gross and fine motor coordination are seen as part of childhood development
for the purposes of this classification system.
Referring back to step 5 in Chapter 2,
Tesch (1991) pointed to the activity in building theory, which involves constant
comparison in order to describe the process of progressive category clarification and
definition. When the researcher finds conceptually related categories, she does not claim
that these form a theory, she merely strips away the particulars to arrive at an underlying
principle which she attempts to demonstrate support for. As she did the literature study,
she found support through establishing that certain concepts fit together. Other authors
would discuss similar phenomena under different terms, so she would combine these
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5 heading.
The second reason for re-categorising the literature into seven broad categories was the
researcher’s consideration of terms that are more ‘social worker friendly’. From her own
experience in the field and from the extensive study on the history of social work (as
demonstrated in the previous chapter), she would incorporate concepts under terms that
are complementary to social work terminology.
For example, she included a concept
such as task orientation under the category of performance, seeing that performance in
roles is, in the researcher’s opinion, a term that more social workers can identify with.
She did this primarily to increase the likelihood of face validity, meaning that she wanted
social workers to identify with the concepts that form part of the classification system.
The selected terms also had to be comparable to those of the person-in-environment
concepts, since the researcher claims that this is the unifying construct of social work.
The broad re-categorisation of Table 4.1 led the researcher to identify seven broad
categories under which most of the identified topics fall. This is an attempt to synthesise
the vast number of concepts into a sensible arrangement that can guide the rest of this
chapter. The seven categories are, by their nature, either part of the attributes the child
brings into the interaction (first five categories), or attributes the people directly involved
with the child bring to the interaction (last two categories):
■
Development, routine, behaviour, performance, and stressors as attributes the
child (as the person) brings into the transaction with the environment.
These
categories can serve as broad categories that will include most of the concepts,
and are distinctive enough to justify a separate category.
For example,
performance can include goals, achievement, etc., but routine involves a different
dynamic that requires a discrete category. (It is relevant to note at this stage, that
the concepts related to physical and mental health have been excluded from this
study, and will be addressed in post-doctoral development).
■
The influences brought about through interaction with the immediate environment
can be simplified into the categories of socialisation and parenting. These are
strongly regulated and influenced by cultural customs. This is a good reason why
the researcher should develop the new technology in a manner that will not
exclude or support any single culture.
Apart from considering multi-cultural
literature, the system can be tested on different cultures to see how the
classification allows for acknowledgement of the cultural influence on the child.
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(This testing would be done in the course of post-doctoral development.)
To
provide
support
for
her
decisions
throughout
the
conceptualisation
and
operationalisation process (steps 6 and 7, Chapter 2) the researcher compared her
concepts with two other frameworks (this is a form of triangulation which is a validation
strategy, see ‘a-z’ in step 14).
The one framework was the Minnesota Classification
Codes for Children and Youth, and a Tool Box for children and teenagers developed by
‘Conduct Management’ (see reference in bibliography).
Further reference to these
frameworks will be included in this chapter, and both can be viewed in Annexure 1A.
Working from the conceptual framework (Chapter 3) and the guidelines set for the
literature study in step 6 (Chapter 2), the researcher was able to confirm, through the
frameworks identified above, which concepts to explore in her attempt to develop a
classification system for childhood social functioning problems. It is interesting how the
literature search in this study identified the same concepts as those in the frameworks in
Annexure 1A.
The researcher will now discuss these concepts under the broad
categories, and illustrate how these relate to the two frameworks mentioned.
In order to illustrate how the researcher summarised what was learned from the literature
in each section, as it applies to the aim of the development (the classification of social
functioning problems in children), she highlighted these sections in blue. This makes it
easier to refer back to those sections in the literature which gave shape to the
development of terms and definitions of the classification system in the next chapter.
4.4
Consideration of childhood development
The importance of the child’s developmental years is best described by St Francis Xavier
(Religious leader, saint and apostle to India, 1506-1552), who said: “Give me the children
until they are seven ^d_any.one -may—have-4hemjafterwards.”
It is logical that a
theoretical model about children will inevitably involve theory on development.
The
researcher will not describe all theories on childhood development, as they are varied and
comprehensive, but throughout her literature search she continually sought out the
theories that had an underlying developmental model, to explain phenomena in child
functioning. As an orientation she included the broad principles explaining development.
There are six guiding principles to understanding development, as presented by Cairns
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\ /
(1979, in Rothbart and Ahadi, 1994: 55):
■
Behaviour, whether social or non-social, is appropriately viewed in terms of an
organised system.
■
The system of which behaviour is part, is not merely ‘organismic’, but for some
functions, particularly social behaviour, it must be expanded to include the acts of
other organisms and the reciprocal relationships that are formed with them.
■
There is continuity in development, such that the organisation at one stage
provides the basis for organisation at the next stage.
It is essentially a dynamic
process that promotes reorganisation and adaptation over time.
■
The need for multiple levels of analysis is a direct corollary of the assumption that
there are interlocked systems associated with the control of behaviour, from
neurobiological events to socio-cultural ones.
■
Behaviour should be viewed in terms of the organisation of which it is part: what
appears to be the ‘same’ activity at two different stages or in two different species
may be similar only in superficial properties.
*
The organism is continuously active and adaptive throughout the course of
development, relative to what system is involved and the circumstances in which
adaptation is assessed.
To translate the above guiding principles into social work language for the purpose of this
study, the researcher can say that development occurs within the organised family
system; that some functions of the child, such as social behaviour, include the acts of
parents and other family members and the reciprocal relationship formed with them;
development at one level prepares the child for development at the next stage, and this
encourages adaptation across time; the control of behaviour is affected by attributes
within the child and to cultural factors in the child’s environment; the child’s behaviour has
meaning only in the context in which it is displayed; and the child partakes in his
development relative to the circumstances in which it is played out.
4.4.1
Developmental stages
The Minnesota classifications and codes for children and youth (1977) used the
categories identified in Table 4.2 for the “Stages of Growth and Development”.
She
included some of the concepts coded under these categories:
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TABLE 4.2 MINNESOTA CLASSIFICATION’S CATEGORIES FOR STAGES
Infancy
Early
Pre-schoolers
childhood
School age
Puberty
Adolescence
child
0-12mnths
1-3 year
4-5 years
6-9 years
10-13 years
14-18 years
Body
Dependence
Curiosity, lacking
Adults, non
Conflict
Abortion
Family
Concern about
exploration
Feeding
family
Exploration
Dependence
Home
child
Mother-infant
Fearfulness
Enuresis
Peers
Peers
Conflict
Object
Feeding
Mother
Problem-solving
Physiological
Family
exploration
changes
People
Mother
Peers
Space
Object
Play
exploration
exploration
Resistance
Relationships
Relationships
Homosexuality
Sexual
Independence
development
Relationship
Withdrawal
Physiological
changes
Self-feeding
Resistance
Pregnancy
Self-toileting
Self-care
Psychosocial
changes
Space
Verbal
exploration
development
Relationships
Speech
School problems,
drop-out
Sexuality
Vocational plans
Withdrawal
'Resistance' is a concept that appears in different stages, and the Minnesota classification
codes referred to resistance to adults, feeding, toileting, treatment (by child and by
parent/s), self care, and speech.
Most of these concepts will be found throughout this
chapter, although it will be in a different order, arranged according to the categories
decided on, as described in the previous section.
Statistics South Africa© (www.statssa.qov.za/census01) gave the descriptions of the
people counted in South Africa during Census 2001 as grouped according to the various
stages in the life cycle: infants (aged 0-4), children (5-13), youth (14-34), adults (35-64),
and the elderly (aged 65 and above).
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The researcher is of the opinion that six categories for development stages as portrayed
by Table 4.2 are unnecessary. From the table above it can be seen that the concepts
under the first two categories, the middle two and the last two are very similar, which
implies that they share the major changes and developmental tasks of that age and can
therefore be combined. With the purpose of classification being to narrow down concepts
to the bare minimum, the researcher believes she is justified in her choice to reduce the
stages to four: baby and toddler stage (infant - 2 years), the pre-school stage (3-6 years),
the school stage (7 to 12 years), and the teenage and adolescent stage (13 to 18 years).
These form part of the development in the next chapter.
4.4.2 Milestones
The first term that comes to mind when thinking about the child’s development, is
milestones. It is what most professions working with children use to evaluate how well a
child is growing on all developmental areas.
This is relatively culturally and
environmentally sensitive. In the researcher’s opinion, most social workers are aware of
the fact that the environment provides the stimulation for development, and communities
with socio-economic disadvantages provide fewer opportunities for stimulation (such as
creches and good schools). Milestones are averages, giving only an indication (and not
an absolute cut-off line) of what can be expected of a child at a certain age. Children,
who fall below the average, justly cause concern regardless of cultural beliefs about the
nature of development. In the researcher’s opinion, the rituals to signify developmental
changes are what differentiate cultures, and not the averages for progressive growth.
This aspect is closely linked to neglect, since a certain amount of stimulation is needed
for a baby to develop into his genetic potential.
In assessing the child’s development, it should be noted that a delay of one year is a
basic criterion that indicates a need for further investigation through the use of a number
of tasks in each of several areas of intellectual functioning. The mere presence of a delay
on one task or a set of similar tasks is certainly not sufficient to make a definitive
judgement about the case. Any child will show some advance or delay. What matters is
overall cognitive organisation and not the result of one specific experiment (Voyat, 1982:
14-15). This can, to a greater or lesser degree, be applied to other areas of development
as well.
The principle behind this is that overall development should be considered.
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Does the child show delay in most areas or only in one? In the next section, movement
(such as sitting up, kicking, etc) is regarded as critical, and, in the researcher’s opinion, a
delay of only a few months should be viewed in a serious light.
The sources on childhood development are as vast as any shared concept amongst
multiple disciplines can be. For this reason the researcher included the summary table
she uses with success in her support to new parents and in training of volunteers, fosterand adoptive parents in Annexure 2. A similar sentiment was voiced by Wolff (1960: 8) in
his intention to:
[limit] the discussion to concepts and processes of developments which could be derived
from simple and concrete observation; and for the position ... theory takes regarding the
inherent co-ordination between the organism and its environment, which is in essence the
problem of development.
From the milestones in Annexure 2, development can be classified on five general levels:
perceptual (visual and hearing); motor or physical development (gross and fine motor
movement and skill); cognitive (language, mental operations); emotional or psychological;
and social development. Milestones assist in determining the stages at which appropriate
developmental tasks should have been achieved by the child. A delay in development
will create problems in his social roles with friends. A delay of one year is used as a
basic criterion for further investigation.
It is necessary for the social worker to be aware of the influence cognitive functioning can
have on social functioning. Her reasons for highlighting this among other developmental
areas, are discussed next.
4.4.3 Cognitive development
The researcher felt it necessary to give more specific attention to cognitive development.
There were a number of reasons for this:
■
Through email correspondence, Prof Karlsfregarded as an expert on the
development of classification systems) suggested that the researcher explore
Piaget’s work on childhood development. He was familiar with previous attempts
to develop a classification for children, and remembered that these researches had
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K >
consulted Piaget’s work.
The concept of word knowledge was also indicated as a child variable in social
■
functioning (Table 4.1).
Language development is dependent on cognitive
development, and language is crucial in relationships.
The researcher is of the opinion that social workers in South Africa do not have
■
sufficiently extensive knowledge in this area, and she felt the need to explore this
area as a backdrop to the development of the classification system.
The
researcher therefore
explored
Piaget’s
sensorimotor
theory
on
cognitive
development. She summarised the various phases into tables (refer to Annexure 2), with
the other assessment aids.
This-section highlights what the social worker needs to
understand with regard to the child’s ability to relate to others at different stages.
Because of the relevance of communication as part of cognitive development, the
researcher felt the need to first highlight the context in which this development occurs.
?
4.4.3.1
Context of development
Gauvain (2001) states that the human intellect develops in a rich social and cultural
context, with the heart of development being the adaptation of the mind to the
circumstances in which growth occurs.
In this light cognitive development can be
described as the process by which basic biological capabilities are shaped, in ways that
fit/With the social and cultural context in which these capabilities will be used. The shape
and trajectory of intellectual growth is inseparable from the social and cultural character of
i
human experience, since humans are social animals and connections between
individuals are a critical aspect of mental life. These connections not only help organise
and sustain the human intellect, they also serve as templates for cognitive growth.
According to a socio-cultural view, people have access to the world indirectly rather than
directly. Material (such as labour-saving devices and forms of technology) and symbolic
tools (such as language, numeracy, and other representational systems) mediate human
behaviour, and cultures have developed many types of tools to support the daily activities
of people. Sign and symbol systems have also been developed to represent, manipulate,
and communicate ideas, providing people with the means to organise and accomplish
everyday practical actions, and their use is passed on to succeeding generations. An
important point is that these tools not only enhance human thinking, they transform it
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< >
1
(Gauvain, 2001).
Cognitive development in everyday life is nested within and emerges from a social world that
contains historical, contemporary and prospective influences. Conventions for organizing human
activity, material and symbolic tools that support knowledge and its development, and social and
institutional practices are inherent aspects of intelligent human action. These influences help
define and steer the developmental course, and they provide opportunities for and impose
constraints upon intellectual growth.
These opportunities and constraints help organize the
developing mind in ways suited to the needs and aspirations of the community in which growth
occurs. It is in this way that the social and cultural context operates as mechanisms for cognitive
change.
Gauvain, 2001.
Consideration should be given to what specific cultures’ ‘symbolic tools’ are, and social
workers should avoid imposing their cultures’ ‘material’ on the children they assess. This
serves as a guideline in the use of the ChildPIE©. Of more importance is that, since
cultural influences impose opportunities or constraints on the developing mind, the social
worker should be aware of any inappropriate cultural influences on the developing mind
of the child.
4.4.3.2
Child variables in development
The significance of Piaget’s theory on development is the relationship between learning
and the interaction the child has with his environment. For the focus of this study it is
necessary to identify variables within the child which will determine the course of
development as transactions with his environment unfolds. (Note that since this is a
classical theory, it has been adjusted to fit with contemporary theories on childhood - the
researcher therefore used an older source to find a purer description of the theory.)
Piaget’s theory of knowledge postulates that:
■
motor action is the source from which mental operations emerge (i.e. thought
arises from sensorimotor activity);
■
man’s knowledge about the world arrives from his concrete experiences with it;
and
■
the unfolding of man’s psychological potentialities exposes him to an ever
expanding sector of reality.
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F
K >
Its central assertions are that:
■
Intelligence is only one aspect of the general biological adaptation to the
environment.
■
Intellectual
adaptation
is
the
progressive
differentiation
of inborn
reflex
mechanisms under the impact of experience.
■
The differentiation of inborn reflex structures and their functions gives rise to the
mental operations by which man conceives of objects, space, time, and causality,
and of the logical relationships which constitute the basis of scientific thought.
Wolff, 1960: 9.
In summary (considering the above bullet points and information from the tables in
Annexure 2), the significance of Piaget’s theory to social work is to know that movement
from birth (and even as a foetus) is important for brain development and for engaging with
the environment from which it receives its stimulation and learning opportunities. It is also
relevant that, as the child gains more experience, more differentiation takes place and,
the more his potentialities unfold, the broader the world becomes that he is exposed to.
The mental operations resulting from this exposure become the framework from which
objects, space, time, and causality are perceived. From around two years, a child shows
increasingly more interest in people, and as intuitive, operational and abstract thinking
develops, the child becomes more adept at relating to his environment.
4.5
Routine
Society is an organised system that expects its inhabitants to adhere to some standard
rules, usually for their own well-being and that of others. From early on we teach our
children unspoken universal rules for their own sake, so they do not violate established
mechanisms which keep the society functional. For example, lavatory habits are private
and separate for the sake of public health, and non-compliance to this will lead to public
shame. Establishing routine is therefore one of the major pre-requisites for healthy social
functioning. This section is not only applicable to biological parents, but is particularly
relevant to children in foster or group home care.
In giving a framework for assessing the development of pre-schoolers, Lilian Katz (2005)
says that, in the course of the child’s development, behaviours in eleven categories can
be observed. These eleven categories are: sleeping-, eating-, and toilet habits; range of
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emotions; friendships; variations in play; responses to authority; curiosity; interest;
spontaneous affection; and enjoyment of the good things in life. All of these categories
are discussed under different sections of this chapter, but significant to this section are
the references to sleeping-, eating-, and toilet habits. The researcher categorised these
three as routine deviations for the purposes of her developmental study.
Katz (2005) says that it should be kept in mind that difficulties in any single category are
no cause for alarm. Indeed, difficulties in several categories do not imply irreversible
problems; rather, they help us notice those periods when the child's life situation, for
many possible reasons, is somewhat out of alignment with his or her emerging needs.
Routine contains all of the ordinary business of a child’s life, like getting up, going to
school, coming home, having dinner, relaxing and going to bed. Routine at a residence is
generally designed to teach the child the habits necessary for survival in society. Routine
provides a safe, predictable environment for children to work on their problems.
The
routine ensures that everyone is rested, properly nourished and well cared for. (Crone
1984:55-56.)
Routine is designed to teach the child the habits necessary for survival in society; to
provide a safe predictable environment; and to ensure that the child is rested, nourished,
and well cared for. A disturbance in any single area of the child’s routine is no cause for
concern.
The researcher is interested in those routine deviations that may be indicative of social
functioning problems in the child.
For example, bedwetting has been identified as an
indication of emotional problems in the child’s life. Or a refusal to eat may be a child’s
only way to control the chaotic environment around him. The first three of these eleven
criteria of sound development - sleeping, eating, and toilet habits - are particularly
sensitive indicators of the child's well-being because only the child has control of them.
The other criteria are more culture-bound and situationally determined. When the pattern
of a child's behaviour in about half of these criteria seems less than optimum over a
period of about a month, some remedial action should be taken.
An author often referred to in this section is Hersov (1985). This source is useful in that it
deals with the classification of a huge variety of childhood problems, focusing on signs
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and symptoms that indicate the presence of a problem.
Selecting this source was
consistent with the guidelines the researcher set for herself, namely to seek out sources
that had already attempted some form of classification.
4 5.1 Sleep problems
A child learns through the interactions with his world, and these are altered through his
own mood which is affected by how well rested he is. The researcher has observed in
practice that a tired child alerts a social worker to other problems, such as the child being
unable to sleep because of conflict between the parents late at night, or concerns that are
not appropriate for the child’s age keeping the child awake.
In using this as a
consideration in the classification of childhood social functioning problems, the social
worker should eliminate the possible physical causes of the sleep disturbance, and
assess whether an emotional aspect is involved which signifies problems in his family or
in other relationships.
Of perhaps more significance is the fact that disturbed sleep
patterns can be indicative of discipline problems. The child needs consistency in order to
develop healthy sleeping patterns, and the parent is the one responsible for providing it.
A varied sleep pattern, which may be perceived as a problem by parents, is common
among very young babies.
This will normally resolve itself if regular routines are
maintained and no other significant problems exist in the family.
The most common
presentation of sleep problems in the very young child is night waking and the difficulties
associated with settling the infant back to sleep. Physical and emotional factors will be
important here, as will the individual temperament of the child.
The child may wake
because of physical discomfort, caused by hunger, or a wet or soiled nappy. Similarly,
teething, colic, and other physical ailments are likely to produce disturbed nights for both
child and parents.
Toddlers, and even tiny babies, are sensitive to variations in the
emotional atmosphere at home. Emotional strains will affect the parents’ handling of the
infant, and produce changes in their regular routine, which the child will very probably
become aware of (Kerfoot and Butler, 1988).
Older children experience more upsetting sleeping problems, which include nightmares,
night terrors, and sleepwalking. Sometimes sleep disturbance is associated with illness
(raised temperature). In the absence of other significant problems, sleep disorders can
be regarded as a common and transient feature of development during childhood. The
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management of sleep problems in children is geared towards establishing a routine,
which clearly emphasizes the difference between daytime and night time activities, and
where the routine for the latter is followed with firmness and consistency. Where children
insist on sleeping in the parent’s bed, small rewards can be used to encourage the child
to stay in his own bed (Kerfoot and Butler, 1988).
In the researcher's opinion, the significance of disturbed sleep as a routine deviation is
that a tired child will not enjoy regular day activities and will be more likely have negative
interactions because of his exhaustion. Tiredness should be a definite consideration in
assessing the child’s interactions, since it will also affect his ability to concentrate. A
varied sleep pattern in young children is normal, but regular night waking and difficulty
falling back to sleep, together with confusion between night and daytime and sleeping
with parents are problematic for parents. These can be caused by physical discomfort,
illness, or the emotional atmosphere in the home. Older children experience nightmares,
night terrors, and sleepwalking.
4.5.2 Bedwetting or enuresis
The failure to achieve bladder or bowel control in accordance with developmental norms
may reflect a maturational delay in some children, but in others it may be indicative of
c
more serious disturbance.
Nocturnal enuresis - night time bedwetting - is the most common presentation of this
problem, and often occurs on its own.
Diurnal enuresis - daytime wetting - is less
common, but can accompany nocturnal enuresis, and is less likely to occur on its own.
Children normally achieve bladder continence between 3 and 4 years of age, and
incontinence of urine after the age of 5 is considered abnormal.
Enuresis is usually
divided into primary and secondary types. Primary enuresis refers to those children who
have never achieved bladder control, while secondary enuresis includes those children
who, having achieved bladder control for a time, then begin to wet again.
Enuresis appears to be more frequent in children of low social class or living in crowded
or disadvantage circumstances, and among those children reared in institutions. Children
tend to grow out of their enuresis problem in the 6 to 9 year age group. Enuresis is a
common problem, which is best seen in terms of a delay in learning bladder control. It
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K I
should be emphasized that the wetting is involuntary and not a deliberate action in the
part of the child (Kerfoot and Butler, 1988).
According to Shaffer (1985: 465-466), combined day and night wetting is associated with
a higher rate of psychiatric disturbance.
Bed-wetters who have an associated urinary
tract infection are several times more likely to wet during the day. Studies suggest that
the anatomical development of the pelvic floor is delayed in some children who wet the
bed, and that their bladders are more irritable. One percent of five year-old girls have
undiagnosed urinary tract infections, and the prevalence of enuresis in infected girls is
five times that of the general population. Infection is also more common in those who wet
frequently. Enuretic children pass urine more often and the volume passed is smaller,
which is indicative of a reduced functional bladder capacity (Shaffer, 1985: 466-467).
The parent’s behaviour also influences the achievement of bladder and bowel control.
Hersov (1985: 469-470) says that parents should put off toilet training until a child is
ready. A child shows his readiness by indicating a wish to pass urine during the daytime,
and/or showing some distress when wet.
The child’s cognitive and language
development calls for a delay until after the age of two. Apart from age, the quality and
amount of reinforcement that is given for appropriate urination or for continence, and the
quality and amount of punishment given for inappropriate incontinence is significant in
potty-training. Encouragement and social rewards hasten the process in children over
two years of age. A mild element of disapproval seems likely to be helpful, but undue
harshness causes stress and problems at the time of training. Other life events during
the toilet-training age also affect its success.
These include family break-up through
death or divorce, temporary separation from the mother for at least a month, birth of a
younger sibling, moving home, admission to hospital, an accident, and a surgical
procedure. Children who are dry at five years and start wetting during the next two years
are more likely to show emotional-behavioural difficulties. It is unsure whether the link
between enuresis and these difficulties is causal, reactive, or coincidental. Some hold
that enuresis is the direct manifestation of an underlying emotional disturbance or conflict,
and that wetting is an immature form of gratification, a manifestation of anxiety, or an
expression of hostility in a child who has difficulty expressing anger in more direct ways.
Depressed mood may have a role in producing enuresis, although the distressing and
sometimes stigmatising condition can result in the depressed mood (Hersov, 1985: 470-
472).
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After the age of five, with the elimination of possible physical (pelvic floor, infection), life
events (divorce, moving, accident) or contextual factors (such as crowded residence),
poor bladder control should alert the social worker to more serious problems. Combined
day and night time wetting is associated with a higher incidence of psychiatric problems in
children. Children who achieved continence and then start wetting again are more likely
to show emotional-behavioural problems. The child needs encouragement and social
rewards to be successful at potty-training.
4.5.3 Soiling or encopresis
Children are normally clean and continent of faeces by the age of three. Encopresis faecal soiling - is considered abnormal after the age of four. This commonly involves the
passing of faeces into clothing, e.g. underwear, pyjamas, etc., and may be accompanied
by smearing (Hersov, 1985).
Soiling by day after the age of five is present in only 1% of children, and is three times
more common in boys. By 40 weeks the infant is able to sit and reacts adaptively to toilet
training, but by one year ‘successes’ are less frequent and resistance appears again. At
15 months the child can stand upright, and the irregularities and resistances lessen, for
he now enjoys going to the toilet, and some children instinctively assume the squat
position. The developmental task is to achieve a working balance between contraction
and relaxation and at first each comes separately under voluntary control. By 18 months
speech is developing and the articulate child who is able to say a word for toilet can relate
this to his bowel movements, and so increase his voluntary control. By the age of three
there is an increased ability to withhold, and the child accepts and even asks for help.
Bowel function becomes a private affair by the age of four, with insistence on a closed
toilet door. Parents may deal with poor toilet training with punitive measures of varying
severity, sometimes leading to ‘holding back’ of stools, chronic constipation, rectal inertia,
and ‘overflow incontinence’. There is an association between training begun before 8
months of age and completed by 18 months, and emotional disturbance in children. The
‘potting couple’ refers to the situation between mother and child that has a system of
stimulus cues for communication.
Under normal conditions the mother responds
promptly to the child’s physiological cues, and her own communications in return make
the child aware of his own cues so he is able to achieve eventual autonomy in bowel
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function.
Some mothers miss stimulus cues so that their child’s learning becomes
deficient, and others misinterpret cues and acted inappropriately without regularly
reinforcing the appropriate behaviour (Hersov, 1985: 482-484).
Hersov (1985) believes that the causation of encopresis can best be understood by
considering the three main ways in which the disorder usually presents. With primary
encopresis, where the child never gained bowel control, children tend to come from
homes with little consistency in routine and social disadvantages.
With secondary
encopresis, where the child soils after achieving bowel control, the regressive behaviour
is precipitated by some emotional trauma, such as the birth of a sibling. Constipation with
overflow soiling reflects a disturbed relationship between the child and his primary
caregiver.
It can stem from toilet training that began too early, with the result that the
child is constipated through his stubborn refusal to pass faeces.
The soiling occurs
through the overflow of more liquid faeces around the faecal blockages.
Poor bowel control after the age of four is considered problematic. Primary encopresis is
associated with homes with little consistency in routine, whereas secondary encopresis is
precipitated by emotional trauma. Overflow soiling reflects a disturbed relationship
between the child and caregiver, most probably because of the use of punitive measures
by the parent. It is necessary for the caregiver to respond promptly to the physiological
cues of the child with communication that alerts the child to his own cues, in order for the
child to achieve continence.
4 5.4 Eating problems
The researcher believes that the significance of good eating routines is that the social
worker has always had an educating role.
She should develop insight into what
constitutes healthy living, and should therefore consider as part of assessing the family
and parenting skills, how the quantity and quality of food are handled. On the other hand,
for many toddlers, eating problems represent a phase in their development which is an
integral part of their need to assert themselves, and to rebel against parental authority.
Children have many ways of testing parental resolve and behavioural boundaries, and
eating may be just one feature of this process. The outcome for such children is usually
good. However, where parental attitudes are negative and intransigent, the problem may
persist into later childhood.
The relational aspect to this routine problem is therefore
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k >
twofold. Firstly, it has significance for assessing the extent to which the parent shows
responsibility for the child’s nutrition, and secondly, it shows the degree to which the
child's handling of food and eating times is a behavioural way for the child to assert
himself or to test boundaries. As with sleeping habits, this easily becomes a discipline
battle for parents.
Eating problems are very common in young children, and can sometimes arise in the
absence of other significant difficulties.
Eating problems in childhood are usually
categorised in the following ways (Kerfoot and Butler, 1988):
•
The quantity of food intake. Too little - one common eating problem is food refusal.
Pressure from the parent for children to eat certain quantities of food can lead to
resistance on the part of the child. Some parents have what we might call ‘The Clean
Plate Syndrome’, where the child is threatened with all manners of sanctions, or
coerced into finishing every item of food put before him. Mealtimes may well become
a battleground, with neither side being prepared to capitulate or compromise. In many
cases the child will have eaten sufficient for his dietary requirements without finishing
all that is placed before him.
Too much - another problem is those children who not only eat their meals, but
everything else. Such children will persistently complain of hunger, even after a large
meal, and will supplement their meals with a variety of other sources of food.
•
The type of food. A lack of a good balanced diet is very common among children
who are food refusers. This may mean that only a very narrow range of foods is
acceptable to the child. There is usually marked parental anxiety even though the
child is generally well nourished and apparently unconcerned about their diet.
•
Children who eat items that are not usually regarded as food. Pica refers to the
eating of items that are not usually regarded as food, for example, wood, paper, soil,
and fabrics. The condition is thought to be indicative of environmental and emotional
distress, and so may be an important indicator for the social worker to be aware of. It
is also thought to be associated with distorted developmental patterns, brain damage,
and mental retardation.
In the older child anorexia and bulimia are very serious eating disorders that can result
in permanent damage to the body and even death. The following information was copied
from a website that provided a helpful concise description of how to identify it in practice
(source: www.remudaranch.com/index.asp )
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!
People with anorexia starve themselves to dangerously thin levels, at least 15% below
their appropriate weight.
Criteria:
■
Low weight.
■
Weight phobia: intense fear of gaining weight or becoming fat, even though underweight.
■
Body image issues: believing you are fat when you are not; making your weight the only
thing you judge yourself on; denying the medical seriousness of your low weight.
■
Loss of menstrual period: for women who have reached puberty, missing at least three
menstrual cycles in a row.
Warning signs:
Loss of menstrual period.
Dieting obsessively when not overweight.
Claiming to feel "fat" when being overweight is not a reality.
Preoccupation with food, calories, nutrition, and/or cooking.
Denial of hunger.
Excessive exercising, being overly active.
Frequent weighing.
Strange food-related behaviours.
Complaints of feeling bloated or nauseated when eating normal amounts of food.
Episodes of binge-eating.
15% or more below normal body weight.
Depression.
People with bulimia binge uncontrollably on large amounts of food - sometimes
thousands of calories at a time - and then purge the calories out of their bodies through
vomiting, starving, excessive exercise, laxatives, or other methods.
Criteria:
■
Binge-eating on a regular basis.
■
Purging: regular efforts to avoid weight gain, including self-induced vomiting, laxatives,
diuretics, enemas, other medications, fasting, or excessive exercise.
■
Frequency: the binge eating and purging both occur, on average, at least twice a week for
three months.
■
Body image issues: making your weight the only thing you judge yourself on.
Warning signs:
■
Excessive concern about weight
■
Strict dieting followed by eating binges.
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■
Frequent overeating, especially when distressed.
■
Binging on high calorie, sweet foods.
■
Use of laxatives, diuretics, strict dieting, vigorous exercise, and/or vomiting to control
weight
■
Leaving for the bathroom after meals.
■
Being secretive about binges or vomiting.
■
Planning binges or opportunities to binge.
■
Feeling out of control.
■
Depressive moods.
Physical complications of eating disorders include the following: acid reflux,
constipation, loss of menstrual cycle, dry skin, feeling cold, slowness of thought, erosion
of the teeth and gums, haemorrhoids, osteopenia/osteoporosis, stunted growth in
adolescents, heart rhythm abnormalities, electrolyte abnormalities, abnormal liver
functioning, elevated cholesterol, and abnormal blood pressure.
The more serious conditions of anorexia and bulimia can be identified through the signs
and symptoms listed above. These are regarded as more extreme disturbances in the
eating routine, which have severe physical effects. An eating disorder can be considered
an emotional problem, and will fit better in Factor 3, with the other mental health related
problems to be developed at post-doctoral level, but the researcher has included the
signs here for the identification of early onset (and not only after a psychiatrist or
psychologist has diagnosed the disorder), especially in younger children. She bases this
on the assumption that young children may imitate an older child or even a mother who is
continuously dieting, and the learning of good nutritional habits may still prevent the
further development of this problem.
In partial support of the researcher’s interest in including signs of an eating disorder for
early identification, the following literature shed an interesting light on anorexia and
bulimia. Russell (1985: 625) says that, although the incidence is lower than is the case in
teenage girls (the most common onset is between 14 and 17 years), anorexia does
appear from 9 to 13 years. The author differentiates between post-pubertal anorexia
(after the start of first menstrual period) and pre-menarchal anorexia (13 years and
younger). An interesting theory raised by Crisp (1980, in Russell, 1985: 626) is that the
eating disorder is determined by a need for the young adolescent to regress into a
simpler existence without the conflicts of growth, sexuality and personal independence.
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Excessive weight-loss ‘switches off’ the central nervous mechanisms controlling sex
hormone activity. This regression is associated with relief and the avoidance of food is
thus reinforced. Another interesting theory by Bruch (1974, in Russell, 1986: 626) is that
most anorexic patients express a "paralysing sense of ineffectiveness", attributable to the
parents’ failure to encourage self-expression. The patient usually lacks autonomy and
fears that she will never meet her parents’ expectations of her.
The significance of these theories on anorexia is that some children (usually girls) may
show early signs of a serious eating disorder, and these have a relational aspect to them.
Indications of avoiding food or trying to loose excessive weight can indicate perceived
high expectations of the child by parents, and a need to resist becoming independent by
regressing through food avoidance. For the purposes of this study, early signs of severe
pre-diagnosed eating problems in the school age child are considered a risk for social
functioning since this may be indicative of a relational problem in the family. The effects
of such poor nutrition on the physical well-being of the child are bound to spill over into
the child’s ability to relate to others and handle stress presented by the environment. In
this early identification period one can work from the premise that, if a parent or teacher
should mention a disturbance in eating patterns with the child, it would be significant
enough to investigate. A diagnosis of an eating disorder by a psychologist or psychiatrist
will require medical and rehabilitative intervention, and such a diagnosis will be indicated
under Factor 3 (mental health - post doctoral development). The focus area of the social
worker involves the effect the disturbance has on the child’s ability to perform in his/her
social roles, and intervention will be focused on the parent-child relationship and teaching
alternative coping mechanisms.
Eating problems as a routine deviation are reflected in the quantity of food being
consumed (too much or too little), in the nutritional value of the food (pica or ‘picky eaters’
or unhealthy diet served by parent), and excessive weight control measures. Phases of
difficulties with eating are normal as children develop. Signs indicating a more serious
disturbance in older children (presenting from as early as 9 years) include binging or
starvation, going to the bathroom after meals, obsession with exercise or body image,
and physical symptoms such as loss of menstrual period and dizziness.
4.6
Behavioural adjustment
Dysfunctional behaviour may be understood to mean "observable conduct that violates
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( /
the established rules of an existing group and which the group consider so dangerous
and embarrassing or irritating that they bring special sanctions to bear against the
persons who exhibit it" (Gullotta, 1996: 4).
Disruptive behaviour is a child’s way of seeking a place in the world as he understands it.
It is based on the mistaken belief that they cannot belong through constructive,
cooperative, or acceptable means.
Children are not usually aware of the purposes of
their behaviour; however, they recognise that some actions bring reinforcement of
belonging and acceptance, while others do not. Children learn to repeat behaviour which
appears to be successful or works for them. The purposes of children’s behaviour can be
identified from the feelings evoked by the behaviour, and caregivers should learn to
respond in ways that will encourage children to gain recognition through acceptable
means (Harrison, 1997).
Problem behaviour is then the observable conduct of the child that violates established
rules for which sanctions are brought to bear against him. The behaviour is the child’s
way of seeking a place in his world, and children learn to repeat behaviour that has
proven effective in the past.
What the researcher has observed in social work practice is that a number of social
workers find it useful to understand the goals behind problem behaviour in order to
assess it in context, and know how to intervene appropriately. She therefore included
these goals in Annexure 2 as part of the assessment aids that will support the new
classification system.
The Minnesota Classification and codes for children and youth (1977) listed the following
concepts under the categories of “Short-term stress or crisis situation - precipitated by
child’s aggressive behaviour” and “Behaviour that affects relationships”.
The list of
concepts under these headings is:
■
Asocial
■
Delinquent
■
Bedwetting
■
Injury by child
■
Conflict
■
Property
Hostile
■
Rape
■
Hyperactive
■
Runaway
■
School
■
Withdrawn
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In the course of her internet searches, the researcher came across a website that
provides access to a range of effective behaviour management tools and development
solutions for professionals working with children. The products have been developed by
psychologists, paediatricians, teachers, dieticians, occupational therapists, speech and
language pathologists and social workers, through case based research (Conduct
Management www.conductmanaqement.com).
The multi-disciplinary development is
significant, since it shows agreement on the importance of certain aspects of the child’s
functioning.
4 6.1 Choice of terms for categories
The researcher looked at the topics in their products outlined above, and has included
two printed pages from their website in Annexure 2: one for childhood (0-12 years), and
one for adolescence. These topics are listed in alphabetical order, and the researcher
includes the themes that form part of their behaviour toolbox.
Although the above
website refers to all of these as behaviours, the concepts included in this chapter have
been arranged differently. Some of the topics are only addressed at post-doctoral level -
these are the emotional / neurological problems (e.g. depression, hyperactivity,
language), and physical problems (auditory, visual, disability, pain management).
To
simplify this study, the researcher left out those topics that were repeats of the child and
adolescent topics, keeping in mind that this ‘toolbox’ had been an inter-disciplinary
development. Since different professions use different terminology, the researcher may
not have used the same word for each topic (e.g. 'distractibility' is later included under
'attention'). Terms also seem to differ for different age groups, for example, 'compliance'
was used more often for younger children and 'cooperation' for older children (see toolbox
in Annexure 1A). The researcher chose to use the former term, which she believes to
mean both that the child decides to cooperate, and that he realises the need to submit to
some kind of authority. Different frameworks in which the topics are differently applied,
were considered.
The researcher summarised the most recent framework found on
assessing a wide variety of childhood aspects in order to give an idea of the terms used.
These terms will be recognised throughout this chapter.
The researcher needed to
establish categories that would bring her closer to an operationalised system,
The
reason for including this list is to show support for the inclusions of the topics throughout
this chapter. It served as a ‘checklist’ for the researcher, and increased her confidence in
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the topics she chose to include.
Child Behaviour Topics
Adolescent Behaviour Topics
>
Aggression
> Anger
>
Bad language
> Bullying
>
Anxiety x
> Attachment V
>
Body image x
> Cooperation V
>
Begin social skills V
> Biting
>
Conversational skills
> Death & Grieving V
>
Communication V
> Compliance
>
Depression x
> Distractibility V
>
Comprehension
> Compulsions
>
Eating disorders V
> Expressing feelingsV
>
Dealing with feelings
> Dealing with moving
>
Divorce V
> Fears & phobias x
>
Dealing with stress V
> Disability awareness x
>
Hyperactivity/impulsivity x
> Lyffl
>
Exploratory play V
> Fine motor V
>
Making friends V
> Manage conflict V
>
Home work
> Inferential thinking A
>
Memory x
> Nutrition V
>
Language x
> Nail biting
>
Obsessive
> Organisation
>
Pain management
> Reading x
>
Peer pressure V
> Problem-solving V
>
Repetitive behaviour
> Self-esteem V
> Spho^aftendance
> Self-abuse
>
Self-stimulation
> Sharing V
>
Sexuality V
> Stealing
>
Shyness V
> SiblingUiS
>
>
Sleeping V
> Soiling V
>
Teasing V
> Terrorism & war
>
Thumb-sucking
> Toilet training V
>
Transition to adulthood P
> Worry
>
Wandering
> Wetting V
□stance abuse
> Suicide x
The concepts included under behavioural adjustment for the purposes of this study are
the ones highlighted in grey.
The topics marked with a tick (V) can be found in other
sections of this chapter where they have been categorised according to the purposes of
this study. The topics marked with an ’x’ were part of the initial literature study, but they
have been excluded from this study because they are better suited to Factor 3 (mental
health), as in the adult PIE.
The ‘P1 indicates topics which received attention in the
previous chapter. The ‘A’ refers to topics found in Annexure 2.
This chapter shows how the terms found in literature were structured into a meaningful
whole, and how this structure will eventually form the starting point for the structuring of
the classification system.
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4.6.2 Elements of behavioural maladjustment
In line with the focus of this study, Lahey and Loeber (1994: 139-140) stated that one
cannot understand any maladaptive pattern of behaviour in children and adolescents
without understanding how that problem changes during the course of development. We
change throughout our lives, but at no time more rapidly than in childhood and
adolescence. The authors present a visual heuristic describing the Developmental Levels
Model with regard to disruptive behaviour.
The researcher combined this model with
concepts from related literature (see Figure 4.1).
Non-aggressive
Aggressive
Delinquency
Truant
/ Mug
'
Cruelty
Destructive
Steal, run \
Force sex away, break-in\
Attacks
Use weapon
Conduct Disorder
Opposition
Defiant /
Dison
r
Substance abuse
Lie
Bully, fight
Cult activities
Hurt animals
Vandalise, Set fires
Temper tantrums
Spiteful
Defiant
Non
Irritable
destructive
Blame others, Touchy
Annoy others
Angry, Argumentative
Swears, break rules
Overt
Covert
FIGURE 4.1 PYRAMID OF DISRUPTIVE BEHAVIOURS
According to the DSMIV (1994), behaviours characterising conduct disorder (CD) fall into
two main groupings: aggressive CD that causes or threatens physical harm to people or
animals; and non-aggressive CD that results in property damage or loss, deceitfulness or
theft, and serious violation of rules.
The disturbance in behaviour causes clinically
significant impairment over a wide range of functioning. The behaviours must have been
present during the past twelve months, with at least one present in the last six months. A
range of symptoms including lying, stealing, truancy, disobedience, destructiveness,
aggression and poor relationships, are identified as helpful in the diagnosis of CD
Slabber, 1999: 14).
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As children who persistently display a number of behaviours of Oppositional Defiant
Disorder (ODD) grow older, some of them add enough Conduct Disorder (CD) behaviours
to their repertoire to meet diagnostic DSM criteria. The narrowing pyramid in Figure 4.1
illustrates that not all children with ODD will develop CD (Lahey and Loeber 1994: 141-
142).
Classification is made difficult because conduct problems themselves change over the
course of development.
The progression to the next category of deviant behaviour
depends on the seriousness of the behaviour.
This developmental levels model only
applies to children who first meet the criteria for CD before puberty. The onset of ODD
and CD seems to be between 7 and 12 years of age for boys, and the onset of more
serious delinquency appears much later. When there is an adolescent onset of CD, the
youth almost exclusively exhibits the non-aggressive behaviours of CD.
There are
suggestions in research that girls differ from boys in that the onset appears to be later,
and they are markedly less aggressive than boys on average - different developmental
models are therefore needed for girls (Lahey and Loeber 1994: 143, 144, 146, 171, 172,
174).
The DSM-IV recognises two sub-types of CD based on the age of onset of symptoms.
For the chil^hoodLanset type, at least one characteristic criterion needs to be evident
before the age of ten. Children with this form are usually male, often display physical
aggression, have disturbed peer relationships and show features of Oppositional Defiant
Disorder (ODD).
They may be impudent (disrespectful, cheeky, presumptuous, ill-
mannered), defiant and negative toward adults. They are more likely to have a chronic
course culminating in adult Antisocial Personality Disorder (APD).
Adolescent-onset
type CD is defined by the absence of any CD criteria before the age of ten. They show
less aggression and have better adaptation with their peers. There is also less prominent
male predominance (Slabber, 1999: 15-16).
Some conduct disorders are labelled situational when they only reveal themselves in the
home or school, whereas others are pervasive (all-encompassing). A new category in the
International Classification of Diseases (ICD-10), family based CD, requires that there is
no significant disturbance or abnormality of social relationships outside the family
(Slabber, 1999: 15).
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\so^
It should become clear what the social worker’s role is in contributing to the correct
diagnosis and treatment of these children. Social workers are the most likely to see these
children on an early intervention level, and should be so knowledgeable about these
disorders that they can identify children manifesting risk factors and symptoms. Serious
behavioural disorders have far reaching long-term, generational effects into adult life and
social functioning, and affect individuals, systems and society.
For the researcher, what is relevant for social work practice is to distinguish between the
levels at which behaviour problems affect the child in his immediate family system and
community. It has been suggested that the less serious problems can still be effectively
dealt with in the family, but the more serious behaviours (at top of the pyramid in Figure
4.1) will necessitate that the social worker explore possible legal intervention with the
child.
For assessment purposes the social worker should consider the following two
categories: Firstly, oppositional or defiant behaviour that ranges from mild oppositional
defiant behaviour to involvement in serious group defiance that has a certain effect on
functioning but does not necessarily have legal implications. Most of these behaviours
will bring discomfort to the child and his parents and teachers rather than to wider
systems around the child.
These behaviours would in most cases be triggered by
problems within the child’s immediate systems, and early intervention should assist
effectively in eliminating these problems before legal intervention is necessary. Secondly,
conduct disturbances that include delinquent offences, requiring possible involvement
from the legal system, since the child has been involved in behaviour that was an offence
to another person or his property. It involves the serious breakdown of the family as a
system for nurturing and protection, with more habitual, dysfunctional behaviour patterns
in the child that need more intensive and long-term intervention. It can point to possible
mental illness and/or other deeper causes.
4.6.3 Oppositional defiant behaviour
For the purposes of this classification system, this category is used for the start of
problem behaviour that is still mild and not clearly indicative of an underlying problem.
Some ‘bad’ behaviour is normal for children, but the need for the social worker to
intervene at the early stages of childhood problems, necessitates inclusion of this section.
Typical defiant behaviour includes swearing (most children go through a stage of using
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dirty language - trying out the words and giggling over having dared to do so, and getting
a reaction from adults with these words); general disobedience and rule-breaking; refusal
to do usual routine tasks, such as homework; eating ‘rituals’; and not helping out around
the house. In most cases the child is trying to assert his independence or communicate
to adults that he is very concerned about something he cannot talk about.
The researcher deviates from the classification given by Lahey and Loeber (1994) in their
pyramid of disruptive behaviours (Figure 4.1). Since the purpose of social work does not
include diagnosing disorders, the researcher decided to divide the behaviours according
to their seriousness with regard to the treatment needed.
Most of the delinquent
behaviour at the top of the pyramid needs corrective and rehabilitative treatment.
Although Lahey and Loeber’s classification identifies lie, bully, fight, vandalise, and
participation in cult activities (the latter categorised by the researcher on the basis of axis
descriptions, i.e. non-aggressive and covert) as conduct disorders, the researcher will
include them as oppositional deviant behaviours.
For the sake of assessing for the
purpose of intervention, the social worker will still attempt to address these problems
within the family and community system. It is unlikely that she will remove the child at the
first prevalence of these problem behaviours.
Oppositional / defiant behaviour therefore includes lying, aggressiveness (bullying and
fighting), cult activities, vandalism (of property and setting fires), and the less serious
problems of temper tantrums, blaming, being irritable, spiteful or annoying, swearing, and
breaking rules. The latter set of problems will not be discussed in this chapter since
these are self-explanatory and less serious (based on the categorisation illustrated in
Figure 4.1). The words to be used in the new classification system will, however, indicate
the presence of oppositional/defiant behaviour.
4.6.3.1
Temper tantrums
Aggression is the result of a reinforced learned response to frustration, although the
earliest response to frustration, the tantrum, occurs before it has been learnt. Mothers,
however, respond to the child’s needs in order to terminate the outburst. With increasing
maturity of the child, mothers become less compliant, but this early experience acts as a
model of reward for aggression, although later interactions with peers make major
contributions to the socialisation of aggressive conduct.
It may be easier to facilitate
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aggression in boys because of their higher activity level, and it is also the social
behaviour in which gender differences, although open to cultural influences, are most
evident (Wolff, 1985: 405).
The tantrum is the earliest response to frustration and is unlearned. The response of
caregivers to the child will determine whether reward for aggression has been
established. Gender and cultural differences are evident in this form of social behaviour.
4.63.2
Lying
Caution needs to be taken as what looks like lying to an adult may merely be the
reflection of the way the child sees things. Some children have vivid imaginations and
have difficulty separating fact from fantasy. It such cases you might talk these matters
over and help the child learn the difference between real and pretend stories. If you are
certain the child is plainly lying parents should let the child know that they are aware of
me child’s lying and that it is viewed as unacceptable (Leigh & Leigh, 1999: 10).
Australian paediatrician, Christopher Green, finds that by the age of two, 2% of children
tell fibs, at age three, 26% and age four, 37%. There are five main reasons why children
lie (Nel, 2001: 73-75):
■
They are not allowed to tell the truth - a child wishes the baby brother would go
back to where he came from. The parent’s reaction to the ‘bitter’ truth would tell a
child that honesty is not the best policy.
s
They lie in self-defence, especially when punishment is the result of owning up.
IS
They lie to give themselves in fantasy what they cannot have in reality. The parent
needs to listen to the truth that lies reveal about the child’s hopes and fears. For
example, “I have a Barney video”.
■
Some children may lie when provoked by adults, as when the adult asks a trick
question. For example, asking where a toy is when the parent knows it is broken.
■
The parents model white lies -- where it is okay to lie when the truth will hurt
someone’s feelings. If the parent also tells the child tall tales, he/ she needs to at
some stage help the child to distinguish what is truth and what is not.
Children may lie because of the consequences they fear for their behaviour or because of
their imagination.
Parental training should develop insight into this reciprocity between
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child and parent that may reinforce lying behaviour. When lying becomes problematic it
is often because of the content the child is lying about (e.g. that he stole something) and
not the lying per se.
4.6.3.3
Aggressiveness
It is hard finding a parent these days who isn’t worried about their children’s emotional
well-being.
These are frightening, difficult times in which to raise any child, but for
children who have had trauma in their lives, it is especially difficult. Foster children are
amongst the highest at risk. There seems to be an increase in aggression and anger
amongst children. The steady onslaught of violent images on television, video games,
the Internet, movies, music lyrics, and newspapers are hurting children. Tragically foster
children have not just seen these images on screen, but have usually witnessed them in
person. The result is that too many children are becoming desensitised to violence, and
have learned that anger is the only way to solve problems (Borba, 1999: 1).
Aggressive behaviour is common in pre-school children, declines during the early school
years, rises at adolescence and declines once more between the ages of 15 and 21
years. High activity levels are associated with aggressive behaviour in young children,
and in children described as difficult by parents, and correlate with nursery school
assessments of wrestling, hitting, pushing, and beating. Restlessness, destructiveness,
fighting, disobedience, bullying, and temper tantrums are more common in boys from
large families. Furthermore, maternal rejection in early childhood, maternal tolerance for
aggressive behaviour in the child, and physically punitive child-rearing methods all
contribute to aggression (Wolff, 1985: 406-407).
A very common prevalence in childhood that reflects aggressive behaviour is bullying.
This problem has been described as endemic to schools.
Bullying is intentional and
unprovoked, and can be considered a form of abuse.
It is either physical or
psychological, and verbal bullying is the most common form.
Both bullies and victims
often have both externalising and internalising problems.
In children victimised during
school years, associations have been reported with later depression, poor self-esteem
and difficulties in sexual relationships. In those who have been bullies, associations have
been found with later criminality. (Sourander, et al., 2000: 873-874).
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Bullying is a form of aggression in which there is an imbalance of power between the
bully and the victim, and it occurs largely within the context of the peer group. Bullying,
which may be direct (e.g. name-calling) or indirect (e.g. gossip), covers a wide range of
behaviours from social exclusion to physical assault, as well as emotional intimidation
that may stir up intense and overwhelming feelings in the victim. With the passing of time
and continued harassment, the victim's options become progressively limited.
For this
reason parents and teachers play a crucial role in righting the power imbalance that
promotes bullying and in supporting the victimised child (Mishna, 2003).
Research findings suggest that all areas of victimised children's lives may be affected academic, social, emotional, psychological, and physical health. After performing a meta
analysis of studies published between 1978 and 1997 that were focused on the link
between bullying and maladjustment, Hawker and Boulton (2000) concluded that boys
and girls of all ages who experience victimisation, suffer a variety of feelings of
psychosocial distress; feeling more anxious, socially unsure, depressed, lonely, and
worse about themselves than do non-victims.
Children who are victimised describe
themselves as unpopular, unhappy, and unsafe at school. They tend to lack friends and
be rejected by peers, and report feeling afraid in school, reacting negatively toward
school, and consequently avoiding school more often.
They may lose motivation for
schoolwork and their grades may deteriorate. Some researchers have found that children
who are frequently bullied are more likely to internalise their distress than to solve the
problem.
Individuals may suffer from the effects of bullying episodes long after they
cease. Students who report being bullied often and who lacked social support appear to
be at greater risk for poor mental health. The impact of victimisation is exacerbated by a
cycle whereby the emotional, physical, and social effects leave victimised children more
vulnerable to further peer maltreatment. The fact that victimisation and self-perceived
peer social competence influence each other suggests a vicious cycle in which low self-
regard and abusive treatment by others are mutually reinforcing.
Bullies are likewise at increased risk to experience maladjustment, albeit different in
nature.
Researchers have established that childhood aggression often continues into
adolescence and that childhood bullying behaviour may progress into adolescent
delinquency or gang activity. Adolescents who were physical and/or relational bullies
display significantly more externalising behaviours, which were made manifest by
symptoms linked with oppositional defiant disorder and conduct disorder. Boys in Grades
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6 through 9 who were bullies were roughly four times more likely to be convicted of a
crime by the age of 24 than were boys who were either victims or who were not involved
in bullying. Children who bully are more likely to be unhappy at school, to have attention
deficit disorder, and to be depressed as youth and as adults. Although some researchers
have found that bullies do not have poor self-esteem, others have found that their self-
esteem is lower than children not involved in bullying. Children who are both bullies and
victims are the most severely rejected by peers and have particularly serious adjustment
problems (Mishna, 2003).
Ecological and societal factors that increase the likelihood of bullying and victimisation
are the attitudes of parents, teachers, and school administrators, and tolerance of
victimisation. Factors that foster victimisation in schools according to Mishna (2003) are:
■
A lack of clear rules regarding aggression.
■
Little or low principal involvement with students.
■
Weak staff cohesion.
■
Minimal teacher and student involvement in decision making.
■
Inadequate supervision.
Factors such as socioeconomic conditions and attitudes toward violence inevitably
contribute to the prevalence of bullying. The extent of victimisation that occurs among
children mirrors both the violence in society and the very institutionalisation of bullying
itself. Moreover, societal attitudes, for instance, homophobia, might also foster bullying
(Mishna, 2003).
Aggressive behaviour involves a verbal or physical action against another person and
includes wrestling, hitting, pushing, and beating.
The earliest form of reaction to
frustration is the tantrum. There is an increase in the prevalence of aggressive behaviour
in pre-school children and in early adolescence. The most common form of aggression in
childhood is bullying. It may be direct or indirect, and covers a wide range of behaviours
from social exclusion to physical assaults, as well as emotional intimidation that may stir
up intense and overwhelming feelings in the victim. It is of concern because childhood
bullying behaviour may progress into adolescent delinquency or gang activity. The victim
of the bullying behaviour is affected with regard to his academic, social, emotional,
psychological, and physical health.
Societal factors such as no clear disapproval of
aggression can foster victimisation.
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46.3.4
Devotion to a cult
Schwartz and Kaslow (1983: 684) noticed that the ‘hippies’ or ‘flower children’ who
ostensibly dropped out of society in response to an unpopular war, poverty and
materialism, gave way in the 1970s to young adults who turned instead to a variety of
religious cults that similarly present individuals with the opportunity to separate from their
families, renounce the larger society, and find a sense of belonging and purpose in a
visible and demarcated subculture.
A source of contemporary parental distress is the fact that becoming a cult member
involves a religious conversion; and acceptance of the new religion then frequently
demands a complete rejection of the family as well as of its values, traditions and
sanctions, while affording the young adults the opportunity to rebel and escape to what
seems like a viable alternative to the family.
It may therefore initially represent a
declaration of independence. The cult offers a milieu in which to negate technology,
education, science and rationality which are so highly respected, even venerated, by their
parents, and to replace these with learning acquired through spiritual devotion and
mysticism. The lure and strength of the cult’s approach lies in a demand for complete
fidelity and allegiance to their mission. This provides a sense of meaning and purpose in
life to confused, existentially adrift young people away from the influence of their parents
who could otherwise dilute the intensity of the involvement. Cult membership thus affects
the family and the individual in ways more basic and destructive than earlier modes of
withdrawal from the family orbit.
Joining a cult is seen as a total and permanent
commitment (Schwartz and Kaslow, 1983: 685).
Patterns observed in parental behaviour which impels the child to withdraw so forcefully
from the bonds of family ties, and so become vulnerable to the pull of a cult, are in some
cases the model of perfection exemplary parents uphold that their children are unable to
fulfil. In other situations the closeness much admired by friends is a pseudo-mutual one
or an expression of an overly enmeshed family. The extreme dependency by many of
those who accept the recruiter’s bait and become embroiled in the cult further
substantiates the supposition that they grew up in fairly enmeshed families.
Today’s
culture values autonomy more and because these two values conflict, children from
enmeshed families experience real problems in trying to survive in an autonomy-valuing
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world; they then become susceptible to giving up autonomy in favour of an even more
confining group. Contradictory communication from ‘good’ parents is also internalised -
we love you tremendously, but we resent your continuing needs and demands and want
time alone so you must go to camp/boarding school/college. Often few rules have been
incorporated since external structure is missing.
Frequently the father is away from
home, working long hours to support his family or for personal aggrandizement, or playing
golf in order to 'make contacts’ to enhance his career. Thus, the presence and influence
of the father as a male authority figure is minimal.
The strength of the father-child
relationship appears to be a critical factor in the vulnerability/non-vulnerability of youth to
cult recruitment (Schwartz and Kaslow, 1983: 687-688).
Evidence of the child’s involvement in occult related activities are behaviour changes
including rebelliousness, publicly rejecting all laws, threats to kill the family or self, and
weird objects like a diary called the ‘book of shadows’, written from back to front. These
are usually accompanied by drug abuse. Sadistic or Satanic ritual abuse has devastating
long term effects on the victim and should be taken seriously (Havenga, 2002).
Helen Keller (1903, in Faul, 1995: 199-200) stated that:
It is a mistake always to contemplate the good and ignore the evil, because by making
people neglectful it lets in disaster.
There is a dangerous optimism of ignorance and
indifference. Optimism that does not count the cost is like a house built on sand. A man
must understand evil and be acquainted with sorrow before he can write himself an optimist
and expect others to believe he has reason for the faith that is in him.
Schwartz and Kaslow (1983: 686) aimed:
to provide a tentative hypothesis about the young people who have become ensnared by
the growing cult phenomenon that appears to entail brain-washing and extreme personality
conversions, euphemistically called ‘snapping’ because of the apparent instantaneous
quality of the change. It is further intended to stimulate dialogue among family therapists
and hard research by clinicians so that we will be better able to comprehend the cults, their
appeal and impact - perhaps to prevent some young people from joining and certainly to
more knowledgeably and effectively treat those who have re-entered the larger society and
their families when they seek our ‘healing’ services.
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The biggest concern with a child’s decision to become part of a cult is that it encourages
defiance against his family and religious values. The insecure, lonely child is swayed by
the perception of belonging offered to him, and he falls prey to negative influences that
may lead him into more criminal activity (such as hurting animals as part of rituals). He
may also fall victim to satanic ritual abuse himself.
4.6.4 Conduct disturbances
Conduct disordered children show little empathy and concern for the feelings, wishes,
and well-being of others.
Aggressive youngsters often misperceive the intentions of
others when the situation becomes ambiguous, and respond in a hostile and threatening
way, and therefore often feel their aggression is reasonable and justified. They may be
callous and lack remorse or guilt and make little attempt to conceal their antisocial
behaviour. Conducts often show low self-esteem, poor frustration tolerance, irritability,
temper tantrums, recklessness, sexual promiscuity, illicit drug abuse, and problems at
school that may lead to expulsion. They may appear isolated or may befriend a much
younger child or form superficial relationships with other antisocial children. Aggressive
CDs are often uncooperative, hostile and provocative in interviews.
Some exude
superficial charm until confronted about their problem behaviours, when they can become
suspicious and angry at the source of the information. This can lead to resentment of the
examiner and belligerence or sullen withdrawal. The child’s aggressive behaviour rarely
seems directed toward any definable goal and offers little pleasure, success or even
sustained advantages with peers or authority figures. Children who join gangs usually
have age-appropriate friendships. Although they still show little concern for other gang
members, they rarely blame them or inform on them.
Gang members mostly have a
history of adequate or even excessive conformity during early childhood, but evidence of
marginal school performance and depressive symptoms are often present. The ICD-10
includes socialised and un-socialised types of CD, in terms of which it recognises an
individual as socialised if he is integrated in either a deviant or non-deviant peer network
(Slabber, 1999: 16-17).
The three most significant risk factors exerting independent effects of CD are family
dysfunction, parental mental illness, and low income, with six indicators of psychosocial
adversity being low socio-economic class, parental criminality, overcrowding, maternal
neurosis, chronic marital discord, and institutional care (Slabber, 1999: 18).
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Delinquency falls more clearly into a socio-legal category and the definition of a juvenile
delinquent is a young person between the ages of 10 and 17 who has been prosecuted
and found guilty of an offence. The kinds of behaviour that commonly result in juvenile
delinquency are thieving, breaking into premises, destructive vandalism (criminal
damage), truancy, and crimes of personal violence, drug and sex offences.
High
delinquency areas are socially fragmented, overcrowded and inhabited by poor
disenfranchised families with diverse social problems, including persistent adult crime,
substance use, high infant mortality, low birth weight and child abuse. The interaction
between family functioning and environmental conditions is incompletely understood as
are the strategies used by families to cope successfully.
Marked effects of parental
neglect and poor quality parenting are observed, with other predisposing factors being
large sibling groups, paternal alcoholism, and factors intrinsic to the child for showing
criminal tendencies (gender and temperament).
Disinhibited as opposed to inhibited
children are those characterised by a lack of fear and high degrees of approach and
social interaction.
These children have a low heart rate and low levels of circulating
Cortisol. This is in keeping with the theory of under-arousal of the central adrenergic
function. Such children may be prone to acquiring CD at times of high family stress
(Slabber, 1999: 19, 21,22).
By staying away from the term ‘disorder’ and combining behaviours that fall under
conduct disorder and delinquency, the researcher will call this section conduct
disturbances. It allows for the inclusion of behaviour problems that may be indicative of a
conduct disorder, but where the child has not yet been diagnosed by a psychiatrist or
psychologist, and delinquent behaviour that may lead to legal involvement. (Should the
social worker work with a child who has been diagnosed with conduct disorder it will form
part of Factor 3 which will include diagnoses from the DSMIV. Should a legal action have
already been taken and the child is a juvenile delinquent, it will form part of Factor 2 as a
justice system problem, as in the adult PIE (refer to Chapter 3 - environment of the
child).) The identification of these problems will signify the need for parental training and
guidance, ensuring early intervention.
The reference to conduct implies that the
behaviours under this category are viewed in a more serious light than mere oppositional
or defiant behaviour.
The behaviours included under this category are: school
attendance problems, running away, substance abuse, and stealing.
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4.6.4.1
School attendance problems
This section is significant for the researcher since attending school is directly linked to
future opportunities, and non-attendance provides delinquents their opportunity for
misbehaviour. When this problem is treated correctly a number of other related problems
are solved simultaneously.
This problem can be described as unauthorised non-
attendance, which can include truancy and school phobia.
Truants are children absent from school without their parents’ knowledge and
permission. These types of children will set off for school but then slip away, either alone
or with others.
A depressing set of circumstances may accompany truancy.
The
constellation of factors include the social class of parents (the lower the class the higher
the incidence of truancy), parents who show little interest in the child’s progress, parental
unemployment, marital conflict in the home, poor parenting and inconsistent disciplining,
and delinquent behaviour such as stealing or drug abuse (Kerfoot and Butler, 1988).
Prolonged or recurrent absence from school is a continuing cause for educational
concern as attendance is regulated by law. Some children are unlawfully withheld from
school by parents, often on the pretext of illness, to keep a family or ill parent company,
or do the shopping, or care for a phobic house-bound mother. Until about 50 years ago
all forms of persistent absence from school were labelled as truancy. The word ‘truant’
derives from an old French word which means ‘an assemblage of beggars’.
The
connotation of roguery remained throughout the sixteenth and seventeenth centuries, but
the term ‘truant’ was only later applied to schoolboys who failed to attend school
regularly. This came much more to the fore with the introduction of compulsory education
in Britain in the second half of the nineteenth century. The ‘truant’ schoolboy was also
dubbed lazy, neglectful of his duties and prone to antisocial acts.
Truancy was
considered to be a precursor of delinquency, and school boards appointed men to ensure
regular attendance. These ‘truant officers’ were cordially disliked as were the correctional
schools, ‘truant schools’, built to house and train the offending children (Hersov, 1985:
382).
Broadwin’s (1932, in Hersov, 1985: 382) original description of truancy is: the child's
absence from school for periods varying from several months to a year. The absence is
consistent. At all times the parents know where the child is. He is with the mother or
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near the home. The reason for the truancy is incomprehensible to the parents and the
school. The child may say that he is afraid to go to school, afraid of the teacher, or say
he does not know why he will not go to school.
When at home he is happy and
apparently carefree, but when dragged to school he is miserable, fearful and, at the first
opportunity, runs home despite the certainty of corporal punishment.
generally sudden.
The onset is
The previous school work and conduct had been fair.
Broadwin’s
original observation that these children feared something terrible happening to their
mother, which made them run home for reassurance and relief of anxiety, was repeated
in many later clinical studies and is the basis for the often repeated statement that the
apparent fear of school is really a fear of leaving home. Children’s fears of school could
be a fear of the teacher, of other pupils or of work with expectation of failure. Fear of
school with refusal to attend occurs in family settings where maternal anxiety, marital
disharmony and parental inconsistency are often significant factors (Hersov, 1985: 382,
383).
School refusal or school phobia entails severe difficulty in attending school often
amounting to prolonged absence; severe emotional upset is shown by symptoms such as
fearfulness, tempers, misery or complaints of feeling ill - for example, headaches or
stomach pains, and in more rare instances actual vomiting, and in the absence of
significant antisocial behaviour such as stealing, lying, wandering, destructiveness, or
sexual misconduct (Kerfoot and Butler, 1988).
Cooper (1966, in Hersov, 1985: 383) found that children with school refusal differed from
truants in that the former came from smaller families of a higher socioeconomic status
where home discipline was overanxious in quality, whereas the truants came from
families lacking in concern about school attendance, which was reflected in the children
by carelessness and defiance of school authority. Tennent (1969, in Hersov, 1985: 383)
found in his study of 65 boys detained in a remand home for non-attendance at school,
that only a small proportion (4%) of the total number on remand had committed no
offence other than not going to school.
An acute onset is more often seen in younger children, whereas older children and
adolescents usually show a more insidious development of school refusal. Precipitating
factors are found at all ages: a minor accident, illness or operation, leaving home for a
school holiday or camp, a move to a new house, a change of class or school, the
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departure or loss of a school friend, the death or illness of a relative to whom the child
was closely attached. All these events appear to represent a threat to the individual child,
arousing anxiety that he cannot control. In older children and adolescents, there is often
no abrupt or definite change in personality, but a gradual withdrawal from peer group
activities formerly enjoyed, such as scouts or guides or youth clubs.
The youngster
ceases to go out, clings to and tries to control his mother, and may express a general fear
or dislike of the world outside home. He may also become stubborn, argumentative and
critical in contrast to his earlier compliant behaviour; often this anger is directed against
his mother. Very often there is no clear precipitating factor other than a change to senior
school which may have occurred as long as a term ago.
The earlier personality
development of the child has been deviant in regard to social relationships with other
children, reflecting anxiety when entering into new situations and a lack of normal
development of independence and sexual identification. Very often the school refusal is
one indication of the young adolescent’s general inability to cope with the increased
demands for an independent existence outside the family and entry into normal peer
group relationships (Hersov, 1985: 384).
It is clear that going to school makes many demands upon a child which alter with age
and school progress. School is the first testing ground in society that lies outside the
more protecting atmosphere of home.
Going to school involves the first of many
continuing separations from home, as well as submission to outside rules and standards
in a situation from which there is no escape and over which little control can be exerted.
A child is judged at school by performance (rather than by reputation and intention) and
by qualities for which he is not responsible such as intellectual endowment, race or social
class. He is exposed to competitive physical activity and rougher children. A negative
attitude to school is shown by more boys than girls at every age (Hersov, 1985: 385).
School attendance problems are viewed as a conduct disturbance because of the legal
implications of non-attendance. Truancy can be linked to the child’s fear of being away
from home; the parent is usually aware of the child’s non-attendance.
School refusal
indicates a more affective cause on the side of the child, resulting in a sudden (early
childhood) or gradual (adolescence) withdrawal from school and peer group activities.
Recognition is given to the fact that going to school places social functioning pressures
on the child, such as competition, racial and gender stereotyping, performance
expectations, and fear of independence; and that situational factors such as death of a
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friend or moving can be causal factors.
4.6.4.2
Running away
In the researcher’s opinion there are two aspects of this form of misbehaviour relevant to
social workers. One is that children run away from their biological families to escape
some unbearable situation at home. The other is that children, who are removed from
their home because of an abusive situation, may resent the disruption in their life and run
away to defy the social worker and welfare system. In both cases the result would be the
concern that these children are living on the streets (begging) or ‘off the streets’
(prostitution, drugs) in order to survive (Raffaelli, et al., 2000: 1432). The concern in both
cases is that the child’s life is in constant danger and his future seriously jeopardised.
The researcher is of the opinion that this behaviour problem fits under conduct
disturbance, because a removal from the street back to the child’s home or alternative
care is regulated by law.
The legal implications of running away, especially when the child is in foster care, are
determined the Child Care Act that declares a child under 18 should stay in the care of
his legal custodian. If a child absconds from the custody of parents or fails to return on
the expiration of absence of leave, he may be apprehended without a warrant by a social
worker, policemen or authorised person. When apprehended, he must be brought before
the Commissioner of child welfare in terms of Section 38(2) of the Child Care Act. The
Commissioner of child welfare may, after having questioned the child, order his return to
the custody or the place of safety from which he absconded.
He may, however, also
order that the child be removed to a place of safety, pending any action by the Minister
(SANCCFW, 1987: 139).
Children start abandoning their homes as early as the age of 11, and the number
becomes alarming after the age of 15. This has a negative impact on society, since these
children get involved in gangs, illegal operations like drug trafficking, and other criminal
acts (Matchinda, 1999: 245-246).
In the researcher’s opinion, a child who runs away from the adults responsible for his care
leaves that protection and can often be found on the street. Some children will run to a
friend or family member’s home, which often results in them being returned to their family
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or placed in alternative care more quickly.
Both continuous running away and the
resulting street children are of more serious concern. Raffaelli, et al. (2000: 1432) quoted
the United Nations definition of street children as any boy or girl for whom the street (in
the widest sense of the word, including unoccupied dwellings, wasteland, etc.) has
become his or her habitual abode and/or source of livelihood, and who is inadequately
protected, supervised, or directed by responsible adults.
The presence of boys on the street is thought to reflect a deliberate survival strategy by
impoverished families who socialise sons into early independence in an appropriate male
context - the street. In contrast, the presence of girls on the street is thought to reflect
family dysfunction which has lead to the breakdown in the socialisation process. The
presence of children and adolescents working and/or living on the streets is typically
attributed to structural factors such as high birth rates, rural-to-urban migration, economic
stagnation, unequal distribution of wealth and lack of government welfare programmes.
Poverty alone, however, does not explain why some youngsters leave home. Families of
homeless street youth are more troubled than those of impoverished youngsters working
on the street but living at home.
More homeless youth experience rural-to-urban
migration, parental death or absence, and physical abuse prior to leaving home. Family
disruption is thus an important factor in the street youth phenomenon (Raffaelli, et al.,
2000: 1432-3).
Income level plays a role in the lifestyle of a family, and is a measurement of the quality of
life of a family.
It determines the quality and quantity of education a child receives.
Children in poor families often live in overcrowded, unsanitary houses, and the parents
may be so busy trying to feed and clothe their children that they give inadequate attention
to behaviour moulding. The hierarchy of needs of Maslow reveals that people only strive
to meet higher needs when elementary ones have been satisfied. The basic needs of
survival are the strongest, and if not met result in deficiency. Starving persons will take
great risks to get food, and such a home situation is likely to push neglected children and
those from poor homes to seek ‘comfort’ in the street, especially if these needs appear to
receive immediate satisfaction there. Rich and educated parents may blend tradition and
modernity to give a sense of direction to their children in the face of social mutations,
while poor and uneducated parents, like their children, are involved in illegal activities in
order to earn an income in the informal sector of the economy, a phenomenon common
among street gangs. Such parents exercise permissive styles which allow children to
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choose any kind of companions. The latter are likely to become victims of street gangs
whose activities are not different from theirs (Matchinda, 1999: 246-247).
Regarding the reasons for leaving home, the most common reason is to escape conflict
or abuse, with more girls than boys giving this reason (Raffaelli, et al., 2000: 1434). In
Africa an unaccompanied child working or living in the streets is referred to by the term
mayibobo (Veale and Dona, 2003: 259). Civil unrest, displacement camps, and cultural
practices of spouse inheritance after paternal death leave many children vulnerable to
leaving home for the streets. (The responsibility for children from the first marriage
traditionally lies with paternal uncles rather than with the new spouse. Adolescent boys
are vulnerable to being pushed into early independence as a result). Some of the regions
in Rwanda have a 30 year history of civil war, with the result that parental death and the
destruction of entire villages have forced the children to live on the street.
Boys are
more vulnerable than girls to living on the street, while girls could more easily be forced
into prostitution and child labour (Veale and Dona, 2003: 255, 256-258, 264).
There is a high proportion of orphaned children in South Africa today, and nearly half the
children sleeping on the street have no parent or guardian. These children grapple with
complex negotiations around issues of identity, grief, and loss, as well as the child’s
position in the family. Lack of identification with and trust in the community may be one
psychological and social factor contributing to why some adolescents may not be
interested in, or return to, their community of origin (Veale and Dona, 2003: 264-265).
Running away is a behaviour that requires legal intervention by the social worker to
ensure the safety of the child. Unattended children will become street children who live
on the street (begging) or off the street (prostitution and drugs). A street child can be
defined as a child for whom the street has become his or her habitual abode and/or
source of livelihood; and who is inadequately protected, supervised, or directed by
responsible adults. The main reasons for running away are to escape poverty or abuse,
permissive parenting, civil unrest and displacement, a lack of identification and trust in the
community, or where the child has no guardian (migration, death, or war). Children start
abandoning their homes as early as the age of 11 with an increase in the number from
the age of 15. The concern with street children is that these children are more likely to
become part of street gangs or resort to delinquency to feed themselves, and they are
under threat of being abused (child labour, prostitution).
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46.4.3
Substance abuse
The most common form of substance abuse in young children is glue sniffing, but
substances such as paint thinner, dry cleaning fluid, nail-lacquer remover, petrol and anti
freeze may also be used for inhalation. The most common method of inhalation is by
direct sniffing from a container. The effects of inhalation are similar to those of alcohol,
and occur very quickly, usually within minutes. The stimulant’s effect is characterised by
excitability, loud and aggressive behaviour, impaired judgment, particularly regarding
personal safety, and poor coordination of physical movements. Regular use will produce
unpleasant physical symptoms, which may be readily apparent to the onlooker.
Symptoms may include the individual appearing pale and lethargic, having a skin irritation
and sores around the mouth and nose, loss of consciousness, or suffering inflammation
of the eyes and throat, together with nausea. In addition to physical symptoms, heavy
users are likely to suffer deterioration in their personal standards of hygiene, and will
appear apathetic and lacking in interest. Long-term use of some substances will result in
damage to the brain, liver, or kidneys (Kerfoot and Butler, 1988).
Drug abuse in adolescents is more often feared or suspected than actually present, but is
nevertheless a recurring problem that can cause psychotic states. Paranoid psychotic
states can occur in adolescents taking between 50 and 325mg of amphetamine per day.
ideas of reference and delusions of persecution are prominent. These stimulant drug
psychoses usually subside in a matter of weeks or a few months, and prolongation of
symptoms suggests either continuing drug usage or schizophrenia.
Amphetamine is
excreted through urine in two days but may be detectable for ten days, although the use
of sodium bicarbonate will delay the excretion of amphetamine, prolong its effect and
confuse test results.
Mood changes and social deterioration occur with the abuse of
morphine derivatives. Lysergic acid and diethylamide (LSD) and related drugs are well
known for their psychotogenic and hallucinogenic effects. The effects come and go within
hours, but in some people lasting personality changes, including persistent psychosis,
have been reported.
Symptoms can include despair, to the extent of suicidal and
homicidal depression. Brief re-experiences (‘flashbacks’) can occur long after the original
drug has been metabolised, and may represent brief anxiety attacks and possibly
emotionally laden perceptions that have in some way been learned (Steinberg, 1985:
572).
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Palmer and Liddle (1996: 115-118) state that there is an emerging group of young people
at risk for long-term consequences of substance abuse; the human cost assuming the
several
forms
of future
health
problems,
psychosomatic symptoms,
ineffective
school/work performance and/or subsequent reduced life opportunities, dysphoric
emotional functioning, and impaired interpersonal relationships.
Substance abuse is the result of multiple factors that are social, intrapersonal, and
developmental in nature. Outcomes in adolescence, be they adaptive or maladaptive,
are the result of the interaction between what an individual brings into this period
(developmental trajectories) and the nature of the challenges and resources available
during this period.
It then requires identifying individual characteristics and capacities
considered as strengths or weaknesses; social resources available before the transition;
specific challenges (demands) and the coping responses needed for adaptation; and how
developmental trajectories, challenges, and resources interact in determining the
outcome.
This suggests a risk/protection framework for conceptualising adolescent
developmental functioning and intervening with many kinds of human problems, ranging
from physical health issues to education (Palmer and Liddle, 1996: 117).
The most relevant theories for social work to help understand why an adolescent has a
substance abuse problem, are: problem behaviour theory, which sees it as part of a
syndrome of problem behaviours that are elements of a deviant adolescent lifestyle
involving non-traditional values such as low religiosity, rebelliousness, and disregard for
the law; social stress theory, which posits risk for substance abuse to be a function of the
stress level in an adolescent’s life and the extent to which this stress is offset by positive
attachments, coping skills, resources, opportunities, community based programmes and
role models (ecological variables);
and family systems theory, which supports family
involvement in the successful treatment of substance abuse and reduction of risk factors
to the adolescent through identifying early signs and improvement of family management
practices (Palmer and Liddle, 1996: 120-121).
A number of physical and emotional symptoms such as the child being lethargic or
excitable, psychosis, mood and personality changes, rebelliousness, ‘flashbacks’, anxiety
attacks, and poor relationships with others, co-occur with substance abuse. The long
term risk of substance abuse centers on serious health problems (such as damage to
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kidneys), mental health problems (such as depression, suicide), behaviour problems
(delinquency, homicide) and reduced opportunities for the future (school attendance and
concentration problems). The causes for substance abuse in a child can be inherent to
the child (low religiosity, deviant lifestyle, high stress and poor coping skills), or inherent
to his immediate relationships and environment (lack of positive attachments, poor role
models, inadequate resources and opportunities). The effect this behaviour problem has
on the child’s social functioning is obvious.
4.6.4.4
Stealinq/theft
Most children try stealing at least once. Some just take much longer to learn that this is
unacceptable behaviour. Some children who are in institutions or in large families where
clothing and toys are shared by a number of other children take longer to learn that they
cannot just use things which belong to others. In the case of some children, getting over
the habit of stealing may take a long time. Sooner or later, if the child is not allowed to
keep stolen articles, he will learn that it is not worth the trouble (Leigh & Leigh, 1999:10).
On the other hand, stealing also manifests as the most common antisocial disorder and
occurs in about 5% of primary school children. In older children it is often a component of
more general delinquent behaviour. Both the pattern of stealing and its antecedents differ
for children at different ages. The youngest, who often started stealing from home in very
early childhood, tend to be unhappy, solitary thieves, engaging in ‘comfort stealing’, with a
background of early separation and maternal rejection. They differ from the majority of
more typical pre-pubescent and young adolescent delinquents who steal in an unplanned
or semi-planned way in groups of three or more, outside their homes, and who come from
deprived socioeconomic backgrounds with inconsistent parents.
Their ‘marauding
offences’ fall into the category of socialised delinquency and are often accompanied by
other conduct disorders; these adolescents are highly associated with educational failure.
Older adolescents who steal objects to serve as trophies or engage in solitary, dangerous
exploits, such as car thefts (‘proving offences’), are thought to be unsure about their
masculinity, and
have a parental
pattern of maternal indulgence and
paternal
punitiveness (Wolff, 1985: 404).
One reason for children to steal may be an expression of anger in response to feeling
unloved, but this expression of anger, and subsequent lying, elicit the very responses of
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anger and disapproval that had been feared.
This reinforces the child’s cravings for
affection and his anger and the symptoms persist (Wolff, 1985: 404).
According to Teevan and Dryburgh (2000: 78), delinquent definitions, values, and
techniques are both learned and supported in intimate peer groups the same way that
conformist behaviour is learned.
Children who start stealing from home at a young stage do it for comfort; they are
unhappy and lonely with a background of maternal rejection or separation.
In early
adolescence children who start stealing do it in a more planned manner with a small
group who come from deprived socio-economic backgrounds with inconsistent parenting.
Older adolescents tend to engage in more serious and dangerous pursuits where the
object they steal serves as a ‘trophy’. It is normal for children to take other’s belongings,
but when children do not stop the behaviour regardless of the consequences, it is
significant of a social functioning problem. For the researcher, the social problems which
become evident through a child’s stealing, are the expression of unhappiness within his
relationships and the socialising effect it has, where the child chooses to adopt the
activities of a more delinquent group.
4.6.4.5
Vandalism
The researcher uses the term vandalism very broadly to refer to any purposeful, physical
action by the child that involves damage to property, usually because of an inability to
suppress dysfunctional urges, or as an expression of anger and hate. Fire-setting is a
more serious form of vandalism.
In a study in Canada where 56 high school boys were asked to explain in their own words
why they had engaged in or refrained from certain delinquencies, it was found that the
most common delinquency is truancy, with 45 of the 56 boys truant at least once in the
previous year. It is also the most frequently committed delinquency; several boys reported
over 200 truancies. Drug use/getting drunk is the second most common delinquency, with
39 boys engaging in this behaviour at least once in the previous year, and a high median
of 24 occurrences. In contrast, fewer boys admitted to a fight (17), or theft/shoplifting (12),
and only 10 boys reported vandalism. The median numbers of these behaviours are also
low - two or three (Teevan and Dryburgh, 2000: 85).
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Fire-setting is a rare but dangerous symptom with differences in ‘perpetrator’: the 6 to 8
year old ‘neurotic’ fire-setters with much latent hostility to parent figures; and the more
delinquent 11 to 15 year olds. Children younger than 10 are more inclined to light fires on
their own at home. Two incidence peaks occur around 8 years and 13 years, although
girls tend to be older (with prevalence among girls generally much less than among
boys). Fire-raisers, compared to other conduct-disordered children, are more destructive,
more antisocial and aggressive, and have greater relationship disorders. These children
often come from unstable and violent homes. Mothers may be addicts or psychotic, and
children often lack physical care and may have witnessed both violence and adult sexual
behaviour. Their own anxiety level is high, with extreme insecurity, often because their
fathers, whether present or absent, are of low status, and have grounds for anxiety over
their own adolescent development (Wolff, 1985: 405).
Purposeful damage of property is a form of problem behaviour in some children, with the
most serious form being fire-setting. Children younger than 10 will most likely light fires
on their own at home. Fire-raisers are found to be more destructive, aggressive and anti
social than children with other types of conduct disturbances. They come from homes
where they have witnessed violence and lacked physical care. They are anxious and
insecure.
4.6.4.6
Serious assault
This category of deviant behaviour by the child is a form of violence as it refers to
physical assault (with the intent to do bodily harm) and sexual assault, referring to rape
and molestation. (The reference to purposeful intent to do harm implies that the child is at
the age of criminal liability).
Halliday-Boykins and Graham (2001: 383) state that, in the wake of shootings targeting
youth in their schools and elsewhere in their communities, much public attention has
been drawn to the impact that community violence has on children and adolescents. The
evidence suggests, however, that, unlike these isolated shootings of unsuspecting youth,
children and adolescents who are victimised by violence are more likely than other youth
to be violent offenders, to be repeat victims, and to have friends who have been both
victims and perpetrators of violence.
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Many adult sexual offenders begin offending as adolescents and are not detected for
many years - if at all. Approximately 20% of all people charged with a sexual offence in
North America are juveniles (Worling and Curwen, 2000: 965).
Three motives operate in every rape - power, anger, and sexuality.
Coercive sexual
behaviour is associated with poor socialisation. Differences between child molesters and
rapists are that the latter have more anger and assertiveness problems; are more
commonly intoxicated while committing an offence; their offence is more opportunistic;
and they are more likely to be diagnosed as personality disordered. On the other hand,
child molesters most commonly suffer from anxiety and depression; are more shy and
introverted; the offence is more commonly planned; they report more deviant sexual
fantasies; and are typically significantly older than rapists, as well as more prone to
impression management. Rapists and child molesters share some common personality
characteristics, including social skills and sexual knowledge deficits, and both groups
have been found to be passive-aggressive (Gudjonsson and Sigurdsson, 2000: 363-364).
According to Weisz and Black (2001), researchers know much less about dating violence
among middle school students.
National prevalence data about sexual assault and
dating violence among youths are difficult to obtain, since official crime statistics often do
not record whether a dating relationship existed between victim and perpetrator.
Approximately one-third to one-half of college students report having experienced dating
violence.
Estimates for younger adolescents generally range from 10 percent to 35
percent. However, as many as 57 percent of students in one high school reported that
they had engaged in at least one aggressive act against a dating partner within the past
year (Weisz and Black, 2001: 89).
Assault by young adolescents involves physical violence against another (school
shootings, gangs), and sexual violence (date rape, molestation of younger child). Anger
and poor socialisation are involved.
4.7
Performance
The researcher is of the opinion that an important intrinsic variable is the child’s drive to
achieve. A child wants to learn from a very young age, and loves to be praised when he
accomplishes a task. When the parent encourages the child to become more and more
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independent, and when the child enters the school system, he relates to the adults in his
life through learning experiences.
It was therefore necessary for the researcher to
explore what motivates a child to perform as this drive affects the relationships the child
engages in.
Scherer and Cushman (1997: 59) used Maslow’s (1954) hierarchy to argue that need
satisfaction is what motivates people. They identified these needs as:
a. Physical - survival and security.
b. Social/affiliation - belonging and esteem.
c. Intellectual/achievement - knowledge and understanding.
d. Aesthetic - creativeness.
e. Self-actualisation.
Maslow maintained that needs must be met at each successive level, beginning with the
lowest or physical needs, before one can move on to the next. Frustrated needs result in
hostility and anxiety. This leads to possibilities for understanding the roots of depression,
anger, substance abuse, loneliness, social isolation, and other non-coping phenomena
(Scherer and Cushman, 1997: 60)
It is clear from the above that the mere need to self-actualise (to become better) is a
motivational force. The motivational drive to perform and to self-actualise is dependent
on a cognitive-emotional interplay within the child, explained through the roles of
achievement, expectation,
and satisfaction, and the effects of frustration, goal-
directedness and creativity.
4.7.1 The role of achievement
Achievement deals specifically with the question of why people engage in transactions
with their environment.
Atkinson (1978) views achievement-oriented behaviour as a
result of a conflict between approach and avoidance tendencies. Associated with every
achievement-related action is the possibility of success (consequent emotion is pride) and
the possibility of failure (consequent emotion is shame).
anticipated
emotions
determine whether
achievement-oriented activities.
an
individual
The strengths of these
will
approach
or
avoid
The tendency to approach or the actual state of
achievement motivation is conceived as a product of the need for achievement (capacity
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to experience pride), the probability of being successful, and the positive effect of pride
resulting from success (Faul, 1995: 160 and 163). The tendency to avoid achievement
tasks is seen as the product of the motive to avoid failure (capacity for reacting with
embarrassment is necessary), the probability of failure, and the negative effect of shame
resulting from failure (Faul, 1995: 164).
The correlation between achievement and social interaction is demonstrated in the fact
that people who achieve their goals in life experience feelings of success, leading to
benevolent actions towards other people.
People who succeed are more likely to
contribute to a charity and help other people. These people have high self-esteem, are
balanced in their involvement in achievement-oriented activities, and they are therefore
able to spend time in relationships (Faul, 1995: 171-172).
The effect of early development on achievement related needs is influenced by aspects of
child-rearing.
Encouragement of achievement and independence are intertwined with
general restrictiveness, beliefs about the child’s competence, physical affection and
reward giving, a general affective climate and warmth in the home, and parental
expectations (Faul, 1995:172).
Eventually the child must be able to direct the pleasure or disappointment after success
or failure at the self. The development of these self-attributes leads to individuals who
pay particular attention to internal feelings of effectiveness and competence, and come to
value these feelings more than others (Faul, 1995: 173).
The relationship between achievement evaluation and effort expenditure is influenced by
cognitive growth.
Among younger children achievement evaluation is determined
primarily by outcome - success is rewarded while failure is punished. Among the 10 to
12 year olds, effort is more influential than an outcome in the allocation of reward and
punishment (response to discipline). The preference of intermediate risk also increases
with cognitive maturation. Younger children tend to prefer easy tasks with sure success,
but shift towards intermediate difficulty when older.
The shift towards intermediate
difficulty might indicate the growing importance of personal feedback and self-knowledge
as motivators of choice, and be mediated by the ability to make self-attributions (Faul,
1995: 173).
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Faul’s (1995: 174) definition of achievement can be adjusted to the child: achievement
relates to the tendency of the child to approach goals that can enhance feelings of
competence and pride, and avoid feelings of failure.
It relates to the development of
awareness within the child of his own needs and potential, and of the striving to reach
goals. The achievement oriented child tends to strive for mastery of tasks to improve
himself and his performance, and he has good development of self-attributions.
The
encouragement of achievement of independence by the parents is an important
contributor of achievement in children. This is influenced by how restrictive the parents
are, by the practice of reward giving, affection, and the parents’ beliefs in and
expectations of the child’s competence. Feelings of success improve the quality of social
interactions.
4.7.2 The role of expectation
The importance of hope (where the world and human nature consist of possibilities) and
optimism (an attitude associated with expectations about the social or material future as
socially desirable, to one's advantage or for one's pleasure) as a stimulus for active
problem-solving is supported by social functioning theory.
Paul (1995) uses the word
'expectation' to refer to an act of integration between the emotion, cognition, and conation
(dimensions of personality); 'expectation' is treated as a concept related to hope and
optimism (Faul, 1995: 193).
The stimulus for social behaviour in any system cannot only be committed to the certainty
of the passage of time, without any energetic relationship to another principle or purpose.
Promise always forms part of the ingredients in a society, and even the most thorough
going secularist is infected by the certainty that, however good or bad the experience is, it
can be better. This concept, which has to date mainly been associated with philosophy
and religion, is now seen as a vital ingredient of a healthy life. Hope can be seen as the
command to keep faith, to remain loyal and committed to action, secure in one’s moral
righteousness, even when rational considerations might call for scepticism (Faul, 1995:
194, 197).
Seligman’s (1991, in Faul, 1995: 197-198) theory on learned optimism states that, to
learn beforehand that to respond can make a difference, can help prevent learned
helplessness.
Learned optimism is more than positive thinking or self-talk, it is the
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explanatory style in which a person habitually explains to himself why things happen. If
the style is optimistic it stops helplessness. Finding temporary and specific causes for
misfortune is the art of hope. Optimism is extremely important because it can protect you
against depression, it can raise your level of achievement, it can enhance your physical
well-being, and is a far more pleasant mental state to be in. There are three crucial
dimensions that distinguish the optimist from the pessimist: believing that bad events are
temporary, that one can go about one’s life even when experiencing considerable
difficulty in one or more aspects, and not losing self-esteem (externalising bad events).
These dimensions can control what people do, govern how long they are helpless, and
determine across how many situations they will have the same response (Faul, 1995:
197-199).
Optimism must, however, not rest on the absence of negative thoughts and pain in one’s
life, but on sincere belief in the greater importance of good and a willing effort to
cooperate with the good.
The person who is sincerely hopeful views the future with
realism based on faith, regards as important and socially acceptable the events hoped
for, and, within the realm of the possible, is ready to do whatever is necessary to make
the future a reality. Hope also increases the amount of pressure that can be withstood
before the disintegration of goal-directed efforts begins.
When one hopes one can
effectively move towards what one wants; one becomes willing to forego other
satisfactions and withstand pressures from other needs and wants to realise the greater
goal or want. The attraction towards goal-directed effort is provided by hope. High hope
people tend to enjoy good relationships since positivism is contagious.
Optimists are
more outwardly directed, and as a result others open up to them and in doing so start to
feel better.
This makes the optimist feel good in turn because pleasure comes from
making others feel good (Faul, 1995: 200, 202).
The effect of early development on expectation has to do with habits or thoughts that are
learned reflexes and that become ingrained through constant repetition. The newborn
infant starts out in helplessness and from there he embarks on a journey of gaining
personal control. Personal control means the ability to change things by one’s voluntary
actions. People learn that there are a considerable number of actions over which they
can take control. These actions involve the way people lead their lives, how they deal
with other people, how they earn a living, and all aspects of existence. Learning that their
actions matter is central to the creation of habitual optimistic thoughts in children (Faul,
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1995: 202-203).
Faul’s (1995: 203) definition of expectation can be adjusted to the child. Expectation can
be defined as the child's development of a positive orientation towards his future. This
positive orientation is cultivated through the child's learning to habitually explain to himself
why things happen in a manner that protects his (healthy) self-esteem, and through
learning self-control, thereby believing that his actions can make a difference.
Expectation is the belief that things are possible, even if they will mean great effort and
faith in oneself and the situation. It is also the belief that evil can be overcome by good,
and that man is inherently good and must be protected from evil. Expectation increases
optimal social functioning through the role of optimism, which can protect the child from
depression, and the role of hope (promise, faith), which increases the amount of pressure
that can be withstood before the child’s goal-directedness will disintegrate. It acts as a
stimulus for active problem-solving.
4.7.3 The role of satisfaction
With regard to social functioning, it is important to get an indication of the manner in
which the individual experiences satisfaction with his transactions in his environment.
Happiness is seen as a perfect lasting state of intense satisfaction, and bliss.
The
challenge in defining happiness/satisfaction lies in whether it is a condition (quality of life)
or an experience (individual’s enjoyment of living). The question arises as to how people
living in seemingly identical conditions can differ so much in their enjoyment of life (Faul,
1995: 177-179, 181).
If happiness is viewed only as an affective experience, momentary pleasures like the use
of drugs will also be seen as inducing a state of happiness. It has more to do with one’s
overall appreciation of one’s life - the assessment of the way in which one’s desires and
goals are satisfied in life. The cognitive part of happiness implies that the person must
more or less know what he wants and he must be able to assess the degree to which his
desires are met.
The affective part of happiness is derived from the emotional
associations that go with the cognitive appraisal of one’s life (Faul, 1995: 183-184).
Aspects that are typically associated with a satisfactory, happy life are self-actualisation,
goal-attainment, virtuous activity, optimal functioning, sufficient money, a good family,
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philosophical activities, and moral activities, with the main objective being that they
represent value judgements on what is more valuable to engage oneself in (Faul, 1995:
184-185).
Unfulfilled aspirations are closely related to changes in a person’s life that must be
attained, whereas fulfilled aspirations are closely related to maintaining the status quo this being easier and less likely to lead to disappointments than dealing with change.
People who pursue short-term goals that are enjoyable and not too difficult, and pursue
these in collaboration with others, also tend to experience more feelings of satisfaction.
These people value interaction with others, they are not egocentric, and, because they
are able to reach their goals and aspirations in life, they experience high self-esteem
(Faul, 1995: 186).
Satisfied people like to be sociable. Extroversion predisposes people, especially young
people, to have favourable life events, especially in the domain of friendship and work.
These in turn lead to a high level of positive well-being, and this increases extroversion.
People who think they get along well with others appear to be happier than those who do
not, and they are more satisfied with their lives. A positive appreciation of life contributes
considerably to the development of social skills. Cheerful people are more liked and have
more friends. Depressed and unhappy people tend to become more isolated and lonely.
The ability to cope with worries or problems is related to happiness, and extroverts
experience their social interaction as a source of happiness and satisfaction. They tend
to have good relationships with partners, family and friends. They seem to spend more
time on visits and entertainment with the people they interact with (Faul, 1995: 187).
Adult happiness appears to be influenced by the degree of stability in family life during
early development. Unhappy people met with a marked amount of instability during their
youth such as illness, death, conflict, and divorce being more frequent in their family
histories.
There are also indicators that contact with parents was relatively less
affectionate. There are strong arguments for the view that children need affection and
stability to grow up to be happy. Linked to the development of happiness is the way in
which people have learned to protect themselves from threatening information by the
unconscious distortion of their perceptions. When children learn from their parents that
there are healthy ways to experience negative feelings, without letting the negative things
destroy their morale, they tend to develop healthy reversal and intellectualisation patterns
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K >
which become internalised in their appreciation of their lives.
Turning negative
experiences into positive appraisals represents a way of keeping up moral without losing
too much contact with the external reality - the pain is denied, but not the problem.
Children who are frequently exposed to long lasting painful events can develop strong
defensive tendencies to cope with the truth that is too painful to bear. This can protect
the child from inner confusion and from losing control all together.
This will lead to
survival but not to happiness or satisfaction with life (Faul, 1995: 188).
Faul’s (1995: 189) definition of satisfaction can be adjusted to the child. It is the unique
expression of a child as to the feelings of well-being he attaches to his life. To be happy
the child needs to learn what he wants from life and move towards fulfilling aspirations.
Engaging in moral activities, a stable family life, experiencing favourable life events from
friendships and schools, and learning healthy ways to experience negative feelings all
increase the cognitive and affective experiences of happiness in the child. Children who
experience satisfaction value interaction with others and are less egocentric, increasing
the ability for optimal social functioning.
4.7.4 Understanding frustration
In assessing social functioning, it is important to get an indication of the manner in which
the individual is frustrated in the achievement of goals and desires, as this can immobilise
him. Long-lasting frustration can lead to apathy and total disintegration of goal-directed
activities - an important indicator of social functioning. Frustration can be understood as
the condition of being thwarted in the satisfaction of a motive or the realisation that the
goal to which one is committed is unattainable. It occurs when the person meets a more
or less insurmountable obstacle on his route to the satisfaction of any vital need, or when
he is unable to transform his potential into satisfactory life experiences (Faul, 1995: 205207).
Frustration can be produced by many stimulus situations: (a) Delay, which is when a
person has learned that reinforcement follows given behaviour, and then has to wait for it.
Delay as a consequence of the developmental phase the individual is in can create
intense frustration.
One of the marks of maturity is the capacity to tolerate delay of
reinforcement. The individual finds, with age, some meaningful ways to integrate, or to
reconcile the opposites of satisfaction and frustration during adolescence (Faul, 1995:
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209-210). (b) Thwarting, where both environmental and internal obstacles can lead to
frustrations.
Frustrations
depend
heavily
characteristics, life situation, and the society.
disability, can be a source of frustration.
on
factors
such
as
age,
personal
Personal limitations, such as illness or
Perceived physical characteristics that are
evaluated through personal or social values, such as unattractiveness, operate as a more
effective barrier to socialisation than the actual characteristic does. A person who lacks
self-control and displays overt aggression can find his behaviour to be a serious limiting
factor.
The behaviour of others is designed to satisfy their own motives and may
constitute a barrier to the individual’s motive fulfilment. For this reason social interaction
inevitably has a component of thwarting and resultant frustration (Faul, 1995: 210-212).
(c) Conflict, where frustration is the result of the simultaneous occurrence of two or more
incompatible needs or motives - the requirements of one preclude satisfaction of the
other. Decision-making is notoriously difficult when the choice among alternatives implies
important consequences for the individual (Faul, 1995: 212-213).
The consequences of frustration mainly centre on the following three distinct hypotheses
(Faul, 1995: 214-217): (a) frustration is an important determinant of human aggression.
The threat of punishment could lead to a displacement of aggression towards substitute
targets.
The probability of aggression is increased if the response has instrumental
value, if the frustration is experienced as unexpected, and if external aggressive cues are
present. If frustration is perceived as unintended, justified, mitigated by extenuating
circumstances, or accidental, people do not get as angry as when it is perceived as the
unjustified intent to hurt. This perception leads to the attribution of blame and retaliation,
(b) Frustration also leads to regression. Regression means the opposite of development
so that behaviour becomes more childish and less mature - a reversion to an earlier, well
established mode of behaviour - and persistence in this mode, despite relative
inefficiency of the behaviour in solving the problem, (c) Frustration leads to fixation.
Fixation is a concept used in learning to designate a high degree of stability. Abnormal
fixation occurs as a response to frequent levels of frustration. Frustration can therefore
lead to rigidity. The behaviour is a terminal response and not a means to an end (no goal
orientation). Responses formed or expressed during frustration are more rigid than any
that can be established through training or learning.
They continue to dominate
behaviour despite their inadequacy. Learning a new response requires letting go of old
responses and the exercising of trial and error, and therefore fixation interferes with
learning. This hypothesis also serves to explain stubborn attitudes such as prejudices
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against certain groups of people.
Frustration tolerance is the extent to which the individual is prepared to return to tasks at
which he has been unsuccessful rather than successful.
Maladaptive adult behaviour
patterns can stem from thwarting during childhood and infancy.
Too much thwarting
during the developmental years does not allow the individual to develop an adequate
reaction to frustration.
If frustration and conflict are introduced gradually, they can be
more adequately handled by developing appropriate reactions. Children can be trained to
tolerate increasingly difficult tasks by gradual exposure to problems of increasing
difficulty.
Variations in tolerance to a situation as the result of exposure to it are
dependent on many conditions, such as the severity of the situation, the length of
exposure to the situation, age at exposure to the situation, and avoidance possibilities
(Faul, 1995:221).
Faul’s (1995: 222) definition of frustration can be adjusted to the child. It refers to the
reaction of the child to the problems in himself and his environment that prevent him from
achieving his goals and desires in life.
It can be produced either by delay, thwarting,
and/or conflict, and can lead to aggression, regression, and/or fixation.
Individual
responses to frustration differ to the extent that the individual is task involved or ego
involved when he approaches tasks, and whether he has internal locus of control or
external locus of control.
Children need gradual exposure to frustration to develop
adequate frustration tolerance and this is influenced by the severity of the situation, the
length of exposure, the age at exposure and avoidance possibilities.
Long-lasting
frustration can lead to apathy and total disintegration of goal-directed activities, which are
important indicators of social functioning. (Refer to frustration on infant level - Piaget - in
Annexure 2.)
4.7.5 Goal-directedness
Goals or intentions influence achievement behaviour. There are two different ways in
which tasks are approached, goals are formed, and personal success is viewed. The first
approach is termed task involvement - the individual is focused on task mastery and
understanding; personal goals revolve around improving skill and gaining insight, and
personal success is independent of the progress of others. The second approach is ego
involvement - the person addresses tasks in order to demonstrate ability to self and
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others; success is evaluated relative to a normative reference group. When confronted
with negative feedback, they tend to display maladaptive behaviour such as helplessness
and interpret it as a sign of low ability. They prefer less challenging tasks and use less
effective task performance strategies (Faul, 1995: 169-170).
Although factors like instincts, previous experience, heredity, and environment play a role
in the formation of personality and in determining behaviour, the primary motivating force
in human life is the movement toward various life goals, whether conscious or
unconscious. The behaviour of the child gets viewed from a perspective of finding out its
goal.
The child may shift goals in various settings and with different people.
In
determining the goal behind the child’s behaviour, the social worker looks at several
factors, such as the child’s behaviour, other people’s reactions to these behaviours, and
the child’s reaction to correction (Kottman, 1995: 13-14, 107-108)
All misbehaviour stems from discouragement. The child lacks the courage to behave in
an active, constructive manner. A child does not misbehave unless he feels a real or
threatened loss of status.
The goals of discouraged children fall into four primary
categories of striving: attention, power, revenge, and proving inadequacy (Kottman, 1995:
107).
The goals of the child are determined through his behaviour. All misbehaviour in children
stems from discouragement and a sense of real or threatened loss of status. The child
strives for attention, power, revenge or proving inadequacy when he behaves in a
discouraged manner.
Since the child may shift goals in different settings and with
different people, the social worker needs to determine what the child’s behaviour is, what
other people’s reactions to these behaviours are, and how the child reacts to correction.
4.7.6 Creativity
The social worker should focus on the special and wonderful qualities of each individual
family member.
Social work involves an exploration of the child’s strengths, so his
assets, family life-style, their goals, and his behaviour are all considered. When a holistic
view of life is taken, the child’s uniqueness across the five tasks of life: school (work),
friends, love, finding meaning in life, and coming to terms with oneself should be
examined.
Each individual expresses his creative ability by making choices and this
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necessitates self-determination.
The ability to make choices allows individuals to
exercise their creativity and uniqueness throughout their life spans. The responsibility of
the social worker is to discover how each child expresses his special and wonderful self,
and to convey a sense of celebration of his uniqueness to the child, parents, and others
who interact with him (Kottman, 1995: 17-18).
More specifically, creativity relates to the need for new experiences with regard to the role
of play/stimulation, language, and the teacher.
To be creative entails creating
uniqueness. Each individual expresses his creative ability by making choices, and this
necessitates self-determination. For young children fantasy play and art provide an outlet
for emotional expression. Self-concept develops systematically, and the social context of
the child plays a huge role. Through social contact the child has an opportunity for self
disclosure and feedback. Especially during the adolescent years, the child is confronted
with a plethora of social events.
The child develops towards independence and the
making of responsible choices. This is hugely influenced by the concept the child has of
himself. The child needs space to express his own uniqueness, and in over-controlling or
abusive families this is a crucial need that cannot be overlooked, since it impacts directly
on the child’s ability to function as an adult. The first context in which a child learns to
express himself are through practising humour on his family, putting rules on play, by
helping out with house chores, and by creating things (e.g. pictures).
The development of creativity within the child implies his ability to assert his uniqueness
and the capacity for decision-making. It relates to the child’s need for new experiences
through play, language, and teaching. Through social contact, the child uses self-control
and feedback to support the expression of creativity.
The child’s development of
independence and responsibility is influenced by his self-concept. The first signs of the
child’s creative expression are through practising humour on his family, putting rules on
play, doing house chores, and the creation of things such as pictures.
4.8
Stress
Stress relates to the manner in which the individual experiences the demands in the
environment as too great. When demands are experienced as too great, it is difficult for
the individual to function optimally.
It is therefore important to get an indication of the
stress levels of the individual in order to assess his level of social functioning. Chronic
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stress is seen in modern day psychology and medicine as a major problem facing people.
We are victimised by stress, an insidious form of illness which comes as a result of our
prosperity and of the pace at which we live in this technologically sophisticated world.
Most definitions of stress "seem to apply stress equally to a form of stimulus (stressor), a
force requiring change or adaptation (strain), a mental state (distress), and a form of
bodily reaction or response" (Faul, 1995: 224-225).
The inclusion of stress in understanding the social functioning of children is based on the
appearance of the concept in many literature sources when childhood functioning is
discussed.
It is the task of the researcher to understand stress in childhood.
As a
guideline she referred to Faul’s (1995) doctoral study on the elements of psycho-social
functioning for a description of what should be understood about stress. She also used
the concepts listed under “short-term stress or crisis situation” in the Minnesota
classification codes to decide what life events to include in this section.
Some of the
concepts (see Annexure 1 A) relate to the environment and the illness which will form part
of Factors 2 and 4 in future developments. The researcher extracted the following from
this list to include these in Factor 1: “transitional crisis”, “adolescent pregnancy” and “due
to anticipated event of change in status”. The meaningful terms from these concepts are:
> Abandonment of child
>
Foster home care
> Adoption of child
>
Institutional placement of child
> Geographic change
>
Public assistance needed
> Remarriage (step family)
>
Public assistance lost
As a combining category, the above terms relating to the child being removed from his
parents’ home will be termed statutory intervention, and will be discussed with regard to
its meaning and the stress this can create for the child.
When training parents and foster parents to be prepared for stressful events in the child’s
life, the researcher gives consideration to how the child will interpret what is happening to
him and how this can be positively influenced.
For this reason she includes a short
discussion on early recall since the reality of practice is that social workers often only see
the child after an event has been processed by him - either in his own way, or in terms of
how it was explained to him by other adults and peers.
The child’s ability to process
stressful events depends largely on his cognitive level of functioning (discussed at the
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beginning of this chapter). Another potential stressful life event is a loss to the child (this
includes moving and death of significant others).
For this reason the researcher also
regarded grief as part of this section.
4.8.1 Understanding stress
Stimulus-orientated views define stress as experiencing specific kinds of stimuli that
places demands on the individual.
Stress is seen as forces within the individual and
environment, and can be indexed in terms of the number of life events experienced within
a given period. (To help the social worker assess how stressful events in the child’s life
are, the researcher included the “Life Events Record” in Annexure 2). Individuals vary in
their view of events as positive or negative depending on the circumstances surrounding
the event and the way in which the event is perceived (Faul, 1995: 226,229).
Response-orientated views focus on the individual’s biological or psychological response
to stressful events. When demand exceeds the resources we think we have, the body
and mind are aroused and all systems are geared up to fight the challenge or to flee from
the situation to avoid harm. Anything that happens for the first time, or that a person
cannot immediately make sense of, is likely to trigger stress. A full-blown stress reaction
will be forthcoming when the danger is real and serious or when uncertainty and doubt
continue on a prolonged basis (Faul, 1995: 229-231).
Lazarus and Folkman (1985, in Faul 1995: 235) define stress as "a particular relationship
between the person and the environment that is appraised by the person as taxing or
exceeding his or her resources and endangering his or her well-being".
Themes
emerging from this approach are: the manner in which the individual appraises the
situation, specific factors that can influence the severity of stress, and the part the
individual can play in instigating the stressors he experiences.
■
Appraisals-. Cognitive appraisal is the process through which a person evaluates any
encounter with a potential stressor in terms of its significance for well-being. Primary
appraisal has to do with the person’s view of a given situation in terms of its threat
value.
Secondary appraisals concern the individual’s appraisal of the resources
available for dealing with threatening or challenging situations (Faul, 1995: 236-237).
■
Factors influencing the severity of stress: The severity of stress is gauged by the
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degree of disruption in functioning involved. The severity of stress depends on the
relationship between the size of the demand and the individual’s resources for dealing
with it.
Aspects that can influence the severity of stress are its importance and
duration, the imminence of the stressor, the perception of threat and inability to handle
the demand, stress tolerance (resources for withstanding the stress), and external
resources and support (Faul 1995: 237-238).
■
The part the individual plays in instigating his own stress: People do create much of
their own stress, not only by how they construe events and cope with them, but also
because of the part they play in instigating the stressors they experience.
The
following disrupting thought patterns must be avoided if someone wants to adapt more
successfully to his environment: extreme thinking, over-generalisation, exaggeration,
and arbitrary conclusions where opinions are formed based on evidence that is not
related to the situation (Jordaan and Jordaan, 1984, in Faul, 1995: 239).
Stress forms part of the developmental phases of the individual. For younger children the
family represents an especially important context for understanding stress and
psychological
difficulties.
There is clear evidence that children’s psychological
dysfunctions are related to their parent’s stressful experiences and to their parent’s
psychological symptoms.
(This is a further argument for including the abilities of the
parents and the influence of the family’s reality into childhood social functioning).
In
adolescence there is a great deal of conflict between the need for emotional and
intellectual freedom, and the desire to remain a child and be protected. Sexual urges,
tentative and unstable relationships, revolt against authority, or sheer boredom can cause
considerable stress. This may be felt as a minor anxiety or may manifest in the form of
gang fights, alcoholism ordrug dependence(Faul, 1995: 241-242).
Faul’s (1995: 242) definition can be adjusted to children, in that stress is seen as the state
the child reaches when he can no longer respond positively to the demands of the
environment. This stage is usually reached when all his internal and external resources
have been exhausted, and is caused by a combination of stressful life events that
demand certain adaptive strategies from the child. In the young child the family plays a
huge role in the experience of stress, and in the adolescent his desire for both freedom
and safety causes stress. The child’s perception and appraisal of stressful events (child’s
view of threat vs. view of available resources), his abilities to deal with the events, and his
subsequent reactions to these events, play a part in his adjustment to stress. Thought
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patterns that prevent successful adaptation to the environment are extreme thinking,
over-generalisation, exaggeration, and arbitrary conclusions where opinions are formed
based on evidence that is not related to the situation.
4.8.2 Emotional effects of stress
There is a strong link between stress and emotions. Certain emotional effects of stress
will influence the child’s interaction with others and his environment. After identifying the
presence of stress, the social worker should also determine what the emotional effects of
stress are on the child.
Psychological stress is understood as "a state characterised by strong negative emotions,
such as fear, anxiety, anger, hostility, or other emotional states evoking distress,
accompanied by physiological and biochemical changes that exceed the baseline level of
arousal" (Strelau, 1998: 362).
4.8.2.1
Fear
Fear is an inevitable and necessary emotion in everyday life, but particular fears may
outlive their usefulness. Their persistence begins to interrupt the child’s capacity to adapt
easily and successfully to the unusual life stresses. Changes with age and individual
differences in the expression of fear and anxiety need to be taken into account.
Fear
during infancy is mainly related to actual events in the immediate environment. As the
child grows older, fantasy and imagination come to play a greater role with the child’s
increasing ability to reflect on past events and to anticipate the future.
Fears may
become linked to possible future dangers or there may be apprehension about the harm
that could stem from inner thoughts or impulses to action. With increasing age, there is a
decrease in fears of tangible and immediate situations, specific objects, noises, falling,
strange objects and persons. Fears of imaginary creatures, of the dark or of being alone
or abandoned increase, but decrease after 14 years. In middle childhood there is some
tendency for fears relating to personal safety and fears of animals to decline.
Fears
concerning school increase from the age of 9 to 12 years. Towards adolescence there is
an increase in fears relating to social relationships, gossip and ridicule, worries about
money, and vague fears about the individual's own identity and whether he is adopted
(Hersov, 1985: 369).
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Fear is only useful as a survival mechanism when it is persistent and starts to interfere
with the child’s ability to adjust to life stresses.
Differences in the type of and the
expression of fear exist among different age groups.
During infancy fear is related to
events in the immediate environment. As the child grows older he begins to fear things
he can imagine, and until the age of 14 years the child fears the dark and being alone. In
middle childhood fears relating to personal safety and animals decline, with fears
concerning school increasing around the age of 9 to 12.
Towards adolescence fears
relate to social relationships, ridicule, and belonging.
4.8.2.2
Helplessness
Helplessness is the final stage one reaches when goal-directed activities disintegrate.
Learned helplessness, as formulated by Seligman (1975, in Faul, 1995: 245-246),
"concentrates on those depressions that begin with a reaction to loss of control over
gratification and relief of suffering, and in which the individual is slow to initiate responses,
believes himself to be powerless and hopeless, and has a negative outlook on the future".
Referring to social dysfunction, unhappiness involves loss of achievement and goaldirectedness, loss of control over feelings of satisfaction and the loss of expectation in
life, as well as the experience of severe frustrations and stressors.
Depression is a
human condition in which all the positive aspects of existence are absent: joy, happiness,
satisfaction, excitement, the love of oneself and the love of life.
In its more extreme
forms, depression is completely incapacitating, leaving the individual unable to cope with
even the simplest demands of daily life (Faul, 1995:247-248).
There are certain definite points on the continuum of depression. On the one end there is
a mild, self-limiting depressive mood that occurs in response to some obvious and
significant life stress. The next point on the continuum is the reaction depression that
causes significant subjective distress, and mild to moderate impairment of the individual’s
capacity to engage in productive activities and to relate satisfactorily to people. When
such a state endures for weeks or months and does not show promise of spontaneous
resolution, the person begins to have doubts as to whether he will ever recover and he
begins to lose hope for the future. The next point is exemplified by the individual who has
a depressive reaction that seriously impairs his sense of hope for the future. This degree
of depression is characterised by suicidal inclinations, serious subjective suffering, and
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obvious impairment of the capacity to enjoy any activity or to participate effectively in
work or personal relationships. The final point is the state of serious depression, and is
represented by the person whose capacity to function is so impaired that hospitalisation is
mandatory. The seriously depressed individual, whether inert and apathetic or agitated
and restless, has suffered a serious regression and impairment of controlling, organising,
directing, and defensive functions of the ego.
He knows only the present and has no
sustaining capacity to recall the past when things were better for him. He also has no
capacity to envision the future as different from the intolerable present (Faul, 1995: 249250).
The person’s body can handle a certain amount of stress before chemical imbalances
occur. If a person has been exposed to too many stressors that have led to numerous
spells of depression, biological changes can take place in his body that can intensify the
feelings of exhaustion and helplessness.
The factor that most disposes a person to
become depressed, is the experience of helplessness in childhood due to failure in the
satisfaction of vital needs. The adult who has been deprived in this manner will need
continual confirmation that he is loved and liked.
depression is likely to follow.
If these needs are not satisfied,
Even temporary but strongly felt experiences of
helplessness in the first years of life can be revived later when something happens to
remind the adult of the earlier traumatic event. Traumatic experiences early in life also
predispose the individual to overreact to analogous conditions in later life.
Emotional
neglect, sexual abuse, divorce and the death of a loved one may furthermore influence
the way children begin to perceive their world, and cause them to form pessimistic habits
or thoughts instead of optimistic ones.
Living in a chaotic, confusing or constantly
changing environment can cause children to doubt that good things will last. They can
come to believe that nothing they do matters. Overcritical and perfectionist parents and
teachers also foster pessimism in children.
Because hopelessness has its roots in
childhood, it is a difficult habit to change. The main developmental notion is the fact that
the child must be able to make some sense of his world and learn the importance of
meaningful activities that can, later in life, help him to decide for himself what his meaning
in life will be (Faul, 1995: 263-264).
Helplessness involves a reaction to loss of control over gratification and relief of suffering,
with the absence of positive aspects such as joy, happiness, satisfaction, excitement, the
love of oneself and the love of life.
A feeling of depression can range from a mild
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response to life stresses, to enduring withdrawal with lack of hope for recovery. A child is
disposed to become depressed when he has the experience of helplessness due to
failure in the satisfaction of vital needs, by being deprived of feeling loved and liked.
Emotional neglect, sexual abuse, divorce and the death of a loved one may furthermore
influence the way children begin to perceive their world, and cause them to form
pessimistic habits or thoughts instead of optimistic ones.
Living in inconsistent
environments can make children doubt that good things will last, and overcritical and
perfectionist parents and teachers can also cause children to question whether what they
do matters.
4.8.3 Statutory intervention
Stress is caused by a lack of equilibrium - a discrepancy between demands and the
individual’s capacity to cope with them.
The magnitude of stress is a function of the
degree of discrepancy, assuming the individual is motivated to cope with the demands
with which he is confronted.
Unpredictable and uncontrollable life events, hassles,
significant life changes, situations of extreme high or extreme low stimulative value, and
internalised values and standards of behaviour, place demands on the individual.
Demands exist in two forms: objective and subjective; the latter is a result of individual
specific appraisal.
Appraisal of threat, harm, and challenge, whether conscious or
unconscious, is the cause of stress (Strelau, 1998: 362-363).
Although statutory intervention is undertaken to safeguard the child, it can still be viewed
as causing disequilibrium in the child’s life.
substituting the roles of his parents.
He has to get used to strangers that are
This substitution happens in one of four ways:
through a place of safety placement (which can be viewed as a shorter term fostering
agreement), foster care, institutional placement, and through adoption.
Most children who need substitute care, need a stable family environment in which to live.
Foster homes meet this need and are the placement of choice.
Foster homes give
children a chance to experience family living with substitute parents in a stable
environment that meets their physical and emotional needs. Social workers have a dual
role: they are responsible for helping foster parents and children adjust to the placement
through support services, and they engage in permanency planning for the child’s future,
including intervention with the biological family (Johnson and Schwartz, 1994: 194, 196).
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Institutions continue to care for and treat children with special needs who cannot benefit
from placements in family foster homes. Children needing institutional care range in age
from preschoolers to adolescents, with problems varying from dependency problems, to
psychological disturbance, to socially maladjusted youths.
Most institutions utilise the
community resources and also attempt to provide services to the families. Funding for
services comes from state and local grants, as well as public beneficiaries. Children with
physical, emotional, and intellectual disabilities; blind or deaf children; children with
psychological disorders; delinquent children; and chemically dependent children are all
served through these institutions, residential treatment facilities, and group homes, by
means of treatment and recreational activities. Although most children placed in such
facilities are there because of special needs, they may also require permanency planning
services. Special needs children are those with physical, emotional, mental, and medical
disabilities or conditions that pose special challenges to parents and/or caregivers. Social
workers perform direct service delivery roles such as individual, family, and group
therapy; as well as indirect services such as staff coordination and supervision,
programme planning, advocacy, and staff training (Johnson and Schwartz, 1994: 196197, 198).
The adoption of children by people not related by blood ties is a legal process. Families
are created or expanded when the ties between biological parents and children are
severed by the courts and legally re-established with adoptive parents. Adopted children
become the legal children of the adoptive parents and are entitled to all the rights and
benefits that a biological child would have. Adoption serves a number of purposes: it
enables children who are legally free to have a permanent home; it provides a way for
couples who are unable to produce children biologically to become parents; it is a way in
which children whose parents cannot care for them are given an adequate home to grow
up in; and, unlike other substitute care, it gives children much needed stability. There are
two primary types of adoption: agency adoption is arranged by a child welfare or social
service agency sanctioned and authorised by law or license to do so; and independent
adoptions, where arrangements are made by a third party acting independently and as a
facilitator between the biological and adoptive parents. The biological parents release the
child up voluntarily. This type of ‘grey’ adoption also includes adoption by a stepparent or
any other relative. Social work’s role is finding the proper adoptive home, completing the
home investigation, and offering support to increase the success of the placement
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(Johnson and Schwartz, 1994: 197-198).
Statutory intervention in a child’s life results in transitional stress or a crisis situation. It
causes disequilibrium that places a demand on the child’s capacity to cope with the
stress. Statutory intervention takes place through the processes the social worker puts
into place to safeguard the child, i.e. place of safety-, foster-, and institutional placement,
as well as adoption. Each option is considered for different reasons, i.e. rehabilitative,
meeting developmental needs, or permanency planning.
The significance of these
interventions in the child’s life includes the experience of loss of something familiar
(discussed later in this section), the child’s own adjustment to new circumstances, which
may involve behaviour problems and motivation (discussed in earlier sections), and how
well it is handled by the adult who is in the parent role (discussed in next section).
4.8.4 Early recollections
The effect of life changes has as much significance as the child’s recall and interpretation
of the events. It is therefore necessary to explore what the child can recall and in what
manner this shapes the child’s concept of himself and the world around him (this is
referred to later by Kottman as lifestyle hypothesis).
'Early recollections’ refers to selected memories from the person’s first 6 to 8 years of life
that provide a brief picture of how an individual views himself, other people, and life in
general, what he or she strives for in life and what he anticipates as likely to occur in life.
Since people selectively remember events from their past, the situations and relationships
they choose to recall usually have some type of significance for them. This can provide
valuable cues about the child’s life-style, mistaken beliefs, social interactions, and goals
of behaviour (Kottman, 1995: 140).
Strategies to use in eliciting the child’s early
recollections are found in Annexure 2.
The effect stress and loss have on the child is determined by the child’s recollection of
these events. The child’s selective memories of his first 6 to 8 years create a picture of
how he sees himself and others and what he thinks is likely to occur. It gives insight on
possible mistaken beliefs the child might have, as well as his social interactions and the
goals for his behaviour.
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4.8.5 Grieving
Social workers are directly involved at that acute point where they have to witness the
pain of a confused and hurt child being taken away from his parents. Whether it is from
separation or death, serious attention must be given to the child’s experience of loss. In
the likelihood the social worker may work with a child who is himself dying of a terminal
illness, who has to face the loss of his life, an understanding of grieving is necessary.
Any adult would want to protect a child from pain and may therefore be prone to keep
things away from him. This however deprives the child of the right to express and resolve
his own regret and concerns, or to check out his own observations.
John Bowlby (in
Jewett, 1994: 2-3) believes that a child can resolve losses appropriately when:
■
The child has enjoyed a reasonably secure relationship with the person who is
leaving or gone.
R
The child receives prompt, accurate information about what has happened and is
allowed to ask all sorts of questions, which adults answer as honestly as possible,
acknowledging when they don’t know.
■
The child is allowed to participate in the family grieving, both publicly and privately.
■
The child has easy access to a trusted parent or adult who can be relied upon for
comfort and a continuing relationship.
Because all children appear to harbour some degree of fundamental and primitive terror
that something catastrophic might happen to their caregivers, and that without their
caregivers’ protection and care they themselves might die, it is best that the news about
loss comes from the adults to whom a child feels closest. Access to someone with whom
the child shares an ongoing history of trustworthiness, concern, and involvement is an
important buffer during crisis or change, and reassures the child that he is not alone, that
there are other people available to provide protection and vital caretaking.
If the loss
entails the departure of a parent, whether because of a new job assignment, parental
separation, serious illness, or incarceration, it is best for both parents to tell the news
together, so the child has a chance to understand that everyone is involved in what is
happening, and regardless of the change they are still a family. If the loss resulted from
parental conflict, separation or divorce, it is particularly important for each parent to take
special care to avoid influencing the child’s reactions and to do whatever is necessary to
reduce the likelihood that the child feels caught in the middle or that he should choose
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sides.
It is also best to let the child know what is happening as soon as the loss or
change seems definite (Jewett, 1994: 3-4).
When experiencing loss the child should express and resolve his own regret and
concerns.
He can manage this appropriately when he has enjoyed a meaningful
relationship with the person who is gone, when he receives accurate information about
what happened and is allowed to ask questions, when he is allowed to participate in the
grieving, and when he has access to a trusted adult who can be relied upon for comfort.
Care should be taken to allay fears the child may have that there will be no one to care
for him, and he should not be allowed to feel responsible for things he has no control
over.
4.8.6 Teenage pregnancies
Adolescence is a time of psychological exploration. It is a period when adolescents reflect
on their strengths, weaknesses, competencies, and fears. Their strengths may include
self-confidence, ambition, self-esteem, and having firm convictions and strong beliefs,
which can lead to reckless, boisterous, risk-taking behaviors, as well as fearlessness and
excessive self-centeredness.
Adolescence is also considered a time of identity
development, identity crisis and egocentrism.
Adolescents may believe that they are
special and not subject to the rules that govern others, in short, invulnerable (Medora and
von der Kellen, 1997: 811).
In the United States more than one million adolescents between the ages of 15 and 19
become pregnant each year. Among sexually experienced youth, about 9% of 14-yearolds, 18% of 15- to 17-year-olds, and 22% of 18- to 19-year-olds become pregnant each
year.
More teenage females become mothers than teenage males become fathers
(Medora and von der Kellen, 1997: 812). Adolescents account for almost one-third of all
births to unwed mothers.
More than one-third of all sexually active teenagers are not
using any contraceptive methods, leaving between 1.5 and 2 million young women at
high risk of unintended pregnancy. The pregnancy risk in the first 6 months of sexual
activity for those teenagers is approximately 50%. Several factors are attributed to the
increased number of unplanned teen pregnancies: teens are more sexually active today
than in earlier generations; teens lack parental supervision due to the increase in twowage earning families; families are under increased stress due to economic hardship;
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there are increased risks associated with sexual abuse; as well as a range of ecological
factors such as the individual's background, culture, and values (Monahan, 2002: 431-
432).
In South Africa, among the nearly 5 million children aged between 14 and 18 years, 1% of
teenagers have given birth to their first child by 14 years, 2.8% by 15, 6.5% by 16,
increasing to 13.1% by age 17, 21.9% by 18, and 30.5% by the age of 19 (South African
Statistics©, 2005: 76).
Adolescent pregnancy is a significant public health issue due to the increased risks of
morbidity and mortality for the adolescent. Approximately one-half of teen mothers go on
welfare within 1 year and 77% within 5 years. Currently the United States has the highest
rate of teen pregnancy of the developed countries.
A correlation with family poverty
exists: for each year after 18 that childbirth is delayed, the probability that the family’s
income is at the poverty level is reduced by 2.5% (Monahan, 2002: 431).
Babies born to teenagers aged 17 and younger have lower mean birth weights and higher
mortality than those born to older women. Similarly, low-birth-weight infants are three
times more likely than those of normal weight to suffer neurological disabilities. Teenage
moms have limitations in parenting skills, which can render them incapable of handling
the demands of motherhood. Half of all teen mothers are not enrolled in school and more
than one-third will never graduate or get a general education degree, with the mother and
child's long-term economic prospects often adversely affected. Another consequence of
early adolescent sexuality is the high risk of sexually transmitted diseases, and their
association with subsequent health and fertility problems. Although the number of AIDS
cases diagnosed among teenagers is small (1% of the reported cases), it can be
assumed that the long mean latency period (11 years) has kept the disease hidden.
Adolescent AIDS cases, however, have increased 77% in the past 2 years, while rates of
other sexually transmitted diseases are higher among sexually active teenagers than they
are among adults. Providing health education to adolescents and preadolescents about
these risks is becoming increasingly important for parents and schools. Social workers
will increasingly work with these adolescents and need to become more knowledgeable
about risk factors and programme alternatives (Monahan, 2002: 432-433).
A historical overview of social work’s philosophy about and orientation to the unmarried
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mother yields several sequential trends. Until the early 1920s, the primary concern of the
social agency was the unmarried mother’s infant, and help to the mother herself was
rarely considered. Since the early 1980s, the unmarried mother’s complete role network
- her relationship to various subsystems, e.g., ethnic group, kinship ties, and so on - has
become part of the caseworker’s psychosocial diagnosis, and enriched the treatment plan
for her and her child. The consideration of economic, social, psychological, and health
variables impinging on the unmarried mother points to a more pressing need for the
provision of community resources (Strean, 1983: 851).
Unwed mothers have been found resistant to social work intervention in the past, seeking
services but not understanding them. They usually do not continue treatment after the
baby is born, and it has not been uncommon for them to repeat the same experience that
brought them to the agency in the first place (Strean, 1983: 854).
Because of the nature of adolescence, teenagers are more prone to engage in risk-taking
behaviour.
The risk of pregnancy amongst sexually active teenagers is progressively
present from the age of 14 years. One third of births to unwed mothers are to teenage
mothers.
The adverse effects of an unplanned pregnancy on a teenager involve the
higher probability of being dependent on public assistance, an increased risk of health
problems with regard to STDs (an alarming increase in adolescent AIDS cases since the
start of this century) and fertility problems, complications for the baby at delivery, possible
developmental problems and poor parenting.
All of the young unmarried mother’s
relationships as well as cultural influences are to be considered when the effect of the
pregnancy is investigated. Economic, social, psychological, and health variables all call
for the provision of community resources.
4.8.7 Abortion
On 1 February 1997, abortion became legal through the Termination of Pregnancy Bill. In
terms of the Bill, a woman has the right to choose to have an abortion during the first 12
weeks of her pregnancy. From the 13th to the 20th weeks of pregnancy, she may choose
to have an abortion if a doctor is of the opinion that:
■
the continued pregnancy is a risk to the woman's physical or mental health; or
■
there is a substantial risk that the foetus would suffer a severe physical or mental
abnormality; or
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■
the pregnancy resulted from rape or incest; or
■
the pregnancy would severely affect the woman’s social and
economic
circumstances.
After the 20th week of pregnancy, abortion can still take place if the pregnancy would
endanger the woman's life or severely deform the foetus. Abortion can only occur with
the consent of the pregnant woman, unless she is incapable of consent (Parliamentary
Bulletin no 8, 1996).
According to Sicelo Fayo (2001 and 2003) in his column Street Talk in the Herald online,
figures by the National Health Department show that between February 1997 and July
2001, a total of 172 494 babies were legally aborted by South African women. Birth rates
have however stayed consistent, averaging 69 800 per annum from 1991 to 2003. The
highest number of births occurred among mothers between 20 and 24 years old, followed
by those in the 25 to 29-year-old age group, then mothers between 30 and 34 years, and
while the lowest number occurred among teenagers between 15 and 19 years.
Approximately 46% of teenage pregnancies in the United States result in live births, 41%
are aborted, and the remainder end in miscarriage or stillbirth (Medora and von der
Hellen, 1997: 812). Most women seek an abortion because of a lack of money, being
unmarried, feeling unprepared, being at school, having too many children, or because the
child is not their partner’s. The majority of women are still ambivalent about their fear of
killing the baby’, the procedure and after-effects, the discomfort of keeping a secret or
being judged, suppression of mothering feelings, fear of the pregnancy becoming too real
as it progresses, thereby forcing her into a hasty decision, and feelings of isolation. In
many cases the woman’s feelings of rejection by others are projections of her own
anxiety and ambivalence (Ullmann, 1983: 710-713).
Motivations against abortion relate to the instinct for self-preservation and the urge to
motherhood. Ambivalence exists in that the pregnancy is rejected even though becoming
pregnant represented a wish fulfilment.
something in them.
Some women feel that abortion destroys
Deutsch (1945, in Ullmann, 1983: 705-706) further reported that,
during menopausal depression, some women who have had abortions express self
accusation - but more recent thinking indicates that this may represent a vehicle for
depression rather than its cause.
She also described a change in the relationship
between the man and the woman after the abortion. Since Deutsch’s work was published
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in 1945, however, it may well reflect the mores of that period.
It is generally agreed that a woman’s reaction to abortion is determined by her general
psychological state. A psychological symptom that does appear is guilt, sometimes as a
reaction to the clinical procedure, sometimes as a result of the punitive attitude of those
caring for the patient. The guilt may be mild or severe. In most cases abortion does not
seem to affect subsequent sexual behaviour of women. Other psychological symptoms
that are often reported with abortion are many instances of insomnia, somatic complaints,
anxiety, and suicidal ideation, as well as an intense preoccupation with the problem of
ending the unwanted pregnancy. Women that have gone through abortion describe a
mourning process that almost invariably takes place, and can affect women in different
ways, depending on pre-existing psychological status. It is maintained that more should
be known about psychosocial implications now that more and more governments are
liberalising their abortion laws (Ullmann, 1983: 706-707).
A teenager can legally request an abortion in the first trimester (12 weeks) of her
pregnancy, and after 20 weeks if serious complications exist. The teenager may choose
an abortion because of insufficient means to provide for herself and the baby, the need to
continue with education, not being married or the shame it would cause her. Reasons for
choosing against abortion will stem from feeling that it is wrong and because of the urge
to motherhood. Psychological effects from the abortion involve guilt, insomnia, somatic
complaints, anxiety, suicidal ideation, and grief. The manner in which the teenager will be
affected depends on her prior psychological state.
In the preceding sections the attributes of the child that influence his social functioning
were discussed. In the following sections the influence that the parents and others have
on the child are discussed.
This immediate influence is different from environmental
influences, which focus on the support or lack of support available to the child, in the
sense that the child is dependent on adults for his survival. The researcher reasons that
the child’s own attributes are influenced early on by the effect adults have on the child,
and can therefore not be separated in the development of Factor 1, which in the adult PIE
is the role performance of the individual.
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4.9
Socialisation
Parent-child interaction serves many different functions, among which affectional
exchange and caretaking are prominent. The interaction is of a primary formative nature
in which the adult is actively involved in extending the child’s behavioural repertoire by
helping him to master some new problem in order to progress to a higher level of
competence in coping with environmental demands. Schaffer (1992: 100) refers to these
as joint involvement episodes, meaning any encounter between two individuals in which
the participants pay joint attention to, and jointly act upon some external topic.
As
children grow older, topics are increasingly likely to assume verbal form. A number of
attentional devices - gazing, pointing, manipulation, and referential speech in particularare available whereby the child can indicate to the parent what the topic of exchange can
be (or visa versa). During joint involvement episodes, children’s behaviour is richer and
more complex, and can therefore elicit a child’s optimal and developmentally most
advanced performance (Schaffer, 1992: 101-103).
In the next sections the researcher will describe the important family function of
socialisation by examining the elements of socialisation, how the child becomes socially
aware, and how factors such as gender, age, and interaction with others influence
socialisation.
4.9.1 Elements in socialisation
The following four factors are indicated as crucial elements in the child’s ability to be
socialised:
■
Internalisation: Affective, self-regulatory, and temperament factors play a role in early
internalisation development. Temperament concepts such as anxiety and fear have
been strongly implicated in moral development.
Anxiety has occasionally been
implicated as the mediator for internalisation. Fearful children are less likely to cheat
and have more resistance to temptation. On the other hand, in parent-child dyads
where the parent is consistently available, supportive, sensitive, responsive, and
empathetic toward the child, children are cooperative, compliant and eager to
internalise parental demands and values. Secure attachment has been associated
with the child’s readiness to comply with the mother. Internalisation should be viewed
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as emerging gradually and having its roots in early compliance to caregivers.
Toddlers’ compliance can be labelled, committed, internalised, or self-regulated when
the child complies with the mother’s request with an enthusiastic and cooperative
spirit, indicating internal endorsement of and commitment to maternal agenda.
Prediction of internalisation may be improved by viewing maternal discipline and
mother-child attachment as effective factors, even for children with different
temperaments. Children who are relatively fearless and not prone to anxiety may not
be equally distressed when confronted with a wrongdoing or failure to comply, and
subtle psychological parental discipline may not be sufficient. A simple increase in
parental applied power may result in anxiety but it may be detrimental to
internalisation, and weak affectionate ties with the caregiver, further results in possible
psychopathy (Kochanska, 1995: 597-599, 611-612).
■
Compliance encompasses the child’s abilities to resist a tempting but forbidden
impulse, to modulate frustration, and to delay gratification and a proactive ability to
carry out an organised action consistent with parental standards.
There is a
distinction between passive and active inhibition - the latter being effortful impulse
control.
Inhibitory control appears in the second year of life.
Early irritability and
unsoothability have been associated with subsequent impulsivity. A particular
mismatch between parental style and the child’s impulsivity may have important
consequences for conscience development. Highly impulsive children whose parents
create unpredictable, chaotic environments may develop serious deficiencies in their
ability to observe standards of conduct.
Conversely, children with high inhibitory
tendencies who are brought up in highly structured environments might develop an
‘over-controlled’ pattern, marked by strict and rigid adherence to standards of conduct
at the cost of their spontaneity (Kochanska, 1993: 335, 337 and 340).
■
Attitudes: Families provide young children with the knowledge and information about
disability and minority groups that they need to form attitudes with.
As children
develop, they increasingly notice differences among children, and then turn to their
parents for an explanation of what those differences mean. The child will experience
an affective component of attitude which is the emotional reaction elicited by the
referent. The child will also have a behavioural intent, which is a predisposition to act
in a certain manner, including a desire to seek or avoid contact with the referent of an
attitude. The typical behaviour of a child towards another is learned from watching
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and modelling their parents and other significant adults. The social environment can
enhance or ease the attitude-behavioural relationship as individuals are influenced by
their beliefs about what important ‘social others’ expect from them. Social norms may
cause a parent to behave in a manner that is inconsistent with his or her attitudes, but
is in accordance with perceived social norms and expectations.
A general belief
exists that direct experience with a class of people reduces the negative attitudes and
stereotypes held toward that group of people, termed the contact hypothesis.
Religious teachings can further support both positive and negative attitudes from the
different viewpoints, of being something special to being demonic or the result of sin.
Better-educated families seem to have more positive attitudes toward inclusion
(Stoneman, 2001: 102, 103-107).
»1
Controlling access:
Parents are gatekeepers of young children’s everyday
experiences. Young children have little control over their own lives. Decisions about
the people with whom they spend time, places they visit, toys and materials with
which they play, and other important aspects of their daily lives are largely controlled
by adults. By managing the experiences that young children encounter, parents can
powerfully shape young children’s attitudes and beliefs. Some families also carefully
control the media their children have access to.
Media, including television, exert
strong socialisation influences on young children. The effects of television on children
are often unplanned. Attitudes and beliefs extracted and learned by children may not
be what the producers intend to teach, but they are powerful nonetheless.
The
opinion of parents will determine the media content that they deem appropriate for
their children (Stoneman, 2001: 115, 118).
Parent-child interaction serves the functions of affectional exchange and caretaking and
has a formative nature, where the parent helps the child become more competent.
Socialisation occurs through joint interaction episodes, where the parent and child pay
joint attention to, and jointly act upon, some external topic.
Four factors are crucial
elements in the ability of the child to be socialised: internalisation, compliance, attitude,
and controlling access.
In children who appropriately fear discipline and who have a
secure attachment with the parent, there will be a willingness to regulate themselves and
they will therefore internalise what is expected of them. Compliance implies the ability to
resist impulses, modulate frustration, delay gratification, as well as a proactive ability to
carry out an organised action consistent with parental standards. For the child to observe
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standards, parental consistency is needed. Children model their parents’ attitudes, which
are influenced by exposure to or contact with the referent of the attitude and the
expectations of important social others.
It involves a feeling being elicited and a
predisposed action towards the person the attitude is focused at.
By managing the
experiences children encounter, parents can powerfully shape children’s attitudes and
beliefs.
4.9.2 Social awareness
Another need which the family provides is to offer opportunities for the child to make
observations and interpretations of the life around them. Children are very likely to make
decisions based on their subjective interpretation of facts rather than on actual facts.
People filter reality through already formed perceptions and conviction in their life-styles.
Children are excellent at observing, but they usually then make inaccurate interpretations
of events and interactions.
These mistaken beliefs become a private logic that often
remains out of their consciousness, but which forms the foundation for their reasoning,
assumptions, decisions, attitudes, and behaviours (Kottman, 1995: 14-16).
Human beings have a need to belong.
In order to establish and maintain a sense of
belonging, children observe the world to determine a way for themselves to gain
significance and fit into different groups. The first group children belong to is their family.
Children watch to see how their families react to different behaviours and attitudes
(modelling).
They note which behaviours gain attention and which gain a sense of
belonging and which not. If the child cannot establish himself as belonging to the family
in a positive way, he will find a negative way to fit into the family. Eventually this way of
establishing belonging becomes the child’s lifestyle; the way the child views himself, the
world, and others, plus the repertoire of behaviours based on these views. As the child
matures, he acts out his lifestyle in the various contexts of school, neighbourhood, work,
dating, and marriage (Kottman, 1995: 10).
More specifically this relates to the need for love and the need for security. The need for
love is met by the child experiencing a stable, continuous, and dependable relationship
with his parents (or permanent parent-substitutes) who themselves enjoy a loving
relationship towards each other.
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Since people are social beings, they are born with the innate capacity to develop social
interest, which is a sense of connectedness to other human beings. Social interest can
be thought of as an index for successful adaptation.
The more developed the social
interest, the more diminished the individual’s feelings of inferiority, alienation, and
isolation. This innate capacity must be fostered and developed, first by the family and
then by other social forces. In order to reach optimal social interest, children must form
an attachment to their primary caretaker, who then helps them expand this connection,
first to siblings and then to friends, classmates, and teachers.
If given proper
encouragement and stimulation, children eventually generalise their feelings of social
interest to all other people they interact with.
Most children who need therapy have a
poorly developed social interest (Kottman, 1995: 12).
For the researcher the specific
needs to be met through social interest are the need for praise and recognition, and
development of healthy sense of competition.
Together with the parental influence on the child’s attitudes and beliefs and the child’s
ability to comply and internalise, another influence is at work — that is, the child’s
development of social awareness. Children, like adults, make decisions based on their
subjective interpretations of events and interactions, and, in the case of children, these
interpretations are usually inaccurate.
Children’s private logic about the world around
them is applied to and determined by their need to belong (how to gain significance and
fit into different groups), their need for love and security (stable and dependable
relationship with parents), and the development of social interest (connectedness to other
human beings).
4.9 3 Childhood gender roles
Different sexes refers to the binary categories of male and female, while gender refers to
the ‘fuzzy’ categories of masculine and feminine, and gender roles concentrates on the
contrasting activities and interests of the two sexes. Role differentiation during childhood
extends beyond these differences in content, involving different roles, organisational
patterns and developmental pathways, which operate within two very different social
contexts. Boys and girls interact mainly with their own sex, and their patterns of social
relations are very different, boys interacting in larger groups where status and reputation
are important, and girls showing more intimate interactions and friendships. Girls use
social speech mainly to maintain friendly interactions, and to create and maintain close
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relationships based on equality and fairness. Boys use speech to assert their status, to
attract and maintain an audience, and to assert themselves when others are speaking.
Role conformity is emphasised more for boys, and the few cross-sex interactions initiated
by boys are such that they serve to emphasise the boundary between their social world
and that of girls.
The masculine role shows different aspects related to development
changes: avoidance of femininity, the physically-based role of boyhood, and the
achievement-based role of adults. The principal developmental change for girls is an
increase in the rigidity of the feminine role at puberty, marked by a decrease in tomboyish
behaviour, a lessening in value of sporting activities and academic achievement, with an
increase in focus on dating, attractiveness, and future marriage plans - the gender
intensification phase (Archer, 1992: 31-32, 36, 51).
Gender has been identified as an important organiser of many aspects of human
development.
In most cultures different roles and behaviours have historically been
considered appropriate for males and females (Raffaelli, et al.: 1432). For the researcher
this implies that gender does determine the development of the child and that cultural
values are played out in gender roles. More than that, the fulfilment of different sexual
roles are necessary for procreation, and it therefore makes sense that a society would
prescribe gender roles.
The child’s social awareness is influenced by his gender.
Boys tend to use social
interaction more for asserting themselves, whereas girls use interaction for maintaining
close ties. Role expectations differ for boys and girls, and these usually have a cultural
context and can be viewed as an important organiser of human development.
4.9.4 Age and pro-social behaviour
Children learn pro-social behaviour from their families.
Parents teach their children
values such as helpfulness, sensitivity, altruism, generosity, and kindness; stimulate role
taking behaviour and empathy; and teach children about consequences that the
behaviour has for the feelings and well-being of others.
Parents socialise in young
children a concern for others through ongoing daily social exchange. Families that
socialised their children in such a way as to emphasise acceptance and pro-social
behaviour, have children who generalised pro-social teaching to other children. Parents
who have more realistic expectations for age-appropriate pro-social behaviours have
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typically developing children who interact more with classmates with disabilities
(Stoneman, 2001: 119-120).
The human being is immersed, right from birth, in a social environment that affects him as
much as his physical environment. There is hardly ever a purely intellectual act that is
unaffected by emotion, and similarly never a purely affective act totally devoid of
comprehension. Consideration of the child’s egocentrism, the growth in ability to play
cooperatively, and the moral development of the child, all reflect an awareness of the
importance of social factors (Borke, 1978: 29).
The operational definition of empathy in
terms of social interaction is the ability to understand the world from another person’s
perspective by imaginatively transporting oneself into the thinking, feeling, and acting of
another.
Young children are primarily egocentric; they reduce all social and physical
influences to their point of view and therefore distort them without realising it, simply
because they can’t distinguish their point of view from that of others. It is only after the
child reaches 7 or 8 years of age that sociocentric thought first appears. The sharing of
ideas and feelings with other children results in a re-examination of the child’s concepts in
relation to those of others. This leads to greater awareness of the self, as distinct and
separate, and to the growing realisation that each person perceives reality from a
different perspective.
The self arises in the process of social experiences, and self-
awareness results from the perception that the other has thoughts and feelings which
differ from one’s own. Taking the role of the parent in early pretend play, demonstrates
an awareness of the difference between the self and the other (Borke, 1978: 30-31).
By three years of age children, regardless of cultural or socioeconomic backgrounds, can
accurately identify happy and unhappy responses in other people.
The ability to
recognise sad and fearful situations, appears to be influenced to some extent by social
class and cultural factors.
The child’s ability to take the perspective of the other is
confined to immediate, simple situations that fall within the realm of the child’s own life
experiences.
The accuracy of perception of other’s feelings, thoughts and motives
increases between the ages of 6 and 12 years. This is the beginning of reciprocity, which
strengthens the individual’s ability to relate to the group. With the transition to formal
operational thinking during adolescence, the individual for the first time is intellectually
capable of the reciprocity, relativism, and objectivity which represent the most advanced
stage of social development (Borke, 1978: 35-36, 39-40).
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By three years a child can accurately distinguish between happy and unhappy responses
in others. Early pretend play indicates that the child is aware of a difference between him
and others. The child starts off being egocentric, and only around the age of seven or
eight, does the first sociocentric thought appear.
This is indicated by the child’s
realisation that others have thoughts and feelings of their own.
The accuracy of the
perception the child has of others' feelings, thoughts and motives increases towards the
age of 12 with the development of reciprocity, which strengthens the child’s ability to
relate to others. During adolescence the child’s social development is most advanced,
with the intellectual capability for relativism and objectivity having developed.
4.9.5 Social skills
Social skills require an interpersonal context for their acquisition and development. The
ability to deal successfully with people can only emerge during social interaction, and is
bound to depend on the cooperation and support of the child’s parents.
Cognitive
functions, dependent on socialisation, are problem-solving, play and attention (Schaffer,
1992: 103). The latter has already received attention under the heading 'performance'.
Problem-solving and play are discussed below.
Problem-solving:
In a study where three- and five-year-old children worked with their
mothers on a sorting task, measures of performance ability on the same task, but working
independently, were obtained before and immediately after the interactive session. These
measures were compared with a group of children who did not experience interaction. It
was found that mother-interaction children made significantly greater gains than the
control group.
Those mothers who provided more verbalisations concerned with goal
direction, monitoring, strategy, and planning in the course of the joint session with the
child had children making the greatest improvement in independent problem-solving.
Thus the more the adult exposed the child to the processes necessary for successful
problem-solving, the greater were the chances that the child would, in due course, be
able to cope with the task alone. Self-directed problem-solving is as effective as adult
guidance (Schaffer, 1992: 103-104).
Frankel and Bates (1990: 810-811) postulate that attachment security is not the only
predictor of problem-solving
adaptations.
They therefore
explored
mother-infant
interactions and maternal perceptions of temperament at 6, 13, and 24 months.
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Interactions during problem-solving tasks may reflect crucial competencies during the
second year of life. Their study focused in part on the quality of naturalistically observed
mother-child interaction, namely positive involvement, defined by maternal characteristics
of
responsiveness,
affective
positivity,
educational
stimulation,
and
reciprocal
communication by the child. The findings of this study confirmed that high levels of
maternal affection and positive interaction were generally associated with greater
harmony and child responsiveness to suggestions, and low levels tended to forecast
more antagonistic, frustrated, and disengaged behaviours (Frankel and Bates, 1990:
817).
Social dysfunction is commonly associated with deficiencies in social skills essential to
achieving self-esteem, forming satisfying interpersonal relationships, and performing
various social roles effectively.
Deficiencies in social skills contribute to difficulties
involving loneliness and depression, marital dysfunction, parent-child problems, family
breakdown, employment problems and various mental health problems (Hepworth and
Larsen, 1990:425-426).
The cognitive functions that need to develop during the socialisation of a child are
problem-solving and play. Directive interaction from the parent is directly related to the
child’s ability to learn to cope with a task on his own as young as three years of age, and
will even lead to competencies in the child’s second year. Goal direction, monitoring,
strategy, planning, responsiveness, affective positivity, educational stimulation, and
reciprocal communication are found to be positive factors that contribute to developing
problem-solving skills during interactions between the parent and child. Social skills are
necessary for healthy social functioning in the child, since these are essential for
achieving self-esteem, forming satisfying relationships, and effectively performing social
roles.
4.9.6 Play
Social learning takes place within a certain interactive milieu.
For a child this is the
activity of play. The researcher will explore the dynamics in play, and then discuss the
other parties involved in this activity with whom the child forms relationships.
Play is the natural way in which a child explores and discovers the world around him to
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eventually also master it. It is of crucial importance for the development of his abilities on
all levels: thoughts and memories, language, movement, hand-feet coordination, social
skills, and emotional maturity. Through play a child can express himself and how he sees
and experiences the world; he learns to share, to consider others, and that he cannot
always be at the centre of attention; it develops his independence and ability to make his
own choices; it develops his creativity; and contributes to his physical development and
control while burning up excess energy. Play further improves a child’s concentration and
teaches him to organise his thoughts and plan his activities.
He gathers information
through play, and it provides opportunities for problem-solving (Pieterse, 2001: 17-18).
Play is a less structured, more open-ended, activity than problem-solving, with less
precisely specified goals. Children’s play frequently occurs in social interaction contexts,
and there are indications that a parent can elicit higher maturity levels in play in the
context of joint involvement episodes, than when the child is alone, with the further
possible implication that developmental progress is fostered by the opportunity to engage
in interactions of this type.
In a study of toddlers aged between 20 and 28 months at
home, interactions were classified through the occurrences of symbolic play according to
the mother’s availability. Both the level of play and the length of play episodes increased
when the mother participated in the child’s activities, compared to when the children were
on their own. The effect varied according to the nature of maternal involvement, being
greatest when mothers actively entered into the child’s activities or encouraged them via
explicit suggestions. Another study of 15 to 30 month-olds also showed children reaching
higher levels of sophistication when playing jointly with the mother, partly because she
provided the necessary motivation by simply making play more fun. One-year-old infants
with the greatest competence in exploratory play tended to have mothers who frequently
focused the child’s attention on objects and events in the environment. Adult stimulation
does have an enhancing effect on infant functioning. Children’s play activities studied at
20 months and 28 months were categorised into four groupings, namely, exploratory,
combinatorial, symbolic, and ambiguous.
The maternal affect differed: at 20 months
exploratory and combination play were affected by the mother’s presence; whereas at 28
months only symbolic play showed an increase. As all mothers provided guidance to an
equal extent in all categories, the children appeared to act selectively in their use of the
mother according to age (Schaffer, 1992: 105-109).
Furth and Kane (1992: 151) state that pretend play has its precursors in infant-parent
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interaction, which sometimes involves make-believe.
Adults are the child’s primary
playmates during the first two years; they take the lead in initiating and elaborating on
playful episodes, but by the end of the second year children can be observed performing
brief, unconnected symbolic actions when playing alone. Play in infant-parent interaction
is frequently marked by joyful laughter, whereas solitary pretend play and social pretend
play with peers are related more to the serious business of comprehending reality. As
children develop, their pretend play becomes more and more sophisticated.
Symbolic
actions are gradually dissociated from their own bodily actions, freed from environmental
cues and integrated in multiple action sequences. At the same time their play with peers
becomes more sociable (Furth and Kane, 1992: 152).
In Annexure 2 the researcher
gives a framework for observing the kind of play in children.
Social learning takes place within the interactive milieu of play. Play is of importance for
the development of the child’s abilities on all levels. The child learns pro-social behaviour
through play, and he gains information about his world.
When the child plays with
someone, especially with the parent, it can elicit higher maturity levels. Play provides the
ideal medium for adult stimulation of the child’s development. Around 20 months of age
the child will use his mother’s involvement more with exploratory play, whereas around 28
months the child uses the mother’s involvement more for symbolic play. Pretend play
also has its precursor in the make-believe games adults play with children.
Solitary
pretend play and social pretend play with peers are used by the child to comprehend
reality.
4.9.7 Peer group
Kauffman (1999) not only mentions the link between socialisation and the development of
behaviour and emotional problems, but he also highlights from research on social
development the role that the peer group plays in socialisation. Especially after the early
grades, socialisation is primarily a function of the child's peer group.
The picture
emerging from research in this area is far more complex, nuanced, and grounded in
social context than was previously assumed. This picture complicates the design of
interventions considerably, requiring us to think more carefully about both the nature of
the relationships among children, and how to change the nature of these relationships
without violating the child’s individual rights and cultural traditions.
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Parents and other adults are implicated in children's social development and in the
prevention of conduct disorder, and new findings do not suggest that adult influences
should be discounted. Rather, the research suggests that to understand peer influences
on the development of emotional and behavioural disorders, we must take into account
the variety of reasons for which peers are rejected or imitated, including children's
perceptions of social relationships and the purposes they have for behaving as they do
(Kauffman, 1999).
Children become part of their culture by interacting with other children and adults. It is
through this interactive process that children construct knowledge about themselves and
others within their culture or social world. As children construct knowledge about how to
interact with other people, they face a greater challenge than when they interact with
material objects. It is much more difficult to predict how a person will react in a particular
situation than it is to predict whether a ball will bounce when dropped. During normal,
everyday interactions, children must adjust their actions as they meet resistance from
others.
Children simultaneously participate in two distinct cultures: the culture of the
adults and their peer culture. Peer culture is viewed as a culture in its own right, not just
an opportunity to practise skills for participation in the adult society. Children co-construct
their peer culture as they interact with each other, establishing patterns that may not be
present during interactions with adults. Children negotiate with each other, not for the
purpose of constructing knowledge for its own sake, but rather to develop a shared
meaning with others that will serve as a framework for continued interaction. This peer
culture is marked by mutuality and helps the children establish a shared identity (Burk,
1996).
A link exists between social development and the development of behavioural and
emotional problems. The child’s peer group also plays a role in the socialisation of the
child, especially after the early grades. Of significance are the reasons for peer rejection
or imitation, as well as children’s perceptions of social relationships and the purposes for
behaving as they do. It becomes more challenging to the child as he begins to relate
more to other people than to material objects. He is then required to adjust his actions as
he meets resistance from the two cultures he participates in: the adult culture, and the
peer culture in which patterns of interactions are co-constructed by the child and his
peers. The peer culture also helps children to establish a shared identity.
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4.9.8 School relations
Children develop a common bond as students with a role in the classroom that is distinct
from the teacher's role. The student roles are not simply in opposition to the teacher; they
are patterns that make sense to the children involved. Although some commonalties may
exist between groups of children, these patterns are generally unique to their particular
peer culture. Peer cultures are like the adult culture in that they are not static entities to
be retained. They evolve as required, as a result of daily interactions and according to
the abilities and needs of the children involved. Just as friendships evolve within the
larger social world, children develop views of their classmates, whether they are friends
or not. Popularity status is influenced by the number of friends a person has, but not by
the intensity of those friendships. It may also be influenced by such things as ability,
physical attractiveness and reputation. Popularity status may also affect the equal footing
within the relationship that allows for greater cooperation. Children may be friends with
others whose popularity status is similar or different from their own (Burk, 1996).
Teachers need to facilitate the development of a psychologically safe environment that
promotes positive social interaction.
As children interact openly with their peers, they
learn more about each other as individuals, and they begin building a history of
interactions. Some interactions will be very positive and develop into lasting friendships.
Others will not, but an atmosphere of acceptance and respect in the classroom will help
them to see each other as equal members of their social world (Burk, 1996).
As students, children form a common bond that is distinct from their relationship with the
teacher. The children develop views of their classmates, whether they are friends with
them or not.
Popularity status within a class setting is determined by the number of
friends the child has, and is influenced by factors such as ability, attractiveness, and
reputation.
The teacher plays an important role in facilitating a psychologically safe
environment that promotes positive interaction, in order for the students to see each other
as equal members of their social world.
4.9.9 Friendships
Friendship is a dynamic, reciprocal relationship between two individuals.
As children
become friends, they negotiate boundaries (implicitly or explicitly) within which both
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partners function. Preschoolers repeatedly establish solidarity in their friendships through
seeking confirmation of being friends.
These negotiated boundaries evolve as the
relationship grows, and in accordance with the children's ages, with a series of
transformations
and
elaborations
of the
child's
understanding
of
reciprocities.
Cooperation is a key factor that contributes to the development and maintenance of
children's friendships, as well as being a result of friendships (Burk, 1996).
By 4 and 5 years of age, approximately three out of four children are involved in a close
relationship with another child, and about three out of ten have more than one.
Friendship networks remain relatively small during the preschool years, whereas school
age children in contrast average five best friends; a number that declines only slightly
among adolescents. Becoming friends and maintaining these relationships are regarded
by children themselves as among the most significant achievements of childhood and
adolescence.
Friendships furnish children with socialisation opportunities not easily
obtained elsewhere, including experience in conflict management and sharing. Among
preschool and younger school-aged children, friendship expectations centre on common
pursuits and concrete reciprocities, while later on they centre on mutual understanding,
loyalty, and trust; these children expect to spend time together, share interests and
engage in self-disclosure (Hartup, 1992: 175-177).
Benjamin, Schneider, Greenman, and Hum (2001) found that friendships are extremely
important components of children’s social, emotional, and cognitive development. Most
pre-school and elementary school children’s friendships last at least six months to a year.
Psychological support variables such as companionship, help, and security play important
roles in maintaining friendship.
These authors also postulate that it is possible that
conflict enables friends to establish a common ground in their relationship because it
helps clarify the behavioural boundaries that are essential for continued friendship.
Conflict can assist in the development of children's ability to take others' perspectives on
an issue, and it affirms the significance of another person's behaviour. Anthropological
studies have demonstrated that friendships exist within a larger cultural context, and that
the interactions within a culture appear to shape the developmental progress of
friendships. Friendship dynamics might reflect a culture's social, economic, and spiritual
characteristics (Benjamin, Schneider, Greenman, and Hum, 2001).
Friendship is a dynamic, reciprocal relationship between two individuals.
As children
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become friends, they negotiate boundaries. Cooperation is a key factor that contributes
to the development and maintenance of children's friendships, as well as being a result of
friendships.
By four to five years of age most children have one friend.
School age
children are more inclined to have a bigger friendship circle, which declines only slightly
among adolescents.
Maintaining friendships is viewed as one of the most significant
achievements of childhood.
Friendships offer children the opportunities for developing
skills in conflict management and sharing. Interactions within the larger culture do shape
the development of friendships in children.
4.9.10 Self-concept
Throughout this chapter, aspects related to the development of self-concept have been
discussed. The researcher uses this section to formalise how self-concept is defined,
and why it is relevant for the child’s socialisation.
Self-esteem is solidified in adolescence.
Self-esteem has been conceptualised as a
component of the overall self-concept. Self-concept refers to the complex set of beliefs
about one’s self, and self-esteem refers to the value or sense of worth one perceives
about one's self (Medora and von der Hellen, 1997).
The adolescent years constitute a unique developmental phase when rapid biological
changes occur in an organism that is relatively mature cognitively and socially, and is
capable of reflecting upon these changes.
Cognitive and social abilities undergo a
change as well, becoming more differentiated and multidimensional.
The young
adolescent is confronted with a plethora of social events, larger in number and in variety
than before. These include moves to more demanding school environments, increases in
unsupervised time (and hence more opportunities for engagement in ‘adult’ behaviour
such as smoking and alcohol use), and changes in peer and family relationships, and in
some cases, initiation of sexual behaviour (Brooks-Gunn and Paikoff, 1992: 63-64).
Although closely related, self-concept differs from self-esteem in that the latter is a
component of the overall self-concept the child has about himself, specifically related to
the value or worth the child places on himself.
Establishing a self-concept is more
significant during the adolescent years when the teenager is confronted with major
changes and more demands from his environment.
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)
/
4.10
Parenting
Under the heading Child Rearing, the Minnesota classification codes list the following:
>
Conflict
behaviour for age
>
Emotional needs
> Cultural differences
>
Physical needs
> Relationships
>
Support
>
Family
> Understanding appropriate
In the next sections, where the researcher attempts to show the role the parent plays in
the social functioning of a child, most of the above topics will be addressed. This will be
done in a format appropriate to this study, so that the literature is classified according to
social interaction problem types. For example, the parents’ responsibility is to meet the
emotional and physical needs of the child. In one of the following sections this will be
addressed as part of child abuse - implying that the child's needs are passively or
actively not met by the parent. The relationship between the parent and child starts early
on where an attachment forms if the parent consistently meets the needs of the infant.
The infant has limited interpersonal skill, and the responsibility for starting this relationship
therefore lies with the parent. Throughout the upbringing of the child it is expected of a
parent to understand what is appropriate for a child’s age.
This relates, in the
researcher’s experience, to the enhancement of the child’s development through
appropriate stimulation, the execution of discipline that fits the ‘crime’, and the levels of
expectation placed on the child. For this reason the researcher includes discipline as part
of the process of socialising the child and affecting the relationship between the parent
and child.
The inclusion of bonding into the classification system is confirmed by the tendency the
researcher has observed for social workers in private practice of to consider it in their
therapeutic work with children. A number of social workers in private practice and in
welfare organisations use a model that offers assessment of the bonding between parent
and child, and intervention strategies to address problems in the relationship. A further
confirmation was that Bowlby was the other author (apart from Piaget) recommended by
Prof Karls at the beginning of this study.
The inclusion of discipline as a factor in
childhood social functioning is also confirmed through the researcher's observation of
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\ >
practice, where many of the problems parents bring to social workers, relate to discipline.
For the purposes of this study the researcher is going to simplify the dynamics of
parenting with regard to the social functioning of the child into managing the behaviour of
the child that coincides with meeting the needs of the child, relationships within the family
that will increase the likelihood of effective child-rearing practices, and the family
dynamics affected by broader systems of influence.
4.10.1
Behaviour management
At the beginning of this chapter, within the discussion of childhood development, one of
the guiding principles of development included the control of the child’s behaviour.
In
organising all the concepts identified in this and the preceding chapter, the researcher
argues that the child is assessed with regard to his own behavioural adjustment, but
because of the child’s dependence on the parent, this is also affected by the parents’
ability to manage, shape and guide the behaviour. The management of behaviour takes
place through the parent’s role in providing for the needs of the child. As has become
clear in discussions on difficult behaviour on the child’s part, some motivation behind this
was to communicate unmet needs.
A crucial need in the child centers around
experiencing love and acceptance from the significant people in his life, within the safe
parameters laid down through discipline. When a child’s needs are not met, it relates to a
form of child abuse.
Matters surrounding discipline and the meeting of needs, raise
aspects of the parenting style and the family atmosphere. These are concepts derived
From an Adlerian (see definition in glossary of terms) approach to treating the child within
his family system, and are viewed by the researcher as applicable to the assessment of
factors that influence the manner in which a child’s behaviour is managed. When the
child lives in a family system where his needs are constantly neglected, the effects of this
injustice towards the child should also be considered when the management of the child’s
behaviour is assessed. The neglect of the child’s needs is considered in the next section,
where the relations within the family are discussed. Although there is a link between the
parent’s management of the child and abuse (too severe physical punishment), it is of
more concern that abuse by the parent indicates a poor parent-child relationship.
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< /
4.10.1.1
Discipline
Community and parental attitudes about child-rearing practices help determine what is seen
as child abuse, as well as reflect cultural values and priorities...Physical punishment of
children is frequently the norm and parents claim the right to punish their children on cultural
and religious grounds.
Collier, etal., 1999:230.
The significance of the correct practice of discipline is crucial in establishing what
constitutes parental management of behaviour and learning, and what constitutes abuse.
For social workers to ignore the role of discipline in society is not only to fail to protect
children from abuse, but it also has a broader influence on the fabric of society:
Child rearing is an obvious point of focus because it is the immediate means of contact
between children and society, and because it may be, itself, shaped by society.
Youniss, 1992: 133.
Discipline involves the establishment of behavioural norms in order for the child to fit into
other social systems; the recognition of boundaries so the child knows what is expected
of him and what is not acceptable; the broadening of knowledge of how the child sees
himself in relation to other people; character forming; and social interaction, whereby the
child learns to develop his own life philosophy with the consideration of other people’s
rights and needs (Venter, 2000: 23).
Discipline is not the slavish following of authority, meeting perfectionist goals, demanding
mature adult behaviour of the child, or proof of obedience. Within a children’s- or foster
home, punishment is regulated through the Child Care Act, and unacceptable methods
include: punishment of the group for individual transgressions; threats to remove the child
from the home or programme; ridicule and shaming; any form of corporal punishment;
withholding basic rights; withholding access to parents and family; denying visits, phone
calls, and letters; isolation from service deliverers; withholding something that’s important
to the child; inappropriate or excessive exercise or work; improper influencing; measures
that bring forth discrimination; and an illicit rewarding system (Venter, 2000: 22-23).
The most common areas in which the setting of limits is usually needed, according to
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V
Claassen and Claassen (1999: 111, 125-129) are sleeping time, eating habits, fighting,
and giving permission.
It should be kept in mind that the most important part of discipline is the balancing of
responsibility and freedom. A child must learn to accept the responsibility that comes with
freedom.
Discipline should at all times be executed in accordance with the child’s
developmental stage (Claassen and Claassen, 1999).
Child-rearing practices reflect cultural values and priorities. It is the immediate means of
contact between children and society.
Discipline involves the establishment of
behavioural norms to recognise boundaries, by broadening the child’s knowledge of how
he sees himself in relation to others, thereby acknowledging their rights and needs.
Discipline should build character in the child and is not the enforcement of dominance or
proof of obedience. Inappropriate means of discipline include threats to leave the child,
withholding basic rights, withholding access to significant people, improper influencing,
and an illicit or discriminative rewarding system. The common areas where the setting of
limits is needed are sleeping time, eating habits, fighting and granting permission to the
child's requests. Discipline should be in accordance with the child’s age, and the child
should be allowed increasing responsibility for his own actions as he gets older.
4.10.1.2
Parental styles
Parental behaviour can either protect the child or put the child at risk of developing
problem behaviours. Authoritarian, disengaged and permissive parenting styles are more
likely than authoritative parenting to be associated with the development of behaviour
problems and low social and cognitive competence in children. Authoritative parenting is
associated with high social competence and low rates of behaviour problems, especially
with lower externalising problems, and particularly among boys. Authoritative parenting,
involving warmth and firm but responsive control, is particularly important in divorced and
remarried custodial parents, in protecting children from the adverse effects of marital
transitions. Thus, in coping with stressful life events, a supportive, structured, predictable
parent-child relationship plays a critical protective role.
An exception to this positive
relationship between authoritative parenting and child outcomes is found among
stepfathers and stepchildren. Authoritative and authoritarian styles involve high levels of
control and relate to high rates of behaviour problems in stepchildren (Hetherington,
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1989: 8).
Parenting styles have an influence on the child’s risk of developing problems.
Authoritarian, disengaged, and permissive parenting styles are associated with the
development of problem
behaviour and
low social
and
cognitive competence.
Authoritative parenting (warm and firm responsive control) is associated with high social
competence and low rates of behaviour problems. A supportive, structured, predictable
parent-child relationship plays a critical protective role during stressful life events.
4.10.1.3 Family atmosphere
The family atmosphere is the characteristic pattern established by parents and presented
to their children as a standard of social living. Family climate is not a direct causal agent
in the development of personality; instead the individual interprets the meaning and
significance of the family atmosphere in the light of his own biased perception.
Understanding the family atmosphere is important since it continually influences how
children view themselves, others, and the world. They form an image of themselves and
how they can gain significance, based on their perceptions of how other people react to
them. Children act as if the family atmosphere represents the way life is supposed to be
(Kottman, 1995: 123-124).
The typical family atmospheres (which can be assessed through the techniques given in
Annexure 2) have been identified by Kottman (1995: 124-130) as follows:
■
Democratic:
Parents in these families are consistent, reasonable, loving, and
respectful. The children are active participants in decision-making and they have
age-appropriate power and responsibilities.
Children who grow up in these
families are self-confident, self-reliant, spontaneous, and articulate about their
feelings and thoughts.
■
Rejective:
Parents have negative self-perceptions, and they have difficulty
showing love to one another and to their children. The children feel as though they
are not accepted or loved. They may block off their own feelings in order to protect
themselves, and they often have trouble expressing themselves or showing love.
Frequently one of the children becomes the scapegoat, and is identified as the
‘patient’ who requires therapy.
The identified patient is also likely to provoke
others into rejecting them.
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■
Authoritarian: Parents demand absolute obedience and expect children to have
perfect behaviour and to adopt parental values without question.
Children can
either become extremely conforming and compliant, or extremely rebellious.
Conforming children can be polite, timid, and anxious. They may develop nervous
habits, tics, ulcers, and other physical evidence of stress and tension.
Lacking
imagination, spontaneity, and initiative, they have difficulty solving problems and
seek out authority figures to make decisions for them. Rebellious children may be
inconsiderate of others, argumentative, and sensitive to blame and praise. They
frequently resort to evasive actions like lying, stealing, drugs, alcohol, and sexual
acting out.
■
Inconsistent: Discipline is erratic and unpredictable. Parents have a laissez faire
attitude or change their minds about what is acceptable, so children are never sure
what the rules are. There is no sense of structure and routine to provide safety
and security. These children never know what others expect of them or what to
expect of others. They assume the world is an arbitrary place with no order or
reason. This makes functioning in situations that demand structure and routine,
like school and work, difficult. These children lack self-control and motivation, and
may be self-centred and crave excitement.
Some of these children try to gain
control through aggressive or manipulative behaviour, and may seem to suffer
from attention problems.
w
Hopeless: Parents in these families have become so discouraged by their internal
personality dynamics and external circumstances that they have given up on life
and humanity. They believe nothing good will ever happen to them - they are
discouraged and pessimistic, and they convey this to their children. The children
feel that they can never accomplish anything or be successful. Their goal usually
becomes proving their inadequacy, stemming from feelings of discouragement and
helplessness.
■
Suppressive: Parents do not allow the expression of ideas and feelings. Children
learn to pretend to be different from what they really are in order to be acceptable.
They learn to mistrust their own feelings, and have problems expressing true
feelings and personal thoughts. Some of these children resort to daydreams and
unrealistic fantasies, in which they feel valued and heard by others. These parents
may even bring a child to therapy to get the professional’s support to change the
children as they would like. If that does not happen they will terminate therapy.
■
Overprotective: Indulgent parents prevent their children from learning by refusing
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to allow them to cope with difficult problems. These parents protect their children
from unpleasantness, sadness, and the reality of life.
Pampered children are
prevented from developing courage, self-confidence, and self-reliance. They have
a strong need for approval and exhibit a great deal of dependence. These children
can develop an attitude that they are not responsible for their own actions, since
they have always been shielded against the consequences of their behaviour.
Their interactions with others may be motivated by the question of ‘what’s in it for
me?’. Most of these parents see nothing wrong with their child’s behaviour.
■
Pitying: This type of atmosphere might be the case for a child with disabilities.
The parents feel sorry for the child and teach him to indulge in self-pity and expect
special privileges. This results in the child not believing in his own capabilities, and
seeing his disability as a handicap rather than a challenge. They often feel life is
unfair, tragic, and full of woe and suffering.
They frequently decide they are
victims and expect sympathy from others or, in some cases, expect others to
abuse them in some way.
■
High-standards:
Parents demand that the children live up to their high
expectations and goals of perfection. When children do not perform, parents are
critical and denigrating. Most of the time these standards are impossible to reach
so the children are left to feel inadequate, inferior, and discouraged. Even when
doing well they believe they can do better. They might become perfectionists who
cannot function without external guidelines for conduct and standards for success.
These children frequently exhibit symptoms of stress and tension.
This strive
towards perfection might be viewed as positive and might thus not be referred for
help.
■
Materialistic:
parents.
Possessiveness, acquisition, and money are important to these
They believe the most acceptable way of gaining significance and
security is to own worldly goods. The family’s values assign more importance to
possessions than human relationships. Children in these families tend to judge
everything by how much it costs, and may not understand the importance of
friendly interactions and simple pleasures. Children might also reject the parents’
values and become idealistic and anti-materialistic. These parents will then see
their children as not appreciating the value of money. Otherwise the parents will
be quite satisfied with acquisitive, selfish children.
Competitive:
Parents exclusively stress success.
Children are compared with
each other, and are encouraged to out do each other, and therefore never learn a
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sense of cooperation. Competent children find aspiration in the comparison with
other siblings, and develop a sense of superiority over others.
children
develop
elevated
levels
of
anxiety,
Many competent
apprehension,
stress,
and
perfectionism, due to the kind of all-or-nothing thinking that suggests they are
failures if they cannot prove themselves to be perfect or the best at anything they
do. Children who cannot be the best in a positive way may decide to become the
worst.
The siblings that do not measure up to the more talented ones may
become so discouraged that their goal becomes one of proving their inadequacy.
■
Disparaging: Parents constantly bombard one another with criticism and usually
doubt their own worth. They may then use criticism to prove they are better than
their children.
As a result of the continuous denigrating remarks, children feel
worthless and miserable.
They become cynical, critical pessimists who do not
believe in or trust themselves or others, and find very little joy in life.
■
inharmonious: Parents spend most of their time bickering and fighting, and use
their children as weapons in their ongoing discord.
They discipline in an
inconsistent manner, depending on their mood and the status of the marital
conflict
There is very little structure or reliable parental support and nurturing.
Children grow up believing that gaining power is the most important goal in
interacting with others.
Having witnessed abuse, they usually believe this is the
pattern in which relationships work. This can hamper their ability to develop and
maintain relationships. Their lack of social interest and the high levels of tension
they experience at home may lead them to enjoy breaking rules and thereby
putting themselves and others in dangerous situations.
A consistently warm
therapist can offer these children an alternative view of relationships.
Family atmospheres are rarely pure and frequently overlap. Apart from this, each child
also reacts uniquely to various elements within the atmosphere (Kottman, 1995).
Family atmosphere is the characteristic pattern established by parents and presented to
their children as a standard of living.
It influences how children see themselves, others
and the world around them, and how they can gain significance based on how they
perceive others reacting towards them (this therefore influences how the child’s behaviour
is managed).
The typical family atmospheres are democratic (children participate in
decision-making), rejective (parents have negative self-perceptions and difficulty showing
love),
authoritarian (parents demand absolute obedience and
perfect behaviour),
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inconsistent (discipline erratic and unpredictable, no structure and routine), hopeless
(parents discouraged and pessimistic), suppressive (parents do not allow the expression
of ideas and feelings), over-protective (parents protect children from any hardships,
thereby preventing them from learning independence), pitying (parents feel sorry for child
and teach him to indulge in self-pity), high standards (parents are critical when children
don't perform), materialistic (parents believe security and significance are gained through
possessions), competitive (children are compared with each other and encouraged to out
do each other), disparaging (parents bombard each other with criticism), and
inharmonious (parents spend most of their time bickering and fighting, and use their
children as weapons in the ongoing discord).
4.10.2 Relations within the family
The factors which can influence the manner in which family members relate to each other
are discussed in this section.
4.10.2.1
Bonding
Bowlby (1969, in Wilson, 2001: 37) was one of the first researchers to suggest the
importance of early relationships on the social and emotional development of children.
His theory conceptualised attachment as a biological drive toward species survival. He
theorised that selective attachment provided protection from predators. In doing so he
revolutionised thinking about the child’s tie to a caregiver, and the disruption of this tie
through separation and deprivation.
Attachment is an intense and enduring bond rooted in the function of protection from
danger. It is a subjective experience by the infant, based on a consistent alleviation of
infant needs.
The infant’s biological needs and behavioural requests must be
consistently addressed by the caregiver in order to foster the sense of trust and security
imperative for attachment to occur. If these needs are appropriately met, the caregiver
becomes a conditioned source of comfort. The infant uses these early experiences to
develop an internal working model, later influencing interpersonal perceptions, attitudes
and expectations. When trust begins to form, the infant will maintain normative social
development, given that the environment consistently satisfies the biological needs. The
caregiver’s sensitivity to the infant’s signals is of critical importance to the development of
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a secure versus and insecure attachment pattern (Wilson, 2001: 38-39).
Bowlby (in Wilson, 2002) divided the attachment cycle into four phases which occur
during the first two years of life. The infant exhibits cues during the first years of life that
encourage proximity to the caregiver.
These include crying, rooting, sucking, and
grasping to prolong physical contact. The infant seeks to minimise the distance between
himself and the caregiver. Between 8 and 12 weeks, the infant starts to discriminate
between caregivers and starts showing a preference for one. The infant expands the
seeking behaviours to include coordinated reaching, scooting, and following a departing
as well as greeting a returning caregiver, in more active efforts to maintain proximity. The
second birthday marks the beginning of ‘goal-corrected’ behaviour - beginning to
anticipate the caregiver’s actions, given that these actions have a reasonable degree of
consistency. The infant can adjust actions to a caregiver’s anticipated behaviour. At the
end of the infant’s two years of bonding, the fundamental feature is the infant’s
understanding of the caregiver’s independence.
caregiver’s motives and feelings.
He begins to acquire insight into the
This characterises the evolution of a partnership
between the infant and caregiver, and an extension of the original bond into a more
sophisticated form of attachment (Wilson, 2002: 37-38).
Proximity and contact with the mother play several roles. Access to the mother underpins
a sense of security that allows the infant to engage in and tolerate stimulation from the
environment.
When the infant is frightened or overwhelmed, the mother serves as a
haven for safety; not to reduce arousal to zero but to bring it within range consistent with
further exploration
and
play.
Confidence
in
the
caregiver’s
availability and
responsiveness also plays an important role in the ability to explore without becoming
anxious or distressed. It puts cognition before emotion in a wide range of secure base
contexts in that it regulates negative affect through cognitive/defensive processes
(Waters, et. al., 2002: 239).
People of all ages do best when they have a trusted attachment figure to whom they can
turn in times of trouble.
Seeking care is important for intimacy because in this life a
person is going to get hurt, and when the innermost core is filled with fear, sadness,
anger and grief, humans are biologically predisposed to want care. So for intimacy the
care-seeking system must be functioning well (Cassidy, 2001: 122).
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Cassidy (2001: 122-136 identifies the following different types of attachment which the
child can form:
■
Secure attachment: the child develops a mental representation of the parent as
loving, responsive and sensitive. If a child is loved and valued, the child will come
to view himself as lovable and valuable. They therefore learn about themselves
from seeing how others view them.
Securely attached children had positive
experiences when they turned to others for care, and these experiences foster
their capacity for intimacy by making them comfortable and confident in seeking
care, and see themselves as worthy of care.
■
Avoidant attachment mothers who are uncomfortable with bodily contact and
reject the infant's bids for comfort, direct the baby’s attachment system to be
activated as little as possible to avoid pain. The baby learns to turn defensively
towards play activity.
The avoidant infant only communicates directly with the
mother when he is feeling well. When distressed he does not signal the mother
directly, and does not seek bodily contact. When these babies are distressed they
will turn to self-soothing behaviours.
In projection tests older children with an
avoidant attachment cannot suggest how the child might cope with separation, and
they tend to present themselves as perfect in every way. The latter is viewed as a
form of defensive idealisation from a child that fears rejection if any imperfection is
found, and they are therefore also less likely to seek support in times of stress.
■
Ambivalent attachment: mothers of insecure/ambivalent infants were inconsistent -
sometimes loving and responsive, but only when they could manage, not in
response to the infant’s signals. Because the infant cannot count on the mother to
monitor its needs, clinging and monitoring her availability closely becomes a good
strategy, so that if need for the mother does arise, the infant will have quick access
to her. The infant takes on more than its share of the burden for maintaining the
connection. They show extreme distress on separation, and difficulty in calming
on reunion. Angry, resistant behaviour towards the parent or fearfulness of benign
stimuli, can be seen as a strategy to gain the mother’s attention. Such a history
explains why these children have trouble maintaining a boundary between another
person’s distress and their own.
They experience themselves as able to gain
attention only by exaggerated signals of need, and they have a seemingly
insatiability for closeness.
■
Disorganised attachment:
these children have had experiences of maternal
behaviour that is so frightening or unpredictable that they could not develop an
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organised, strategic response to it, and so the attachment system is behaviourally
disorganised, including freezing and disorientation.
Frightening behaviour by a
parent activates simultaneous inevitable competing tendencies: to flee to the
parent as a haven for safety, and to flee from the parent as a source of alarm. The
mother is viewed as hostile, violent, incoherent, and frightening.
The Diagnostic and Statistical Manual of Mental Disorders recognises Reactive
Attachment Disorder (RAD) - a behavioural disorder marked by developmentally
inappropriate social relatedness. In most contexts this disorder appears before the age of
five as one of the most severe forms of infant psychopathology in terms of attachment
disturbances. This disorder is characterised by an inability to form normal relationships
with others and impairment in social development, marked by sociophatic behaviours
during early childhood (siblings and animals are often the recipients of uncontrolled rage).
The risk for RAD is increased by factors that contribute to abuse and neglect, as in infants
who are disabled or unwanted and/or parent characteristics that interfere with the
normative attachment cycle.
In terms of the caregiver, risk factors include parental
depression, isolation, and lack of social support, as well as extreme deprivation and
abuse during own upbringing. Other risk factors include difficult or lethargic infants who
may frustrate a caregiver from behaving appropriately, chronically ill infants, lack of
contact between caregiver and infant due to hospitalisation during the first weeks of life,
and extended separations from or multiple changes in the primary caregiver. There exist
two subtypes of RAD: the inhibited type - reflected in persistent failure to initiate and
respond to social interactions in a developmentally appropriate manner, resistance to
comfort, and a mixed pattern of approach and avoidance behaviour; and the disinhibited
type - exhibits social promiscuity, is charming, telling strangers that he/she loves them,
and asking them to come home with him/her. These children share a lack of empathy,
limited eye contact, cruelty to animals, poor impulse control, lack of causal thinking and
conscience, abnormal speech patterns, and inappropriate affection with strangers. These
manifestations occur early in childhood and require immediate clinical intervention.
Indicators of attachment disturbances in infants include: a weak crying response and/or
tactile defensiveness, marked stiffness, or limp posturing, poor sucking response or little
eye contact, as well as no reciprocal smile response and indifference to others (Wilson,
2001: 42-44).
Adolescents labelled as dismissing (derogatory and cut off from attachment experiences)
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are associated with conduct and substance abuse disorders. Those labelled preoccupied
(passive, angry, and entangled by past experiences) are more likely to suffer from
affective disorders, and manifest overt disclosure of symptomatic distress.
The
insecure/resistant pattern of attachment is the only classification predictive of future
anxiety disorders (Wilson, 2001: 41-42).
Attachment is an intense and enduring bond rooted in the function of protection from
danger by the caregiver/parent. The constant meeting of needs fosters the sense of trust
and security needed for bonding and normal social development to take place.
Attachment occurs mostly during the first two years of the child’s life.
The infant
participates in the process through exhibiting cues to encourage proximity and by
discriminately seeking out a preferred caregiver. Towards the end of the bonding process
the child starts to anticipate the caregiver's responses to his needs, and starts to gain
understanding of the caregiver’s separateness from himself. The child must be able to
seek out care when distressed and should be sure about the parent’s availability in order
to explore his environment without becoming anxious. The parent participates through
being available and responding to the child’s cues.
When the parent does this
consistently the child will develop a secure attachment, but when she displays rejecting,
inconsistent, or frightening responses, the child will respectively develop avoidant,
ambivalent, and disorganised attachment. The avoidant child will not signal his mother
when in distress, fearing rejection when imperfection is showed. The ambivalent child will
be clingy to his caregiver since he feels responsible for keeping her available, and so
uses exaggerated signals of need.
The disorganised child will display opposing
behaviours of wanting to flee to the parent for safety and fleeing from the parent as
source of alarm. Developmentally inappropriate social relatedness before the age of five
is cause for concern. The inappropriate behaviour can either be inhibited - resisting
comfort and a mixed pattern of approach and avoidance, or disinhibited - being socially
promiscuous.
It indicates an inability to form normal relationships with others, and the
display of possible uncontrolled rage towards animals or siblings. In extreme cases these
children show little empathy, causal thinking, and conscience, as well as cruelty and poor
impulse control. In adolescents poor attachment experiences can increase their chance
of developing conduct-, substance abuse-, affective-, and anxiety disorders.
The researcher included literature on how to assess the attachment of the child in
Annexure 2.
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4 10.2.2 Family constellation / birth order
Family constellation refers to the personality traits of each member of the family, the
emotional connections among various members, the dominance or submission of
different members, the size of the family, age differences among the children, the gender
of the children, sibling subsets, and the birth order. Each birth order position has certain
traits that are typical of individuals who find themselves in that place in the family
constellation. There are many factors that influence psychological birth order. These
include the above constellation traits, plus factors like having a handicapped child,
differential treatment based on gender, cultural background, family myths, educational
experiences, physical development, and the time elapsed between the births of children.
In families where there is no significant time span between the children, the psychological
components that affect the family constellation become even more important (Kottman,
1995).
In examining the child’s life-style, the therapist must determine how these conditions
influenced the child’s perception of his psychological position. Each position has certain
assets and liabilities. Information about this will enhance ways of encouraging the child
by building on assets and planning remediation for the liabilities (Kottman, 1995: 135-
139):
Only children spend their entire childhood surrounded by people who are older
and more proficient than they are. They may therefore decide to develop skills that
gain approval from adults, or to cultivate character traits such as shyness or
helplessness that gain sympathy.
These children usually enjoy their position as
the centre of attention, but may also feel anxious because they are always under
scrutiny.
They do not automatically have playmates and may have difficulty
relating to their peers, preferring the company of adults.
The parents of these
children may sometimes pamper them, leading them to believe they do not need to
earn things through their own efforts, and that they can get something just because
they want it.
If their requests aren’t granted they may feel unfairly treated and
refuse to cooperate.
Only children frequently
independence, intelligence, and creativity.
have strengths such
as
They can be highly self-entertaining
and self-reliant.
First children have precarious positions in the family. Being first may entitle them
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to special privileges and strong relationships with their parents.
Because this
place may be threatened by the birth of subsequent children, they may feel
dethroned. Their strengths are a sense of responsibility and reliability, as well as
being organised, achievement orientated, protective of others, nurturing, and
helpful. They frequently have strong leadership skills, and would therefore choose
to gain their significance in the family by co-opting personality traits that are highly
valued by the family unit. They may have strong social skills when interacting with
adults since they have spent a lot of time with older people. The liabilities usually
involve taking their assets to the extreme, and tending to be overly responsible,
excessively organised, overprotective, and bossy. They may be so interested in
achievement that they neglect building relationships with others. Their social skills
with their peers may be weak because they are less comfortable being an equal
with individuals their own age. If older children feel overly threatened by younger
children they may become extremely discouraged, believing they must be the best
and most powerful, or they are worthless.
■
Second children spend their entire lives striving to catch up to the oldest, feeling
a great deal of pressure and inferiority. Frequently, especially if they are close in
age, second children’s personalities are exact opposites of the first children, and,
because they never have their parents’ undivided attention, these children may
develop the idea that they do not deserve attention. Typical second children have
strong social skills because they learn early that they must get along with others.
They usually put out a lot of effort because they have always felt a need to try
harder. Quite frequently these children excel in athletics. Unfortunately they tend
to be easily discouraged, fearing they can never measure up to the oldest child.
They may adopt negative personality traits as a contrast to what is valued by the
family, in order to create a place of significance for themselves. They may also be
hyperactive or anxious, as though they are in a race that they cannot win.
■
Middle children. When the third child is born the second gets squeezed into the
middle where he does not have the rights of the eldest or the privileges of the
youngest, and therefore may feel neglected and unloved. Because they are in the
middle of things, they become adept at mediating and peacemaking.
These
children see the different sides of every situation, which gives them a sense of
objectivity.
However, understanding varied points of view can also be a liability
because they might have difficulty making decisions and may become overly
worried about fairness. The ability to look at experiences and relationships from
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many vantage points does however enhance middle children’s ability to be
innovative and creative. Since they struggle to find their place they might find it in
being the rebel child - the one who is different. This may be comfortable for a
time, but may become discouraging. If the latter continues, the child might drift
towards the useless side of life and become the problem child in his family.
■
Youngest children usually have few responsibilities and many privileges. They
get attention for being babies without really having to do anything to earn attention.
Being the smallest and the weakest of the siblings, they may feel as though the
other members don’t take them seriously. In order to compensate for this there
are three main routes they tend to take in life: (a) they can become speeders,
working hard to catch up and surpass their older siblings; (b)
they can get
discouraged, give in to their feelings of inferiority, and decide not to even try and
compete; or (c) they can choose to excel in areas that are completely unique to
them.
No matter what route they choose, they are usually charming and
entertaining. They have strong senses of humour and the ability to manipulate
people into giving them what they want. They may expect privileges they do not
earn and expect others to make decisions and take responsibility for them. They
prefer not to lead but may also have difficulty following if they do not see it being to
their advantage.
Their ability to get what they want may leave people feeling
resentful at being manipulated.
The constellation of the family is a combination of the personalities of the members,
emotional interconnectedness, dominance and submission of members, the size of the
family, age and gender differences among children, and the birth order,
The
psychological birth order is influenced by having a handicapped child, by cultural
background, educational experiences, and the time elapsed between the births of
children. Knowing the assets and liabilities of each position allows for strengthening of
the assets and remedying the liabilities.
The different psychological positions in the
family (with their liabilities in brackets) are: only children (difficulty relating with other
children, spoilt, uncooperative); first children (overly responsible, bossy, driven); second
children (believe they do not deserve attention, discouraged, oppose family values);
middle children (difficulty making decisions, gain significance through problem behaviour);
and youngest children (speeders, inferiority, manipulators).
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4.10.2.3 Child abuse
Child abuse is a social problem with negative effects such as school problems, behaviour
problems, depression, anxiety, and post-traumatic stress disorder.
Research also
suggests that early family experiences exert an important influence on the development
of future parenting skills (Banyard, 1997: 1095).
Child victims of extra-familial sexual
abuse show adjustment problems in both emotional and behavioural domains (Manion, et
al., 1998: 1286).
There is an association between childhood emotional abuse and
negative psychological outcomes such as aggression, emotional unresponsiveness,
depression, suicidality, personality disturbances, and low self-esteem (Collier, et al.,
1999: 239). The consistent and problematic effects of child maltreatment on the child’s
ability to negotiate stage-salient developmental tasks include severe disturbances in
several domains of adaptive functioning, such as the development of a secure attachment
to the primary caregiver, affect and physiological self-regulation, the development of
autonomy and a sense of self, and the establishment of peer relationships (Muller, et al.,
2000: 450).
Furthermore, sexual victimisation has implications for the probability that
teenage girls will resort to weight regulation practices, both multiple and extreme forms of
weight regulation (Thompson, et al., 2001: 300).
The Minnesota Classifications and Codes for Children and Youth (1977) includes the
category “Abuse of Child’’, which lists physical abuse, sexual abuse, and neglect, both
emotional and physical.
In the researcher’s opinion, the category is too narrow.
Literature and child care legislation have given more specialised attention to the nature of
child abuse over the past 20 years. For this reason, she has broadened this category to
allow a more specific description of the abuse through the classification system.
Veltkamp and Miller (1994: 7) define an abused or neglected child as "one whose
physical or mental health is harmed or impaired, or threatened to be harmed or impaired,
by an action or lack of action by the parent or other people responsible for the child’s well
being". Abuse can also be seen as the extent to which a parent or caregiver executes
negative, unacceptable measures of control on the child. (Wolfe 1991:8).
Any of the
following forms of abuse will inevitably influence the child’s development and adversely
influence his overall well-being:
■
Physical abuse involves the parent or caregiver being responsible for or allowing
injury to come to the child (Veltkamp and Miller 1994: 7). It involves any physical
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injury or anything else that jeopardizes the well-being or life of a child, and includes
violent methods of discipline such as beatings that cause lacerations, abrasions,
bone or skull fractures, or intentional burning (Johnson and Schwartz, 1994: 187).
■
Emotional abuse involves the continual scapegoating and rejection of a specific
child by his caretakers. Severe verbal abuse and berating are present, and can
even involve psychological terrorism where a child is, for instance, locked up in
dark cellars or threatened with physical harm.
Emotional neglect is where
meaningful adults are unable to provide necessary nurturing, stimulation,
encouragement, and protection of the child at various stages of development
(O’Hagan 1993:19).
■
Sexual abuse is any sexual, exploitive activity with children, whether it involves
physical contact or not, by a person who uses his superiority in terms of age,
physical strength or position in relationship to the child, to meet his or her own
emotional and sexual needs (Draucker 1992:3). Sexual abuse of children includes
parent-child incest initiated by one or both parents; a child being forced into sexual
activity by stepparents, relatives, or family friends; the rape of a child by a stranger;
and sexual exploitation such as prostitution or pornography (Johnson and
Schwartz, 1994: 187).
■
Incest is a sexual relationship between persons who are such close family that
they are forbidden by law to marry (Swanepoel and Wessels 1992:143). Dietz and
Craft (1986: 780) explored a prevalent attitude presented in the literature, that the
mother of the incest victim is the true abuser in the family, engineering the entire
incestuous relationship or perpetuating it through her unconscious consent.
Mothers in these families generally viewed as passive, dependent and submissive,
chronically depressed, overburdened, and unable to protect their daughters or
exert a restraining influence on their husbands. The typical incestuous family is
patriarchal; the father is the authoritarian head of the household.
He may
underscore his authority with physical violence, drink heavily, and be unduly
restrictive of his daughter’s social life. An “affectionate” type of father (seven out of
twenty cases) is also reported in the literature. This type of father does not use
force or threats in sexual relationships with his daughter, but is careful to obtain
her consent, either through “tenderness” and concern, or bribes of money and gifts
(Dietz and Craft, 1986: 781,782).
a
Neglect involves the chronic lack of attention to a child’s basic needs for food,
clothes, shelter, medical care, and supervision.
Sensitivity towards poverty is a
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requirement in the assessment of neglect (Veltkamp and Miller 1994:17). Parental
neglect is damaging because of its subtle nature, involving deprivation of the
physical necessities of life, emotional security and affection, education, medical
care, as well as inadequate supervision and abandonment (Johnson and
Schwartz, 1994: 187). Child neglect appears to be a matter of degree, involves
multiple factors, is relative to the observer, involves an act of omission, and varies
from community to community depending on community standards. It involves
failure to provide food, clothing, shelter, medical care, and supervision, as well as
failure to protect children from harm, and in general, it can be a difference in
perception between professionals and community members. One must consider a
variety of cultural practices when defining neglect in order to clarify whether the
neglect is intentional or an application of beliefs and practices that are
inappropriate in certain situations (Roditti, 2005).
The categorisation of vignettes by Collier et al. (1999: 234) in their study of culturally
sensitive definitions of child abuse in the Republic of Palau (in the Pacific Islands), proved
helpful in the search for objectified indicators of abusive behaviours that have been found
applicable, in spite of cultural differences.
She describes these categories in the table
below. This table will be expanded and included as part of the manual describing the
child abuse index.
Although all types of abuse can be seen as devastating, the effects of sexual abuse on
the child are, in the researcher’s opinion, the most disturbing to the adults in the child’s
life.
One can still wonder why a child is so aggressive (a consequence of witnessing
violence), but it is shocking when a child displays age-inappropriate sexual behaviour.
For this reason the researcher has highlighted the possible reactions to sexual abuse,
following Table 4.3.
TABLE 4.3 ABUSIVE PARENTAL BEHAVIOURS
Category of abuse
Physical
Operationalised behaviour
Spanking leads to child thrown against wall
Pulling arm and dislocating shoulder
Place hand on open flame for no reason
Beating for not doing homework
Sexual
Touch breast while hugging
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Sleeping in same bedroom as parents
Sleeping in same bed as lonely dad
Sexual abuse blamed on victim
Sleeping in same bed as parents
Emotional
Observes domestic violence
Name calling for incorrect homework
‘Silent treatment’
Child told to find another home
Child called ‘mental’
Non-physical
Encouraged to steal
Boy dressed as girl
Encourage child to drink alcohol
Parent using drugs around child
Neglect
Refuse to take child to counsellor
Leash on leg tied to door
Child left with aging grandparent
Left alone by parents
Handicapped child kept in cage
Retarded child left alone
Ignore rashes and sores
The legacy of sexual abuse is one of depression, self-destructive behaviour, anxiety,
feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, a tendency
towards re-victimisation, substance abuse, and sexual maladjustment.
Thirty-eight
percent of women have an abusive contact offence before the age of 18. The effects of
child sexual abuse appear to be more similar than different for males and females. The
experience of sexual assault has both short-term and long-term effects, involving fear,
anxiety, depression, and decrements in social adjustments (Terre and Burkhart, 1996:
141, 143).
All children need affection.
Children who have been deprived of a normal amount of
affection may have an even greater need. They may go to greater extremes to get this
affection and even be seductive. It is important to teach these children appropriate ways
of getting the love they seek. This may call for real frankness and discretion. It is very
appropriate to hug and kiss children, and they also need this touching. Prolonged kissing
or fondling is inappropriate, however. Such behaviour can be over-stimulating to children.
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Sometimes a child’s seductiveness can cause problems between parents if either of them
is made uncomfortable by the behaviour. These feelings should be discussed with each
other. Some parents have been reluctant to do so in order not to appear childish, overly
suspicious, or petty (Leigh and Leigh, 1999: 11). A social worker should be concerned
when a child displays seductiveness as a means of getting affection. This implies that the
child’s family environment is not providing appropriate emotional nurturing, and the
chance that the child has been exposed to adult sexual behaviour is very high. This
pattern should be broken early in the child’s life to prevent later patterns of promiscuity
and resulting problems such as teenage pregnancy and sexually transmitted diseases.
While today’s attitude towards sex is somewhat more casual than in the past, most
parents still find themselves much more upset than they thought they would be when they
find their children involved in sex play. This can be especially troublesome if a foster
child has a history of being sexually abused, or if the history indicates the parents were
promiscuous.
It is important to remember sex play is a normal part of a child’s
development, and they should not be made to feel there is something wrong with them
because they are normally curious.
Nevertheless, such behaviour is not socially
acceptable and you do not want the child to be ostracised by other children or their
parents. Children should be kept reasonably busy and should not be left unsupervised
for long periods (Leigh and Leigh, 1999: 11).
For the social worker warning lights should appear when a child shows sexual behaviour
that is mimicking behaviour not appropriate for the maturity level of the child. What the
children see on the media also plays a role, and exposing the child to inappropriate visual
stimuli also constitutes sexual abuse. So although the social worker should take family
context into account, she should be very critical as to whether or not the environment
promotes the child’s current and future emotional functioning.
Child abuse is a social problem with adverse effects including school-, behaviour-, and
emotional problems; the poor development of future parental skills; disturbances in
development and adaptive functioning; and physical problems (such as extreme weight
regulation). Abuse is the result of the caregiver’s harmful action or lack of action. These
behaviours manifest themselves through physical abuse (physical injury, violent methods
of discipline); emotional abuse (continuous scapegoating, rejection, berating, threats,
isolation, and poor nurturing, stimulation and encouragement); sexual abuse (physical or
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non-physical sexual exploitation, rape) and incest (sexual relationship between close
family, mother perpetuates, father dominates or manipulates); as well as neglect (chronic
lack of meeting child’s needs, can be a matter of degree, is culturally sensitive and
sensitive to poverty, and is relative to the observer). Worrying signs of abuse on the
child’s part are inappropriate sex play, seductiveness, sexually transmitted diseases,
teenage pregnancy and constant emotional and behavioural disturbances.
4.10.3 Disrupted family system
For the researcher, the issue of support raised in the Minnesota Classification Codes
refers to the support the parent has in his/her role in child-rearing. The family is the most
basic unit for support, and in the instances to be discussed next, that support has
collapsed, or is under threat.
Massey (1986: 25) described the family system as an integral unit that both embodies, in
its interconnected multiplicity, varying perspectives in the viewpoints of the members, and
can be observed from different vantage points. The system and its co-evolving members
reform, reshape, and reconstruct each other over time through multiple, ongoing
feedback loops of inter-perceiving, inter-experiencing, and interacting. The responsive
members and the system "circularly cause" each other, as the family system forms a
gestalt over the generations.
Persons-in-context create systems that reciprocally
reinforce patterns of living together as persons and systems co-evolve in a coherence of
mutual fit (Massey, 1986: 28).
A family is a system in which co-evolving members reform, reshape and reconstruct each
other through multiple ongoing feedback loops of inter-perceiving, inter-experiencing and
interacting. It is the first person-in-environment experience the child has, and the health
of the family has an influence on the parenting the child receives.
4.10.3.1
Divorced families
Family relationships can buffer or exacerbate children’s long-term adjustment to divorce
and remarriage. In a six-year follow up study of a total of 180 families, more differences
with regard to punishment and control than with regard to warmth and affection
distinguished divorced mothers from mothers in other family types.
Divorced mothers
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were ineffectual in their control attempts, and gave many instructions with little followthrough. They tended to nag, chatter and complain, and were often involved in angry,
escalating coercive cycles with their sons. Negative behaviour which initiated subsequent
neutral or positive behaviour by the other person (‘start-ups’) was twice as likely, and
negative exchanges were likely to continue longer than in any other dyad in any family
type. The relationship between the custodial mothers and their adolescent sons can be
viewed as intense and ambivalent rather than hostile and rejecting, since warm feelings
were also expressed in many of these dyads (Hetherington, 1989: 5).
Both sons and daughters in divorced families were allowed more responsibility,
independence, and power in decision-making than children in non-divorced families.
These children grew up more quickly; they successfully interrupt their mothers and their
mothers yielded to their demands more often.
In some cases this greater power and
independence resulted in an egalitarian, mutually supportive relationship, but in other
cases, especially when the emotional demands or responsibilities required by the mother
were inappropriate, since they were beyond the child’s capabilities or interfered with the
child’s normal activities, resentment, rebellion, or behaviour problems often followed
(Hetherington, 1989: 5).
Divorced mothers monitored their children less closely than did mothers in non-divorced
families. They knew less about where their children were, who they were with, and what
they were doing.
Children in one-parent households were less likely to have adult
supervision in parental absence. One way children coped with their parents’ divorce was
by disengaging from the family.
Boys in particular spent significantly less time in the
home with parents or other adults, and more time with peers.
Stepsons were also
significantly more disengaged that were sons in non-divorced families (Hetherington,
1989: 5-6).
Fewer differences were observed in the relationships between divorced mothers and their
daughters, and those of mothers and daughters in non-divorced families. Mother and
daughters in mother-headed families in fact expressed considerable satisfaction with their
relationship.
One exception to this was found among divorced mothers and early-
maturing daughters where family conflict was higher, with the weakening of the mother
child bond and greater involvement with older peers.
Research suggests that this
relationship may experience more problems as daughters become pubescent and
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involved in heterosexual activities (Hetherington, 1989: 6).
Among non-divorced couples, the closeness of the marital relationship, as well as
participation and support from the spouse in child rearing were positively related to
parental warmth and involvement with the child, and negatively related to parent-child
conflict (Hetherington, 1989: 7).
A divorce does have an effect on the behaviour management of children.
Divorced
mothers seem to be more directive, resulting in more negative exchanges with her
children than when a couple shares parental responsibility. Conflict between the mother
and daughter is higher in mother-headed households than in other mother-daughter
relationships, especially as the child approaches adolescence.
An intense and
ambivalent relationship exists between the mother and her teenage son. The children of
divorce seem to gain independence and power in decision-making faster than those in
Some children of divorce cope through disengaging from the
non-divorced families.
family and becoming more involved with older peers:
4.10.3.2 Stepfamilies
Stepfamilies have alternately been referred to as ’reconstructed’, 'blended', and
’synergistic' families. All these designations imply that the stepfamily is a variation of the
nuclear family unit.
Furthermore, they convey the connotation that it is a deviant,
aberrant, or second-class form of the “real” family, which consists of the biological parents
and their children. Parents from a divorce can be the objects of blame, children are the
objects of pity, and some stigma attaches to all family members (Johnson, 1983: 830).
Stresses and tensions endemic to stepfamily relationships have their roots in social
conditions arising from economic change and culturally conditioned beliefs and
expectations.
The tendency to overlook these origins tends to reinforce the feelings
experienced by members of stepfamilies that they are failures in human relations by
virtue of being part of a stepfamily.
The fact that millions of stepfamilies are now in
existence should suggest that there are forces exterior to families and individuals that
create conditions favourable to divorce and remarriage (Johnson, 1983: 830-831).
The early stage of remarriage may be a honeymoon period when the parents, if not the
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children, want to make the family relationship successful.
Neither mothers nor
stepfathers in the six-year follow up study of 180 families were successful in controlling
and monitoring their children’s behaviour, although mothers who had been remarried for
more than two years were more successful. In the first two years following remarriage,
conflict between mothers and daughters was high, and the latter were more demanding,
hostile, likely to exhibit coercion, and less warm towards both parents than were girls in
divorced or non-divorced families. Over a long period these behaviours did improve. The
behaviour of stepsons and their mothers and stepfathers was very different. Although
mothers and stepfathers initially viewed sons as very difficult, the behaviour improved
over time, although this improvement may only happen when the remarriage has
occurred before adolescence.
Stepfathers reported greater improvement among
stepsons and greater warmth and involvement with them than with stepdaughters
(Hetherington, 1989: 6-7).
Among remarried families, closeness in the marital relationship and active involvement in
parenting by the stepfather were associated with high levels of conflict between the child
and both the mother and the stepfather. These conditions were also associated with high
rates of behaviour problems, especially when the stepchild was a girl.
It seems likely
that, in the early stages of remarriage, new stepfathers are viewed as intruders or
competitors for the mother’s affection. Since boys in divorced families have often been
involved in coercive or ambivalent relationships with their mothers, they may have little to
lose and something to gain from remarriage in the long run. By contrast, daughters in
one-parent families have played more responsible, powerful roles and have had more
positive relationships with their divorced mothers than have sons. They may see both
their independence and their relationship with the mother as threatened by a new
stepfather, and therefore resent their mother for remarrying, which is reflected in sulky,
resistant, ignoring, critical behaviour by daughters toward the remarried parents. With the
adolescent’s increased striving for independence and concerns about awakening
sexuality, this may make them especially resistant to the introduction of a stepfather. The
lack of biological relatedness may heighten concerns about what constitutes appropriate
forms of affection between them. Children between the ages of 9 and 15 years are most
resistant to the introduction of a stepparent. Older adolescents are future oriented and
are anticipating leaving home.
For them the presence of a stepfather to some extent
relieves their own responsibility for the economic and emotional well-being of the mother.
Although stepfamilies change over time, stepfathers remained much less authoritative
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< )
and much more disengaged than fathers in non-divorced families (Hetherington, 1989: 7).
The following characteristics are present to some degree in most stepfamily relationships
(Johnson, 1983: 832-837):
■
Complexity.
When two people who are already parents remarry, both new
spouses may add children to their full-time or part-time menage. The greater the
number of newly acquired family members, the greater the complexity of the
relationship with which family members must cope. Stepfamilies are characterised
by multifaceted relationships involving a variety of people whose roles are in flux.
Each relationship carries with it a set of expectations and a question of delineation
of turf.
Turf refers to the boundaries outlining the rights, privileges, and
possessions
of each
psychological.
individual;
these
boundaries
may
be
physical
or
When people who are already parents remarry, a new type of
extended family comes into being.
Unlike members of the traditional extended
family however, members of stepfamilies have not lived in close proximity with
each other for years. They are likely to have different life-styles and values. This
factor, combined with the number of diverse relationships with which family
members must cope, contributes to the high degree of complexity found in
reconstituted families.
■
Variability. Unlike children in the original nuclear family, stepchildren do not start
their lives with a stepparent, but instead are introduced to him or her at some point
during the course of their development. This introduction may take place at any
age and under a variety of different conditions. Variables relating to the children
that influence the success of this introduction include the following: age of the
children at the time of the parent’s remarriage, degree of attachment to the absent
parent, length of time since loss of the absent parent through death or divorce,
degree of continuing involvement with the absent parent, degree of attachment to
and need for the natural parent in the home, number of siblings and stepsiblings
with whom to compete or share activities, special needs related to health or
disability, personal charm and attractiveness, and extent of need for parenting from
the stepparent.
Variables relating to the natural parents include the following:
amount of time and energy available for the children, degree of emotional
investment in the children relative to involvement in other aspects of life, degree of
stress being experienced in life, extent of antagonism toward the ex-spouse, ability
to manage the home, physical and mental well-being, and expectations concerning
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what one is entitled to get out of life. Level of expectation is an important factor
because high expectations are likely to be accompanied by stress when they are
not fulfilled. Lastly, the following variables related to the stepparent: whether he or
she has raised children, amount of previous experience with children, extent of
need to assume a parenting role with the stepchild, extent of emotional investment
in non-family activities such as a career or a-vocational interests, willingness to
share the spouse with the children (which is related to the individual’s expectations
about what he or she is entitled to and what the children are entitled to), previous
experience and comfort with family living, and presence of own children who need
time and attention. As a general rule, the degree of solidarity that develops in the
reconstituted family is likely to be a function of the interplay of the variables
described.
■
Losses and gains. The realignment of family arrangements often results in gains
for some individuals and losses for others.
For example, the new wife of a
divorced man gains a portion of his time, income, and affectionate feelings, which
were formerly the exclusive province of his children.
Conversely, when
stepchildren enter the home, the new spouse loses privacy and time alone with his
or her mate.
Having less time than before with a parent or having to share a
parent’s affection with an outsider constitutes a substantial loss, and as such it is a
realistic basis for anger and hostility.
Having to relinquish privacy in one’s own
home in order to take in someone else’s children is also a realistic basis for
hostility. These losses are often a built-in component of life in a stepfamily. They
are real and need to be openly acknowledged as such. Potential benefits should
be explored so that they can be developed. Examples of these include: relief from
constant physical and emotional burdens of child care; children can often form
relationships of friendship and solidarity with stepsiblings on the basis of common,
shared experiences; children who have been raised in an atmosphere of strife prior
to a divorce frequently have the opportunity to see a parent and stepparent live
harmoniously; parents who are emotionally satisfied have more to give their
children than parents who are lonely or frustrated from being single; children may
expand their circle of friendly, interested adults - that is, develop new extended
families - by acquiring new relatives such as step-grandparents.
■
Differences in life-style.
People with different life-styles are often thrust on one
another when a remarriage takes place. The new additions to the family are not
chosen by the family as a group but by the adult who is acquiring a mate. This is
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true even when the stated purpose of the remarriage is to “find a mother (or father)
for the children.” The acquisition of stepparents or stepchildren can be likened to
the acquisition of an in-law.
Conflicts stemming from differences in pre-existing
life-styles arise within stepfamilies in relation to various aspects of living. These
include areas such as: discipline, eating habits, division of labour, and attitudes
towards sex.
Stepfamilies exist within social conditions influenced by economic change and culturally
conditioned beliefs and expectations, with some stigma attached to being a ‘deviation’
from the nuclear family. The first two years after remarriage seem to be the most difficult
time to exert parental control over the children. The relationship between stepparents
and sons are better if the remarriage occurred before adolescence.
Closeness in the
marital relationship and the involvement of the stepparent increase the level of conflict
between the child and both parents. More behaviour difficulties seem to exist with girls.
Children between 9 and 15 years are most resistant to the introduction of a stepparent.
Influences on the family dynamics of stepfamilies include the lack of biological
relatedness which heightens the concern about what appropriate affection between the
stepparent and child is; stepfathers seem to be more disengaged than fathers in non
divorced families, probably related to the multiple relationships that form part of the family
and questions of ‘turf (role conflict, unclear expectations, own experience in raising
children, involvement of other parent and the maturity of the couple to manage the home);
the introduction of a new extended family with their own values; appraisal of the losses
and gains with regard to time, attention, privacy, sharing of responsibility and support;
and differences in lifestyle relating to discipline, habits, chores, and attitudes.
4 10.3.3 Single parent families
Mother-only families have become increasingly common during the past three decades.
In 1960, only about 9% of families with children in the United States were headed by
unmarried women, but this increased in 1999 to over 20%. Furthermore, throughout the
1980s and 1990s, female-headed families with children were five times more likely to be
poor than were two-parent families with children. Growing up in a single-parent family is
associated with negative socio-emotional outcomes for children, including diminished
educational attainment.
As compared with children from two-parent families, children
raised in single-parent families have lower test scores, less frequent school attendance,
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fewer years of schooling, and higher high school dropout rates. This is problematic since
educational achievement is one of the best predictors of factors such as occupational
status and earnings that contribute strongly to a child's future economic well-being (Zhan
and Sherraden, 2003).
In female-headed families, characteristics of the parent may have important effects on the
schooling of her children.
Although most researchers would agree that children of
female-headed households are more vulnerable, not every child from these families has
low educational achievement. The answer to what accounts for the range of well-being
among children of female-headed households may lie in identifying the resources that
some female-headed families use to buffer the risks of poverty.
If resources and
strengths can be identified within this family group, then future policy can leverage these
assets to mitigate intergenerational vulnerability among these families (Zhan and
Sherraden, 2003).
Some of the strengths present in some single parents which can account for children
being less vulnerable are greater future orientation, development of other assets,
improved household stability, greater focus and specialisation, a foundation for risk
taking, increased personal efficacy (great sense of effectiveness, strength, and control
over one's situation), increased social influence, increased political participation, and
enhanced welfare of offspring. Family assets such as these are also more stable across
generations than is income. Of all the forms of parental influence on children, financial
assets may be the easiest to transmit. Assets affect attitudes and behaviours as well.
For example, home owners tend to have greater life satisfaction and higher self-esteem.
They are also more likely to be involved in community improvement activities and assets
may have positive effects on expectations about the future. They may also help others
make specific plans with regard to work and family.
Savings and house values have
significant and positive links with attitudes and behaviours, such as prudence, efficacy,
connectedness, and effort. Moreover, some attitude changes may lead to other social,
economic, and intergenerational outcomes. Assets may help people first shape hopes
and plans, leading, in turn, to positive social and economic outcomes. Opposing this view
is the reality that having a low level of economic resources reduces one's ability to be a
good parent, in part because negative attitudes and behaviours are transferred to children
(Zhan and Sherraden, 2003).
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In the previous decade children of female-headed households were five times more likely
to be poor, and these children were likely to have poor educational outcomes.
differentiation can be made between income and assets.
A
If the single parent has
personal assets, such as greater future orientation, development of other assets,
improved household stability, greater focus and specialisation, a foundation for risk
taking, increased personal efficacy (great sense of effectiveness, strength, and control
over one's situation), increased social influence, increased political participation, and
owning a home, the adverse effects of single-parenting can be managed.
The
transferring of attitudes plays one of the biggest roles in the healthy development of the
child.
The utilising of other resources (not having the traditional support typical of a
nuclear family) determines the attitude with which the single-parent will meet the
challenge of raising children alone.
4.10.3.4 Child-headed families
Problems, from having to deal with lack of food to searching for education and security,
are not uncommon ones for thousands of children in Rwanda. According to a report by
the non-governmental organisation World Vision, and supported by the U.N. Children's
Fund (UNICEF), more than 85 000 households in Rwanda are headed by children under
the age of 18. Such families, whose parents were lost during the genocide and forced
migration, are among the poorest in Rwandan society.
The report estimates that 95
percent of the children interviewed lacked adequate access either to health or to
education. Child-led households suffer from a perceived lack of recognition; they want
more protection, and they are usually marginalized when it comes to the allocation of
resources in society. These children can be exploited for cheap labour or harassed and
have less security over land rights and other ownership than adult-headed households.
The children interviewed tend to survive on meagre resources, earning their living by
fetching water, carrying goods, or performing domestic work and odd jobs. Of even more
concern is that they are often detached from mainstream society (Haq, 1998: 1).
Girls, who comprise three-quarters of all child heads of families, face the worst risks.
They may be forced to have sex, either by being raped or offered money for sex. Added
to this, they live in a society where women have no automatic inheritance rights, so that
the households and land they supervise can be taken away from them. In some areas,
like Byumba, the problem is made worse by the practice of polygamy, which the report
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I
says has caused considerable land sub-division, leaving little for cultivation. The conflict
over scarce resources among such families adds more hurdles to child-headed
households, who have no legal right to inherit the land which belonged to their families
(Haq, 1998: 1).
The reality faced by child-headed families involves inadequate access to health services
and education, and they survive on meagre resources. They lack protection and can be
exploited for cheap labour or can be harassed.
The broader cultural influence of
polygamy leads to considerable land sub-division, with child-headed households having
no rights to inherit. This influence together with the conflict over scarce resources makes
these families more vulnerable.
4.10.3.5 Children raised by grandparents
Although grandparents’ raising their grandchildren is not a new phenomenon, the number
of grandchildren under age 18 living with grandparents is steadily increasing, and the
conditions under which some assume primary parenting responsibilities is a growing
concern. About 32% of these grandparents are aged between 55 and 64, while 20.5%
are over 65.
Many older grandparents are emotionally, physically, and financially
devastated by the added cost and responsibility, and have multiple health concerns. The
children they care for often live in poverty and have emotional, learning, and physical
disabilities. Education, training, and support services have not kept pace with the unique
needs of these older parents. Research done by the University of California Cooperative
Extension (UCCE) in Alameda County found that about 81 % of the 98 grandparents from
Alameda County reported one or more chronic conditions. At least 61% had arthritis or
gout; 52% had high blood pressure; 48% were overweight; 42% had stress-related
conditions; 23% had high blood cholesterol; 16% had heart conditions; 10% had diabetes;
10% had food allergies; 12% had other allergies; and 9% had cancer.
Of the 121
grandparents, 52% reported that their grandchildren had special needs. About 38% had
attention deficit or hyperactivity disorder; 15% had severe learning disabilities; 11% had
emotional disorders; 10% were exposed to drugs; 7% had developmental disorders
(Down’s syndrome or cerebral palsy); and 7% had respiratory problems or asthmatic
conditions, and this while 4.4% had no medical insurance (Blackburn, 2000).
Grandparents also reported conflicting emotions towards their parenting responsibilities.
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Their lives had been disrupted and redirected, and some felt that an outside force was
controlling their options, their lives, and their futures.
They expressed anger and
frustration, but also gratification with their parenting roles, Some felt unappreciated and
resented their methods of parenting being questioned.
Emotional conflicts with their
children sometimes created negative feelings about their grandparenting roles, and may
even in some cases have affected their attitudes towards their grandchildren. In most
cases they needed help with child care, discipline, coping with adolescent problems,
explaining the absence of the biological parents, and helping with homework (Blackburn,
2000).
Three-generation households and extended families have long enabled grandparents to
play key roles in childrearing and support of their grandchildren. Millions of grandparents
live in the homes of their children.
Many grandmothers, in particular, care for their
grandchildren while the parents work or study.
Primary grandparents often contribute
economically, and care for their grandchildren in times of parental absences, illness,
death, etc.
But population studies show a change over time in the composition of
grandparent households, where not only grandchildren stay with grandparents, but also
the mothers and in some cases the father or both the parents. The issues germane to
the grandparenting dilemma in the new millennium are the conditions under which elderly
grandparents are forced into primary parenting roles.
Many live in poverty and are
parenting for reasons related to substance abuse, particularly in urban centers. Our data
from grandparent conference participants shows that 51% became caregivers because of
substance abuse factors. Other causes are unemployment, homelessness, incarceration,
homicides, teen pregnancy, AIDS, abandonment, neglect, abuse, lack of child care, and
inability of the parents to meet special emotional, physical, and psychosocial needs
(Blackburn, 2000).
Aged grandparents are easily overwhelmed by the responsibility and cost of raising their
grandchildren if their role of extended family member changes to that of parent. They are
likely to have health problems and live in poverty. The stress of child-rearing is worsened
by problems such as disability and behaviour difficulties experienced by the child. The
adjustment in their role from grandparent to parent may cause resentment and negative
management of their grandchildren. The reasons for responsibility being shifted include
the effect of substance abuse, unemployment, homelessness, incarceration, teen
pregnancy, AIDS, and the inability to care for the children or child abuse by the parents.
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4.10.3.6 Domestic violence
According to Potgieter (2004), all child witnesses of violence are traumatised, and most
will experience anxiety, depression, stress and disassociation. Childhood development is
literally arrested, both cognitively and psychologically. She quotes Perry (1993) when he
says that the same remarkable qualities of the developing brain which allow the growing
child to internalise and rapidly learn, ultimately betray the child in the sense that his brain
develops as around the notion that the entire world is chaotic, unpredictable, violent,
frightening and devoid of nurturance.
Delinquent behaviour results after exposure to
domestic violence in 20 to 40% of cases. An interrelationship between domestic violence
and child abuse exists. Child abuse is present in 30 to 70% of families with domestic
violence; incestuous families have a 25 to 75% coincidence of domestic violence; and
80% of perpetrators engage in multiple targets; their prognosis for recovery is suggested
to be as poor as that of paedophiles’.
From an ecological standpoint, social support has an influence on the relationship
between exposure to violence and psychopathology among high risk adolescents. The
rates at which children are exposed to violence within both the family and the community
are alarmingly high. An estimated 15 out of 1000 children below the age of 18 were
victims of substantiated physical abuse, sexual abuse, or neglect in 1995 (based on child
protective service reports nationwide in the US).
Exposure to domestic violence is
estimated at approximately 10 million children per year.
Between 35% and 64% of
children in the inner city (especially African American youth) reported witnessing a
shooting or stabbing; between 24% and 43% had witnessed someone being killed; and
as high as 96% of children reported hearing gunshots in their neighbourhoods. Many are
also the direct victims of community violence: 38% from a sample of youths between 14
and 18 had been mugged, 20% had been stabbed, and 11% had been shot.
Many
studies indicate that children exposed to violence are at an increased risk for negative
developmental outcomes and psychopathology (Muller, et al., 2000: 450).
While it is evident that a certain proportion of children and adolescents exposed to
various forms of violence within their families and communities display significant
emotional and behavioural difficulties, some demonstrate better adaptation. In attempting
to explain such resilient outcomes, researchers have begun to explore the role various
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protective factors play. There is good evidence corroborating the protective effects of
social support (Miller, et al., 2000: 451).
The dynamics involved in a family where wife battering occurs, center around the
pathological self-structure the two adults develop. The wife uses defence mechanisms
and blames herself for the battering, while defending the husband. The wife fluctuates
from being hopeful in harmonious times to hurt and angry in abusive times. This is why
mothers inexplicably stay in abusive relationships, during which time the child is
traumatised on two levels: by what he observes and by the realisation that he is unable to
do anything about it (Potgieter, 2004).
Children are exposed to domestic violence within their homes either by the violent conflict
between their parents, or by the violence in their immediate neighbourhoods. Children
who witness violence may experience anxiety, depression, stress, and disassociation.
Interrelationships between
domestic violence and child abuse, as well as the
development of delinquent behaviour exist. Social support has a positive effect on the
outcome for the child. When a mother stays in an abusive relationship because of her
own psychological dynamics, the child is traumatised by what he observes and by the
realisation that he cannot do anything about it.
4.10.3.7 Impact of poverty on families
At least 12 million people in six African countries are facing potential famine in the most
severe food crisis to hit the region in at least a decade. The United Nations estimates
that 4 million tons of food will be needed over the next year to meet the region's
emergency food needs. While flood and drought have played some role in creating the
current situation, much of its cause is political. In Zimbabwe, for example, governmentsponsored land seizures have devastated agricultural production and caused the national
currency to plummet in value.
In Malawi, a densely-populated, agrarian country that is
one of the region's worst hit, one of the major causes of the crisis is the lack of seeds and
fertilizer.
Subsidized farming programmes have been cut drastically in recent years,
leaving thousands of families with nothing to plant and no fertilizer with which to coax a
harvest from the overworked land. The United Nations has not yet labelled this current
food crisis a famine, saying the death toll is still low. But for those living on the margins of
society, particularly women who are divorced or widowed, the situation has already
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reached crisis proportions (Itano, 2002: 1).
In Central and Southern Malawi, women traditionally move to their husbands' villages
after marriage.
If a woman's husband dies, she must marry her husband's brother or
return to her home village with her children, leaving behind all the property acquired
during her marriage. In difficult times like now, women often return to communities that
can spare little to help their returning relatives. At a feeding center run by the Roman
Catholic Church in the small village of Mphako, 38 severely malnourished children live
with their siblings and mothers in tiny rooms around a barren courtyard. For a compound
filled with children, the center is oddly silent. Many of the sick children are breastfeeding
infants who are too weak to cry. They are slowly starving with their mothers. Many of the
families that have been hardest hit by the food crisis are also suffering from the effects of
the AIDS epidemic (Itano, 2002:1).
Gerdes and Van Ede (1990: 480) say that economic factors have an influence on a
person’s standard of living and social values.
Socio-economic factors determine a
person’s level of education, living arrangements, and interests. Members of low-socio
economic groups belong to fewer social organisations, have fewer friends outside the
family, have less time for recreation, and tend to be spectators instead of participants.
The social worker is interested in the effect of societal factors on the family.
families are struggling simply to survive under the burden
Many
of insurmountable
environmental pressures and deprivations, and attempting somehow to manage and care
for their families with limited access to resources considered necessary for a reasonable
or adequate standard of life. Many families have limited access to education, resulting in
limited knowledge and skill with which to enter the economic mainstream. A cycle of
poverty and exclusion is thus perpetuated (Hartman and Laird, 1983: 188-189).
Cultural and political influences have an impact on families through the impact on national
currency and land ownership. Obstacles such as poor vegetation can become especially
critical for vulnerable families (such as female-headed households and those suffering
from the effects of AIDS).
Poverty impacts directly on the healthy growth of the child. It
negatively influences the family’s standard of living and inclusion in mainstream society.
So far this chapter has presented a discussion of the relevant themes in the literature,
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starting with the conceptual framework and moving on to consider other frameworks
(such as the Minnesota Codes).
This discussion has led to an understanding of the
concepts that describe the social functioning of the child, and these should now be
shaped into category themes and definitions that can be linked to current reality. At the
beginning of this chapter, the researcher showed how she re-organised the terms from lS|
the conceptual framework into two broad areas, namely, attributes of the child and direct
i
influences on the child in his maturation process; both areas influence the child's social
functioning. The seven broad categories of social functioning concepts in childhood will
be defined based on the discussions in this chapter. These definitions can be seen as
another function of Systematic Research Synthesis, namely the creation of new concepts.
u:
O L.
The researcher gives a new definition to the seven broad categories which she has BBS
identified in order to describe social functioning in children.
4,11
Operationalisation of concepts
This chapter started the operationalisation process by synthesising the vast number of
concepts into headings (see step 6 in Chapter 2) based on the conceptual framework
developed in Chapter 3 (step 5 of the Adapted Design and Development Model). Step 7
in Chapter 2 explained the conceptualisation process, and highlighted that the en
product of this process is the specification of a set of indicators of what one has in mind, [g
It will be helpful to at this point look at the next steps, since 'operationalisation' is the
specification of what operations need to take place, in order to clarify what will be
measured.
To progress from a vague sense of what a term means to more a specific meaning,
involves the identification of a nominal definition, leading to an operational definition,
which will give the user the specific measurements in the real world. Faul and Hudson 83
(1999, quoted in Chapter 2, step 7) stated that, in the process of operationalisation, we
I
specify what we mean when we use a term through a set of indicators. What was even
more relevant was their statement that "even if someone disagrees with the operational
definition, the person will have a good idea [of] how to interpret the results, because of
the clarity about the meaning of the term" (Faul and Hudson, 1999). For the researcher,
this is a safeguard with regard to reliability. Provided her definitions of the items in the^
eventual classification are adequately clear, the users of the system should arrive at the
same results, even if they disagree with the indicators of that problem.
Their
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disagreement will, however, raise validity questions, since there will not be consensus
that the tool measures what it is intended to measure.
Considering the above aspect of indicators, the researcher argues that, if clarity is of
more importance to ensure reliability, then the developers of the adult PIE were correct in
making the system a-theoretical. The focus is not on agreement of the indicators based
on one's own theoretical approach; it is on how well the definition states the focus of the
assessment. In establishing indicators, the researcher should avoid the use of theories
and only focus on what will indicate the presence of a certain aspect pertaining to the
social functioning of the child.
This brings one back to the argument raised in Chapter 3: that a unifying construct is
needed.
The researcher claims that approaching the indicators in the way described
above, does support the conceptual framework from which they were developed.
Although the system does not support any specific theory, the indicators must still
describe the social functioning of the child, and this description comes from the concepts
that are identified. The concepts are embedded in a person-in-environment approach
(refer to Chapter 3 - conceptual framework), and it is the researcher’s opinion that this
approach should be seen as a unifying construct which no social worker can argue with.
It seems valid to question why any social worker, given her training and the history of the
development of social work, would claim not to treat the client within his environment.
There may, however, be disagreement about how this construct should be translated into
the new technology, and that is why further refinement by practitioners will be necessary
(see recommendations in Chapter 7).
To summarise the process of operationalisation discussed in Chapter 2, under step 7,
Fisher (1989, in Faul, 1995) states that variable names stem from first forming a
conceptual definition, then an operational definition, then renaming the concept to better
match what can or will be measured.
This looping process continues, resulting in a
gradual refinement of the variable name and its measurement, until a reasonable fit is
obtained.
The concepts derived from this chapter are presented in Table 4.4.
The
process of derivation started with the conceptual framework in the previous chapter, and
was refined through the use of headings to highlight uniformities (see Systematic
Research Synthesis in step 5 of Chapter 2).
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TABLE 4.4 CATEGORY DEFINITIONS OF CHILDHOOD SOCIAL FUNCTIONING
DEVELOPMENT: The child’s developmental stage is considered with regard to the
necessary skills required to function within his environment. For this reason, established
milestones, cognitive ability, the influence of the environment and child factors, such as
ability to learn (although neurological problems are part of Factor 3), are assessed. It
occurs within a family system when the function of social behaviour of the child is affected
by the parents. Development at one level prepares the child for development at the next
level, which encourages adaptation over time.
ROUTINE:
This is designed to teach the child the habits necessary for survival in
society; to provide a safe, predictable environment; and to ensure that the child is rested,
nourished, and well cared for. A disturbance in any single area of the child’s routine is no
cause for concern.
Deviations in expected healthy routines affecting sleep, lavatory
manners, and food intake are noteworthy, fortheir value in signifying underlying problems
and other social functioning problems that may be caused as a result.
BEH AVIOURAL ADJUSTMENT: This is the observable conduct of the child that violates
established rules for which sanctions are brought to bear against him. The behaviour is
the child’s way of seeking a place in his world, and he learns to repeat behaviour that has
proven effective in the past. The child is expected to develop control over impulses, and
the inability to do so results in behaviour difficulties that affect the relationships the child
has with significant others.
The levels of seriousness of these difficulties must be
acknowledged.
PERFORMANCE:
The very nature of childhood implies a demand for growth and
maturation. Certain inherent drives are needed for the child to be motivated to learn and
perform.
The senses of achievement, expectation, satisfaction, and frustration are
relevant, together with a consideration of the goal-directedness and creative ability in the
child- Performance can be seen as the motivational drive to perform and to self-actualise,
which is dependent on a cognitive-emotional interplay within the child.
STRESS: This is seen as the state the child reaches when he can no longer respond
positively to the demands of the environment. This stage is usually reached when all his
internal and external resources have been exhausted, and is caused by a combination of
stressful life events that demand certain adaptive strategies from the child. Stress can
have a paralysing effect on the child’s functioning ability.
The sources and effects of
stress during the course of a child’s life are considered, including the emotional effects of
short and long-term stress; the child’s ability to recall significant events; and the
influences of crisis, loss and intervention.
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SOCIAi£ISAjlO||: This occurs through parent-child interaction that serves the functions
of affectional exchange and caretaking, and has a formative nature where the parent
helps the child become more competent.
Other relationships can also influence
socialisation of the child. Through social exchanges with an adult, even a very young
child can be socially influenced. How much the child can be socialised within his family
and cultural norms and standards depends on internalisation, compliance, attitudes, and
the parental control of access.
The result should be a social awareness and interest;
gender role identity; positive self-concept; pro-social behaviour; and social skills obtained
through play interactions with adults, peers, friends, and other pupils.
PARENTING: This involves the responsibilities of guiding, caring for, and stimulating the
child during his (maturing years. The interactive process through which social learning
takes place, involves influencing factors related to the parents’ ability to guide the child
and to keep him safe.
The influencing factors include the management of behaviour
through discipline, parenting styles, and family atmosphere; the quality of the relationship
through the process of bonding or lack of attachment, birth order (siblings), and the
occurrence of abuse and its effects. Any disruption in the family system, such as divorce,
remarriage, single parenting, child-headed families, children raised by grandparents,
domestic violence, and poverty would also be an influencing factor.
The seven factors derived from the conceptual framework at the beginning of this
chapter, are indicative of the state of social functioning in the child. To put this into a
classification system will demand more descriptive information as well as other
considerations (as identified in step 3 of Chapter 2) to determine what form the
classification will take. The system will therefore not have the same arrangement as the
seven factors above, but the consideration of these factors should be evident in the
classification system in order to correctly identify the social functioning problems of
children.
As Rubin and Babbie (1993) stated in Chapter 2, the end result of conceptualisation is a
set of indicators which show the presence or absence of the concept being studied. The
researcher uses the term indicator to mean something that gives an indication of a state
or the course of a process. More specifically, it’s a phenomenon that can be interpreted
as a signal for some state of being or the aspect that provides information on the value of
the variable, for example, blushing is an indication of shyness (Plug, et al., 1991: 153). A
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variable is a concept’s empirical counterpart.
Where concepts are in the domain of
theory, variables are a matter of observation and measurement, and therefore require
more specificity than concepts (Rubin and Babbie, 1993: 45). Figure 4.2 illustrates the
operationalisation process followed in this study.
Figure 4.2 summarises the process that has been followed from Chapter 3 where it was
determined what the focus area of social work is, and how social functioning of children
can be viewed in terms of the person-in-environment approach. This led to a conceptual
framework that aimed to give a broad guideline of what concepts should be searched for
in literature on childhood functioning. Together with the guidelines for a literature search
in step 6 (Chapter 2), this framework served to structure the literature, and from this,
chapter headings were employed in a first attempt to simplify the overwhelming amount of
information.
From the content of the literature survey, sets of indicators are to be
identified through copying the blue paragraphs to another document (not included in
thesis) and to adapt the paragraphs to construct statements that indicate the presence of
a problem (see Chapter 5).
These categories will then be transformed into a format
similar to that of the adult PIE, and a pilot test conducted to determine whether the
researcher’s developmental assumptions show some validity and reliability (Chapter 6
and 7). The definitions to be derived from the indicators will be incorporated into a user
manual, which fulfils the requirements for step 10 of the Adapted Design and
Development Model.
In the next chapter it will become clear how the researcher began with the concepts
identified in Table 4.4, and created subcategories within each concept.
Each
subcategory will be operationalised into the indicators which form the basis of the
category definitions given in Chapter 7. Since the new classification system has its own
design requirements, the researcher will also illustrate where the concept, with its
indicators, can be found in the new classification system.
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FIGURE 4.2 OPERATIONALISATION PROCESS FOR NEW TECHNOLOGY
Use unifying construct
of social functioning
and identify concepts
that describe childhood
social functioning
1. Use PIE
approach to find
concepts that
assess social
functioning in
2. Use conceptual
> framework (chapter 3)
& SRS (chapter 2) to
guide literature
search (validity)
Synthesis of
research through
categorizing and
re-categorizing
under chapter
headings
Children (conceptual
framework)
Determine
attitude of
practitioner
towards new
development
&get
feedback for
adjustments
Identify 7 broad categories
of concepts, specify sub
categories and develop
indicators
5. Select & orden
classification items
& pilot test face
validity & interrater
reliability
(standardization)
3. Explore the
identified social
functioning terms in
literature to increase
understanding of
Child (indicators)
4. Create
operational
definitions for the
items of the
classification system
(design)
Consider requirements
for a classification
system and use
framework of adult PIE
classification system
4.12
Summary
In the process of categorising the literature in this chapter, the researcher became aware
that a basic assumption underlying this study is that the focus of the classification system
is social functioning as it relates to relational problems, and is then expressed through
emotional and behavioural problems.
In other words, when person-in-environment
classification is applied to the theory of the child’s social functioning, the researcher’s
primary concern is with what the problem says about the child’s relational abilities, rather
than focusing on the emotional and behavioural difficulties.
These difficulties simply
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serve to signal that there is a problem with the child in the context of his immediate
environment. The assumption that social functioning is directly equivalent to relational
problems, served to ensure that the researcher did not fall into the trap of describing the
problem in the words of other professions.
Being conscious of cultural (ecological) factors within the literature on childhood
functioning, the researcher used logical thinking to construct the summaries at the end of
each section. She would, for instance with child-headed families, highlight practices in a
country as possible cultural factors at play in the obstacles faced by these families.
Although the influences are not necessarily applicable to other cultures, in mentioning
what cultural influences are applicable in a country with a high incidence of children as
heads of households, the social worker is made aware of the possible causes for their
limited access to resources.
In the process of summarising the literature in order to find a simpler definition for a
category, the researcher would question the purpose of the summary.
Attempting to
highlight why the social worker should be considering a particular aspect for assessment
of social functioning in the child, would automatically lead her to the question of when iit is
a problem.
She would then take clinical indicators into consideration (for example,
enuresis is a problem after the age of five, or teenagers with anorexia are 15% or more
below their ideal weight). Apart from the fact that she had to be careful not to adopt the
language of other professions for social work, she also realised that an assessment of the
initial assessment would be conducted in the course of this study. In other words, if a
disturbance in eating patterns is assessed as a possible problem, it will be evaluated in
the light of whether there are enough ‘danger-signs’ to warrant concern (these danger
signs often being the symptom language from other disciplines) However, within the
classification system developed in this study, the significance of a disturbance in eating
patterns is related to the effect a disturbance in routine will have on the child’s social
functioning - that is, how the resulting irritability, for example, will influence the child’s
actions towards others with whom she has a relationship. This should be considered in
the training of social workers. The danger for misinterpretation is based on the idea that
the eating problem should only be indicated if it has an effect on the child’s relational life,
and not simply because the signs are present.
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In deciding what to include in a shorter summary at the end of each topic, the researcher
tried to establish
the words and information which are most universally applied to
children (for example, in the case of 'discipline', she extended the regulations of Child
Care Act to include children in their biological families as well as in alternative care). This
exercise was necessary because the aim of this study is to develop a classification
system that is, by its nature, universally applicable. In having to decide on which words to
include (for example, in the summary of the family constellation section), the researcher
compared the words of the different psychological positions in order to determine what
distinguishes one from the other. In this summary the words that indicate the presence
of the psychological effects of birth order, are given in brackets. The researcher relied on
her own judgment in writing these summaries, and her assumptions will have to be
validated through testing by practitioners.
The researcher came to appreciate through this chapter, the guidelines she used at the
onset of her literature study (set out in step 6 of the Adapted Design and Development
Model). Through looking at literature sources that were local, recent, and by credible
authors (authors that would repeatedly be quoted on a specific topic, their books were 2nd
or 3rd editions, and their books and articles are used in university curricula), she found
credible information that allowed her to reduce the amount of literature used under each
topic. In other words, the researcher did not need to always take literature from a number
of sources to prove that they say the same thing. It would be obvious that the authors
consulted a variety of sources themselves or the researcher would see the same
propositions in other studies, allowing her to only use one source.
The assumptions that need external validation are those that were made in the
researcher’s logical line of thinking, as she progressed from what a classification for
social work would entail, to the decisions made about the terms used and the concepts
included
under
the
same
categories
(e.g.
division
of
behaviours
under
’oppositional/defiant', and 'conduct disturbance' or categorisation of topics under
'parenting').
This initial standardisation of the classification system can only be done
through pilot tests, since this chapter only involves part of the eventual classification
system. It only considers Factor 1, which is similar to that of the adult PIE (classifying
social role problems). An extensive validity study at this point is therefore not costeffective, since the system would simply need to be tested again on completion.
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This chapter presented a literature survey in support of the new technology. Although the
next step is a further reduction of the theoretical concepts into more observable
indicators, the information in this chapter is relevant to the eventual training of the users
of the new technology. Although some information may seem to be omitted from the next
operational step, the users will still need an understanding of the underlying theoretical
concepts found in this chapter. This is necessary for the correct use of the classification
system. The importance of training is consistent with the requirement given in Chapter 2,
step 3b: that the user of a classification system will need knowledge beyond that of the
system.
Through a detailed study of the theoretical background to this project, the
researcher has prepared herself to train users in the system which is part of the design
and development process (step 20, Chapter 2 - indicated as post-doctoral development).
The next chapter describes the design process, while Chapter 6 presents an evaluation of
the results from the initial testing of this system. The refined product is presented in
Chapter 7.
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Chapter 5
Design of the new technology
A man is not idle because he is absorbed in thought. There is a visible labour and there is an
invisible labour.
- Victor Hugo French dramatist, novelist, and poet (1802-1885)
5.1
Introduction
Thus far in this study, a conceptual framework for the child in his environment has been
developed, as well as a categorisation of the concepts found in childhood social
functioning literature. This chapter continues to operationalise the concepts identified
through the conceptual framework in Chapter 3 and explored in Chapter 4. At the end of
Chapter 4 the most significant meanings of concepts were extracted, in order to start
shaping the content of the classification system for childhood social functioning. This
chapter presents the design process, and starts with illustrations of the concepts or
broad categories, as well as with their subcategories and indicators. It will also illustrate
where the subcategories can be found in the new classification system that is presented
in Chapter 7. This chapter then ends with a discussion of the decisions made by the
researcher during the design of the new technology.
It should be noted that the process discussed in this chapter was initially broader. As
the researcher re-adjusted the focus of her study, she removed literature that had been
part of the first draft, and had been tested in the pilot study (discussed in Chapter 6).
The first draft included more theoretical concepts, such as neurological problems. This
chapter only includes the subcategories that remained part of the final draft, as
presented in Chapter 7. This narrowing down of concepts was partly a response to
feedback from Prof. Karls (see Chapter 6), and partly a means of limiting the overload of
data that would have adversely affected validity (see ‘a-z’ in step 14, validation
methods). There will therefore be some terms in the pilot drafts that are not discussed
here. The reason for this is that, in developmental research, the findings of the testing
are already incorporated into the technology (step 12 in Chapter 2 of the Adapted
Design and Development Model). The whole point of a pilot study is to pre-test and
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modify the study (see McBurney, step 12, Chapter 2 of this thesis). In the case of this
doctoral study, two pilot studies were done to present a draft that will need larger scale
testing, once the remainder of the classification system’s parts have also been
developed (post-doctoral).
The researcher now has the task of identifying assessment areas that came from the
conceptual framework and eventual literature study, and placing these into a format
similar to that of the adult PIE. This implies a conscious exploration of the concepts and
how these relate to social interaction problems in childhood roles, while simultaneously
considering how each concept will compare with the adult PIE. The primary reason for
this comparison is an attempt to match the adult PIE's degree of applicability to social
work issues. The end result of this process is an outline of social roles that point to the
area in which the child has social functioning problems, and problem types that explain
what type of social interaction problem the child is experiencing in that role.
5.2
Conceptual definitions
To orientate the reader, the researcher gives the following illustration of what
conceptualisation process has occurred so far. Figure 5.1 shows how the development
progressed in the preceding chapters.
FIGURE 5.1 THE PROGRESSION OF THE CONCEPTUAL DEVELOPMENT
ChM in.neiiSoWBf
text
eMWW
CgtefloriesfromcW*1;?,Uh
90
I fem?
s
Subpateoofies&11 „
{BrWW*
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261
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The figure illustrates that Chapter 3 resulted in a conceptual framework that placed the
concept of childhood person-in-environment functioning within the framework of social
work. The literature study in Chapter 4 was guided by the conceptual framework that led
the researcher to broad categories that describe the child’s social functioning. Chapter 5
will show how subcategories were identified from these broad categories and how the
indicators implied by these subcategories formed the definitions given in Chapter 7.
Table 4.4 in the previous chapter contained the broad categories and a description of
what is described under each. To begin with, the researcher will list these seven broad
categories in Figure 5.2. Following from this, the indicators within each category will be
identified. The definitions used to describe each category in the new classification
system are derived from these identifications. The definitions of the subcategories will
come from the blue paragraphs in Chapter 4.
Development
Routine
Behavioural adjustment
Performance
Stress
Socialisation
Parenting
FIGURE 5.2 THE SEVEN BROAD CATEGORIES OF CHILDHOOD SOCIAL FUNCTIONING
The second part of step 6 in Chapter 2 referred to Systematic Research Synthesis.
According to Rothman, et al. (1994), this entails a degree of invention that makes a new
integrated whole from the parts of a body of research (literature) findings. This occurred
in the previous chapter in which the researcher was able to identify subcategories.
These categories, with their subcategories, are illustrated in Figure 5.3 in the next
section.
Rothman, et al. (1994) further argue that conceptual integration requires
qualitative judgements that are subject to reliability questions. The researcher made a
number of such judgements as discussed at the end of Chapter 4 and in the last part of
this chapter. Since these judgements are subject to reliability questions, she comments
on the reliability of the process in Chapter 8.
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FIGURE 5.3 CHILDHOOD SOCIAL FUNCTIONING CONCEPTS AND SUBCATEGORIES
Uj Broad category
Sub-category
lZI
'2
I________
I
Oppositional defunco
[ ’ Condict dKturi»nwi.... 1
'
ty 8
(.
..-.v; ..s.-
■'
■'.... j
]
—{'gjOFiilj
I
I
f
ROUTINE
I■
eZU»
j |
[
r
,.j
Goal-<Srectedness
■ ~ J
C-
SOdALiSATON...........
Teenage pregnancy
j
Social awareness
Intemafezation & compliance~j_
Statutory intervention
''
j
~[ I
«“-*
]
[
I
|
J
~
Creativeness
f
PARENTING
I
)- |
1
Wiiign
j
[ ^apps:urocia> |
[
Serious assault
] H
j -I
[
Eating problems
'
Vandalism
1
------ (ZZ!2—1—]
'
;
p"~a
]
)
[
CTvofce ■
j
Single-parents
Grandparent famlies
Peer group
f
Friendships
[ >;
]
_
)
......... Domestic v.olence
Poverty
Emgiaga'J
]
[ L
[
“ Chad abuse
77
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The end product of conceptualisation is the specification of a set of indicators of what one
has in mind - indicating the presence or absence of the concept being studied (see Rubin
and Babbie, 1993 - step 7 in Chapter 2).
5.3
Indicators for operational definitions
Q
In this section the researcher works from the concepts of childhood social functioning as ^O£
defined in the previous section. These broad categories were identified by the researcher
when she synthesised the different concepts derived from the conceptual framework.
Figure 5.3 shows these broad categories with their subcategories in terms of which the
researcher arranged the literature on childhood social functioning.
This figure is an
illustration of the first steps towards the operational definitions to be used for the
classification system.
The steps or operations to be followed in changing the concepts derived so far into
measurements in the real world are:
Use subcategories to suggest what the components of childhood social functioning
are.
Identify variables from the blue paragraphs in Chapter 4 to obtain indicators of the
presence or absence of each childhood social functioning concept.
Make visual representations of the variables under each category.
Evaluate how the variables can fit into the design of the classification system.
Write operational definitions that comply with the following requirements:
o
Fit into a format similar to that of the adult PIE.
o
State the variable in the form of a problem, i.e. absence of positive attributes
or presence of negative attributes.
Figures 5.4 - 5.10 below illustrate the next operations that took place. These provided
the indicators to be used in the operational definitions. The assumption underlying these
operations is that indicators serve as signals of some state (see Chapter 4); the ‘signals’
to follow indicate a social functioning problem in a particular area of the child’s life. Table
4.4 in Chapter 4 provided general category definitions to start the reduction and re-(®
categorising of the literature (see synthesis, step 6).
Chapter 7 presents descriptive
definitions (focusing on what the user will need to understand) in line with the indicators
identified in this chapter.
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FIGURE 5.4 INDICATORS OF THE CONCEPT: DEVELOPMENT
Development
Occurs within a family system
Functions include acts of others
'
.
•
■
•
•
Development at one level prepares child
for noxt stage
Encourages adaptation over time. Delay
of 1 year seen as problematic
5 levels: perceptual, physical, cognitive,
emotional & social
4 stages: baby & toddler; pre-schpol (36); school (7-12); adolescent (13-18)
3
&
Culture offers opportunities or constraints
on the child’s development
Mental operations offer the framework from
which objects, space, time, causality are
perceived
As intuition, operational and abstract thinking
develops the child becomes more adept at
relating to the social environment
z
Movement stimulates brain development
(see Annexure 2 on Piaget)
4
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FIGURE 5.5 INDICATORS OF THE CONCEPT: ROUTINE
ROUTINE
Sleep disturbance inhibits ability for child to
participate in daily activities
Regular night waking is problematic for
parents & is caused by physical discomfort
illness or emotional atmosphere at home
Older children experience problems with
nightmares, night terrors & sleepwalking
Poor bladder control after the age of 5 is
considered abnormal with consideration of live
events, contextual & physical factors
Combined day & night time wetting & wetting
after continence was achieved indicates the
presence of more serious problems
Poor bowel control after the age of 4 is concerning'
for its association to inconsistent routine,
emotional trauma & a disturbed relationship with
caregiver‘
A response to the child’s physiological cues &
communication by the parent to make child
aware of his cues is necessary
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..
Eating problems involve the quantity & quality of
food with signs such as binging, starving,
obsession with weight & physical signs indicating
_________ more severe problems ________ y
266
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FIGURE 5.6 INDICATORS OF THE CONCEPT: BEHAVIOUR ADJUSTMENT
CONDUCT
DISTURBANCES
OPPOSITIONAL DEVIANT
BEHAVIOUR
^School attendance is enforced by law. Truancy^
I
& School refusal
Temper tantrum is the earliest unlearned '
response to frustration
Link with social pressures, e.g. competition,
stereotyping, expectation
(.
Lie out of fear for consequences or give
account of imagination
Aggression includes wrestling, hitting,
pushing & biting
Bullying ranges from social exclusion to
gang activity, always victimising
Parental tolerance & rewarding of negative
behaviour play role
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Physical & emotional changes noticeable with
drug abuse. Risk to health & safety
Predispositions: low religiosity, lifestyle, high stress,
poor coping, no attachments, poor role models,
inadequate opportunity J
Fire-setting serious form of vandalism. Fire-setters"
more destructive, aggressive & anti-social. Anxious
I
& insecure
J
y
Assault can be physical (shooting) or sexual (rape)/
Poor socialisation & anger
(Initial defiance makes child vulnerable to
more serious criminal activity
x.
2-
Comfort & trophy type stealing. Younger children
solitary thieves. Older children riskier & in groups.
Risk for delinquency. ,
Child seeking belonging easy target for
getting involved in deviant behaviour
<........................... ‘
: W
Unattended runaways often live of the street. Run
from poverty, abuse, no parent, unrest &
I
displacement
J
a
Cults encourage defiance against family
values & beliefs & prey to ritual abuse
J
y
FIGURE 5.7 INDICATORS OF THE CONCEPT: PERFORMANCE
PERFORMANCE
independence are important contributors. Success improve interaction
J
Expectation is positive orientation towards future. Believe actions can make a difference.
Optimism protects from depression, improve interaction. Hope & faith in self increases ability to
I withstand pressure before goal-directedness disintegrate. Acts as stimulus for problem-solving ,
Satisfaction is displayed in unique expression of well-being attached to own life. Value interaction
■
with others & less egocentric. Engaging in moral activities, a stable family life, experiencing
< favourable events & learning healthy wavs to manage negative feelings increase happiness, y
Frustration is reflected in reaction to problems that prevent achievement of goals & desires.
Produced by delay, thwarting, conflict & lead to aggression, regression, or fixation.
___________________ ____________________________________ ,
f
Individual responses differ re: task or ego involved; internal or external locus of control. 'I
Need gradual exposure to develop tolerance influenced by length & severity of & age at
I
exposure. Long-lasting frustration leads to apathy & disintegration of opal activity.____ y
•______________ Relevance of setting & reaction to behaviour is important_________
J
f Creatlyjty is ability toassert uniqueness & capacity for decision-making. Relates to need for new!
experiences through play, language & teaching. Influenced by self-control, feedback & selfI_______
concept. Present through humour, putting rules to plav, & drawings___________ J
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FIGURE 5.8 INDICATORS OF THE CONCEPT: STRESS
r
“Th.
—' Pl
STRESS
Q
Stress leads to emotional responses of fear & helplessness. Can fear real or
imagined things. In young child centers on safety, in teenager on social interactions
Helplessness involves a loss of control over gratification & relief of suffering. Can
lead to withdrawal & lack of hope for recovery. Not being loved lead to pessimism
Statutory intervention causes transitional stress or disequilibrium. Although to
safeguard the child causes removal from familiar. Handling by adult NB. Adjustment
\____________________________ _/
Selective, accumulated memories of 1st 6-8 years determine how child views self &
what he thinks is likely to occur. Gives insight on mistaken beliefs & goal of behavior
Resolving grief is managed by having had a meaning relationship with person he
lost, being given accurate information & allowed to ask question, access to trusted
adult for comfort. Teenagers prefer support from friends,
Risk of pregnancy under sexually active teenagers from 14 years. Higher risk for
dependency on public assistance, fertility problems, birth complications, poor
<parenting, effect on own relationships,
Can legally request abortion before 12 weeks. Choose for reasons of continuing
education, avoid shame. Effects of guilt, insomnia, anxiety, grief, somatic, suicide
<'
'•
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Os
FIGURE 5.9 INDICATORS OF THE CONCEPT: SOCIALISATION
SOCIALISATION
----------- [F°“' ele,n"''s
.................................................................................................................................................................
"nw,n9 ,c““- °Mp"n,t'
....................................................
............................................................................................................:
,
■
_____________f Social awareness influenced by gender. Boys use interaction to assert self, girls for maintaining close ties.'
Role expectations influenced by culture.
-------------------
;;most advanced J
Directive interaction from parent relates to child's coping with task. Goal-direction, monitoring, planning, responsiveness,
---------------------- 1 positivity, stimulation & communication contribute to developing problem-solving skills. Social skills NB for interaction, re:
----------------------
_____________
r Social learning takes place through play, learns pro-social behavipur & get information about world. Help to develop
maturity.& to comprehend reality. Exploratory, symbolic & pretend play. Ideal medium for adult stimulation
Peer 9™'P ^n exercise influence through rejection or imitation. Child starts to relate more with people than material
°b^cts. Peer culture helps Idenhfy shared .dentrty & co-construct peer mteractions.
_____________ Students share common bond. Develop views of their classmates. Popularity status depends on number of'
I
friends, influenced by ability, attractiveness & reputation. Teacher creates safe class
_____________ fFriendship is dynamic reciprocal relationship based on cooperation. By 4 to 5.years.most have one friend s']
by school age larger circle. Opportunities to learn conflict management & sharing
_____________
Self-esteem refers to value child places on. self. Development of self-concept is important for teenager
when faced with major changes & more demands from environment
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<52^'
FIGURE 5.10 INDICATORS OF THE CONCEPT- PARENTING
Parentirig
PARENTING
Parent task of managing behaviour through discipline, influenced by own style & family atmosphere.
Child-rearing reflects cultural norms & contact between society & child
Discipline involves establishment of behavioural norms. Focus to build character not dominance. Threats to leave, illicit']
rewarding, withholding rights
nghts are inappropriate. Limits needed for sleep time, permission giving,
aivina. fighting
fiahtina & eating
eatina habits.
<---- -—.— __
Should be in accordance with child’s age & be given more responsibility
,
'
' Parenting style influences child’s reaction. Authoritarian, permissive & disengaged styles correlates with
problem behaviour & low social & cognitive competence. Supportive, consistent style = protective
.......................................................
-............ . . ............................... . ......... . . .........................:.............. .... ..... -i..................................
j
'Family atmosphere is presented as way of living. Influence how see self, others & the world & how to gain')
significance. Can be democratic, rejective, inconsistent, hopeless, materialistic, inharmonious, etc
Relations within the family are influenced by bonding, birth order & child abuse. Attachment is long &
enduring bond rooted in protection from danger. Family constellation is combination of personalities.
& security & normal social development takes place (during 1sl 2 ]
X?
years). Child needs to signal need & learn to anticipate response - learn separateness from caregiver.
.................................. .................. .......................................... ..... ..............................................................................■ ■■■ I-. ~i........
•
..........................; ■ .................................. .................... '
. ..................................... ................................................. :■
•
.........
.
. ............:.......................... •
J
< - ..^sinhibited. Extreme cases child lacks empathy, causal thinking & conscience & presents poor impulse control
—educational .experiences & time elapsed between births. Each position brings possible liabilities to develop in child
S?S3^$:
____________ f Adverse effects of abuse involve school, behaviour, emotional & physical problems with poor development in future parental skills & disturbances in adaptive functioning. Abuse = caregiver’s harmful actions
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FIGURE 5.10 INDICATORS OF THE CONCEPT: PARENTING (continued)
PARENTING
Divorce affects the management of the child’s behaviour in the changing roles parents
take - becoming more directive & children rebelling against change. More strain on
_____________________ parent-child relationship _______
’
J
Stepfamihes often have stigma of deviation from normal family. First 2 years more
H
difficult. Children resent intrusion. Marital relationship under strain. New values & sharing
<____________
of time & attention with new siblings stressful________________,
Single-parent families more vulnerable to poverty & poor education. Assets can
strengthen position. Attitude of parent meeting the challenge & utilization of resources
<influence outcome for children,
" <c-—
[
<
n ................................ ..................................................................................................................... i i.. i.. i.
n.................................................................... ,....................................
,........................... ,................................
...
.
................................. ,,
,
....
Child-headed families have inadequate access to resources. Exposed to
exploitation. No rights to property. Role-reversal for responsible child
J
Grandparents responsible for own childrens grandchildren are easily overwhelmed.
Health problems makes child-rearing challenging. Being responsible for grandchild is the
■ ■■
result of parent’s inability:
'Children exposed to violence in home or in neighbourhood. Child traumatized'
by witnessing violence and realization that he cannot do anything about it.
Poverty has direct correlation with vulnerability of families and developmental outcomes of
children. Negatively effects family’s standard of living & inclusion into mainstream society.
■
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"
d
Figures 5.4 - 5.10 also indicate at what ‘place’ in the classification system the concept will
be found.
For example, routine can be found under problem types in the new
classification system (see Chapter 7). As the purpose of this chapter is to explain the
design process, the researcher first discusses the decision surrounding the eventual
system as background to the system’s development.
Design decisions
5.4
[
j
Apart from the discussion under step 8 in Chapter 2, the researcher will highlight parts of
the design process in this section. The following was established in step 8:
■
The classification system measures direct and indirect observables, as well as
theoretical creations.
■
The purpose of the system includes aspects of both performance and predictive
testing.
The format of the system is based on principles of the multiple-choice format.
To show more specifically how the researcher progressed towards the end product of this
study, she will highlight the decisions made along the way. The purpose of this is to show
how all the steps contributed to the final product. Other aspects of step 8 and step 9
receive attention in the next sections.
5.4.1
Name of the new technology
In presenting her ideas to colleagues throughout the development and design phase, the
researcher had to start referring to her development in a way that suggested that it had a
shape and identifiable properties, not only in order to suggest progress, but also to start [JU
eliciting trust on the grounds that a lot of thought had gone into the development. She
therefore needed a name for her development that not only related directly to its primary
aim, but also provided support for the reason for its development, which is to develop a
childhood version of the PIE.
Another consideration was that the name should have some marketable properties so
that it could be affiliated with the well-established PIE for adults.
The researcher
proposed the name ‘ChildPIE©’ in email correspondence to Prof Karls, following which it
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was referred to as such in subsequent emails.
This name not only supports the researcher’s desire to add to the existing PIE, making it
obvious that she is addressing a shortcoming of the adult system, it also implies that the
new classification system is based on a similar framework to that of the adult PIE. After,
the whole classification system has been developed, this decision will form part of a more
formal process referred to in step 20 of the Adapted Design and Development Model (see
Chapter 2).
5.4.2 A problem focus
The limitations of the study addressed in Chapter 1 included questions that had been
raised about the PIE system, that may also be relevant to the development resulting from
this study. Lowery and Mattaini (1997) raised some concerns that were addressed by the
developers in a formal article.
One of the issues related to the PIE’s emphasis on
problems in the way the person functions, and they questioned whether it adequately
prompts practitioners to focus on strengths (Karls, Lowery, Mattaini, and Wandrei, 1997).
Referring back to her discussion on diagnosis versus classification in Chapter 2 under
step 3B, the researcher needs to emphasise again that this new technology is not
intended to be used as a cause-and-effect diagnostic tool.
It is designed as a tool for
collecting relevant information on problems in the child’s social functioning. As authors
like Goldstein and Turner (see step 3B in Chapter 2) both argued in the 1980s, that
without person-in-environment problem classifications to describe coping and adaptations
by the client, it would be easy to fall back on old and vague formulations of what is wrong
and how to correct it.
For the researcher, the whole purpose of assessment is to accurately determine what
problem must be focused on. Some social work professionals may criticise any tool that
focuses on problem identification. However, in the light of needing to clarify person-inenvironment problems, being over-cautious about problem identification makes no sense.
At the same time the researcher does recognise Lowery and Mattaini’s (1997) concern
about whether PIE truly assists with the identification of strengths in the client. A similar
question was raised in the researcher’s Master's dissertation (see Oosthuizen, 1999).
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< /
The coping index in PIE rates the coping but does not list what the individual strengths of
the person are.
For this reason, the researcher decided to explore temperament in
children as a more specific description of strengths, but she had to exclude it from this
study as the focus shifted to determining reliability. In other words, she had to exclude
the testing of the coding indexes in order to first test role and problem type (this will be
seen in the next chapter). The aspect of strengths in the child will now receive attention
as part of the researcher’s post-doctoral developments.
Therefore, although the
developments on including strengths are not obvious in this doctoral study, the researcher
is keenly aware of its absolute necessity.
5.4.3 Operationalisation and classification systems
As mentioned in Chapter 1, the researcher adapted the Design and Development Model
to include a step where she can explore the unique attributes of classification systems.
She therefore needed to be sensitive to the requirements of a classification system
(discussed in step 3 in Chapter 2) in the process of operationalisation. The points to be
discussed next all have an impact on the operationalisation process in this study.
5.4.3.1
The role of the user
Reference was made by Turner in 1983 to the fact that the social worker should be able
to assess how much a client is like others, what the profession says about clients with
similar traits, and how they differ from other clients, needing an approach that is most
appropriate for the individuality of client. He stated that:
To slavishly follow a prescribed formulation makes the therapist a technician rather than a
professional. Whether the latter is a more serious detriment than working from no diagnosis
is a moot point.
Turner, 1983: xxx.
For the researcher this implies that, in using a classification system, the social worker
plays an active role. The worker should have adequate knowledge on the problem being
assessed and is responsible for placing it into the appropriate context when using a
classification system to come to a clearer understanding of the client’s problem.
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In similar fashion, Richmond (1917, in Karls and Wandrei, 1994: 13) recognised in what
she called ‘social diagnosis’, an attempt to arrive at an exact definition of the social
situation and personality of a given client.
A worker’s skill comes into play with the
weeding out of those matters of lesser importance, and the arrival at an effective and
cooperatively implemented action plan.
The implication this has for decisions on the development is that the researcher does not
take responsibility for what the social worker practitioner should know. The practitioners
that will eventually use this new classification system will have their own experience and
training to take into account. The intention of this development is not to incorporate all
the specialised fields in social work with children.
When the development eventually reaches the dissemination phase it will be useful to
give guidelines for the minimum requirements a prospective user of the classification
system should have to be able to utilise the technology.
5.4.3.2
The volume of included material
A further implication the role of the user has for the researcher, is that the social worker
using the classification system to be developed should have enough knowledge about
how the system works to be able to use it accurately. This complicated the development
of a user-friendly innovation (step 10 in Chapter 2), which for her meant a manual with the
definitions of the terms used in the classification system. She realised it was necessary
to give a thorough explanation of each concept, and struggled to keep these short and
simple (as the developers of the adult PIE had succeeded in doing). Because this study
only involves developing part of the classification system, the researcher decided to keep
the descriptions of the definitions to be used in the pilot study long for two reasons.
Firstly, for control purposes, to decrease the external influences on reliability testing -
with relatively little information on what is being measured, it is more difficult for the raters
who test the classification system to arrive at the same conclusions. Secondly, although
the end result should be short and concise definitions which support the terms used in the
classification system, having an initial raw version of such a manual still allows for more
aspects to be evaluated and commented on by the respondents, thereby refining the
development.
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< /
5.4.3.3
The theoretical construct perceived to be supported at face value
The other question directed at the validity of the PIE by Lowery and Mattaini (in Karls,
Lowery, Mattaini, and Wandrei, 1997) centered on one of its underlining principles - the
fact that it is a-theoretical. These authors argue that practitioners who claim to be nontheoretical, actually operate out of conceptual frames that simply remain unarticulated.
The concern exists that the system might lead practitioners, and especially students, to
view individuals as aggregates of problems, aggregates of social roles, or aggregates of
psychiatric disorders, rather than as persons indivisibly rooted in transactional realities.
The dynamics are precisely what need to be the focus of clinical assessment.
Social
functioning, and therefore practice, is about verbs (i.e. events, dynamics, exchanges, and
relationships) rather than nouns (i.e. problems, diagnoses, and conditions). It is much
more difficult to capture verbs in an assessment framework, but if the ontological reality of
practice lies in such transactions, as most major social work theorists argue, aggregate
lists like PIE are quite limited for capturing the crucial variables.
Turner (1983) is of the opinion that:
One of the unfortunate results of the gap between the professional literature and the
mainstream of practice has been a tendency to devalue traditional knowledge
If the
newer approaches to therapy are more effective than those presently used, then we must
adopt them. Responsible professional behaviour demands this. To make this comparison
requires a full understanding of the old and the new
Much of the disappointment in the
results of treatment stems not from a fault in our theory and its application but from a failure
to utilise fully the rich amounts of data, knowledge, and skill accumulated over the years.
One of the causes of this failure to tap effectively the rich resources of accumulated
professional expertise has been our reliance on oral tradition and the reluctance to set out in
an organized useful way what we know, what we do not know, what has been effective, and
what has not
Until we can be more precise in declaring how we assess people and
what therefore we choose to do with them and for them, our practice efficiency will remain
static.
Although there will always be different important focus areas in social work, a
classification system does not develop apart from it but alongside policies and historical
changes. Goldstein (1980) supported this notion in her paper presented at a conference
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held by the National Association of Social Workers (NASW), on the knowledge base of
clinical social work. She argued that:
... while the boundaries of our knowledge have expanded in ways that may outstrip our
integrative capacity, we have little systematic knowledge to bring to bear on the helping
process to help people cope more effectively in their life transactions. We need to rely less
on abstractions and become more active in the pursuit of knowledge of the real life
problems our clients face and the specific interventions that are effective in helping them.
Goldstein, 1980: 45.
In providing the theoretical foundation for a classification system, the dynamics and rich
resources of accumulated professional expertise should be considered while the
integrative capacity of the profession should still be valued.
This supports both the
exploration of the core of social work and childhood social functioning concepts as well as
the narrowing down to a theoretical construct done by the researcher. She is well aware
of the diverse theoretical models supported by social workers in practice, and realises
that some may question what frameworks she seems to support in the development of a
new classification system. The researcher is of the opinion that she cannot attempt to
find a construct that will incorporate all the relevant theoretical models used by social
workers, but that this should not deter her from attempting to offer a less abstract
approach to addressing the social functioning problems of children, which we, as part of a
profession, have claimed to be doing for years.
So, apart from doing her own investigation into the history and purpose of social work
(Chapter 3), the researcher has resisted the suggestion of inclusion of specific theories,
such as the client-centered approach. She did this in cases where no evidence exists
that the majority of the profession subscribe to the theory, or that it would still be
supported in the next decade. For this reason, the researcher focused on classic theories
that have stayed in the helping professions for the last few decades, as well as on newer
theories that are compatible with the person-in-environment construct. Apart from this,
however, a classification system does not exclude the methods used by practitioners -
how they address the identified problems still remains their prerogative.
She also disagrees with Lowery and Mattaini’s (1997) criticism of the use of “nouns rather
than verbs”.
The process of operationalisation takes the dynamics of the person’s
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functioning and translates it into observable terms.
therefore not justified.
Their focus on these terms is
The focus should be on taking theory and finding quantifiable
means to measure it in practice, in order to ensure accountability.
The researcher
suspects that this will be a continuing point of disagreement among social workers, but
that should not stop the development of technologies, and it should not take the choice to
use them away from practitioners.
5.4.3.4
Underlying principles of the design
The real intention of this study is to provide systematic knowledge in an attempt to
integrate our diverse practice, knowledge and skill. From what has been said so far in
this thesis about classification, and based on the design decisions, the classification
system to be developed should consider the following principles:
■
The social worker needs an understanding of how much the client is like others, as
well as how he is different from all other clients.
The social worker utilises what the profession has said about the client problem
together with a process of weeding out matters of lesser importance.
The desired result is arriving at an effective and cooperatively implemented action
plan appropriate to the client’s individuality.
&
Even if agreement regarding sets of indicators is lacking, a classification system
gives the practitioner an idea of how to interpret the results of the assessment,
because of clarity in meaning.
*
A classification system assists the profession in relying less on abstractions and
instead becoming more active in the pursuit of knowledge of the real life problems
our clients face.
It should be sufficiently simple and ‘user-friendly’, be used as a tool of information
exchange, and be sensitive enough to allow early detection of childhood problems.
5.4.4 Utilising the PIE framework
The PIE was developed as a means for planning and testing social work interventions.
Limiting the number of factors in the system to four is consistent with developing a holistic
conception of social work based on a minimum system framework. As a tool to classify and
code problems of social functioning, the PIE is operationally part of the method-of-practice
component. It would be used as part of a comprehensive assessment of what needs to be
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done to bring about desired change in social well-being. The PIE concept was initially used
to identify interpersonal social functioning problems on the person side and social institution
problems that exist in society on the environment side.
To expand PIE into a broad
perspective bio-psychosocial assessment model, two additional person side factors were
included: the mental health and the physical health status of the individual.
Ramsay, 1994: 189.
Since the structure of the adult PIE shapes the structure of the ChildPIE©, it is necessary
to give a short overview of what this structure is, to show why the particular format is
selected for the ChildPIE©. Table 5.1 gives an overview of the structure of the PIE for
adults.
TABLE 5.1: THE BASIC STRUCTURE OF THE PIE
FACTOR I: SOCIAL FUNCTIONING PROBLEMS:
A:
Social role in which each problem is identified (4 categories)
B:
Type of problem in social role (9 types)
C:
Severity of the problem (6-point indicator)
D:
Duration of the problem (6-point indicator)
E:
The ability of the client to cope with problem (6-point indicator)
FACTOR II: ENVIRONMENTAL PROBLEMS:
A:
Social system where each problem is identified (6 systems)
B:
Specific type of problem within each social system
C:
Severity of the problem (6-point indicator)
D:
Duration of the problem (6-point indicator)
E:
Discrimination in any of these systems (12 demographic factors)
FACTOR III: MENTAL HEALTH PROBLEMS:
A:
Clinical syndromes (Axis I of DSM-IV)
B:
Personality and developmental disorder (Axis II of DSM-IV)
FACTOR IV: PHYSICAL HEALTH PROBLEMS:
A:
Diseases diagnosed by a physician (Axis III of DSM-IV, ICD-9/10)
B:
Other health problems reported by clients and others
Karls and Wandrei, 1994, Manual - the mini PIE, in Oosthuizen, 1999: 31.
Table 5.1 illustrates that the classification system has four factors. In similar fashion the
ChildPIE© will have the same four factors, although the types and number of categories
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(indicated in brackets in the table) differ. Only Factor 1 for the child version has been
developed as part of this study. For the purposes of this study, the same indexes are
used to indicate the severity and duration of the problem as well as the coping ability of
the client. Table 5.2 gives a summary of the type of roles, their definitions, and the sub
roles of the adult PIE. The researcher used the type of roles and their definitions as.a .
guideline to what possible types of social roles can exist for the child as well.
She
referred to these broad categories, but adjusted them according to the categories
identified through the conceptual process. What these categories and definitions entail is
discussed in Chapter 7.
TABLE 5.2 ROLE TYPES
ROLE TYPE
DEFINITION
SUBROLES
Family roles
social roles that are played out in the context of
- parent role
a family setting where the members are linked
- spouse role
by
blood,
the
law
or formal
or
informal
arrangements
- child role
- sibling role
- other family role
- significant other role
Other
roles played out in interpersonal relationships
- lover role
interpersonal
between individuals who are not members of the
- friend role
rotes
same family
- neighbour role
- member role
- other interpersonal role
Occupational
those social roles performed in the paid or
- worker role-paid
roles
unpaid economy as well as in the academic
- worker role-home
settings
- worker role-volunteer
- student role
- other occupational role
Special life
roles people may willingly or unwillingly engage
- consumer role
situation roles
in through the course of their life
- inpatient/client role
- outpatient/client role
- probationer/parolee role
- prisoner role
- immigrant role-legal
- immigrant role- undocumented
- immigrant role-refugee
I_____
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r
- other special life situation role
Karls and Wandrei, 1994, in Oosthuizen, 1999: 32.
Table 5.3 below shows that there are nine types of problems that can occur in any of the
roles mentioned in the previous table. These types are believed to be descriptive of most
interactional difficulties. In the adult version, these problem types are printed in a block,
with their codes, below the Factor 1 social functioning problems page of the Mini PIE (the
manual of the adult PIE). The "x”s that form part of the codes, as illustrated in Table 5.3,
indicate the position they have within the summary code (Oosthuizen, 1999: 34).
In a
later section, where the researcher discusses the narrowing down of the area of testing,
she will refer to the coding again.
TABLE 5.3 PROBLEM TYPES
TYPE
CODE
DEFINITION
power type
xxIOxxx
Problems involve the misuse or abuse of physical or psychological power. Power is
the ability to do act, perform, or produce. Power also includes the ability to influence
others.
Related problems are problems involving conflict.
Conflict is a sharp
disagreement or the opposition of ideas, interests, or other elements between people.
The tensions generated by conflict have the potential of motivating the persons
involved towards problem solving.
consequences.
However these tensions can have maladaptive
Power problems can increase from mild disagreement to abuse,
murder and open warfare.
ambivalence
xx20xxx
Ambivalence is a state of internal tensions involving conflicting feelings about people or
things.
type
It is a common problem inherited in role performance expectations.
The
tensions generated by ambivalence have the potential of motivating people toward
problem solving, but may also result in role performance behaviour that confuses and
provokes others.
responsibility
type
xxSOxxx
Responsibility is the obligation to fulfill certain role requirements. Role performance,
prescribed
behaviour,
assigned
responsibility, and
sanctions for inadequate
performance are defined by a person’s community, transmitted through the
community’s culture, and internalized by the person. If these responsibilities are felt to
be overwhelming, oppressive or too difficult, the person may be unhappy or distressed.
The person’s sense of well-being depends on seeing himself as having fulfilled role
expectations. A negative self-evaluation may have serious effects on self-esteem.
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dependency
xx40xxx
type
Dependency is the condition of being influenced, controlled, or supported by another
person. Dependency needs exist in almost every person and vary situationally and
with the life cycle.
Cultural patterns have a strong influence in determining how
dependency needs are met. If a person’s dependency needs are not adequately met,
the individual’s role performance may be negatively affected.
Independence is
freedom from the influence of others. It is the ability of a person to direct his own life
and to initiate behaviour based on one’s inner convictions and resources. Striving for
independence, mastery and self-actualization characterize human growth and
development. Perceived or real obstacles to achieving this may produce frustration,
anger, rebellion, and dysfunctional role performance behaviour. Chronic frustration can
lead to depression and loss of hope
loss type
xx50xxx
Separation is the breaking apart from a person or thing to which a person has attached
emotional significance.
Loss is a permanent separation that is accompanied by a
grieving process. The loss or threatened loss of a significant person creates anxiety,
resentment, anger, hopelessness, and a lack of energy, will or ability to deal with
change.
Social role performance under these circumstances becomes difficult.
A
change in status is also frequently experienced as loss. Status is a person’s position
with regard to the law, a relationship, a group, the community, or society as a whole.
Status generally reflects a stable arrangement over a period of time and a change in
status disrupts this stability and creates distress. A person who is unsure of his status
or unhappy with it, may also develop social functioning problems.
isolation type
xx60xxx
To be isolated is to be apart from others and alone. Withdrawal is the process by
which an individual can isolate himself and this is usually in response to a perceived
hurt or other stress. Shy, fearful, or uncomfortable people can isolate themselves in
relationships and from what they perceive as the stresses of participation. This can be
a chronic state related to longstanding problems of self-esteem or a mental disorder.
People in new situations or communities may have problems establishing new
relationships, and social roles familiar to them may not be adaptive.
victimization
xxZOxxx
Intimidation is the fear of anticipated harm. Victimization is turning this fear into a
behavioural pattern in which a person gives in to fears, giving up his power to deal with
type
the intimidator or victimizer. Such relationships bring about serious role functioning
problems. Drastic changes in a person’s social or occupational performance may also
cause the individual to feel powerless, alienated, personally deficient, and without the
ability to control the situation.
Perceived threats can be very stressful, leading to
feelings of helplessness and anticipation of further harm.
mixed type
xxSOxxx
This is used when no one dimension of role performance is predominant and when the
role problem can best be described by a mixture of dimensions.
other type
xx90xxx
This is used when none of the above mentioned problem types adequately describe
the given case situation.
Karls and Wandrei, 1994: 27, and Manual in Oosthuizen, 1999: 33-34.
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Included in Table 5.3 are descriptions of the terms used in the adult PIE and in the
system itself. The problem types are illustrated as an index where the words are
represented by numbers to be used next to the social role type.
In the case of the
ChildPIE©, the researcher will arrange the relevant problem types in a similar manner
(see Chapter 7). In developing the definitions in Chapter 7, the researcher also borrowed
This overview of the adult version was
from some of the descriptions of the PIE.
therefore necessary.
5.4.5 Perceived needs of the practitioner
From her own experiences in child care work, the researcher is aware of the need to
always have the child’s age available. This is necessary to place behaviour into context,
and it influences the intervention plan. The researcher is also very aware of the multi
problem families social workers deal with.
For this reason the researcher decided to
include two new features that are not part of the adult PIE in order to meet the needs of
practitioners. These new features are an index indicating the developmental stage of the
child to be selected at the top of the form, and an index at the bottom of the form to be
used to code which problem the social worker is assessing: the primary, secondary, or
relevant problem. The definitions and illustrations of these can be found in Chapter 7. As
an added feature to ensure cross-referencing between the child’s ChildPIE© assessment
and the file information, the researcher added a block at the top that allows for the
parent's and child’s information (see Chapter 7).
5.4.6 Validity and reliability considerations
Part of ensuring validity and reliability is exercising control over variables that can have an
adverse effect on the process of development or on the outcome of testing the
classification system.
The researcher therefore had to make some certain regarding
variables which could influence the development.
5.4.6.1
Narrowing down the area for testing
The drive for validity and reliability influenced the researcher’s decision on what aspects
to test as part of this doctoral study, leading to a further reduction in the area of
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development.
To illustrate this point she will refer here to her decision about the indexes (to be
discussed in more detail in Chapter 7). The researcher initially included a discussion on
temperament in Chapter 4 as a tentative theory as a basis for understanding coping in
children. James Karls, however, suggested through email correspondence (Annexure 1)
that the researcher should initially not include the numerical coding in the testing, but
focus instead on testing the validity and reliability of the social roles and problem types.
The researcher intended to test the sample’s response to the coding, since the
respondents in her Master’s study felt it was one of the benefits of the PIE.
The
researcher also wanted to test her theory on making abuse a separate index, so it could
be considered in the case of each problem type selected as relating to the social role
problem. If the researcher could assume that a large number of children referred to a
social worker may have suffered some form of abuse, the abuse index will allow for the
opportunity to specify what type of abuse; and when abuse exists, the social worker can
still identify the social role problem type as well (i.e. what type of relationship problem
exists apart from or because of the occurrence of abuse). She therefore only applied the
coding to the social roles, problems and types of abuse. So later on in Chapter 7, when
the coping index is discussed, the researcher will only refer to her thought processes in
applying coping to childhood functioning.
In narrowing down the area of testing she could focus more on the validity of the initial
groundwork of the development, and this guided her decision on what to include in the
development that forms part of this study.
5.4.6.2
The pilot study
The pre-testing of a measuring instrument consists of trying it out on a small number of
people who have similar characteristics to those of the target group. Probability does not
normally play a role in the pilot study since the researcher does not intend to generalise
the findings.
Even so, the pilot study should take all heterogeneous factors into
consideration (Strydom, 1998: 179).
The reason for only doing pilot tests in this study lies with the fact that larger-scale testing
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will only be meaningful once the whole ChildPIE© system has been developed. Through
the use of pilot testing, the researcher could evaluate the parts of the development she
systematically engages in against a more objective standard, in order to identify the areas
that need to be refined in order to increase the validity and reliability of the ChildPIE©.
The use of interrater testing on two drafts of the ChildPIE© gave the researcher data on
the reliability of her initial attempts. Chapter 6 will include samples of the first two drafts,
and the results obtained from the pilot tests.
In her first draft, the practical reality of
translating interactional problems into social roles and problem types had not been fully
appreciated.
However, a meeting between Dr Roestenburg (study promoter) and Prof
Karls in Santa Barbara (USA), meant that the researcher’s first attempt could be properly
reviewed, and feedback given (refer to email correspondence from Prof Karls included in
Chapter 6). As a result of this objective review after three years of development, the
researcher realised that the framework used to develop the first draft was a psycho-social
listing of factors instead of person-in-environment factors that identify the role in which the
problem occurs, and what type of problem this is. In the process of changing the initial
psycho-social listing, the researcher was able to more clearly identify what the problem
types should be, since the latter described the type of problem in which the social role
only indicates in what area of the child’s life he is experiencing the problem.
The discussion of the initial testing and the results of the pilot study form part of the next
chapter. This chapter has focused only on the development that was refined through the
pilot testing. To illustrate this development, the second draft will include a problem type
named ‘neurological complications’. (This category is not discussed in this chapter, since
the researcher excluded it from Factor 1 of the ChildPIE© to include it later as part of a
listing of mental health problems in children in Factor 3 - post-doctoral development.
This was done after clarification received from a meeting between the researcher and
Prof Karls (see Chapter 6) that some of the aspects included would fit better under a
mental health category (as with the adult PIE).)
Deciding to first do pilot tests to form the groundwork of the development had an influence
on the validity and reliability testing. The classification system is still likely to undergo
changes before it can be tested on a larger scale.
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5A7 Cultural sensitivity
Karls and Wandrei (1994: 7, Mini PIE) argue that:
A person’s social role can be defined in terms of fulfilling a recognized and regulated
position in society such as parent, student, or employee. Tradition, law, and societal and
family values define the content of roles. Although the major functions of the role remain
generally the same across cultures, the way in which the functions are accomplished may
vary from culture to culture and from subgroup to subgroup within a specific culture.
The researcher understands this to mean that, in order to ensure that the ChildPIE© can
claim to be a-cultural (and therefore be viewed as applicable to all cultures), she would
need to merely name the social roles through which a child relates to others, and steer
clear of adding value-based criteria to the roles. For a technology to be useful in multi
cultural South Africa, this formed an important consideration in the development of the
ChildPIE©.
5.5
Description of the ChildPIE©
At the beginning of the section on design decisions in this chapter, the researcher
mentioned what the classification system as a whole will measure, for what purpose it will
be utilised, and what the format will be. The rest of the section described how decisions
regarding operationalisation and standardisation further shaped the system’s design. In
this step the researcher gives a practical description of the ChildPIE©.
Part of step 8 of the Adapted Design and Development Model used in this study, includes
the need to specify the purpose of the development. A description of the ChildPIE© must
state the purpose it is intended for. The first part of the ChildPIE© developed through this
study has as its purpose to identify the social functioning problems children experience
within a specific social role, in terms of types of interactional problems related to
childhood.
The ChildPIE© will have the same structure as the original PIE in order to maintain
attributes like the measuring of intensity and duration, identifying strengths and resources,
and having a visual, dual focus on inter-personal functioning aspects as well as societal
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factors that play a role in the client’s fit with his environment.
5.6
Summary
The researcher has demonstrated the design process in.this chapter. The next chapter
will present the initial developments that were tested in the pilot study, and show what
significant results lead her to the final draft of this doctoral study. The final draft will be
presented in Chapter 7, with conclusions and recommendations for further refinement in
Chapter 8.
The indicators in this chapter are the important aspects of childhood social functioning
that would alert the social worker to the presence of a problem in a specific area. These
indicators found different places in the format of the Child PI E©, and they are described in
the definitions given in Chapter 7. These definitions will eventually form part of a user
manual similar to the MiniPIE designed for the adult PIE.
Relevant and useful information existed within the categories and their indicators.
In
adjusting the categories into the design (as shaped by design decisions addressed in this
chapter) the seven concepts from Table 4.4 describe childhood social functioning. These
seven concepts are, however, slightly different in the classification system. This is the
reason why the researcher indicated in Figures 5.4 to 5.10 where the concept will be
found and, more specifically, in Chapter 7 indicated the origins of each operational
definition.
The researcher will keep this format until further refinement shows a need for change.
Chapter 8 will give recommendations on how the initial design will be assessed for
usefulness and applicability to determine what further changes may be necessary.
In step 7, Chapter 2, Fisher (1989, in Faul, 1995) said that sometimes the concept of the
variable that you end with is a bit different from the original one you started with, but at
least you are measuring what you are talking about, if only because you are talking about
what you are measuring.
In this regard, the focus of this and previous chapters has
certainly been on what is being measured: childhood social functioning.
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Chapter 6
Data Results & Interpretation
Make no little plans; they have no magic to stir men's blood ... Make big plans, aim high in hope and
work.
- Daniel H. Burnham (1846 - 1912) -
6.1
Introduction
Fhe interesting working principle of inter-subjectivity states that, if several scientists agree
that something exists, it gets treated as though it has an objective existence (Rubin and
Babbie, 1993: 44). In attempting to determine whether practitioners in essence agree with
the content of the new development, the researcher is attempting to determine whether
there is agreement that her statements and concepts (see glossary of terms for definitions)
exist inter-subjectively.
The chances of agreement increase when the researcher can
produce proof of her validation processes.
It is important to keep in mind what Lindahl
(2001, in step 14, Chapter 2) said about validity: that it is more difficult to measure or
‘prove’ than reliability, as it is inferred from circumstantial evidence.
Two validation processes crucial to this study were explained in step 6 (a theoretical
validation) and step 14 (an empirical validation) in Chapter 2.
explained in Chapters 3 and 4.
The first process was
Its implementation led to the design phase
(operationalisation and design decisions) explained in Chapter 5. The product drafted from
this application was tested as empirical validation and the results of this test are presented
in this chapter.
At the beginning of the product testing and standardisation phase of the Adapted Design
and Development Model (Chapter 2), Smit (1991) emphasises that the information acquired
through testing is the result of a close control of factors (preceding administration of the
test) and the interpretation of findings (use of data after application). Standardisation then
includes the content, the application procedure, and the interpretation procedure. As was
mentioned in the previous paragraph, the content of the ChildPIE© received extensive
attention preceding the administration of the test. The testing procedure forms part of the
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standardisation of the ChildPIE©.
The researcher will set out in this chapter what
measures were used to control the testing environment, and what procedure was used for
interpretation, keeping the ‘a to z’ guidelines in mind (see validation methods, step 14,
Chapter 2). In more practical terms, the researcher compiled a list of the feedback points
at the end of each panel or meeting (to be discussed momentarily) and implemented the
suggested changes (to form part of the developmental research) as far as these fell within
the aim of her study. These served as clarification points in the course of the development,
and enabled the researcher to share responsibility for the decisions she made with
colleagues.
The interpretation procedure for the interrater tests involved quantitative
(statistical) computing, and this will be discussed later in this chapter.
In this chapter the researcher will first report on feedback from experts in the field of
childhood functioning or measurement, and on the two pilot tests that were conducted on
the initial development, after which she will draw some conclusions about the design. The
feedback obtained from the results is integrated into the design to form the development
presented in Chapter 7.
6.2
Mjt
Data sets utilised in the study
Since further research and refinement are not only necessary but invited by the researcher, ^5?
the shape and form of this study should be replicable by other researchers. The researcher (§0
finds it necessary, therefore, first to give a summary of the process used to gather the data,
J
as it was described in steps 12 to 14 of the Adapted Design and Development Model in
Chapter 2.
Strydom (1998: 179) emphasises that a pilot study commences with a literature study; the
experience of experts is then on the table. The researchers should therefore at least obtain CTO
an overview of the concrete field of investigation, which should finally be complemented by MIBI
a thorough study of a few cases. The preceding chapters illustrated how an overview of
childhood social functioning was obtained. This section will show the data sets obtained
from the experience of experts in the field, together with the need for the initial
standardisation of the classification system.
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The aspects of a pilot study include the following (Strydom, 1998: 179-182):
■
Study of the literature - the researcher has to be up to date with existing knowledge
in her prospective subject. The wealth of literature which will confront the researcher
may frighten rather than encourage her. The purpose of this literature study is to
orientate her to what literature exists and whether it is freely available. A detailed
study of the literature becomes relevant during the main investigation. The literature
study is not only important for the clear formulation of the problem, but also for
executing the planning and actual implementation of the investigation.
■
The experience of experts - utilisation of experts can help to delineate the problem
more sharply and to gain valuable information on the more technical and practical
aspects of the prospective research endeavour. In spite of the wealth of literature
that may exist in any discipline, it usually only represents a section of the knowledge
of people involved daily in the specific field. Since the field of social work is already
so broad, people automatically specialise, and it makes sense to utilise these
people’s knowledge and experience. Experts do not necessarily always shed light
on a subject; they may instead complicate the conceptualisation of the problem
formulation. They may also attempt to force their own ideas on the researcher. This
is why it is important for the researcher to have her ideas in place and to be selective
about what she chooses to incorporate into her study.
Information should be
gathered using a brief, structured interview schedule so minimum time is lost with
general questions and comments.
’
Preliminary exploratory studies - to obtain a picture of the real practical situation
where prospective investigation will be executed, the researcher should address the
goals and objectives, resources, research population, procedures of data collection,
and possible errors which may occur.
It has as its purpose to plan out a basic
framework for the research project. It alerts the researcher to possible unforeseen
problems that may emerge during the main investigation.
■
Intensive study of strategic units — which requires the researcher to expose a few
cases to exactly the same procedures as planned for the main investigation in order
to modify the measuring instrument.
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For the reasons mentioned above the researcher was satisfied with only inviting a few
colleagues to her presentations, and with using a small number of respondents to test the
ChildPIE©. Her ideas and conceptualisations were only presented in the third year of her
study, by which time she had extensive data on childhood social functioning.
In each
presentation, the researcher asked a few related questions to obtain feedback on the
She exposed the ChildPIE© to real case studies through the
development so far.
interrater tests.
The test methods that form part of the pilot study will be discussed in
subsequent sections. First it is necessary to explain how the use of pilot testing to test the
initial development of the ChildPIE© led to three sets of data.
To illustrate the three data sets, Figure 6.1 shows the means by which relevant information
was obtained on different aspects of the development.
The figure below outlines the
purpose for the researcher to engage in the investigation, and how she obtained the
information required. This overview will take shape when the results are discussed.
□ Purpose of data gathering
Expert feedback
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□ Method of data gathering
Face validity
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o
LU
CO
Pilot studies
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Q
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FIGURE 6.1 THREE DATA SETS OBTAINED THROUGH PILOT STUDY
For steps 12-14 of the Adapted Design and Development Model, an initial pilot study
methodology was used. To replicate this study the same steps will be used, but the testing
will be done on larger scale and the pilot testing methodology will be less relevant than it is
in this stage of the development.
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It is first necessary to clarify that the results discussed in this section are those obtained
from testing the initial versions of the ChildPIE©. The Adapted Design and Development
Model will guide further developments of the other factors of the ChildPIE©. Other means
of standardisation will be implemented. This study provides the first factor of the ChildPIE©
classification system, and it is on the testing of this initial draft that this chapter reports.
The conclusions are directly implemented into this study to lead to the improved draft in the
next chapter.
It will seem that the results in this chapter are based on a development that is slightly
different to that proposed in the previous chapters. Problem types and index terms have
been included in the illustrations of the drafts that were tested that were not included in
Chapter 5.
The reason for this is that certain aspects (such as temperament) brought
considerations into the study that were too broad to address properly. Feedback (such as
the meeting in South Africa with James Karls who suggested moving certain problem types
to a mental health factor) led to the removal of certain categories that had been part of the
first designs. For the purpose of this study there is no reason for Chapter 5 to reflect these
categories. The reason for certain changes will become clear through the discussion of the
results in this chapter. In the last chapter the researcher outlines what was learnt through
the development process as an introduction to the realisation of how much more is still to
be done on this development.
6.3
Overview of data analysis
As the previous section shows, the researcher obtained different data sets through the pilot
study. The following figure will illustrate how these different processes came together in
the development, design and testing of the ChildPIE©. The pilot study formed the means
through which the first technical analysis (see step 14, Chapter 2) could be done. The
purpose of this study still falls under the Adapted Design and Development Model, and step
15 of this model involves addressing the design problems that are highlighted through
testing reliability and validity. Figure 6.2 shows where the design was adjusted as data was
gathered and analysed.
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I—I Qualitative data
Quantitative data
Expert opinion
£Z
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4^
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1st draft
Feedback from
questionnaire
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2nd pilot test
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Interrater
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Interrater
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IZ
FIGURE 6.2 OVERVIEW OF DATA ANALYSIS
The purpose of the above illustration is also to provide a time frame for when the data sets
in Figure 6.1 were obtained.
For example, the opinions of the panel on how well the
researcher has conceptualised the development occurred during the design phase that led
to the first draft of the ChildPIE©, while the information from the questionnaires was
obtained during the first pilot tests, when the respondents of the study reflected on their
experiences of the system. Both of these provided information on how well the system is
perceived as applicable to social work with children.
Figure 6.2 illustrates that, when the researcher started with the development of the
ChildPIE©, she presented her ideas to a panel of colleagues from whom she received
suggestions and support (this formed part of the required step 11, Chapter 2). She also
communicated with James Karls who is viewed as an expert as a result of his development
of the adult PIE.
As Whittaker, ef a/., (1994) state in Chapter 2 (step 12), clinical
judgement, practice wisdom, and subjective evaluation of practitioners are viewed as valid
and important pieces of information, and the researcher therefore considered and
implemented their suggestions throughout her design process. As the figure illustrates, the
first draft was drawn from feedback from these resources together with her own opinions
and knowledge gained from literature. Five social workers from practice used the first draft
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on case studies after a short training session as part of a pilot study. From the sample’s
selection of categories the researcher could determine through frequency tables (computed
by STATCON - see Chapter 2, step 12: data management) what the interrater agreement
was (interrater agreement was discussed in step 14 in Chapter 2). This sample also filled
in a questionnaire designed to obtain feedback on how they perceived the new
classification system. The first draft was also presented to James Karls by the researcher’s
study
promoter,
and
Karls
provided
the
researcher with
feedback
via
email G-Sr
correspondence. Karls also provided feedback during his visit to South Africa (see Table
6.1 for time line of these occasions).
:J
Figure 6.2 further illustrates that the information gained from expert opinion, the^gx
questionnaire and interrater computations led to the refinement of the first draft.
The
researcher compiled the second draft, and three of the five respondents agreed to
implement the second draft on a number of case studies. The findings from the second
testing brought the researcher to a number of conclusions that will be discussed in this
chapter.
-
The rest of this chapter reports on the findings from the data gathering processes
discussed in this section, starting with a description of the sample.
6.4
Selected sample
Cod}
Since the sections that follow refer to the professionals involved during this study, it is r||||r
necessary to describe the sample at this stage. The sample was selected for the pilot
study, and three of the five respondents were also involved in the second pilot test. These SS
respondents were not only the raters whose scores on the ChildPIE© were used to
determine interrater reliability, they were also the professionals the researcher administered
the questionnaire to (after the first pilot study). Two of the three data sets were therefore
obtained from this sample. Those professionals who were involved in the study to a lesser^Sj
degree as part of the panel discussions will be referred to in the next section when the
feedback assemblage is given. Table 6.1 presents the profile of the sample used in this
study. The raters that have been highlighted (in blue) are the ones who were able to
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participate in the researcher’s second rater study as well.
TABLE 6.1 SAMPLE PROFILE
PROFILE:
Rater 1 (A)
GENDER
Fe^le
AGE
50
Years social
Rater 3 (C)
Rater 2 (B)
Rater 5 (E)
Rater 4(D)
Female
Female
42
28
18
19
6
T7”...
29
10
19
5
9
29
■
Female
Female
__
50
work experience
Years
experience with
children
Number if
5
3°
____
.
___
35
89
50
children on
annual caseload
Training in child
Ryana Ravat & Alida
Reactive Play
Reactive Play
Client-centered and
Play therapy
assessment
Herbst Play therapy
Assessment &
Assessment &
systems approach
course through
training (temperament)
Therapy
Therapy
Highest
Enrolled for Masters
M. Diac social work
Honours degree
qualification
_ ____________
Current
Marriage and Family
—
employment
clinic - own practice
department of
health
Private Practice
Honours degree
Diploma
___________ _
Boys Town
Supervisor of NG
Yusuf Dadoo
Magalies
Welfare Krugersdorp
Hospital
The selection criteria were met in this sample (step 13, Chapter 2). The social workers
were homogenous enough in that they came from the same geographical service delivery
area and were all women. They had sufficient experience; they all had some training in
working with children; they were close enough to the age category of 30 to 55, and they
were all women working in or around the West Rand. The one respondent who worked
outside the area had a lot of expertise in the area of measurement.
Her work involved
training in the West Rand, so she had sufficient knowledge of the work being done with
children in the area.
The premise underlying the limitation regarding practice area is to
control external influences such as different approaches to working with children in different
areas (for example, rural areas differ from urban areas). As explained under reliability in
step 14 of Chapter 2, other factors such as feelings can colour the interpretations made
when using the classification system.
The researcher therefore tried to find a group of
social workers who would not have strongly opposing views on working with children.
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The researcher experienced a practical problem in getting social workers to take two days
away from their practice to be trained in the ChildPIE.
In the end five practitioners were
able to participate for one day. The training had to be shortened, and the sample was only
able to work through 16 of the 29 case studies. This initial pilot study has already shown
some significant results about the validity and reliability of the ChildPIE©, as will be
discussed. A second pilot study then became feasible, since the researcher could make
use of the same trained sample, give them a more user-friendly and concrete manual that
they could look through in their own time, and give them a week in which to work through
all the case studies that needed to be focused on the child’s problem. (A large portion of
the family background of these studies needed to be excluded from the study since this
confuses the purpose of the child-only classification.)
6.5
Data results
Data analysis entails the breaking down of data into constituent parts to obtain answers to
research questions.
Finding answers from data implies the interpretation of the data in
order to explain it.
Data analysis means the categorising, ordering, manipulating and
summarising of data. This is done to reduce data to an intelligible and interpretable form so
it can be studied and tested, and for conclusions to be drawn. The simplest form of data
analysis is univariate analysis, which means that one variable is analysed, mainly with a
view to describing that variable.
This means that all the data gathered needs to be
summarised and displayed for easy comprehension and use.
This displayed summary
provides the researcher with useful information, and provides the foundation for more
sophisticated analyses at a later stage (De Vos and Fouche, 1998b: 203-204). The next
sections will describe the data in summarised and displayed form, and the researcher will
also indicate which data set is applicable.
This study has a mixed design; including elements of both qualitative and quantitative data
gathering approaches (see Figure 6.2). The next sections will present the results gained
from the researcher’s qualitative enquiries and the quantitative investigation in interrater
reliability. There were a number of qualitative sources, namely the feedback from the panel
discussions and presentations (see Table 6.2), a qualitative questionnaire during the first
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pilot testing, and expert opinion from James Karls (co-developer of the adult PIE).
6.5.1 Feedback assemblage
In step 14 (Chapter 2), two considerations were found necessary for the initial development
from literature, namely to prove an accepted measure of face validity (appears relevant to
users) and to use verification strategies (checking for biases in data).
The researcher
attempts to ensure face validity in two ways: firstly through a conceptual framework that is
viewed as applicable to social work (proof from literature that the common base for social
work is person-in-environment - Chapter 3); and secondly through using a format similar to
that of the adult PIE (Chapter 5). To build further validation into her process the researcher
presented her progress to colleagues (step 11, Chapter 2). The university’s requirement
for panel discussions provided the ideal vehicle to accomplish this. The researcher’s own
bias and assumptions about the theoretical base for this development were checked by the
objective attendants of her panel discussions.
The attendants included students, social
workers from practice (welfare organisations and private practice working with children),
and representatives from the university.
This feedback served another important function for the researcher. She wanted support
for her opinion that the social work profession needs a classification system.
A
classification system needs to be adopted by practitioners to be of any use, and this early
exposure of the ChildPIE© gave the researcher confidence in its possible future success.
Although the true focus of her data gathering was to have the ChildPIE© tested to
determine its reliability, she found all the participation in her developmental process to be of
value.
Table 6.2 gives a description of the progressive incidents where the researcher obtained
feedback from practitioners and academicians (the timeline can also be viewed with this
display).
Consideration of the timeline is helpful since the researcher made use of
feedback at various stages during the development and design process. To display a lot of
feedback in a sensible format, the researcher made use of a table and she combined the
data sets (see Figure 6.1). The table gives the date, the target group and method of data
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gathering, the length and the subject under discussion. The pilot tests are marked with an
asterisk (*); UJ stands for University of Johannesburg; and CPD refers to continuing
professional development points.
TIMELINE FOR DATA SETS
TABLE 6.2 FEEDBACK ASSEMBLAGE
Target group
Method
Duration
Subject
Start
Dr. Wim Roestenburg - study
Meetings, e-
Periodic
Research process, content
January
promoter and chairperson of
mail, and
of development and
2002
council’s ecometric committee
phone calls
requirements for academic
Date
achievement
24 July
Members from social work
Presentation
2003
department UJ and
and panel
and benefit to profession;
representatives from practice
discussion
and methodology and
2 hours
(5 attendants)
Motivation for the study
design
21 August
Members from social work
Presentation
2003
department UJ and
and panel
Psycho-social
representatives from practice
discussion
enhancement and
2 hours
Theoretical model part 1:
literature on childhood
(7 attendants)
functioning
18
Members from social work
Presentation
September
department UJ and
and panel
Context of child
2003
representatives from practice
discussion
assessment
2 hours
Theoretical model part 2:
(7 attendants)
12 February
Members from social work
Presentation
2004
department UJ and
and panel
classification system and
representatives from practice
discussion
operasionalising steps
2 hours
Requirements of a
(4 attendants)
25 March
Members from social work
Presentation
2004
department UJ and
and panel
representatives from practice
discussion
2 hours
First draft of the Child PIE
(psycho-social framework)
(4 attendants)
* 11 June
Social work practitioners
Workshop
2004
selected as sample
and data
8 hours
Childhood functioning;
ChildPIE framework;
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(5 respondents)
gathering
guidelines for use;
presentation of case
studies; rating and
completing questionnaire
on experience
4 to 10 July
Study promoter meets with
Feedback to
2004
developer of adult PIE in
researcher via
and theoretical model
Santa Barbara and presents
e-mail
supporting the
20 to 28
n/a
Discussion of framework
document written by
development - points of
researcher to present
clarification on role
development
framework
3 of the 5 respondents of the
Telephonic
August
previous rating agrees to rate
follow-up
2004
the adjusted ChildPIE
6
45 representatives from social
3 speaker-
September
work practice and members of
seminar
2004
social work department UJ
of the ChildPIE.
invited to a CPD accredited
Evaluation forms to be
presentation with Prof Karls as
send to participants to
international quest speaker
provide feedback
6
Researcher, study promoter
September
and Prof Karls
1 week
Feedback on definitions in
manual and suggestions
for improvement.
Meeting
3 hours
The future of ecometrics;
the PIE; and development
3 hours
Possibility of inclusion into
adult PIE; international
2004
support and cooperation;
necessity of funding for
future development
7
Researcher and Prof Karls
Meeting
2 hours
Problems with current
September
definitions; four-factor
2004
framework;
encouragement to become
project director of task
committee responsible for
refinement of ChildPIE.
A further summary of the feedback obtained from the occasions outlined in Table 6.2, are
given next. The researcher will, in Table 6.3, present the relevant feedback she received
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with an indication of how she incorporated it into her study. The feedback in this table only
includes that from the first data set.
6.5.2 Feedback from panel and meetings
FIRST DATA SET
TABLE 6.3 SUMMARY OF FEEDBACK
Feedback given
Actions taken by researcher
Received
from
Look at social functioning definition as
Panel
Took care in systematically developing a
underlying theory
discussion
conceptual framework - chapter 3
Busy with grounded theory as well
Panel
Included grounded theory in research
discussion
methodology (step 5, chapter 2)
Definite benefits for developmental
Panel
Support for study
assessment in child welfare
discussion
Courts need something they can
Panel
approve
discussion
Objectivity in testing can be obtained
Panel
Used small homogeneous group of specialists
through homogeneous group & video
discussion
in services to child & case studies from
Will need large reliability testing (post-doctoral)
case studies. Focus on specialist in
experienced social worker’s file - made no
child practice
changes to dynamics around child.
Too many theories to work together but
Panel
Used systematic process of arriving at
eclectic approach is good
discussion
theoretical base for development & advocate
person-in-environment as encompassing
framework
Gets too fragmented
Panel
Take out sections from chapter that does not
discussion
have the same focus - choosing logical flow
above total comprehensiveness (see brevity
under definition of thesis in glossary of terms)
Include street children
Panel
Covered it under runaway as behaviour problem
discussion
Look at learning difficulties & language
Panel
Included as neurological problem type
discussion
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How does social development get
Panel
Included description in glossary of terms and
addressed?
discussion
discussed small section in chapter 3 to show
compatibility.
Transcribe assessment framework into
Panel
Need is acknowledged for eventual user manual
guidelines for practitioners
discussion
when product completed (post-doctoral)
Should write article on assessment
Panel
Acknowledge need for reporting on study.
framework
discussion
Gave class to 4th year students at UJ
System will allow for early intervention,
Panel
Support for study
which is in child’s best interest (see
discussion
definition under social welfare in
glossary of terms)
Allow other professionals to also use
Panel
This will only be feasible if other professionals
the classification system
discussion
have similar goals in their approach to clients as
social work
May have trouble with theory in practice
Seminar
Made theory as focus for this study less
Seminar
System should be free-standing from
Meeting
Named it ChildPIE© to be marketable as classi
adult PIE
with Karls
fication system on its own. Will need to develop
factor 2,3&4 for child as well (post-doctoral) -
not just include with existing PIE
Should get a task force to help with
Meeting
Approach a number of key persons in childhood
development & sanction & support
with Karls
assessment to join the task team in post
system - between 6 & 12 members
doctoral refinement
Should get sponsorship & legitimacy
Meeting
Plan to present a proposal to the National
through showing there is sufficient
with Karls
Research Foundation to apply for their post
interest & that system will improve
doctorate development bursaries with proof of
assessment of problems to avoid
initial endorsement of the system.
incorrect decisions in care of child
ChildPIE© should be marketed as
Meeting
Will consider start in training to get support &
development / experiment
with Karls
improvement & not expect system to be perfect
before exposing it to practice
System must have explanatory piece at
Meeting
Realise initial draft should already have such
beginning - instruction sheet stating to
with Karls
instructions, since this thesis (see definition in
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identify role where problem presents
glossary of terms) is already exposure for the
and then to describe it
ChildPIE© - should be understood by readers
Be careful to inject theory - avoid word
Meeting
Theories got filtered through operationalisation
‘cause’ & to move into explanations
with Karls
process - use descriptions in’new form & not as
original theory explained it
Suggestions for definitions to avoid
Meeting
Rethink long definitions of initial design. Use
abstraction - it should describe, ask self with Karls
indicators to help focus on what is observed in
if it helps practitioner define problem
practice.
Move Affliction (emotional problems) &
Meeting
Removed the 2 problem types to include in
neurological problem type to factor 3
with Karls
factor 3 when rest of system is developed (post
doctoral)
Break conduct problem type into 2
Meeting
Go back to division found in literature & rethink
types
with Karls
categorisation & operationalisation
Should be comprehensive assessment,
Meeting
Supports researcher’s sentiment that umbrella
not agency driven
with Karls
approach should describe goal of assessment
while own methods are the ways to achieve
goal. Social workers should unite in language
The purpose of the above summary of feedback is to illustrate the influences that existed in
the development of the ChildPIE©. The researcher could not have attempted this on her
own.
This shows that she fulfilled her responsibility by involving practitioners in the
process. Some of the suggestions in the above table should be recognisable from previous
chapters, as the goal of developmental research is to incorporate findings into the design
as part of the study.
The second part of the first data set that included meetings and correspondence with an
expert is described next.
6.5.3 Feedback from an expert
The researcher was invited to accompany Dr. Roestenburg to an international conference
on multi-cultural diversity in Los Angeles, and then also to meet with Prof. James Karls on
the ChildPIE©. A presentation of the system to James Karls, the international expert who
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had co-developed the original PIE system, was of considerable benefit. His response and
support to the development are conveyed in Figure 6.3. The ideas Karls refers to at the
end of this email were previously listed in Table 6.2. Other email correspondence can be
found in Annexure 1.
FIRST DATA SET
■
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3mk.3rls@aol.corfi
Date:
10 Jdy2004 11:27 PM
To:
5wanzen@teltoms3.net
Cc:
wjhr@lw.rdu.ac.za
Subject:
rkiWDTF
ChildPIE
......................................■...............................................................................................
3
We had a very enjoyable visit with Dr. Rostenburg who gave me a copy of your ChildPIE paper. I did read it thoroughly and would
like to give you some of my thoughts. First I can see you have done a great deal of work on the subject and appear quite committed
to developing a PIE system for children. The paper I reviewed was fairly brief and does not give some of the thinking in deciding the
variable you chose for the assessment process. I understand from Dr. Rostenburg that you are submitting a more comprehensive
document to the faculty for your degree requirements. From the information I had in your paper I have some concerns. The major
one is that I do not see in the system you present the "biopsychosocial" base that is at the core of PIE. For reasons that are not
explained you did not use the PIE template in arranging your assessment framework. Do you explain this in your dissertation?
Another major point is your statement is that children do not have social role and therefore do not have social functioning problems
as in the adult PIE. This is not really so. Children have social roles from the moment they begin relating to the birth mother and
other care providers in infancy up to the time they leave the student role and enter the world of adult social roles. I do not see any
significant reference to what is Factor II in the Adult PIE, i.e., the social institutions that we have to provide help to children as they
move up the life cycle. Any reason for this? Your system show a mix of what are Factors 3 and 4 in the adult PIE in the parts you
have developed. I think that without separating out those elements that are mental fro physical that the user of Child PIE would have
a difficult time applying the instrument. I did have some conversation with Dr. Rostenburg about your paper and I hope he will share
some of his comments with you. I do plan to be in JohannesburgSeptember 3, leaving Septembers or 9.1 would enjoy meeting with
you to elaborate on rny views of your work and to see how we might get a ChildPIE completed and in operation, sincerely,
J. M. Karls
Bl
i
i
Si
■
FIGURE 6.3 E-MAIL CORRESPONDENCE FROM EXPERT
... J
1 Start!
..........
I
'■
• 4 Mkr V|O doktora
............. ..
■J ChildPIE My Dcaimente . .
u5-l«H
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It should be kept in mind that the initial ChildPIE© draft had been pilot tested by the time of
this correspondence (see time-line of data sets in Table6.2). It will become clear later how
the first draft changed from a psycho-social listing of functioning factors to a social role and
problem type system. The correspondence in Figure 6.3 played a significant part in the
researcher’s re-evaluation of the idea that it would not helpful to measure children’s
functioning against some external role expectation determined by the society in which the
child lives. She initially wanted a more objective assessment of the functioning of the child,
rather than a reflection of what role society believes he failed in (role expectation). While
considering how her identified assessment areas could fit into the role framework of PIE,
she began to understand that the social role within the classification area merely describes
the area in which the child has functioning problems, and that the degree in which societal
expectations influence the assessment depend on the practitioner using the system and not
the classification itself, provided that the role definitions stay culturally sensitive. She then
re-evaluated the descriptions of the adult PIE against the literature on psycho-social
functioning, and realised that this model could still provide descriptions of the intra-and
interpersonal intricacies (see definitions in glossary of terms) of the child’s fit with the
environment if it were described in the problem types index (similar to the adult PIE). This
reasoning helps to understand the content of the correspondence in Figure 6.3.
Moving away from psycho-social listing also supports not subscribing to a school of thought
that can invite criticism from other schools. The researcher shares Karls and Wandrei’s
(1994) sentiment that the use of role does not mean that the system adheres to role theory
- it is the operationalised ‘place’ where the person interacts with his environment. The use
of person-in-environment as a unifying construct was supported in the discussions in
Chapter 3.
A discussion with Dr Roestenburg helped the researcher clarify how psycho-social theory,
while seemingly the same, differs from person-in-environment descriptions in practice. The
researcher's realisation of the significance of this distinction has meant that this study is
able to make an essential contribution to social work as a profession.
This realisation
served to distinguish this development from the broad psycho-social assessment
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framework which we as a profession essentially share with psychology. This assumption is
based on Turner’s (1987) explanation of the psychosocial paradigm in the Encyclopaedia of
Social Work:
It has been and continues to be greatly influenced by psychoanalytic theory and the later
developments of ego psychology. It has incorporated knowledge from systems theory and
from ecological theory, communication theory, role theory, family theory, small group theory,
and cognitive and behavioural theories.
Crisis theory has also become an important
component of the system’s theoretical base. In addition psychosocial theory has incorporated
material from the social sciences in such areas as class, ethnicity, race, religion, and values.
This approach has emphasized the synthesis of knowledge of the human condition regardless
of source or orientation. This integration has lead to the enrichment of knowledge of the
person-in-situation paradigm.
Rubin and Babbie, 1993: 47.
To avoid endorsing an approach that is build on psycho-analytic theory, it makes more
sense to extract from psycho-social theory its contribution to the person-in-environment
construct, and to focus on ‘purer’ approaches to social work. It is interesting that, although
person-in-context was a term used by Mary Richmond in the early 1900s (see history of
social work in Chapter 3), the literature seems to show person-in-situation as coming from
psycho-social and systems thinking. The relevance for the study at this point is that some
confusion of terms and approaches may exist in practice which the person-in-environment
classification system may help to clarify.
It is easy to confuse paradigms that closely resemble each other when looking at new
interpretations given to a theoretical model (Karls also speaks of the PIE system’s bio
psychosocial base).
Social work’s tendency to use a synthesis of existing theories also
became evident during the first pilot trial of the development (this was seen as a positive
aspect by a member in the panel discussion, see Table 6.3 - eclectic). This lack of clear
boundaries seems to confuse social workers as to the role they play in the bigger context of
helping. In the course of developing practice models for organisations, the researcher has
had managers admit that they cannot measure or respond to the effectiveness of practices
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because of the diverse methods used by social workers.
There is a lack of common
objectives in practice.
By keeping the development within a person-in-environment framework, the researcher
believes that she is developing a tool that is of more use in social work’s area of expertise,
and confirms the sentiment of the task committee and developers involved in the
development of the adult PIE - that the tool should assess the role functioning of the client
within the context of a social system that supports this functioning. The developers of the
adult PIE provided an answer, in the form of a technology, to what Turner had highlighted
in 1987 (Rubin and Babbie, 1993: 47-48): that the profession’s understanding needs to be
expanded to include the complexity of interrelationships among social systems and the
effects these have on clients, the setting in which services are provided and its differential
impact on clients, the client’s and worker’s ethnic identities, the environmental realities in
which clients live, the political climate of the times, and how these variables help or hinder
individuals, families, and groups in achieving their goals.
Karls’ feedback is consistent with the aim of the classification system. Having to focus on
social interaction and on developing a multi-factoral system meets the needs for a holistic
assessment that describes the areas of the problem that is of relevance to social work. His
insistence on using social role and systems that help the child function within this role
supports the concepts of niche and habitat (ecology), which describes the person within his
environment. For the researcher to be able to state that she developed a system from the
foundation of person-in-environment, she had to adhere to the feedback from Karls.
In
order to meet the requirements for offering the ChildPIE© as a unifying construct, the
researcher also had to acknowledge the feedback from the sample that tested her system.
The qualitative feedback proved valuable in the refinement of the ChildPIE©.
Another aspect of the development of the ChildPIE© that were addressed through
correspondence with the expert, was what place the ChildPIE© will have with regard to the
existing PIE. The domain of the study which limits the development to one factor (social
role functioning), was initially motivated by the idea of incorporating the child’s social role
functioning as Factor 0, to be included before Factor 1 (the adult social role functioning of
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the existing PIE). Following Karls’ suggestion to develop a free-standing childhood system
(see Table 6.3) given that there seems to be a strong need for one, the researcher could
still only develop one part of the classification system in this study.
It was also realised
that, should the childhood social role functioning be included in the existing PIE, this would
have reliability implications for the adult PIE since a major change would have been
brought into the system which could effect its current reliability.
6.5.4
Feedback from the questionnaire
The sample was asked to complete a questionnaire after they had been trained in the
system and after they had applied the system to selected case studies.
The aim of the
questionnaire was to evaluate their experience of the ChildPIE©.
(A copy of the
questionnaire can be viewed in Annexure 3). Their responses have been tabulated below:
SECOND DATA SET
TABLE 6.4 RESULTS FROM QUESTIONNAIRE
Qualitative question
Select critical areas in
child assessment &
process
Gaps or challenges in
service delivery to
children
Is there a need fora
tool that classifies
problems in childhood
functioning?_______
Would the use of
categories help to
identify needs and
plan effective
intervention?______
What problems do
you foresee in social
workers using a
Respondent B
answer
Determine
developmental
needs; teaching
parental skills;
teaching social
skills
Respondent C
answer
Promoting growth;
statutory
representation; find
suitable placement;
networking for
services; initiate
community projects
Respondent D
answer
Determine
developmental
needs; statutory
representation;
teaching parental
skills; crisis
intervention
Respondent E
answer
Family therapy;
teaching parental
skills; manage
problem behaviour;
networking for
services; crisis
intervention
Limited resources;
court not child
friendly; counselling
& therapy______
Yes
Little time for
therapy; effective
handling of
problems_____
Yes
Counselling / play
therapy-the child’s
inputs in his situation
Yes
Sufficient
experience &
training. Work
unstructured
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Not wanting to
make the time
Subjectivity
Respondent A
answer
Determine
developmental needs;
family therapy; statutory
representation; teaching
parental skills; teaching
social skills; manage
problem behaviour;
networking for services;
crisis intervention
Police and court system
not child-friendly
Won’t use it
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classification system?
Was most of the
theory known to you?
I Specify theories
j unknown to you
Yes
Yes
Yes
Yes
Yes
Attachment theory
Some I can’t
remember
Some information
was new
Some unknown
I What theoretical
| model do you
' predominantly use in
I practice?_________
Keirsey Temperament
Reactive play &
Gestalt
Reactive play
Some new theories
unknown, must be
followed up with
training________
Gestalt
Is the classification
compatible with this
model?__________
What would you like
to see included in this
system?
Yes
Yes
Yes
Yes
To distinguish
between physical and
emotional neglect
Unsure
Is there any part of
the theory you feel
should not be used
by social workers?
Does the prospect of
having a something
similar to the DSM IV
in social work excite
you?____________
Was the classification
system easy to
administer?_______
I Was the classification
i very time consuming?
I Did you find the
i descriptions in the
I user manual
j understandably
clear?___________
Do you think this
system truly
measures the
functioning of the
child?____________
What is your overall
impression of the
classification system?
No
Very
comprehensive
- includes a lot
of theories
No
Yes
Yes
Yes
Client-centered
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Yes
No
Yes
No
Yes
(too little time to
cover, but very
practical)
No
Yes
Yes
Yes
Yes
Yes
Yes
Very usable. Training
necessary
Enables you to
work more goaldirected
Excellent resource
for social work
profession that can
be used as a reliable
measure in court
Very good model
Still a bit confusing,
but probably because
of limited time for
training
The information gained that is of most significance to the researcher, is that all five
respondents agreed on the following:
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■
There is a need for a tool that will classify social functioning problems in children and
that the system actually does measure the child’s functioning.
■
Most of the theory (themes) represented in the system was known to them. They
were familiar, on the whole, with the person-in-environment approach.
■
The majority of the respondents felt that a theoretical foundation should be used in
social work.
■
With the exception of one respondent who did not answer, all felt that the system
was compatible with the practice model they use.
■
All agreed that the system measures the functioning of the child.
■
All the respondents were extremely positive at the prospect of having a classification
system that will do for social work what the DSM system did for psychiatry.
The researcher included questions regarding the underlying person-in-environment
approach (that is represented by the themes used in the system) in an attempt to establish
support for her premise that all social workers are involved at the place where the client
meets his environment. This also provides some support for the face validity of the system,
in that it seems to measure precisely what social work practice requires. The respondents
replied positively to questions such as "Does it truly measures functioning?". This shows
that they felt all the aspects were sufficient to describe the functioning of the child. Proving
whether it actually does this is a question of construct and criterion validity (see definitions
under validity in glossary of terms), but for the purpose of this study there is some evidence
that the system is viewed as a valid reflection of what it is intended to measure.
A lack of agreement among the respondents existed with regard to the following:
■
One person said the system wasn’t easy to administer.
■
Two respondents said that the system was time-consuming.
■
And two said the descriptions in the manual were unclear.
From the feedback the respondents gave on their impression of the system, the
researcher’s opinion that training is crucial to the credibility of the ChildPIE©, has been
confirmed. Both the validity of the system and the consistency with which raters will rate
cases is as dependent on the framework of items as it is on the accuracy and clarity of the
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accompanying manual. It was interesting that one of the theories noted as being unknown
to one of the respondents was attachment theory. It will be highlighted in the discussion of 1—
the first pilot testing that the code for attachment was frequently used. This supports Paul's j
(1995) argument regarding the clarity of a definition (Chapter 4). Even if the respondent did
a.
not agree with the definition, she would be able to use it correctly provided that it was
clearly expressed and understood. The fact that bonding was used so often could mean
that its definition was clear (see the regular use of code 021 in Table 6.5). This reflects to
some extent on the success of researcher’s operationalisation process.
The respondents’ answers during the one-day workshop and their subsequent questions | -.:
if
conveyed a genuine interest in the ChildPIE©, and they made suggestions in an attempt to
solve possible implementation problems.
These suggestions were not captured by theCg
questionnaire, although they influenced the adjustment of the design as the inappropriate /
J
exposure a parent allows to influence the child was subsequently included as a form of
abuse (see abuse index, Chapter 7). This was also consistent with literature on domestic
gjS
violence (see Chapter 4).
6.5.5 Interrater reliability
Using two or more independent observers to collect data at the same time helps to ensure
the reliability or replicability of the findings.
As a general rule, levels of inter-observer
agreement of 80% or higher suggest that the instrument is consistent over time (De Vos,
1998b: 397).
I
: If
The purpose of the interrater tests can be viewed as a test-retest procedure (see Chapter (g)
2, step 14). To determine reliability in a measurement tool it needs to be proven that the
tool will produce the same result if it is used on the same subject again.
If the tool is
reliable, the changes in scores would be attributable to changes in the subject. This is what
is needed in measurement technology in social work. The social worker wants assurance (dto)
that the changes shown by the measurement are the result of intervention in the client’sc^||||
life, and not the result of the tool's inconsistency.
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In using different raters to use the same measurement (ChildPIE©) on the same subjects
(case studies), the researcher is allowing the tool to be retested. Since the differences
among the raters could have an influence on the ratings, it was necessary to keep the
group as homogenous as possible. This was an attempt to control the variables that could
influence the ratings, showing poor reliability because of external influences and not
inconsistencies in the measurement tool.
The third data set therefore involves all the quantitative results obtained from two interrater
tests done on two initial drafts of the ChildPIE©.
In order to objectify the testing, the
researcher made use of real case studies from practice, given by a credible social worker
with more than ten years' experience in child welfare at the Department of Social
Development and as a social worker in private practice.
6.5.5.1
Results from the first pilot test
When initially planning her test procedures (cf. determining the application procedure - see
Smit (1991) in the introduction to this chapter), STATCON advised the researcher to use at
least three raters and around 30 case studies.
It was important to have enough case
studies to cover all the possible options in the classification system. The researcher asked
an experienced, senior social worker for real case studies from her caseload, and she
provided the researcher with 29 that were diverse enough to attempt to cover all the
options in the classification system, especially since multiple problems were present. This
is one of the reasons for the inclusion of primary, secondary, and relevant problem
classifications in the sample (refer to the index given below Table 6.5 - proposed by Karls,
see Annexure 1). In the case of the first pilot test the time was limited and the raters only
managed to rate 16 of the 29 case studies.
This first draft in Figure 6.4 was developed using the first categorisation of social
functioning items. It was a broad spectrum listing that included the psycho-social aspects
identified by Faul (1995): ‘unmet needs’ as they relate to the child’s development and
relationship with parents/caregivers, emotional difficulties, conduct disturbances, delinquent
offences, and neurological deficiencies.
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The problems listed in Figure 6.4 were included on the premise that they affect the child’s
ability to function optimally in relationships and in broader society. The inclusion of the
indexes.(except for the developmental stage one) has already been discussed in Chapter
5. The purpose of the developmental stage index is to show in what developmental stage
the child falls at the time the problem occurs. A broader description of this index is given
in Chapter 7.
The first pilot test involved the testing of the first ChildPIE© draft.
In
hindsight the researcher can see the problems with this design as became evident in the
course of feedback from the expert. Nevertheless, the respondents reacted favourably to
the classification system. This response is probably more the result of seeing a system
that can be applied to current practice, than being convinced at this early stage, of its
reliability.
If the researcher now considers the question of face validity given in data set two
(questionnaire), she is left with a question regarding what social workers in practice
perceive social work with children to be. The respondents all answered that the system
truly measures social functioning.
The researcher initially regarded the influence of
neurological and physical aspects as part of social functioning. She has since recognised
the need to differentiate clearly between these aspects on the grounds that, although they
influence social functioning, the focus should be the dynamics of relational factors, with
only recognition of aspects that form part of the speciality field of other professions. The
researcher initially reasoned that the system (with the psycho-social listing) would help
identify problems that need referral, but found that the focus shifted to social functioning
after re-examining the conceptual framework and social functioning categories (Chapter 3
and 4).
In other words the researcher became aware that it is essential to have the
system focus on the expertise within social work, and not to focus on other disciplines.
The qualitative results of the first pilot study revealed the necessity of questioning what is
perceived as social work practice should be raised. It seems likely that social work in
literature and social work in practice may differ, which reinforces the need for a
classification system to unify social workers. Table 6.5 below presents the raw data of
the codes as selected by each respondent for each case study.
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THIRD DATASET
TABLE 6.5 CODING OF 1st INTERRATER STUDY
CASE STUDY NUMBER:
Rater
Problem
A
Primary
1
6
02^ 125~~ 131"
___
023
043
Seeon(w 036
121- 033
044.
036
041
Relevant
023 ?
023
3
023
Relevant
7
8
fQ 036 7
051" 023
034
12
13
14
19
22
25
26
27
025 ?~|HH
Hi
056
056
023
044
056
043
025?
023
034?
036
037?
034
025
025
03??
021
131
021
022?
035
067
121 136
033 ?
044021? -021“ 021
___
035? ' 016
022
023
022
' 035 ?
033 ?
023
043
02?“- 025
023 ?
021
043
035?
036
013
021
021
021
021 ?
023.
021?
036
023?
023
176
025 ?
035 ?
022
013
064?
131
025
033
031
023?
016
023?
023?
036
034
037?
022
025
022?
025
"021
021?
025 ?
021 ?
041 ’
022
021. . 021
IB
____
025 ?
035 .
037?
021 ?
064 ?
Bi
033 ?
022?
053
038
038
.^sss/?022' *
■i
Wi
015
021?
022? ■031?
033
031 ?
035
067
052
035 ?
036?
023
021?
035
015
______
035
054
041-
031
’ 031
033 /
021.
021
025?
041'
025?
023
023
021 ?
Relevant
031
1038^
. 023.....
12F~ 022?
025 ? " 021?
Primary
021
041
Secondary
031
Relevant
0T5
Prirn3fy
Secondary
Secondary
Relevant
-
023 ?
023 ?
.
023?
052?
035
043
031
043
023
033 ?
035 ?
051
031
021?
024
036?
035
023
025
033 ?
016
023.... 038
036?
025
025
w
038
023?
C
E
4
5
B
D
2
034
023?
025 ?
021?
052?
032
133
052?
023?
131
125
034?
014
023?
133
016
Primary = problem that needs immediate attention (crisis intervention)
Colour matching shows agreement on case studies
Secondary = less serious but needs follow up
? shows agreement but not given same priority by raters
Relevant = underlying problem that needs attention in the long-term and continuous monitoring
(overall agreement)
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I
From the raw data in Table 6.5, only case study number 6 showed agreement among
all the raters on the primary problem. Four respondents showed agreement on case
studies 1, 3 and 8, and three respondents agreed on case studies 4, 7, 14 and 19.
Another observable tendency from the raw data is that the code 021 was often
selected (even by respondents who did not subscribe to a play therapy model that
assesses bonding). For this pilot study 021 presented bonding as a problem. This
provides some evidence that bonding is relevant to social work and that it was often
viewed by the sample as a relational problem.
Since the refined ChildPIE© with
adjusted codes and definitions will be presented in the next chapter, the researcher
did not give the meaning represented by every code in Table 6.5.
Part of the
validation of data (interpretation procedure) is to be on the look-out for extreme cases
and to reflect on them. She cannot, however, make any causal linkages since most
observations do not equate to evidence (see salience under ‘a to z’, step 14, Chapter
2).
According to Cooper (1989), the categorisation, ordering, manipulation, and
summary of data provides a means of obtaining answers to research questions (see
data analysis step 12 in Chapter 2).
The student consultant from STATCON at the University of Johannesburg computed
the raw data in Table 6.5, and Table 6.6 below gives the frequency analysis the
researcher used to determine the interrater reliability.
THIRD DATASET
TABLE 6.6 FREQUENCY ANALYSIS
INTERRATER AGREEABILITY COUNT
INTERRATER AGREEABILITY
SCORE:
.. .....
3
2
0
4
5
Total
Count Count Count Count Count Count
Number of raters with same
primary classification
3
3
6
Number of raters with same
secondary classification
4
10
2
Number of raters with same
relevant classification
7
9
Number of raters with same
overall classification
3
1
16
16
16
6
7
3
16
The frequency table above points out that there was more agreement between raters
on the primary problem type, and no significant agreement on relevant type. In the
overall classification, where raters had the same classification codes but allocated
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these different priorities with regard to primary, secondary and relevant, the
agreement was very high.
The percentage of agreement on the primary problem, which essentially is the first
problem the practitioner will be treating, is 62.5%.
This percentage reflects the
majority of agreement, meaning that out of 10 (6+3+1) of the 16 case studies, at least
three of the five raters agreed on what the primary problem type is. This percentage is
reduced if you only consider the number of case studies all five raters agreed on (3
out of the 16 cases). According to Rubin and Babbie (see step 14, Chapter 2), 70% to
80% is needed to show strong reliability. The average percentage of interrater scores
for the first pilot test was therefore too low to be considered reliable. This first part of
the third data set, shows the classification numbers chosen by each respondent and
the frequency tables of these selections done in the first pilot study. The second part
of the third data set similarly presents the quantitative data of the second pilot test.
6.5.5.2
Results from the second pilot test
From the feedback obtained through the questionnaire and the guidance from Karls
and Roestenburg (see previous discussion under section 6.5.3), the researcher
developed a second draft to address the following shortcomings in order to increase
interrater reliability in a second testing:
■
Transcribe childhood social functioning from a psycho-social listing to social
roles and descriptive problem types by re-categorising the elements of the
conceptual framework.
■
Shorten the classification system where possible to make it less time
consuming.
■
Make the definitions for each theme in the classification system more
descriptive in order to make it easier to administer.
With regard to the application procedure, the researcher made three changes to
counteract the adverse effects of lack of time in the previous procedure:
■
Let the respondents implement the system in their own time in order to finish 25
case studies.
Give clearer directions to ensure that the respondents understand the
definitions. Select the role type problem and describe it with the problem type
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' I
indexes - focusing only on role type and problem type. (Although the
respondents were free to use the other indexes such as the abuse type,
duration, severity, and coping indexes; these were not included in the interrater
reliability computing.)
The researcher excluded four of the case studies that she considered to be too
long and possibly confusing. Since she could not explain the case studies to
the respondents and thereby possibly influence their choices, the researcher
chose not to include confusing case studies that might adversely affect the
interrater score.
Further smaller changes made to the ChildPIE© after its initial testing were:
■
To move the developmental stage index to the top of the system and use letters
in alphabetical order to indicate the stage; and to use the stage (?) as the first
letter of the coding (see the discussion on coding in Chapter 7).
■
Create another type of abuse that includes a form of abuse against the child by
his peers.
Figure 6.5 on the following page shows the second draft of the ChildPIE©.
Since
significant changes were made to the ChildPIE© when the researcher switched from a
psycho-social listing to social role with problem types, it was necessary to do another
pilot test on the adjusted version.
When the researcher approached the sample
respondents to test this version, three agreed to take the manual and implement it on
25 case studies in their own time and return it after a week. Their previous training on
how to utilise the system was found to be sufficient for this test, with the researcher
having provided them with new descriptions and being available for questions about
the new draft.
Since the researcher removed some of the case studies, the case
study numbers of the two different sets of test results cannot be compared (the first
pilot test was also done on only 16 of the case studies selected before the
commencement of the first pilot test). The ChildPIE© drafts used on the case studies
were also different and could not be compared.
For future reference it would,
however, prove useful to keep all test findings in order to build data to be used for
comparative analysis.
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k /
FIGURE 6.5 ChildPIE© USED IN 2nd INTERRATER STUDY
(social role)
Child’s Name:
Z
Child’s D.O.B.:
Caregiver’s Name:
Contact number:
J.
Interview date:
FACTOR 0: CHILD SOCIAL FUNCTIONING PROBLEMS
Evaluator:
INDICATE CHILD’S DEVELOPMENTAL STAGE
[b| Three to Six years
[a] Infant to two years
__
.
[d| Thirteen to eighteen years
§ Seven to twelve years
__ ____________ _
□URAT.OH
CODE
01. FAMILIAL ROLES
™uese
PROBLEM'
TYPE
ABUSE
I STRENGTH
RECOMMENDED INTERVENTION
011
? Natural child
S|S)12
7 Surrogate child
? Sibling
013
? Caregiver (role reversal)
014
? Relative
015
? Other (specify)
01®
>E
02. OTHER INTERPERSl
ION
OURATK
STRENGTH
RECOMMENDED INTERVENTION
021
? Playmate
? Friend^^^^^^
? F
PROBLEM
TYPE
-■
tner (girt/boyfriend)
022
■
023
■-
1
— __________
?pufM,
025
? Otfiei (specify)
027
r
_________
CODE
03. SPECIAL LIFE SITUATION ROLES
PROBLEM
IYpE
ABUSE
TYPE
DURATION
STRENGTH
RECOMMENDED INTERVENTION
0311
? Special care recipient
(332
? Juvenile
033
? Other (specify)
034
TYPE OF SOCIAL INTERACTION PROBLEM
TYPE OF ABUSE
01 Inhibition
03 Milestone delay
05 Performance
07 Loss
09 Conduct
11 Other (specify)
1 No Maltreatment evident
2 Ineffective discipline
3 Inappropriate exposure
4 Neglect
5 Emotional insult & threats
6 Intimidation (peers)
7 Physical harm
8 Sexual Violation
02 Routine
04 Pro-sociability
06 Goal-direction
08 Affliction
1 0 Neurological
complications
-■
■
DURATION OF PROBLEM
■
1
1
1 More than five years
2 One to five years
3 Six months to one year
4 One to six months
5 Two weeks to one month
6 Less than two weeks
I
COPING STRENGTHS
1 Outstanding
3 Adequate
5 Inadequate
2 Above average
4 Somewhat inadequate
6 No coping strengths
|
PRIORITY CODE:
P-Primary S-Secondary R-Relevant
© 2004 ChildPIE Rika Swanzen
The results of this second testing are illustrated in Table 6. 7, which shows the
classification choices made by the raters on the 25 case studies. There were too
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many case studies to include in this chapter. To illustrate two of them and to illustrate
how the ChildPIE© can be used, the researcher is including a practical sample
towards the end of Chapter 7. Table 6.7 presents the raw data from the second pilot
study, and the tables following this illustrate the statistical agreement among the
codes selected by the three different raters on the same case studies.
THIRD DATASET
TABLE 6.7 SECOND INTERRATER STUDY CODES
CASE
STUDY
1
2
3
_4_
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
RATERJ_________ ________ RATER 2
Problem type
Problem type
Social role
Social role
011
011
024
024
023
011
012
031
011
011
013
012
031
033
011
032
011
011
013
012
013
012
011
011
011
07
06
09
02
01
02
01
06
07
08
02
05
09
06
01
03
03
01
05
01
04
03
07
01
06
025
013
024
012
012
011
012
026
012
011
011
012
031
033
012
011
011
013
014
012
031
011
024
014
012
05
06
01
02
07
02
09
09
06
07
05
03
09
09
03
10
03
06
08
08
10
01
09
08
RATER 3______
Social role Problem type
011
08
011
01
024
04
012
02
022
06
011
02
012
01
026
09
011
07
08
011
05
031
012
03
031
01
023
01
012
01
011
10
03
011
015
02
015
06
012
02
012
08
011
10
07
011
10
011
011
08
What was relevant about the data the researcher received back after the second
testing is that all the respondents in the first pilot test used the category names and
only one tried to give the codes, but in the second pilot test all three respondents only
used the coding system (explained in Chapter 7). This gave the researcher some
positive indication of increased confidence in the system.
The respondents had
voiced their uncertainty with regard to the coding during the first pilot test, but became
more familiar with the system during the second test. The researcher suspects that
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having time to study the system allowed them the opportunity to discover that the
coding is less troublesome than was initially presumed.
Another observation from the raw data is that this time there were two case studies in
which all three respondents agreed (case studies 6 and 17). Two raters agreed on
case studies 4, 7, 8, 9, 10, 12, 13, 16, 22 and 23.
At face value the interrater
agreement was much higher in the second test than the first.
Table 6.8 and Table 6.9 below illustrate the frequencies STATCON computed for the
social role and the problem type. The frequency for the first test was done on the
number of case studies (since the first draft could be viewed as a problem list),
whereas the second draft required data analysis on two levels of classification: the
respondent first chose the role in which the child has a problem, and then selected the
type of problem that existed in that role.
TABLE 6.8 FREQUENCY TABLE FOR SOCIAL ROLE (2nd RATER STUDY)
Number of cases
SOCIAL ROLE TYPE
Number of cases with same classification by 3 raters________ 8_____________
Number of cases with same classification by 2 raters________ 12____________
Number of cases with different classification by all raters______ 5_____________
Number of cases where at least one rater did not give a rating 0_____________
25
Total case studies
TABLE 6.9 FREQUENCY TABLE FOR PROBLEM TYPE (2nd RATER STUDY)
PROBLEM TYPE_________________________________ Number of cases
Number of cases with same classification by 3 raters_______ 3
Number of cases with same classification by 2 raters_______ 14
7_____________
Number of cases with different classification by all raters
Number of cases where at least one rater did not give a rating 2_________
Total case studies
25
8TATCON advised the researcher to consider the total number of cases with the
same codes by 2 and 3 raters, since 2 out of the 3 raters still showed interrater
agreement. The raw data given in Table 6.7 reflected that, at times, all three agreed
on the social role but differed on the problem type. In her interpretation of the results,
the researcher has to account for variable differences between the three raters that
she could not control. There may have been external influences on the classification
decision that do not reflect on the reliability of the ChildPIE©.
The researcher
calculated the percentage of the total agreement on case studies, including those with
agreement among 3 and 2 raters. In doing this she found the following:
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Social role: (8+12)/ 25 x 100 = 80% = high interrater reliability
Problem type: (3+14) / 25 x 100 = 68% = low interrater reliability
The problem types showed low interrater reliability. The researcher is of the opinion
that this might be attributable to overly lengthy definitions, and she reconsidered the
operational process in order to get clearer indicators of the presence of the problem,
and so to further clarify the definitions. This will be applied to the definitions discussed
in Chapter 7. Roestenburg suggested the use of an external coder and/or the use of
software to check for objectivity and to get new ideas. This suggestion is consistent
with the validation strategies the researcher built into this study (‘a to z’), and this will
be regarded as essential in any further developments on a post-doctoral level.
The researcher learned a great deal from both these designs and from all three data
sets. A summary will be provided next of the changes implemented based on the
research results.
6.6
Adjustments made on the basis of test results
Both the drafts used in the two pilot tests served as valuable contributors to the study.
Errors are instructive: the results of full field testing are used to resolve problems with
the measurement system and intervention. Adaptations in the language, content and
intervention methods may produce desired behaviour changes and outcomes for the full
range of intended beneficiaries.
Repeated tinkering with the intervention helps to
ensure that it will reliably produce intended effects.
Rothman and Thomas, 1994, in De Vos, 1998 b\ 398.
This section highlights the changes made to the ChildPIE© as it is presented in
Chapter 7.
The researcher also indicates the changes made to the classification
system in green in the next chapter. These changes are based on feedback from the
three data sets mentioned at the beginning of this chapter. Two types of changes
occurred.
Firstly, to increase face validity and the perception of usefulness of the
system, the researcher made changes to the system based on qualitative feedback
from the five raters.
Secondly, since the second rater testing showed insufficient
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reliability, the researcher had to assume that a random error had occurred.
She
concluded earlier in this chapter that the definitions may have been unclear (this was
also suggested in the questionnaire completed after the first testing). She therefore
reconsidered the problem types, focusing on simplifying them even further.
Change Factor ‘0’ to ‘1’. This implies that the remainder of the factors will be
developed in their own right, and will not only be incorporated as Factor 0. (This
initial idea to incorporate the childhood version into the existing PIE would have
created validity and reliability issues for the PIE; see Prof. Karls' opinion in
Table 6.2.)
■
Shorten the descriptions under problem types, and focus on what indicators are
needed for the social worker to identify the presence of the problem in question.
■
Remove neurological complications from the problem type index to form part of
Factor 3 (mental health) in post-doctoral developments.
B
Split the conduct problem type into two types of behavioural maladjustments,
namely oppositional deviant behaviour and conduct disturbance. The purpose
of this is to differentiate between alarming behaviour and that of more serious
nature (which has legal consequences). This is a change the researcher would
first want to test against more opinions, since it may be unnecessary to list
problems of a less serious nature.
■
Remove the ‘affliction’ problem type (see first index in Figure 6.5) since it refers
to emotional problems that will fit better with a mental health factor (post
doctoral development).
E
Include ‘goal-direction’ problem type under the ‘performance’ problem type.
Since another change has been made to the ChildPIE©, the draft in Chapter 7 cannot
be regarded as having been tested for reliability, but can be viewed as an improved
version because of the interrater reliability studies done on the previous drafts.
Chapter 8 will give recommendations on further development of the ChildPIE©.
6.7
Summary
This chapter described how the researcher obtained information through qualitative
feedback and through interrater reliability. After implementing suggested changes and
responding to problems highlighted by the first pilot study, an overall improvement in
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reliability was shown in the second pilot study. A pilot study gives the researcher a
chance to test her procedures on a smaller scale.
In this study it did provide the
researcher with an opportunity to adjust aspects in her application procedure, and it
provided her with information to use to refine the ChildPIE©, which is the goal of the
Adapted Design and Development Model.
The less threatening pilot studies provided the researcher with the opportunity to first
reflect on the difficulties in development and in reliability testing before conducting
large scale testing. What she would have done differently in retrospect is to have
made
use
of an
external
coder or a
software
program
to
objectify her
operationalisation process. Since the definitions of the categories are so crucial in the
accurate use of the ChildPIE©, the researcher would have done well to have external
validation for her decisions with regard to the inclusion and the selection of indicators.
It is expected that a development of this magnitude will be submitted to frequent
changes, and the researcher was encouraged by the response it has elicited at this
early stage. The interest shown thus far and the specific suggestions for improvement
not only suggest that there is a strong possibility of further support, but also shows
that the social workers exposed to the ChildPIE© so far, have had sufficient
understanding to have insight into what would make the system more useable or
applicable.
Overall, then, reliability will be improved through clearer definitions. For this study, the
definitions for the problem types will be revised and, in the continued development
following this study, more expertise will be needed to adjust the system to suit current
practice. The researcher will need to pay closer attention to the raters' understanding
of the definitions, and ensure that the case studies used to implement the system are
not ambiguous.
The next chapter presents the refined Child PIE©: its instructions for use, its design,
and its definitions. But first Figure 6.6 on the next page gives an illustration of how the
validity and reliability were handled in every phase of the Adapted Design and
Development Model, with suggestions as to how the insufficient reliability should be
addressed. Figure 6.6 provides an overview of how the next steps fit into the design
and development process. The horizontal bars represent the different phases, with the
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major actions presented in blocks. The vertical bar shows that the reliability was found
not to be sufficient, and the blocks on the right of this bar list possible actions that
could help to increase the reliability of the ChildPIE©. These blocks on the right form
the basis of the recommendations given in Chapter 8. Figure 6.6 thus illustrates, step-
by-step, the process followed in the development of a valid and reliable classification
system.
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PLANNING
■
Explore methodology & Adjust
Grounded theory - Person
Literature review on childhood social
design
in-Environment
functioning
n
s
u
DEVELOPING
■“f
Organise through use of
List & categorise
Social role & problem types
critical thinking & SRS
psychosocial design
design
Separate development of
physical & mental health
c
aspects from problem types
IJ
STANDARDISATION
_________________
-en
Explore possibility of study
worthiness & interrater agreement; analyse qualitative
i t
audit. Refinement by task
judgements on theoretical framework & tool (content)
rj
committee
Preceding administration: Control of bias &
Post-administration use of data: Determine trust
conditions for interrater-reliability testing; sensitive
data management & ensuring trustworthiness.
■ r
______
TESTING
e__
____
1bl pilot study on psycho
Qualitative questionnaire on
2nd pilot study on social role
social framework
practitioners’ opinions about design
and problem type framework
■ i
coding of childhood social
b
Approximately 60% interrater
Positive reaction to concept of
Approximately 80% interrater
reliability (highest on primary
classification system and description
reliability on social roles; agree
problem)
of childhood functioning problems
ment on problem types poor
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.
functioning literature
FINDINGS
FIGURE 6.6 RESEARCHER’S PROCESS
Independent & computer
I
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H'
326
!.
y
Bigger scale testing on
final completed product
i i
Chapter 7
The ChildPIE©
Just because something doesn’t do what you planned it to do doesn't mean it's useless.
- Thomas A. Edison (1847 - 1931)-
7.1.
Introduction
This chapter is the product of the accumulative development of this study. The previous
chapters helped to shape the design of the ChildPIE© and the test of its integrity. This
chapter presents the results of all the actions described up to this point in the study. The
chapter describes how and why the system should be used. A draft of the ChildPIE© has
been provided, and the definitions that describe the categories included.
The development shown in this chapter is the first factor of the ChildPIE© classification
system for childhood social functioning problems. Subsequent development is planned in
order to make it a comprehensive system (see Chapter 8). The first factor of the ChildPIE©
has as its aim to offer descriptions around the seven identified broad categories of
development, routine, behaviour adjustment, performance, socialisation and parenting.
The content of this chapter will eventually become the first part of the user manual (the
other parts are the definitions of the factors to be developed at post-doctoral level). This
chapter involves the presentation of the end product - the culmination of the intention of
this study - the ChildPIE©.
The researcher will give initial instructions for the use of the ChildPIE© by professionals
who need to classify the social functioning problems in children.
An illustration of the
ChildPIE© is then provided, followed by the definitions needed to be able use the
classification system. Where changes suggested by the results in the previous chapter
have already been integrated, the text is highlighted in green.
These changes were
mentioned in the previous chapter, but some of the changes are further elaborated on for
the purpose of describing aspects of the adapted ChildPIE©.
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7.2.
Instructions for use
■
The words in the system are supported by a definition. The user must have a
good understanding of each definition before selecting an option.
■
First select the role in which the child is presented with a social functioning
problem, and then use the indexes to describe the nature of the problem.
■
Factor 1 represents the social functioning problems of the child in relation to
others - it assesses how well the child is functioning in those relationships.
■
The block on the top right-hand corner allows the user to fill in the administrative
details needed for filing and referencing.
■
Use the primary, secondary and relevant codes for multi-problem cases in order
to prioritise three classifications of the problems.
■
The alphabetical letters will help you to indicate the developmental stage the
child is in, since this influences intervention decisions (see sections 7.4.2.1 and
7.4.3 below).
■
7.3.
As far as possible the parent, and /or other professionals must be consulted.
Benefits for practice
What the practitioner gains from using the ChildPIE© is that it helps to clarify the child’s
unique problems and helps the social worker to become aware of the problems and
prioritise them with regard to their intensity and importance. It helps the social worker to
rely less on abstractions as the use of the ChildPIE© gives her an objective tool to measure
her own assumptions against.
Having to select a suitable category allows for deeper
analysis than simply what is most obvious. In Chapter 1, the researcher motivated for the
possible benefits of developing a classification system for social functioning problems in
children. Some of the foreseen benefits given in Table 1.1 (in Chapter 1) hold true in the
case of the ChildPIE© The proposed benefits such as the numerical value, which can
assist social workers with their monthly statistics, offer a more empirical way of describing
their caseloads. The streamlining of the referral process allows for a framework that can be
used to screen which children will benefit most from involvement in programmes.
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Dow well the ChildPIE© will perform will depend on its adoption by practitioners, and this
depends on their seeing the value the ChildPIE© can add to their treatment of children.
The only limitation to the value ChildPIE© will have for the profession is how reliable the
system is perceived to be.
Proving reliability is therefore one of the most important
requirements for the adoption of the ChildPIE© in practice.
7.4.
Use by practitioners
ChildPIE© has been developed for use by social workers, students, and social auxiliary
workers. In cases where other professionals such as child care workers might operate from
a person-in-environment perspective, and lack an alternative classification system, it would
be possible to broaden ChildPIE’s use by including them. This will be clarified in later
developments, and as the system is presented to experts in the field.
In Chapter 5 some of the underlying principles of the ChildPIE© design were summarised.
It is essential that users understand these principles together with the instructions given
earlier in this chapter. The most important principle of ChildPIE© is that it should be utilised
as a tool to classify the child’s social functioning in a language that can be understood by
other social workers. The practitioner should use all she knows about the client and social
functioning problems to support the ChildPIE© assessment.
Before attempting a
ChildPIE© assessment, the user must be sure that he/she understands the system. To
grasp the benefits of having a unifying practice and theoretical language, the social work
profession must first be open to the adoption of classification systems such as the PIE and
the ChildPIE©.
It is necessary to illustrate the system that has been referred to throughout this thesis, first
as the ‘new technology’ and now as the end product of the study: the ChildPIE©. A one
page summary of the social functioning categories is given in Figure 7.1, followed by the
definitions that describe the items in the ChildPIE©.
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Child’s Name:
Child’s D.O.B.:
The ChildPIE©
7.5.
Caregiver’s Name:
Contact number:
FACTOR 1: CHILD SOCIAL FUNCTIONING PROBLEMS
Interview date:i
Evaluator:
.
INDICATE CHILD’S DEVELOPMENTAL STAGE
[a) Infant to two years
§ Three to Six years
§ Seven to twelve years
CODE
01. FAMILIAL ROLES
Natural child
11
Surrogate child
12
Sb ling
13
Caregiver (role reversal)
14
Relative
15
Other (specify)
16
PROBLEM
TYPE
ABUSE
TYPE
§ Thirteen to eighteen years
DURATION
STRENGTH
RECOMMENDED INTERVENTION
DURATION
STRB^GTH
RECOMMENDED INTERVENTION
■1
: -(
p,
02. OTHER INTERPERSONAL ROLES
.EM
ABUSE
TYPE
__
Z____
~7''.... ;
Playmate
Friend
Partner (grl/boyfrend) ■'
..
_____
Peer
_
25
n Pupil.;:
I
...
w
26
___
27
'
•
-
03. SPECIAL LIFE SITUATION ROLES
i U
-
CODE
PROBLEM
-TYPE
ABUSE
TYPE
OURAHON
STRENGTH
RECOMMENDED INTERVENTION
31
Speca! care Wient ^
32
Juvenile
33
Other (specify)
34
TYPE OF SOCIAL INTERACTION PROBLEM
TYPE OF ABUSE
DURATION OF PROBLEM
COPING STRENGTHS
01 Milestone delay
03 Inhibition
05 Performance
07 Loss
1 No Maltreatment evident
2 Ineffective discipline
3 Inappropriate exposure
4 Neglect
5 Emotional insult & threats
6 Intimidation by peers
7 Physical harm
8 Sexual Violation
1 More than five years
2 One to five years
3 Six months to one year
4 One to six months
5 Two weeks to one month
6 Less than two weeks
1 Outstanding
3 Adequate
5 Inadequate
02 Routine
04 Pro-sociability
06 Frustration
08 Opposition I Defiance
09 Cnndiictdistiirhance 1 0 Other (snerifvl
©2005 ChildPIE Rika Swanzen
PRIORITY CODE:
P-Primary S-Secondary R-Relevant
FIGURE 7.1 THE CHILDPIE©
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2 Above average
4 Somewhat inadequate
6 No coping strengths
7.6.
Category definitions
The uniqueness of classification systems from other forms of measurement automatically
implies that the new technology also requires a different type of operationalisation. The
end result would be the name of a category, and this name would then represent a
J
thorough (but short and concise) description of the concept in question. The name itself is
not the same as an item that needs to carry with it the full meaning of what is being tested. ®
Responsibility for the correct implementation of the classification system lies in proper
training and a clear manual, which serves as a quick and easy reference and reminder of
what the categories represent. To optimise the correct use of the ChildPIE©, ensuring
validity and reliability, depends on both the integrity of the tool and how well the manual
understood.
A very important guideline set for this study, was to avoid the term 'disorder', since this
implies existing requirements for a definite cluster of symptoms that have been studied
extensively. The ‘symptoms’ relevant to social work differ from most of these requirements,
and because social work resists the medical disease-oriented model, this is even more
reason to avoid the classification of disorders. So although some of the literature was HSib
borrowed from diagnostic criteria, all was filtered through the person-in-environment
framework, and inclusion was only relevant with regard to the effect it has on the child’s
ability to interact socially with others and his environment. This was done to comply with be
the criteria set out in step 6 of Chapter 2. Where problems fall outside this ChildPIE©
framework, referral is suggested since it implies that the problem area does not form part of
social work practice,
The necessity for referral will be clearer through the use of this
classification system, since there is more descriptive language regarding the concerns of
social work. Furthermore, the referral will offer the psychiatrist, psychologist, occupational
therapist, or physiotherapist a clear and concise picture of what the social worker has found
outside of her field of expertise; reducing the need for and time spent on reassessment at a
cost to the child and his family.
During the meeting with James Karls (see Chapter 6, Tables 6.1 and 6.2), it was proposed
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that the format of the definitions for the manual should be such that, when the user reads it,
she must first know what is meant by the definition and then be given an example. In
support of this proposal, Karls gave an example of a statement that does not explain a
theory: ‘aggression exists when a child commits acts harmful to others’. The researcher
has implemented this suggestion in presenting the definitions described in the rest of this
chapter. She indicates typical cases in which the problem occurs, but is still careful to give
a practical case example to illustrate the problem. The researcher believes that the system
needs more exposure in order to establish clearly the ways in which each role and type can
be used in practice. Once these have been established, it will be possible to provide real
examples as part of the description. She will, however, give one practice example towards
the end of this chapter, as this example formed part of the case studies used for the pilot
studies. This illustrates how the ChildPIE©can be applied in practice.
7.6.1 Childhood social roles
As discussed in Chapters 5 and 6, the researcher utilised the framework of the adult PIE,
which meant that she adapted concepts from the literature on the social functioning of the
child, to reflect the interactional role they would occupy when a social functioning problem
occurs.
The roles identified and described next are the result of the laborious
operationalisation process, the implementation of suggested changes and a number of the
researcher’s own ideas and creativity. Chapter 6 showed high reliability for the social role
types in the second rater study, so the researcher did not change the definitions after the
last test in order to protect the reliability of this part of the system.
Karls and Wandrei’s (1994) identified four major categories of roles, namely family roles,
other interpersonal roles, occupational roles, and special life situations roles (see Chapter
5). The sub-roles needed to be adjusted for the child, and these are the new definitions
that formed part of a manual which the respondents referred to when they applied the
ChildPIE© to case studies (see interrater reliability tests in the previous chapter).
The
researcher cannot include the first manuals because of space constraints. She has only
included the adjusted definitions in this chapter.
The terms used to describe the
subcategories and definitions were all motivated by terms found in the literature survey
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(Chapter 4), directed and clarified by the indicators the researcher identified in Chapter 5.
The researcher will cross-reference the definitions to show where they came from using
brackets and in purple after each definition. The researcher also indicated in Figures 5.4 to
5.10 (Chapter 5) whether the indicators could be found as a problem type or a social role.
Note that the categories and subcategories identified in Chapters 4 and 5 (see Figure 5.3 in
Chapter 5), have been absorbed into terms that firstly had to fit within a social role or a
problem type or abuse type index, and secondly had to reflect language that would help the
social worker immediately identify its meaning. Although the terms used may look different
in the actual system, they still reflect the seven broad categories and subcategories that
were identified as the descriptors of childhood social functioning. In training social workers
in the use of the ChildPIE©, the childhood social functioning framework will still be used as
the conceptual background of the system. The indicators identified in Figures 5.4 to 5.10 in
Chapter 5 were used to develop the definitions of each social role or problem type index.
The social roles identified for children are described next.
Family roles are social roles that are played out in the context of a family setting in which
people are linked by blood, the law, or formal or informal arrangements (Karls and Wandrei,
1994: 25). Within the family, individuals are socialised, protected, and nurtured so they can
develop skills necessary for their well-being and survival according to their status in the
family. For the child these would include:
Natural child role - this refers to his/her role as the son or daughter of his/her mother
and father.
This role is influenced by socialisation processes and is frequently
assessed in terms of obedience and the need for discipline. A child will manifest a
problem in this role when he does not submit to parental authority and does not
comply with family rules, or when he resists family rituals and exhibits behaviour that
is hurtful to the rest of the family. Problems in this role negatively affect his/her social
functioning, since it will be difficult to protect the child from harm in the environment,
and he/she would not learn the skills necessary for functional relations such as
respect, self-control, cultural identity, security, independence, and so on (Parenting,
[definition of family], behaviour management).
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Surrogate child role - this specifies the role a child has to assume in a family where
all members are not biologically related. One or both the natural (biological) parent
roles have been substituted, so that possible roles include stepchild, foster child,
adopted child, and where donor eggs or sperms were used to conceive a child. In the
technical sense, the family meets all the requirements of a nuclear family consisting of
spouse-, parental-, and sibling subsystems, but the child is also related to others who
are not part of the family he/she lives with. Being related to someone who the child
does not share everyday life with is relevant for the child’s sense of belonging and
identity formation. It also implies challenges for the family in adjusting to each other
and in combining more than one family’s values, interests, expectations, demands,
and problems. Problems in this role involve the incorrect handling of dynamics typical
of reconstructed families. In most cases parents who remarry are unprepared for the
intensity of family battles, and struggle to find middle ground for diverse needs and
divided loyalties (Parenting: disrupted family system, Stress: statutory intervention).
Sibling role - this denotes his/her role as brother or sister, and involves biological
siblings as well as adopted and stepsiblings.
This role is influenced by family
atmosphere and involvement of parents as role models.
It can be affected by
disability in a sibling, by differences in gender, and by values attributed to the child by
other family members. Birth order influences the expectations held for each child in
the family, and this can support or detract from perception of fairness and experiences
in sharing, trust, mutual activities, and assertiveness.
Each psychological position
holds liabilities in the child’s development. Problems in this role would be an unnatural
amount of anger and hatred by the sibling; feelings of rejection, isolation, and
scapegoating; and behaviour towards a brother or sister that puts him/her at risk.
Failure to thrive in this initial relationship with those closer in age than parents, inhibits
the development of pro-social behaviour such as empathy, altruism, sharing,
negotiation, accommodation, sacrifice, and so forth (Parenting: relations within the
family).
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? Caregiver role - this alludes to cases where the child is forced to take up a caring
role, either by dysfunction within the parental subsystem, such as substance abuse or
mental illness, or by the absence of the parental subsystem in the case of
abandonment and death. In the light of the HIV/AIDS epidemic, this refers particularly
to child-headed families, where the eldest child in the home has become the caregiver
after the death of the only remaining adult who provided and cared for the family.
Indirectly it can also point to single parent households, where the parent allows the
child to take up the role of the ‘missing’ parent. Typically these children may lack
other sex role models and may have never known the other parent. The danger exists
that the needs of the child are not viewed as important, in the face of the huge
struggle for survival. Problems arise because heading a household requires skills that
children are not expected to have developed. It robs a child of his/her developmental
process, and forces the weakly protected family into disarray. It could lead to early
experiences of hopelessness, disillusionment, depression, and no opportunity for self
development by the care-giving child (Parenting: disrupted family system).
'a Relative role - this signifies the extended family relationships the child has, including
that of grandchild, cousin, niece/nephew, and aunt/uncle. Grandparents offer the first
safe place outside the parental home. In some cases grandparents may live with the
nuclear family or even look after their grandchildren. Problems exist when the child
does not experience a close relationship with extended family members.
Lacking
another family member that loves the child unconditionally can stunt the process of
differentiation.
Problems can also be caused by differences in viewpoints on
parenting, religion, cultural practices, etc. The risk for confrontation increases and the
family lacks a social support system from the extended family they are at odds with.
As children mature their systems become larger and they learn more about relating to
others. The extended family is therefore a crucial system for learning skills in social
interaction, especially because, although related, these families have different
backgrounds and viewpoints. The child is then confronted with people with similarities
as well as differences (researcher’s own synthesis of concepts to differentiate this role
from nuclear family roles - comparative to adult PIE).
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> Other - this category points to informal roles attributed to the child by himself or other
members of his family. These can be roles the child previously occupied where ties
still exist, such as being the stepchild of the second husband who the mother has
since also divorced; a foster parent the child stayed with before she/he was
reintegrated with the biological family; or a ‘big-brother’ role where he is accepted by
another child as serving a significant other role.
Other interpersonal roles are social roles that are also played out in interpersonal
relationships between individuals, but these persons are not members of the same family.
They interact with each other because of physical proximity or common interest (Karls and
Wandrei, 1994: 25). For the child these would include:
T Playmate role - is the first social relationship an older infant has with other children
close in age.
It applies to children under the age of four, since friendships only
develop after the age of four. Before this children play alone or show parallel play.
They may play next to other children, but are focused on their own activity and not on
social interaction. They show interest in other children, however, as evidenced by
instances where one infant will start crying when he/she hears another cry, or by an
initial form of copying behaviour where the infant will try and simulate what she/he
sees another child doing. Problems in this role that will impact future relationships
with peers can be noticed this young in behaviour such as severe separation anxiety,
lack of interest in other children and play activities, and in aversive behaviours such as
biting, pinching, yelling, etc. and tactile sensitivity that makes it difficult for the child to
touch objects or be touched by other people (Socialisation: play).
Friend role - conveys the first social relationship with a peer where genuine interest
in each other is evident, usually occurring after the age of four.
Friendship is a
dynamic, reciprocal relationship between two individuals. As children become friends,
they negotiate boundaries within which both partners function. Among preschool and
younger school-aged children, friendship expectations centre on common pursuits and
concrete reciprocities, while later on they centre on mutual understanding, loyalty, and
trust; expecting to spend time together, share interests and engage in self-disclosure.
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Friendships furnish children with socialisation opportunities not easily obtained
elsewhere, including experience in conflict management and sharing. Problems in this
role would become visible in a child who isolates him/herself, who tends to engage in
bullying behaviour, and who over-identifies with older children or adults (Socialisation,
friendships).
1 Partner role - implies a romantic relationship with someone with the presence of
sexual attraction.
It coincides with sexual maturity during early adolescence.
Although boy/girlfriend relationships can occur earlier, these do not usually have the
same impact and hardly cause social interaction problems.
With the start of
adolescence, however, the teenager’s self-esteem, gender identity development,
physical and emotional well-being, and relationship-building skills are all involved and
affected by the romantic involvement.
The quality of this role will be evaluated in
terms of exclusivity, the amount of jealousy, presence of abusiveness, and the extent
to which emotional security needs are met.
Problems in this role relate to sexual
promiscuity and the dangers of contracting sexually transmitted diseases or becoming
pregnant, as well as an increase in risk for suicidal behaviour and eating problems
resulting from intense emotional upheaval and disillusionment (Stress: teenage
pregnancy and abortion, considered PIE’s definition).
x Peer role - represents the interactions of near same-age children with the absence of
positive emotional involvement. These children are merely in close physical proximity
on a regular basis and may share in some common activities, but with no mutual
attraction or interest. These typically involve the child in his church, school, aftercare,
and sport settings. It also includes the neighbour’s child or the children of the parents’
friends with whom he has situational play experiences. Since children do not usually
control their daily routine they will be subjected to contact with children who are not
their friends or partners. Children simultaneously participate in two distinct cultures:
the culture of the adults and their peer culture. Children co-construct their peer culture
as they interact with each other, and it helps the child to identify a shared identity.
Problems in this role will involve any type of rejection the child initiates or receives on
the basis of his personality, disability or illness, as well as experiences with racism and
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stigma. Imitation of peers who model negative behaviour also constitutes a problem in
this role (Socialisation: peer group).
I? Pupil role - expresses the relationship of the child to his tutors, be it in pre-school
(day-mothers, playgroup, creche, kindergarten, and nursery school), primary school,
secondary school (high school), Sunday school, or boarding school. This relationship
is closely related to the teacher’s perception of teachability, educational outcome, and
manageability in class. The quality of this relationship is mostly linked to academic
achievement.
Activity level, attention span, cognitive ability, temperament traits,
behaviour trends, problem-solving, motivation, achievement, and goal-directedness
are all relevant aspects of performance in this role. A pupil’s achievement should be
viewed in the context of his being a thinker, leader, follower, or agitator (achievement
temperaments). Characteristics of the teacher as well as school policies and practices
influence the child’s response to his school experiences. Problems in this role will be
visible in expressions of hopelessness, excessive stress, and disabling frustration. A
more obvious indicator of trouble in school performance would be school grades,
although this by itself is hardly a reliable measure for the social functioning of the
child.
Poor participation in school activities and constant negative feedback to the
child regarding her/his adjustment in the education system, shapes his/her character
in the formative years of her/his life.
Another indication of problems in this role
involves activities that compete for the time the child should spend on schoolwork and
the child’s time being over-scheduled (Socialisation: school relations).
Member role - involving voluntary affiliation and participation with a group of
individuals associated for a common purpose and adhering to mutually agreed-upon
beliefs or regulations. The responsibilities and expectations of the role vary according
to the purpose and structure of the group, which can be organised for political (youth
protests), religious (including cult activity), social (community involvement or
gangsterism), or recreational (sport and culture) reasons. Problems in this role relate
to interference caused by involvement in the particular group with other areas of
functioning. Rituals and expectations that form part of membership to the group may
demand rebelliousness and unquestionable surrender. The child then does not learn
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to differentiate between the social group and his/her family system, but rather
becomes dependent on another system to describe her/his behaviour (researcher’s
own synthesis of concepts to differentiate this role from others - comparative to adult
PIE).
S Other - this category refers to the roles related to school, church and neighbourhood,
not specifically mentioned here, especially leadership roles that encompass a lot of
the child’s time and effort. Examples of these are headgirl or headboy, captain of a
sport’s team, member of a debating society, chairperson of the chess association, etc.
Special life situation roles are roles people may voluntary or involuntary assume
throughout the course of their lives. They are time-limited, situation-specific roles people
assume in addition to or in place of their usual roles (Karls and Wandrei, 1994: 26).
Children may occupy any of the following of these roles:
Client role - assumes all those instances where the child is receiving professional
treatment. This could be through referral for statutory intervention in the case of child
maltreatment, or private referral for therapeutic intervention
in the case of
developmental delay, adjustment problems, and medical treatment to restore chemical
imbalances or improvement of functioning through physical therapy. Problems in this
role would involve the child being uncooperative in the treatment process, or would
involve the guardian's perception that there is poor rapport and a lack of trust between
child and therapist. The child can indirectly sabotage treatment attempts through the
increase of problem behaviour or pleading with parents to withdraw them from
therapy. In most cases, however, children more readily adjust to change than adults
as a result of having fewer established patterns. Parents may be defensive about
their role in maintaining the problem and may be antagonistic towards the professional
(compared with PIE).
5S' Special care recipient - encompasses the client role, except for the fact that the child
is admitted to an institution to receive special care fora prescribed period of time. The
specialised care role includes inpatient centres for drug rehabilitation, special schools
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for disabilities such as deafness, blindness, autism, mental retardation, severe
behaviour difficulties and so on, as well as hospitals for long-term and chronic
treatment of mental health problems, and terminal illnesses such as AIDS and cancer.
Problems in this role will entail resistance to treatment or initial compliance only to be
released from the special care institution.
This applies particularly in the case of
teenagers who manipulate their way out whilst planning to run away in order not to be
re-institutionalised. With regard to special care for disabilities, the child may have
difficulty adjusting to the centre’s routine and activities, and may become too old for
the centre as he becomes a teenager, needing a transfer, which then means further
adjustment problems.
In cases where a child needing special consideration is
incorporated into mainstream schools, problems such as ridicule and being ostracised,
as well as risk of injury are of concern. (Based on physical and neurological problems
that were removed from this study to address later as Factors 3 and 4 - the need for
this role will exist in the final product, especially with regard to the HIV/AIDS epidemic,
so the researcher retained it).
Juvenile role - this indicates the time-frame situation a child finds himself in after
being convicted of a crime and incarcerated in juvenile detention. This could only
happen after the age of 10, when the child is seen by the justice system as having
criminal responsibility. Problems with this role involve the safety of the child among
other juveniles that may be more violent and abusive, poor prognosis for rehabilitation,
and the effects that fear, uncertainty and strict routine will have on the well-being of
the child. Because the child is still young, reintegration into society is a big concern.
The child misses out on education and mainstream life, which adversely affects his
functioning and future possibilities. Socialisation in this late stage of childhood comes
from others in prison and from prisoners who model worse criminal behaviour than the
child was originally charged with. The concern in the latter case would be the extent
to which the child is open to these external influences (Behaviour adjustment: conduct
disturbances).
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f Other - the roles in this category involve unusual roles children occupy for a short
time that differ from their everyday, more usual roles, and which are not covered by
the previous categories.
7,6.2 Indexes
The indexes are the blocks below the role categories that represent further descriptions
(with codes) to be used to identify the dynamics at work in the specific social role problem.
By listing options in index form, the researcher attempts (as did the developers of PIE) to
provide
standardised
terminology
for describing
the
most
commonly
characteristics of frequently occurring social functioning problems.
observed
The social worker
should keep in mind that the social role functioning problem and the types of problems
within this role describe the child’s difficulty and not the other person in the relationship.
7.6.2.1
Developmental stages
In the child’s life there are critical stages of transition into a new age category that have
These tasks have to be successfully
significance with regard to developmental tasks.
completed to prepare the child for the next stage. This places new demands on the child’s
role performance. The ChildPIE© divides the stages in the child’s development into the
following categories: baby and toddler stage (infant to 2 years), the pre-school stage (3 to 6
years), the school stage (7 to 12 years), and the teenage and adolescent stage (13 to 18
years). The social worker is given the option to include this information in the classification
code (as illustrated in section 7.4.3), since the child’s age impacts directly on discerning
age-appropriate childhood problems. The researcher has deliberately listed these stages
at the top of the classification system (instead of at the bottom as with the other indexes) in
order to orientate the user to first identify the child’s developmental stage, before identifying
the social roles the child has a problem with.
This mechanism was included in the
ChildPIE© in an attempt to counteract a typical misuse of classification systems, that is,
having a client focus without regard for the context in which the problem occurs. This index
came from the broad category of Development (see Chapter 4).
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7.6.2.2
Problem types
Problem types describe the kind of interactional difficulty that is occurring or has occurred
between the client (child) and another person.
It is assumed that a relationship is now
strained, disrupted, or broken (Karls and Wandrei, 1994: 16 manual).
Some problem types were given names that differed from the concepts identified and
described in Chapters 4 and 5. The reason why the category name will be different here, is
the researcher’s consideration of the fact that the problem type should describe the
problem in social interaction terms (see Annexure 1 - advice from email correspondence
with Karls) and the importance of using language that is friendly and familiar for social
workers, to increase the face validity of the system.
In selecting a particular word, the
researcher is hoping to provide a term that can easily be related to the definitions, so that it
is easy for the user to remember after it has been explained once. This is one way in which
to make the system easy to administer.
Since the problem types did not show sufficient interrater reliability, the researcher needs to
elaborate on her decisions regarding the problem types. The changes resulting from the
interrater testing and expert feedback (see Chapter 6) involved splitting conduct problems
into oppositional defiance and conduct disturbance, since there is adequate reason to
differentiate between the two. The researcher considered removing goal-direction since it
describes reasons for behavioural problems and can be included partly under the
performance problem type and partly under oppositional defiance problem type.
Being
presented with a child with behaviour problems and understanding his reasons for this
would mean both categories were applicable, which is obviously not desirable for a
classification system - it should be mutually exclusive. In the first case study, presented in
the second rater test, previous problems with regard to schoolwork were explained in the
context of a custody battle. One rater said it was a loss issue, with conduct as a secondary
problem, while the second said a performance problem, and the third said affliction as
primary but goal-direction as a secondary problem. The researcher assumes that there is a
reliability issue surrounding these problem types. The researcher also suspects that the
respondents decided collectively on the social role and problem types. For instance, if the
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problem seems to be performance, it fits the pupil role. This is why the instructions at the
beginning of the chapter are important. The social worker must first decide in what role the
child should be placed, and then describe what type of problem he/she is experiencing in
this role. When the researcher attempted to incorporate the description of goal-direction
under performance, she realised that she would run the risk of making the performance
type unreliable if it were to incorporate two different responses to be observed in the child.
As a result of the frustration caused by the thwarting of goal-directed activities, the
researcher changed the name to frustration as the child’s response and will present this to
the task committee in the post-doctoral refinement and development stage, for their
opinion.
The researcher is of the opinion that not enough recognition for family dynamics were
given, and initially wanted to include another problem type. The dynamics under parenting
are, however, included under the abuse types as inappropriate discipline; under the
inhibition problem type as a reaction to dysfunctional attachment; and under the
descriptions of family roles. The role the family plays in socialisation is covered under the
pro-social behaviour problem type. A category still missing, though, is one that refers to the
aspects surrounding disruption in family life - more specifically the child’s reaction to the
social interaction taking place. In splitting oppositional defiance from conduct disturbance,
the researcher believes an opportunity was created to look at defiance as a rebellious act in
itself, but also as a reaction to certain family dynamics occurring around the child. Since
categorised headings in Chapter 4 included disrupted family systems as affecting the
parents’ management of the child’s behaviour (since the focus of Factor 1 of the Child PI E©
is on the child and not the parents), it makes sense to combine these aspects under a
heading that describes the child’s reaction: oppositional defiance. The researcher could
have used 'rebelliousness', but she is of the opinion that this word triggers negative
associations, laying the blame on the child for wilfully resisting what is good. Oppositional
defiance sounds more professional.
One of the researcher’s conclusions regarding the low reliability of the problem types in the
second rater study was that the definitions were too long to be easily understandable
(especially when first used by the rater). The researcher shortened the definitions, using
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the indicators in Chapter 5 as guiding points. The definitions are now much shorter, and
where they are still rather long, two or more subcategories are combined under one
classification. The different (refined) problem types are described next. Again the crossreferencing of the broad and subcategories will be done in brackets.
Milestone delay problem type includes perceptual, physical, cognitive, emotional,
and social development that is behind age-appropriate norms.
The child learns
through, movement, his/her senses, and contact with others. Any aspect that blocks
the occurrence of any of these three aspects will limit the child’s chance for growth
and maturity. Through movement brain development is stimulated and through mental
operations the child learns about objects, space, time and causality.
Further
development of intuition, operational and abstract thinking prepares the child for
interacting with his social environment.
Sensitivity should exist for differences in
symbolic learning tools in different cultures. A problem in this area will include a delay
in development in any of the five areas mentioned above, as well as problematic
development of mental operations needed to prepare the child for social interaction
(Development: milestones and cognitive development).
3 Routine problem type supports the belief that lack of routine creates problems in
social functioning.
Routine is designed to teach the child the habits necessary for
survival in society, to provide a safe predictable environment, and to ensure that the
child is rested, nourished, and well cared for. A disturbance in any single area of the
child’s routine is no cause for concern. The parent-child relationship is under strain
when the child fails to adopt routines of eating, grooming, and sleeping. Night waking,
because of physical discomfort or emotional atmosphere, and the difficulties
associated with settling the infant back to sleep, as well as nightmares and
sleepwalking, do produce disturbed nights for both child and parents, which leads to
exhaustion and a decreased capacity to handle the stress accompanied by constant
caretaking.
The failure to achieve bladder or bowel control in accordance with
developmental norms may reflect a lack of routine. After five (for bladder continence)
and four years (for bowel continence) concerns are raised with regard to life events,
and contextual and physical causes. Chronic constipation, rectal inertia, and ‘overflow
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incontinence’, may be evidence of parental punitive measures with potty-training.
Eating disturbance centres around the quantity and quality intake of food with
reference to signs of starvation and binging in the older child.
A problem in this
category will involve disturbance in more than one area of the child’s routine, which
may indicate environmental stressors or mismanagement of the establishment of
norms for the child by the parent, such as a lack of responding to cues, punitive
measures, and poor communication. The risk for the healthy development of the child
necessitates intervention in this area (Routine).
U Inhibition problem type encompasses the cluster of behaviours displayed by the
child, which indicates a disruption in early bonding experiences (in the first two years).
The child displays disbelief that she/he will be kept safe and that others can be
trusted. Without a secure base from which to explore he will show intolerance to
stimulation, he will not seek out comfort and won’t offer comfort to others either, and
he lacks confidence in the autonomous self. In teenage relationships the adolescent
with inhibition problems will show distrust in the relationship’s ability to withstand the
stress of negotiating needs and wants and cannot tolerate it if the partner fails to
provide for his needs. As part of this problem type, but presenting as the opposite of
detachment, is the disinhibited type of attachment disorder, where the young child will
The manifestation of problems with
indiscriminately show affection to strangers.
intimacy in adolescent children mostly centres around sexual behaviour.
Adverse
outcomes associated with adolescent pregnancy and childbearing have serious
socioeconomic and personal consequences for young mothers, because of a reduced
probability of high school graduation and higher rates of poverty. With the unwanted
pregnancy psychosomatic symptoms of insomnia, somatic complaints, anxiety, and
suicidal ideation, as well as an intense preoccupation with the problem of ending the
unwanted pregnancy, present themselves.
Where the teenager opts for abortion,
psychological symptoms, mainly of guilt, mourning, and self-accusation, do appear,
although it does not affect subsequent sexual behaviour. Disinhibited as opposed to
inhibited children are those characterised by a lack of fear and high degrees of
approach and social interaction. A problem in this area will involve the child’s display
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of inappropriate social connections that can result in a promiscuous or inhibited style
of interacting with others (Parenting: bonding, Stress: teenage pregnancy, abortion).
B Performance problem type points to the internal drive the older child needs to
develop a sense of accomplishment and confidence in his abilities.
Achievement
deals specifically with the question of why people engage in transactions with their
environment. Associated with every achievement-related action is the possibility of
success (consequent emotion is pride) and the possibility of failure (consequent
emotion is shame). The strengths of these anticipated emotions determine whether
an individual will approach or avoid achievement-oriented activities. It is natural for
the child to want to avoid failure and will seek out those activities with the highest
probability for success. The positive feelings gained from a sense of achievement
have a positive influence on the child’s social interaction with others. The child needs
encouragement, someone believing in his competence, and the ability to attribute
successes to his own attempts, to be motivated to achieve. Social comparison and
competition are healthy milestones in this process. Closely related to achievement is
the capacity for problem-solving and expectation acts as a stimulus for problem
solving. Expectation consists of the constructs of hope (where the world and human
nature consist of possibilities) and optimism (an attitude associated with an
expectation about social or material future as socially desirable, to his advantage or
for his pleasure). Hope offers faith and optimism provides a positive explanatory style
in which the child habitually explains to himself why things happen - both stop
hopelessness and makes the child more outgoing and his positivism contagious. For
a child to develop this important buffer, he needs to have learned that his actions
matter and that he can exert some control over outcomes. Intelligence and talent do
play a role, but the focus of social work intervention is the psycho-social motivation
behind learning, and not IQ or school-readiness testing (Performance).
3 Frustration problem type symbolises the major developmental task of developing life
goals, which form the motivating force behind behaviour and are the vehicle through
which a person obtains satisfaction in life. The child must start to develop a sense of
what he wants and he must be able to assess the degree to which his desires are met.
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This is accompanied by the strive for self-actualisation and a need to be involved in
virtuous activities. Hindered goal-attainment leads to frustration - a condition of being
thwarted in the satisfaction of a motive or the realisation that the goal to which one is
Committed is unattainable.
Frustrations depend heavily on factors such as age,
personal characteristics, life situations, and the society in which the child lives, as well
as factors such as physical illness or disability that constitute obstacles to goal
attainment. Frustration can lead to aggression, fixation and regression in the child.
Gradual exposure to frustration will help the child develop frustration tolerance, and
this is influenced by the severity and length of the exposure, the child’s age at the time
of the exposure and the possibility of avoidance. Long-standing frustration can lead to
apathy and discouragement. Problems in this area will involve instances where the
child’s goals are thwarted, resulting in frustrated reaction of which the most extreme
form is apathy, and it will be relevant in cases where the child shows low frustration
tolerance or where the frustrating situation is too much for the child to manage at his
age (Performance, frustration).
Pro-sociability problem type expresses the requirement put to children to learn
values such as helpfulness, sensitivity, altruism, generosity, and kindness. By three
years of age children, regardless of cultural or socioeconomic backgrounds, can
accurately identify happy and unhappy responses in other people. The accuracy of
perception of other’s feelings, thoughts and motives increases between the ages of 6
and 12 years. This is the beginning of reciprocity, which strengthens the individual’s
ability to relate to the group. With the transition to formal operational thinking during
adolescence, the individual for the first time is intellectually capable of the reciprocity,
relativism, and objectivity which represents the most advanced stage of social
development. A problem in this area will involve parents abdicating their responsibility
to model positive, non-discriminative attitudes towards others, to control access to
negative external influences, and stimulating appropriate role-taking behaviour.
The
problem manifests itself in children lacking inhibitory control, internalisation of what
they are being taught and compliance whereby they choose to abide by the normative
code upheld to them.
Gender roles do influence pro-social behaviour, with girls
seeming more cooperative and boys more competitive.
A problem in this area is
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further implied when the child does not develop social interest, which would diminish
the child’s feelings of inferiority, alienation, and isolation. Specific needs met through
social interest are the need for praise and recognition (Socialisation, pro-social
behaviour, elements, and gender role identity).
Loss problem type describes the life situation that causes the child an excessive
sense of loss, requiring a period of mourning. All types of loss create the need for
adjustment, and therefore cause transitional stress in the child. Other ways in which a
child loses his parent include statutory intervention by the social worker, leading to
foster home placement, special care institutionalisation and adoption.
The child
selectively accumulates memories in his first 6 to 8 years of life that determine how he
gives meaning to what happens to him. An understanding of this is necessary to
determine mistaken beliefs that exacerbate the situation.
A child needs guidance
through the grieving process and in order to resolve losses acceptably; he should
enjoy a secure relationship with the person who is leaving or gone; he should receive
prompt, accurate information about what has happened and should be allowed to ask
all sorts of questions, which adults answer as honestly as possible, acknowledging
when they don’t know; and he should be allowed to participate in the family grieving,
both publicly and privately. If the child has easy access to a trusted parent or adult
who can be relied upon for comfort and a continuing relationship, the process will be
easier on the child. A teenager prefers to receive comfort from his friends rather than
from other adults. Loss of control over gratification and relief of suffering can lead to
feelings of helplessness, which can involve withdrawal, lack of hope and pessimism.
A problem in this area will refer to a child experiencing stress through having to adapt
to losing something familiar that is crucial to his sense of security. It will also indicate
when the child’s grieving process has been blocked or handled inappropriately,
leading to a negative mood in the child (Stress, early recollection, statutory
intervention, grieving, hopelessness).
B Oppositional behaviour type represents behaviour in the child that opposes the
expectation of the adult. Typical oppositional behaviours are temper tantrums, lying,
aggressiveness and devotion to a cult.
The child intends to make his objections
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known or attempts to avoid the consequences of his behaviour. Changing dynamics
in a family can demand too much adjustment of the child which causes the child to
resist affection or discipline measures from caregivers. Children who experience the
need to belong are easy prey for poor external influences. A defiant child creates
greater risk of his becoming involved in more serious conduct disturbance.
All
misbehaviour stems from discouragement in the child. Negative goals involve gaining
attention, power, seeking revenge in hurting others to protect themselves from further
hurt, and proving inadequacy which gains them pity. When children develop positive
behavioural goals,
these involve gaining attention through
involvement and
contribution, gaining autonomy and self-responsibility - believing they can make
responsible decisions and have age-appropriate power and resources, striving for
justice and fairness, and avoiding conflict by accepting other’s opinions.
An early
understanding of goals and causes behind deviant behaviour can help with early
intervention to prevent the development of more serious conduct disturbances.
A
problem in this area would therefore include the early warning signs of resisting
parental authority with any of the four goals that stem from discouragement in the child
(Behaviour adjustment: oppositional defiance, Parenting: disrupted family system,
Performance: goal-directedness).
M Conduct disturbance problem type represents a number of more serious behaviour
problems presented by the child.
Conduct disturbances differ from oppositional
defiance in that the child is now rebelling against lawful expectations placed on his
conduct. Conduct problems include school attendance problems, running away/street
children, substance abuse, stealing/theft, vandalism, and serious assault. Risk factors
for developing conduct problems are family dysfunction, parental mental illness and
criminality, low socio-economic class, and institutional care. A juvenile delinquent is a
young person between the age of 10 (criminal responsibility) and 17 who has been
prosecuted and found guilty of an offence. Factors in the interaction the child has with
others that predispose him to conduct problems are competition, stereotyping,
expectations, poverty, abuse, low religiosity, poor coping, poor role models,
inadequate opportunity, no attachments, poor socialisation, anger and anxiety.
A
problem in this area will imply that the child is engaging in behaviour that is illegal
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which presents great risks for his health, safety, freedom and adjustment in
relationships (Parenting: behaviour management, conduct disturbance).
Consideration should be given to what specific cultures’ ‘symbolic tools’ are, and social
workers should avoid imposing their cultures’ ‘material’ on the children they assess. This
serves as a guideline in the use of the ChildPIE©.
Of more importance is that, since
cultural influences impose opportunities or constraints on the developing mind, the social
worker should be aware of any inappropriate cultural influences on the developing mind of
the child.
Other. This option serves as an opportunity for the social worker to include other
problem types, only when the practitioner has ensured that she understands the
definitions well and has therefore found a case that cannot fit into one of the provided
types.
The indexes discussed next formed part of the development of this study, but it should be
noted that, although the respondents used these indexes in the pilot studies, the researcher
did not use the scores for the interrater reliability testing (see Chapter 6).
7.6.2.3
Child abuse types
Child abuse is a social problem with negative effects such as school problems, behaviour
problems, depression, anxiety, and post-traumatic stress disorder. It is further associated
with negative psychological outcomes such as aggression, emotional unresponsiveness,
depression, suicidality, personality disturbances, and low self-esteem.
Research also
suggests that early family experiences exert an important influence on the development of
future parenting skills. The consistent and problematic effects of child maltreatment on the
child’s ability to negotiate stage-salient developmental tasks include severe disturbances in
several domains of adaptive functioning, such as the development of a secure attachment
to the primary caregiver, affect and physiological self-regulation, the development of
autonomy and a sense of self, and the establishment of peer relationships. Furthermore,
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sexual victimisation has implications for the probability that teenage girls will resort to
multiple and extreme forms of weight regulation practices.
It is therefore obvious that abuse severely affects childhood functioning and deserves a
separate index to describe the type of abuse the child is exposed to.
In every case of
social role functioning, the abuse the child is exposed to needs immediate intervention to
safeguard the child. The researcher chose not to merely have ‘abuse’ as a problem type.
The reason for this is that she predicts that it would be used in the majority of cases and
that it would obscure the more intrinsic dynamics of the child’s presenting problem. To
separate it out into different types gives this index the form of external, environmental
stressor that has been introduced into the child’s life by adults. In the case of abuse, the
child’s innocence is used to force on him something he cannot even comprehend. With
other attributes that cause problems in relationships such as hyperactivity, the child brings
that attribute into the relationship - it was not forced on him from the outside.
The
respondents of the pilot study agreed with this use for the index.
The original PIE does not have another index that brings another dimension to the social
role and problem type. It does have a severity index, which the researcher is not including
in the ChildPIE©. The severity index in the PIE has as its function to differentiate the
instances when the changes and transitions of everyday life become extensive, rapid, and
problem-producing (Karls and Wandrei, 1994: 35 manual). The researcher goes from the
premise that, especially with children, the social work profession is geared towards early
intervention, and she is therefore of the opinion that a severity index may be redundant in
the case of childhood functioning.
It differs slightly with adults in the sense that they
exercise more choice in the matter of receiving treatment. A further argument is that when
any abuse is present it immediately indicates that the problem is severe enough to indicate
the need for immediate intervention.
1
No maltreatment evident - is used to indicate that the social worker is not aware of
any abuse that plays into the dynamic of the child’s social role functioning.
2
Ineffective discipline - points to the fine line between appropriate discipline and
abusive power assertion. Inappropriate disciplining expects the slavish following of
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authority, meeting perfectionistic goals, demanding mature adult behaviour, or proof
of obedience. Appropriate discipline is the establishment of behavioural norms and
boundaries to assist the child’s adjustment to his environment, character forming
and guiding the development of a life philosophy that considers other people’s rights
and needs. With ineffective discipline the child is merely the recipient of parental
frustration and anger, and not the student in learning about life. The parenting style
should also fit the developmental stage of the child.
3
Inappropriate exposure - is an option suggested by respondents of the pilot study
to refer to behaviour by the parent that exposes the child to dysfunctional and
unhealthy behaviour, or otherwise allowing the child to be exposed to such
behaviour.
It implies a form of passive abuse where the parent neglects his
socialising responsibility. The parent does not control the child’s access to negative
influences in and outside the house (e.g. free access to television all day). Apart
from this, the parent also introduces unhealthy examples of functioning such as
over-indulging in substances which carries a high risk for developing dependency
and domestic violence.
4
Neglect - involves the chronic lack of attention to a child’s basic needs for food,
clothing, shelter, medical care, education, and supervision, as well as inattention to
emotional security, affection, encouragement, and stimulation. In its most severe
from neglect would lead to abandonment.
Sensitivity towards poverty is a
requirement in the assessment of neglect.
5
Emotional
insult and threats
emotional abuse involves the continual
scapegoating and rejection of a specific child by his caretakers.
Severe verbal
abuse, berating, severe yelling, and excessively high demands are present, and can
even involve psychological terrorism where a child is, for instance, locked up in dark
cellars or threatened with physical harm. Meeting the child’s emotional need is a
prerequisite to personality development and psychological well-being. The tell-tale
signs of emotional abuse are difficult to detect, but some kind of disturbance in the
child’s behaviour is a usual symptom.
6
Intimidation by peers - A child can also be abused by other children, either of the
same age or a little older.
Bullying is a form of aggression in which there is an
imbalance of power between the bully and the victim, and it occurs largely within the
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context of the peer group.
Bullying, which may be direct (e.g. name-calling) or
indirect (e.g. gossip), covers a wide range of behaviours from social exclusion to
physical assaults, as well as emotional intimidation that may stir up intense and
overwhelming feelings in the victim. All areas of these victimised children's lives
may be affected - academic, social, emotional, psychological, and physical health.
Boy and girl victims of all ages suffer from feeling anxious, socially eccentric, unsafe,
depressed, and lonely. Victimisation's impact is exacerbated by a cycle whereby the
emotional, physical, and social effects leave victimised children more vulnerable to
further peer maltreatment. The fact that victimisation and self-perceived peer social
competence influence each other, suggests a vicious cycle in which low self-regard
and abusive treatment by others are mutually reinforcing.
Pupils in special
education are more likely to be victimised, as are those with chronic medical
conditions.
7
Physical harm - means that the parent or caregiver is responsible for or allows
injury to come to the child.
It involves any physical injury or anything else that
jeopardizes the well-being or life of a child and includes violent methods of discipline
such as beatings that cause lacerations, abrasions, bone or skull fractures, or
intentional burning.
8
Sexual violation - includes any sexual, exploitative activity with children, whether it
involves physical contact or not, by a person who uses his superiority in terms of
age, physical strength or position in relationship to the child, to meet his or her own
emotional and sexual needs. Sexual abuse of children includes parent-child incest
initiated by one or both parents; a child being forced into sexual activity by
stepparents, relatives, or family friends; the rape of a child by a stranger; and sexual
manipulation such as prostitution or pornography as well as sadistic cruelty. Special
attention must be given to signs of Rape Trauma Syndrome - it is an acute phase
and long-term reorganisation process that occurs as a result of forcible rape or
attempted forcible rape. This syndrome of behavioural, somatic, and psychological
reactions is an acute stress reaction to a life-threatening situation. Rape is defined
as the carnal knowledge of a teenager by an assailant by force and against her/his
will as a violent act using sex as a weapon.
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7.6.2.4
Duration of the problem
The duration index indicates the length of the problem.
It alerts the practitioner to the
degree of urgency for intervention, as well as providing a measure of the prognosis for
problem resolution while also considering the client's ability to cope. A client with good
coping skills and a recently developed problem has a higher probability for problem
resolution than one with a chronic problem and poor coping skills (Karls and Wandrei,
1994: 36 manual). The researcher used the same values for the duration index; what these
values represent, is self-explanatory.
7.6.2.5
Coping strengths
In the MiniPIE (PIE manual) Karls and Wandrei (1994: 37) see coping index as consisting
of the social worker’s rating of the client’s ability to solve problems, capacity to act
independently, and his or her ego strength, insight, and intellectual capacity. According to
these authors social work intervention is most needed when the client lacks adequate
coping skills.
According to the Dictionary of Social Work, coping can be defined as a
process whereby a person successfully deals with a problem and life situations, which
indicates goodness of fit (Terminology Committee for Social Work, 1995: 15).
One of the key concepts in childhood social functioning identified in the conceptual
framework at the end of Chapter 3 is temperament.
For the researcher this concept is
more meaningful when looked at as a reference point for coping in children. If the child’s
coping strengths need to reflect inner mechanisms that will help the child cope with external
pressures, temperament traits which have been apparent since birth, can give an indication
of how likely the child is to cope with stressful situations. To assess strengths the social
worker would need to identify inherent traits that exist despite the child’s circumstances,
which can be used to strengthen and empower the child. In other words, one would want
to know what already exists that can be built upon during the intervention process. This
part of the ChildPIE© classification system does however not receive further attention as
part of this doctoral study, and will be subjected to further developments at post-doctoral
level.
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f
7.6.2.6
Priority code
Because we work with multi-problem families, in most cases there will be more than one
problem seen as important by the social worker during assessment. For this reason the
researcher included a new code, namely the priority code, to identify problems as either
primary (perceived as the biggest problem, and needing immediate attention, constituting a
crisis); secondary (second most serious that would need immediate follow-up attention after
crisis has been diverted); and relevant (an underlying problem that needs definite long-term
intervention).
During her pilot study, the sample found this code highly applicable to
practice as it allows for a bigger chance for the real problem to be treated thoroughly.
Using this code would mean that the same ChildPIE© can be used for all the child’s
problems and the code would be followed by a “P”, “S”, or “R”.
The inclusion of this code deviates from the residual category of ‘mixed’ provided in PIE.
The researcher found that the respondents had a problem with using this category in a
previous study, since the description is then still unclear as it cannot explain which ones are
included under ’mixed’ (except for an accompanying report which will obliterate the purpose
behind the use of a coded classification system). In the pilot study, respondents came up
with the idea of utilising the format of priority coding that was used for the purpose of data
gathering during the interrater test. To have priority coding as part of the eventual system
will allow for a differentiation between aspects of the child’s problems according to priority
ratings. To intervene in the child’s problems the practitioner has to start with one problem
which can receive priority while the other related issues are also classified so as not to lose
sight of their implications on the child’s ‘here-and-now’ state.
7.6.3 Coding
The coding procedure works in a similar way to that of the original PIE: the descriptions in
the indexes have a numerical value which is placed next to the social role that has been
selected.
By filling in the codes in the spaces provided, the social worker ensures a
thorough assessment of not only the role that presents problems, but also the dynamics
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affecting it. By using numerical values to identify these dynamics, the social worker works
towards using numbers (and letters) to describe a complex problem instead of writing long
reports.
By using apposite classifications that have pre-existing descriptions, two social
workers who both use the ChildPIE© will be able to refer to a code of only 7 numbers and 2
symbol characters in length, which will explain all relevant aspects regarding the child for
the purpose of intervention. The structure and format of the coding are illustrated in Figure
7.2. The lower case ('small') letters will be explained below, but the meaning of the capital
letters can be found in the top and last indexes in Figure 7.1.
They have also been
described in previous sections.
Developmental
stage
a
b
c
e
d
Priority Code
(As B, C, or D)
(P, S.orR)
FIGURE 7.2 CHILDPIE© CODING
a = Social role; it can range between - 11to 16 for familial roles
- 21 to 27 for other interpersonal roles
- 31 to 34 for special life situation roles
b = Problem type; it can range from 1 to 10
c = Abuse type; it can range from 1 to 8
d = Duration of the problem; it can range from 1to 6
e = Coping strengths; it can range from 1 to 6
Each space will get one of the numbers indicated by the small letters (depending on choice
of role, problem, abuse, duration and coping type.
In the final development of the
ChildPIE©, an assessment summary will be developed similar to that of the adult PIE, that
will have as its purpose to help the social worker transfer the codes from the system into
one line and to join the classifications of the different factors.
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/
7.7
Intervention plan
At this stage of development the option to write the recommended intervention down as
part of the assessment, serves the purpose of guiding the social worker’s thinking towards
treatment and not merely assessment. At a later stage the researcher intends to develop a
supporting intervention model. This can also be categorised and coded, and can later be
included in the coding of the classification. This would also offer more focused intervention,
geared at addressing the specific identified problems.
Snyder (1997: 536) gave his main criticism of the PIE as being identical to his criticism of
the DSM-IV, claiming that neither assessment tool has much to say about methods of
treatment. Perhaps the profession should consider abandoning the age-old link between
knowledge and practice, and between diagnosis and treatment, and consider the now more
pragmatic link between reimbursable assessments and third-party payer treatments. In the
current social work milieu where social workers in private practice are expected to use ICD-
10 codes (International Classification of Diseases) for medical fund reimbursements, the
need to offer some form of classification for third party payments for treatments is already
required. The PIE and ChildPIE© assessments certainly would call for more social work
intervention, and one would assume that social workers would want to adopt their own
system of classification instead of using that of another discipline.
7.8
A practical illustration
The researcher thought it appropriate to present the two case studies on which there was
agreement by all three respondents in the second pilot study. These applications of the
ChildPIE© on real cases in practice will offer an illustration of how the system can be used.
The case studies also illustrate how the problem type with the child’s social role can be
combined with an abuse type.
J. is two-and-a-half years old. She is a very active toddler and is prone to take things and
break them. She seems to get no discipline from her parents who spoil her. She is crazy
about her father and does not want to be separated from him. She sleeps with the couple in
their bed. Her father often walks naked in the house and seems not to realise that this can
negatively influence J.’s development. When she is with her grandparents she also runs
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around naked in the house and asks the grandfather to inspect her naked body. The mother
worries about this behaviour. This behaviour has occurred since her second birthday when
she also seemed to have become excessively active. She does not respond to guidance from
authority figures. She has proved to be very intelligent and seems able to negotiate what she
wants.
All three raters saw this as a problem occurring in the Natural child role (code 11) and as a
Routine type problem (code 02). Inappropriate exposure (code 03) was also indicated as a
form of abuse. The Relative role (code 15) can also be considered as a secondary area in
which intervention may be needed with regard to the grandparents and the setting of
boundaries that refer to Ineffective discipline (code 2) of the type of abuse index.
M. is 19 months old. In the past year the mother has found caring for the child more and
more difficult. The child is still only taking in fluids as her only source of nutrition, she seems
to be underweight and seem to lack age-appropriate stimulation. She has insect bite marks
and a case of flu. M. shows clingy behaviour towards her father and is hesitant to go to
strangers.
All three respondents chose the Natural child role (code 11) and the Milestone delay
problem type (code 03). The researcher did not test agreeability on the rest of the indexes
but all of the respondents also indicated Neglect (code 4) as an abuse problem type.
In
both these cases Inhibition (code 01) can be considered as a secondary problem type with
a reference to attachment behaviour that may be of concern.
7.9
Summary
This chapter presented the core of this study - the Child PIE©, which is the accumulation of
four years’ of development. The writing process was an opportunity to rethink the design
and to adjust the plan. Since the goal of the Child PI E© is to describe the social functioning
problems of children, it has to be clearly understandable and directly applicable. There is
still more to be done before one can say with confidence that this is a reliable system.
In Chapter 8 the researcher will reflect on what was learned from the developmental
process, and will give some indication of the next steps required in the further development
of a classification system for childhood social functioning that can be disseminated into
practice.
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< /
Chapter 8
Conclusions & Recommendations
Five senses; an incurably abstract intellect; a haphazardly selective memory; a set of
preconceptions and assumptions so numerous that I can never examine more than minority
of them - never become conscious of them all. How much of total reality can such an
apparatus let through?
- C. S. Lewis (English essayist, juvenile novelist, & Christian apologist, 1898-1963)
8.1
Introduction
The quote provided in step 12 of Chapter 2 by Reid (1994) is significant in
understanding the form of this chapter. Reid states that developmental research differs
from conventional research in that the conclusions derived from the conventional study
are hoped to influence future practice, whereas modifications proposed in development
research are incorporated directly into the intervention under development.
This
chapter thus reflects on what has been learned and accomplished through the
developmental process, as well as on what the next steps should be.
The preceding chapters involved the implementation of the steps of the Adapted Design
and Development Model set out in Chapter 2. All these steps guided the researcher
towards the development of a new technology which was designed, named, tested, and
refined as a result.
This chapter brings it all together and gives an idea of what
development on the ChildPIE© is planned next.
The researcher learned the following in the course of the development process:
■
Validity and reliability require control of various aspects during different times in
the developmental process, i.e. even control over the decision of which articles or
books to use as literature.
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K >
■
Breaking the development down into a step-by-step process, and not trying to
deal with all aspects at once improves the chances of ensuring the validity and
reliability of each part.
■
Continuous objective feedback from others is essential - a number of people in
the field are more informed on different aspects than you are.
■
A good research study has to re-adjust itself according to obstacles along the
way in order to remain feasible, even if it means changing course a few times.
■
Her own experience and judgement played a significant role in the flow of the
study. This study was a training tool for the researcher in exercising confidence
in her own opinion and ability to put forth a valid argument.
■
Despite striving for a comprehensive study that simultaneously narrows down the
operationalised terms for inclusion, the study still showed poor integration at
times.
It was difficult to consider so much information on childhood social
functioning and then reduce it to a one-page system that will represent all the
information through an understanding of the selected terms.
■
A high level of scientific precision is required to develop a classification tool for
any profession, and this becomes the researcher's life's work.
Each category
should exclude the others (a case example should not be able to fit into more
than one category). This is extremely difficult to accomplish, and demands that
the user’s judgement, knowledge of the system, experience and training are all
brought into play.
Next in this chapter the researcher will give conclusions on the development process in
this study, and will then present recommendations on how to improve the integrity of the
ChildPIE©.
8.2 Conclusions on the development
In Chapter 2, a number of steps were described in shaping the design process. Since
the purpose of these steps was to ensure that each part of the process contributed to
the development of a valid and reliable tool, the researcher needs to evaluate how the
requirements for the most important steps were met. The steps in Chapter 2 were the
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methodological steps to accomplish the goal and objectives set out in Chapter 1. The
researcher’s goal in this study was to develop a classification with which to categorise
childhood social functioning problems. This meant developing a conceptual framework
in terms of which to direct the inclusion of and decision-making about the literature,
designing a system in accordance with certain requirements, and testing the first draft.
The techniques and competencies needed to accomplish this are evaluated in the
following sections.
8.2.1 Method of information gathering
The researcher commented throughout this thesis on what she views as social work’s
unifying construct as well as how she arrived at the concepts used as the foundation for
the development. How she decided what to include and how she checked for biases all
ensured that the content of the classification system would have probability for validity.
Cooper’s (1989) statement regarding the literature review (step 6 of Chapter 2) is
relevant to the experience in this study.
The findings of different studies are very
complex and the instinct for uncovering variables that influence a relation are important
in the synthesis process. This study was definitely an exercise in the uncovering of
relations among different concepts.
Not only did the researcher have to be vigilant
about what content she chose to include, she also had to put the information into a new
framework for assessing social functioning in children. This proved successful, and was
adequate for the purposes of this study.
8.2.2 Design and development competencies
The competencies the researcher needed to conduct a design and development study
were outlined in Chapter 2, step 12. The researcher wanted to evaluate herself on
these at the end of the study. Most of the competencies she developed in the course of
the study were through study guidance and experience. The researcher mastered the
theoretical and conceptual background of what was set out in this study. The measure
of reliability established by this initial design shows competency in synthesising diverse
concepts into an integrated whole. She was able to at least tentatively conceptualise
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the problems relevant to social functioning in children.
The researcher used a
structured plan in approaching information sources (highlighted at the beginning of
Chapter 4). She also showed a lot of innovation in transforming the information and
conceptual framework into a classification system.
She further submitted her
intervention to pilot testing with subsequent revision of the system. The ability to apply
multiple methodologies was a challenge for the researcher, and only towards the end of
her study could she conceptualise how all the parts came together.
Following the
completion of this thesis (which is the first form of communication), she will continue to
focus on how to gain support from practice and how to communicate her research
results. The researcher also learnt that to communicate the intricacies of her study
involves the delivering of focused and concise arguments.
8.2.3 Meeting measurement criteria
In step 3 of the Adapted Design and Development Model, the researcher explored what
would be required of a classification system with regard to being a measurement
technology and with regard to assessing children. The two summaries at the end of
step 3a and step 3b (in Chapter 2), can be used in determining whether the criteria for
measurement tools have been met by the Child PIE© system. The first summary at the
end of step 3a gives requirements for the system as a measurement tool, and the one
at the end of step 3b gives requirements for the system as a classification tool. In the
researcher’s opinion, the following criteria of a measurement tool have been met
through the ChildPIE© system, even if only in part:
■
It helps to describe childhood social functioning problems more clearly and
accurately.
■
It assists in determining the intensity and duration of the occurrence of events.
■
It provides clearer feedback to the client, thereby supporting empowerment.
■
It facilitates practice decisions and can enhance the effectiveness of practice
efforts.
In Table 2.1 (Chapter 2), Roestenburg (2003) emphasised that the accountability issues
in classification systems centre around sufficient training in and uniform application of
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the system. The limited time provided for training in and administering of the ChildPIE©
during the pilot tests was explained in Chapter 6. Inadequate training may be regarded
as a reason for limited reliability. If the training is not clear, the respondents apply the
system in different ways, and therefore have poor interrater agreement.
Apart from
focussing on more effective training, the researcher also needs to ensure that the user
guidelines are very specific and clear. This will also increase the likelihood of uniform
application. With regard to the summary at the end of step 3b, the researcher is of the
opinion that the ChildPIE© meets the following requirements for classifying children:
■
It alerts the social worker to the combination of factors, such as role functioning,
social interaction problems, and the occurrence of abuse.
■
The conceptual framework, categories, and indicators (Chapters 3 to 5) provide
the social worker with broader knowledge on childhood social functioning,
thereby enabling more effective use of the ChildPIE©.
The reference to coping skill helps the social worker to label the child not only in
terms of his problems, but also in terms of his strengths.
■
The respondents of the study could identify with the ChildPIE©.
■
It is simple and user-friendly.
"
One of the user guidelines suggests the involvement of a parent/guardian in the
assessment, since the child lacks sufficient abstract reasoning to be included in
the assessment.
*
The ChildPIE© is a tool for collecting and ordering relevant information that can
produce a comprehensive social functioning assessment of the child client.
As a classification system depends a lot upon the manner in which it is used, clear
instructions should be developed. Complying with instructions for use depends on the
user and not the system. Therefore some control over the test conditions will always lie
with the perceptions and judgement of the social worker, and this will inevitably have an
effect on reliability. Within the domain of this study, however, the most important criteria
for a measurement technology were met.
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8.2.4 Meeting validation criteria for a classification system
A further framework in terms of which to evaluate the ChildPIE© was provided- by the
validation process undergone by the adult PIE.
The researcher evaluated the
ChildPIE© against the criteria set out by Karls and Wandrei with regard to the validation
of a classification system (see step 14 in Chapter 2).
The ChildPIE© has met their
validation criteria in the following ways:
■
The first criterion was acceptability, which indicates that users agree that the
categories and their definitions have face validity, and that they encompass the
language of the profession. Although the sample was small and their feedback
cannot be generalised to the rest of the profession, this feedback was positive
with regard to acceptability, which supports further exposure of the ChildPIE© to
practice.
■
The second criterion was feasibility, which indicates that the system is
understandable and easily applied. Again there was initial support to assume
likely feasibility of the ChildPIE©.
■
The third criterion, coverage, is achieved when there is goodness of fit of the
system in practice, and since clients did not fall into the residual category of
‘other’, the researcher is positive in this regard. None of the three raters made
use of the residual category within the social role or problem type categories. It
may therefore be assumed that the raters found available options for all 25 case
studies (they did not feel there was a problem that was not covered by the
ChildPIE©). Of course this does not mean that there will never be a problem the
social worker cannot find an option for, but it does give some positive feedback
about the integrity of the content at this early stage of development.
The researcher presents concluding comments on the reliability and validation of the
system as well as the other criteria in the following sections.
8.2.5 Finding a unifying construct
The reliability of the ChildPIE© will have little significance if social workers do not adopt
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the system. Practitioners’ adoption of the system depends on the extent to which they
believe the system reflects and assists with the aims of the profession. In the course of
this study, the researcher adequately illustrated that person-in-environment may be
regarded as the unifying construct for social work. She can further conclude that the
ChildPIE© system does in part (in Factor 1) reflect a person-in-environment approach,
and that the system has a likely chance of being adopted by practitioners. The positive
response from the respondents (see Chapter 6) provides encouraging support for
assuming a likelihood of the adoption of the ChildPIE© may exist.
8.2.6 Validation guidelines
According to Karls and Wandrei’s (1994) criteria for a classification system, the
validation of a system is a measure of its usefulness, and reflects how well it measures
what it is supposed to measure.
The validation process at this early stage of the
development focused on ensuring that the content of the classification system was
based on information gained in a structured, controlled way.
For this a number of
strategies were used, i.e. Grounded theory-, literature review- and Systematic Research
Synthesis principles (steps 5 and 6, Chapter 2), as well as the validation techniques
summarised under the ‘a to z’. The former principles served well in the collection and
organisation of the data gained from the literature. The validation techniques served as
a good guideline for handling the data, although it was easily applied throughout all the
decision-making required for this development.
To illustrate this, the researcher
discusses some of the aspects related to the validation process she adhered to.
The researcher found that the constant comparison that forms part of Systematic
Research Synthesis was difficult to verify. A considerable number of topics had to be
included in the development of a classification system, so she considered different
aspects of them, and decided to include those which related to the purpose of the
technology. This mental process was made evident through cross-referencing between
chapters and sections.
Extensive use of a variety of resources increased the integrity of the concepts in the
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development. The researcher used articles and books, both recent and older, classical
sources, formal and informal information, international and local publications, and
literature from different disciplines. She kept a look out for-opposing or contradictory
explanations, and the replication of findings among studies. She made use of feedback
obtained at various points in the developmental cycle. The researcher also reflected on
the assumptions and co-occurrences found in the literature study in her summary at the
end of Chapter 4.
With the search for adequate information resources comes the risk of too much
information.
The researcher struggled with data overload.
This became a real
challenge while trying to establish a sound theoretical understanding of the concepts to
be used in the development of the new technology. An overload of information carries
the risk of losing focus, but the practical guidelines for the literature study were adhered
to by the researcher, and the study concentrated on aspects related to the child’s social
functioning. This was confirmed through the comparison with two other frameworks that
contained similar concepts to those used for the Child PIE©.
Constant clarification
through study guidance served an auditing and review function.
With regard to verification strategies (see ‘a to z’ in step 14 of Chapter 2), the
researcher continuously had to re-evaluate her decision to include certain literature both
to avoid overload and not to focus simply on the most common or noticeable aspects of
childhood social functioning. She used different information channels and redirected
her search whenever new conclusions were drawn. She kept her bias in check, and
assumed that literature from certain professions might be of value (such as the
diagnostic terms used in psychiatry). The researcher examined the research method
through which results and conclusions were obtained to justify the validity of each
literature source. By using the questions at ‘z’, she strengthened the conclusions drawn
from literature. The researcher showed a preference for literature in which 'classical*
authors were cited, and for the literature in which theoretical concepts were discussed.
The researcher sought out articles that produced new evidence on previous findings,
since the questioning of results is part of validation and therefore necessary in research.
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< )
The threats to validity related to the gathering process, discussed as part of step 6 in
Chapter 2, included the fact that not all studies pertinent to the topic of interest have
been included, and that individuals or elements in the case studies are not
representative of all individuals or elements in the target population.
Based on
feedback from panel discussions with colleagues in social work practice and education
as well as her study promoter, the researcher is confident that she can judge the
comprehensiveness of the literature search to be adequate.
Referring back the
discussion on pilot studies at the beginning of Chapter 6, a broad overview of literature
on the topic of the study was an important part of this study. She is also confident that
she investigated research done on different population groups (although not always on
the same elements being researched - she could therefore not make comparative
conclusions).
It was her task to conceptualise the content of the new technology in
such a way that it can be seen as a-cultural (free of cultural association in order to be
applicable across a number of different cultures), as is the case with the adult PIE.
With regard to the handling of data (from the interrater test), the researcher experienced
the effect of missing data. In the second pilot study the participants did not so readily
provide responses on the ‘relevant’ choice. This narrowed down the responses that
could be compared to see whether there was overall interrater agreement. Because the
sample was so small, one rater’s non-response on a case study made it impossible to
get a strong interrater agreement
In some cases the raters couldn’t choose between
two options, and this apparent discrepancy in information exposed mistakes in
reasoning by the respondent as well as a lack of clarity in the case study as to what the
presenting problem was.
The fault in reasoning can be addressed through clear
instruction. However, having different opinions on the child's most serious problem will,
in the opinion of the researcher, remain a reality with regard to validity in social work
measurement.
Overall the researcher is satisfied with the steps she took in ensuring validity.
Her
measures were sufficient for the purpose of this study.
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8.2.7 Limitations of the study
Even though Chapter 6 showed how .valuable information was gained through reliability
testing, some limitations were also evident. According to Karls and Wandrei’s (1994)
reference to the reliability of a classification system, the system should indicate how well
practitioners using the system agree with each other on the identification of the
categories.
This relates to the function of the new technology, implying that, if the
ChildPIE© is reliable, it will produce the same category code if the assessment is
repeated on the same child (provided other influences are controlled). If the ChildPIE©
is reliable, a change in findings in different assessments will indicate a change in the
child’s social functioning.
The pilot tests in this study created a controlled environment
on small scale, and the initial results show promise that what the ChildPIE© measures
is not the result of random occurrences. Instead the system has shown that it is able to
measure a certain concept consistently. Although the perceived reason for insufficient
reliability in one part of the system (unclear definitions in problem type) has been
addressed through refinement (in Chapter 7), the new system has not yet been tested.
Concern therefore still exists with regard to the overall reliability of the ChildPIE©.
An oversight with regard to the reliability testing in this study is that, although the case
studies were diverse enough to cover most of the options, the researcher did not
analyse whether all of the social role options were used by the raters. Although social
role may have a high reliability, it became clear with hindsight that some of the roles
were not selected, and it is not certain how their reliability compares with the roles that
were chosen. At face value all the roles were selected by the three raters, but two of
the roles were selected by only one rater, and five roles were selected by only two of
the raters. Absolute interrater agreement was lacking with regard to these roles. This
shows that more in depth analysis on a number of ratings is needed to prove reliability.
8.2.8 Discrepancies in process
Some discrepancies challenged the researcher’s logical reasoning during the process of
development. Having an a-theoretical classification system to avoid criticism of the new
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classification system, while at the same time having to build a theoretical framework
from which the classification can be designed. She settled this discrepancy for herself
by understanding that the development of a theory is a necessary step in the total
design and development process.
Concepts must be derived from somewhere and
should be perceived as valid (proven theories). Through an operational process the
theory is translated into observable definitions. These definitions take form in a system
like the ChildPIE©, but are placed in the system in such a way that they are worded in
an a-theoretical manner.
Another seeming discrepancy is what differentiates diagnosis from classification (see
step 3b, Chapter 2). A classification does not offer a cause-and-effect relationship but
merely a description of the dynamics of the problem.
The researcher felt that, to
understand the interactional dynamics of social relationships, she had to look at the
cause of the problem. This was resolved on the basis of Karis’ argument (see Table
6.2) about not using the word ‘cause’ since it implies a relationship. This study was
based on the assumption that, when describing (classifying), you must take care not to
explain why but rather to state what is.
The researcher is of the opinion that she
approached the definitions of the ChildPIE© effectively in this manner.
It can be concluded that the study systematically met the requirements set out in the
steps of the Adapted Design and Development Model. The aims of the study were
achieved, with the result that it contributes to social work practice through the
development of a new technology that will not only help the social worker describe
social functioning problems in children, but also provide a unifying language for social
workers dealing with children. The successful implementation in practice will, however,
depend on further development, and these recommendations are presented in the
following section.
8.3
Recommendations
The recommendations for this study arose from the realisation that the researcher has
completed all of the development that needs to be done on the ChildPIE© to make it a
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reliable tool for use in social work practice. Specific attention should now be paid to a
few aspects resulting from this study, and these are discussed below.
The following recommendations apply to the refinement of the ChildPIE©:
•
The development of Factors 2, 3 and 4 of the ChildPIE© to include the
assessment of the child on environmental, mental- and physical health
aspects.
•
Selection and contracting of a task committee based on expertise and
available time to further refine the ChildPIE©, and to provide endorsement
for the system’s use in practice.
•
External and objective review of the system by the task committee and/or
objective coder/computer coding. Their task would involve considering the
adequacy of the social roles and problem types of Factor 1 (as obtained
through the operational and design process - Chapter 5), and to refine the
definitions used in this study (Chapter 7).
•
Contact with the developers of PIE and exploration of future networking
options.
•
Further development of a user-friendly manual in consultation with
practitioners.
•
Large scale replication of the pilot studies done in this study on the
completed product and writing a proposal for funding.
•
Publications to report on the progress of the ChildPIE© and to gain of
support for its application.
•
Planning of training workshops and establishment of a certification process.
These are the next steps recommended for further development of the Child PIE®. The
researcher also recommends that social workers in practice should, as far as possible,
start implementing aspects of the ChildPIE© for it to gain exposure from practice, in
order to learn how to increase the fit between the system and practice.
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Should negotiations about the future of ChildPIE be completed and the final
development drafted and standardised, the next step for the researcher would be to
have the system accredited by the Council for Social Services in South Africa.
Acquiring practice interest accreditation for Continuous Professional Development (CPD
point value) can be used as the motivating force. The last phase of the research design
(marketing and dissemination) will then need attention.
8.4
Value of the ChildPIE©
The researcher highlighted the use and benefits of the ChildPIE© in the previous
chapter, which provided support for the description of the ChildPIE© system. Of even
more significance than this description is the practical value the system adds to the
availability of measurement technology for social workers.
The ChildPIE© was
developed to address the need for a comprehensive assessment that social workers in
various settings can use, not only to assess the child in social work language, but also
to communicate in a time efficient manner. The ChildPIE© calls for a refocus on the
assessment of childhood social functioning.
More importantly, it should join social
workers in a common pursuit for clearer classifications of childhood social functioning
problems that will lead to more focused and effective practice interventions. In using
the ChildPIE© as a tool for gathering information on social functioning problems, the
face of research, needs assessment, and programme development in social work can
be changed.
8.5
Summary
From the start of this thesis the researcher showed the need for a unifying construct for
social work and showed what this construct should be. It is only fitting to end the thesis
by agreeing with Turner (1983) as well as Karls and Wandrei (1994) in their argument
that a classification system should be a conceptual tool that helps the social worker to
apply the profession’s rich and extensive body of knowledge, and that social work will
only gain parity with other major people professions when it adopts its own system to do
this.
Karls and Wandrei (1994: 18) made the point that the creation of DSM and
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psychiatry’s promotion of it as a universal classification system required millions of
dollars and a great expenditure of energy by psychiatry, with accompanying defections
. by various practitioners. However, as a result of that effort, almost all mental health
workers use the system, and the status of psychiatry has been greatly enhanced.
Karls and Wandrei (1994) also argue that the future of PIE is linked to the readiness
and willingness of social work practitioners, administrators, and educators to take the
difficult step of learning and implementing a new or unfamiliar way of identifying client
problems. This is, by association, also true for the ChildPIE©.
No part of the four-year process which compiled this study was wasted, since the
researcher learned from the ‘failed’ attempts as she could never have learnt from a
textbook, how to successfully accomplish what she set out to do. As with any new
project, it was hard to imagine at first how much she had undertaken, and it is with
ambivalence that she now ends this part of the development in order to embark on
finding new participants, fresh resources, and more knowledge on the chosen topic.
The ChildPIE© has done well in meeting the requirements set out in this study and the
advice of the co-developer of the adult PIE, but more importantly, it has done well in
meeting the needs of practitioners. The call for accountability in practice and clearer
descriptions of client problems were recognised. In the last step described in Chapter
2, Corrigan, et al. (1994), state that implementation of a new development is facilitated
when innovations can be phased in with evidence of incremental success along the
way. This is how the developers of PIE started its implementation, and this is also how
the ChildPIE© will be phased into practice. Since science is tentative (see definition in
glossary of terms), the new childhood social functioning classification system is a
tentative theory, not invalid, or even unproven, just tentative.
The value of the first
partial attempt at a classification system to identify social functioning problems in
children can therefore not be questioned.
The researcher is of the opinion that the South African social work climate is ready for
this transition since the focus is currently on ecometrics (see Chapter 1).
The
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profession will benefit significantly it supports developing technologies by implementing
them. Therefore researchers and sponsors should join resources in contributing to the
standardisation of these new technologies. More importantly, an integration of practice
principles in social work is required. As discussed in Chapter 3, an integrated approach
to social work will provide continuity in a constantly changing world, and will allow for an
evaluation of the impact of various core components on one another.
In the
researcher’s opinion these two benefits are currently sought after within the field of
social work. The adoption of a classification system for social work will accelerate the
integration of the profession’s members and its principles.
This study set out to prove that there can be a unifying construct of person-inenvironment in social work. As stated in Chapter 3, one of the obstacles to finding an
integrated approach in social work, is the tendency to accept theories and methods
without questioning them. The person-in-environment approach to practice formed part
of social work from its early beginnings.
A classification system that helps identify
person-in-environment problems is therefore ideally suited for social work.
The
improvement of such a system by extending its use to include the classification of these
transactional problems in children, further supports the adoption of this system.
The ChildPIE© is a new technology, and all technologies must be standardised to allow
for their safe use. Time, energy and money will have to be spent in order to bring the
ChildPIE© from its current tentative state to maturation. The researcher is committed to
this endeavour as a result of her belief in the professional ideals and objectives which
social work upholds.
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GLOSSARY OF TERMS
1. Accessibility
With regard to social development (see definition), accessibility is needed In terms of
physical, geographical conditions, time, language and need (Department of Social Services,
2004: 8).
2. Accommodation
Piaget’s sensorimotor theory sees that parallel to assimilation (see definition), and
complimenting it to bring about an adaptive relationship, is the function of accommodation.
The assimilation of sensorimotor elements to a given schema (see definition) would not
bring about behavioural changes and would therefore not result in adaptation. This process
by which the schema changes to conform to the assimilated reality condition guarantees
that a pattern of behaviour is not disrupted when the organism encounters new objects or
stimuli which can almost but not quite be assimilated to the schema. Whatever is or can be
assimilated to a schema is called the aliment for that schema (Wolff, 1960: 24).
3. Accountability
It refers to organisations’ and social workers’ compliance with all legislative, policy, and
financial regulations (Department of Social Services, 2004: 8).
4. Adlerian theory
Adlerian theory provides an explanation of how people form their personalities, how they
interact with others, how they are motivated, and how they become maladjusted.
The
assumption underlying Adlerian counselling theory is that people are indivisible, social,
decision-making beings whose actions and psychological movement have purpose. Each
person is seen as an individual within a social setting, with the capacity to decide and to
choose.
People are seen as socially embedded, goal directed, subjective, and creative
being who must be viewed from a holistic perspective (Kottman, 1995: 9-10).
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5. Adulthood
In understanding the process of maturating to reach the above milestone, Bocknek (1986)
provides the following explanation for adulthood:
•
Adult implies a developmental sequence in which the growth process has been
completed
•
Maturity involves variables such as stability, differentiating organisation, intimacy and
generativity (Ericson) with psycho-social functions of parenthood and teaching, selfactualisation, a healthy grasp of reality and competent choice
6. Analysis
Analysis is seen as the dissection of a person’s behaviour to discover his underlying driving
forces and wishes (Plug, et al, 1991: 22).
7. Anomy
Social
instability
caused
by erosion
of standards
and
values,
Alienation
and
purposelessness experienced by a person or a class as a result of a lack of standards,
values, or ideals: “We must now brace ourselves for disquisitions on peer pressure,
adolescent anomie and rage” (Charles Krauthammer - www.dictionary.com).
8. Aspect
The perception a person holds with regard to a matter, or one or the other side of the matter
as seen from a certain viewpoint (Plug, et al, 1991: 29).
9. Assessment
According to Hepworth and Larsen (1990: 193) assessment is the process of gathering,
analysing, and synthesizing salient data into a formulation that encompasses the following
dimensions:
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/
❖ The nature of the client’s problems, including special attention to developmental
needs and stressors associated with life transitions that require major adaptations.
❖ Coping capacities of clients and significant others, including strengths, skills,
personality assets, limitations, and deficiencies.
❖ Relevant systems involved in client’s problems and the nature of reciprocal
transactions between clients and these systems.
❖ Resources that are available or are needed to remedy or ameliorate problems,
and the
❖ Client’s motivation to work on their problems.
The nature of the assessment process varies according to the practitioner’s specified role,
which is largely determined by the setting in which the social worker functions.
10. Assimilation
With Piaget’s theory on cognitive development, sensorimotor experiences are registered in
the schema (see definition) by the invariant function of assimilation.
Psychological
assimilation is the tendency of every behaviour pattern or of every psychological state to
conserve itself and, toward this end, to take its functional alimentation from the external
environment.
It is the reproductive assimilation that constitutes the schemata, the latter
acquiring their existence as soon as a behaviour pattern (regardless of its simplicity) gives
rise to an attempt at spontaneous repetition and thus become schematised (Wolff, 1960:
23).
11. Asymmetrical / complementary interactions
An interpersonal relationship wherein both persons accept the structuring of the relationship
of the other in order for their behaviour to fit with or compliment the other, for example the
relationship between tutor and pupil (Plug, etal, 1991:183).
12. A-theoretical
Unrelated to or lacking a theoretical basis (www.dictionarv.com).
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13. Atrophy
The deterioration of organs, nerves, and cells, which usually stems from malnutrition,
inactivity, injury of nerves, or lack of oxygen to the nerves (Plug, et al., 1991: 33).
14. Community
There are three levels at which the term community may be used, namely:
❖ Geographical communities representing people within a defined geographical boundary
❖ Functional communities referring to specific groups which exist within geographical
communities, such as women, or youth.
❖ Communities with common interest made up of defined specific groups across
geographical boundaries, for example members of a savings club (Van Rooyen and
Bennett, 1995: 17).
15. Community development
Community development refers to the process and method that is aimed at enhancing the
capacity of communities to respond to their own needs and improving their capacity for
development,
through
community
mobilisation,
strength
based
approaches
empowerment programmes (Department of Social Services, 2004: 15).
and
Community
development is perceived as a complex process made up of two essential elements
(Department of Social Services, 2004: 15-16):
The participation of people in efforts to improve their level of living, developing a sense of
ownership of the process, taking initiative and contributing meaningfully to joint planning,
decision-making and implementation / evaluation
The mobilisation and provision of resources, and the creation of access to opportunities that
encourage initiative, self-help and initiatives for mutual benefits
16. Concepts
Concepts are the basic building blocks of theory. They are abstract elements representing
classes of phenomena within the field of study (Turner, 1986 IN Rubin & Babbie, 1993: 45).
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17. Conceptualisation
The process by which to understand a specific thing through forming thoughts about it, and
by finding and manipulating a description, and explanation of the concepts.
Concept
formation differs slightly in that it refers to the process by which a person forms or acquires
his own concepts through education and experience (Plug, et al, 1991: 185 & 37).
18. Conduct Disorder
Conduct disorder (CD) is characterised by persistent dissocial, aggressive, or defiant
behaviour representing serious violations of age-appropriate norms or the basic rights of
others.
The diagnosis of CD depends on social judgement and, by implication, is a
relational problem - aberrant relationships with animals, peers or authority. Although the
relationship is the cornerstone of CD, the relationship as experienced by the child is often
overlooked (Slabber, 1999: 7,13).
19. Conflict resolution
Conflict usually refers to disputes and disrupted relations between individuals or groups who
have incompatible or rival purposes, value-based norms, needs, feelings, opinions, interests
or desires (Chetkow-Yanoov, 1997: 16).
20. Construct
A concept that is defined formally with reference to relations between empirically observed
things.
It is also an idea or abstraction that exists of two poles which allows for
classification and prediction of events, for example good-bad, strange-familiar (Plug, et al,
1991: 187).
21. Culture
Culture generally refers to the distinctive body of customs, beliefs, and institutions
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characteristic of a racial, ethnic, religious or national group. Social factors such as socio
economic status and client variables such as sexual orientation and age are also important
in classifying problems and could be included in a broader definition of culture (Lopez and
Nunez, 1987: 270).
22. Delinquency
Delinquency is a broad and heterogeneous concept. It reflects diverse antisocial acts such
as theft, burglary, robbery, vandalism, drug use, and violence. Technically, the term
"juvenile delinquency" is a legal concept that involves juveniles breaking the law. On the
other hand, most delinquent acts are not detected, and consequently the more general term
"delinquency" is almost synonymous with antisocial behavior (Liu, 2004).
23. Dementia
An organic brain syndrome characterised by loss of intellectual ability and eventual
impediment of his social and work functioning.
It includes poor memory, poor abstract
thinking and judgement, disturbance of higher cortical functions, and personality changes
(Plug, et al., 1991 59).
24. Depression
A depressive illness is a whole-body illness, involving the body, mood, and thoughts.
It
affects the way a person eats and sleeps, the way he or she feels about themselves, and
the way they think about things. Five to six percent of the population will have a depressive
disorder during the course of their lives, and nearly two-thirds do not get the help they need.
Treatment can alleviate the symptoms in over 80% of cases.
Major depression is
manifested by a combination of symptoms that interfere with the ability to work, sleep, eat,
and enjoyment of once pleasurable activities (Depression and Anxiety support group, 1998:
1,2).
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25. Development
Development is the process by which organisms grow and change over the course of their
lives (Shaffer, 1996:4).
.
Chanpier (1997) defines a stage of development as an age period when certain needs,
behaviours, experiences, and capabilities are common and different from other age groups.
Each stage of development has certain tasks associated with it. These tasks focus energy
toward certain goals. For example, one of the main tasks of an adolescent is establishing
independence. The goal might be leaving home and starting a career after high school.
For eight-year-olds, a developmental task is to develop a sense of accomplishment from the
ability to learn and apply skills.
This could focus their energy on the goal of hitting a
baseball or reading a more advanced book.
According to Leinet (1998) at each stage of development the child is learning in several
areas at the same time.
A toddler is learning to walk (physical), learning colours
(intellectual), is uncomfortable with strangers (social), expressing feelings of independence
(emotional), and becoming aware of adult disapproval for misbehaviour (moral).
26. Developmental social welfare
Developmental Social Welfare focuses on social protection, the maximisation of human
potential and on fostering self-reliance and participation in decision-making. It also stresses
services that are family oriented, community-based, and integrated (United Nations, 1987
IN Department of Social Services, 2004: 12).
Related concepts are: appropriateness,
efficiency, effectiveness, empowerment, equity, participation, partnership, self-reliance,
social integration, sustainability, transparency and universal access.
Appropriateness implies responsiveness to social, economic, cultural and indigenous and
political conditions (Department of Social Services, 2004: 8).
Efficiency and effectiveness imply the achievement of objectives in a most cost-effective
manner (Department of Social Services, 2004: 8).
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Empowerment refers to power relations being shifted towards people achieving greater
control and influence over decisions and resources that impact on the quality of their lives
through increasingly interdependent relationships (Department of Social Services, 2004: 8).
Equity means expenditure of resources based on need, priorities, and historical imbalances
(Department of Social Services, 2004: 8).
Participation implies that people should be fully engaged in their own process of learning,
growth and change, starting from where they are and moving at their own pace (Department
of Social Services, 2004: 7).
Partnership is the collective responsibility of government, civil society and the business
sector to deliver services (Department of Social Services, 2004: 9)
Self-reliance means people should be connected to each other and with their environment
in ways that make them more effective in their individual and collective efforts toward a
better life, including development of leadership, decision-making, planning, and so on
(Department of Social Services, 2004: 7-8).
Social integration involves policies and programmes, which promote social justice
(Department of Social Services, 2004: 9).
Sustainability means the achievement and long-term maintenance of desired goals
(Department of Social Services, 2004: 9).
Transparency means access to information, openness of administrative and management
procedures (Department of Social Services, 2004: 8).
Universal access implies that social development services are available to all vulnerable
groups. No individual or group is denied access either because of lack of resources or lack
of knowledge of how to access services (Department of Social Services, 2004: 8).
27. Diagnosis
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Diagnosis is associated with symptoms, disease, and dysfunction, and because of its focus
on what is wrong with a client it is not seen as complimentary to social work theory
(Hepworth and Larsen, 1990: 193).
28. Early childhood inclusion
Early childhood inclusion refers to legislation amendments allowing for the inclusion of
disabled and developmentally at risk children in a meaningful early intervention system. It is
the existence of planned participation between children with and without disabilities in the
context of children’s educational / developmental programs. Inclusion replaces terms such
as mainstreaming and integration. This inclusion is not limited to schools but extend to the
participation of children with disabilities and their families in typical activities found in their
neighbourhoods and communities (Guralnick, 2001: 3-4).
29. Evaluation
Evaluation in the helping process has a direct link with the attainment of goals.
Goals
involve growth or changes that have no limits, and judgements must be mutually made
about when a satisfactory degree of change has been attained. Evaluation then enables
social workers to test the efficacy of interventions and to monitor their own success, failures,
and progress in achieving favourable outcomes (Hepworth and Larsen, 1990: 36&37).
To Rothman and Thomas (1994: 267) evaluation in intervention research meant an
empirical inquiry directed toward determining the effects of the intervention, including its
effectiveness.
30. Foster care
Foster care is the statutory substitute care within a family circle for children who cannot be
cared for by their own parents in the short, medium or long term, while services are
continued to the parents in order to return the children to their care within a specific period.
A foster parent is a person, other than a parent or guardian, in whose care a foster child is
placed under the Child Care Act, 74 of 1983. A foster child is a child who, in accordance
with legislation, is placed in the care of a foster parent (Van der Westhuizen, 2001: 8)
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31. Generalising assimilation and differentiation
The process by which new aliment is incorporated into a global schema so as to create
disequilibrium, and eventually to construct a series of derivative sub-organisations is called
the function of generalising assimilation. As the consequence of generalising assimilation a
global schema undergoes differentiation and the newly acquired schemata as well as the
original schema will operate separately or in conjunction in the more highly differentiated
mental organisation. During the early years of sensorimotor development, generalisation is
the consequence of environmental variations imposed on the passive organism rather than
the result of the organism’s active generalising tendency (Wolff, 1960: 26).
32. Human needs
Human needs are those resources people need to survive as individuals and to function
appropriately in their society.
Needs differ according to situations and developmental
stages. Human needs usually include the following:
□ Sufficient food, clothing, and shelter for physical survival
□ A safe environment and adequate health care for protection from and
treatment for illness and accidents
□ Relationships with other people that provide a sense of being cared for, of
being loved, and of belonging
□ Opportunities
for
emotional,
intellectual,
and
spiritual
growth
and
development, including the opportunity for the individual to make use of their
innate talents and interests
□ Opportunities for participation in making decisions about the common life of
one’s own society, including the ability to make appropriate contributions to
the maintenance of life together (Johnson and Schwartz, 1994: 4).
33. Informal settlements
Informal settlements are those where no formal structures or development of services had
taken place, and where no plans had been authorised or passed for that particular area or
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community. Seen in this light it is not synonymous with squatter settlements (Van Rooyen
and Bennett, 1995:17-18).
34. Item
An item is any single indicator that enables a practitioner to assign a number to a client in a
systematic way in order to represent some property of the client with respect to that
specified variable. It is the smallest possible device for gathering information and consists
of one statement, one question, or one stimulus that is used to obtain needed information
(Hudson, 1982:138).
35. Inter-personal
A term referring to the processes whereby one or more persons are involved, for example
relationships among group members (Plug, et al, 1991: 161)
36. Intra-personal
A term referring to the process that occurs within an individual (Plug, et al, 1991:163)
37. Item analysis
Involves establishing certain characteristics of potential items of a test or inventory, like
difficulty value, correlation with total test score, and discrimination index. On the basis of
the results of item analysis, item selection is executed (Plug, et al, 1991:166).
Item difficulty is reflected by the proportion of respondents that were able to answer the item
correctly. The discrimination index refers to the quantitative measurement of how well a
test item distinguishes between persons that differ with regard to the aspect being
measured (Plug, et al, 1991: 166 & 67).
38. Measurement
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"Measurement is the assignment of numbers to events or objects according to rules that
permit important properties of the objects or events to be represented by properties of the
number system” (McBurney, 1994: 69).
The rules by which the numbers are assigned to the events determine how useful the
measurement is (McBurney, 1994: 69).
Questionnaires, indexes, or scales are all instrument types used for measuring (De Vos and
Fouche, 1998: 82).
39. Mutual assimilation and accommodation and integration
In Piaget’s theory on cognitive development the function by which two or more behaviour
patterns coordinate to form a new pattern of higher complexity is called mutual
assimilation and accommodation. Its effect is the integration of schemata into super
ordinate organisations. Two schemata which have differentiated from one global schema,
or two originally independent schemata which have each assimilated the sensorimotor
components of two or more simultaneously active circular reactions, will remain in
disequilibrium until they have been integrated as a new super-ordinate organisation (Wolff,
1960: 27).
40. Neonatal
A term referring to the period shortly after birth and the first two to four weeks of the child’s
life (Plug, et al., 1991:234).
41. Operasionalisation
A methodological approach that attempts to remove unclear and ambiguous terminology
from scientific language by demanding that the meaning of all concepts are made clear
through operational definitions.
Operational definitions then are definitions that link the
meaning of the concept to the procedures used to measure, test, or discern that particular
aspect (Plug, et al, 1991: 252).
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42. Paradigm
A paradigm is a fundamental model or scheme that organises our view of something.
Although a paradigm doesn’t necessarily answer important questions, it tells us where to
look for the answers, and where you look largely determines the answers you’ll find (Rubin
& Babbie, 1993: 45)
43. Perceptual Motor development
The obtaining of information by the brain through the senses as a result of motor movement
(Sasse, 1990:27).
44. Perinatal
A term referring to the period just before, during, and after the birth of a baby (Plug, et al.,
1991:271).
45. Prenatal
A term referring to the period from conception until birth (Plug, et al., 1991: 282).
46. Psychopathology
A branch of psychology that studies abnormal behaviour and mental illness (Plug et al.,
1991:296).
47. Psychosocial
Term pointing to cases that are both psychological and social, in other words where both
the individual and other people are involved.
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48. Psycoticism
A personality dimension which can be identified through factor analysis and which is related
to tendencies towards.psychotic behaviour (Plug, et al, 1991:297).
49. Random error
The part of the value of a variable that can be attributed to chance (McBumey, 1994:126).
50. Recognitory assimilation
With Piaget’s theory on cognitive development the eventual phase of learning involves the
flowing process: Once a global schema is differentiated and its derivatives integrated, the
infant may encounter a familiar object - i.e., an object to which his behaviour is already
adapted. He will respond to the object but no circular reaction will be set into motion and
the behaviour pattern remains essentially unchanged. Such a single response which is not
followed by a self-initiated repetition is explained by the assumption that the encounter has
not created a need to function (the behaviour is already adapted to that particular stimulus),
and that the assimilation of the aliment to the schema is already in equilibrium with the
schema’s accommodation to it.
This is called recognitory assimilation, because the
response implies a kind of recognition which constitutes the basis for later complex
recognitions and discriminations.
Recognitory assimilation does not lead to repetition of
behaviour and does not induce a new disequilibrium and does not lead to further
differentiation (Wolff, 1960: 27-28).
51. Reflex and REM sleep
A Reflex is an involuntary motor reaction to stimuli during early infancy (Shaffer, 1996: 160
& Trawick-Smith, 1997:128). REM sleep is a state of active or irregular sleep in which the
eyes move rapidly beneath the eyelids and brain-wave activity is similar to the pattern
displayed when awake (Shaffer, 1996:163).
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52. Schemata
Piaget postulated the existence of flexible mental organisations - the schemata - in order to
account for the influence of all previous experiences of a particular behaviour pattern on the
form of that pattern in the present. The schema is the primary unit of mental organisation
where past experiences are stored and makes the partial determinants of present
behaviour. This implies that an inherent mental organisation exists before the organism has
experienced the external environment and he experiences the environment in terms of this
existing organisation (Wolff, 1960: 21-22).
53. Science
Science is a way of obtaining knowledge by means of objective observations. Objectivity
sets science apart from what is not science and this is why scientists place importance on
proper research methods. Because science is an empirical enterprise, it follows that new
evidence is constantly being discovered that contradicts previous knowledge. Science is
tentative - it never claims to have the whole truth on any question. Technology has the
goal of making something work, whereas science has the task of understanding why it
works (McBumey, 1994: 8-10).
54. Social / community support systems
A person’s social support system refers to the nurturing environment in which vital needs
are met.
This environment should in essence provide in the following (Hepworth and
Larsen, 1990: 248-249):
Attachment, provided by close affectional relationships that give a sense of security
and sense of belonging.
❖ Social integration, provided by memberships in a network of persons that share
interests and values.
❖ The opportunity to nurture others, which provides incentive to endure in the face of
adversity.
❖ Validation of personal growth, which promotes self-esteem, provided by family and
colleagues.
❖ A sense of reliable alliance, provided primarily by kin.
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k /
<* Help and guidance, provided by informal advisors in resolving difficulties that arise.
55. Social development and social development approach
Social Development is a process of planned social change designed to promote the well
being of the population as a whole in conjunction with a dynamic process of economic
development. The goal of social development is the promotion of social welfare. Welfare is
used in the broadest meaning to connote a condition of social well being which occurs when
social problems are satisfactory managed, social needs are met and social opportunities
are created (Midgeley, 1995 IN: Department of Social Services, 2004:11).
Social development approach uniquely integrates economic and social objectives.
It not
only recognises the critical importance of economic and social development in raising
standards of living but also actively seeks to harness economic development for social
goals (Department of Social Services, 2004: 11).
56. Social functioning
Social functioning means the role performance of an individual in its entirety at all levels of
his existence, in interaction with other individuals, families, groups, communities and
situations in his environment (Social Service Professions Act 110 of 1978 IN Department of
Social Services, 2004: 14).
57. Social Indicator
Roestenburg (1999: 15) quotes the definition by the US Department of Health, Education,
and Welfare of 1969, in describing social indicators to be a statistic of direct normative
interest, which facilitates concise, comprehensive, and balanced judgements about the
condition of major aspects of society.
The normative nature implies that indicators are not merely value-free descriptions of
reality, but measurements of increases and decreases in societal conditions, thus making it
restrictive since norms can change in time and might be influenced by pressures from
subgroups or influential subjective opinions (Roestenburg, 1999: 31).
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58. Social services
Social services refer to the broader and comprehensive range of services relating to social
welfare services and community development provided
in a continuum to ensure
sustainability of intervention efforts Department of Social Services, 2004: 12).
59. Social Welfare
For Friedlander (1961) social welfare implies the organized system of social services and
institutions, designed to aid individuals and groups to attain satisfying standards of life and
health, and personal and social relationships that permit them to develop their full capacities
and to promote their well-being in harmony with the needs of their family and the community
(Roestenburg, 1999: 15).
Classification of welfare service delivery occurs in terms of the levels of intervention and in
terms of the nature of services (Department of Social Services, 2004: 19).
The levels of intervention are (Department of Social Services, 2004: 19-20):
Prevention - strengthen and build the capacity and self-reliance of client.
Early intervention (non-statutory) - use developmental and therapeutic programmes to
ensure those at risk are assisted before statutory services are required.
Statutory intervention / residential or alternative care - client becomes involved in court
case or is no longer able to function adequately in the community.
Reconstruction and aftercare - services to enable client to return to family and community
as quickly as possible.
The core services rendered by the social service sector are grouped into the following 5
categories (Department of Social Services, 2004: 22-24):
Promotion and prevention services
Rehabilitation services
Protection services
Continuing services
Mental health and addiction services
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(/
60. Social work
Social work means a professional service performed by a social worker aimed at the
improvement in the social functioning of people (Social Service Professions Act 110 of 1978
IN Department of Social Services, 2004:14).
61. Standardisation
Standardisation is the procedure whereby a test is prepared for use. This involves the
finalisation of the outlay of the test, specifying the way in which it should be applied, testing
it on a large group from the population for which the test is intended, the calculation of
norms, and establishing the validity and reliability of the test (Plug, et al, 1991: 346).
62. Statements
A theory comprises of several types of statements. One type of statement and axiom, is a
fundamental assertion - taken to be true - on which theory is grounded. A proposition is a
conclusion drawn about the relationships among concepts,
interrelationships among the axioms.
based on the logical
Hypotheses are specified expectations about
empirical reality, derived from propositions (Rubin & Babbie, 1993: 45).
63. Symmetrical / egalitarian interactions
An interpersonal relationship in which both persons display similar behaviour with each
other, which implies that neither of them accepts the other’s structuring of the relationship.
The relationship is therefore competitive (Plug, et al, 1991: 326).
64. Syndromes
Central to the concept is the sense of a unique constellation of signs and symptoms which
occur together frequently enough to suggest an underlying disease process. Syndromes
form useful working rules to deal with the complexity of symptomatology (Walsh, 1991:19).
391
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65. Task
Any action or series of actions related to an (exercise), with a specific goal and which
constitute an aspect of this (exercise). Task analysis will then be the systematic study of
the worker’s task or tasks and the situation in which it is conducted (Plug, et al, 1991: 358).
66. Theory
Social scientific theory has to do with what is, not what should be. Scientific theory cannot
settle debates on value. Social scientist cannot agree on what is right or wrong, only on
some measures of aspects related to human science. In the way a stopwatch cannot tell us
who is the fastest runner unless we agree that speed is the critical criterion, social scientist
need to agree on what are the common criteria when measuring human behaviour. Social
science can assist in knowing what is and why. A theory is a systematic explanation for tge
observed facts and probalistic relationships that relate to a particular aspect of life (Rubin
and Babbie, 1993: 18&45).
67. Thesis
The term thesis is commonly used to refer to a scholarly paper as a presentation of an
argument in support of a proposition as a way of focusing your writing. An argument is a
set of reasons in support of a proposition.
A thesis can be seen as a written report, a
scientific writing aiming to persuade as well as to inform. Good report writing include clarity
(say exactly what mean as directly as possible), brevity (does every word, phrase and
sentence contribute to the paper), and felicity - pleasingness of style (McBumey, 1994:
331-333)
68. Validity
Construct validity - the property of a test that actually measures the constructs it is
designed to measure and no others.
Face validity - the idea that a test should appear superficially to test what it is supposed to
test.
392
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Content validity - the idea that a test should sample the range of behaviour represented by
the theoretical concept being tested.
Criterion validity - idea that a test should correlate with other measures of the same
theoretical construct.
(McBurney, 1994: 123)
69. Variable
A variable is a concept’s empirical counterpart.
Where concepts are in the domain of
theory, variables are a matter of observation and measurement, and therefore require more
specificity than concepts (Rubin and Babbie, 1993: 45). A quantitative variable varies in
amount whereas a categorical variable varies in kind (McBurney, 1994: 65).
393
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EMAIL CORRESPONDENCE FROM JAMES KARLS
Pa&c 1 ol'l
Swanzan
From:
To:
Clc:
.com>
I korni&a. net>
<ram3ay1^maiLaat.n«t>; <<2imsay<g»ac3s,u«sa^iary.ca>
Monday. Novemi>er 20, 2000 ©:12 PM
Re: Oissertetion on PtE
<
I am pleased to hear from you and will be $lad to correspond with ^mi. on bow
to develop PIE in S. A. I enjoyed meeting Or RoeMenburg and hearing, his
presentation We were very pleased to hear of PTE application in S, A. noting
yoor positive experience. ReganSng the use of PIE with children .and
adolescence ftn sure you are aware that a PIE assessment of the parents sheds
much light on the problems experienced by the child. It can also be used with
older emancipated adolexcenets as it stands. Otherwise there is need to
develop a child assessment system utilizing the PIE concepts. We have mti had
tiw rescurees re work on this but hope that we-.might some lime m the future.
On teaching PIE in S, A. we would be glad to aasm you in developing
workshops The mw software -CompuPIE by myemlf and associates and the
Imeracdve learning piece developed by Richard Ramsay in Canada. should
help in conducting workshops, and training programs. If you aren't acquainted
with this material yet let me know.. You can learn about CompuPlE at
www CqmpuPfFqrg and I' am ectag this nwssage io Prof. Ramsay so he ean tell
you more about Im software. You can of courae copy the MinM>IE without
violating the copyright and we the encyclopedia, article to introduce Pie in
training sessions at low cost. There is no easy way to reproduce.the Manual,
but you might want to develop reference copies for those who can’i afford to
purchase the manual. Please share what you thin ofthese comment^ and let me
know if you want to acquire the soRware. Ifyou can download the
demnstration version and .find it useful let. me know so that we can discuss
how we might work together forhter. Sincere^ James M. Karts, Ph.O. ECRW
Clime Associate Professor, University ofSouthern California
From:
TO!
Serstr
.com >
Tuesgsdhay. I^ovember S8-. 2000 10^20 PM
Fie m S.A.
■'Ffwnks for sharing ymir tihou^hts and infb al>out yourselF. Congratulations on
pending parenthood.. From w-har you have said 1 oonelude you ceiiainly tave the
spirit and the eocrsy to proceed with trainir^g others in the PIH System. IF
you wish to go ahead, with planning workshops and training sessions please do
so. There is nodtsng to prevent an enuepeneur fiom initiating training.
sessions.. .Many social workers are teaching it without formal training or our
erxlorsement and that's ok by us. In the USA it helps if*you have an.
aTHHation with a school of social work or your profoasiortal association. It
improves your credibility. We thmk the system is straightforward enough that
a smart teacher with the kind of motivation you exhibit can do a competent
job. We can help IT you have questions or run into difficulties. If you have
a fax number please semi it We ca» seod some materials via that method since
same items are not in format, to send by email. .Axe .you acquainted with Pedro
Rankin and hlike Wey'ors at the School for Psychosocial Behavioral Sciences at
Pctdhehtroam? Mike has a copy of the .RIH todning CO developed by Oick
Ramsay and may have a copy of the d«Tio versfon of CcanpuPIB If you krow him
or could otherwise borrow that CO you might get some good ideas, on how to
teacii FIB using a computer.. Tell us how your plans are shaping up and what
you need to get lauanched.
On your question about what lead us to develop PT^. It springs foom some of
the same sentiment you describe in your relationship with psychology. In the
US s*ociai work is required to use psychaatry’R classi Heat ion system
fox a variety of reasons and so play s a secondary’ role in. ’‘’treating**
clfonts/patients. We require social workers to leame this system even tho wc
have a diOerent philosophy and approach. .1 think social work’s holistic
approach is much nwrc effoctsve than psyctnatry*s -disease model and so arose
the task of developing a comparable system beat one which gave s-ociai work’s
model primacy and also clarified social work’s areas of expertise. This lead
to the work we have done thus far. Best JMKarls
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James M . Kaals
1335 Mission Kid&e Road
Sassta Barbam, Califoroia <>3103
SO5 5<S4 4&WS;iaKK.
24S2
jnAari^ao! eom
Oesw Rika Swasn^es*-
Use 3%%l»<$ays have come and
and we are w-c51 into the new year. I had pbmncd «o send yoo the
wexirnyMMayh^g; material to help in ycwjsr- teammsg sestons. I geracraSy ask trainees to read one of these ( the
artScSe is mors* U3efwl> before •cosnss^f. to the Sirs®, session. 31 is reSaosvely xho-« f.shorlcr than she
bo«.< cStapaesrs) and gets snexst people mto she coswepts and lar^taa^e of PUS more easily than from a straiglM
Seemm. The nsatsit learmng ccRnes in apptym& the concepts to first video arsd the five cases- {depending on
sawe they dostflt
jtoImwb). For!ivecases ■_
'_"
_
ges km in dettfil <w pmcess. It helps to have the presemsaiem done by someone who is already pretty PIE
savvy.
ym» ca® get it to operate and find it usefid let me know and well send a code number to make it pcsmaimsrt.
To cspen the «fc«no versskm ose ""demo* fiwr the esratiy code when asked «M» the installafion. Your brother
sbmdd be able to JSgme this mat.. Since weW invested a saribstamiaS assMMsu® of money in the devciopmeoa of
the sofiware we hope to be able to gsat some compeaasation bur I -wowdd be willing to waive the charges if
you w«»dd prowMste it in your traimng sasssknES.
Ect me kwsw- how tbin^s are gong. Scmaeday I should lake So v^sit Smath Africa. Bess wishes for the saew
year amd for the birth of a happy hesahhy chiM
—
?W3Ca»is
Swanzen
From:
To:
Sentz
Subiece
net>
Friday. January 25, 20CG B:55 AM
FIE in South Afnca
f waa pleased to hear from you that you hope to be aUe to be creative and function wen work in your parent
rote as weH as your oomipationai rote. It does Uifce a m to raise a small child and pursue a career i hope you
have a helpful partner. 1*1 try to ans’sver some of your quesOom In your las? email message- Hrst the £11
disasier has awakened our ahzens to rhe face that we are nm InvukiemtMe. some have responded with anger
amd a desire for revenge. Others am pondedng the political sluaOon that brouahl this incident about.. Uke in a
post Iraunwttc ease th® fwlngs are now be tied for most but the anxiety and fear of danger persists. The
United States will not be quite the same again.
On your ■ •ff '.xt to utilize {PIE in your doctoral research: h appears you would really like to do a version of the
PIE that would ba applicable to Ghildren. At the time we were cunslruoting the system we had hoped to have a
system that would include children but our resources at the time preciuded that. W® thought that there would
do. So far only a grot^ of psycnoiogists In the New England area have worked on il and I do not know how
successful they have been. If you think you want to oreete a version of toe PIE that would be used exclusively
for Mildren I think you could use the same dwgn we developed for adults. For Factor I you could identify the
common miaucmships that children have and the types of problems that occur For Factor II you could identify
the weiei imOultora mat exist to mos? somties to address me support of children. You couid use most of the
same megortes that we have in PIE. And you could also include a listing of common childhood Mental health
problems, for Factor HI and physical heahh problems, tor Factor IV Showing the mieraetton between adults
and ehitonen to cWfciift to do to a systematic way. that to why we toft a sectton in the software for the assessor
to describe in written terms their optotons about the case dynamics.
The selection of content tor PIE was the result of som^ two years of debate amongM a group of practitioner
and academicians. We
tor the system you see as being descriptive of a efiente problem and with a
minimum of imposltton of any of the many theories of human behavior that our calleagues use. We think the
system w-e have describes the common human shuattons in most cultures as witnessed by the fact that in the
six years since the publtohtog of PIE many other countries with different cultures than th® US have been able
to -adapt the system to their use (Korea, Japan, Hungary, Spanish speaker, French speakers, Greece, etc,)
I wish you we0 in your effort. From our point of view you are free to totoxtoce the PIE system to you
colleagues in. South Africa. We are more inierestod to promoting a universal system for social work than m
monkery gain. K®ep me posted on your progress, James M. Karts
423
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S wanzen
From:
Sent:
Subject:
<■ Umkarls^aol. wm >
<swanzm@ teikemea. net >
Thursday, August 07. 20)3 7.30 PM
Child PIE
I have returned to Santa Barbara and have had time to twview your earlier
and your project
pFOposal. First the fefer^nc^s. The encyclopedia reference is from the Enc’/clopedia. of Sociw VWrk punisher
MA.SVV Press, Wshingto,O..C..
The PIE article >s rt VoB^pp 1B1_8-1B27 The New Technology article
was
1o- answer your question, about the ^esthnnalreiS^'in field lasting; 1 was unable to find the
papers oq mis but I can tell you the method used; We had developed an early version
The system andsn a
format similar to the Msni~P1H We asked the president of each NASW chapter to identify three sempr soda!
work practitioners who might participate -n tie test TtW'S^ social workers were given written i-nformation about
rhe eysiem and tnstnjcti.ons on how to use it in practice, they
asked io use the system on three cases
and then to send vs their critique of the system answering questions such as was the system clear and
mderstandabie..did it help son out the problems the cheni/pa?ient presented, Aid if lead to an intervention
plsn Respondents were also asked to make raGommand^^^to
points a at. might t>a contusing
The information gained from this field test was used to refine the system and to produce a second version of
PIE that was tested again r» different parts of the U. S. A in the second field test groups of social work
prEKztr.ro^rs wore first provided training in the system (a 6 hour workshop) and fhen were presented cases
(video taped) wh?ch they were asked to assess using the PIE. System. This proCteW addressed concerns
a^out inter ratec..reiiabHHy and\b»sg«n...te address
need to varrfy yahdity of the system. Some of this >s
reported :n the PIE Manual in the Chapter by Janet WHfemAwho conducted'much of our rehabihty and validity
study.
As I read you proposal I think you have taken on an enormous task, i would be interested in hearing front ydo
what the content of the ChildPIE System would be I thin I had mentioned to you (ct st is in some of our
publications) ^at the task force had considered dwelopfog a PIE for children but. for praci^ai purposes: (lack
of tiwM arxi time) opted to focus on adults I do think the PIE structure could be
to chi Wren but much
wk would need to be done to Hieritify the social timet inning prabtems of children m deferent ages.
Environment-^ issues would aiso be different for cftildren and so d would be necessary to examine the content
of PIE’s Facfor II and determine how many of the items ere relevant for children. PIE'S Factors H and h/
stfouki pose little problem. Keep me posted on your progress. JMKaris
tSywa oz-j^r?:
f® rc>iy»:
T0:
zScHn-t;
’*S>v>/i7«na'»f?-rj'' -«> swMrfzen@telk0msa.net'-■James K-arte" ■•:.Jmkaris@.aol.cbm>
■C^turUay,
'sG. ;>OOU rt QI P’M
:
Tjumu-Jily i n.».•<.»
to uml.srs'.totoef wtoy- ? 10 orjQirml r’lfc -.733 Ue-v^fope-a toy
vr*o!«?
i too toot ttoiri^
i to:-avto enough kno^oa<g:o or o-.xportfs.^ to too this-, toy
At tfu« po<m l
l
fjotrt ttoo
1 >^<r to^toi v- p^toos Uif-vou.^eitotois. in front of post's sj-nto < offo^rj.ss
And Uavin<3 Or F^o^a-ste-ntosuig wtoo so .j rne^jor
foro^ in ^uichn-g occteditahot of ,t,3i»dardv<» 1 smo-s^j^s; i gjet very rfeft fe-oUU..ic. v •rc-n-ii Him <n vtoUelctonjg tko
■'.y
. t e Oct t to. it ne i«» oxc it^to <31 •e,*=, n i«? to op®’ fvl\ r*“ isornn.j »-5 to -"lo • of op ttoo miti 11
tor "ny
toootor?5te=- on wtosch I c-ssn-1mproy to oti over the-foHovvi'rtgj. f-sw yoorgi.. I siirri.vt.-jsy <nvare ibcit I only oot to knew
totoout yo‘.,- t ’’to ? 4 year?.
if was iriiti iUy developed
Oq I think 1 am
- »lv reolistiC
My srvto.si
mocfeto for c hiklhooto s,toe.-i<4 I u< lotiomn^ i«-. toto^-O on Vto?> ^yll« (“1
Utohnttson of ecofcsqv
I ■ -it n^-> r VO eoncfcrpts- rmm^ly
(th« physsiosM on cl s-ooii&l ft.«rhno wjttoin .4 psaruouter ctolturis* sotrinto)
o.-to/trs- f^wt«xttjs>4srs. of
©j:GUf>i®d-;by PTtofototom of thto stoOrritTioriily). I
Concepts' formsi ttoo fo».jricibtion
- for. nx-. sineft s-s rru-festone fh maturity involve fjntoincj one's- rote in isooioty. From this-1. reason thot it tos not
exp^oreto of ohjltoren to U»ke Mp roles »?i sotoety until Hiev sarts mniuro (whtuh le^eHy ss^ts, d^ftn^ci n«»
n-sotoady non oUituratly if ;ijs £-een toifferently of Otour^e)
For ttoie reneon the roioo of tno Fie cennot. toe us.eci feut
sei the uftirr.ete “totu-ses.
tohrlo
© row into This ohrkfFH- n>uof Stojorefofo otesi^+y protoiems. tfiait o-nn
smpotoe >rk!s* rrs-atursty At present i tom looking isito 'asses^-ment sa^peoie: rno^t social- wo> kje?r.-s in TS A wosjlto
irn-Jutoe tnget s« oompreh^n^A^ picture tof: the ctoiRro oitusitiori
Theie arefhtee «.fe«,ifs (or factors’! of
the- ohilto rrnrrapertsonai Eispoctfasj the fetn-uly «iy^tem (prjm«»ry etoci firrst r^/nli.’.-r! of the ohiito
loyponjupte for teto^nin^ is^tef-perr-sorirjl rs;kiil'A>;. eriti the toroetoer oommsjmfy tout xx>fh reej^srp to -s-uppoto of tn«^
otosito 3s ^ovoiopment v ett-anr (c
to Umilr »i t th?- pommunity) toepJth <_ »>U&
thtoot^ uhynioia! ilines,=«e-s,.ssl! imp«'uing growtfi and rmtuiitv> <>Hd ths* odnr^tiosial sytoetn (nVening to ih" atovor
y MncVon of ->oc!o<
vzus k tto Ci-i-^un.' irsoluiSfon of vnlneraWe mci el «h»fc <_'hittoren to heve«ec{M®U toppof-furirty to oooorrte funotsonol
.• .
.
yy^ll hiist i 5. Trying to put it iff *1 r?ubsih»»?i
Two m<ajor unef^rtyin^j ll-iej-orfor
opincj
rnodel that guides
ais-.’s^ssin sorit £?nU interyention rs th« c.-<a«s«f■
rnoUoi as ttotsorih'oei toy-R’cythnKan
S-'n<jor (1 998) sand
AUl^r^-s! >
hietapv mudul by Koitman
Sinoo rci,ouic_-fo hnk«sg5«^ te 1^.0 fnt*e-omt« to uase
management (which cothbmes:'ene4)o.-one .«ancf‘^tofhnrn.jrilty approaches) i• ys4fi include ah inittal resource H-'S-tfor
Gauten&'se.ruioe-%. with tto«“ fnt^r v«5?ntfon rnocioi to too «tev«;»'jopfi»U
Lik® yow know sj®®«ssment’S. ^bal- iss to
!ooU into mi:4?rvfen'tioff
so I thOK.ij^l’»t i whould provs<i«=“ thfe too.ck-Mp to sa'ssi^-'S^irtt.Sjot »n
torm of So
intervention moUefJ
’
Apme^toov.-s- ? onrmot pifc-tn.-'eznoti iotly • het ng si The* onto pr lh»®and-haviwgosutoT^ rm-Xiuc-i rr? my hei-scJs. Put then-, i
thsrik
who ever clewetopes-to sbrhething'new must have SJarred at is point \M;ore riothsno foli into place
Wop-e it
sotYn? .•sonse?, and I would iik«» to hear-your thoMQhts on it
F?-’krs ■ ■
i orriy m-m'*® tmck
l.-arvei Hn<®
»-
<■' ‘ '.- whole? woe^
424
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03 February 2004 12:20 AM
swanzen@telkom$a. net
ChidPIE
1 I was able to download your material on ChildPIE. While some of it was not clear to me it appears that you are indeed progressing
I well with the project and I wish you well in your efforts. We are contemplating traveling in South Africa next September and ask
i your opinion on whether or not this is a good time for such a tour. We contemplate visiting Johannesburg, Capetown and Kruger
i National Park I would like to meet Dr. Rostenberg and your colleagues who are interested in the PIE System and wonder if the
university is in session at this time. J.M.Karls
]
fed
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CompuPIE@aol. com
26 February 2004 07:24 PM
EarlLedford@crosswindsyouthservices. or g
swanzenStelkomsa. net
Re: PIE for youth and adolescents
'Ss-'
s Thanks for the inquiry. Actually the current version of PIE is usable with older adolescents and with some tweaking can be useful in
assessing problems of children. I have had correspondence with several colleagues about developing a PIE system for children.
The one that is most promising is being developed by colleagues at Rand Afrikaans University in Johannesburg. Dr. Wim
Roestenburg has used PIE in psychiatric facilities there and a colleague Rika Swamzen is in the process of developing a
"ChildPIE". I’m sure she’d enjoy corresponding with you about her work and your interests. We are planning a revision of the current
PIE book and manual and would appreciate your keeping in touch with us about your work in this area. James M. Karls PhD.LCSW
USC School of Social Work
■H.n it
Fdit
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iinkark@aol.com
26 February 2004 07:35 PM
s wanzen@telkomsa, net
ChHdPIE
^t .forv irded an inquiry about PIE for children. I hope you can share with this colleague your work. Also we have made airline
rvatifr>‘- a visit to South Africa. We expect to arrive in Johannesburg on September 4 and return to California on October 1.
. shall be on our own for part of this time but are also on a tour that will take us to Capetown and Kruger National Park. I hope to
be able to meet with you and Dr.Roestenburg and others who are interested in the PIE System. I met Dr. Mike Weyers from
Potchefstroomse University in Montreal several years ago. Is he still interested in PIE? Jim Karls
:
a
Sgi ft Outlook ex...
J.
O O
■'■
■
425
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Rika
From:
To:
Cc:
Sent:
Attach:
Subject:
“Rika Swanzen" <swanzen@telkomsa.net>
“Earl Ledford’* <EarlLedford@crosswindsyouthservices.org >
“James Karls” <Jmkarls@aol.com>
29 February 2004 12:41 AM
Categories.doc
•
Re: PIE - young adolescents and children
Hi
I’ve started my third year PhD this year and is inspired by the fact that
the original PIE is so successful in the states after 10 years since its
development. This off course implies that I am only in the beginning stages
of the development and the development of the whole classification system
falls even beyond the scope of my studies. I have thus far developed a
research methodology through which I will develop the whole system and its
validation and reliability testing (since I have no protocol for its
development apart from the PIE - S.A. also differs in terms of focus areas
with regard to service delivery to children); I have developed a theoretical
model that underlines the system (this includes the case management model
that focuses on psychosocial enhancement that directs the efforts of the
social worker, and my own attempt at putting together what is meant with
social functioning in children); and I am now at the operasionalisation
phase. By the end of this year I hope to have done a validation study on
the first part of the classification system for children
I divided the development into three parts, that will probably form three
factors in the classification system, namely the child (intra-personal
aspects - see attachment); family (first system of the child - assessing
family functioning with a focus on aspects needed to provide in the
developmental needs of children); and the community (heavy focus on the
advocacy role of social worker with regard to schools - inclusion,
disability, AIDS, etc.)
Panel discussions with colleagues here have proved positive. My reasoning
in very simple terms used Van Zyl’s definition of what ecology is, namely
the study of the fit between an organism and his environment. Two related
concepts are habitat (society, community the organism lives in) and niche
(the statuses or roles the organism participates in - this is dependent on
maturity) I therefore deducted that in assessing social functioning with
children you have to look at what is crucial in their development to ensure
that they take up these roles in adult life (which carries over to the PIE
as is). I am attaching my first basic attempt at categorizing for you, but
please treat it as a work in progress (also remember it is only one third of
the total classification system). I am also sure it will stir more
questions so feel free to ask me - there is a lot of literature backing
these basic categories. Note that I am still looking at temperaments
throughout childhood development as a way to identify strengths in the
child, so it is not yet included. You will see that the lines in between
the categories is at times diffuse - this indicates that it is not possible
426
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to totally separate the one category from the other - certain behaviour does
not only occur in one age category for example. To therefore understand the
assessment for your age group, you will need to understand the previous
building blocks that may not be in place. The literature is not anything
new to social work with children - the way it is put together to allow for
communication within the discipline as well as inter-disciplinary, is new.
This is hoped to be an assessment framework that adds, assists, and
compliments all other work in social work thus far.
Hope to here from you soon
Regards
Rika
---- Original Message----From: "Earl Ledford" <EarlLedford@crosswindsyQUthservices.org >
To: <swanzen@telkomsa.net>
Sent. Thursday, February 26, 2004 9:52 PM
Subject: PIE - young adolescents and children
Rika Swanzen:
Ti.e organization I am consulting with is interested in using PIE for their
assessment and case management format. The population served is generally
12 -18 year olds and their families. Dr. Karls indicated in an email
res: ionse to my request for assistance in this area that you were doing some
pi . using work in adapting the PIE to youth.
I would be very interested in any information, insight, examples, etc. that
would assist me in adapting the PIE for use with younger adolescents.
Thank you for any assistance or direction that you may be able to provide.
Earl Ledford, MSW, LCSW, CST
427
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Jmkarls@aol.com
27 May 2004 07:17 PM
swanzen@telkomsa. net
Fwd: Visit to California
| r "i Visit to California (092 bytes)
I couldnnt get through on Prof Rostenburg's email. Could you get this message to him? He tells me you are hard at work on the
testing. I hope it goes well for you. J.M.Karls
> Re: ChildPIE
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06 May 2004 06:46 PM
swanzen@telkomsa. net
Glad to see you're at this stage. Testing for validity and reliability is quite difficult. I suggest you look at the chapter in the PIE Book
on Reseach Issues where some of our difficulties in getting the testing done are described. To get the full range of possible
combinations was beyond our abilities at the time (we had limited time and financial resources). On your specific question about
identifying the problems, we asked the testers to list all the problems and to indicate the primary one if possible. Depending on
your testers and how much time you have you could get them to indicate Primary, secondary and so forth, it is important that all
problems be listed so that when you do the analysis you can try to determine degree of agreement. I suggest that you not try to do
too much about the coding unless it is an integral part of the testing. We found that writing in the codes slowed the process and
was may have prevented a richer description of the problem complex. Most social workers don't like numbers anyway; so if you can
get them to identify the problems and deal with the coding later you're more likely to get better test results. Sorry you wont make it
to California. That website I gave you does have listings of Dutch Reform Churches buried in it, and you might try yet to contact
them for future reference. Good luck with the testing. Keep me posted on how it goes. I'll be glad to try to answer any other
questions. JMKarls
&i ChildPIE
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Jrnkar ls@aol. com
Date:
10 July 2004 11:27 PM
To:
swarizen@telkomsa.net
Cc:
Subject:
w jhr@lw. rau. ac. za
ChildPIE
We had a very enjoyable visit with Dr. Rostenburg who gave me a copy of your ChildPIE paper. I did read it thoroughly and would
like to give you some of my thoughts. First I can see you have done a great deal of work on the subject and appear quite
committed to developing a PIE system for children. The paper I reviewed was fairly brief and does not give some of the thinking in
deciding the variable you chose for the assessment process. I understand from Dr. Rostenburg that you are submitting a more
comprehensive document to the faculty for your degree requirements. From the information I had in your paper I have some
concerns. The major one is that I do not see in the system you present the "biopsychosocial" base that is at the core of PIE. For
reasons that are not explained you did not use the PIE template in arranging your assessment framework. Do you explain this in
your dissertation? Another major point is your statement is that children do not have social role and therefore do not have social
functioning problems as in the adult PIE. This is not really so. Children have social roles from the moment they begin relating to the
birth mother and other care providers in infancy up to the time they leave the student role and enter the world of adult social roles. I
do not see any significant reference to what is Factor II in the Adult PIE, i.e., the social institutions that we have to provide help to
children as they move up the life cycle. Any reason for this? Your system show a mix of what are Factors 3 and 4 in the adult PIE
in the parts you have developed. I think that without separating out those elements that are mental fro physical that the user of
Child PIE would have a difficult time applying the instrument I did have some conversation with Dr. Rostenburg about your paper
and I hope he will share some of his comments with you. I do plan to be in JohannesburgSeptember 3, leaving September 8 or 9. I
would enjoy meeting with you to elaborate on my views of your work and to see how we might get a ChildPIE completed and in
operation, sincerely, J. M. Karls
.................................................. ’'"
|
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PM .... carlsreturntoCdfo,™____ ' '
^£J) The Karls return to California.eml (3.54 KB)
_
— Original Message----From: Jmkads@aol.corn
To: svvanzen@telkomsa.net
Sent: Saturday, October 23, 2004 7:45 PM
Subject: Fwd: The Karls return to California
Hello Rika. I'm starting to get caught up after our long visit to your part of the world. For whatever reason my eamil to
Dr.Roestenbvurg has been rejected; so I ask you to forward it to him. I hope you are well and that you are near the end of your
formal studies. I would like to communicate with you as you continue to develo the ChildPIE. so, could you tell me what has
happened since we met at RAU and how you would like me to hlep. Jim Karls
M «■: W "T AI.. :H H A vr H A S S O Cl AT1 O N
IN SANTA BARBARA eOUTM’FV
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Classifications
*
and Codes
for
Children ai\d
i *
Youth
SOCIAL
WORK
I
i
□
MINNESOTA SYSTEMS RESEARCH, INC.
430
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!
CLASSIFICATIONS ANO CODES
FOR
CHILDREN AND YOUTH
SOCIAL
WORK
4
•»-
Revxsfe4 OctWer 197?
Developed Under DHEW Maternal and Child Health
Training Grant No. MCT-001036-02
Copyright, Minnesota Systems Research, Inc., 1975
431
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\ 7
SOCXM. wmc CJuASSXFICATTO^S AMD CODHS
...... ............ QUICK
5**- ANTICIPATORY guidance
53" EHVIRCWIENTAL PROBLEMS (COMT’D)
500
501
WELL CHILD
CHILD NEEDS ENRICHMENT OF
SOCIAL FUNCTHMMG
502 FAMILY NEEDS ENRICWff OF
534 MENTAL HEALTH SERVICES IKADEQUAT
5'35 to 539 CURRENTLY UNUSED
54- STAGES PF GROWTH AND DEVEL
• SOCIAL FUNCTWWMG
CHILD NEEDS SERVICES
540 INFANCY (0-12 MONTHS)
54) EARLY CHILDHOOD (1-3 YEARS)
542 PRE-SCHOOLERS (4-5 YEARS)
543 SCHOOL AGE CHILD (6-9 TEARS)
544 PUBERTY
545 ADOLESCENCE
546 to 549 CURRENTLY UNUSED
503
504 FAMILY NEEDS SERVICES
505 AT RISK-CHILD’S PHYSICAL CONDITION
506 AT RISK-FAMILY’S MENTAL OR
PHYSICAL CONDITION
507
AT RISK-FAMILY DIFFICULTIES
(NOT RELATED TO CHILD)
BOB AT RISK-FAMILY DIFFICULTIES
55~
IN MEETING CHILD’S NEEDS
509 AT RISK-ENVIROlYHEHTAk FACTORS
SOCIAL FUNCTIONING AFFECTEO BY .
M" g^.S.j:PHYSICMsCONpmON
. «
CHRONIC
5W
CHILD'S self-care disturbed
PEER GROUP RELATIONSHIPS IMPAIRED
512 FAMILY FUNCTIONING IMPAIRED
513 FAMILY FUNCTIONING IMPAIRED (COHT’D)
514 FORMAL EDUCATION DISRUPTED
515 PROBLEMS REGARDING NECESSARY
medical care
516 CHILD’S SELF-IMAGE AFFECTED-NEGATIVE
517 to 519 CURRENTLY UNUSED
511
52- BEHAVIORAL/PIOTIONAL/LEARNING PROBLEMS
520 LEARNIKG RETARDED/AFFECTED
521 BEHAVIOR AFFECTS RELATIONSHIPS
522 EM0TIWU- DISORDER
523 RESISTANCE TO TREATMENT
' 524 to 529 CURRENTLY UNUSED
S3* ENVIRONMENTAL problems
530 INADEQUATE HOUSING
531 PROBLEMS IN NEIGHBORHOOD
532 PROBLEMS IN SCHOOL SETTING
633 SOCIAL SERVICES INADEQUATE
QfclM-SRESS^ta CRtSIS. SinOMt
550
551
552
553
HOUSING THREATENED OR LOST
ECCNOMIC CRISIS
TRANSISTIONAL CRISIS
PRECIPITATED BY CHILO’
aggressive behavior
554 CRISIS IN FAMILY FUNCTIONING
555 CRISIS IN HOME MANAGEMENT
55* CHILD'S ACUTE ILLNESS/SURGERY
557 CHRONIC AND/OR POTENTIALLY
FATAL ILLNESS
558 DUE TO ANTICIPATED EVENT OR
CHANGE IN STATUS
559 ADOLESCENT PREGNANCY
56- CHILD REARING AND HCHE MANAGEMENT
560 CHILD REARING
561 HOME MANAGEMENT DISORGANIZED
562 FINANCIAL PROBLEMS
563 to 569 CURRENTLY UNUSED
57- ABUSE OF CHILO
570 PHYSICAL ABUSE
571 SEXUAL ABUSE
572 NEGLECT; EMOTIONAL AND PHYSICAL
573 to 579 CURRENTLY UNUSED
gCURRENTLY UNUSED
59432
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- ALPHABETICAL LISTING !>--
SOCIAL WORK CLASSIFICATIONS AND CODES
- A ABANDONMENT OF CHILD
552.3
ABSENCE OF CHILD FROM HOME
512.9
ABORTION
545.5
ABUSE OF CHILD
Neglect .
Physical
Sexual ..
«•> < # » » •
... see 572
... see 570
.... see 571
ACCEPTABILITY
Availability of Medical Care
....
ADOLESCENCE
Abortion ............
Concern About Child ..
Conflict ............
Fami ly ..............
Homosexuality ......
Independence .......
Lack of Knowledge of
Marriage ...........
Physiological Changes
Pregnancy .......
Psychosocial Changes
Relationships
......
Runaway ...............
School Problems, Dropout
Separation Problems ....
Sexuality
................
Vocational Plans .......
Withdrawal
........
ADOPTION OF CHILD
... 515.0, 515.1
515.2
... 545.5
... 545.7
545.0
... 545.0, 545.1
545.6
545.3
545.4
545.0
545.6
545.0
559, 545.5
545.0
545.1, 545.3
545.6
... 545.4
... 545.2
... 545.1
... 545.3
... 545.8
... 545.1
552.4
433
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27
ADULTS
See Also PARENTS
... 545.3
... 541.3
... 521.0
... 542.5
Difficulty With School Age .
Fear of
In Authority
Resistance to....
-
see 521
AGGRESSIVE BEHAVIOR ...
ALCOHOLISM
... 522.6
Child .... .................................
... 531.1
Community . ........................ ..... ...
7/554.4’ 560.5
Fami ly ....
570.1, 572.1
ANXIETY ABOUT ILLNESS . « .
. *' • .« ■ • • . • • » •
514.5
» a a
ASOCIAL BEHAVIOR ...
•»
... 521.2
514.2, 514.4
ATTENDANCE AT SCHOOL .f..
... 522.3
ANOREXIA ...
...... 522.0
AUTISM ...
B *•
521.4
BEDWETTING ...
BEHAVIOR
Asocial ........
Bedwetting ....
Conflict, School
Hostile ... — ..
Hyperactive ....
School ....
Withdrawn .....
»
BEHAVIOR CRISIS
Delinquent
Injuries ....
Property
Rape ...
Runaway
.......... 521.2
....... . 521.4
....... 521.3
... 521.0, 521.1
....
521.3
..... 521.3
... 521.0, 521.1
..... 553.7
553.0, 533.1
553.2, 533.3
553.6
.... 553.4
553.5
434
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28
BICULTURAL SERVICES NEEDED ...
... 532.3, 533.4
534.4
BILINGUAL LEARNING PROBLEMS ...
... 520.3
516.2, 556.5
■BODY IMAGE
c 515.5
CARE PROVIDER PROBLEMS ...
... 515.4
CARETAKER PROBLEMS
Child Abuse ...
Neglect
... 570.2, 571.2
. see 572, 572.2
512.5
CHILD/PARENT RELATIONSHIPS ....
CHILD REARING
Appropriate Behavior for Age —.
Conflict
Cultural Differences ...........
Emotional Needs
Family
Parents
Physical Needs
Relationships
Single-Parent
Support
COMMUNICATION PROBLEMS
Bilingual ......
Child
.
Family
.... 560.0
560.1
560.1
_ _ -..560.4
. 560.3, 560.5
. 560.0, 560.2
560.4, 560.5, 560.7
560.4
560.1
.......... 560.5
.... 560.3, 560.5
*
520.3, 532.3
510.5,. 541.7
542.7, 543.4
531.2, 561.3
COMMUNITY
See NEIGHBORHOOD
COMPLIANCE
Self Care
COMPULSIVE BEHAVIOR ...
510.4
... 522.5
435
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29
CONFLICT
Adolescence ........................
Child/Parent .
Extended Family
Family/Care Provider
Marital ............. a...............
School ...................
Sibling
Puberty
*' * «••***«. r * • » • • »■* * » * a . • « * .. « «
CRISIS
Behavior of Child .....
Economic
Family Functioning ....
Home Managemen t ........
.... 545.0
.... 512.5
.... 512.3
.... 515.4
.... 512.3
521.3
.... 512.4
.... 544.2
. see 5S3
- see 551
. see 554
. see 555
. see 550
. see 556
Housing .................
Illness/Surgery of Child
CULTURAL DIFFERENCES *
Home ™
\
Neighborhood
.
School ..........................
CURIOSITY
Lacking in Preschool Child
.. 560.1
.. 531.7
. 532.3,, 532.4
542.6
- D DAY CARE
DEATH IM FAMILY
DELINQUENT BEHAVIOR
533.0
554.1, 557.7
553.4
DEPENDENCE ON
Family .
Mother
Peers
512.0, 542.3
545.7
...... 541.4
..... 511.4
DEPRESSION
Child ....
Mother ..-
522.2
560.5
436
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30
520.8
DEVELOPMENTAL DELAY IK LEARNING
DEVELOPMENTAL STAGES
See INFANCY, EARLY CHILDHOOD, PRESCHOOL,
SCHOOL AGE, PUBERTY, ADOLESCENCE
DISTURBED SELF CARE
Eating ......
Grooming ....
Sleeping ....
Toileting ....
510.1
510.3
510.0
510.2
DIVORCE
554.3
DRUG ABUSE
Child, Youth
Family
Neighborhood
522.6
554.4, 560.7
... 531.1
■»
- E EARLY CHILDHOOD
Adults
............
Children ............
Dependence .......
Exploration
Fearfulness .....
Feeding....
Mother ...........
Object Exploration
Resistance ......
Self-Feeding ....
Self-Toileting ..
Space Exploration
Speech
........
EATING
Disturbed Self-Care
Early Childhood ...
Infancy ....._ _
...... 541.3
...... 541.2
...... 541.4
541.0, 541.1
541.3
...... 541.5
...... 541.4
541.0
541.5, 541.6
541.7
.......... 541.5
.......... 541.6
..... 541.1
.......... 541.7
510.1
541.5
540.6
437
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\ )
31
ECONOMIC CRISIS
... 551.0
... 551.2
... 551.1
... 551.2
Employment, Laid Off
Expenditures ............
Public Assistance ..
Unanticipated ..........
EDUCATION
Also see SCHOOL
Age Difference
:
Alternative Needed ....
Anxiety
Attendance
Avoidance
Capacity
Classmates
Handicapped
Homebound .............
Hospitalized
Illness
Learning Difficulties ..
Participation In
Placement
Resources Limited .....
Transportation
» ♦
♦ ♦
••
♦ ♦ • • •
• - • ♦ •
••
*
EMOTIONAL PROBLEMS
Drug Abuse .......
Neurotic
Psychotic
Relationships, Family
Relationships
Social
EMPLOYMENT PROBLEM
ENRICHMENT NEEDED
514.6
* 532.7, 545.2
.............. 514.5
514.2
. 514.4
. 514.3
. 514.6
• * . 514.7
514.1
..... 514.0
514.4, 514.5
514.5, 514.6
514.3
514.7 514.8
• • • * • ..
520.4
.. 514.2
. 522.6
. 522.1
522.0
522.0, 522.1
561.3
522.0, 522.1
551.0, 562.1
545.8
see 501 , 502
ENURESIS
521.4
EQUIPMENT
Home Care of IIIness/Surgery
556.4
EXTENDED FAMILY
Relationships With
512.3
438
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32
- F
FAILURE TO THRIVE
5-10.6
. FAMILY
Adolescence
545.0, 545.1
545.2
Communications ,............................ , *,......
.,
561.3
Composi t ion
*
....... 552.1
Crisis in Functioning
..... see 554
Dysfunctional
...r
...... 560.2
Help During lllness/Surgery
. 556.2
Isolation
»••«»•»....«.. . 531.2
New Baby
. 554.8
Problem Interferes with Child‘s Medical Treatment . . 515.6
Puberty
..... 544.2, 544.3
544.4
Single Parent ............................
............. 560.6
Support
............ 560.3
Supportive Services Heeded ..
533,5
Well Child
.... see 502, 504
505, 506, 507
Values Affecting Education
.. 520.2
FAMILY CRISIS
Alcoholism
Death .a......,.,...
Divorce
Drug Abuse
.
Hospitalization ....
Illness, Acute .....
Mental Illness .....
Pregnancy
Separation .........
FAMILY RELATIONSHIPS
Absence of Child
Child Health
Child • Parent
Conflict
Dependence
Extended Family ...
Feelings .......
Independence ......
Outside Functioning
Parents ............
Recreation
Restrictions .......
Siblings
.... 554.4
554.2
.... 554.3
.... 554.4
.... 554.0
.... 554.0
.... 554.5
.... 554.5
.... 554.3
....... 512.8
513.0, 513.1
...... 512.5
... see 512
...... 512.0
....... 512.3
...... 513.0
....... 512.2
512.7
.* r see 512
512.7
512.5
512.0, 512.1
439
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33
FEARFULNESS
Early Childhood
FEEDING
Early Childhood
Infancy ...
* * •* ■»*«**.»...*.* 541.3
4>
........
541.5
540.6
FEELINGS, NEGATIVE
.. 513,0
FINANCIAL PROBLEMS
illness/Surgery
Medical Care ..
Support Needed
556.3
515.3
. 533.6
FOSTER HOME CARE ..
552.5, 558.2
*
G GANGS
Abuse of Child ♦
Child Involved ....
In Cconunity .
GEOGRAPHIC CHANGE
570,5* 571.5
553.4
. 552.0
* * '*• ♦ *- 4 W « « » « 4
GROOMING
Disturbed
«•• 510» 3
- H HANDICAPPED
Education of Child
HANDICAPPED PARENT
* » + *
.....
514.7
HEALTH OF CHILO THREATENED .....
HOMEBOUND
Education
.......
see 506, S6Q,3
A * » 4 * ♦
• *••***„
«•»<»»»»**
513.0. 513.1
514.1
440
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\ I
533.2
HOMEMAKER SERVICES NEEDED
HOME CARE AFTER ILLNESS/SURGERY
556.4
*
HOME MANAGEMENT
see 561
HOME MANAGEMENT CRISIS
Clothing
Food . —
Heat
Utilities
Water
... 555.1
... 555.0
... 555.2
... 555.2
... 555.2
••••
«* ♦
•••••
HOSPITALIZATION
Education During
Family Member
Anticipated for Child
..
HOUSING
Inadequate
Infested
Insecure
Lead Paint Hazard
Overcrowded
♦
... 514.0
... 554.0
... 558.1
... 530.3, 530.4
530.7
530.6
530.5
... 530.8
.... 530.0, 530.1
530.2
«►
HOUSING CRISIS
Eviction
Fire .—
Mortgage
*
... 550.1
... 550.0
... 550.6
HOUSEHOLD WORK ...
... 521.3
HYPERACTIVITY ...
- I ILLNESS
Anxiety About
Family Member
Used to Avoid School
514.5
554.0
515.4
441
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35
ILLNESS/SURGERY OF CHILD
Body Image Affected
••*
•••
Child's Understanding of ....
Equipment Needed ...........
Family
Financial Problems
Home Care
Medical Plan
Parental Understanding
Special Help Needed
. 556.5
. 556.1
» » • • . 556.4
. 556.2
• • « • » 556.3
. 556.4
556*0, 556.1
556.0
....... 556.2, 556.4
INDEPENDENCE
In Adolescence ..
From Family
From Peers .....
.. 545.1
.. 512.1
.. 511.5
INTERPERSONAL PROBLEMS
See RELATIONSHIPS
*
ISOLATION FROM PEERS • • • •
••»
INFANCY
Body Exploration
Feeding
Mother - Infant
....
Object Exploration
People .............
. Space Exploration
INJURY, BY CHILD TO
Parents .....
Peers
Self
Siblings ....
»»»•
*
511.0
... 540.0
.. 540.1, 540.6
................ 540.2
........ .
540.4
................ 540.3
540.5
... 553.1
553.1
553.0
553.1
INSTITUTIONAL BARRIERS TO CHILD TREATMENT
515.5
:nstitutional placement of child
552.8
442
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- I
LEARNING PROBLEMS
Age Differences
514.6
. 520.3
, 520.8
.... 520.4
.... 520.2
.... 514-4
............. - 520-0
................. 520-3
Bilingual ......
DisabiliV
—,
Educational Resources Limited .
Family Values ...
Illness ....................
Intellectual Deficiency ...
Language ..................
Perceptual
.................
- - * a » '•*
LEGAL SERVICES REEDED .
I. »».
520 J
533.7
W V «» *
- HMEDICAL
Care Plan ..............
Status Threatened
. 556.0, 555.1
. 513.0, 513.1
.....
MEDICAL CARE
Acceptable to ChiWFamily
Available
Coiwurii ty Resources ......
Conflict with Personnel ..
Family Problems .........
Financial Problems ......
Institutional Problem ....
Personnel ................
Transportation to
.
MEDICAL HEALTH SERVICES INADEQUATE
MEMTAL ILLNESS
Child ...
Family ..
. 515-1
... 515.0
. 515.0
. 515.4
see 515
. 515.3
. 515-5
•*•«»##***»*•♦
... 515.4, 515.5
512.2
*
* ♦ ♦ V » # « •
* V •
♦ *
► ♦ ♦ »
♦ ♦ *• ♦ *
see 534
,, see 522» 534
.. see 534, 554.5
MOTIVATION LACKING
......
see 523
.... 560.8
Interference with ... *
... 557.7
Child
Parent
MOURNING
443
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37
N
NEGLECT OF CHILD
•*
NEIGHBORHOOD PROBLEMS
•••
Alcohol
Criminal Behavior ...
Dangerous
Drugs ..
Gangs ..
Police
Racial Tension ....
»•
Recreation
Sanitation
Sense of Community
Shopping
?...
••
Traffic
•»
NEUROTIC PROBLEM
Child
Family
see 572
531.1
531.1
531.0, 531.1
531.4
531.1
531.1
..... 531.3
..... 531.7
..... 531.4
531.5
531.1, 531.2
531.6
531.0
522.1
see 506, 560.5
0 OBESITY
522.2
OVERCROWDING
- Home
School
... 530.0
... 532.0
OUTSIDE FUNCTIONING OF PARENTS IMPAIRED ....
... 512.8
444
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< I
38
- P PARENT
Abusing Child ........
Child Relationship
Child Rearing
Depressed Mother
••-■
Family Relationships
Handicapped
Inwature, Low Intellectual Capacity ...
Injured by Child
Job Interfered with Treatment for Child
Lacks Understanding of Child
Language Barrier^ Cultural Differences
Mental, Emotional Problems
Heglects Child
Physical Disability
Single
»»««»•**• ••••-« ***’»**
PARENConflict, Chronic Marital Discord
Health
Outside Functioning
PASSIVITY .
560.4
.... 553.1
........ 515.6
.. 544.2, 545.0
560.1
560.5
see 572
........ 560.3
...
560.6
.... see 507, 512.2
..................
Reirarriage
Self Concept Disturbed
.... see 570
512.5
..see 560
see 506, 560.5
.... see 512
see 505, 560.3
.
560.2
...... 513.5, 513.6
............ 512.8
552.2
...................
512.6
522.4
F * » • »
PEERS
Adolescence
Age Difference in School
Dependence on .............
Independence FrOsii ......
Injury to by Child ....
Involvement with
........
Isolation From
Lack of Interest in ....
Participation with .....
Preschool Age .....
Puberty .........
Rejection by .......
Relationships with .....
School Age
......
Withdrawal From ........
.... see 511. 516.6
531.1. 545.2, 545.3
514.6
..... 511.4
........ 511.5
553.1
....
511.2
511.0
541.2
511.7
542 1
’^”’?544X 544*1
511.3
511.6
..........
543.0
............ ............. 511.1
.................
.............
445
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39
PERCEPTUAL PROBLEM IN CHILD •
520.1
PHYSICAL ABUSE OF CHILD
PHYSICAL CONDITION OF CHILO
And Family ....
And Peers ..
»
Well Child .
see 570
see 512
see 511
... see 505, 506
*'*♦.*•*«
PHYSIOLOGICAL CHANGES
In Adolescence ..
In Puberty
.. 545.0
.. 544.2
PLACEMENT IN SCHOOL
Availability ....
Handicapped
Inappropriate ....
... 514.8
514.7
532.7, 545.2
OST PARTUM DEPRESSION
Mother
.. ....
.
Youth--- ----------- -
> <9
♦
•
... 554.8
... 545.7
♦ • ♦•• •
PREJUDICE
In Communi ty ...
In School .....
PREGNANCY
Mother ...
Terminated
Youth ....
... 531.7
... 532.4
»
♦
•
554.6
545.5
... see 559, 545.5
PRESCHOOL AGE
Adults, Non-Parental ...
Curiosity .............
Dependence
.......
Mother
.
Peers
Play
Relationships
...
Resistance ............
Self-Care
Verbal Development
542.5
542,6
542.3
542.3
... 542.1
... 542.4
542.1, 542.2
♦
542.0, 542.5
542.0
..... 542.7
PROPERTY DESTRUCTION
553.3
PROTECTIVE SERVICES NEEDED
533.1
PSYCHOLOGICAL NEEDS ...
In Adolescence __
Services Inadequate
..- see 516, 522
535
...
545.0
....... see 534
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40
522.8
PSYCHOSOMATIC SYMPTOMS
PSYCHOTIC PROBLEM
... 522.0
. 560.5, 570.0
571.0, 572.0
Of Child ....
Of Parent —
PUBERTY
Conflict
Family .......
:
544.2
.. 544.2, 544.3
544.4
.. 544.0, 544.1
. 544.2
... 544.0, 544.1
544.3, 544.4
••• 544•0, 544.1
544.2
544.3, 544.4
»•*•*
Peers
......
Physiological Changes .
Relationships ........
Sexual Development ....
Withdrawal
PUBLIC ASSISTANCE
•>Loss or Threatened Loss ...
551.1
PUBLIC ASSISTANCE NEEDED ...
... 551.1, 533.6
558.0
PUBLIC ASSISTANCE REFUSED ...
. 551.5
- RRACIAL PREJUDICE IN SCHOOL ...
RACIAL TENSION IN COMMUNITY
RAPE
By Child, Youth ..
To Child
....
**
... 532.4
531.7
... 533.2
see 571
RECREATION
Family ....
*
Neighborhood ..
Programs Needed
School .......
... 512.7
... 531.4
... 533.3
... 532.6
REJECTION BY PEERS ...
... 511.3
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ni
RELATIONSHIPS
Adolescence
Adults in Authority ..
Child - Parent
Cultural Conflict ....
Family
... 545.1, 545.5
521.0
512.5
• >««.* *: * * ••• <• •»***•* «
550.1
see 512, 513
561.3
see 522
.... see 511, 521.1
543.0
542.1 , 542.2
see 544
... see 543
512.0, 512.1
512.4
«
* ♦ * 9
Emotional Problems
Peers ...
» ♦
Preschool ..
Puberty ...
School Age
Siblings ...
* ♦
* • • a •»••*««» » »
»
RESISTANCE TO
Adults
542.5
Feeding ...................................... 510.0, 540.5
Toileting
Treatment, by Child ...
Treatment, by Parent(s)
Self Care ..
Speech ....
• 9 » 9
541.5
#
* «»
#
* • ♦ ♦
. 521.4, 541.6
.... see 523
560.3
see 510, 542.0
. 541.7, 542.7
see 505, 505
507, 508, 509
RISK TO WELL CHILD
RUNAWAY CHILD, YOUTH
552.7, 545.4
*****
******
SANITATION
In Home ........
In Neighborhood ....
«
.... 530.3, 530.5
... 531.5
•*»»•
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SCHOOL
. Also See EDUCATION
Behavior ...
...
Bilingual Heeds ..
Busing ..........
Ethnic Problems ..
Inadequate ......
w »
Individualization ....
Overcrowd!ng ........
Phobia
Placement ...........
Prejudice ...........
Racial Problems .....
Recreati on ..........
Security ----- ----- Supportive Services ..
Teacher .............
• « «« •-»*'*'*
......... 521.3
...... 532.3
..... 532.2
........ 532,4
.. 532.5, 532.6
532.8
532.8
... 532.0
... 520.6
... 532.7
... 532.4
... 532.4
... 532.6
... 532.1
... 532.6
... 532.5
SCHOOL AGE CHILD
Adults, Non-Family .
Home
Peers
Problem Solving ....
Relationships .....
SECURITY
Community
Home ....
School ..
**
543.3
543.1
543.0
.... 543.2
543.0, 543.3
. 531.3
. 530.4
SELF CARE
Eating ....
510.1, 540.6
Grooming ..
Resistance
Sleeping ..
Toileting .
541.5
510.3
542.0
510.0
510.2, 541.6
SELF IMAGE
Child
Parent
SELF INFLICTED INJURY
see 521
... 512.6
553.0
SEPARATION
Child During Transitional Crisis
Child, School Age ..........................
Parents
Youth From Family ........................
see 552
... 543.1
... 554.3
... 545.1
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^3
SEXUAL
Abuse of Child
............
Body Image ......
..............
Development During Adolescence .....
Development During Puberty ........
Genitals Malformed or Lacking ......
Identity
.
Relationships ..
»»«*
Surgery .......
Treatment
* •*
* * ♦ »
... see 571
...... 516.3
... see 545
... see 544
516.3
516.1, 516.3
... see 516
516.1, 516.2
.. 516.1, 516.2
SIBLINGS
Injured by Child ....
Relationships with ...
553.1
... 512.0, 512.1
512.4
SINGLE PARENT FAMILY
560.5
SLEEPING DISTURBED
... 510.0
SLEEPING PROBLEMS ...
SOCIAL SERVICES
Bicultural
Day Care
Family
Financial .....
Homemaker
Legal .........
Protective .....
Public Financial
Recreational ...
Supportive ...
4*
***•
SPEECH
Early Childhood ..
Preschool
..
*
*
«**■»*
V
522.7, 540.8
.... 533.4
.... 533.0
.... 533.5
. 533.6
. 533.2
. 533.7
. 533.1
. 533.6
. 533.3
. 533.5
541.7
542.7
SUPPORTIVE SERVICES
Also See SOCIAL SERVICES
Family ............
School
....
Well Child .............
SUPPORTIVE RELATIONSHIPS
Single Parent
SURGERY/ILLNESS OF CHILD
... 533.5
532.6
see 503, 504
. 560.5
see 556
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< )
M.
TEACHER PROBLEMS
532.5
TEENAGE PREGNANCY
TRANSITIONAL CRISIS
Abandorwient
Adoption
Family
FostGr
#»«»<»,«
Geographic Change
Remarriage
» 559
»>*««•«>««« 552.3
. 553.4
’'/552'i, 552.3
552.5
«« •»««
552.0
• ».» «•»>»» . 552.2
.... .
TRANSPORTATION
To School ..
To Treatment
TOILETING
... 514.2
... STS.2
......
510.2, 521.4
541.6
UUNCONTROLLABLE BEHAVIOR
553,5
UNDERSTANDING OF
Age Appropriate Behavior by Parent
Illness/Surgery by Child
Illness/Surgery by Parent
UNEMPLOYMENT
UNPREDICTABLE BEHAVIOR
*
■«
>
.
560.0
555.1
556.0
551.0, 562.1
545.8
*»
553.5
451
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< )
45
- VVERBAL DEVELOPMENT
Preschool ...
School Age
... 541.7, 542.7
543.4
VOCATIONAL ASSISTANCE .
545.7
545.8
-wWELL CHILD
Enri chment Needed ....
Environment ......... • •..
Fam ly
see 501, 502
......... ......... see 509
see 502, 504
506 507 508
Physical Condition .......................... see 505’ 506
K7Sk
see 505, 506
507, 508, 509
Servi ces Needed ......
....... see 503, 504
Social Functioning ....
see 501, 502
Well Child
.
......... see 500
WITHDRAWAL
In Adolescence ....
From Adults
From Peers ........
In Puberty
...
......... 545.4
521.0
... 511.1, 521.1
... 544.3, 544.4
-XYZ-
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Conduct
Management
W WSWIY TO WUVKM
minimis
BehivlarTiadta
Pooteiml
Child BehavK Tooto * Table « Topics
Child Behavitz Tarbox
TOPICS
AHenthn
Behavtour Management
Memory
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Ptxfestaftd
Lhoosmg the Correct Product
MeofWfcs
Feature Ctoparto
Prttg
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lire
tam l&
tot us
TOPIC AREAS
Aggrttsim
AggrestoAHermtives
Anger
taiety
Muchrneht
Auditory
tadurwie
Beginning Socht Stolls
Mg
Mtying
Cotmnmtaiw
^moBrawaw
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customers please
':' emet Sdtota
-1 f-.tmiM Sitarten
Coff^lianct
tanpienenwn
CompuWOfts
6 tatemtC
CorwaltaarStolls
Dealing with Feeiings
■>■ i* wstih
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SeMmiwidt Stress
Mb a ete^r
Oeprwkm
OtsaMlltyAwaren^s
Wwr
Eating
Explmtory Play
Problem SoWig
Ratfiij&Ungusge
Sodsl-wnstaMlWj
Fears
FtieMw
Foltwiii Olrectta
FttodsNp WHihgHelping with Homework
HyperactMty
tts if/wwi T I k J
inieien^wt FmiiMqj
Language Oevf^npmeHt
Lying
Wrroy Games
Memory Strategies
MemoiyTooh
Social Mi
Spedaiwts
vOmwSMi
School Elated
SgfcUw Atteota
Sdftoe
SeW Esteem
Sdf'StlwWon
Sharing
Shyness
SKing Rivalry
Steeping
Social Problem SbMnf
Mntg
SWalirtg
5tr«?ssofTijra?^a’i
HrtBftfct
Tantrum
Nanverbat Problem Solving
Cfeses5ii5f&
Organtatto
Over Ealing
Painiteafaiw
Bdwlwr
Teashg
Vtel Aumion
RedudhgOistfactibihy
BepeOtive BehavicMjr
School Bus BetoW
Visual Motor
visual Perception
Wandering
Wetting
ThwnbsucMng
Wlfet Training
(W Eatifig
Verbal ProbtoSoiw
* Ortfy available oo the Global hofesstooal verston.
BaatoCBTmOtol
Bad CBT GO PrafeOll
453
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CM Conduct
Management
III
THC GATEWAY TO
BEHAVIOR soturms
A^Mwscent Behavior Toolbox
Adolescent Behavior Tooibces
Child Behavior Toolbox
Glow R^fess^nal
Adolescent Behaviar Toolbox contain® o-rer 1000 practical, dinteal and research-based
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Developed In comuhatton with a team &f psycb^H^
ate«togy is developed
from case-based research and is rWwced to published wwks for further reading aa
appropriate.
Choosing the Correct Product
Table of Wtes
Feature CewaHson
Frlcihg
IHFOIWATOM
Ccouct Us
About SM
Employment
ABT. designed to support profe^stonals worlds with adctescents up to 13 years old,
wg.l bi future releases provide an option where the strategies MH be structured for
direct use by the adc^escent. Thte additional approach will comkterabty wleten the
number of ways in which ABT can be used.
.Adol^ent Behavior Toolbox works m simile way t> CMd BehaMgr Toolbox (see
How It Works) The Topk Grot^ the Wa
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Adolescent Behavior Toolbox * Topte Group & Tof>k Matrix
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Annexure 2
Aids assisting ChildPIE© assessment
TABLE 1 SUMMARY OF MILESTONES
i
AGE
TYPE OF
DEVELOPMENT
Cognitive
development
6-T
Month
I
1 to 4
i Cognitive
! rnontns | development
111
i V4
I months
Motor
development
!
1-6
j months
Emotional
development
AVERAGE MILESTONE TO BE ACHIEVED
The infant performs simple, involuntary reflexes:
Reflex
Grasp
ing
Description
Grasps tightly any object - such as
parent’s finger - which is placed in
the palm.
Moro
The arms are outstretched and then
pulled into the body in response to a
loud noise or sudden loss of support.
Root
ing
When an infant’s cheek is touched,
the head is turned in that direction.
Suck
ing
The newborn sucks when an object
comes in contact with the mouth.
Walking
The newborn takes steps when
placed on a surface or against a step.
Swim
ming
An infant immersed in water will
display active movement of the arms
and legs and involuntarily hold his or
her breath. This swimming reflex will
keep an infant afloat for some time,
allowing easy rescue.
Developmental course
Reflex becomes less strong at - I
months. Grasp movements
develop into fine motor abilities in
later life.__________________
The reflex disappears by 5
months. However the child
continues to react to unexpected
noises or a loss of bodily support.
The reflex becomes less strong
at 3 months and is replaced by
voluntary head turning._______
The reflex becomes less strong
at 3 months. The baby gains
voluntary control over sucking.
Disappears in the first 8 weeks
unless the infant has regular
opportunities to practice this
response.
Infant engage in movement, finds that it creates an interesting sensation and is
repeated. There is yet no understanding of cause and effect._____________
• Babies make noises & gestures to communicate
• Babbling becomes more elaborate as vocal systems mature
• Starts to recognize rituals like bathing & feeding
• Baby raises head, can lift chin up from floor or bed
• Turns head towards sound
• Raises chest up off the floor or bed
• Can follow objects with eyes at an angle of 180 degrees
• Sits up with adult support
• Starts rolling first from stomach to back, then back to stomach
• Can bring hands together
• Bats at objects, cannot grasp them for more than few seconds______
SLEEP
• Newborns spend a significant time sleeping
» They are not easily stimulated or aroused by moderate noise or other
455
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sensations
In the first weeks baby may sleep 16 to 20 hours in each 24 hour period,
sleeping in REM sleep
• These hours are not continuous and are usually brief naps of 3 to 4 hours
• As they get older they spend less time sleeping and more time awake,
alert, and attending to the environment.
• By four months baby may sleep for 6 continuous hours at night, and 14
hours throughout the day
CRYING
• Crying is the means by which babies communicate their needs
• The early cries are provoked by physical discomforts such as hunger,
pain, illness, being too hot or cold, or loud noises
FEAR
• Too much stimulation (like bright light) will cause baby to cry
• May dislike bathing and being undressed
• The sensation of being dropped cause shock and real fear
HUMOUR
• Shows enjoyment at seeing familiar face by 6 weeks
• Shows pleasure at seeing a familiar face or own reflection by 3 months
• Will laugh when tickled
• Shows pleasure with contented coos
• Can differentiate between a friendly and stern face____________________
VISION
• Newborns can see objects that are about 20 cm away quite well
• Babies can see colours, and prefers contrasting ones like, black, red, navy
• By 4 months babies discriminate amongst faces and different emotional
expressions
• May like looking in the mirror
HEARING
• Babies are startled by loud noises
• They find certain sounds, such as singing and heartbeats, soothing
• Will turn head to direction sound is coming from
• They recognize their parents’ voices
TASTE & SMELL
• Babies are bom with taste preferences
• Can distinguish among the five tastes: sour, bitter, salty, sweet, and
neutral
• Distinguish among pleasant and unpleasant smells
TOUCH
• A newborn’s receptors in the skin are sensitive to touch, temperature and
pain
• Sense of touch develops before birth and parental touch has a positive
effect on babies emotions and health_______
• Infant engages in circular reactions - he shakes a rattle, notes an
interesting result and shakes it again
• Can repeat certain sounds like ‘ba-ba-ba’
•
1 -6
months
Perceptual
development
4-8
months
Cognitive
development
4-8
months
Motor
development
•
•
•
•
•
•
•
Reaches for and grasps objects with both hands
Sit alone steadily
Discovers own body parts like feet & plays with it
Shake toys & drop it so adult can pick it up
Stands (shakily) with adult support or pulled up against something
Starts teething anytime from 5 months
Can start drinking from a cup & can hold bottle
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< /
•
^-12
; I-.notional
| months
n/elopment
7 to 12
months
Social
development
9 to 15
•gnitive
months ; development
< to 15
mo nths
Motor
development
Can manage finger foods
SLEEP
• As winds improve & the number of feeds lesson, baby will most probably
be sleeping through
• Can get back to sleep without attention or feed
• Won’t need nappy change during night at this stage, unless it is soiled
CRYING
• Will start crying from frustration
• Are comforted easily
• Will moan rather when hungry or wet
FEAR
• Baby is more confident but show intense fear about one or two particular
things
• Best way to manage fear at this stage is avoiding it
HUMOUR
• Finds situations amusing when they are unusual or surprising
• Laugh at games where you hide something & ask ‘where it is’, ‘there it is’
• The focus starts to shift away from actions involving the self towards
______ objects & other people in their environment________________________
• Takes more initiative in contact with other, like holding out hands to
indicate wanting to be picked up
• Shouts to get attention
• May be possessive about toys
• Enjoy social gatherings - as long as you are near
• By a year will show affection through kissing & hugging
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Says first words during this time
Type of words would be names of things, like ball & mommy & social
expressions like ‘bye-bye’
By one year say at least five recognisable words
Make singing sounds
Responds to simple instructions
Responds to own name
Points to objects
By fifteen months he should have a vocabulary of 10 words
Can stack at least 2 blocks by end of this stage
Very curious - will open all boxes, cupboards & drawers__________
Holds toy in each hand
Can let go of object deliberately
Wave goodbye
Clap hands
Puts objects in a box
Pick up small object with thumb & forefinger
Crawl or inch his way across the floor
Pull himself to standing position
By twelve months he stands unaided
May walk while holding onto hands or furniture
Put food in his mouth
By fifteen months he should walk unaided
Attempts to feed himself with a spoon
Gets into sitting position from stomach
Drinks from cup - messily
Birth weight has almost tripled
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13 to 18
months
Emotional
development
13 to 18
months
Social
development
16 to 24
months
Cognitive
development
16 to 24
months
Motor
development
19 to 24
months
Emotional
development
19 to 24
months
Social
development
SLEEP
• Should ideally be sleeping in own bed & room
• Might still need parents to stay with him when afraid & insecure
CRYING
’• Will mostly cry because he is hurt or for being scolded
• May start crying for toys & things he wants
FEAR
• Nightmares may start appearing
• Mostly afraid of dogs & the dark
HUMOUR
• His increased self-confidence allows him to enjoy everyday experiences
that might previously have worried him
• He will love pushing toys up & down in the bath & splashing with hands &
_______feet in water__________________________________________________
• May get upset & frustrated
• Shows anxiety when separated from familiar caregiver
• Still very dependent on parent
• Makes two-word sentences
• Can point to body parts
• Can scribble using a crayon
• Builds tower of six blocks
• Can draw horizontal & vertical lines
• Says short phrases
• Identify pictures in a book
• Refers to himself by name_______________________________________
• Successfully feed self with spoon
• Turn the pages of a book
•
Can walk backwards
• Throws ball without falling
• Picks up toys from floor without falling
• Climb up & down stairs
• Knows which objects go together (cup & saucer)_____________________
SLEEP
• Can sleep from around 9 at night till 5 or 6 o’clock next morning
• Use of night light may be necessary to prevent child from waking up &
having a fright
CRYING
• More yelling than crying
• May learn how to manipulate with the use of tears
FEAR
• Starts being concerned with injuries - will need lots of plasters & ‘kiss-mebetters’
• May still fear separation from parents
HUMOUR
• He starts having good arm & leg coordination & likes activities that
involves this newskill, like running in a circle or jumping
• He will enjoy fun books, with flaps with hidden pictures underneath______
• Will start being interested in play mates, but will quickly loose interest in
them
• Will snatch toys away
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V /
; 2 to 3
I years
, Cognitive
development
, 2 io 3
Motor
development
jyears
fr
motional
development
! yi.Ur'b
I
i
2 to 3
■sars
Social
development
1'3 to 4
i years
Cognitive
development
3 to 4
years
Motor
development
•
Likes to explore without adult
•
Uses around 50 to 300 words
• Asks names of objects
•
Talks about herself, using own name
• Recognise self on photo
•
Can build a tower of six blocks
•
Puzzles fascinate her
•
Use T, ‘me’, and ‘you’ correctly
•
Repeat nursery rhymes & songs_____________ ____________________
•
Undress self
• Walk on tip-toes
• Jump on both feet
• Throws & kicks a ball
• Walk stairs putting both feet on each step
•
Climbs on & off furniture
•
Climb a simple jungle gym
•
Becomes toilet trained
•
Shows preference with one hand
•
Can push self with feet on plastic bike or car
•
Starts loosing baby fat & arms & legs grow
•
Probably has all twenty teeth_____________________________________
SLEEP
• As child is being potty-trained fluids before bed-time should be limited,
since a wet bed will disturb sleep
•
May start refusing to go to sleep, or fall asleep in own bed
CRYING
•
May overreact emotionally on seemingly harmless incidents
• Tantrum starts & out of character responses when toddler does not get his
way
FEAR
•
Imagination develops, so he is more prone to what if fears
• Will need what he treasures most nearby
HUMOUR
•
He likes the unexpected but may be frightened by surprises
•
Read stories with unexpected endings & games like pretending your feet
______ are stuck together & the only way to move is by jumping_______________
•
Copies mother or siblings
•
Plays parallel with other children - near them not with them
•
May get frustrated & have tantrums
Knows the difference between big & small
Use adjectives when talking about people & things
Starts to recognise colours
Understand simple concepts of numbers
Knows minimum of 200 words & carries simple conversation
Asks constant questions
Talks about experiences
Can name colours and point out three primary colours
Can copy a circle on paper
Can draw figure with head & features
Builds tower of 9 or more blocks_______________________
Rides a tricycle
Stands on one foot briefly
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\ /
3 to 4
years
Emotional
development
3 to 4
year
Social
development
4 to 5
years
Cognitive
development
4 to 5
years
Motor
development
4 to 5
years
Social
development
5 to 6
years
Cognitive
development
•
•
•
•
•
FEAR
•
•
Walk stairs alternating feet
Pulls trousers up & down
Wash hands
Eats competently with spoon or fork
Cuts with scissors_____________________________________________
Sensitive for change in routine & familiar places
Parent needs to show he is in control, so child does not feel misplaced
anxiety of having to be in charge
HUMOUR
• His increased self-confidence allows him to enjoy everyday experiences
that might previously have worried him
• He will love pushing toys up & down in the bath & splashing with hands &
feet in water
• Enjoys make-believe & role-playing_______________________________
• Plays with other children
• Starts to understand social rules like sharing & turn-taking
• Helps you & join in your activities
• Cans stay dry night and day
• Tantrums are less frequent_____________________________________
• Drawings of people have more details - nose, ears, hands & fingers
• Draws recognisable house
• Learn to count (to 20)
• Remember full name & address
• Knows own gender
• Build steps with blocks & a 10 block tower
• Use correct language most of the time
• Asks the meaning of words
• Can name 18 objects in a book
• Understands the concepts of being tired, cold, alone, & late
• Knows what is high & low
• Knows his age
• Likes poems and jokes, might use swear words_____________________
• Jump on one (preferred) foot
• Sit with knees crossed
• Balance for 3 to 5 seconds
• Can make a sharp turn while running
• Can fasten buttons
• Can put on socks & shoes
• Good control over muscles
_________ __ _________ ______
• Can argue with others but learn to share
• ‘Cheeky’ at times
• Boastful & bossy
• Can plan games cooperatively
• Wants independence__________________________________________
• Knows his daily routine follows a set pattern
• Can complete a two-part command (such as lift toy & put it in box)
• Knows a R1 coin from 50c
• May be able to write own name
• Shows out most colours
• Draw square, triangle, and a few letters
• Can fold paper in four parts
• Knows whether it is morning or afternoon
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\ i
5 to 6
| years
Motor
development
5 to 6
years
: Social
i development
i
6 to 7
years
Cognitive
development
6 to 7
years
Motor
development
i 7to8
Motor
' development
! years
I
! Puberty | Physical & Sexual
10 to 15 |I maturation
i
I years
Knows the materials things are made of, such as wood, glass
Wants to complete activities
Play pretend games___________________________________________
Can touch toes while keeping legs straight
Jump on one of either of his feet
Can walk on thin line
Can pull thread through needle
Colour in pictures
Can use knife & fork
Run on toes__________________________________________________
Choose own friends
Shows caring behaviour towards others
Social & well-balanced
Sense of fair behaviour & understanding of rules develop
Handles own daily, personal needs well____________________________
School absorbs the child as he starts to read, write, and count
His thirst for knowledge is constant and he regularly asks questions along
the lines of ‘who’, “what’, ‘where’, ‘how’, and ‘why’
Books are read for pleasure & information
Can describe how one object differs from another
Mathematical skills develop
Knows four coins
May write independently
Repeat sentences with 10 syllables
Can name 20 pictures in book
More precise drawings_______________ ________________________ _
Fastens own shoe laces
Jump over a rope 25 cm from the ground
Learn to jump with rope
Can tear a piece of paper neatly down the side
Can run up steps
Catch a small ball using hands only
Perform jumping jacks
Swing a bat & strike a ball
Run between 14 & 18 feet per second
Throw a ball 40 to 70 feet
Balance on one foot with eyes closed
Growth spurt describes the rapid acceleration in height & weight, and
marks the beginning of adolescence
Girls enter the growth spurt by the age often & boys around 13 years
For most girls sexual maturation starts around 11 when fatty tissue
accumulates around the nipples, forming small ‘breast buds’
Sex organs mature, the vagina becomes larger internally, and the walls of
the uterus develop a powerful set of muscles
At about 12 to 13 years, the average girls reaches menarche - the time of
her first menstruation
Sexual maturation for boys happens between 11 and 12 with the
enlargement of the testes often accompanied by pubic hair
At age 14-15 the penis is fully developed & semen can be ejaculated
Facial hair begins to sprout & the voice lowers.
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TABLE 2. PHASES OF COGNITIVE DEVELOPMENT
<PE OF COGNITIVE
PHASE 1
PHASE 2
PHASE 3
PHASE 4
PHASE 5
PHASE 6
Use of reflexes
- birth to 1
month________
Tendency toward
Primary circular
reactions - 2-6
months____________
New activities
Secondary circular
reactions - 5-8 months
Tertiary circular reactions - 12-16
months
Child discovers his action
Coordination of
secondary schemata- 812 months_____________
Child acts not only to
The child experiments and by this he
Invention of new means through
mental combinations 16-24
months
______________________
Trail-and-error methods are replaced
conservation with
discovered by chance
has influence on external
influence external event but
invents new procedures which will
by true inventions which come about
repeat of reflex
contact and new motor
objects & interest shifts to
modifies his procedure in
achieve novel result in the
by spontaneous restructuring and
behaviours
components become
external effects of action.
such a way as to achieve a
environment. Perceptual cues of an
differentiation of familiar schemata and
DEVELOPMENT
c
CD
without external
part of behavioural
Searches for motor
specific result. Persisting in
object established that object as a
the elaboration of new anticipatory
E
stimulation. End
repertory. New
procedure that will repeat
efforts includes desire to
certainty for the child. Any perceived
thought patterns prior to any inter
of 1st month,
behaviour for which
new discovery and ge
achieve the familiar goal in
object begins to activate a set of
action with actual objects. Child will
infant applies
there were no inborn
neralises it. Discovers by
unfamiliar circumstances
mental anticipations which goes
persist in his search for hidden object -
reflexes to a
co-ordinations give
accident new properties
and to undertake inter
beyond the immediately perceived. In
it is now conserved independent of
variety of objects,
indication that
of object. Starts to follow
mediate actions for this
a concrete sense he knows there must
perceptual contact since a mental re
becoming
experience influences
object beginning to leave
purpose. The child can
be more to the object than al-ready
presentation of it exists. By imitating
modified and
behaviour. Infant co
his visual and tactile
intentionally move an object
experienced, but does not have mental
other people and studying effects of
adapted to new
ordinates two or more
space. Desire to make
back and forth in front of
representations to replace perceptual
own body movements, child becomes
objects.
reflexes as new
spectacle last implies
face to study changes in his
cues. An increased awareness of ex
aware of self in relation to other ob-
behaviour patterns.
start of goal-directedness,
perception. Object exists as
ternal centers of causes reduces the
jects and acquires a sense of reci
Affect-expressive
while application of
distinct from action but is
child's belief in the magical power of
procal interactions. Use of language -
movements are first
procedures with magical
still dependent on previous
his actions. Time is freed from its
has vocal symbol for focus of action.
observed in this stage
intent to new spectacles
experience. By removing
action context and now pertains to
Child able to devise detours to desired
and refer to the smile
is almost self-initiated
that which obscures the toy
objective sequences of displacement
goal. Mental inventions = think out
as a pre-verbal
activity. Child will
he is after and then
perceived independent of motor
actions before executing them.
indication of
"change self to keep
grasping the toy, show that
participation. New procedures are
Representation = the capacity to
recognition.
environment constant.
the relationship of ends and
discovered by trial-and-error but he
imagine the environment as is or would
Q.
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CD
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CD
"O
o
o
E
o
(A
C
(D
cn
means is established and it
can also conceive of slight variations in
be if altered, without perceptual clues.
conserves the time
what he perceived and to this extent
Applies only to concrete situations and
sequence of before-after.
motor action is replaced by thought.
immediate surroundings.
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♦
I
(PE OF COGNITIVE
DEVELOPMENT
Pre-conceptual thoughts -2 to 4 years
Intuitive thoughts -4 to 7 years
Toddler does not yet understand what concepts entail - that it points to certain classes of things
Intuitive thoughts refer to thinking not based on logic but conclusions made on the
that has some similarities that forms the basis for them being grouped together.
grounds of what the toddler observes.
Characteristics of the Pre-operational phase
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Semiotic (symbolic)
Egocentrism: todd
Concepts of causality:
Realism:
Animism:
Syncretism:
Classification: the
Conservation: toddler does
Serial
Number comprehension:
function: the mental
ler views the world
Finalism has to do with
toddler cannot
children
combining unre
grouping together
not understand that certain
formation:
counting does not
representation of
from his own per
the meaning toddlers
differentiate
give life to
lated ideas and
of objects on the
traits such as length,
toddler is un-
necessarily imply
something, visible
spective, implying
attach to 'why' ques
be tween
lifeless ob-
facts together on
basis of some trait.
amount, and mass stays
able to ar-
comprehension. Number
in the following:
he cannot imagine
tions. Being unsatis
psychological
jects & the
the basis of child’s
The child younger
unchanged despite certain
range objects
is a collection of objects
postponed imitation
himself in the posi
fied with answers to
and physical
same con
own subjective
than 5 'A use
transformations. The rea
according to
conceived as both
where model is not
tion of another. It
these questions can be
events & and
sciousness
and egocentric
graphic presenta
son for this is that the todd-
size and to
equivalent and
present anymore;
can be observed in
attributed to the two
also not be-
as humans.
judgement (girl
tions -place
ler centres his attention on
understand that
orderable, their only
symbolic play; start
use of language
meanings of'why'.
tween what is
Life is attri-
does not have a
objects behind
only one aspect (thickness),
if A is big-ger
difference thus being
drawing; verbal
where he talks to
Firstly it implies the
internal and ex
buted firstly
name because
each other and
without considering the rest
than B and B
reduced to their position
recall (say 'woef
himself without the
effect of the action and
ternal. The
on the
she can’t talk).
call it a snake, or
(length); he does not have
bigger than C,
in a series. True
after dog has left);
goal of communi
with that the underlying
name of the ob-
basis of its
Jucsta-position:
group it according
operational thoughts that
then A is bigger
comprehension implies
and language. This
cating; when he re
motivation (why did
ject is the object
activity
facts that are real
to shape and then
would consider the reverse-
than C. A
that the child
function leads to
peats certain state
you break it?).
to the toddler At
(sun gives
ly related can’t be
change to group it
bility of the action done on
relation-ship
understands the ordinal
use of symbols &
ments over and
Secondly it refers to
age 4 the child
light), then
brought in relation
according to
the object; he bases his
exists be-tween
trait of numbers; the
signs. Symbols are
over; or in playing
the cause of something
sees dreams as
with move
- confusing cause
colour. From 5 'A
conclusion on intuitive ob-
the child’s me-
cardinal trait (number
personal (what they
while both have
(why is it rain-ing?).
something exis
ment (wa
and effect (he
to 7 years, which
servation rather than logical
mory and serial
stands for all the dasses
stand for depend
their own conver-
The toddler cannot dis
ting outside
ter in river
teased the dog
is the non-graphic
reasoning (does not con
forma-tion
with that number of
on individual) &
sation without com-
tinguish between the
himself & sees
moves).
because it bit him).
stage, children
sider that nothing has been
ability.
elements); through
toddlers use it idio-
municating with
two meanings.
it as real. The 7
This is de
Transductive
classify according
taken away or added to ob
Teaching that
additions and
syncratically (same
each other. Private
Artifidalism refers for
year old under
pendent on
reasoning:
to one dimension,
ject when form was
focuses on
multiplication numbers
symbol represent
talk can be found in
example to the todd
stands that
culture and
making deductions
but cannot do
changed); he focuses his at
what is the
can be combined in
different things).
sociai speech until
ler's belief that the sun
dreams are in a
whether or
from one case to
simultaneous
tention on the present con
same and what
different wholes, and
Signs are conven
the age of 10 & in
is a burning match. It
person’s mind
not the
Other cases (if tea
classification on
dition without considering
is dif-ferent im-
through deduction and
tional - everyone
all probability helps
manifests prior to
and not in
child knows
is yellow, than
the basis of more
the transformation; he is not
proves serial
division wholes can be
attaches the same
the child to focus
religious teaching.
reality.
anything
oranges must also
than one criteria,
aware of the conservation of
formation with
fractionated again; and
meaning to them
on the execution of
Relation between
about the
now be yellow and
nor hierarchical
identity; and he does not
regard to de
conservation of numbers
(traffic signs) and
cognitive tasks.
nature & person seen
object.
not green
classification.
comprehend reciprocal na
grees of
- one-to-one similarities
ture - if something becomes
brightness.
(seeing if there is as
toddler learns these
as 'the moon grows be
from example and
cause children grows’
instruction.
anymore).
longer it will become leaner.
much bottles as there is
glasses if separate.
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Operational thinking involves operations used in thoughts. An operation is in effect an internalised action which has become reversible and coordinated with other
operations in a grouping governed by the laws of the system as a whole. Reversibility takes two forms: invariance — an operation executed in one direction can also be
executed in the opposite direction; and compensation - for every operation there is another that compensates for the effect of the first. Age 7-12 years
c
0
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o
re
uo
o
L.
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c
0
J
Decentra-
Loqic thinking
Decrease in eqo-
Concepts of causality:
Realism: child
Animism:
Syncretism and jucsta-
Classification:
Conservation
Serial formation:
lisation:
& insight in
centrism: can
does not confuse
realises that
by the age
position: between 7 and
child now under-
around 8 the child
the child wodd be
prehension:
child can
trans-
consider the po
meaning of cause and
thoughts
of 11/12
8 years the confusing
stands dass-
understands con
able to solve a
child
take differ-
formation:
sition of another.
effect anymore and
happen in the
children's
combination of ideas and
inclusion; that a
servation of sub
problem where
comprehends
rent aspects
thought is
Able to alter his
under-stands that
mind and is
view of what
facts are found more in a
subclass is always
stance but not
transitiveness (M is
ordinal and
of a matter
logical and not
viewpoint after
some things happen
untouchable
lives and
child's language than his
smaller than the
mass, which is
taller than K, and K
cardinal traits
into consi-
intuitive
deliberation. Co
by coincidence.
and invisible.
has a
reasoning (child would
dass that includes
only accom
is taller than E -
of numbers, as
deration
anymore. He
operation and con-
Around 11/12 the
The child
conscience
through a saying and its
this subclass. The
plished around
who is the tallest?)
well as how it
sirndta-
considers the
forming to others
child realises that
distinguishes
corresponds
meaning together in one
child can now
10, and volume,
plays a role if it is
can be made
neously.
nature of the
increases. Com-
there is a natural
between words
with that of
sentence). The same is
decentralise and
accomplished
presented concre
less and more
transformation
municate during
cause for phenomena
and names and
adults.
found where the child
can do multiple
around 12years.
tely. Only at the
(see previous
and not only
Play
in nature.
that which the
does not bring that which
and hierarchical
The ability is
end of the phase it
phase).
names
is related in relation.
dassifi cation
influenced by
can be done with-
the end result.
represent.
schooling.
Number com-
out visual presentation.
The adolescent starts to think about statements that are not linked to concrete objects. He considers religious, scientific, ethical, political and personal concepts. Age
13 and older. The following traits can be distinguished during this phase.
rc
c
Abstract thoughts: can
The real vs.
Propositional thoughts:
Sdentific thinking:
Hypothetic-deductive
Comprehension of
Combination
Egocentrism: the adolescent tends to
0
think about thoughts in
the
teenager can reason on the
teenager develops
reasoning: from investigating
proportionality: the
thoughts:
think about everything and is therefore
itself = reflective abstrac-
probable:
basis of propositions without
the ability to consider
the details, making hypothesis
teenager discovers that a
enables the
spending a lot of time thinking about his
ro
L-
tion. Can think about the
teenager
considering the reality. He
all the factors of a
about solutions and deductions
small weight can balance a
adolescent to
own thoughts. This preoccupation is
relation-ship between
does not
can make statements about
situation a all the
are made. The possible are put
bigger one if it is moved
think of all
seen as centring and it limits his formal-
abstract concepts and
only think of
statements and draw
possible solutions for
above what is, forming the
further from the middle of
possible
operational thoughts. This egocentrism
can replace symbols with
the here-
conclusions about
a problem. Options
basis for experimenting. Can
the scale. He can in other
combinations
leads to the creation of an imaginary
others (mathematics).
and-now but
conclusions = two-order
will be systematically
also consider both the logical
words understand the
of elements in
audience, and finds it difficult to
Can explore & question
also what
operations.
tested in order to
relationship between hypo
relationship between mass
a collection.
differentiate between his own thoughts
existing systems
can or may
arrive at the correct
thesis and the factual relation
and distance, and can solve
and what others think about him. He
be.
answer.
ship between a hypothesis and
the problem of balance in an
experiences his thoughts as feelings as
an empirical given = inter-
abstract way.
unique and new. He therefore creates a
0)
Q.
Oi
E
<D
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0)
0
proportional logic.
personal fable and his view often leads to
a feeling of being misunderstood. This
usually declines after the age of 16.
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The Pre-ope rational, Concrete-operational, and Formal-operational phases are described
according to Botha, et al (1990: 258-271); Louw, et al, (1990: 331-340); and Thom (1990: 418421,424), who placed Piaget’s learning theory within a developmental context with regard to the
kindergarten, school-going, and teenage child.
The previous table is a summarised guideline to the child’s progress .through cognitive
developmental stadiums is relevant for the social worker in assessing the child. Not only does it
give an idea of areas in which the child may lack stimulation, it also puts expectations of social
functioning within the context of the child’s ability. A child cannot show positive social
behaviour if he is not developmentally ready to do so.
The goals behind problem behaviour
To understand the goals of the child’s behaviour discussed next it is necessary to understand it
in the context of repetition control which describes a tendency to repeat certain patterns of
behaviour. Children who have been abused seem driven to relive their past. They provoke
people into treating them just as their abusers did. The reasons for this are complex. Troubled
children recreate the very situations that frightened them, hoping this time they will be less
frightened. Originally they may have felt completely helpless. Now they are trying to get more
control over what happens to them. This is an emotion and not a conscious process. No one
can be talked out of it. No one is to blame for it. You teach children to behave differently by not
giving the same unsatisfactory responses they have learned to expect (Leigh & Leigh, 1999: 8).
More specifically then the four goals of misbehaviour that allows identification are discussed
next for purposes of assessment and the appropriate play therapy techniques to encourage
more appropriate goals are discussed in the intervention model - post doctorate (Kottman, 1995
and Harrison, 1997):
Attention: Children whose goal is attention believe the only way they are significant is
when they are the centres of attention. When others do not pay attention they feel
insignificant and unimportant. They need attention in order to feel they belong. Children
will try a constructive route first but if they feel they have not gained acceptance and
belonging, they switch to destructive mode. Whether they use the positive or active
mode depends on their own personal courage and energy. There are four possible
routes to get attention and each subcategory has distinctive types of typical behaviour:
Caregivers responding to inappropriate attention seeking behaviour usually reinforce the
child’s belief that this should be the pattern of behaviour. A child displaying unacceptable
behaviour to achieve the goal of attention has leamt that this usually gets her/him what she/he
wants. Because of past reinforcement and perceptions, children believe that in order to gain
recognition or to be accepted they need to be the focus of attention or the one who is
demanding service. We all need attention, and children need to be helped to develop positive
and appropriate ways of gaining attention by being encouraged and appreciated when
cooperating and contributing acceptably.
The active constructive route: This child has many positive behaviours and
o
mannerisms, all designed to make him the centre of attention. This child is usually the
teacher’s pet or model child who uses ‘goodness’ to get recognition. He is frequently
over conscientious and may use tattling as a way to gain attention. This child does nice
things for other people and draws attention to his good deeds all the while.
The passive constructive route: This child exhibits good behaviour less obviously and
o
then wistfully waits for someone else to notice them. This child might act like a clinging
vine and expects other to take care of him. This child may receive a lot of attention for
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)
good looks or a charming personality and may develop a need for admiration and
service.
o
The active destructive route: This child may frequently be the class clown or the
family smart aleck. He uses negative behaviour in a rather loud, obvious fashion to get
attention. He may be silly, argumentative, overly active, easily distracted, or bullying.
Pepper (1980 in Kottman 1995) described different types of children that fit this
category:
■ The s/vow-o/fis the child who uses flamboyantly negative behaviour to get attention and
he likes to shock people.
■ The obstructive child becomes a nuisance.
■ The enfant terrible child purposely breaks rules of tact and convention. He interrupts
and says rude things. He may be witty, sly, and clever in interactions with other children
and adults.
■ The walking question mark constantly asks questions, even though he knows the
answers.
■ The unstable child gives up easily and constantly needs reassurance and bolstering,
even though he is capable of many things.
A child who is an active destructive attention seeker may, at one time, use any or all of these
behaviours to gain attention.
o
The passive destructive route: This child is not quite so obvious and is frequently
characterised as lazy or dependent. This child may appear to be shy and use
bashfulness to keep other people involved. He may be messy, perpetually late, or
unwilling to do chores. This child can also exhibit a great deal of fear and anxiety,
constantly needing reassurance and care. He or she may use eating difficulties, speech
impediments, or reading problems to gain significance and keep people paying
attention.
When adults interact with children motivated by attention, they feel mildly annoyed, and will give
these children attention, either negatively or positively. Initially with constructive attention
seekers the adult will react favourably, but the child’s constant need for involvement begins to
strain the relationship. With destructive behaviour adults may try to coax them into more
appropriate behaviour to which these children temporarily reduce or eliminate annoying
behaviours. When others are paying attention to them they may feel content and stop
demanding interaction. However when they stop being the centre of attention, their anxiety
escalates, and soon they resume the behaviour they typically use to gain attention.
Power. Children whose goal is power believe they only count when they are in control,
of themselves, of other people, and of situations. When they are not they feel worthless
and unimportant and try to regain the power by any available means. They typically
show faces that look self-confident and superior, even smug. This is not how they really
feel however. They have usually tried to gain significance in more constructive ways
and have not achieved a sense of belonging, and now believe they must achieve power
to be safe and secure. The primary distinction between the active and passive
manifestations of power seeking is in the degree of energy children devote to their
behaviour.
Children whose behaviour fits into this category are those who wish to control and be the
boss, which may be fine if this behaviour is achieved through acceptable means. It is
important to avoid becoming involved when a child displays negative behaviour, as it serves to
reinforce the child’s belief that this is how to gain recognition and acceptance. When
behaviour is inappropriate, withdraw from the contest. Later use guidance methods to
reinforce acceptable behaviour such as offering choices, allowing the child to experience
consequences, acknowledging the child’s feelings.
Active power seekers get into power struggles with authority figures and peers by
o
arguing, fighting, contradicting, and acting with open defiance. Many times they use
temper tantrums to get what they want. They may also tell blatant lies, cheat to win at
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games, and use other forms of dishonesty to stay in control.
Passive power seekers get into power struggles by being disobedient, forgetful,
manipulative, stubborn’ lazy, and uncooperative. They do not overtly challenge others
but get their way in refusing to act as expected.
When adults encounter power seekers they get angry they may feel challenged or threatened
by the child’s need for control. Adults may react to this challenge by engaging in power
struggles or may threaten them or use preaching to induce them to comply with rules and
structure. These strategies rarely succeed and when punished they usually escalate their
negative behaviour. A child whose goal is power usually comes from a background in which
one of the following three circumstances exist:
a) The family does not allow him or her to have a reasonable or appropriate modicum of
power.
b) The family allows the child to have an excessive amount of power, or
c) The family is chaotic, disorganized, and lacking in a sense of structure and safety.
Revenge: These children seek to get even or to punish others for pain and injury
inflicted^on Jhem. They may have experienced physical, sexual or emotional abuse, or
neglect, and want to protect themselves in future by striking out before anyone else has
a chance to hurt them. They have only experienced relationships to be painful and
believe that the way to establish and maintain a relationship is to inflict pain. Other
times these children may be thwarted in their attempts to make things go their way and
may lash out to exact revenge for perceived hurts resulting from their frustration. Many
times revenge-seeking children will believe they are unacceptable, unlovable, and
unwanted. They may even believe that they deserve to be hurt and expect others to
reject them so they reject others first. There is an active and passive form of revenge.
Misbehaviour, which has revenge as its purpose, is more a complex emotional goal. Children
who are feeling discouraged and angry with someone or something usually display this type of
misbehaviour. The child behaves in a way, which shows she/he wants to hurt others the way
she/he feels hurt, although the behaviour is directed at someone or something different The
‘revenge’ child needs to be given lots of opportunities where the child can feel good about
him/herself and where the child is being encouraged. The child’s feelings need to be
acknowledged and inappropriate behaviour redirected without it being given undue attention.
Children, who engage in active revenge seeking, are violent, malicious, and cruel.
They are frequently the bullies who hurt other children and adults physically or
emotionally. When losing at games they may try to punish those who best them. Bed
wetting and soiling clothes are sometimes exhibited and can be metaphoric
communication for children’s feelings to the adults who clean up after them. They may
also steal favourite and treasured possessions of others in order to hurt them.
Children who passively strive for revenge exhibit more subtle behaviours like being
moody, pouty, threatening, or withdrawn. They may refuse to participate in activities
and sabotage those they do join. The difference between passive power children and
passive revenge children is intent. Power children want control; revenge children want
to hurt others. Adult who encounter these children usually feel hurt and act on it by
withdrawing from the child, which provides support to the child’s belief that they are
unlovable. Other adults may retaliate which inflames the child’s desire to get further
revenge. Whenever they experience any kind of reprimand or correction these children
assume the punishment is designed to hurt them and their immediate response is to
escalate their efforts to hurt others.
Proving inadequacy: Children who are trying to prove that they are inadequate are truly
discouraged, .They protect themselves from the demands of life by avoiding activities in
which they feel deficient. They may decide that they cannot do things as well as they
want to, other people can, or they ought to be able to. Inadequate behaviour is usually
passive; the child will not try, gives up easily, avoids the company of others, but the
ultimate form of discouragement is active - suicide. In certain families parents may
o
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\ )
have contributed to the child’s negative self-images because of their own
discouragement, which can take the form of neglect, over-ambition, pressure,
pessimism, criticism, and impossibly hard standards. Sometimes however, children get
discourage because they compare themselves unfavourably to siblings and peers. In
cases where children have some type of challenging condition, such as learning
disabilities, attention-deficit/hyperactivity disorder, physical disability, or’ mental
retardation, their assessment that they cannot do as well as others may be accurate, but
in most other cases the perception is disproportionate to the problem. Adults interacting
with these children usually feel helpless, hopeless, and just as discouraged as the
children. They then frequently give up on these children since they tend to get worse
with attempts to intervene rather then better. When these discouraged children
experience failure or correction, they sink even deeper into their despair and give up
even small attempts at success or progress.
Children with assumed inadequacy usually feel very discouraged with a low self-esteem.
Because of past reinforcement, they believe they belong through gaining attention and
recognition by being unable and incapable. In other words, they have discovered that by
withdrawing from responsibilities or participation, they can in fact avoid effort, yet still gain
attention because people will pity them and thus do things for them. Adults need to offer
encouragement, avoid doing things for the child that she could do herself, for example,
feeding and dressing, and ensure that they are providing experiences and challenges
appropriate to that child’s level.
The goals behindpositive behaviour
There are four additional goals that result in positive behaviour. The first is the goal of attention,
involvement, and contribution, where these children help others because they believe they
can belong by contributing. The second goal; autonomy and self-responsibility involve
children believing they can make responsible decisions and have age-appropriate power.
These children are resourceful, exhibit self-discipline and self-control, and take care of
themselves. The third goal is justice and fairness. In response to cruelty and hurt, these
children return kindness and caring. The fourth goal is avoiding conflict and acceptance of
other people’s opinions.
These children believe there are better ways of solving
disagreement than to argue or fight. They ignore provocations, withdraw from power struggles,
and resist peer pressure. Most of the children who come to play therapy however, are striving
toward goals of misbehaviour. Both types of goals must be recognised since the ultimate goal
of therapy is to help children strive for the positive goals (Kottman, 1995: 14).
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TABLE 3. THE LIFE EVENTS RECORD AS ASSESSMENT OF STRESS IN
CHILDREN AND ADOLESCENTS
LIFE CHANGE UNITS
LIFE EVENTS
Beginning nursery school, first grade, or high school
Pre-school
Elementary
Junior High
Senior High
42
46
45
42
“52
“
56
Change to a different school
33
Birth or adoption of brother or sister
50
50
50
Brother or sister leaving home
39
36
"33
37
Hospitalisation of brother or sister
37
41
44 ' • ■ '
41
Death of brother or sister
59
68
71
68
Change of father’s occupation requiring increased absence
36
45
Los of job by parent
23
38
48
46
Marital separation of parents
74
“Tg-~- ------ ----------------
69
Divorce of parents
78
"84
84"
77
Hospitalisation of parent (serious illness)
51
55
54
______________
55
Death of parent
89
91
Death of grandparent
30
38
Marriage of parent to stepparent
62
65
63
Jail sentence of parent for 30 days or less
34
44
50
50
38
87
94
| 35
'
“
36
_
63
53
75
Jail sentence of parent for 1 year or more
67
67
76
Addition of third adult to family
39
"41
34
34
Change in parent’s financial status
21
-29
40
45
Mother beginning work
47
Decrease in number of arguments between parents
21
—-----------I-----44 ':------ -I-------36 ------25
|29
Increase in number of arguments between parents
44
y
26
27
48
46
29
46
26
'
' .<
70
51
Decrease in number of arguments with parents
22
27
I Increase in number of arguments with parents
39
'47'. ':
[Discovery of being an adopted child
33
.52:
Acquiring a visible deformity
"52
-69--------------
Having a visible congenital deformity
39
"60"“"““"70~_
Hospitalisation of yourself (child)
59
62
I Change in acceptance by peers
38
X.
, Outstanding personal achievement
• ■
47
64
__
‘sF
- -- ~~~~~~
62
59
' ; " ' "58
..... 46
___
67
23
39
45
38
53
65
63
| Failure of a year in school
57
62
56
Suspension from school
46
Death of a close friend
Pregnancy of an unwed teenage sister
Becoming involved with drugs or alcohol
Becoming a member of church/synagogue
50
36
__
25 :
_
'
60
64
70
J"76
28
31
Not making an extracurricular activity you wanted to be involved in
55
Breaking up with boy/girlfriend
47
Beginning to date
"55
Fathering an unwed pregnancy
Unwed pregnancy
Being accepted to a college of your choice
Getting married
53
~
51
76
77
2!____
92
43
101
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EMLYRECOLLECTIONS
Establish rapport, observe the child’s unusual behaviour, .and gather information about the
child’s family constellation. These preliminary procedures give the therapist a basis for deciding
whether to ask the child to draw, tell, or act (out using puppets) the early recollections. The
therapist gathers between 5 and 7 early recollections, this should happen over the course of
a few sessions to avoid the child becoming bored or rebellious. The therapist initiates the
expressions of the child by saying: “Draw me a picture of something that happened when you
were little", or “Tell me a story about something that happened when you were younger”, or
“Use the puppets to show me something you did when you were a kid\ Ask the child to tell you
what is happening and write down everything the child says. Detailed information helps the
therapist to interpret the meaning of the early memory. It is important to ask the child to
describe the feelings associated with the memory and relate the age when it occurred (Kottman,
1995:140-141).
After the child related several early recollections, the therapist begins to look for the central
theme of each memory and the overall pattern among the memories. By considering the
following questions the therapist can begin to formulate ideas about the child’s life-style
(Kottman, 1995: 141-142):
o What is the feeling tone of each recollection? Is there a pattern in the feeling tones of the
different recollections?
o What is the focus of each memory? What stands out as being the most important and most
vivid part of the memory? Is there a pattern in the foci of the memories?
o Is the client part of each memory? If so is the client an observer or participant? Is there a
pattern?
o If the client is part of the recollection, is he alone or with others? Is there an inter-memory
pattern of being alone or with others?
o If the client is part, what is the relationship to others in the memory? Is there an inter
memory pattern of relationships?
o If the client is part, does he give or take from others? Patterns?
o Is there a major concern with people or material possessions or the situation? Is there a
pattern?
o Does the client appear to feel or act superior to others or inferior to others in the memory?
Is there a pattern?
o Is the client in control of the situation? If the client is in control, how is he gaining the
power? If someone else is in control, who is it and how are they getting the control?
Patterns?
o Is the client taking care of others or are others taking care of the client? How is the caring
happening? What are others taking care of for the client? Are there any patterns?
o What emotions does the client associate with the memory? How strong are the emotions?
What does the client think the emotions are about? Are there any patterns?
o Is the client conforming or rebelling? Patterns?
Children’s early recollections can be distilled versions of their life-styles. By examining these
early memories and looking for patterns, the therapist begins to comprehend children’s attitudes
towards themselves, their relationships with others, and their views about the world.
life-style hypotheses
From the information gathered about the family atmosphere, the family constellation and
psychological birth order position, and the early recollections, a picture of the child’s
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perceptions, basic convictions, private logic, ways of gaining significance, and goal of
behaviour emerges. By putting all of these data together the therapist can organize a
conceptualisation of the child’s life-style by making guesses about how the child might complete
the following sentence stems (Kottman, 1995:142-143):
o I am...or I must be...
o Others are...or Others treat me...
o The world is.. .or Life is...
o Therefore, it makes sense that my behaviour must be ...or therefore I must act as if...
For each of these sentence stems, the therapist will probably have several possible
completions, depending on the life task being considered. The conceptualisation can be shared
with the child in a gradual, subtle way. In the intervention phase the therapist helps the child to
gain insight into his life-style, by making guesses, using metaphors and art techniques, and
offering interpretations of conversations and play to share with the child a sense of how the
clients sees self, others, and the world and how he acts as if these perceptions are true.
Familylifestyle
The primary emphasis in the information-gathering process is the perception of the parents of
how the child gains his of her significance in the family; how the child interacts with other family
members; how the child views him or herself, others and the world; and how the child’s
behaviours grow from this viewpoint. Parents are also asked to describe the birth order and
personality of each of the children. It is also helpful to have parents rate the children in the
family on qualities such as intelligence, helpfulness, materialism, and selfishness. This
helps to understand how the child’s psychological position in the family affects the child. It is
also important to ask the parents about the marital relationship, their own family of origin, their
relationship with the children, and their views on, and strategies of discipline. This information
gives the therapist a perspective on the family atmosphere. Asking about the daily routine and
the child’s responsibilities helps the therapist to understand possible goals of behaviour.
Very important is to know if any kind of event or circumstance that could adversely affect the
child has occurred in the child’s life. The therapist can use the information gathered as a basis
for teaching the parent new strategies for perceiving and interacting with the child, through
reframing. This information is also invaluable in choosing appropriate parenting skills to teach
them (Kottman, 1995: 37-38).
The four phases of Adlerian therapy are building a relationship, exploring the client’s (child’s)
life-style, helping the client gain insight into his or her life-style, and reorienting and re-educating
the client (Kottman, 1995: 18). The phase that is relevant for assessment and for inclusion into
the new technology, is ‘exploring the child’s life-style’. In order to investigate the child’s life
style, the social worker uses observation of play and other interactions, questioning techniques,
and art therapy strategies to gather information form both the child and parents about the goals
of the child’s behaviour (discussed in first part of chapter 5), the family constellation, family
atmosphere, and early recollection. This gets organised into a conceptualisation to be shared in
the intervention phase (Kottman, 1995: 18).
DETERMINING THEIEVEL OFPLOY INA CHILD
To give an observable framework for assessing play within an interpersonal-role context the
researcher gives the observational system of general behaviour of children in nursery school
used by Gamier and Latour (1994) to study cooperation in pre-school children.
KIND OF PLAY
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1. Play alone. The child is alone and plays independently of the others. He/she may be
2.
3.
4.
5.
6.
7.
8.
9.
playing with an object which is different from that used by others, playing with out an object
apart from the others and without reference to what the others are doing.
Play side by side. The child plays in a group of other children, but independently and
without any substantial interaction with them. The children do not modify or influence each
other. Essentially, the child is beside and not with others. An example: the children are
sitting side - by - side in the grass, each playing with earth and grass independently,
sometimes exchanging a word.
Play with others. The child plays with others. There is verbal and nonverbal interaction
about the form of the common play or the material of the play. Each child is involved in the
activity but does nearly the same thing as the other child. There is no division or
organization of the task and no subordination to the group. Each acts as he or she wishes.
An example: one child begins to run and the other imitates her and they run for a while in a
perfect circle.
Structured group play. Child plays in the group. There is organized action so that
everybody is able to attain a common aim. Division of different tasks is evident and allows
everybody to play a certain role in the organized activity. Each child tries to support the
action of the other. The different actions of the members of the group involved in the activity
are coordinated in time and space. An example: An informal game organized by the
children, "Put at the comer", where they dance around.
Ruled play. The children, as in cooperative play, are involved in very structured activity
with a subdivision of the group into 2 cooperative sub - groups which are in com petition and
whose activities respect certain strict rules. An example is a formal game.
No Play. The child is engaged in no apparent occupation. He/she may be wandering
around or standing aimlessly and paying more or less attention to the activities of the group.
Ephemeral play. A child who is not playing begins a movement of any kind as if to enter
into a specific play situation and then stops. Some activity begins but is interrupted.
Looking for play. The child spends most of his or her time watching the other children
play. He speaks and suggests, but does not enter overtly into the play himself. He stands
near the group or the other child with whom he would like to play, but just stays at a
distance to be able to hear or see what happens.
Instigative play. The child stands in front of the group and begins to make movements of
some play with an object and looks at the group in such a way as to make them play with
him or her.
FORM OF THE ACTIVITY
1. Unoccupied. The child is not involved in an activity, but is standing and waiting or resting.
2. Looking outside of the area. The child is not interested in the ball or the other children,
but is focussed on a person or an object situated in or passing by the play area.
3. Interest in an object. The child's attention is focussed on an object, and the object is the
central aspect of the activity.
4. Speaks with adult. The child tries to, or directly speaks with one adult in or out of the play
space. The child can initiate the exchange or simply answer the adult.
5. Active. The child moves nearly continuously, using different forms of movement and
seemingly moves for movement's sake. An example is that during a sequence of whatever
length, the child jumps, laughs, falls, and moves around with no precise goals.
6. Imitate. The child does a reproduction of what somebody else has done. He/she copies
the general activity of another child.
7. Attracted by other’s activity. Several children are playing together or a child is engaged in
an activity before the focal child goes to them and by looking, or other means, manifests
interest in being involved in the activity.
8. Show off. The child faces the others and performs various movements and gestures, with
or without an object. During the performance, the child stops and checks to see if the
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audience is watching. The child may gesture to the audience to join the play, but does not
really allow them to do so.
9. Execute other's proposition. One child gives a direction and the focal child passively
executes it without offering resistance. The focal child does what another child has directed
and follows that activity, but without taking an active part in the play. Generally, the play is
quickly neglected. An example is when one boy tried to organize a baseball game by
positioning first one child, then the other on the field. Although the child accepted the
placement, they quickly left their places and did not play the game.
10. Organize another's activity. The focal child directs the activity of others. The child may
order them to do an activity or explain to them how to do it. The other children execute the
directions more passively than actively, that is, they do not fully cooperate in the task.
11. Stimulate other’s activity. The child comes directly to the others and by gestures or vocal
communication strongly encourages the others to participate. An example is when a girl
faces the group when holding the ball. She gestures with the ball that they should join her in
play, looking at their reaction. Finally, she throws the ball so that they may catch it.
12. Participation in a common activity. The child is involved in a common, spontaneous
activity of the group. The child is very active and interested in the group activity, but the
activity remains unorganized. There is no discussion of plan, and no set of exp licit or
implicit rules. An example is when different children are playing with the ball and one girl
has the ball on her head. Each time the ball falls off, one boy picks it up and brings it back.
13. Participation in organized activity. The activity in which the focal child participates is
highly organized. Each child must follow certain rules in order to accomplish a specific role.
An example is when the children are sitting in a circle and one child is running around the
outside. The child signals the other child by tapping on the head and the second child
chases the first until he reaches the second child's place.
14. Lead the organized activity. The focal child directs the organized activity of the group by
explaining, answering questions, and assigning roles. The others both ask for directions
and consent to their instructions. An example is when, during a regular game, the focal
child explains the rules, gives out tasks, and insures the order of each action.
15. Play fight. Rough physical contact of varying degrees, but without the agonistic character
of real fighting. Play fighting is more tentative, less forceful, and generally more "playful" in
nature.
Facial expressions, if they can be seen, are never angry, but rather are
characterized by smiling and laughing. There are no angry vocal expressions or crying.
In assessing the existence or quality of a friendship in a child’s life, the following markers can be
used: asking parents or teachers who know enough about the children’s feelings towards each
other, to point out who the child’s friends are; children can be asked to name other children who
they especially like (reliable around 6/7 years); observing proximity-maintenance; and
behavioural reciprocities (Hartup, 1992: 179-181).
BONDING
Poor attachment becomes a problem when the child’s behavioural disorganisation severely
impairs his functioning across several areas of life. To establish whether a problem in the
bonding process exists, the style of showing affection and seeking comfort from the caregiver
should be observed. A lack of affectionate interchange between child and caregiver and/or
indiscriminate affection with strangers is a cause for concern. Another clinical area of behaviour
is the degree of cooperation between child and caregiver: Excessive dependence on the
caregiver or an inability to seek support of the attachment figure is problematic. Exploratory
behaviours are of clinical interest as well. A child that fails to check back with the caregiver or
use the caregiver as a secure exploratory base may be displaying disturbed attachment
behaviours. The clinical assessment of attachment disturbances should be based on a focused
history and a systematic observation of parent/infant interaction. Together these provide the
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clinician with the opportunity to highlight potential barriers to normative attachment
development, including the physical or emotional availability of the caregiver due to illness,
addiction, developmental disability, or extended separation. These life events can be clinically
significant in the formation of attachment patterns. The impact of infant/caregiver separation on
institutionalised infants showed three general phases, namely protest, despair, and
detachment. During the initial phase the child shows obvious signs of distress: extensive crying,
searching behaviour, and refusal of alternative figures. Eventually the acting-out behaviours
subside, and the child withdraws from social interaction. Seemingly in a state of mourning, the
child becomes inactive and passive toward the environment. With time the child no longer
rejects alternative figures, but upon reuniting with the original attachment figure is apathetic and
remote. Along with extended separation, inconsistent care can disturb the formation of trust
needed to form a lasting attachment bond. This may be due in part to the inability of the infant,
caregiver, of both to fully understand how to relate to a person in an intimate or reciprocal
manner (Wilson, 2001: 40-41).
Zeanah (1996 in Wilson, 2001: 45-46) proposed a more complete model of classification,
integrating current attachment research to encompass a wider range of attachment
disturbances. This system identifies three major types: non-attached; disordered; and
disrupted. Children classified as non-attached are those over the age of 10 months who
have shown no preferred attachment to anyone. Two subtypes of this group would coincide
with the subtypes of the DSM’s: nonattachment with indiscriminate sociability (disinhibited) and
nonattachment with emotional withdrawal (inhibited).
Disordered attachments would
characterise those children who do not use the caregiver as a secure base of
exploration. Three subtypes are: a child who is excessively clingy and inhibited in exploration
(disordered attachment with inhibition); a child who fails to check back with the caregiver in
times of danger (disordered attachment with self-endangerment); and a child who tends to worry
excessively about the emotional well-being of the caregiver (disordered attachment with role
reversal). Disrupted attachment describes the grief response upon the loss of a primary
caregiver. Because of the importance of the attachment figure during the first three years, the
loss of an attachment figure at this time would be qualitative different that at other
developmental stages, predisposing the child to problems in attachment. When these criteria
were tested for reliability and validity and compared with those from the DSM, four independent
clinicians assessing 48 clinical case studies, greater uniformity in diagnosis of disordered
attachment was found.
METHOD OF INVESTIGATING F/IMILYATMOSPHERE
There are three methods of gathering knowledge about a child’s family atmosphere; observing
the child and the parent, asking questions, and using art techniques (Kottman, 1995: 130-134).
> Observing the child and parents: The child can be observed in the play sessions and the
parents in consultation sessions, and the child and parents together in the waiting room to
get a general feeling of the atmosphere. Although this information cannot stand alone,
observed data are sometimes more accurate than self report from the client. The child
usually acts out the family atmosphere situations with dolls, animal families, puppets, and
kitchenware. The child expresses thoughts and feelings about how family members
interact, how family values are expressed, and assorted other elements of family dynamics.
The therapist notes these observations, ask questions, make interpretations, or reflect
feelings connected with what is happening in the play.
The use of metaphor in
communicating to the child about how play relates to what is happening at home is useful.
The therapist should always observe non-verbal behaviour to see if it congruent with
parents’ statements, and to point out discrepancies.
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> Asking questions: This is useful in finding out about the parents’ relationship and
discipline philosophies and practices. The following are questions focussed on gaining
information regarding the child’s life-style (Kottman, 1995: 209-216):
TO PARENTS:
o If the presenting problem wasn’t happening, how would things be different in your family?
o Describe each person in your family.
o Which of the child’s brother/s and/or sister/s is most different from him or her, and how is the
sibling different?
o Which of the child’s brother/s and/or sister/s is most like him or her, and how is the sibling
alike?
o Who is mom’s favourite?
o Who is dad’s favourite?
o Who of the kids is most like dad, and how are they alike?
o Who of the kids is most like mom, and how are they alike?
o Which one of the parents is the client most alike, and in what ways?
o Describe the relationship between parents. Who makes the decisions? Who is more
ambitious for the children? Do you openly disagree? About what?
o What is your philosophy on discipline? What happens when you have different opinions on
how to handle parenting situations?
o Who has been important in the child’s life? In what way?
o Do any family members use alcohol or drugs? To what extend? How does it affect the rest
of the family?
o What would you like to change about your family?
o How does the client stand out in the family? Positively - what successes? Negatively what gets him into trouble?
o What does the child want to be when he grow up?
o Describe a typical day?
o What are the child’s responsibilities - getting up in the morning; getting off to school; getting
to bed at night; household chores; taking care of pets; does he stay alone and when; what Is
mealtime like?
o Does the child have nightmares? Dreams? What about? How do you handle them?
o What traumatic events have occurred during the child’s life? How was this handled? How
did the child react?
o What are your hopes and dreams for the child?
o How do things go at school? What does he like best and least about school? Favourite and
least favourite subjects? What does he do best at school? What does the teacher like best
about him? What would he like to change about school? What does he get in trouble for at
school? What is the consequence of getting in trouble?
o How does the child get along with adults?
o How does he get along with other children the same age, older, and younger?
o Who is his best friend? Describe the friend, and say what he likes about the friend? What
would you like to change about his relationship with other children?
o What kinds of behaviour does the child engage in that is bothersome to you? What is family
members’ response to the behaviour? What does the child do when corrected or criticized?
o What is the child the most afraid of? How can you tell he is afraid? How do you react when
he’s afraid?
o What does the child get angry about? How can you tell? How do you react?
o What does the child feel sad about? How can you tell? How do you react?
o What hurts the child’s feelings? What is it about this that hurts his feelings? How can you
tell his feelings are hurt, and how do you react to it?
TO CHILDREN:
o Describe the people in your family?
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o
Which of your brothers and sisters are most different from you and how? And who are most
like you and how?
o What kind of person is your dad?
o What kind of person is your mother?
o Which of the kids is your mom’s / dad’s favourite?
•o Which one of your parents are you most alike and how are you alike?
o What do you get in trouble for at home? What happens then (consequences)?
o What happens when your parents disagree? What do they disagree about?
o What would you like to change about your family?
o How do things go at school? What do you like best? What do you like least? What would
you rather be doing than school?
o What do you do best at school? What is your favourite and least favourite subject? What
does your teacher like most about you?
o What would you like to change about school? What do you get in trouble for at school?
What happens when you get in trouble?
o How do you get along with adults? Who is your favourite adult to be around? What do you
like about him or her? Who is your least favourite adult and what don’t you like about him or
her?
o What does your favourite adult like about you?
o How do you get along with other kids your age; kids younger; and kids older than you? (Ask
separately)
o Who is your best friend? Describe him or her? What does he or she like about you?
o What would you like to change about your relationship with other kids?
o If you had three wishes, what would they be?
o If you could be any animal, what animal would it be? What do you like about the animal?
How do you think that animal is like you? What are the qualities of that animal you admire
or wish to have?
o If anything in your life could be different, what would you ant to change?
o If you could be any toy in the playroom, what would you be? What do you like about the
toy?
o What is your favourite book or story? What do you like about it? Who is favourite character
in the book or story? What do you like about him, her, or it?
o What is your favourite movie? What do you like about it? Who is your favourite movie
character? What do you like about him/her?
o What is your favourite television show? What do you like about the show? Who is your
favourite character? What do you like about him/her?
o Do you remember any of the dreams you have at night? Describe them. How do you feel
when you wake up? How do other react when you tell them about the dreams?
o What are you most afraid of? What scares you about it? How do you act when you’re
afraid? How do other people react when you feel afraid?
o What do you get the most angry about? What is there about it that makes you angry? How
do you act when you’re angry? How do others react when you feel angry?
o What do you get the most sad about? What is there about it that makes you sad? How do
you act when you’re sad? How do others react when you feel sad?
o What hurts you? What about that hurts you? How do you act when hurt? How do others
react?
o What do you wish you were better at doing?
o What are you good at?
o What do you like about yourself?
It is essential to ask both the child and parent similar questions in order to get a multifaceted
picture of how family members interact. This prevents just one person from dominating the
counsellor’s perception of the family. Especially with the child it is necessary to first establish a
relationship before asking the questions. It is also necessary not to overwhelm the clients with a
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series of questions. Try to fit the questions into the flow of the conversations during the
sessions and avoid using a questionnaire that may be too intimidating to the family. Be
sensitive to non-verbal behaviour that might indicate you needing to stop the questioning. It is
helpful to use the child’s play to ask questions indirectly.
> Using art techniques: A very useful strategy in getting information is to use the Kinetic
Family Drawing (KFD). Kottman (1995: 217-218) gives the following instructions for using a
KFD:
G/ve the ch//d a pencil and eraser and several sheets of paper and say: ‘Draw a picture of
everyone in your family for me. Everybody in the family needs to be DOING something. I would
like you to draw whole people instead of stick people. And remember each one must be doing
some kind of action’. This can then be followed up by the following questions about each of the
figures:
o Who is the person? What is his or her relationship to you?
o How old is she?
o Can you tell me a little bit about this person? What is this person doing? How does this
person feel?
o What does this person need the most?
o How do you feel about this person?
o How does this person get along with other people?
o What does this person wish for?
o What is this person thinking?
o What do you like about this person?
o What don’t you like about this person?
o What happened to this person right before the picture?
o What will happen to this person right after the picture?
o What will happen to this person in the future?
o What is the family doing?
o What will happen to this family right after the picture?
o What happened to this family right before the picture?
o What will happen to this family in the future?
o If you could change anything about this family, what would it be?
This strategy can also be used to get a Kinetic School Drawing by giving the child the following
instructions (Kottman, 1995: 219-220):
Td like you to draw a school picture for me. Put yourself, your teacher, and a friend or two in
the picture. Make everybody DO something. Try to draw whole people and not stick people ’.
Similar questions to the above can be asked, with added ones like the following:
o What does this person do for fun?
o What does this person think about school?
o Which of these friends are you most alike? How?
o Which of these friends are most different from you? How?
o Which of these friends do you spend the most time with? Doing what?
o Which of these friends is the teacher’s favourite? Why?
o Which of these friends doesn’t the teacher like?
o What is the class doing?
o What will happen to the class right after this picture?
o What happened to the class right before the picture?
o What will happen to the class in the future?
o If you could change anything about the class, what would it be?
To interpret the drawing use a common sense approach, looking at what the child has drawn as
representative of how the child perceives each person gaining significance in the family. Look
for interactional patterns and attitudes expressed in the drawing. If a child refuses to draw,
suggest drawing a symbol for each member and to explain what each mean. The child can also
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be offered a magazine form which to take pictures for the family drawing (Kottman, 1995: 133134):
METHOD OFIHKSTIGfiTING FAMILYCOHSHLUTION
The same techniques can be used as those used to investigate family atmosphere.
Observation, questioning strategies, and art techniques are useful exploring methods. The
therapist’s goal is to find information in areas of liabilities and assets (strengths). The following
rating scale is helpful in getting this information from the parents (Kottman, 1995: 211-212).
o
Rate siblings on the following:
HIGHEST
LOWEST
Intelligent
Hard working
Good grades
Follows rules
Helps at home
Complains / critical
Considerate
Selfish
Tries to please
Hurt feelings
Temper
Materialistic
Friends
High standards
Athletic
Spoiled
Best looking
Punished
In using art techniques the therapist can ask the child to draw a timeline illustrating when each
child was born. Puppets, photograph collages, and clay sculptures can be useful to help the
child explore the cultural background of the family, different views of the relative values of males
and females, or the effects of having a sibling with disabilities.
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ANNEXURE 3: Conceptualisation & questionnaire
Summary of social functioning in children
Intra personal
>
Inter
personal
Welfare and
Private
Practice
•
•
•
e
•
•
•
•
•
Childhood
Development
Emotional Needs
Psychosocial
functioning
Behavioural
Problems
Temperament
Birth order
Responds to
teaching of family
members
Affected by function
of the system
1st system to teach children
inter-personal skills
Responsible for meeting child
needs directly and through
mobilizing resources for child’s
benefit
>
Community.
.
.
Community
Development
& Advocacy
•
•
•
Assessment of
Independent Living
Relational Dynamics
Family Problems
•
•
•
School Problems
Health System
Environmental
stressors
T
Constitute the
immediate
community
Influence the
community positive
or negative based
on nature of
involvement
Provides
resources/servi
ces for optimal
functioning
Can enable or
disable healthy
growth
Figure 1.
Social Functioning in Children
The following table is a summary of the theoretical concepts discussed in the initial
literature chapter. It shows how the concepts interrelate to formulate a model which
the comprehensive classification system is based on.
Some of the lines are not
straight; this indicates that the boundaries between the developmental stages are not
rigid. Some of the problems or needs can also apply to other age categories, but this
theoretical classification gives a guideline to when those needs or problems are most
likely to occur. These illustrations were used to present the developing ideas to the
panel of experts.
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TABLE 1. SUMMARY OF THEORETICAL CONCEPTS
Age
Category
Baby and
Toddler
(0 to 2yrs)
Development
Tasks
_____________
Sensory
mastery
Psychosocial
Needs
School Child
(7 to 12 yrs)
✓//////✓////>
Adolescence
(13 to 18yrs)
Inability to seek '
care
Z
stimulation:
Belonging and
connectedness:
• Expectation
(hope)
• Concurring
hopelessness
///////✓/✓/
Autonomy
Sexual
Maturity
Connectedness and
creativeness
• Achievement
• Motivation
x Discouraged behavioural
goals:
Sleep problems s
Enuresis/
Encopresis
Effect of child
abuse &
ineffective
discipline (selfesteem)
Depression
Suicide
Rape Trauma
syndrome
Eating disorders
x
x
•
•
•
•
Attention vs. contribution x
Power vs. avoiding conflict
Revenge vs. fairness
Proving inadequacy vs.
self-responsibility
?
Over-activity and attention
;
deficit
Oppositional/defiant disorder
(argumentative, annoying,
;
spiteful, tantrums)
'
\
;
■
;
;
Easy Baby
Difficult Baby
5
'
Slow-to-warm
up
Motor
deficiencies
Speech
disability
Reading delay ;
z
Hyperactivity
Attention
deficit
Autism
ZZZZZZZZZZZZZZZZZZZZZZZZZZZZz-
Sexual promiscuity
Substance abuse
Religious cults
Oppositional Defiant Behaviour
Conduct disorder (fire setting,
stealing, lying, running away)
Delinquency (criminal offence)
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Temperament/
Strengths
ZZz^ZZ/ZZZZZZZZZZZZZZZZZZZZZZZZZ,^
Anxiety
zzzzzzzzzzzzzzzzzzzzz zzzz/zzzzzzzzzzzz
Goal directedness:
• Frustration and
stress
management
• Development of
identity
Learning
disabilities
and brain
an damage
Perinatal
complications
Meningitis
Down
Syndrome
Deaf / Blind
Motor impairments
///Z/////Z/Z/Z/Z zzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzz
Social skill
mastery
Colic
Insecurity
Trust
Satisfaction
(subjective well-
z z z z z z z z z 1°$ z z z z z
Motor
Development
Behavioural dysfunction
_____________________________________________________________________________________________________________ :_______________________________________________________________________________________________________________________________________________________ ___
Bonding and
•
•
Pre-School
Child
(3 to 6yrs)
Affectional
disorders
Social inap
propriateness
Psychosis
Personality
Disorder
I I tI
8
ENVIRONMENT
❖
❖
❖
❖
Includes micro-, meso-, exo-, macro-, and
chronosystems
Ecological principles support individual, intrinsic
value; diversity; Involvement of stakeholders; and
small service delivery systems
Person-in-environment practice aims to improve
a child’s sense in mastery; mobilisation of personal
social network; and link individual concerns in ways
that promote social empowerment through collective
action.
Building blocks in practice include optimisation of
strengths and fostering hope
SOCIAL WORKER
❖ The social worker works within a practice domain that
Portray the enhancement of person-in-environment as
its purpose
❖ She uses her own systematic methods and intervention
to accomplish this purpose
❖ She also functions within a personal environment where
her well-being and resources influences how she will
apply selected methods of intervention
❖ She has an understanding of ‘single-otherness’ and
‘plural-otherness’.
❖ She describes the environment with regard to ‘personal
otherness’, ‘resource otherness’, and ‘validator otherness’
❖ Inter-subjective sharing of external experiences is the basis
for the acquisition of language as well as the means by which
a child learns how to participate in the creation and
FAMILY
modification of cultural information within the environment.
❖ This process builds a rich inner life and an inner
comprehension of reality that enables participation in intimate
relationships.
❖ Culture is the shared understandings people use to
coordinate their activities.
❖ Socialisation is the process through which the child is helped
to acquire cultural information and relational skills necessary
to participate fully
♦:* Once an infant becomes capable of inter-subjectively
experienced states, its mother becomes engaged in the
socialization of her child.
Feu
CHILD
❖ Social relationships involve the enactment of roles - the
person’s organised pattern for behaving fashioned by
the status or functions he carries in relation to others.
❖ The child has value regardless of his usefulness to
others.
❖ Children do fulfil parent-ascribed roles as well as own
experimentation with novel ways of interacting that
meet needs of both social participants
❖ The following attributes regarding the child role need to
exist: congruity, continuity, clarity, complimentarity,
competence, and flexibility.
❖ Child obtains knowledge about the self-in-environment
relationship: direct experience with the world and one’s
ability to have effect; words; and inter-subjectively
shared experiences
❖ Participates in the continuous process of creating and
transforming meaning through language that has a
social reality
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FIGURE 3. A CONSOLIDATION OF CONCEPTS INFLUENCING CHILDHOOD SOCIAL INTERACTION
SurroS3*8
Nam
Social interaction
_______skills
Communication
9
Barriers to social interaction
Developmental tasks involved
Speech delay; Dyslexia; Blindness/Deafness
Problem-solving
Assertiveness
Pro-social behaviour
(e.g. empathy)
Cognitive learning; Motor Development; Acquisition
of language________________________________
Mental Retardation; Hyper-activity; Attention
Creativeness / Imagination; Organisation; GoalDeficit; Depression_______________________ directedness_______________________________
Bullying / Victimisation; Birth order influence;
Self-confidence; Self regulation (temperament);
Routine deviations; Delinquency____________ Independence______________________________
Autism; Post Traumatic Stress; Sexual
Differentiation; Friendship; Play experiences
inappropriateness; Inhibition_______________
_________ ENVIRONMENTAL INFLUEI
Socialisation
iT
chik>
Attachment
S Divorce & remarriage >
Single-parenting
Discipline
e
n
i
Special car*
Domestic violence
Poverty
piei"1
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Maltreatment
G
r
•
9
I
v
FIGURE 4: QUESTIONNAIRE AND FORM FOR RATINGS
i
Gender:
__________
_ Years of social work experience:
Name:
Highest Qualification:
Age:
______
Years experience with children:
Select the social work spheres you have had
experience in:
□ Community work
□ Child welfare
□ Health sector
□ Private practice
□ School sector
□ Disabilities
List the gaps or challenges that exist, in your
opinion, in service delivery to children:
Select the typical areas you see as critical when assessing children
□ Determine developmental needs □ Promoting growth
□ Family therapy □ Statutory representation
□ Teaching parental skills
Teaching social skills □ Manage problem behaviour
□ Find suitable placement □ Advocacy for infringed rights
Activist for special needs
□ Networking for services □ Initiate community projects □ Crisis intervention______•___________
Approximately how many children do you have on your annual caseload?
Do you agree that there is a need for a tool to classify problems in childhood functioning? aYes nNo
Would the use of categories help to identify needs and plan effective intervention?
aYes nNo
What problem/s do you foresee in social workers using a classification system?
□Yes aNo
Was most of the theory known to you?
Was any of the theory unknown to you? Specify
Is there any part of the theory you feel should
not be used by social workers?
What theoretical model do you predominantly use in practice?
Is the classification model compatible with this model?
What would you like to see included in the theory?
What is your overall impression of the
classification system?
Rika Swanzen
Does the prospect of having something similar to the DSMIV in social work excite you?
Was the classification system easy to administer?
Was the classification very time consuming?
Did you find the descriptions in the user manual understandably clear?
Do you think this classification system truly measures the functioning of the child?
What role can you play to assist with the implementation of this system in social work?
9300414
D. Lit. et Phil
Rand Afrikaans University
The development and validation of a classification system for children
Date of data gathering:
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Processed:
□Yes nNo
□Yes nNo
□Yes aNo
□Yes nNo
□Yes nNo
□Yes nNo
□Yes nNo
Name: __________
Highest Qualification:
Please read the case studies and
proceed to categorise the problems you
assess according to the biggest
(primary) problem that needs immediate
attention, the second (secondary) most
serious problem that needs to be
followed up, and the underlying
(relevant) problem that needs more long
term care and continuous monitoring. If
you are able to provide the full
classification code, please do so
Gender:_______________
Years of social work experience:
#1
#4
#7
Primary_________________
#10 Secondary_______________ #11
#14
#18
#22
#26
Relevant
Primary_________________
Secondary_______________
Relevant
Primary_________________
Secondary_______________
Relevant________________
Primary_________________
Secondary_______________
Relevant
Primary_________________
Secondary_______________
Relevant
#15
#19
#23
#27
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
#2
#5
#8
#12
#16
#20
#24
#28
Age: ______________
Years experience with children:
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
#3
#6
#9
#13
#17
#21
#25
#29
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Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
Primary
Secondary
Relevant
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