How Does Chronic Illness Effect Child Development? Research Paper Example

While there are many theories on child development this paper will focus on two: attachment theory (aka Bowlby-Infant Care-giver Attachment theory) and the transactional regulation model of development. This paper will mainly use Sameroff’s (2010) theories to postulate how chronic illness effects child development along with supporting theorists on the subject (Smetana, Fonagy & Target). The paper will focus on the research being done in the field and how this research is applicable to developing theories or supporting Sameroff’s already well-established theories.

Sameroff (2010) postulates a discourse on the nurture argument. The nurture argument gained popularity in the 1960’s and was explained in three-fold encompassing ethology, behavioral genetics, and the cognitive revolution. Two decades after this theory was established there was another shift in the nurture theory wherein a focus on poverty and social ecology was established. These issues are significant in Sameroff’s (2010) theories as controversy over developmental studies in infants cycle back to the forefront of the nature vs. nurture arguments. Sameroff (2009) begins his theories by differentiating between interactions and transactions where interactions are described as:

“…dependencies in which the activity of one element is correlated with another” (p. 24) and transactions as “…when the activity of one element changes the usual activity of another, either quantitatively by increasing or decreasing the usual level of response or qualitatively by eliciting or initiating a new response” (p. 24). For the former, Sameroff defines it through a concrete example: he references the ability to smile in reciprocity. The latter is exemplified by the theorists as being when instead of a smile being delivered for a smile in reciprocity, a frown takes it place. The frown in turn will be met with confusion on the part of the initiator of this transaction.

Sameroff (2010) focuses on extrapolating the bio-psycho-social ecology in his theories. The theorist describes development as something that is transactional throughout the course of an infant’s discovery of the world, the theorists states, “[t]he… development of any process in the individual is influenced by interplay with processes in the individual’s context over time” (p. 6). A child then becomes a product, or even by definition a by-product of this dynamic of human exchanges. The interactions that occur on a daily basis in the infant’s life between itself and outside sources such as parents, siblings, teachers, babysitters, etc. These social settings in turn aid the infant in negotiating their environment. As these time-table factors aid in a child’s normal development, so too does illness impart it’s own impact. When a child is ill, the extended amount of time they are overcome by this illness directly impacts the time table by which they are supposed to be fulfilling normal everyday routine development such as motor skill coordination, picking up on social cues, etc. The responses a child achieves in their environment directly affects their relationship with that environment as well as with the people whom inhabit said environment. When an illness occurs in a child’s life, then, these responses, interactions, and engagements that allow a child to properly and timely develop certain skills, is retarded. Thus, the child’s developmental capacities are altered and these changes in turn affect the developmental time table for all other stages in their early infancy and perhaps even into their toddlerhood. Sameroff states that people, infants, are byproducts of the thousands or millions of complexities that comprise their environments and are in turn effected by, influenced, and form as individuals because of them, “[t]he… development of any process in the individual is influenced by interplay with processes in the individual’s context over time” (Sameroff, 2010, p. 6). Thus, a child is not only a by-product of its numerous social settings but is also, in fact, a by-product of its biological ones.

Sameroff (2010) argues for the development of an infant through social interactions and environmental factors. While a child is engaged in such contrivances, they may also be impacted from the lack of them. The isolation of a child when it’s sick becomes tantamount to a household being imprisoned. While the household is in this insular state, no visitors are permitted in. Thus, the interaction and engagement that the child would necessarily be exposed to is limited until the illness subsides. Also, when the illness becomes full throttle or there is paralysis, danger of further infection, or even allergies, the sequestering of the infant becomes all encompassing. Lack of transactions on a social level is detrimental to cognitive development. Environments and the people that comprise them, Sameroff (2010) sees as interactionary devices for children that allow them engage in multiple cognitive capacities and their affect on the child’s brain is indelible cognitive science and child development.

According to Sameroff’s (2010) attachment theory, attachment occurs early in life. This is seen in multiple arenas such as kangaroo care in which infants are put into the mother’s lap immediately upon being delivered, infants being held immediately upon being born, etc. Thus, attachment is a tactile response to the infant’s environment. These early-formed attachments aid in the development of romantic attachments later in life. The closeness that is fostered as soon as birth later aids in cognitive responses to feelings of love and intimacy (Smetana, 2006, 271).

Attachment theory also lends itself to be understand through cognitive ability and illness in a child in this manner: the framework of the theory suggests that the self is organized into internal machinations chief among which is a human’s ability to self-reflect. This ability, if delivered in a normal and positive light may extrapolate a life time of self-knowledge and impetus to personal behavior that may not otherwise have been present. This self-reflection extends to the infant understanding their environment and their expectations of the people inhabiting that environment (fostering of trust is developed during this stage; an extension of attachment). When this function is not working properly because of impoverished mentalizing skills due to illness or living in an insular environment, the infant turned adult will maintain this level of impoverishment and it will detrimentally affect it’s relationship with the outside world. This may be seen in a child’s writing in which they describe their world in very stereotyped ways with low-level descriptions. In counter-argument to this, Fonagy & Target (1997) suggest that, “This does not imply developmental delay or regression” (p. 695) but rather it merely is suggestive as to how incredibly intricate the ability to  “coordinate” these two very distinct (two) levels of functioning truly are. The authors go on to state that “The abusive or emotionally depriving world within which they developed has engendered in them the sophisticated skills that were required for adaptation” (p. 695). Thus, the ability to talk of such things as “ deficit or absence of a capacity” (p. 695) in these individuals is not only understated but grossly simplified. In these individuals, the authors argue,  “Measures of global abilities may not yield a difference” (p. 695) but that there are efforts being made that go beyond the clinical study of the aforementioned terms and that such efforts must be measured, rather, by their “situational specificity of the failure of reflective function” (p. 695).

With a dialectic or transactional model “there is a bidirectional causality inherent to such biological vulnerabilities: They both provoke situations of conflict and place grave limitations on the child’s capacity to acquire the flexibility needed for their adaptive handling” (Fonagy & Target, 1997, p. 696). The authors state that there may be a correlation between these disorders and “hyperactivity or attention deficit disorder” (p. 696). These disorders may be endemic of poor parental adjustments to the child’s behavior. This in turn may limit the parent’s ability to help the child develop mentally up to standard with its “normal” growth group. This in turn will detrimentally affect it’s learning capacity as when put in a room with it’s peers, their lack of attention caused from such factors begins to separate them from the standard. This in turn undermines their capacity to learn, foster creativity, and neglect their self-reflective ability, as Fonagy & Target (1997) state, “, the predominant response to emotional situations will be a nonreflective one, readily disowned by the self. Naturally the absence of reflective function in such situations will give the appearance of rigidity to the person’s behavior as if only a singular pattern of response were accessible” (p. 696). The authors go on to state that the absence of this aforementioned reflective function may “further exaggerate an antisocial response by forcing the individual to see the other not as another intentional agent, but in nonhuman terms, as a body, as representing a social position or agency, or as a faceless member of a group” (p. 696). The maltreatment of a child, early illness or trauma defined in any capacity has a restrictive influence on not only the child’s cognition but their social development.

Fonagy & Target (1997) state that this restriction has two different levels: maltreatment and protective factor. Through maltreatment a child learns how not to gain another’s perspective. That is to say that through maltreatment part of the amygdala is detrimentally affected and the child has a “disincentive for taking the perspective of others, because of the actual hostility of the intentional stance of the abuser, as well as the constraints upon the self which an older person’s failure to understand the child’s budding intentionality imposes” (Fonagy & Target, 1997, p. 696). Through the missing of the protective factor a child is socially incompetent in that they do not, or cannot understand traumatic interpersonal situations lived through or communicated to them, by others. The authors go on to state that maltreated child is detrimentally affected two-fold: they are vulnerable to long-term maladaptive effect and in their resilience to face or even conquer it (Fonagy & Target, 1997, p. 696). The authors go on with specifics for handicapped children by stating that “The predominantly nonmentalizing stance adopted in such situations therefore handicaps the individual and, if the vicious circle is unbroken, may come to dominate all interpersonal relationships. We believe that at this stage severe developmental psychopathology, in the adult entrenched personality disorder, is the likely consequence” (Fonagy & Target, 1997, p. 696).

This paper has documented in what ways childhood illness detrimentally affects a child’s capacity for cognitive abilities, social cues, social acceptability, and a child’s empathy through damage to their amygdala. In any discussion on the dichotomy of nature vs. nurture the idea of both become apparent. When this dichotomy is applied to Sameroff’s (2010) theories on attachment and transactional regulation model, it becomes paramount. Whether or not the cause of an illness or a disability is predominated by pathogens or by maltreatment, the outcomes are similar. Sameroff doesn’t touch upon all of the negative effects of this dichotomy but brings to light the bio-psycho-social ecology of the issue.

References

Fonagy, P., & Target, M. (1997) Attachment and reflective function: Their role in self-organization. Development and Psychopathology, 9, 679–700.

Sameroff, A. (2010). A unified theory of development: A dialectic integration of nature and nurture. Child Development, 81, 6-22.

Sameroff, A. (2009). The transactional model. In A. Sameroff (Ed.), The transactional model of development: How children and contexts shape each other (pp. 23–32). Washington, DC: American Psychological Association.

Smetana, J. G., Campione-Barr, N., & Metzger, A. (2006). Adolescent development in interpersonal and societal contexts. Annual Review of Psychology, 57, 255-284.