Human Growth and Development

An Introduction for Social Workers

John Sudbery, Andrew Whittaker

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351397551
• Edition: 2
• Topic: Medicine
• Subtopic: Health Care Delivery

Social workers work with people at all stages of life, tackling a multitude of personal, social, health, welfare, legal and educational issues. As a result, all social work students need to understand human growth and development throughout the lifespan.

This fully revised and expanded second edition of this introductory text for social workers provides a knowledge base about human development from conception to death. It is designed to encourage understanding of a wide range of experiences: from the developmental trajectories of children in care, to adult mental distress and the experiences of people with dementia, to bereavement. Using engaging narratives to illustrate each topic, the authors clearly introduce and analyse different theoretical approaches, and link them to real-life situations faced by social workers.

Packed with case studies, this student-friendly book includes overviews, summaries, questions and further reading in each chapter, as well as a 'Taking it further' section providing greater depth on key theoretical issues. A reference section contains a glossary and overviews of the principal theories discussed throughout the book. It is an essential read for all social work students.

CHAPTER 1

Beginnings

In this chapter you will find:

■Introductory reading

■Making sense of development requires biological, psychological and sociological knowledge

■Bio-psychosocial knowledge: an overview of the approaches which will be used in the book

■Genes, environment and behaviour: a section written in a more formal academic style

INTRODUCTORY READING

‘I’m pregnant,’ she said, ‘I’ve not told anyone else yet.’

These words point to the different ways in which a social worker needs to be able to understand human development.

In the first three months after conception the baby can be said to be ‘taking shape’ – developing the basic plan of a human body, including a head, arms, legs, hands and feet. In the next three months, the organs and limbs will be developing in size, complexity and functionality; the mother can feel her baby moving, and the baby responds to stimuli. Continuing to simplify this finely tuned and intricate process, in the next three months each interlinked part of the tiny body will continue to grow in size, efficiency and complexity until birth, and the baby in this period becomes increasingly able to survive outside the womb. In keeping with this simplified account, if drugs interfere with the process in the first three months, parts of the baby may be malformed or missing; and malnutrition is more likely to cause small size if it occurs in the final three months rather than in the earlier phases.

During pregnancy, a special enzyme in the placenta acts to block the stress hormone cortisol from reaching the foetus (DiPietro et al., 2006). However, if a mother experiences intense or chronically stressful situations where she feels out of control, such as domestic abuse or severe poverty, this can over time affect the enzyme, leading to it being less effective (Gerhardt, 2015). The result is that the baby can be flooded with stress hormones, which can lead to later difficulties. For example, they are likely to be born more irritable and prone to crying (van der Waal et al., 2007). This is because of the effects that stress hormones have on the baby’s amygdala (involved in emotions) and the hypothalamus (involved in memory). An amygdala that has had to cope with considerable stress in early life tends to react more, working harder and growing larger. Unfortunately, this means the person is more sensitive to stress and the mechanisms for managing the stress response are weakened. This is an important finding, but there is a danger that it can be used as a form of ‘victim blaming’, in which mothers who experience considerable stress (such as being victims of domestic abuse) are viewed as being responsible for their child’s difficulties. It is important to bear in mind that there are positive aspects of later caregiving that can have a positive effect. For example, secure attachment and positive bonding during the first year can enable a small hippocampus affected by stress to be restored to normal volume (Buss et al., 2012; Gerhardt, 2015).

We have no words that can accurately describe the unborn baby’s experience. We know that it hears sound, as after birth it will respond differently to pieces of music which have been played repeatedly during pregnancy – presumably most of these sounds are the internal noises of its mother’s body and the muffled penetration of her voice, talking, singing, shouting. In a fascinating series of observations, Piontelli (2002) found that at the age of 5, twins were still using routines for mutual comforting which had been observed by ultrasound when they were in the womb. And then at some point the baby will be gripped harder than it is ever likely to be gripped again, so hard that the bones of its skull fold over each other. Over a period between seven and fourteen hours on average, it will be propelled in repeated shoves down a narrow tube until it bursts into a noisy, bright, colourful environment totally different from the world it has experienced previously. This shocking experience will usually have the effect you might predict – having been massively stimulated the baby will be awake for an initial period and then fall into a deep exhausted sleep.

You will be able to find many sources of further information about pregnancy, including websites which you can locate for yourself. Detail appropriate to this level of study can be found in Chapter 2 of Boyd and Bee (2014).

We could tell a related story for the mother’s own bodily development during pregnancy, but instead, let us think about a different perspective: the developmental meaning of the pregnancy in a woman’s life, its significance and implications, which are different for every mother.

Nicola

Perhaps the young woman is Nicola, pregnant with her second child, anticipating that she will leave paid work for at least the next five or six years. She is a 26-year-old Black British woman who has made a good start to her career. She and her partner have planned – to the degree that these things can be planned – that his income and some state benefit will support the family until she goes back to work when both children are at school. She is not very clothes-conscious, but usually looks smart in her business suit when she goes to work. She’s very busy day-to-day with her first child – let us say a boy – but her partner, a neighbour with whom she’s close, her mother whom she sees once or twice a week and some friends who had babies at the same time as her, are all involved in the planning for when she has her new baby. During her first pregnancy, she had many thoughts and daydreams about how the life of her child would turn out; she has similar thoughts now, but when asked about the future she says, ‘Oh, I just hope everything’s going to be OK, I’m really quite stretched this time, what with work, my son Matthew, Steve’s job and the pregnancy as well. I just hope the baby will be healthy, have ten fingers and ten toes, and we’ll get everything sorted in time.’ What she says, of course, depends on whom she is talking to; she has a friend at work with whom she particularly chats about her toddler and the pregnancy.

Naoko

But every pregnancy, every woman, is different. Maybe the young woman is Naoko and this is her first baby. She was born and brought up 6,000 miles away in Japan, and is now living in the UK with Paul, whom she met as a student. She sees her mother only once a year. Her partner’s parents are supportive, but although they are geographically closer, their routines, expectations, standards of healthcare, religious beliefs and daily language are all a second culture for her. English people find her rather quiet and reserved, and she still occasionally struggles to find the word she wants. She is sometimes surprised by the behaviour of boys and girls and by the attitudes of women where she lives.

Tia

And a social worker must be prepared to understand a myriad of different developmental stages. The mother-to-be may be Tia, aged 16 and having just left a children’s home. She’s talking on the phone to Claire, the only person she trusts. Claire is 15 and also in care. The children’s home, known as ‘Number 24’, has been Tia’s third placement in two years, before which she lived in six foster homes. Her keyworker sometimes listens, alarmed, as she jabs her finger into her belly and says, ‘I hate if, deliberately emphasising the word ‘it’, and continuing, ‘I hope it’s gone when I wake up.’ She doesn’t say much at all to this worker, whom she has known for only four months, since she left the children’s home. However, she does speak about the time she thinks she got pregnant, which was when she stayed out all night at a friend’s squat, and felt pressurised into sex, almost without caring what she did. The significance of the pregnancy in her life? Her ferocious displays of independence and wilfulness had always been partly a reaction to her pervasive sense of helplessness before fate; defiant strivings to carve out some control for herself in the midst of major events which usually seemed just to happen to her. The pregnancy was little different. She is defiantly independent, proclaiming her competence to do whatever is required; she also has the sneaking hope, daydream, that the baby might be the one person in the world who will really love her, who will be hers; sometimes she is terrified of the responsibility and tasks that she hardly dares think about. At the same time, a young woman with a ferocious temper, a short fuse, intolerance born of frustration, she is bitterly angry towards the latest interference in her life. Underlying this is the overwhelming sense of helplessness and lack of control over events. As earlier in her life, she feels that things are done to her, they happen without her permission, and her attempts at effective influence repeatedly seem to dissolve into a position of impotence.

Social support

One feature common to each story is that however independent and competent each pregnant woman is (and all have demonstrated great strength and resourcefulness in their lives to date), each needs emotional and practical support, and this will have particular significance at the birth and afterwards. This support may come from many different directions – a partner; a circle of female friends; the woman’s mother; a religious grouping; various official, medical or social staff, for example. As a social worker, you could potentially be involved in any of these situations, and it would be a routine part of your professional assessment to understand the nature of the woman’s needs, how what you have to offer fits in with all the other sources of support available (or missing), and the potential outcome of offering support.

Toddlers to grandparents

There are of course other people involved in this scenario, each at a different stage of life. It is typical of social work that these all have to be kept in mind. Unlike doctors, psychologists, counsellors or many other human service professionals, as a social worker, it is usual for you to have professional responsibility for several different life stages at the same time.

For Matthew, Nicola’s first child, this pregnancy, and more importantly the birth, may represent a big milestone. Until now, he has been the sole focus of parental attention, love, annoyance and preoccupation. In this attention, the adults who keep him safe are concerned about his welfare, ensure they are there for him, focus all their parental love solely on him. His experience is that they are captivated by him when he offers a single smile or takes a first few tottering steps. One utterance that sounds as if it might be a word evokes doting admiration. This is shortly to change for ever, a dramatic change as he is supplanted by a rival for his mother’s love and attention – ‘Can’t we just put her in the bin?’ as one boy said of his young sister.

It may be, too, that the partner is facing some of the most stressful periods in his life as he juggles new responsibilities at work, financial responsibilities at home – and he too may have troubles about the direction of Nicola’s affections, the time she has for him, changes in her sexual impulses – he turns over choices, perhaps dilemmas, as to how to satisfy his sexual needs; with her he will be finding his way, managing and relating to an increasingly independent toddler, and later a schoolchild. Then there are Nicola’s parents, in whose development grandchildren are likely to be extremely significant. They were older than many – 64 when Nicola became pregnant again – and they are a major part of their grandchildren’s lives. Nicola’s first child has experienced much of his daytime care at their house.

On the other hand, think of the world from the point of view of Naoko’s parents. They see their daughter and grandchild for only one week in the year. They will perhaps have questions, worries, ab...