Monday, June 12, 2006

Family Advocacy - Part One - By Terry Coyier

Who Was Jean Piaget?

Jean Piaget was to cognitive development as Albert Einstein was to physics. In fact Einstein was afan of Piaget's work. Jean Piaget was born in Switzerland on Aug. 9, 1896. He published his first scientific paper at the age of 10. By the age of 22 he already had a doctorate in zoology. He became interested in psychoanalysis after WWII and attended lectures given by Carl Jung. He then studied in Paris working in Alfred Binet's child psychology lab. It was there that he first began to notice that children of the same ages answered true/false questions similarly.

He returned to Switzerland and spent many years studying and conversing with children. He realized through his conversations that when asked a question a child did not necessarily give an incorrect answer just because the answer wasn't an adult response. They instead gave logical answers based on the knowledge that they had within them. He concluded that if adults try to teach children to quickly that it prevents them from reinventing it themselves, thus making it their own.

His career spanned nearly 75 years and he is credited with developing several new fields of science including developmental psychology, cognitive theory and what later became genetic epistemology. Without him, some of today's modern methods would have never come about. Many of his theories are still the basis for modern child development including the "Theory of Knowledge Construction." This theory is based upon the principle that when a child comes into contact with a new piece of information, his mind must understand it in a way that fits his current view of the world. If it doesn't fit the mold then the child will re-construct their knowledge so they can assimilate the new information. It is much like constructing a building - you cannot start with the top, you must build the foundation first and then develop up from the base.

Four Stages of Cognitive Development in Children

Let's take a minute to get a feel for Piaget's 4 stages of cognitive development in children. Remember, he spent most of his life studying and interacting with children and I think his theory makes a lot of sense.

Stage I: Sensorimotor (Infancy)

Infants learn about the world around them through sensation and movement. The focus at this stage is on motor and reflex actions. They take a great interest in the faces and voices of caretakers. Parents can aid in their development by making faces, talking and singing to their little ones.

Stage II: Preoperation (Toddler & Early Childhood)

This stage's main focus on the child's intellectual development is language and using symbols (e.g. words and pictures). The child will act intuitively at this stage. They have active imaginations and vivid fantasies. It is not uncommon for the child to personify objects, thus giving toys and dolls human like qualities. Parents should take the time to help them learn language and promote their imaginations ,as well as pay attention to how they play with objects.

Stage III: Concrete Operation(Elementary & Early Adolescence

During this stage children start to process abstract concepts such as numbers and relationships. Before a child could only manipulate things physically. Now they begin to be able to manipulate them mentally as well. To do this they need concrete examples or they will not understand the concept. A child's development should focus on giving concrete examples of ideas.

Stage IV: Formal Operation (Adolescence & Early Adulthood)

This is the stage where children begin to reason logically and analytically without needing concrete examples as before. Children are now capable of hypothetical and deductive reasoning. Encouraging young people to consider multiple possibilities will help their development at this stage.

All of these stages represent areas of opportunity or risk of failure when it comes to helping your child get through the world. This task is tough enough for two parents who are normal by societies standards. Throw in a parent who suffers from a mental illness and you face a much greater challenge. This is the reason I started with the 4 stages of development - so that parents could see areas that they could reach out to their children in an appropriate way and affect them in a positive manner.

Some General Statistics

~*~Almost 1/3 of American women and 1/5 of American men provide evidence of psychiatric disorder in the past 12 months. Of these women, 65% are mothers; 52% are fathers.

~*~Women and men with mental illness are at least as likely, if not more likely, than those without psychiatric disorder to become parents.

~*~The majority of adults falling into psychiatric diagnostic categories (affective disorders,anxiety disorders, PTSD, psychotic disorders, etc.) are parents.

~*~1 in 4 American families are affected by parental mental illness.

Why Parents Don't Seek Help

One of the biggest reasons that adults don't seek assistance for their mental problems is due to the stigma that is still attached to having a mental illness. Unfortunately many people still do not view mental illnesses as a medical problem but as a personal flaw or weakness in the person. You still hear the mentally ill referred to as "crazy," "loony," "nuts," "psycho," or even worse terms.

One of the other reasons for not seeking treatment is that mental illness is the primary reason for custodial challenge. Some studies have reported as many as 70-80% of parents with a mental illness have lost custody of their children due to their illness (Burton, 1990). There remains a strong misconception that mentally ill parents are violent and are therefore at an increased risk for abusing their children. While this may be true for alcohol and drug abusers, it is not true for parents with psychiatric disorders getting treatment.

Still, for these reasons many people are afraid of getting the help that they need. They are afraid their symptoms may give the impression that they would be an unfit parent. If they are seen as unfit they could lose their children. Therefore families may not receive the services they need to raise healthy children. Thus a vicious cycle begins.

Warning Signs

The following is a list of symptoms that could indicate that children are not dealing well with a parent's mental illness. Mind you, these are also signs for other causes such as trouble in school, peer pressure, sexual problems, abuse, relationship problems, substance abuse, a change in circumstances at home and a host of other issues. Still, I felt they were worth mentioning. If you notice any of these things in your children over a continual period for 3-4 weeks, please seek help for them. Never turn a blind eye and think that the problem will solve itself.


*bad temper or irritability

*crying a lot

*sleeping problems


*not talking to people or going out with friends

*eating more or less than usual or skipping meals

*giving up hobbies


*feeling lazy, bored or tired

*stealing or getting into trouble

*not looking after themselves (hygiene)

*low self-esteem

*acting recklessly

*drinking alcohol or using drugs

*skipping school

*preferring to be alone

How Children are Affected - Risk or Resilience?

As seen above in Jean Piaget's "Theory of Knowledge Construction," children are only capable of understanding things if they have the knowledge from the preceding level of development. At each level they can be affected either adversely or positively by their interactions with their parents - regardless if the parent has a mental illness or not. The challenge here is the capability of mentally ill parents to provide what is needed at each stage. (This is where you want to go back and re-read the section on the 4 stages of cognitive development.) It is up to us as parents to provide them what is needed and as a mentally ill parent that becomes quite a challenge.

Now, research clearly indicates that parental mental illness increases the risk of the child developing emotional or behavior problems. (I'm leaving out genetics here since it is a different issue.) Children with the most serious emotional disturbances, served by systems of care across the U.S., report high rates of parental mental illness, psychiatric hospitalizations and substance abuse (Comprehensive Community Mental Health Services for Children and their Families Program, Annual Report to Congress, 1998). This report shows nothing of the relationship between the age of a child and their exposure to parental mental illness. Some feel that if children are exposed repeatedly at a young age their risk is higher. However, some studies have failed to find conclusive results regarding age or developmental stages in regards to their level of risk (Oyserman et al.; Weissman, 1989).

Stressors outside of the family detrimentally affect children of parents with a mental illness. Stressful issues that increase the likelihood of emotional or behavioral problems are minority status, low levels of education, stigma, single parenthood, social isolation and poverty (Biedel & Turner, 1997; Hammen et al., 1987; Harnish et al., 1995; Sameroff & Seifer, 1983). These types of issues are difficult at best for a child to cope with but when you add in a mentally ill parent the problem is simply compounded massively.

The gender of the child also appears to play a roll in how they react to a parent's illness, although there is conflicting evidence in how exactly. Some studies show that girls are more adversely affected and some feel that it is boys who have a worse time coping. Studies have shown, however, that girls are more prone to develop depression and boys are more likely to exhibit conduct problems (Cummings & Davies, 1994).

It is well documented that children with greater intelligence, better social skills and stronger cognitive processes have been shown to be more resilient to their parental mental illness (Beardslee & Podorefsky, 1988; Radke-Yarrow & Sherman, 1990.) Cognitive skills such as a positive and coherent self-concept, a positive attribution style, effective coping and problem solving abilities have been associated with positive outcomes among children in general and specifically among children with depressed mothers (Beardslee & Podorefsky, 1988; Downey & Walker, 1989; Radke-Yarrow et al., 1995)

Terry J. Coyier is a 37-year-old college student studying for an Associates of Applied Sciences degree. She is also a freelance writer who writes about bipolar disorder and other mental illnesses. Terry was diagnosed with bipolar ten years ago. She lives with her son in the Dallas/Ft. Worth Metroplex. Terry is an author on http://www.Writing.Com/ which is a site for Writers and her personal portfolio can be viewed here.

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