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Case History Project

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kylee robison

on 9 May 2016

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Transcript of Case History Project

Prenatal Medical Care
Planned Conception
The genes the embryo has inherited will pre determine looks and much of the character.
examples: Strength and stubbornness like the mother.
Mother's hair
At fertilization much of the physical, intellectual and personality development predetermined through genetics of the parents.
both parents do not have a family history of obesity
both parents exercise daily
The effects by genes on the physical will conclude that the child will not be obese.
Germinal Stage (first two weeks)
First two weeks of development after fertilization
36 hours after fertilization, the zygote enters mitosis.
fragile 3rd week the embryo folds to form a long tube. The top layer of the tube, ectoderm, will grow into the head, the lower layer, endoderm, will become the digestive system.
The amniotic sac is a fluid filled membrane that surrounds the embryo.
The placenta develops in the uterus to allow oxygen, nourishment, and wastes to pass between mother and embryo.
Birth Process
Genetic Counseling, testing, and screening for the presence of recessive genetic disorders
Two Ultra sounds and 4D scan
High quality prenatal care, including educational, social, and nutritional services
Childbirth preparation class
Yoga stretches
hospital birth (12-14 hours)
Midwife for emotional support (birthing mother does not have a living mother to help with birthing process)
Used electronic fetal monitoring to track fetus heartbeat

After good prenatal care, Healthy pregnancy, Newborn son born without complications. Mother is exhausted but joyously overwhelmed to bring life into the world. The baby is healthy and beautiful. The father is having all of the emotions but is very helpful in assisting in the aid of positivity.

helps with postpartum period
assistance in breastfeeding

Parenting Styles
blending warmth and respect.
Gives choices, including the child
A lot of discussions

childs friend
no boundaries no rules
left up to the child to make choices

A dash of Authoritarian- some control

Case History Project
The males genetic code (sperm), passes through the cervices through the uterus and into the fallopian tube towards the female genetic code (the egg)
Effects by genes on the physical
Embryonic Stage (2-8 weeks)
3 weeks the first organ to form, the heart.
beats 80x per min.
6 weeks The embryo is 1 inch long and the eyes form with no eyelids.
8 weeks the embryo is known as a fetus. Until this time the embryo was dependent on the yoke sack at the base of the umbilical cord.
The fetus is supported by the plancenta, the life force until birth.
Fetal Stage (9-36)
9 weeks nervous system develops throughout the body. The fetus has been still throughout growth up until this point. The body starts to twitch. The movement is crucial in stimulating growth in joints and muscles.
10 weeks The first ultra sound check. The first view of the fetus.
Accurate due date August 4
11 weeks The fetus begins kicking/moving/bouncing within the womb. This motion increases the stepping reflex, crucial for survival skill of walking.
Fetal Stage continued
6-11 weeks most dramatic transformation within the pregnancy
At 3 inches long Over 200 nerves have been made
12 weeks less risk of miscarriage.
testosterone is being built within the sex organs.
Fetal Stage continued
4 months (16 weeks) the nervous system movements are bing controlled by the brain.
Central nercous system extends contections from the brain to the body
The brain regulates the heart 140-150 beats per min
The fetus develops an unconscious awareness of the space around them. This helps the fetus interact within their environment
The heart beat can be heard through ultra sound.
Fetal Stage continued
18 weeks
fetus mimics life outside of the womb
digestive system show signs of activity
The fetus begins to swallow amniotic fluid
The mother is aware of the fetus movements for the first time
2nd Ultra detailed ultra sound to survey anatomy and measure rate of growth.
1st sign of blinking reflex seen through a 4D scan
Five months fingerprints develop
Fetal Stage continued
6 months
The earliest a baby can be born with a chance of survival
The fetus has reached a landmark, it is quite possible it could survive on it's own
movements become more aware
Past morning sickness, the most energetic state for the mother
First stimulation of the world beyond. Ears, nose, taste buds and nerves that respond to touch are now mature
Fetal stage continued
25 weeks
eyelashes grow
30 weeks
Brain development and central nervous system is still senstive
show basic ability to recognize the voice of the mother and native language
38 weeks
Full term
Influences of Maternal
"The prenatal environment is the mother's body and virtually everything that affect her well-being, from her diet to her moods, may alter her unborn child's environment and influence its growth and health" (pg 54)
Consciouss environment- limit exposure to smog and no second hand smoke
good nutrition- example Organic vegetables and folic acid
non strenuous work
hormone changes (trying to stay positive and aware)
stress management-stress can have negative effects on the baby and effect how they respond to stressful situations later in life.
Influences of Paternal
Negative effects on male sperm
excessive alcohol
tight underwear
Genetic effects
The sex
The father has not been exposed to environmental factors nor has smoked or wears tight underwear.
The sperm is healthy
Effects on the Intellectual and Personality
Both parents achieved a masters degree. With heredity there will be a strong influence on intelligence.

Both parents have introverted personalities. Calm and collected natured humans both creating an open and welcoming environment.
A mixture

Martorell, Gabriela. <i>Child: From Birth to Adolescence</i>. New York, NY: McGraw-Hill, 2013. Print.

<i>In The Womb</i>. Dir. Toby Macdonald. National Geographic Documentary, 2010. YouTube.
Infancy to Toddler

When Thomas was born , he was 18 inches long and weighed 8 pounds. His sleeping habits developed into frequent naps and sleeping throughout the night, awaking when hungry. Thomas is a happy breasting feeding baby and over the course of 20 months grew 11 inches and 22 pounds. Thomas began the stages of walking by himself after he turned 1, with walking with an adult holding his hands and holding onto something. Using gestures, such as outstretched arms when he wanted to be picked up, and a small vocabulary with expression and the makings of utter words. Thomas could make his needs and desires clear and his parents were able to identify the difference in cries to figure out the need. Thomas continued to sleep though the night and took two short naps during the day. Throughout this raid stage of physical growth Thomas is a developing beautiful healthy infant who at 13 months was coasting toward toddlerhood.

Physical Development "development from the neck down"

0-4 month Milestone : head control
prone, lift head,
Prone, chest up, use arms for support, Roll over, Support some weight with legs, Sit without support

9-12 Milestone: sitting
Stand with support, Pull self to stand, Walking using furniture for support
Stand along easily, Walking alone easily

18-24 Milestone: walking
Walking, fast walking, running and play ground ready
24-3 years
The brain grows in complexity and influence

Throughout physical growth and development of motor skills are rapid

Brain Development:
"The brain is like a car-it needs gas, brake fuel, oil, coolant, and other substances to perform at peak efficiency...The structure is continually modified by environmental experiences"

Cerebrum is divided into two hemispheres, each with specialized functions. The left hemisphere is the center of language and logical thinking. The right hemisphere processes visual and spatial information, enabling us to read maps or draw. Banding these two is the corpus callosum.

Each hemisphere has four lobes: the occipital, parietal, temporal, and frontal lobes. The regions of the cerebral cortex governs vision, hearing, and other sensory information grow rapidly in the first few months after birth and are mature by 6 months, the areas of the frontal cortex which governs abstract thought, mental associations, remembering, and deliberate motor responses grow little during this periods and remain immature through adolescence.

"The growth of the brain is a lifelong process fundamental to physical, cognitive, and emotional development."

Through rich environments Thomas is making neural connections.
example: Tummy time at 3 months in front of rotating canvas paintings of flowers and soothing and stimulating colors.

Basic needs met> feel safe> in order to make connections for strong brain growth
Ability to learn and ability to remember present
Use of symbols and the ability to solve problems developed by the end of Thomas' 2nd year
Comprehension and use of language developed rapidly.
Language Development
rapid growth in communication, including crying, using gestures and facial expressions. synchronizing attention with caregivers
babbling, forming one word sentences, and constructing multiple word sentences.
Vygotsky Theory of Cognitive Development
"how the culture context affects"
Zone of Proximal Development (ZPD)
the distance between the most difficult task a child can do alone and the most difficult task a child can do with help.
Scaffolding-name used for the assistance a teacher or peer offer a child

example of ZPD:
Thomas can cruise with the use of couch to walk.
Daddy holds Thomas' hands to walk for practice
overtime Thomas figures out how to walk alone.
Piaget's Theory of Cognitive Development
Sensorimotor stage: During this time the baby relies on his senses and physical activity to learn about the world. Learning through the senses, reflexes, and manipulation of materials.

Developing schemes-how children organized their way of thinking. example: file folders

Object permanence- the baby has come to realize that something exists even when he can't see it.
Example: The spoon drops from the tray, the Thomas leans over pointing and fussing and wanting it back. I hand Thomas the spoon back and he smiles then tosses it right back down again.
To maintain and respond reassuringly to separation anxiety, we keep Thomas on scheduled routines.
1-Infant exercises their inborn reflexes and gain some control over them.
2- Primary circular reactions
infants repeat, environment begins to play a part
3-experimental with objects.
Sitting up, motion on tummy, some goal directed, and actions are intentional
4-more control with the body and the ability to do with the body, anticipate events.
5- mobility wise, walking with a different way to perceive the world. Trial and error to figure out problems.
6 mental combinations
gestures, and symbolic thought.
anticipate events
example: Children react to the lunch cart when they see it through the window, they remember the routine and steps on how get ready for lunch.
Cognitive tool example: books
strategy with potty training of how to unzip pants and how to turn on the sink.

Play helps cognitive development and having open ended interactions.
Cognitive (continued)
Psychosocial Developments
Attachment to parents and others form
Self-awareness develops
Shift from dependence to autonomy begins.
Interest in other children increases.
Erikson's Psychosocial Theory
Stage (Birth-12 months) - Trust vs Mistrust Strength developed: Hope
During this stage a babies' task is to develop a sense of trust in themselves, in other people, and in the world around them
External-belief that significant adults will be present to meet the baby's needs
Internal- belief in his own power to effect change and cope with a variety of circumstances.
Through establishing Trust we are installing in Thomas that the world is a good place to be and that we will be there to meet his physical need and to guide and help support. Stability, and create an open environment where Thomas has the power to engage his parents through tears, smiles, or fussing whenever he needs our help.

Stage (1-3 Years)- Autonomy vs. Shame and Doubt Strength developed: Willpower
The developmental task of this stage is to acquire a sense of Autonomy (independence) without suffering extremes of shame and doubt.

Psychosocial (Continued)
Ainsworth's Attachment Theory
Secure attachment- babies with secure attachment might cry or protest when a caregiver leaves but they obtain the comfort they need quickly and effectively upon the caregivers return, and they calm easily upon contact.
Thomas would cry if I thought he was asleep and put him in his crib but would calm when I would pick him back up.
This influenced a secure attachment to the nurturing of parents which influenced Thomas's ability to interact positively with his peers.

Baumrind's Parenting Styles
A Dash of Authoritarian

Thomas is being raised in an environment of blended warmth and respect for his individuality along with establishing social values. We have talked (appropriately) to Thomas all throughout his stages of birth and infancy. Talking and creating rich environment for exploration and installing in him that questions are good and that curiosity along with exploring is good, open, and safe. We are firm in maintain standards and routines in order to help keep Thomas balanced mentally, physically, and emotionally. We impose limited punishment when necessary, within the context of a warm, supportive relationship. We encourage verbal negotiation and give- and- take. This has installed a development of security in Thomas that he knows he is loved. He is self-reliant, self-controlled, self-assertive, exploratory, and content.
It's Thomas' first day of Kindergarten, we decided as parents to both take Thomas together on his first day of school because this is such a special day. Thomas picked out blueberries to put in his pancakes this morning. "My blueberry pancake day" he chanted as we put the blueberries in the pancake (egocentric). as we drive him to school a flood of memories surround as I reflect on the past precious years we have spent with Thomas.

Physical/Motor Development
At the age of 3 Thomas was a little chunky with the sweetest round cheeks and golden brown hair. Ready go at his own pace, Thomas, at three, he can jump, and ascend a stairway alternating feet, unaided.
At 4, Thomas grew four inches height from 38.7 at age of 3 to 42.1 inches by age 4
Now at 5 Thomas has lost his baby rolls and has become slender with his limbs lengthening creating an athletic appearance.
Thomas can hop on one foot, walk backward, use utensils, and sleeps 10-11 hours at night.

Thomas' environment is influence by outside. We go outside everyday if the weather permits. We have two gardens at home, a fruit/vegetable and flower. Thomas is such a wonderful helper he loves to watch things grow. We go outside everyday. The transitioning to school has made this to where we go outside in the morning to pick out which fruit will be incorporated in that morning meal. When we are outside Thomas has his arm basket for harvesting and his watering can to help give the plants life, and his own water bottle to keep hydrated. We converse a lot about what we are doing and what each food represents in the food group and the cultural meaning behind it. Through this we hope to install good habits within Thomas about how important it is to move our bodies, water our bodies like we hydrate the earth, and how to be gentle with Mother Earth.
Oral Health
-We went to the dentist for the first time a week after his 5th birthday. After all the mornings and nightly conversation during the routine of brushing our teeth we would talk about the importance of oral health it was time for our visit to the Dentist. We bought Thomas a series of books to read at storytime that went through the experience of going to the dentist.

Thomas was a little apprehensive at first, I could tell by his body language that he was still trying to put it all together. I asked if he would like to have a special story time this morning and reread a book to his choosing. He chose one of the dentist books that we have read the week before. After the story he seemed more confident and prepare for the trip that we were going to make that morning. After our morning routine of breakfast and getting ready for the day. He asked if he could bring his dentist books to the dentist with him? "What a wonderful Idea!" I encouraged.
He showed the dentist the books he had been reading. The Dentist responded openly and wonderfully. We had a very successful trip to the dentist.

since Thomas is over 40 lbs he has upgraded to a highback booster seat.
When picking out the seat we asked Thomas what color he gravitated towards.
After discovering colors (Cognitive development) he chose "Blue".
Cognitive/Language Development

Thomas is getting more process orientated through this stage of where he is in his cognitive development but his way of thinking is illogical.
His memory is getting better but he is not linked with time.

example: Thomas loves Christmas and he thinks that it was just yesterday but it is now currently April. He has such good memories from Christmas but time is still a very abstract concept for him to grasp.

Imaginary/creative/fantasy play is a very popular way he expresses himself through play. Through observing Thomas' behavior with play it is very apparent that this is an outlet.

Play has reassured Thomas' cognitive development that through his concepts of experience he has an outlet to release and just play.

Thomas' has also learned his letters, numbers, and colors.
He has been able to accomplish this through rich experiences of outside in the garden with counting the berries and tomatoes and what color they are and what letter each fruit and vegetable starts with

"My apple is red, I have one apple, my apple has an A"
and they imagination" (Egocentric Piaget)

"The red apple and the blue berry make purple pie" (color association) (language development)

Vygotsky "Life through collaborative learning''

Zone of proximal development- "what we can do alone and what we can do with help"
example for Thomas' he learned to tie his shoes from both parents. With the whole family wearing converse shoes that tie. Through this Thomas learned how to tie his shoes rather quickly.

We cook a lot and Thomas is such a good helper.
He has learned how to crack and egg and how to measure things. He loves measuring flour and to wear it as well.

Through these experiences Thomas has developed self talk.
When Thomas is completing a task he will talk himself through the steps verbally in order to hear them out loud. Example would be when we are watering the garden he says " I need my watering can, Okay now lets put some water in the can to help the flowers grow, now time to watch the plants dance."

We pay attention to what Thomas is interested in that focus allows us to see what to build on and also what his attention span allows.

Piaget's Theory of Cognitive Development

We create rich environments and experiences while being present for Thomas. With a focus on the processes and how Thomas got to where he is thinking through these experiences. We love to ask questions to extend learn but we are only facilitators. We are very child driven.
Leading up to Thomas tying his shoes we built a board and nailed it to the floor in his exploration area of the living room that had old tops of my tennis shoes glued to them so that the strings were easy to remove if needed for washing but so that he could sit and explore first when he was younger with the strings and feel the textures to now learning how to loop and tie different shoes that dad wears too.
We took different approaches to theroiest when it comes to Thomas' age. As he grew to be Five we used ZPD with Vygotsky to help tie his shoes with a collaborative learning environment.
Cognitively Thomas' development is at Pre Opperitional egocentric stage.
We have limited TV time, if so we have Thomas pick out a movie he likes but it is still limited on the weekends. Well, one Tuesday evening Thomas wanted to watch a movie to his liking but it was a weekday not a weekend day and he could not grasp the concept of time (which is where he should be at in his developmental stage) he was egocentric about his wanting to watch his movie again.
Thomas lacks conservation, I have seen this by taking 20 blocks and stacking each equal the same and I ask Thomas "are theses they same?" Thomas resonds "Yes" I knocked one stack over and scattered them on the floor. I asked again, "Are these the same?" Thomas responds "No" there is more in the pile that is scattered.

Psychosocial/ Erikson's Psychosocial theory
Initiative vs. Guilt "a healthy balance in between.''

Example: I am in the kitchen putting up the dishes, Thomas is helping me but wants to adventure off into the house. After I finish in the kitchen I find that Thomas has pulled out the his (washable kid safe) paints and he has them on the wooden floor painting on top of a piece of paper. Majority of the paint is starting to go off of the piece of paper and onto the floor but Thomas figuring out that he can make other colors by mixing colors together. The approach I have to situation is calm and I am excited that my child feel safe to explore and has the never ending amount of wonder. My response is "Thomas, what are you working so hard on?" and he beings to tell me all of the wonderful colors that are showing up through this paint.
My response promotes initiative to express his creativity. My positive and encouraging response grows confidence in him. The focus on the "gains" he has made creates a sense of success and accomplishment.

Thomas has a secure attachment to his mother and father but has develop a attachment to his grandmothers around when he turned 3. His grandparents on on both sides are very much involved with life. He seems to have formed an attachment to my (his mothers) grandparents. Since his is the only child they are "his memaw" and "my papaw" (egocentric about his grandparents) My parents ( his grandparents) provide a very rich environment and experiences for Thomas. Their guidance strategies promote initiative and are very child driven and guide him in the ways of our Culture.
Thomas' father's parents are divorced so "grandma" is a single unit for Thomas and the grandpa seems sort of distance based on the guidance strategies his father's father uses. We think there is fear that has come from the guidance strategies of Thomas' grandfather on his dads side. The attachment to grandma and grandpa on mom's side is a result of the rich environment and experiences.
Baumrind parenting
guidance strategies through problem solving. Thomas' cognitive development is more enhanced. Thomas is able to have more conversations he is thinking things through and we are having more conversations where he is more included. Our focus with conversation is if we make this choice then what should be the consequence of that.
I do not promote nor like spanking. It is very detrimental. Our parenting styles are very Authoritative and not trying to put emphases of control or obedience. I have seen that involving Thomas and talking things through really helps him make connections and begin to understand a perspective outside of his own egocentric self. Through this we build our relationship more and continue to establish trust and involvement.
Physical/Brian development
Thomas's growth during his middle childhood stage has slowed but remains healthy and steady. He has grown 2-3 inches yearly from 6-11 and has doubled his weight during that period. Thomas begin to loose his primary teeth at 6 with loosing about 4 teeth per year until age 11. This was a big time for the tooth fairy. He caught me trying to sneak money at age 9 but played along until about 11 for my sake. (a form of empathy for his mother)

Examples of physical motor development: Body is changing by height, he is building strength, fine motor skills developed by example of using scissors.

Example of physical health: Thomas was not exposed to early group care so the first year of kindergarten has Thomas sick a lot due to the exposure to other children. We helped him combat by building his immune system with kids vitamin C and with kids emergency drink supplement.

For Thomas' brain health, he meets his nutritional daily value of 2,400 calories including a variety of organic grains, fruits, vegetables, along with different pastas, breads, and protein. During meal prep we have conversation about healthy foods and Thomas' helps cook and create balanced meals. Thomas' sleeping patterns have gone from 11 hours at 5 years, 10 hours at 9, and 9 hours at 11 years old. Thomas is a very active child. He loves outdoors and is involved in recreational sports. With this active lifestyle he has not developed sleeping patterns nor problems.
Thomas' memories are better. He is staring to understand time a little better and understood around age 7 that his birthday came once a year. His ability to think logically has increased but is more concrete.
Abstract thinking came towards to end of middle childhood at around 10 years of age. There was a noticeable shift in cognitive thinking around 6-7 after Thomas learned how to do math and learned to read.
example: he would use math to demonstrate how much he could spend at the science museum. I gave him 20 dollars and his dinosaur cost 10 he subtracted and knew he had $10 left over.
another example: Thomas learned how to count change.
Thomas' egocentrism has diminshed and his ability to want to see other points of view (empathy) has developed.
Thomas loves school. He loves to learn and be active but also he loves hanging out with his friends. Thomas gets a long great with his peers and his teacher always has encouraging words about his performance in school.

Thomas' language has increased and his is more curious about words and how to spell them. He has picked up lingo and different concepts of things from school from being in a environment along with is peers.
example: Thomas' friend has a "magical" forest in is backyard.
7-11 Concrete Operational

Thomas possess the characteristic of reversibility, which allows him to reverse the direction of his thoughts.
example: Thomas was able to retrace his steps at school to find his lost lunchbox
Thomas is no longer counting on his fingers because he is beginning to think abstractly and he has began to notice differences in classes of objects.
example: At age four Thomas called every dog a "doggie" by the age of 8 he understood there was a difference between grandma's lab and his corgi.

Vygotsky Zone of Proximal Development
Through observation and good judgement about how to best support Thomas' learning we scaffold Thomas' learning development.
example: Thomas wanted to learn how to play the piano. We found he a good teacher and she is giving him lessons.
example: Thomas was afraid to rock climb at first but after watching his father, his fathers friends, and going through a training class. Thomas' father through ZPD taught Thomas' how to rock climb.
Thomas is developing at a healthy balanced rate through life so far. His psychosocial is developing through observation. For example, when Thomas sees someone upset he wants to help them.
Thomas got a compliment card from school stating that a peer fell in line while walking to lunch and Thomas ran over to help her up and sure she was okay. He is able to describe how he feels instead of outward cries to demonstrate emotion. He is a great problem solver, and he is demonstrating moral development.
example: During conversation of "discipline" if Thomas has done something wrong he helps problem solve his behavior.
Thomas' self esteem is positive and compares himself to other children but in a observatory way.
example: Her hair is brown like mine but not blonde like his
This comparison has not effected his self esteem. We instill body positively within Thomas. That all humans are created equal and that we must love everyone for the beautiful light they hold inside.
He tells his peers that we are unique, beautiful humans.

Erikson Industry versus inferiority
Thomas is learning the skills of his culture of school and home
example: He is experiencing school and meeting the expectations.
Baumrind's Parenting styles
Our parenting style has continued to be very Authoritative through Thomas' development we have seen that his response to this parenting style has been calm, not disruptive, with a healthy self esteem, and mental health. He can communicate with his parents openly demonstrating trust. He is not being controlled nor pressured to be obedient. Through this his behavior demonstrates that exploration and play is good. He demonstrates respect for other humans and his parents. Through which his behavior demonstrates he has not felt the need nor has demonstrated the need to act out.
If a situation with our emotions arises we talk about those emotions and do healthy activities to balance those out.
Communication and conversation seems to be the key with this overall parenting style. Our focus with conversation with consequence is if we make this choice then what should what should be the consequence.
Through this we continue to build our relationship more and continue growing to establish trust and involvement.

Erickson "Who am I?"
Identity versus identity confusion
Major task of Adolescence resolves 3 major issues
choice of an occupation, adoption of values to live by, development of a sexual identity.
When Thomas was 11 he stated that he wanted to be an artist. That summer he went to a camp that allowed him to explore different forms of art. He experienced his first girlfriend at this camp establishing his development of his sexual identity. Throughout adolescence Thomas' search for his "idenity" was observed as a "normal" journey. We focus on Thomas' interest and support his search within finding his true self. This encouragement has resulted with the ability to have healthy communication with his parents.Example Thomas does not feel the need to hide things from his parents and talks openly about his feelings and thoughts. This aids with his parents being able to observe how to best support Thomas during the years of adolescence.
When Thomas was 17 he went on a mission trip to Cambodia and saw poverty first hand. This completely changed Thomas. He was able to see before his eyes the answers to the questions he had pondered that encouraged his involvement t with the homeless shelter which gave him the opportunity to travel and help build homes in the village the trip took place. When Thomas returned his motivation for his future unfolded. He changed his mind from playing college basketball to studying medicine and becoming a doctor to help provide medical assistance in Less developed countries.
Physical and Brain Development
Thomas' physical health during his adolescence years has been rapid and profound. He experienced a growth spurt from age 11 to 17 ending at being six foot tall.
During this growth spurt parts of his body were out of proportion, resulting in his "teenage gawkiness" stage.
Thomas began showing signs of puberty around age 10, showing signs of healthy primary sex characteristics including normal organ growth. Signs of secondary sex characteristic included changes in his voice, muscular development and the growth of facial and body hair.
example: Thomas grew two little hairs on his chin when he was 14 and exclaimed how it was time for him to shave. By the end of adolescence Thomas experienced the stages of puberty and is well on his way of transformation from boy to man.
Brain growth
Throughout Thomas' adolescence years we have encouraged the importance of physical health. "The benefits of regular exercise include improved strength and endurance, healthier bones and muscles, weight control, and reduced anxiety and stress, as well as increased self-esteem, school grades, and well being." Through multiple rich healthy activities and well rounded experiences
(Examples: Camping with his father out in the wilderness. Learning how to Rock climb with his friends.
Running 5K marathons with his Parents. River rafting with his Uncle. Walking up every morning to run with his parents.) Thomas is able to make strong neuronal connections which has helped further his cognitive growth. He is able to exercise his brain by learning to order his thoughts, understand abstract concepts, and develop self control. This is laying the neural foundations that will serve him for the rest of his life.

Cognitive and Language development
Thomas' overall cognitive development throughout adolescence has demonstrated healthy development with milestones reaching in the ability to think abstractly and use scientific reasoning.

Immature characteristics of adolescent thought:
example Thomas thinks that "Parents who test positive for drug use should have their children removed permanently from their homes" "But where would those kids go?" I asked him. This exampled opened up conversation to explain other perspectives on this thought which encouraged Thomas to consider other possible outcomes to this situation. Thomas was focus on the big picture while neglecting the details of how it would play out in reality.
Language Development: Thomas' vocabulary continues to grow during adolescence and aid to that is due to his love for reading. "By age 16 to 18 the average young person knows approximately 80,000 words"
An example of language development
and with the advent of adsract thought Thomas

the t
"however, otherwise, anyway, therefore, really, and probably" to express logical relationships in conversation.
Piaget's Theory/Vygotsky
Thomas reached the highest level of Piaget's cognitive development -Formal operations- around the age 11. Thomas' ability to think logically and in hypothetical terms. No longer limited by the here and now, Thomas understands historical time and extraterrestrial space. He can use symbols for symbols, for example: "Letting the letter x stand for an unknown numeral and thus can learn algebra and calculus"
An example of Thomas reaching the stage of formal operations is the questions he ponders and writes in his journal like "Is it wrong to steal food for your starving children?" and "If a tree falls in the forest and no one is there to hear it, does it make a sound?"

Through Vygotsky's belief that language presents the shared experience necessary for building cognitive development, encouraging conversation reassuring that talking is necessary for clarification in life, and with careful observation along with good judgement with ZPD Thomas Cognitive developmental growth has shown to be balanced and healthy over the course of adolescence.
example: 11-12 Thomas' older teammate on his 11-13 little league baseball team taught Thomas how throw a curve ball after practice.
11 years- Thomas learns a bad word from the neighborhood kids his plays basketball with.
13 years- Thomas learns how to shave from his father.
15 years- Thomas learns to drive his grandfathers stick shift truck after receiving his permit. His grandfather is the scaffolder within this example.

Example of moral development: We talked Thomas into volunteering at a soup kitchen over Thanksgiving on year; although he complained about it at the time, the experience was pivotal for him. Over the holiday season he thought about how fortunate he was. He thought about how different life would of been if he was born into a different family and about whether or not it was fair that some had so much and some so little. Eventually his New Year's resolution was to volunteer at a homeless shelter once a week. This showing gains in Thomas' moral development.
Marcia's Identity issues
Baumrind's Parenting Styles
"Authoritative parents urge adolescents to look at both sides of issues, welcome their participation in family decisions, and admit that children sometimes know more than parents."

Through Thomas' adolescence years we have approached parenting with Authoritative. Since school is a major environment for Thomas throughout adolescent we have made it a important factor in academic success to be greatly involved in Thomas' education.
Example: Thomas receives praise and privileges for good grades.
From 11-14 these privileges ranged from staying over at a friends house or his friends staying over on the weekends. From 15-18 these privileges changed to extending curfew to receiving his first car for making the honor roll every year in high school and graduating with honors.
Thomas received a bad grade for the first time his sophomore year of high school and we encouraged him to try harder and offered to help in anyway that we could. He had a tutor in English that year of school and progressed positively.

Through this approach to parenting we have been able to strike a balance with Thomas between making demands and being responsive. We insist on important rules, norms, and values but are willing to listen, explain, and negotiate. Thomas response to this style of parenting has been observed with more self discipline and no behavior problems. Over the course of adolescence Thomas has become self-confident and competent academically and socially.
Since Thomas' ethnicity is Caucasian and Native American, he has experienced ethnic factors in identity formation.

Diffused: Thomas has done little or no exploration of his ethnicity and does not clearly understand the issues involved. At the age of 11 this was were Thomas was at with forming his identity. To him he was an 11 year old boy with interests in art, music, and sports. He did not know what it meant to be "Eastern Band Cherokee" We did not was to force an identity but taught Thomas about the ways as he grew more of an interest in them.

Foreclosed: At age 14 Thomas has done little or no exploration of his ethnicity but has clear feeling about it. These feelings are expressed within a positive manner for he knows that he is of Native American decent and the rarity but is in exploration or being a teenager

Moratorium: At age 17 Thomas has began to explore his ethnicity but is confused about what it means to him. Thomas spent a summer with his aunt and uncle that live on the reservation in Cherokee, North Carolina from where is mother is from. That summer he learned how to play stick ball with his cousins. ( A traditional game that aids in the traditional transition of a boy becoming a man.) Thomas was confused about what it meant to be a Cherokee boy but began to explore what that means to him.
Achieved: Thomas has explored his identity and understands and accepts his ethnicity.
Thomas learns the ways of the Cherokee people through the help of his uncles and family when he visits in the summertime. Overtime this part of Thomas has become central to his identity.
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