Children and Adolescents

Although it was once widely held that development through toddlerhood was the only significant time of tremendous brain growth, findings from neuroscience have identified adolescence as a second significant period of brain-based changes. Profound modification of brain structure, function, and connectivity, paired with heightened sensitivity to environment, places adolescence both as a heightened period of risk and importantly as a time of tremendous opportunity. These findings are of key relevance for social-work policy and practice, for they speak to the ways in which the adolescent brain both is vulnerable to adverse conditions and remains responsive to positive environmental input such as interventions that support recovery and resilience.

Although rates of adolescent pregnancy have exhibited a downward trend since 1991, the United States continues to have a significantly higher rate than other industrialized nations. Adolescent pregnancy, especially in early and middle adolescence, has long-term developmental and economic impact on the teen and her child, in addition to high social costs. This entry describes the current trends in adolescent pregnancy in the United States, and examines factors reported in the research literature as associated with adolescent pregnancy, discusses federal policy directed toward adolescent pregnancy prevention, and identifies various intervention programs.

Despite rapid medical advances, children in this country still face significant barriers to adequate health care, including unequal access to insurance and health care. There is great need and opportunity in our nation at this time to advocate for the advancement and prioritization of pediatric health care. Children remain vulnerable to the challenges of poverty, violence, firearms, mental health, and health care access. Social workers play an important role in assisting children and families who face health care crises by providing supportive services, advocacy, culturally grounded assessment, trauma informed care, and evidence-based interventions to improve healthcare outcomes and quality of life. The Patient Protection and Affordable Care Act (ACA), signed into law in 2010, has increased access to pediatric health and behavioral health services. While the future of this law is uncertain at the time of this writing, social work is and will continue to be an important discipline to assist children and families in the areas of health promotion and adaptation to illness and injury.

The history of social work is deeply rooted in helping vulnerable populations improve their well-being, and children have been at the forefront of these efforts since the inception of the profession. Health is long understood to be critical to children’s well-being. Social workers who are skilled in integrating different systems can play pivotal roles in engineering new and improving existing health-care infrastructures and can act as advocates for fusing health-service systems with other social infrastructures to optimize outcomes for children. This entry reviews trends in children’s health throughout the world, particularly in the United States. It describes the dramatic improvements in reducing infant mortality, child mortality and morbidity from many infectious diseases as well as accidental and environmental causes, and the unequal progress in realizing children’s health. The challenges that lie ahead that pose risks to children’s health are discussed, including the health inequities created among and within countries by social, economic, and political factors. An argument for a comprehensive, integrated, evidence-based, and cross-disciplinary approach to improve children’s future health is presented.

Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.

HIV/AIDS has introduced an array of issues and needs for children, youth, and their families. Family-focused interventions have emerged as a viable strategy for researchers and practitioners seeking effective and appropriate responses for the prevention, treatment, and care of children, youth, and families affected by HIV/AIDS. This discussion provides an overview of the epidemiology of HIV infection among children and youth, and highlights common elements and trends in the development, implementation, and testing of family-focused interventions. The discussion concludes with a commentary on areas for future attention.

Social reform efforts of the settlement-house movement have provided, in part, the foundation for today’s Maternal and Child Health Bureau’s policies, programs, and services. Planning, implementing, and evaluating policies and programs that affect the health and well-being of mothers and children require a multidisciplinary approach. Social workers, whose skills encompass direct services, advocacy, planning and research, community development, and administration, have a critical role to play in improving the health outcomes of maternal and child populations.

Scientific findings from social sciences, neurobiology, endocrinology, and immunology highlight the adaptive benefits of positive emotion and activity to both mental and physical health. Positive activity, such as engagement with music and exercise, can also contribute to favorable health outcomes. This article reviews scientific evidence of the adaptive benefits of positive emotion and activity throughout the life course, with examples drawn from the fetal environment through late adulthood. Specifically, the text weaves together theory and empirical findings from an interdisciplinary literature to describe how positive emotion and activity help to build important cognitive, social, and physical resources throughout the life course.