3.10: Children’s Mental Health
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Learning Objectives
By the end of this chapter, you should be able to:
- Discuss what mental health is and what that looks like during early childhood.
- Explain how mental health practices should begin during infancy.
- Describe mental health problems that young children may experience.
- Examine the impact of adverse childhood experiences, trauma, and stress on your children.
- Reflect on how to support young children’s resilience and social and emotional competence.
- Outline ways early care and education programs should be supporting young children’s mental health (including engaging families).
- Explain what trauma-informed care is.
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Warning: This chapter contains information about childhood trauma that may be triggering for some readers. |
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Licensing RegulationsTitle 22 Regulations that relate to this chapter include: 101223 PERSONAL RIGHTS
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Introduction
Mental health in childhood means reaching developmental and emotional milestones, and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in early care and education programs and school, and in their communities. 505
Mental health is an important part of overall health and well-being. Mental health includes emotional, psychological, and social well-being. It affects how people think, feel, and act. It also helps determine how people handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. 506 When early educators and families know more about early childhood mental health, they are better able to support children’s learning and development. 507
Foundation for Mental Health
Beginning at birth, children need positive relationships with the adults who care for them. When children learn to recognize and share their feelings with trusted adults, they feel good about themselves. These relationships help them develop the confidence to learn new skills. Children thrive when adults support their strengths and needs. Responsive adults help children feel safe and valued and learn how to get along well with others.
Children who can manage their feelings can learn and play with peers. They are better able to plan, monitor and control their behavior. They can also adjust to changes in schedules and routines. Children who get along with adults learn to work together and follow rules. They can also show concern for, and share, take turns and compromise with other children. 508
Mental Health from the Beginning
Infant mental health practice applies knowledge of relationships to support and enhance healthy social and emotional development and to prevent and treat mental health disorders. The following definition of infant mental health was developed by a group of experts with the common understanding that observing young children’s interactions with parents and other significant people is key for the assessment of emotional well-being.
In addition, experts also suggest keeping in mind the infants’ underlying biology that could include temperament and compromises to resilience from early trauma. Infant mental health is the developing capacity of the child from birth to three to: experience, regulate, and express emotions; form close and secure interpersonal relationships; and explore the environment and learn—all in the context of family, community, and cultural expectations for young children. Infant mental health is synonymous with healthy social and emotional development. (ZERO TO THREE Infant Mental Health Task Force, December, 2001) The mental and physical health of infants and toddlers is critically influenced by the daily behaviors of their caregivers.
The following sections describe key concepts related to the mental health of infants. These concepts enhance what is included in the previous definition:
- “Developing capacity” highlights the extraordinarily rapid pace of growth and change in the first 3 years. Although newborns experience intense feelings and are active partners in their relationships with adults, the differentiation and complexity of a young child’s emotional and social development increases markedly over time.
- Infants and toddlers initially depend heavily on adults to help them experience, regulate, and express emotions. Infants’ cries and coos evoke strong reactions in their caregivers. An infant’s ability to master feelings develops through give and take.
- Through relationships with parents and other caregivers, infants and toddlers learn what people expect of them and what they can expect of other people. Infants and toddlers learn through what they experience within relationships and what they observe in adult’s interactions with one another.
- Infants and toddlers share and communicate feelings and experiences with significant caregivers and other children. Infants and toddlers interact with one another in emotionally meaningful ways. Parents and caregivers help young children name the feelings and understand their effect on others.
- The drive to explore and master one’s environment is inborn in humans. An essential component of infants’ and toddlers’ well-being is the self-esteem that grows out of mastering their bodies and the environment as well as sharing that mastery with parents and significant caregivers.
- Every child is a unique blend of characteristics; infants’ and toddlers’ developmental pathways will reflect not only their individual constitutional differences but also the contributions of their caregiving environments. Temperament, or the way an individual approaches the world, influences how tentatively or vigorously an infant might engage with a new person, toy, or situation.
- The state of adults’ emotional well-being and life circumstances profoundly affects the quality of infant-caregiver relationships as well as infant and toddler mental health. Parents and other significant caregivers bring their own temperament and past experiences to relationships.
- Culture influences every aspect of human development. This broad influence affects the way that infant mental health is understood; the goals and expectations adults have for young children’s development; and the childrearing practices that parents and caregivers use to promote, protect, or restore infants’ and toddlers’ mental health. 510
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Pause to ReflectHow does this toddler’s exploration relate to his self-esteem? |
Mental Health in Early Childhood
Early childhood mental health (birth to 5 years) is a child’s growing capacity to do these things, all in the cultural context of family and community (adapted from ZERO TO THREE):
- Experience, regulate, and express emotions
- Develop close, secure, relationships
- Explore the surroundings and learn.
Early childhood mental health is the same as social emotional development. 512 Social and emotional development is important to early learning. Many social-emotional qualities—such as curiosity; self-confidence as a learner; self-control of attention, thinking, and impulses; and initiative in developing new ideas—are essential to learning at any age. Learning, problem solving, and creativity rely on these social-emotional and motivational qualities as well as basic cognitive skills.
When learning occurs in groups, such as in preschool classrooms or family child care programs, the social environment significantly influences how learning occurs. When young children enjoy interacting with adults and other children, they are more enthusiastic about activities and participate more. Furthermore, the interest and enthusiasm of others fuels the child’s own excitement about learning, and children are also motivated by others’ acknowledgment of the child’s accomplishments. 513
It is important because it affects a child’s ability to:
- Express their needs
- Pay attention
- Solve problems
- Get along with others
- Follow directions
- Persist when challenged
- Manage their emotions
- Take initiative
- Be curious and interested in learning 514
Interviews with preschool and kindergarten teachers indicate that children who have the greatest difficulties in learning are hindered by the lack of these social-emotional qualities more than by the inability to identify letters or numbers. Children who are delayed or impaired in developing these social-emotional and motivational qualities:
- may have difficulty controlling their emotions or behavior,
- may not readily work independently or in a group,
- often appear to lack curiosity or be uninterested in learning, and
- may have difficulties getting along with others, which may undermine the learning environment for all children 515
Children’s mental health is critical to their later school success as well. Children who
- are able to follow directions and pay attention are able to focus on learning.
- can express their feelings are able to get help when they need it.
- learn to persist when frustrated can overcome challenges.
- feel good about themselves are able to work on their own.
- can control their behavior are able to stay on task. 516
Finally, the importance of social-emotional development to early learning is consistent with the research on brain science. The developing brain is not neatly divided into separate areas governing learning, thinking, and emotions. Instead, it is a highly interconnected organ with different regions influencing, and being affected by, the others. This means, for example, that young children who experience emotional challenges (perhaps because of stress) are less ready for learning because brain regions related to memory are being affected by other regions governing emotion. This conclusion from brain research is, of course, consistent with the everyday experience of teachers of children whose stressful lives often lead to emotional, behavioral, and learning difficulties. 517
Childhoods Mental Health Issues
There are two types of mental health issues this chapter is going to address. The first is diagnosable mental problems. The second is the result of Adverse Childhood Experiences and childhood trauma.
Mental Health Problems
Mental health problems, which the CDC refers to as mental disorders, among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day.
Among the more common mental health problems that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD, which has already been addressed in Chapter 10), anxiety, and behavior disorders. 518
Anxiety and Depression
Many children have fears and worries, and may feel sad and hopeless from time to time. Strong fears may appear at different times during development. For example, toddlers are often very distressed about being away from their parents, even if they are safe and cared for. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Because the symptoms primarily involve thoughts and feelings, they are called internalizing disorders.
Anxiety
When children do not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include
- Being very afraid when away from parents (separation anxiety)
- Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
- Being very afraid of school and other places where there are people (social anxiety)
- Being very worried about the future and about bad things happening (general anxiety)
- Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)
Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.
Depression
Occasionally being sad or feeling hopeless is a part of every child’s life. However, some children feel sad or uninterested in things that they used to enjoy, or feel helpless or hopeless in situations they are able to change. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.
Examples of behaviors often seen in children with depression include
- Feeling sad, hopeless, or irritable a lot of the time
- Not wanting to do or enjoy doing fun things
- Showing changes in eating patterns – eating a lot more or a lot less than usual
- Showing changes in sleep patterns – sleeping a lot more or a lot less than normal
- Showing changes in energy – being tired and sluggish or tense and restless a lot of the time
- Having a hard time paying attention
- Feeling worthless, useless, or guilty
- Showing self-injury and self-destructive behavior
Extreme depression can lead a child to think about suicide or plan for suicide. While less common in early childhood, for youth ages 10-24 years, suicide is among the leading causes of death.
Some children may not talk about their helpless and hopeless thoughts, and may not appear sad. Depression might also cause a child to make trouble or act unmotivated, causing others not to notice that the child is depressed or to incorrectly label the child as a trouble-maker or lazy. 519
Behavior or Conduct Problems
Children sometimes argue, are aggressive, or act angry or defiant around adults. A behavior disorder may be diagnosed when these disruptive behaviors are uncommon for the child’s age at the time, persist over time, or are severe. Because disruptive behavior disorders involve acting out and showing unwanted behavior towards others they are often called externalizing disorders.
Oppositional Defiant Disorder
When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.
Examples of ODD behaviors include:
- Often being angry or losing one’s temper
- Often arguing with adults or refusing to comply with adults’ rules or requests
- Often resentful or spiteful
- Deliberately annoying others or becoming annoyed with others
- Often blaming other people for one’s own mistakes or misbehavior
Conduct Disorder
Conduct Disorder (CD) is diagnosed when children show an ongoing pattern of aggression toward others, and serious violations of rules and social norms at home, in school, and with peers. In older children, these rule violations may involve breaking the law and result in arrest. Children with CD are more likely to get injured and may have difficulties getting along with peers.
Examples of CD behaviors include:
- Breaking serious rules, such as running away, or for older children staying out at night when told not to or skipping school
- Being aggressive in a way that causes harm, such as bullying, fighting, or being cruel to animals
- Lying, stealing, or damaging other people’s property on purpose 521
Obsessive-Compulsive Disorder (OCD)
Many children occasionally have thoughts that bother them, and they might feel like they have to do something about those thoughts, even if their actions don’t actually make sense. For example, they might worry about having bad luck if they don’t wear a favorite piece of clothing. For some children, the thoughts and the urges to perform certain actions persist, even if they try to ignore them or make them go away. Children may have an obsessive-compulsive disorder (OCD) when unwanted thoughts, and the behaviors they feel they must do because of the thoughts, happen frequently, take up a lot of time (more than an hour a day), interfere with their activities, or make them very upset. The thoughts are called obsessions. The behaviors are called compulsions.
Having OCD means having obsessions, compulsions, or both.
Examples of obsessive or compulsive behaviors include:
- Having unwanted thoughts, impulses, or images that occur over and over and which cause anxiety or distress.
- Having to think about or say something over and over (for example, counting, or repeating words over and over silently or out loud)
- Having to do something over and over (for example, handwashing, placing things in a specific order, or checking the same things over and over, like whether a door is locked)
- Having to do something over and over according to certain rules that must be followed exactly in order to make an obsession go away.
Children do these behaviors because they have the feeling that the behaviors will prevent bad things from happening or will make them feel better. However, the behavior is not typically connected to actual danger of something bad happening, or the behavior is extreme, such as washing hands multiple times per hour.
A common myth is that OCD means being really neat and orderly. Sometimes, OCD behaviors may involve cleaning, but many times someone with OCD is too focused on one thing that must be done over and over, rather than on being organized. Obsessions and compulsions can also change over time. 522
Post-Traumatic Stress Disorder (PTSD)
All children may experience very stressful events that affect how they think and feel. Most of the time, children recover quickly and well. However, sometimes children who experience severe stress, such as from an injury, from the death or threatened death of a close family member or friend, or from violence, will be affected long-term. The child could experience this trauma directly or could witness it happening to someone else. When children develop long term symptoms (longer than one month) from such stress, which are upsetting or interfere with their relationships and activities, they may be diagnosed with post-traumatic stress disorder (PTSD).
Examples of PTSD symptoms include:
- Reliving the event over and over in thought or in play
- Nightmares and sleep problems
- Becoming very upset when something causes memories of the event
- Lack of positive emotions
- Intense ongoing fear or sadness
- Irritability and angry outbursts
- Constantly looking for possible threats, being easily startled
- Acting helpless, hopeless or withdrawn
- Denying that the event happened or feeling numb
- Avoiding places or people associated with the event
Because children who have experienced traumatic stress may seem restless, fidgety, or have trouble paying attention and staying organized, the symptoms of traumatic stress can be confused with symptoms of attention-deficit/hyperactivity disorder (ADHD).
Examples of events that could cause PTSD include:
- Physical, sexual, or emotional maltreatment
- Being a victim or witness to violence or crime
- Serious illness or death of a close family member or friend
- Natural or manmade disasters
- Severe car accidents 524
Diagnosis and Treatment of Mental Health Problems in Childhood
Symptoms of mental health problems change over time as a child grows, and may include difficulties with how a child plays, learns, speaks, and acts or how the child handles their emotions. Symptoms often start in early childhood, although some disorders may develop during the teenage years. The diagnosis is often made in the school years and sometimes earlier. However, some children with a mental disorder may not be recognized or diagnosed as having one.
Figure 11.5 – Mental health problems in childhood. 525
Childhood mental health problems can, and should, be treated and managed. There are many treatment options based on the best and most current medical evidence, so families and doctors should work closely with everyone involved in the child’s treatment — teachers, coaches, therapists, and other service providers. Taking advantage of all the resources available will help parents, health professionals, and educators guide the child towards success. Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders and their families. 526
Adverse Childhood Experiences and Trauma
The childhood years, from the prenatal period to late adolescence, are the “building block” years that help set the stage for adult relationships, behaviors, health, and social outcomes. 527 The occurrence of Adverse Childhood Experiences and childhood trauma can damage those building blocks. Early care and education programs can help children develop resilience to combat the negative effects of those.
Adverse Childhood Experiences
Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years) such as experiencing violence, abuse, or neglect; witnessing violence in the home; and having a family member attempt or die by suicide. Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with substance misuse, mental health problems, or instability due to parental separation or incarceration of a parent, sibling or other member of the household.
Traumatic events in childhood can be emotionally painful or distressing and can have effects that persist for years. Factors such as the nature, frequency and seriousness of the traumatic event, prior history of trauma, and available family and community supports can shape a child’s response to trauma. 528
Adverse Childhood Experiences and associated conditions such as living in under-resourced or racially segregated neighborhoods, frequently moving, experiencing food insecurity, and other instability can cause toxic stress (i.e., prolonged activation of the stress-response system). Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of multigenerational poverty resulting from limited educational and economic opportunities.
A large and growing body of research indicates that toxic stress during childhood can harm the most basic levels of the nervous, endocrine, and immune systems, and that such exposures can even alter the physical structure of DNA (epigenetic effects). Changes to the brain from toxic stress can affect such things as attention, impulsive behavior, decision-making, learning, emotion, and response to stress. Absent factors that can prevent or reduce toxic stress, children growing up under these conditions often struggle to learn and complete schooling. They are at increased risk of becoming involved in crime and violence, using alcohol or drugs, and engaging in other health-risk behaviors (e.g., early initiation of sexual activity; unprotected sex; and suicide attempts). They are susceptible to disease, illness, and mental health challenges over their lifetime. Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, family, jobs, and depression throughout life—the effects of which can be passed on to their own children. 530
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Pause to Reflect If it feels safe to you, find your own ACE score using the assessment at https://www.ncjfcj.org/wp-content/uploads/2006/10/Finding-Your-Ace-Score.pdf . What impact do you think this had and/or still has on you? What might this mean for you when you care for young children who have the own ACEs and trauma? |
Childhood Trauma
Childhood trauma occurs when a child experiences an actual or threatened negative event, series of events, or set of circumstances that cause emotional pain and overwhelm the child’s ability to cope. Childhood trauma is widespread and can take many forms. Common types of childhood trauma include:
- Abuse and neglect
- Family violence
- Community violence
- School violence
- Life-threatening accidents and injuries
- Frightening or painful medical procedures
- Serious and untreated parental mental illness
- Loss of or separation from a parent or other loved one
- Natural or manmade disasters
- War or terrorist attack
- Forced displacement or refugee status
- Discrimination
- Extreme poverty
Trauma exposure often begins early in life. Young children are at the highest risk for exposure to trauma and are most vulnerable to its adverse effects. An estimated half of all children in the United States—approximately 35 million—are exposed to at least one type of trauma prior to their eighth birthday. For example, child abuse and neglect are most common among children younger than age 3. Children under age 5 are most likely to incur injuries from falls, choking, and poisoning, and represent the majority of children who witness domestic violence. Children from certain racial and ethnic groups also are more likely to experience adversities that can cause trauma. For example, exposure to childhood adversity is more common among black and Hispanic children than among white children, even when accounting for the role of income.
Childhood trauma is strongly linked to mental and physical health problems over the lifespan. It negatively impacts brain development, cognitive development, learning, social-emotional development, the ability to develop secure attachments to others, and physical health; it is also associated with a shortened lifespan. A considerable body of research demonstrates that children suffer the most severe, long-lasting, and harmful effects when trauma exposure begins early in life, takes multiple forms, is severe and pervasive, and involves harm by a parent or other primary caregiver—often referred to as complex trauma .
Childhood trauma is more likely to lead to post-traumatic stress disorder (PTSD) than trauma that occurs in adulthood. Children exposed to several different forms of trauma are more likely to exhibit PTSD (e.g., anxiety, depression, anger, aggression, dissociation) than children with chronic exposure to a single type of trauma. Children and youth with PTSD may re-experience the traumatic event through intrusive memories, nightmares, and flashbacks; avoid situations or people that remind them of the trauma; and feel intense anxiety that disrupts their everyday lives. In addition, they may engage in aggressive, self-destructive, or reckless behavior; have trouble sleeping; or remain in a state of hypervigilance, an exaggerated state of awareness and reactivity to their environments. However, there is no typical reaction to trauma. The vast majority of children show distress immediately following a traumatic event, but most return to their prior level of functioning.
Generally, children’s reactions to trauma differ based on the nature of the trauma; the child’s individual, family, and neighborhood characteristics; and the overall balance of risk and protective factors in their lives. It also depends on their age and developmental stage.
Young children who experience trauma may:
- Have difficulties forming an attachment to caregivers
- Experience excessive fear of strangers or separation anxiety
- Have trouble eating and sleeping
- Be especially fussy
- Show regression after reaching a developmental milestone (e.g., sleeping through the night, toilet training)
School-age children who experience trauma may:
- Engage in aggressive behavior
- Become withdrawn
- Fixate on their own safety or the safety of others
- Re-enact the traumatic event through play
- Have frequent nightmares
- Exhibit difficulty concentrating in school
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Brain Development |
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Cognition |
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Physical Health |
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Emotions |
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Resilience to Childhood Trauma
When parents, service providers, and programs employ a resilience framework to childhood trauma, they understand there are always opportunities to support positive developmental trajectories among children, even if they have experienced trauma. Resilience has been defined as “a dynamic process encompassing positive adaptation within the context of significant adversity. ” Resilience is not a personal trait that individuals do or do not possess (thus, the term “resiliency” is best avoided because it connotes an individual characteristic), but rather a product of interacting factors—biological, psychological, social, and cultural—that determine how a child responds to traumatic events.
Resilience to trauma can be defined in several ways: positive child outcomes despite exposure to trauma, prevention of trauma recurrence despite high risk for further exposure, or avoidance of traumatic experiences altogether in the face of significant risk. All three of these conceptualizations of resilience are based on an ecological approach.
Using an ecological approach to promote resilience in development among children who experience trauma is useful because it assumes that there are multiple levels of influence on a child’s development—the individual, parent, family, school, community, and culture—which may increase or decrease a child’s risk for and response to experiencing trauma. These various influences are often referred to as risk and protective factors.
Risk factors are circumstances, characteristics, conditions, events, or traits at the individual, family, community, or cultural level that may increase the likelihood a person will experience adversity (e.g., childhood trauma, re-traumatization, or negative outcomes due to trauma). Risk factors for specific types of trauma may vary, but commonly include living in poverty, a lack of social supports, and prior history of trauma.  However, the presence of risk factors or membership in a high-risk group does not necessarily mean that a child will experience trauma or its most adverse effects. Protective factors can buffer children from risk and improve the odds of resilient functioning.
Protective factors are characteristics, conditions, or events that promote healthy development and minimize the risk or likelihood a person will experience a particular illness or event, or its related negative outcomes. Research shows that the strongest protective factor linked with resilience to childhood trauma is the reliable presence of a sensitive, nurturing, and responsive adult. The presence of such a figure can help children by restoring a sense of safety, predictability, and control; giving them the feeling of safety; providing them a way to process traumatic events; protecting them from re-traumatization; supporting their development of self-regulation; and helping them heal.
In addition, the National Child Traumatic Stress Network highlights the following protective factors that promote resilience to childhood trauma:
- Support from family, friends, people at school, and members of the community
- A sense of safety at home, at school, and in the community
- High self-esteem and positive sense of self-worth
- Self-efficacy
- Spiritual or cultural beliefs, goals, or dreams for the future that provide a sense of meaning to a child’s life
- A talent or skill in a particular area (e.g., excelling in school or in a sport)
- Coping skills that can be applied to varying situations
Finally, resilience to childhood trauma depends largely on the supports available to a child and his or her family. Family members, teachers, mental health providers, child welfare workers, and other community service providers can work together to ensure that children and families receive the emotional and concrete supports (e.g., food, shelter, financial stability) they need. This system of care approach is also a cornerstone of TIC. 533
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Pause to Reflect What risk factors did you encounter in your own childhood? What protective factors did you experience? How did/does this effect your resilience? |
Early Care and Education’s Role in Children’s Mental Health
Many practices of high-quality early care and education programs promote mental health and well-being including:
- Screening and assessment of infants’ and toddlers’ social and emotional well-being support the functions of promotion, prevention, and intervention.
- integrating curriculum and individualization.
- A well-designed space is comfortable for infants and toddlers with different temperaments as well as for their teachers and parents.
- Poorly designed environments are stressful. Teachers are concerned about the safety and well-being of children, and their saying “no” occupies a great deal of teacher energy and attention. The time teachers spend monitoring keeps them from interacting with an infant or toddler in ways that build self-esteem.
- Having partnerships with community resources that families can be referred to.
- Reciprocal communication with families. 534
Mental health services in early care and education programs can address:
- Promotion—helping all children to feel good about themselves, to get along with others and to manage their behavior.

- Early Identification—paying attention to mental health problems early on.
- Treatment—helping connect families with appropriate help for children with mental health problems. 535
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Nine Things Early Care and Education Programs Should Know |
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Infant and Early Childhood Mental Health Consultation Infant and Early Childhood Mental Health Consultation (IECMHC) a prevention-based service that pairs a mental health consultant with families and adults who work with infants and young children in the different settings where they learn and grow, such as child care, preschool, and their home. The aim is to build adults’ capacity to strengthen and support the healthy social and emotional development of children―early and before intervention is needed. IECMHC has been shown to improve children’s social skills and emotional functioning, promote healthy relationships, reduce challenging behaviors, reduce the number of suspensions and expulsions, improve classroom quality, and reduce provider stress, burnout, and turnover. 537 |
Increasing Children’s Opportunities to Practice Social Skills and Emotional Competencies
Everyday activities in the classroom can be planned and implemented to help children’s social and emotional development (which, as mentioned, is the same as their mental health).
Teaching Children About Emotions
There are many things that teachers can do to help support children’s understanding emotions. Here are some ideas:
- Make faces expressing different emotions and have children guess what you might be feeling.
- Throughout the day, help children learn to label their own emotions (e.g., "It looks like you are feeling mad that we can't go outside; what can we do to help you feel better?").
- While reading stories to children, have children guess how the characters in the story are feeling. Ask questions like, "How can you tell that the character is feeling that way? Can you make a face that shows that feeling?"
- Use puppets to act out different situations; for example, one puppet takes a toy from another puppet. Ask the children what emotion(s) the puppets might be feeling.
- Frequently direct children to look at each other's faces and think about how they are feeling.
- Listen to some different types of music, such as rock or classical, and let the children dance to the music. Ask children how the song made the children feel.
Teaching Children about Friendship
Being in an environment with many same-aged peers that are all learning about how to express themselves, work with others, and regulate their behaviors provides a great place to help children learn about friendships. Here are some ideas:
- Model asking others for help. If you have a task to do in the classroom, involve another child.

- Have children help during routines such as putting out cots or mats for naptime.
- Talk about your own social behaviors. You can say things like, "I said 'thank you' to Ms. Tanya because she passed me the milk," or "I think I'll hold the door open for Jamal because his hands are full."
- Identify certain items in centers that require children to help each other, like taking a dollhouse off a shelf, moving the car garage, or feeding the class pet. Explain to children that it takes two friends to do these things.
- Provide toys and play games that require two or more people, like a wagon or toss and catch game.
- Make a "Friendship Board" on a bulletin board in your classroom. Take pictures when children are working together on something or playing together and put them on the wall.
Teaching Children about Problem-Solving
Everyday life presents many opportunities for children to engage in identifying problems and generating and trying out solutions. Here are some ideas for in the classroom:
- Use naturally occurring opportunities to work problem-solving words into the classroom vocabulary. When there aren't enough glue sticks or too many people wanting to go in a certain center, say things like, "We have a problem. What can we do to fix it?"
- Use naturally occurring problems in small groups to brainstorm possible solutions. Talk about that problem and come up with some ideas that could work to solve the problem.
- Use puppets to act out problem situations during group time. Ask the children to come up with a solution for the problem.
- When a child asks for help, take the opportunity to involve another child in solving the problem. You can say, "Let's look and see if one of your friends can help you. Marne, Sheila needs a glue stick and there are no more. Can you help her solve her problem?"
- Encourage the children while they are working through a problem and provide them with recognition when they solve it. You can use a situation that ended well as an example to discuss in large group.
- Discuss the problems that characters are having in the books you are reading. Brainstorm some possible solutions and guess what they are going to do.
- Make up a song about what to do when children have a problem. For example, to the Row, Row, Row Your Boat tune: "Problem, problem, problem, oh what can we do? Stop and think of something new. I'll try it out with you."
- If similar solutions keep coming up during discussions of problem-solving, start a "Solution Board" that shows the different solutions with an image to represent it. Children can use it to help think of solutions as problems arise, and the teacher can prompt a child to go look at it.
Teaching Children about Handling Disappointment and Difficult Emotions
Handling intense emotions and the disappointment when things don’t go their way are challenging for young children (and even adults!) to navigate. But teachers can help children develop techniques to handle difficult emotions. Here are some ideas:
- Throughout the day, model labeling your own emotions. For example, "I feel frustrated because I cannot open this jar of paint."
- Help children learn to label their emotions when they have conflict with other children: "Bobby, it looks like you are feeling angry because Terrence took away your toy. Can you tell Terrence how it makes you feel when he takes your toy away?"
- When children cry, identify their feelings, and yours too. "I know that was really scary falling off the slide. I was worried about you. I am glad you are okay. Is there something I can do to help you until you feel better?"
- Help children learn how to take deep breaths by "smelling the flowers" and "blowing out the birthday candles." Knowing how to breathe deeply is an important part of learning how to calm down when angry or upset.
- Give children materials to use to get out their anger. They can use a toy hammer, squeeze playdough, or run laps at recess. Let them know that it is okay to be angry and that there are safe ways to express anger.
- Act out the difference between feeling tense (like a robot or statue) and relaxed (like a rag doll or stuffed animal). Have children act it out, too, so they begin to learn to identify when they are becoming wound up.
- Help children learn to label their own emotions. You can say, "It looks like you are really frustrated over here. What is the problem?"
- Give children different situations, such as "A child is very sad because he misses his mom," and let them act it out. Talk about the emotion and some things the child might do to feel better.
- Children's storybooks have lots of opportunities to talk about dealing with certain emotions. Point out characters' simple emotions like happy, sad, mad, and excited, and look for opportunities to label more complex ones like disappointed, frustrated, surprised, and embarrassed. See what the characters do to deal with those emotions and whether or not the children think it was a good way. Brainstorm other things that could have been done when the characters were feeling that way.
- If children are feeling sad at drop-off, have them "write" a letter or draw a picture to show their caregivers at pick-up time. Talk about how it is ok to feel sad, but that their caregiver will come back at the end of the day. 540
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Engaging Families in Supporting Children’s Social-Emotional Development There are many things you can do to give families ideas of how to support their children’s social and emotional development at home too. You can
Some specific ideas you can give parents include the following:
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Supporting Children Under Stress
Supporting children’s mental health also extends to helping children deal with the stress that they may encounter. One of the most important things teachers can do is provide the child with a predictable, safe haven where children can feel secure. Teachers can create a comfortable and comforting everyday routine that is child-centered, individualized, responsive, and helpfully structured to give young children a sense of control and predictability that may be lacking in other aspects of the child’s life. Central to these efforts is providing children with supportive adult relationships that are reliable and helpful. This may be more difficult than one would expect because young children under stress often test these relationships to see whether teachers and other adults will remain responsive to them even when children act defiantly or negatively.
In some circumstances, it can be helpful for teachers to obtain the advice of an early childhood mental health consultant who can observe the child in the classroom, talk with the teacher about the child’s behavior, and suggest strategies for providing supportive assistance. Early childhood mental health consultants can be valuable resources to an early childhood education program. They can help teachers provide much-needed support to young children who may not have other such sources of support elsewhere in their lives. 542
Trauma-Informed Care
As mentioned, children who are exposed to traumatic life events are at significant risk for developing serious and long-lasting problems across multiple areas of development. However, children are far more likely to exhibit resilience to childhood trauma when child-serving programs, institutions, and service systems understand the impact of childhood trauma, share common ways to talk and think about trauma, and thoroughly integrate effective practices and policies to address it—an approach often referred to as trauma-informed care (TIC) .
The context in which children live, learn, and grow shapes both their immediate and long-term well-being. Accordingly, children who experience trauma are more likely to exhibit resilience when their environments are responsive to their specific needs. Families, schools, community-based programs and services, and the individuals caring for children can increase the chances of resilience following childhood trauma when they become aware of the impact of childhood trauma, provide a sense of safety and predictability, protect children from further adversity, and offer pathways for their recovery. In other words, children benefit when these entities provide them with trauma-informed care (TIC).
Despite its focus on trauma, TIC is inherently a strengths-based perspective that emphasizes resilience instead of pathology. TIC has been defined and implemented in a number of ways, but the Substance Abuse and Mental Health Services Administration has identified four key elements—the Four Rs (see Figure 11.12)
Applying TIC to real-world settings begins with a child’s first contact with a program, institution, or service system. It requires a comprehensive and multi-pronged effort involving the many adults in children’s lives. For example, in a school or afterschool program, TIC means increasing trauma-related knowledge and skills among program facilitators, school administrators, bus drivers, food service workers, classroom assistants, administrative staff, volunteers, teachers, leadership, special education professionals, school social workers and psychologists, families, and anyone else who comes into contact with children. However, increasing trauma knowledge is only one aspect of TIC, which also means that the individuals who care for children must be able to:
- Realize the widespread nature of childhood trauma and how it impacts the child’s emotional, social, behavioral, cognitive, brain, and physical development, as well as their mental health. In addition, adults must be aware of the influence of trauma on family members, first responders, service providers, and others who may experience secondary stress (trauma-related reactions to exposure to another person’s traumatic experience). In some instances, adults endure the same traumatic events or circumstances as the child (e.g., a natural disaster, community violence, death of a community member) and may benefit from similar supports.
- Recognize the symptoms of trauma, including how trauma reactions (i.e., symptoms of posttraumatic stress) vary by gender, age, type of trauma, or setting. In addition, the adults in children’s lives must understand that a child’s challenging behaviors are normal, self-protective, and adaptive reactions to highly stressful situations, rather than viewing that child as intentionally misbehaving. Children’s trauma reactions are understood to be adaptive efforts to protect themselves in response to traumatic events. For example, a child may be hypervigilant to an adult’s anger or disapproval because, in the past, he or she experienced physical abuse by a parent. Or, a child may disassociate or daydream as a learned response that enables them to avoid feeling or thinking about a traumatic experience. In addition, TIC means recognizing that trauma may influence a child’s engagement in activities and services, interactions with peers and adults, and responsiveness to rules and guidelines.
- Respond by making necessary adjustments, in their own language and behavior, to the child’s environment; and to policies, procedures, and practices to support the child’s recovery and resilience to trauma.
- Resist re-traumatization by actively shaping children’s environments to avoid triggers (sounds, sights, smells, objects, places, or people that remind an individual of the original trauma) and protect children from further trauma, which can exacerbate the negative impacts of trauma and interfere with the healing process.
Training and Professional Development on Child Trauma
Providing adults (staff, leadership, families, and community partners) with training and professional development on childhood trauma is an important component of implementing TIC. It is essential that adults become aware of the prevalence and impact of trauma, and learn to apply a “trauma lens” (i.e., gain the capacity to view children’s difficulties in behavior, learning, and relationships as natural reactions to trauma that warrant understanding and sensitive care). In addition, adults can learn key strategies to manage trauma-related problems in childhood. These include:
- creating environments that feel physically and emotionally safe.
- teaching children self-regulation, language and communication skills, and how to build healthy relationships.
- learning each child’s trauma triggers and how both the child and adults can limit, anticipate, and cope with them.
- supporting the development of healthy attachments with parents and other caregivers, as well as positive relationships with peers.
Evaluations of TIC initiatives also indicate that when parents, service providers, and programs share a common language and view of trauma, they are better able to work together to meet children’s needs.
Training and professional development opportunities are also important for increasing the capacity of adults to attend to other aspects of TIC, including:
- family engagement.
- practices that are responsive to culture, gender, and sexual orientation.
- collaboration with community service providers (e.g., mental health providers who can screen for childhood trauma and provide evidence-based treatment).
- developing and integrating emergency and crisis response protocols.
- and establishing trauma-informed policies that support positive youth development despite exposure to trauma.
Building capacity and maintaining an ongoing commitment to TIC efforts are critical to sustainability. However, although it is a critical component of TIC, training staff and parents on the impact of childhood trauma is not sufficient and does not in and of itself constitute TIC. TIC must also include comprehensive, ongoing professional development and education for parents, families, school staff, out-of-school program staff, and community service providers on jointly addressing childhood trauma.
Secondary Traumatic Stress
TIC also means attending to the psychological and physical safety and well-being of the adults who care for children who have experienced trauma. Professionals, parents, and other caregiving adults may suffer secondary traumatic stress (trauma-related reactions to exposure to another person’s traumatic experience). The National Child Traumatic Stress Network recommends the following strategies to combat secondary traumatic stress and reduce related staff burnout and turnover:
- Provide high-quality, reflective supervision
- Maintain trauma workload balance
- Support workplace self-care groups
- Enhance the physical safety of staff
- Provide training to both staff and leadership to increase awareness about secondary traumatic stress and how to address it effectively
- Develop opportunities for staff and leadership to learn about and engage in self-care practices.
- Create external partnerships with secondary traumatic stress experts.
- Regularly assess the vulnerability and resilience of staff and leadership to second traumatic stress
- Create a buddy system for self-care accountability. 544
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Pause to Reflect What are key take-aways for you about how teachers can support children’s mental health? What are some ways that you can stay mentally healthy as well? |
Summary
Children’s mental health (their social and emotional development) must be intentionally supported from the beginning. Children with mental health problems (both diagnosed and that may go undiagnosed) and children who experience adverse childhood experiences, trauma, and stress may need additional mental health support. Early care and education programs should practice trauma informed care and recognize their role in helping children, and their families, to develop resilience.


10.6: Glacial Environments
Glacial Influence
Glacial environments do not form a single, coherent depositional system but instead interact with and overprint existing systems such as fluvial, lacustrine, and eolian environments. While glacially-overprinted environments closely resemble warmer-climate versions of those same environments, diagnosis of glacial influence depends on recognizing the diagnostic features described below.
Glacial Indicators
One of the more widespread glacially influenced deposits is loess , composed of wind-blown silt. These fine-grained deposits accumulate downwind of glaciated regions, often forming extensive blankets of sediment. Once lithified, loess appears as a nondescript siltstone, making it difficult to distinguish from other silt-rich deposits unless it is found in association with other glacial indicators.
A more direct glacial deposit is glacial till , which lithifies into diamictite over time. This deposit consists of a poorly sorted mixture of mud, sand, and gravel, accumulating beneath or in front of a glacier. The lack of sorting and the mix of clast sizes distinguish it from other deposits, but care must be taken in interpretation, as similar textures can result from debris flows. A key diagnostic feature of glacial till is the presence of striated , faceted , or bullet-shaped clasts , which form due to abrasion within moving glacial ice, incorporation of faceted ventifacts, and dynamics within glacial ice, respectively.
Varves are annual couplets of sand and mud, recording alternating high-energy summer deposits and finer winter deposits when the lake is ice-covered. While varves provide a clear record of cold climate, similar rhythmic layering can occur in non-glacial settings such as tidal flats or fluvial systems with pulses of floodwater.
Ice-rafted debris serves as an additional indicator of glacial, or at least freezing conditions. As icebergs calve from sediment-laden glaciers, they can drift into open water and release debris as they melt. This process results in outsized clasts that are encased within fine-grained sediments. Mudrocks formed in cold climates might also contain glendonites , which are pseudomorphs of the mineral ikaite which forms only in near freezing conditions.


9.2: Diffusion and Transportation of Oxygen
Diagram 9.2 : Cross section of an alveolus
The air in the alveoli is rich in oxygen while the blood in the capillaries around the alveoli is deoxygenated. This is because the haemoglobin in the red blood cells has released all the oxygen it has been carrying to the cells of the body. Oxygen diffuses from high concentration to low concentration. It therefore crosses the narrow barrier between the alveoli and the capillaries to enter the blood and combine with the haemoglobin in the red blood cells to form oxyhaemoglobin .
The narrow diameter of the capillaries around the alveoli means that the blood flow is slowed down and that the red cells are squeezed against the capillary walls. Both of these factors help the oxygen diffuse into the blood (see diagram 9.2).
When the blood reaches the capillaries of the tissues the oxygen splits from the haemoglobin molecule. It then diffuses into the tissue fluid and then into the cells.


18.2: Why Technology?
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If technology is the answer, what is the question? The paradox of technology-enhanced education is that technology changes very rapidly and human beings very slowly. It would seem to make sense for proponents of e-learning to begin with the learners. (Bates & Poole, 2003, p. xiii)
Many institutions and organizations are embracing technology in an effort to support the transformation of how, when, and where instruction is provided, and how learning is organized within a digital environment. Educational technologies connect learners and instructors in different geographic locations, transforming the learning environment and traditional notions about instructor-led education and training. In e-learning programs learners now choose when to engage in the lesson, and from what location—home, school, work, or abroad. Digital technologies deliver lessons to learners, replacing the traditional instructor in front of a classroom. E-learning programs are used to provide self-paced, online environments that change learning from delivery of information to facilitated coaching, mentoring, and peer learning. Learning is being transformed from the “sage on the stage” model to a learner centred “guide on the side” model.
Research on the use of educational technologies indicates they can be a powerful means of transforming teaching and learning, particularly in how both are organized (Crichton & Kinsel, 2000; Dexter, Anderson & Becker, 1999) and the use of new technologies has the potential to affect teaching and learning positively (Bennett, McMillan-Culp, Honey, Tally & Spielvogel, 2000). However, the integration and use of technologies in today’s complex organizational environments demand significant change, and the literature is clear about the central role of leadership (Fullan, 1993, 2001, 2003; Leithwood & Duke, 1999; Sergiovanni, 1994, 2001; Creighton, 2003). While leadership and the management of change have been well studied and documented, little has been written about the role leaders play in the success or failure of adopting educational technologies and implementing e-learning programs.
Transformational leadership theory, first described by Burns (1978) and Bass (1985), and later elaborated on by Leithwood and colleagues (Leithwood & Riel, 2003; Leithwood & Jantzi, 2005; Silins & Mulford, 2002), lends itself to describing and understanding the processes involved in the implementation of educational technologies in e-learning environments. Leadership is a central factor in the successful use of education technologies (Creighton, 2003; Coleman, 2003; Davidson, 2003; Foster & St. Hilaire, 2003; Hughes & Zachariah, 2001; National Center for Education Statistics, 2000). Transformational leadership in this context is about deploying technologies to accomplish core organizational goals in attaining a shared vision compelling enough to transform practice. Stated another way, implementing educational technologies requires us to resolve significant instructional, pedagogical, and technological issues, all of which need to be balanced against the purposes of learning. This kind of change management requires leadership. Transformational leadership theory can offer insight into fundamental assumptions about change, control, order, organizations, and people, and provide a more useful base from which to examine leadership and e-learning program adoption.


8.3: Exercises
LAB 8 EXERCISE \(\PageIndex{1}\)
Identify the following
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List the defining visual characteristics of this muscle and draw arrows to features on the photograph that illustrate each characteristic.
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Muscle Type Visual characteristics 1. _____________________________________________
2. _____________________________________________
3. _____________________________________________
4. _____________________________________________ |
- Obtain a slide of skeletal muscle tissue from the slide box.
- View the slide on an appropriate objective.
- Fill out the blanks next to your drawing.
In the circle below, draw a representative sample of key features you identified, taking care to correctly and clearly draw their true shapes and directions. Draw your structures proportionately to their size in your microscope’s field of view.
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Total Magnification: _________________
Type of eptihelium: _________________
Source of tissue: ____________________
Function of this phase: _______________
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Type of muscle tissue:
LAB 8 EXERCISE \(\PageIndex{2}\)
LAB 8 EXERCISE \(\PageIndex{3}\)
LAB 8 EXERCISE \(\PageIndex{4}\)


17.6: The Adrenal Glands
Learning Objectives
- Describe the location and structure of the adrenal glands
- Identify the hormones produced by the adrenal cortex and adrenal medulla, and summarize their target cells and effects
The adrenal glands are wedges of glandular and neuroendocrine tissue adhering to the top of the kidneys by a fibrous capsule (Figure \(\PageIndex{1}\)). The adrenal glands have a rich blood supply and experience one of the highest rates of blood flow in the body. They are served by several arteries branching off the aorta, including the suprarenal and renal arteries. Blood flows to each adrenal gland at the adrenal cortex and then drains into the adrenal medulla. Adrenal hormones are released into the circulation via the left and right suprarenal veins.
The adrenal gland consists of an outer cortex of glandular tissue and an inner medulla of nervous tissue. The cortex itself is divided into three zones: the zona glomerulosa , the zona fasciculata , and the zona reticularis . Each region secretes its own set of hormones.
The adrenal cortex , as a component of the hypothalamic-pituitary-adrenal (HPA) axis, secretes steroid hormones important for the regulation of the long-term stress response, blood pressure and blood volume, nutrient uptake and storage, fluid and electrolyte balance, and inflammation. The HPA axis involves the stimulation of hormone release of adrenocorticotropic hormone (ACTH) from the pituitary by the hypothalamus. ACTH then stimulates the adrenal cortex to produce the hormone cortisol. This pathway will be discussed in more detail below.
The adrenal medulla is neuroendocrine tissue composed of postganglionic sympathetic nervous system (SNS) neurons. It is really an extension of the autonomic nervous system, which regulates homeostasis in the body. The sympathomedullary (SAM) pathway involves the stimulation of the medulla by impulses from the hypothalamus via neurons from the thoracic spinal cord. The medulla is stimulated to secrete the amine hormones epinephrine and norepinephrine.
One of the major functions of the adrenal gland is to respond to stress. Stress can be either physical or psychological or both. Physical stresses include exposing the body to injury, walking outside in cold and wet conditions without a coat on, or malnutrition. Psychological stresses include the perception of a physical threat, a fight with a loved one, or just a bad day at school.
The body responds in different ways to short-term stress and long-term stress following a pattern known as the general adaptation syndrome (GAS) . Stage one of GAS is called the alarm reaction . This is short-term stress, the fight-or-flight response, mediated by the hormones epinephrine and norepinephrine from the adrenal medulla via the SAM pathway. Their function is to prepare the body for extreme physical exertion. Once this stress is relieved, the body quickly returns to normal. The section on the adrenal medulla covers this response in more detail.
If the stress is not soon relieved, the body adapts to the stress in the second stage called the stage of resistance . If a person is starving for example, the body may send signals to the gastrointestinal tract to maximize the absorption of nutrients from food.
If the stress continues for a longer term however, the body responds with symptoms quite different than the fight-or-flight response. During the stage of exhaustion , individuals may begin to suffer depression, the suppression of their immune response, severe fatigue, or even a fatal heart attack. These symptoms are mediated by the hormones of the adrenal cortex, especially cortisol, released as a result of signals from the HPA axis.
Adrenal hormones also have several non–stress-related functions, including the increase of blood sodium and glucose levels, which will be described in detail below.
Adrenal Cortex
The adrenal cortex consists of multiple layers of lipid-storing cells that occur in three structurally distinct regions. Each of these regions produces different hormones.
Hormones of the Zona Glomerulosa
The most superficial region of the adrenal cortex is the zona glomerulosa, which produces a group of hormones collectively referred to as mineralocorticoids because of their effect on body minerals, especially sodium and potassium. These hormones are essential for fluid and electrolyte balance.
Aldosterone is the major mineralocorticoid. It is important in the regulation of the concentration of sodium and potassium ions in urine, sweat, and saliva. For example, it is released in response to elevated blood K + , low blood Na + , low blood pressure, or low blood volume. In response, aldosterone increases the excretion of K + and the retention of Na + , which in turn increases blood volume and blood pressure. Its secretion is prompted when CRH from the hypothalamus triggers ACTH release from the anterior pituitary.
Aldosterone is also a key component of the renin-angiotensin-aldosterone system (RAAS) in which specialized cells of the kidneys secrete the enzyme renin in response to low blood volume or low blood pressure. Renin then catalyzes the conversion of the blood protein angiotensinogen, produced by the liver, to the hormone angiotensin I. Angiotensin I is converted in the lungs to angiotensin II by angiotensin-converting enzyme (ACE) . Angiotensin II has three major functions:
- Initiating vasoconstriction of the arterioles, decreasing blood flow
- Stimulating kidney tubules to reabsorb NaCl and water, increasing blood volume
- Signaling the adrenal cortex to secrete aldosterone, the effects of which further contribute to fluid retention, restoring blood pressure and blood volume
For individuals with hypertension, or high blood pressure, drugs are available that block the production of angiotensin II. These drugs, known as ACE inhibitors, block the ACE enzyme from converting angiotensin I to angiotensin II, thus mitigating the latter’s ability to increase blood pressure.
Hormones of the Zona Fasciculata
The intermediate region of the adrenal cortex is the zona fasciculata, named as such because the cells form small fascicles (bundles) separated by tiny blood vessels. The cells of the zona fasciculata produce hormones called glucocorticoids because of their role in glucose metabolism. The most important of these is cortisol , some of which the liver converts to cortisone. A glucocorticoid produced in much smaller amounts is corticosterone. In response to long-term stressors, the hypothalamus secretes CRH, which in turn triggers the release of ACTH by the anterior pituitary. ACTH triggers the release of the glucocorticoids. Their overall effect is to inhibit tissue building while stimulating the breakdown of stored nutrients to maintain adequate fuel supplies. In conditions of long-term stress, for example, cortisol promotes the catabolism of glycogen to glucose, the catabolism of stored triglycerides into fatty acids and glycerol, and the catabolism of muscle proteins into amino acids. These raw materials can then be used to synthesize additional glucose and ketones for use as body fuels. The hippocampus, which is part of the temporal lobe of the cerebral cortices and important in memory formation, is highly sensitive to stress levels because of its many glucocorticoid receptors.
You are probably familiar with prescription and over-the-counter medications containing glucocorticoids, such as cortisone injections into inflamed joints, prednisone tablets and steroid-based inhalers used to manage severe asthma, and hydrocortisone creams applied to relieve itchy skin rashes. These drugs reflect another role of cortisol—the downregulation of the immune system, which inhibits the inflammatory response.
Hormones of the Zona Reticularis
The deepest region of the adrenal cortex is the zona reticularis, which produces small amounts of a class of steroid sex hormones called androgens. During puberty and most of adulthood, androgens are produced in the gonads. The androgens produced in the zona reticularis supplement the gonadal androgens. They are produced in response to ACTH from the anterior pituitary and are converted in the tissues to testosterone or estrogens. In adult women, they may contribute to the sex drive, but their function in adult men is not well understood. In post-menopausal women, as the functions of the ovaries decline, the main source of estrogens becomes the androgens produced by the zona reticularis.
Adrenal Medulla
As noted earlier, the adrenal cortex releases glucocorticoids in response to long-term stress such as severe illness. In contrast, the adrenal medulla releases its hormones in response to acute, short-term stress mediated by the sympathetic nervous system (SNS).
The medullary tissue is composed of unique postganglionic SNS neurons called chromaffin cells, which are large and irregularly shaped, and produce the neurotransmitters epinephrine (also called adrenaline) and norepinephrine (or noradrenaline). Epinephrine is produced in greater quantities—approximately a 4 to 1 ratio with norepinephrine—and is the more powerful hormone. Because the chromaffin cells release epinephrine and norepinephrine into the systemic circulation, where they travel widely and exert effects on distant cells, they are considered hormones. Derived from the amino acid tyrosine, they are chemically classified as catecholamines.
The secretion of medullary epinephrine and norepinephrine is controlled by a neural pathway that originates from the hypothalamus in response to danger or stress (the SAM pathway). Both epinephrine and norepinephrine signal the liver and skeletal muscle cells to convert glycogen into glucose, resulting in increased blood glucose levels. These hormones increase the heart rate, pulse, and blood pressure to prepare the body to fight the perceived threat or flee from it. In addition, the pathway dilates the airways, raising blood oxygen levels. It also prompts vasodilation, further increasing the oxygenation of important organs such as the lungs, brain, heart, and skeletal muscle. At the same time, it triggers vasoconstriction to blood vessels serving less essential organs such as the gastrointestinal tract, kidneys, and skin, and downregulates some components of the immune system. Other effects include a dry mouth, loss of appetite, pupil dilation, and a loss of peripheral vision. The major hormones of the adrenal glands are summarized in Table \(\PageIndex{1}\).
| Adrenal gland | Associated hormones | Chemical class | Effect |
|---|---|---|---|
| Adrenal cortex | Aldosterone | Steroid | Increases blood Na + levels |
| Adrenal cortex | Cortisol, corticosterone, cortisone | Steroid | Increase blood glucose levels |
| Adrenal medulla | Epinephrine, norepinephrine | Amine | Stimulate fight-or-flight response |
Disorders Involving the Adrenal Glands
Several disorders are caused by the dysregulation of the hormones produced by the adrenal glands. For example, Cushing’s disease is a disorder characterized by high blood glucose levels and the accumulation of lipid deposits on the face and neck. It is caused by hypersecretion of cortisol. The most common source of Cushing’s disease is a pituitary tumor that secretes cortisol or ACTH in abnormally high amounts. Other common signs of Cushing’s disease include the development of a moon-shaped face, a buffalo hump on the back of the neck, rapid weight gain, and hair loss. Chronically elevated glucose levels are also associated with an elevated risk of developing type 2 diabetes. In addition to hyperglycemia, chronically elevated glucocorticoids compromise immunity, resistance to infection, and memory, and can result in rapid weight gain and hair loss.
In contrast, the hyposecretion of corticosteroids can result in Addison’s disease, a rare disorder that causes low blood glucose levels and low blood sodium levels. The signs and symptoms of Addison’s disease are vague and are typical of other disorders as well, making diagnosis difficult. They may include general weakness, abdominal pain, weight loss, nausea, vomiting, sweating, and cravings for salty food.
Chapter Review
The adrenal glands, located superior to each kidney, consist of two regions: the adrenal cortex and adrenal medulla. The adrenal cortex—the outer layer of the gland—produces mineralocorticoids, glucocorticoids, and androgens. The adrenal medulla at the core of the gland produces epinephrine and norepinephrine.
The adrenal glands mediate a short-term stress response and a long-term stress response. A perceived threat results in the secretion of epinephrine and norepinephrine from the adrenal medulla, which mediate the fight-or-flight response. The long-term stress response is mediated by the secretion of CRH from the hypothalamus, which triggers ACTH, which in turn stimulates the secretion of corticosteroids from the adrenal cortex. The mineralocorticoids, chiefly aldosterone, cause sodium and fluid retention, which increases blood volume and blood pressure.
Interactive Link Questions
Visit this link to view an animation describing the location and function of the adrenal glands. Which hormone produced by the adrenal glands is responsible for mobilization of energy stores?
Answer: Cortisol.
Review Questions
Q. The adrenal glands are attached superiorly to which organ?
A. thyroid
B. liver
C. kidneys
D. hypothalamus
Answer: C
Q. What secretory cell type is found in the adrenal medulla?
A. chromaffin cells
B. neuroglial cells
C. follicle cells
D. oxyphil cells
Answer: A
Q. Cushing’s disease is a disorder caused by ________.
A. abnormally low levels of cortisol
B. abnormally high levels of cortisol
C. abnormally low levels of aldosterone
D. abnormally high levels of aldosterone
Answer: B
Q. Which of the following responses s not part of the fight-or-flight response?
A. pupil dilation
B. increased oxygen supply to the lungs
C. suppressed digestion
D. reduced mental activity
Answer: D
Critical Thinking Questions
Q. What are the three regions of the adrenal cortex and what hormones do they produce?
A. The outer region is the zona glomerulosa, which produces mineralocorticoids such as aldosterone; the next region is the zona fasciculata, which produces glucocorticoids such as cortisol; the inner region is the zona reticularis, which produces androgens.
Q. If innervation to the adrenal medulla were disrupted, what would be the physiological outcome?
A. Damage to the innervation of the adrenal medulla would prevent the adrenal glands from responding to the hypothalamus during the fight-or-flight response. Therefore, the response would be reduced.
Q. Compare and contrast the short-term and long-term stress response.
A. The short-term stress response involves the hormones epinephrine and norepinephrine, which work to increase the oxygen supply to organs important for extreme muscular action such as the brain, lungs, and muscles. In the long-term stress response, the hormone cortisol is involved in catabolism of glycogen stores, proteins, and triglycerides, glucose and ketone synthesis, and downregulation of the immune system.
Glossary
- adrenal cortex
- outer region of the adrenal glands consisting of multiple layers of epithelial cells and capillary networks that produces mineralocorticoids and glucocorticoids
- adrenal glands
- endocrine glands located at the top of each kidney that are important for the regulation of the stress response, blood pressure and blood volume, water homeostasis, and electrolyte levels
- adrenal medulla
- inner layer of the adrenal glands that plays an important role in the stress response by producing epinephrine and norepinephrine
- angiotensin-converting enzyme
- the enzyme that converts angiotensin I to angiotensin II
- alarm reaction
- the short-term stress, or the fight-or-flight response, of stage one of the general adaptation syndrome mediated by the hormones epinephrine and norepinephrine
- aldosterone
- hormone produced and secreted by the adrenal cortex that stimulates sodium and fluid retention and increases blood volume and blood pressure
- chromaffin
- neuroendocrine cells of the adrenal medulla
- cortisol
- glucocorticoid important in gluconeogenesis, the catabolism of glycogen, and downregulation of the immune system
- epinephrine
- primary and most potent catecholamine hormone secreted by the adrenal medulla in response to short-term stress; also called adrenaline
- general adaptation syndrome (GAS)
- the human body’s three-stage response pattern to short- and long-term stress
- glucocorticoids
- hormones produced by the zona fasciculata of the adrenal cortex that influence glucose metabolism
- mineralocorticoids
- hormones produced by the zona glomerulosa cells of the adrenal cortex that influence fluid and electrolyte balance
- norepinephrine
- secondary catecholamine hormone secreted by the adrenal medulla in response to short-term stress; also called noradrenaline
- stage of exhaustion
- stage three of the general adaptation syndrome; the body’s long-term response to stress mediated by the hormones of the adrenal cortex
- stage of resistance
- stage two of the general adaptation syndrome; the body’s continued response to stress after stage one diminishes
- zona fasciculata
- intermediate region of the adrenal cortex that produce hormones called glucocorticoids
- zona glomerulosa
- most superficial region of the adrenal cortex, which produces the hormones collectively referred to as mineralocorticoids
- zona reticularis
- deepest region of the adrenal cortex, which produces the steroid sex hormones called androgens


6.2: Experience, Expression, and Equity
“If you have only two pennies, spend the first on bread and the other on hyacinths for your soul.” –Arab Proverb
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“If you have only two pennies, spend the first on bread and the other on hyacinths for your soul.” –Arab Proverb
In this chapter we will study the effects of visual culture on how families function in the United States.
You may wonder about the inclusion of art and beauty in a text that discusses the needs of families. But it can be argued that American individuals and families need art both as individuals and as a civilization. In addition,how society defines art and what is considered to be “beautiful” is relevant to equity and family outcomes.
Visual culture is described as the combination of visual events in which “information, meaning, or pleasure” [1] are communicated to the consumer.
The information that we take in through our eyes is both immense and psychologically powerful, affecting us in ways that take time and cognition to understand. It is the intent of this chapter to highlight the wa ys in which visual culture affects families, both in the way we view ourselves, and in the ways we can access resources such as education, employment, and wealth.
Art is one w ay in which people share ideas, express themselves, and communicate. Consider the painting or print hanging in your doctor’s office. What about the graffiti you passed on the way to the bus stop? Artistic expression exemplifies the richness of a culture and energizes our thought processes. We are exposed to art, design and creativity all day long, whether we realize it or not.
How and where an individual is able to access art is largely related to the values and beliefs a culture holds as a standard for determining what is desirable in a society, both by artistic and by beauty standards. Individuals have
specific, individualized beliefs, but can still share collective values. An example is the quote, “You can’t be too rich or too thin”. An underlying value that engenders this quote would be that being wealthy and being thin are good and desirable.
Values shape how a society views what is ‘beautiful’ and what kinds of art are valued. In Beauty is a concept that is flexible and contains contextual significance depending on where you live and the time of where you are living. A family’s access to art that speaks to their culture, interests, and imagination depends on what is available in the popular media and accessible in their geographic region. In Western Culture, art was historically housed in museums. In Indiginous cultures, art often takes the form of useful objects, such as baskets and clothing.
Today art and other imagery are easily accessible in digitized forms of technology, which are accessed through


13.3: Are student-written textbooks credible?
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By Pauline Thorson
Learning Targets
To learn more about Student Written Text Material.
To understand that the student written material can be considered credible material.
To understand the effects of students writing their own textbooks.
Introduction
As technology advances, so does the way we learn. Now students on the university level, in a more technologically advanced age have the chance to write our own textbooks. Not only is this affordable,but it can also be used in the future. One may think we have been thrown into the deep end however with this class we have the chance to walk through the steps of writing our own textbook for future teachers to use as a reference. Individually we are responsible for one article and critiquing our fellow classmates. As a group we have the responsibility of informing the future educators.
A student-written text material is formed by a group of students in grade school, high school, or even at the university level. Students, teachers or professors collaborate to produce a text from which others can learn.
History
The start of the written language can be traced back to cavemen. These cavemen would write on the walls of caves with rocks, clay, and sometimes blood. They did this to teach others where to find food.
The Ancient Egyptians were among the first to develop a formal language, hieroglyphics, and writing utensils, which included papyrus and a primitive ink. They would also use scrolls to record information. These scrolls could be considered one of the first textbooks. However, according to John Wakefield, University of North Alabama, textbooks were invented by Aelius Donatus, in 4 A.D. in a catechism style. Student would answer a question posed by the teacher (Wakefield, 2008 p 5).
Civilization used the quill and ink on parchment for almost a thousand years.
Jumping forward in history, the use of modern style pen and paper, typewriters and most recently computers are used compose our thoughts. There is not much of a jump to make from composing thoughts on a computer to a group of students publishing a textbook.
Student Work
The students write articles within the textbook as part of a course in which they are enrolled. This is usually under the guidance of a teacher or professor. Most teachers and students eventually find that they learn best from teaching others.
As for the process, the students choose an article or two to write with other classmates and get guidance from peers. Then they try to get current and relevant information out to better educate themselves and their fellow classmates.
But if you wish to know more about the authors, you can look their information up in the About the Authors section of the book.
Credible Information
You may think, what would students know about writing a textbook? They are just learning the basics. You would be surprised, because when one person becomes a master of some idea or profession they also have to go through a trial in which they learn a great bit and in turn can teach what they have learned. How many times does a child fall before he or she learns to walk? How many of us still stumble or stub a toe every now and then? With these analogies one could say that we are learning all the time. It is with this continual learning process that we eventually do become masters of what we are learning thus, being able to teach others through our own experiences.
Also the students get to learn with their fellow students and provide peer reviews. Peer reviews are the chance for students to advise, suggest and guide their classmates into producing the best work they can.
We as a class get to learn and critique our peers in order to help them learn things about themselves as well as ourselves. This is a new way to get ourselves and fellow students thinking and exercising our minds (Nodding 2008).
Effects
There is no cost to the college student in purchasing a text for a course that employs this method of learning. This is a big plus for most students considering that most students have a budget and really do not want to have to shell out 100's to 1000's of dollars if they do not have to. The Washington Post recently reported that "Sales of used textbooks last year grew 15 percent to $2 billion, with double-digit growth expected through 2011, according to Simba Information, a market research group. Meanwhile, sales of new textbooks have grown by 4 to 5 percent annually, with the market this year expected to reach $3.6 billion."(Mui & Kinzie 2008, para 120). This can be quite the daunting figure for the students of the future.
"Of course, the most immediate benefit of classroom teaching and textbook writing is that they allow you to mold the minds of students."(Mankiw 2007) Mankiw, a Harvard Professor, continues to say that as one writes a textbook one can begin to understand their weaknesses and how to strengthen them with the correct information (Mankiw 2007).
This textbook will also give future pre-service teachers, students learning to teach, an up to date reference, in which to learn how we all can teach each other and some of the stumbling blocks along the way. Which Kevin Hunter found that in a NEA survey that "39 percent of teachers said they do not have enough textbooks to assign homework to their students, and 32 percent reported their oldest textbook was more than 10 years old." (Hunter, 2006).
After it is all written, the student (with fellow classmates) get the honor of being able to say they wrote a textbook, which will look good on a resume'.
As with this modern age of technology we do have cheaper ways of getting books online but, why pay for something when you can learn so much more by writing it?
Future Classes
There is a debate that if students start writing their own books then the textbook companies will lose money. However, the publishers make money from republishing the same information year after year. The future of student written textbooks is a definite possibility of the future.
Conclusion
Textbooks have been around for a great deal of time. As time has changed, humans have evolved the way of learning to fit the surroundings that have been created. Scientists developed ideas that led to the invention of the computer. It is the computer that people now use to compose a textbook for future teachers to read. The computer and classes allow us to develop the techniques and forgo the cost of buying another book and in turn to learn a great deal from fellow classmates!
References
Hunter, Kevin. (2006) A Textbook Case. T.H.E. Journal.33 (15) 48, 50
Mankiw, Greg. (March 4, 2007). On Textbook Writing. Retrieved September 23, 2008, from Greg Mankiw Blog: Random Observations for Students of Economics. Website: http://gregmankiw.blogspot.com/2007/03/on-textbook-writing.html
Mui, Ylan Q. and Susan Kinzie. August 20, 2008. Break on Cost of Textbooks Unlikely Before Last Bell, 2010. The Washington Post p. A01
Noddings, Nel. (February 2008). All Our Students Thinking. Educational Leadership 65(5) 8-13
NEA/AAP Survey Finds Nationwide Textbook Shortages, Teachers Don't Have Enough Books to Assign Homework.NEA News Release October 8, 2002
Wakefield, John F. (1998, June) A Brief History of Textbooks: Where Have We Been All These Years? St. Petersburg, FL. Meeting of the Text and Academic Authors (Eric Document Reproduction Service No. ED 419 246)


3: Organic Compounds - Alkanes and Their Stereochemistry
After you have completed Chapter 3, you should be able to
- fulfill the detailed objectives listed under each section.
- identify some of the commonest functional groups.
- write the structures and names of the first ten straight-chain alkanes.
- recognize and name the simple alkyl substituents, and give the systematic names for branched-chain alkanes.
- briefly describe some of the processes used during the refining of petroleum.
- briefly describe the physical properties of alkanes.
- draw a number of possible conformations of some simple alkanes and alkane-like compounds, and represent the energies of such conformations on energy versus rotation diagrams.
- define, and use in context, the key terms introduced in this chapter.
This chapter begins with an introduction to the concept of the functional group, a concept that facilitates the systematic study of organic chemistry. Next, we introduce the fundamentals of organic nomenclature (i.e., the naming of organic chemicals) through examination of the alkane family of compounds. We then discuss, briefly, the occurrence and properties of alkanes, and end with a description of cis - trans isomerism in cycloalkanes.
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- 3.1: Functional Groups
- Functional groups are atoms or small groups of atoms (two to four) that exhibit a characteristic reactivity. A particular functional group will almost always display its characteristic chemical behavior when it is present in a compound. Because of their importance in understanding organic chemistry, functional groups have characteristic names that often carry over in the naming of individual compounds incorporating specific groups
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- 3.2: Alkanes and Alkane Isomers
- Alkanes are organic compounds that consist entirely of single-bonded carbon and hydrogen atoms and lack any other functional groups. Alkanes have the general formula CnH2n+2 and can be subdivided into the following three groups: the linear straight-chain alkanes, branched alkanes, and cycloalkanes. Alkanes are also saturated hydrocarbons. Cycloalkanes are cyclic hydrocarbons, meaning that the carbons of the molecule are arranged in the form of a ring.
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- 3.3: Alkyl Groups
- The IUPAC system requires first that we have names for simple unbranched chains, as noted above, and second that we have names for simple alkyl groups that may be attached to the chains. Examples of some common alkyl groups are given in the following table. Note that the "ane" suffix is replaced by "yl" in naming groups. The symbol R is used to designate a generic (unspecified) alkyl group.
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- 3.6: Conformations of Ethane
- Conformational isomerism involves rotation about sigma bonds, and does not involve any differences in the connectivity or geometry of bonding. Two or more structures that are categorized as conformational isomers, or conformers, are really just two of the exact same molecule that differ only in terms of the angle about one or more sigma bonds.
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- 3.8: Gasoline - A Deeper Look
- The petroleum that is pumped out of the ground at locations around the world is a complex mixture of several thousand organic compounds, including straight-chain alkanes, cycloalkanes, alkenes, and aromatic hydrocarbons with four to several hundred carbon atoms. The identities and relative abundances of the components vary depending on the source.