Culture, Identity and Wellbeing in Children and Young People

Shanti Raman

Area Community Paediatrician-CP

Sydney South West Area Health Service

Shanti Raman

Proposed Structure of Presentation:

Background Definitions Hypothesis Critical theories: identity, acculturation Culture and child rearing What needs to be done

Shanti Raman

Context

Migration: universal phenomenon Unprecedented internal/ external migration Australia today: dynamic multicultural society Globalisation:

– Rapid social change– Positive and negative results– Differential effects on the poor

Shanti Raman

Why cultural identity and wellbeing?

Global burden of mental health problems: in Australian children 1 in 6

Cultural influences on child development and behaviour

Little scholarly work on cultural identity and links to wellbeing in Australia

Emerging literature about protective role of ethnic identity

Shanti Raman

Culture(Frisby, 1992)

As a pattern of living, customs, traditions, values, attitudes as significant artistic/humanitarian/scientific achievement of the

group as “race consciousness” -guide individual identification as values, norms of the immediate context (eg of the family,

streets, etc) as refers to superficial differences between macro and micro

groups (ie clothing, music, speech) as refers to outer appearance (“culturally different”)

Shanti Raman

Definitions

Ethnicity:– ethnic self-identity– ascribed ethnic identity– cultural identity– racial identity– Nationality– descent

Race: measure of social exclusion/ inclusion

Helms J, 1997

Shanti Raman

Distinctions: racial and ethnic identity

Identity models

Racial: reactions to societal dynamics of “racial” oppression based on physical characteristics assumed to be racial or genetic in nature

Ethnic: if acquisition or maintenance of cultural characteristics (eg language, religion) are defining principles

Helms 1996

Shanti Raman

Cultural Identity

captures change, uncertainty and ambiguity incorporates diversity and pluralism there are a number of different ‘selves’ at different

levels and their true psychological integration will lead to better psychological functioning

Incorporates any factor that may account for

“differential” patterns of learned or shared behaviour

Acculturation

Those phenomena which result when groups of individuals with different cultures come into continuous first hand contact; subsequent changes in both groups (Redfield et al, 1936)

Shanti Raman

Acculturation

Phinney 1990, based on Berry et al 1986

So how does this relate to Childrearing.....

And child development, behaviour?

Shanti Raman

Child Development ….Complex….

Change is constant

Difference is the norm

Context is central

Shanti Raman

Culture.....Complex!

Change is constant

Difference is the norm

Context is central

Shanti Raman

Relationship between Culture, Moderator Variables

Dominant Culture

Influences

Nondominant

Cultural

Influences

Acculturation Enculturation

Ethnic/Racial

Identity

Psychological

functioning

Moderator

Variables

Moderator

Variables

Shanti Raman

Moderator Variables

Type of acculturating group (voluntary or forced) social characteristics oppression and legal constraints racism, prejudice and discrimination cultural characteristics language used and fluency individual characteristics

Shanti Raman

Where does that leave us?

Examining children and development in their cultural context…..complex

More problematic definitions: behaviour, disorder, illness, mental health,

Need to consider multiple levels: family, school, peers, society, health services

Culture and child development

“The biological immaturity of children is the only fact with any certainty that can be said about children’s development.”

Sami Timimi 2005

Shanti Raman

Parenting is a universal, but highly variable behaviour

– Feeding – sleeping – discipline and moral reasoning – toilet training – teaching – communicating– giving affection

Shanti Raman

It is known that childrearing practices influence the rate and expression of

children’s development

Shanti Raman

The Milestone Approach

Shanti Raman

The Age Range Approach: DDST

Shanti Raman

Not all children develop according to the commonly used guidelines:

Motor precocity of African infants who sit, crawl and walk at least two months earlier than caucasian infants (Ainsworth, 1977; Geber and Dean, 1957; Capute et al, 1985)

Fine motor precocity but delayed walking of Yucatecan Mexican infants compared to US norms (Solomons and Solomons, 1975)

Advanced attainment of pencil skills in Japanese children compared to British norms (Saida and Miyashita, 1979)

Slight motor delay of Mayan Indian infants compared to US norms (Brazelton, 1972)

Methodical problems in many studies prevent generalisation of findings

Shanti Raman

Cultural Differences in Skill and Behaviour

– Early motor development – Obedience– Toilet training– Verbal Skills– Temperament– Feeding– Crying– Independence– Learning– Sleeping

Shanti Raman

Early Emotional Learning in Infants:

A Cross-Cultural Examination Emotional and interactive behavior learnt in the 1st

year of life: much of this learning takes place subcortically

Wide review of published literature: Richman, Miller & Solomon, Le Vine et al, Barr, Brazelton, Sigel

2 widely divergent parental models:

– Pedagogic– Child centred

Commons and Miller 1998

Shanti Raman

Cultural differences in Parental Goals

Pedagogic: major goals are for children to learn to feel emotionally independent from their parents and to develop interactive and language skills

Child-centred: a model in which the most important goal is protecting the health and survival of the infant

Hallmark study: Le Vine et al 1994, Child care and culture: Lessons from Africa.

Shanti Raman

Pedagogic Model

Shanti Raman

Pedagogic Model (Western model)

Independence and Sleeping Patterns– infants in their own beds and often in their own rooms– lack of co-sleeping

Other Separation– relatively tolerant of other separations: eg infants left with

unrelated nonresident babysitters, weekend away

Verbalizing and face to face interaction– parents believe infants are active participants in interactions – they talk to, look at, smile at and interact with infants from birth

emphasis on verbal interaction, emphasis on physical contact Consoling

– mothers relatively tolerant of infant crying

Shanti Raman

Child-Centred Model

Shanti Raman

Child Centred Model: largely non-western

Independence and Sleeping Patterns– Co-sleeping and breastfeeding on demand

High physical contact Consoling

– respond rapidly to crying, high rates of holding and touching– increased holding by mothers tends to result in infants who cry less

Verbalizing and face to face interaction– do not typically talk to their infants extensively– do not see infants as capable of communicating or of understanding

language

– do not engage in stimulating face-to-face interactions

Shanti Raman

Cultural differences in Goals of Development

Western world: career, marriage, house, car, TV Traditional (Aboriginal): achieving full tribal status Immigrant families: children better off than parents,

security, pride in children’s success Factors influencing

– Parents own status– Migration story: refugee, economic, push/pull factors– Religious affiliations– Political environment– Gender

Shanti Raman

Contrasting Cultural Practices: Communication

There is an emphasis on nonverbal, observational learning for infants.

There is an emphasis on direct, verbal learning for infants.

Children learn language primarily through eavesdropping and observing. Adults usually do not “talk with” young infants.

Adults have “conversations” with young infants. Adults endow the smallest vocalisations of the baby with meaning and intentionality, and react to them emotionally.

Mainstream Non-Western

Shanti Raman

Contrasting Cultural Practices

During feeding the adult’s primary purpose may be to ensure that the child eats an adequate meal with the minimum amount of waste or mess.

Adults encourage infants to learn self-feeding, even if learning to self-feed means making a mess.

Babies are often in close physical contact with the parents or caregivers. These babies learn to use nonverbal communication such as gestures with their hands or changes in muscle tone or posture to get their needs met.

Babies spend a lot of time by themselves – sleeping in separate rooms, and amusing themselves in playpens – and learn to use verbal communication to get the attention of adults, e.g. calling out to the parent or caregiver out of necessity.

Mainstream Non-Western

Shanti Raman

Contrasting Cultural Practices

Children learn about adult activities by being present as adults go about their jobs and household tasks. Children have responsibility to learn culturally valued behaviours and practices by observing adults.

Children are provided with a scaled-down version of adult activities. During interactions in such activities the parent adjusts speech and actions to the child’s level of skill and understanding.

Toilet training is introduced when the child is quite young. The child learns through being cooperative in a partnership with the parent

Toilet training typically occurs when the child is physically

mature and able to talk. The child learns through becoming increasingly dependent

Mainstream Non-Western

Shanti Raman

What about psychological wellbeing?

Shanti Raman

?? Wellbeing: difficult to measure

Meta-analysis of acculturation and adjustment (1992) No consistent unidirectional effect SES very important Low SES groups: symptoms and conflict with acculturation High SES groups with ethnic social support networks: high self

esteem and coping (eg Asians) Ethnic social network + SES = sense of efficacy and adaptation

Shanti Raman

Ethnic Identity and Wellbeing in Chinese and Turkish teens in Netherlands (Verkuyten 1994)

4 types of identification: dissociative, acculturative (bicultural), assimilative, marginal

Majority were dissociative or acculturative Turkish: those who identified with own group and biculturals had

positive self esteem– Girls who were dissociative had higher self esteem than boys

Chinese: assimilative and marginal group had more negative feelings, correlated with low collectivism scores

Shanti Raman

Ethnic Identity in ethnocultural youth and Wellbeing (Roberts, Phinney et al 1999)

5,500 students in high school, Houston: AA, Euro, Hispanics, Chinese, Indian, Vietnamese, PI, mixed

Measures: Ethnic identity, self esteem, coping, optimism, mastery, loneliness, depression

MEIM: overall reliable across diverse groups High ethnic identity scores: associated with self-esteem, coping,

mastery and optimism Correlation of ethnic salience with MEIM: high European Americans: lowest scores on ethnic identity Indian and Pakistani teens highest scores on ethnic identity

Shanti Raman

Where does that leave us?

Culture, Identity, Wellbeing, Development…..– complex+++

Comprehensive assessment of effects of culture on children’s wellbeing may not be possible– but worth giving a shot

Need to consider multiple levels: family, school, peers, society, health services– also age, gender and language

Shanti Raman

Recommendations:

Socio-cultural/political background of immigrant gps Acknowledge importance of culture in children’s

behaviour and development Understand benefits of cultural capital Assessment of cultural identity:

– language use – cultural practices and pride – Perceived prejudice/discrimination– religious affiliation– socialisation with in-group