The Biological Perspective

Figure 1. Childhood disorders encompass a large category of disorders that can be explained by the interplay between biological, social/cultural, and psychological causes. Some childhood disorders, such as autism spectrum disorder, are known to have strong genetic and biological causes (autism is estimated to have a heritability rate of up to 90%, and ADHD up to 74%). Some disorders, such as learning disabilities cause by Down syndrome and fragile X syndrome can be entirely explained by biological factors. Other learning disorders and behavioral disorders have fewer biological ties and can be better explained by sociocultural and psychological factors.

As you know, the biological perspective focuses on the nature aspect regarding the etiology of childhood disorders. In other words, it looks at genetic or hereditary reasons for a disorder. Researchers and professionals who embrace this way of thinking believe that a genetic trait (something that someone is born with) is the underlying root of the mental health or development problem. Types of disorders that would fall in line with the biological perspective would be Down’s syndrome, fragile X syndrome (both caused by genetic abnormalities), and motor disorders (caused by a genetic mutation affecting the cerebrum). It is believed that various genes and gene mutations may be an underlying cause for autism. In other disorders, such as stuttering, ADHD, learning disorders, and conduct disorders, there isn’t enough evidence to suggest that nature alone is the reason for the development of these disorders, however, research suggests that there may be some familial heredity, indicating some genetic predisposition is at play. Twin studies and family mental health/development history can help researchers learn more about possible biological causes for disorders in children and adolescents.

The Sociocultural Perspective

The sociocultural perspective views a person’s behaviors and/or symptoms in light of their culture and background. A critical part of development and growth includes social activities such as education and learning. Children learn from adults who, generally, provide an explanation of what one “can” or “can’t” do, as well as providing children with a model of socially acceptable behavior; this can also be seen carried out through media and in other realms.

Psychologist Lev Vygotsky described and explained childhood disorders in light of the greater sociocultural context. For example, he viewed disorders as social abnormalities and argued that they’re not actually abnormal behaviors unless they go against what is considered normal in a social context. A disability will psychologically affect someone very differently based on various social environments. Vygotsky provided an example by mentioning that a child who was blind would have a much different experience were they a young girl in America versus a young boy in Ukraine, the child of a highly affluent German, etc. According to Vygotsky, from this social perspective, the main issue for a child with a disability, is not the development, mental or neurological problem in and of itself, but rather the social implications that it bears.^[1]

It is important to always consider the cross-cultural impact of research and how treatment might look in different settings with families that have different religious beliefs, social upbringing, and cultural contexts. This may be part of the neurodiverse movement as well (mentioned previously on the page discussing autism spectrum disorder). What would it look like if those with mild ASD weren’t diagnosed but rather seen as functioning differently and socially accepted for who they were and how they interacted with the world?

The Psychodynamic Perspective

Psychodynamic theory suggests that there are three areas at work in determining a person’s personality and behavior: the id, superego, and ego. Disorders that could possibly be viewed as being “stuck” in the id could be conduct disorders since these involve more primitive drives and urges of “acting out” versus trying to live up to standards of “right” and “wrong” within socially acceptable norms.

The Humanistic Perspective

The humanistic perspective rejects the idea of biological determinism—that regardless of nature, nurture has more influence in determining the potential outcomes of one’s life. According to Rogers, parents can help their children achieve their ideal self by giving them unconditional positive regard, or unconditional love. In the development of self-concept, positive regard is key. Unconditional positive regard is an environment that is free of preconceived notions of value.

Figure 2. FAS is caused by environmental influences that cause biological damage to a developing fetus.

According to Maslow’s Hierarchy of Needs, at the very minimum, children must have their physiological, safety, and love/belonging needs met before they can achieve self-esteem and eventually, self-actualization. When the needs at the bottom of this hierarchy aren’t met (due to abuse, neglect, etc.) this can lead to mental health and emotional concerns. These challenges are what could contribute to the development of disorders. Fetal alcohol syndrome (FAS) or oppositional defiance disorder, for example, may fall in line with this viewpoint since these are seen as being caused by the environment versus having a strictly biological cause. FAS is caused by environmental exposures, such as prenatal exposure to alcohol, drugs, and toxins. Though there is some research to indicate that genes, hereditary traits, and neurobiological factors may cause ODD, there are studies that show environmental risk factors that increase the risk of development for ODD. These factors include negative parenting practices, insecure parent-child attachments, and family instability—all areas that would affect the basic physiological and safety needs of a child.

The Cognitive Perspective

Cognitive psychology focuses on studying our thoughts and their relationship to our experiences and our actions. Viewed as a cognitive disorder and treated with CBT or other types of psychotherapy, ADHD symptoms have been found to be reduced; coupled with proper medication management, functioning may greatly improve.

Conduct disorders may be another category that could be viewed from this perspective. Most theories hold that, although inhibition of antisocial conduct is primarily mediated by affective empathy (i.e., vicarious affective responsiveness), cognitive dimensions of empathy such as perspective-taking skills also play a substantial role. For instance, it has been suggested that the ability to differentiate among and identify others’ affective states and the ability to take their cognitive and affective perspective are prerequisites for empathizing and thereby inhibiting antisocial conduct.^[2] With this prerequisites in mind, the types of treatments implicated could help children with conduct disorders possibly learn empathy and thus reduce symptoms of these disorders.

The Behavioral Perspective

Another way of looking at childhood disorders is through the lens of conditioning. If someone is conditioned to act or react a certain way, this conditioning could lead to the diagnosis of certain disorders. For example, a child with a learning disorder who is shamed for doing poorly in school may become averse to going to school. Some use this explanation to argue against labeling children with disorders. On the other hand, conditioning could be used to evoke the reaction a parent wishes to see in their child, perhaps helping them sleep or concentrate better. This could be a helpful type of treatment for children with anxiety or easily distracted.^[3]