16 Self-Perception Issues
Standards of Care
Bright Futures: Guidelines for Health Supervision (Hagen et al, 2008) does not specifically address self-perception, but interweaves it throughout the approach to health supervision. Bright Futures in Practice: Mental Health (Jellinek et al, 2002) focuses on prevention of psychosocial problems and early recognition of mental disorders. The comprehensive practice guide and toolkit have a section in each developmental chapter that focuses on self-functioning and its appropriate assessment and management. Both the Healthy People 2020 objectives (USDHHS, 2010b) and the Guide to Clinical Preventive Services (U.S. Preventive Services Task Force [USPSTF], 2010) address the need to screen for depression and potential suicide. Depression and suicide are potential complications of negative self-esteem and should be considered by the provider working with children and adolescents (see Chapter 19 for an in-depth discussion of these topics).
Normal Patterns of Self-Perception
Components of Self-Perception
BOX 16-1 Key Components of Self-Perception
Significance: “I am loved.” (Parent: “I love you, no matter what.”)
Worthiness: “I am OK. I like and respect myself.” (Parent: “I accept and respect you.”)
Competence: “I can do it.” (Parent: “I believe in you. You can do it.”)
BOX 16-2 Enhancing Self-Perception: The Cycle of Learning
• Curiosity results in exploration.
• Exploration results in discovery.
• Discovery results in pleasure.
• Pleasure leads to repetition.
• Repetition results in mastery.
• Mastery results in new skills.
• New skills lead to confidence.
• Confidence contributes to self-esteem.
• Self-esteem increases sense of security.
From Perry BD: Creating novelty, Scholas Parent Child 9:67-68, 2001. Copyright © 2001 by Scholastic Inc.
Children who do not feel significant, worthy, and competent look increasingly to external measures, such as those listed in Box 16-3, to try to create a positive self-perception. Physical attractiveness, socioeconomic status, and intelligence (academic achievement) are three measures frequently used in society to evaluate people. State of physical health, temperament, coping style, and an overly protective environment are other factors that affect self-perception. However, undue or excessive emphasis on external measures causes children to compare themselves with others, adopting the description and evaluation others make of them. Most of us are what we think others think we are (Dobson, 1999), or “If you think you can’t, you can’t” (Neifert, 2005). Children whose self-perception is based on a comparison of themselves with others feel and describe themselves as insecure, inferior, and inadequate. Attempting to prove themselves, they often become both bossy and aggressive, or people pleasers and approval seekers. Red flags for self-perception are listed in Box 16-4.
BOX 16-3 External Measures Used to Build Self-Perception
Physical appearance or attractiveness: How do I look?
Importance: Whom do I know? Who knows me?
Financial status: What and how much do I have?
BOX 16-4 Red Flags for Self-Perception Problems
• Constantly asking for reassurance: Do I look OK? Am I fat?
• Constantly showing bravado: Do you know I know so and so? Do you know I’m involved with such and such?
• Depression or suicide: You are better off without me.
• Obsessive disorders, such as eating disorders, alcohol or drug use
Data from Slattery J: Self-esteem. In Discovery years, focus on your child, CD, 2005.
Developmental Stages
BOX 16-5 Developmental Stages of Self-Perception
Emergence of Self (First Stage)
• Infants—view the world as responsive or unresponsive to their needs and learn that they are separate individuals who affect others by their behavior.
• Toddlers—explore their capabilities and limits and make others aware of their needs, desires, and concerns.
• Preschoolers—begin to use personal pronouns and pretend play, become aware of discrepancies in abilities, discover their bodies, move from seeing themselves as the center of the world, describe themselves categorically.
Refining the Self (Second Stage)
• School-age children—become more confident of their own self-evaluation, evaluate self on the basis of external evidence, compare themselves with others, increasingly depend on peers for self-evaluation, criticize and ridicule deviations from normal.
• Early adolescents— “try-on” images, finalize body image, focus on physical and emotional changes with peer acceptance determining self-evaluation, use interpersonal self-description.
• Late adolescents—refine and crystallize self-perception (physical, social, spiritual) with values, goals, and competencies guiding their future in place.
Refining the self, the second stage of self-development, occurs in school-age children and adolescents as they developmentally become more self-aware. Friendships, peers, and the time spent in various activities play increasingly larger roles in shaping the child’s character and personality and thus self-perception. As early as 5 to 10 years old, children will cite themselves, not adults, as the authority on self-knowledge (Burton and Mitchell, 2003). Cultural stereotypes, such as those found in magazines, television, billboards, and the Internet, influence the child’s perception of society’s “ideal” self. School-age children are preoccupied with evaluating themselves on the basis of external evidence: cognitive and physical skills, achievements, physical appearance, social abilities and acceptance, and a sense of control. They are particularly prone to comparing themselves with others, making them more vulnerable to social pressure. Any deviation from what society considers “normal” is subject to criticism and ridicule.
Developmental Assets, Thriving, and “Sparks”
Building on the initial research done with adolescents, the Search Institute has now created Developmental Asset Lists for Adolescents (ages 12 to 18), Middle Childhood (ages 8 to 12), Grades K-3 (ages 5 to 9), and Early Childhood (ages 3 to 5). The asset lists have been translated into 14 different languages. All of these are accessible without charge at the Search Institute website (www.search-institute.org). Common threads and unique features for each developmental age group are reflected in the asset lists. The middle childhood assets include the transition toward emerging self-hood and self-regulation. The early-childhood assets respond to early childhood issues with essential ingredients that relate to school readiness, school success, and a happy productive life.
The latest research coming from the Search Institute has to do with the concepts of thriving and sparks (Search Institute, 2010c,d). Thriving “focuses on how an individual is ‘doing’ at any given point in time as well as the path that he or she is taking into the future.” Thriving indicators are “constructive behaviors, postures, and commitments that societies value and need in youth.” Sparks, as identified by Benson (2008), are “something inside your teenager that gets him excited. Sparks are the thing that gives teenagers (and actually all people) meaning.” Sparks are “an interest, talent, skill, asset, or dream that truly excites young people and helps them discover their true passions.” Using sparks help young people develop positive self-perception and discover and cultivate talents and interests that shape the rest of their lives. The 10 most common sparks identified by American teenagers are listed in Box 16-6.
Environmental Influences
Glascoe and Leew (2010) identified six positive parenting behaviors and perceptions that predicted average to above-average development in young children. Children with developmental assets that prepare them for school are less likely to have low self-esteem. Additionally, Glascoe and Leew (2010) identified four psychosocial risk factors. The parenting behaviors and risk factors are listed in Table 16-1. Riesch and colleagues (2006) reviewed individual, family, and environmental factors that predict poor self-esteem. Improving the parent-child communication process may reduce the risk of low self-esteem. In contrast, Neifert (2005) has identified six common errors that parents unintentionally make that chip away at their child’s self-esteem (Box 16-7). A study of French-Canadian children who experienced verbal aggression from parents (e.g., rejection, demeaning, terrorizing, criticizing, or insulting) showed significantly lower self-esteem. These children perceived themselves as less competent, less comfortable, less worthy, and more prone to depression (Solomon and Serres, 1999). In general, peers and authority figures serve to confirm or deny what is taught at home.
TABLE 16-1 Positive Parenting Behaviors and Psychosocial Risk Factors Affecting Child Development and Self-Perception
Positive Parenting Behaviors and Perceptions | Psychosocial Risk Factors |
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