Key Takeaways
- Prenatal development is influenced by teratogens, maternal health, and environmental factors that can have lasting effects
- Typical developmental milestones provide benchmarks but must be considered within cultural context
- Aging and gerontology are increasingly important as the population ages, requiring knowledge of both normal aging and age-related conditions
- Kübler-Ross identified five stages of grief (denial, anger, bargaining, depression, acceptance) that are not necessarily linear
- The dual-process model of grief describes oscillation between loss-oriented and restoration-oriented coping
- Major life transitions (marriage, divorce, retirement, disability) can trigger both crisis and growth
- Social workers must distinguish between typical developmental challenges and clinical disorders requiring intervention
Lifespan Development
Social workers must understand human development across the entire lifespan — from prenatal development through end of life — to effectively assess clients, identify developmental challenges, and provide appropriate interventions. The ASWB exam tests your ability to recognize both typical (normative) and atypical (non-normative) development and apply this knowledge to clinical practice.
Prenatal Development
Prenatal development occurs in three stages:
- Germinal Period (Weeks 1-2): The fertilized egg (zygote) divides and implants in the uterine wall
- Embryonic Period (Weeks 3-8): Major organs and body structures form; the organism is most vulnerable to teratogens (substances that cause birth defects)
- Fetal Period (Weeks 9-Birth): Continued growth and maturation of all body systems
Teratogens that can harm prenatal development include:
- Alcohol: Leading preventable cause of intellectual disability; can cause Fetal Alcohol Spectrum Disorders (FASD)
- Tobacco: Associated with low birth weight, premature birth, and SIDS
- Illicit drugs: Opioids, cocaine, methamphetamine can cause neonatal abstinence syndrome and developmental delays
- Certain medications: Some prescription drugs (e.g., certain anti-epileptic drugs, isotretinoin) are teratogenic
- Environmental toxins: Lead, mercury, pesticides
Key Developmental Milestones
| Age | Physical | Cognitive | Social-Emotional |
|---|---|---|---|
| 0-12 months | Sits, crawls, may walk | Object permanence developing | Attachment forming, stranger anxiety |
| 1-3 years | Walking, running, fine motor skills | Language explosion, symbolic play | Autonomy, parallel play, tantrums |
| 3-6 years | Improved coordination | Preoperational thinking, imagination | Initiative, cooperative play, friendships |
| 6-12 years | Growth slows, puberty begins | Concrete operations, reading/math | Industry, peer relationships, moral development |
| 12-18 years | Puberty, physical maturation | Abstract reasoning, identity formation | Identity exploration, peer influence, risk-taking |
| 18-40 years | Peak physical condition, then gradual decline | Postformal thinking, career development | Intimacy, partnerships, parenting |
| 40-65 years | Menopause/andropause, sensory changes | Expertise and crystallized intelligence peak | Generativity, career reflection, caring for aging parents |
| 65+ years | Physical decline, chronic conditions | Wisdom, some cognitive decline | Life review, integrity vs. despair, loss |
Aging and Gerontology
As the population ages, social workers increasingly serve older adults. Key concepts in gerontological social work include:
- Normal aging vs. pathological aging: Not all cognitive decline is dementia; some memory changes are normal with aging
- Ageism: Prejudice and discrimination against older adults that affects access to services and quality of care
- Dementia types: Alzheimer's disease (most common), vascular dementia, Lewy body dementia, frontotemporal dementia
- Elder abuse: Physical, emotional, sexual, financial abuse, and neglect — social workers are mandated reporters
- Advance directives: Living wills, healthcare proxies, and do-not-resuscitate (DNR) orders
- Caregiver stress: Family members caring for aging relatives often experience burnout, depression, and social isolation
During which prenatal period is the developing organism MOST vulnerable to teratogens?
Grief and Loss
Understanding grief and loss is essential for social work practice. Social workers encounter clients dealing with death, divorce, job loss, health changes, and other significant losses.
Kübler-Ross Five Stages of Grief
Elisabeth Kübler-Ross identified five emotional stages that people may experience when facing death or significant loss:
- Denial: "This can't be happening." A defense mechanism that buffers the initial shock.
- Anger: "Why me? This isn't fair!" Feelings of frustration and helplessness directed outward.
- Bargaining: "If only I had..." Attempts to negotiate or make deals (often with God or fate) to reverse the loss.
- Depression: "What's the point?" Deep sadness and withdrawal as the reality of the loss sets in.
- Acceptance: "I can find peace with this." Coming to terms with the reality of the loss.
Important: These stages are not linear and not universal. People may experience them in any order, skip stages, revisit stages, or experience multiple stages simultaneously. Kübler-Ross herself noted that these stages were never meant to be a rigid framework.
Dual-Process Model of Grief (Stroebe & Schut)
The dual-process model offers a more contemporary understanding of grief, describing how bereaved individuals oscillate between two types of coping:
- Loss-oriented coping: Focusing on the loss itself — grieving, crying, yearning for the deceased, reviewing memories, processing the emotional pain
- Restoration-oriented coping: Focusing on adapting to life changes — taking on new roles and responsibilities, developing a new identity, managing daily life without the deceased
- Oscillation: Healthy grieving involves moving back and forth between loss-oriented and restoration-oriented coping. Neither extreme (constant grief nor avoidance of grief) is healthy.
Complicated Grief
When grief becomes prolonged and debilitating, it may meet criteria for Prolonged Grief Disorder (now included in the DSM-5-TR). Signs include:
- Intense longing and preoccupation with the deceased lasting more than 12 months (6 months for children)
- Identity disruption, sense of disbelief, avoidance of reminders
- Intense emotional pain (anger, bitterness, guilt)
- Difficulty engaging in activities, maintaining relationships, or planning for the future
- Significant functional impairment
Major Life Transitions
Social workers help clients navigate significant life transitions that can trigger both crisis and growth:
- Marriage/Partnership: Adjustment to shared living, role changes, blending families
- Parenthood: Identity shift, sleep deprivation, relationship changes, postpartum mood disorders
- Divorce/Separation: Grief, custody issues, financial changes, co-parenting challenges
- Job loss/Career change: Identity disruption, financial stress, loss of social network
- Retirement: Loss of structure, identity, and social connections; financial adjustments
- Chronic illness/Disability: Adjusting to functional limitations, grief for lost abilities, caregiver dynamics
- Immigration/Relocation: Cultural adjustment, loss of social support, language barriers
According to the dual-process model of grief (Stroebe & Schut), healthy grieving involves:
Put Kübler-Ross's five stages of grief in the traditional order:
Arrange the items in the correct order
A client whose spouse died 18 months ago reports persistent yearning, inability to accept the death, avoidance of reminders, and difficulty functioning at work. The MOST likely assessment is:
What is the LEADING preventable cause of intellectual disability in prenatal development?
An 80-year-old client reflects on her life and expresses deep regret about missed opportunities and broken relationships. According to Erikson, she is struggling with:
Which of the following is the MOST common type of dementia?
Prejudice and discrimination against older adults that affects their access to services and quality of care is called: