research abstract about child and adolescent development pdf free download

Child Growth and Development

(12 reviews)

Jennifer Paris

Antoinette Ricardo

Dawn Rymond

Alexa Johnson

Copyright Year: 2018

Last Update: 2019

Publisher: College of the Canyons

Language: English

Formats Available

Conditions of use.

Learn more about reviews.

Reviewed by Mistie Potts, Assistant Professor, Manchester University on 11/22/22

This text covers some topics with more detail than necessary (e.g., detailing infant urination) yet it lacks comprehensiveness in a few areas that may need revision. For example, the text discusses issues with vaccines and offers a 2018 vaccine... read more

Comprehensiveness rating: 4 see less

This text covers some topics with more detail than necessary (e.g., detailing infant urination) yet it lacks comprehensiveness in a few areas that may need revision. For example, the text discusses issues with vaccines and offers a 2018 vaccine schedule for infants. The text brushes over “commonly circulated concerns” regarding vaccines and dispels these with statements about the small number of antigens a body receives through vaccines versus the numerous antigens the body normally encounters. With changes in vaccines currently offered, shifting CDC viewpoints on recommendations, and changing requirements for vaccine regulations among vaccine producers, the authors will need to revisit this information to comprehensively address all recommended vaccines, potential risks, and side effects among other topics in the current zeitgeist of our world.

Content Accuracy rating: 3

At face level, the content shared within this book appears accurate. It would be a great task to individually check each in-text citation and determine relevance, credibility and accuracy. It is notable that many of the citations, although this text was updated in 2019, remain outdated. Authors could update many of the in-text citations for current references. For example, multiple in-text citations refer to the March of Dimes and many are dated from 2012 or 2015. To increase content accuracy, authors should consider revisiting their content and current citations to determine if these continue to be the most relevant sources or if revisions are necessary. Finally, readers could benefit from a reference list in this textbook. With multiple in-text citations throughout the book, it is surprising no reference list is provided.

Relevance/Longevity rating: 4

This text would be ideal for an introduction to child development course and could possibly be used in a high school dual credit or beginning undergraduate course or certificate program such as a CDA. The outdated citations and formatting in APA 6th edition cry out for updating. Putting those aside, the content provides a solid base for learners interested in pursuing educational domains/careers relevant to child development. Certain issues (i.e., romantic relationships in adolescence, sexual orientation, and vaccination) may need to be revisited and updated, or instructors using this text will need to include supplemental information to provide students with current research findings and changes in these areas.

Clarity rating: 4

The text reads like an encyclopedia entry. It provides bold print headers and brief definitions with a few examples. Sprinkled throughout the text are helpful photographs with captions describing the images. The words chosen in the text are relatable to most high school or undergraduate level readers and do not burden the reader with expert level academic vocabulary. The layout of the text and images is simple and repetitive with photographs complementing the text entries. This allows the reader to focus their concentration on comprehension rather than deciphering a more confusing format. An index where readers could go back and search for certain terms within the textbook would be helpful. Additionally, a glossary of key terms would add clarity to this textbook.

Consistency rating: 5

Chapters appear in a similar layout throughout the textbook. The reader can anticipate the flow of the text and easily identify important terms. Authors utilized familiar headings in each chapter providing consistency to the reader.

Modularity rating: 4

Given the repetitive structure and the layout of the topics by developmental issues (physical, social emotional) the book could be divided into sections or modules. It would be easier if infancy and fetal development were more clearly distinct and stages of infant development more clearly defined, however the book could still be approached in sections or modules.

Organization/Structure/Flow rating: 4

The text is organized in a logical way when we consider our own developmental trajectories. For this reason, readers learning about these topics can easily relate to the flow of topics as they are presented throughout the book. However, when attempting to find certain topics, the reader must consider what part of development that topic may inhabit and then turn to the portion of the book aligned with that developmental issue. To ease the organization and improve readability as a reference book, authors could implement an index in the back of the book. With an index by topic, readers could quickly turn to pages covering specific topics of interest. Additionally, the text structure could be improved by providing some guiding questions or reflection prompts for readers. This would provide signals for readers to stop and think about their comprehension of the material and would also benefit instructors using this textbook in classroom settings.

Interface rating: 4

The online interface for this textbook did not hinder readability or comprehension of the text. All information including photographs, charts, and diagrams appeared to be clearly depicted within this interface. To ease reading this text online authors should create a live table of contents with bookmarks to the beginning of chapters. This book does not offer such links and therefore the reader must scroll through the pdf to find each chapter or topic.

Grammatical Errors rating: 5

No grammatical errors were found in reviewing this textbook.

Cultural Relevance rating: 3

Cultural diversity is represented throughout this text by way of the topics described and the images selected. The authors provide various perspectives that individuals or groups from multiple cultures may resonate with including parenting styles, developmental trajectories, sexuality, approaches to feeding infants, and the social emotional development of children. This text could expand in the realm of cultural diversity by addressing current issues regarding many of the hot topics in our society. Additionally, this textbook could include other types of cultural diversity aside from geographical location (e.g., religion-based or ability-based differences).

While this text lacks some of the features I would appreciate as an instructor (e.g., study guides, review questions, prompts for critical thinking/reflection) and it does not contain an index or glossary, it would be appropriate as an accessible resource for an introduction to child development. Students could easily access this text and find reliable and easily readable information to build basic content knowledge in this domain.

Reviewed by Caroline Taylor, Instructor, Virginia Tech on 12/30/21

Each chapter is comprehensively described and organized by the period of development. Although infancy and toddlerhood are grouped together, they are logically organized and discussed within each chapter. One helpful addition that would largely... read more

Each chapter is comprehensively described and organized by the period of development. Although infancy and toddlerhood are grouped together, they are logically organized and discussed within each chapter. One helpful addition that would largely contribute to the comprehensiveness is a glossary of terms at the end of the text.

From my reading, the content is accurate and unbiased. However, it is difficult to confidently respond due to a lack of references. It is sometimes clear where the information came from, but when I followed one link to a citation the link was to another textbook. There are many citations embedded within the text, but it would be beneficial (and helpful for further reading) to have a list of references at the end of each chapter. The references used within the text are also older, so implementing updated references would also enhance accuracy. If used for a course, instructors will need to supplement the textbook readings with other materials.

This text can be implemented for many semesters to come, though as previously discussed, further readings and updated materials can be used to supplement this text. It provides a good foundation for students to read prior to lectures.

Clarity rating: 5

This text is unique in its writing style for a textbook. It is written in a way that is easily accessible to students and is also engaging. The text doesn't overly use jargon or provide complex, long-winded examples. The examples used are clear and concise. Many key terms are in bold which is helpful to the reader.

For the terms that are in bold, it would be helpful to have a definition of the term listed separately on the page within the side margins, as well as include the definition in a glossary at the end.

Each period of development is consistently described by first addressing physical development, cognitive development, and then social-emotional development.

Modularity rating: 5

This text is easily divisible to assign to students. There were few (if any) large blocks of texts without subheadings, graphs, or images. This feature not only improves modularity but also promotes engagement with the reading.

Organization/Structure/Flow rating: 5

The organization of the text flows logically. I appreciate the order of the topics, which are clearly described in the first chapter by each period of development. Although infancy and toddlerhood are grouped into one period of development, development is appropriately described for both infants and toddlers. Key theories are discussed for infants and toddlers and clearly presented for the appropriate age.

Interface rating: 5

There were no significant interface issues. No images or charts were distorted.

It would be helpful to the reader if the table of contents included a navigation option, but this doesn't detract from the overall interface.

I did not see any grammatical errors.

This text includes some cultural examples across each area of development, such as differences in first words, parenting styles, personalities, and attachments styles (to list a few). The photos included throughout the text are inclusive of various family styles, races, and ethnicities. This text could implement more cultural components, but does include some cultural examples. Again, instructors can supplement more cultural examples to bolster the reading.

This text is a great introductory text for students. The text is written in a fun, approachable way for students. Though the text is not as interactive (e.g., further reading suggestions, list of references, discussion points at the end of each chapter, etc.), this is a great resource to cover development that is open access.

Reviewed by Charlotte Wilinsky, Assistant Professor of Psychology, Holyoke Community College on 6/29/21

This text is very thorough in its coverage of child and adolescent development. Important theories and frameworks in developmental psychology are discussed in appropriate depth. There is no glossary of terms at the end of the text, but I do not... read more

Comprehensiveness rating: 5 see less

This text is very thorough in its coverage of child and adolescent development. Important theories and frameworks in developmental psychology are discussed in appropriate depth. There is no glossary of terms at the end of the text, but I do not think this really hurts its comprehensiveness.

Content Accuracy rating: 5

The citations throughout the textbook help to ensure its accuracy. However, the text could benefit from additional references to recent empirical studies in the developmental field.

It seems as if updates to this textbook will be relatively easy and straightforward to implement given how well organized the text is and its numerous sections and subsections. For example, a recent narrative review was published on the effects of corporal punishment (Heilmann et al., 2021). The addition of a reference to this review, and other more recent work on spanking and other forms of corporal punishment, could serve to update the text's section on spanking (pp. 223-224; p. 418).

The text is very clear and easily understandable.

Consistency rating: 4

There do not appear to be any inconsistencies in the text. The lack of a glossary at the end of the text may be a limitation in this area, however, since glossaries can help with consistent use of language or clarify when different terms are used.

This textbook does an excellent job of dividing up and organizing its chapters. For example, chapters start with bulleted objectives and end with a bulleted conclusion section. Within each chapter, there are many headings and subheadings, making it easy for the reader to methodically read through the chapter or quickly identify a section of interest. This would also assist in assigning reading on specific topics. Additionally, the text is broken up by relevant photos, charts, graphs, and diagrams, depending on the topic being discussed.

This textbook takes a chronological approach. The broad developmental stages covered include, in order, birth and the newborn, infancy and toddlerhood, early childhood, middle childhood, and adolescence. Starting with the infancy and toddlerhood stage, physical, cognitive, and social emotional development are covered.

There are no interface issues with this textbook. It is easily accessible as a PDF file. Images are clear and there is no distortion apparent.

I did not notice any grammatical errors.

Cultural Relevance rating: 4

This text does a good job of including content relevant to different cultures and backgrounds. One example of this is in the "Cultural Influences on Parenting Styles" subsection (p. 222). Here the authors discuss how socioeconomic status and cultural background can affect parenting styles. Including references to specific studies could further strengthen this section, and, more broadly, additional specific examples grounded in research could help to fortify similar sections focused on cultural differences.

Overall, I think this is a terrific resource for a child and adolescent development course. It is user-friendly and comprehensive.

Reviewed by Lois Pribble, Lecturer, University of Oregon on 6/14/21

This book provides a really thorough overview of the different stages of development, key theories of child development and in-depth information about developmental domains. read more

This book provides a really thorough overview of the different stages of development, key theories of child development and in-depth information about developmental domains.

The book provides accurate information, emphasizes using data based on scientific research, and is stated in a non-biased fashion.

Relevance/Longevity rating: 5

The book is relevant and provides up-to-date information. There are areas where updates will need to be made as research and practices change (e.g., autism information), but it is written in a way where updates should be easy to make as needed.

The book is clear and easy to read. It is well organized.

Good consistency in format and language.

It would be very easy to assign students certain chapters to read based on content such as theory, developmental stages, or developmental domains.

Very well organized.

Clear and easy to follow.

I did not find any grammatical errors.

Cultural Relevance rating: 5

General content related to culture was infused throughout the book. The pictures used were of children and families from a variety of cultures.

This book provides a very thorough introduction to child development, emphasizing child development theories, stages of development, and developmental domains.

Reviewed by Nancy Pynchon, Adjunct Faculty, Middlesex Community College on 4/14/21

Overall this textbook is comprehensive of all aspects of children's development. It provided a brief introduction to the different relevant theorists of childhood development . read more

Overall this textbook is comprehensive of all aspects of children's development. It provided a brief introduction to the different relevant theorists of childhood development .

Content Accuracy rating: 4

Most of the information is accurately written, there is some outdated references, for example: Many adults can remember being spanked as a child. This method of discipline continues to be endorsed by the majority of parents (Smith, 2012). It seems as though there may be more current research on parent's methods of discipline as this information is 10 years old. (page 223).

The content was current with the terminology used.

Easy to follow the references made in the chapters.

Each chapter covers the different stages of development and includes the theories of each stage with guided information for each age group.

The formatting of the book makes it reader friendly and easy to follow the content.

Very consistent from chapter to chapter.

Provided a lot of charts and references within each chapter.

Formatted and written concisely.

Included several different references to diversity in the chapters.

There was no glossary at the end of the book and there were no vignettes or reflective thinking scenarios in the chapters. Overall it was a well written book on child development which covered infancy through adolescents.

Reviewed by Deborah Murphy, Full Time Instructor, Rogue Community College on 1/11/21

The text is excellent for its content and presentation. The only criticism is that neither an index nor a glossary are provided. read more

Comprehensiveness rating: 3 see less

The text is excellent for its content and presentation. The only criticism is that neither an index nor a glossary are provided.

The material seems very accurate and current. It is well written. It is very professionally done and is accessible to students.

This text addresses topics that will serve this field in positive ways that should be able to address the needs of students and instructors for the next several years.

Complex concepts are delivered accurately and are still accessible for students . Figures and tables complement the text . Terms are explained and are embedded in the text, not in a glossary. I do think indices and glossaries are helpful tools. Terminology is highlighted with bold fonts to accentuate definitions.

Yes the text is consistent in its format. As this is a text on Child Development it consistently addresses each developmental domain and then repeats the sequence for each age group in childhood. It is very logically presented.

Yes this text is definitely divisible. This text addresses development from conception to adolescents. For the community college course that my department wants to use it is very adaptable. Our course ends at middle school age development; our courses are offered on a quarter system. This text is adaptable for the content and our term time schedule.

This text book flows very clearly from Basic principles to Conception. It then divides each stage of development into Physical, Cognitive and Social Emotional development. Those concepts and information are then repeated for each stage of development. e.g. Infants and Toddler-hood, Early Childhood, and Middle Childhood. It is very clearly presented.

It is very professionally presented. It is quite attractive in its presentation .

I saw no errors

The text appears to be aware of being diverse and inclusive both in its content and its graphics. It discusses culture and represents a variety of family structures representing contemporary society.

It is wonderfully researched. It will serve our students well. It is comprehensive and constructed very well. I have enjoyed getting familiar with this text and am looking forward to using it with my students in this upcoming term. The authors have presented a valuable, well written book that will be an addition to our field. Their scholarly efforts are very apparent. All of this text earns high grades in my evaluation. My only criticism is, as mentioned above, is that there is not a glossary or index provided. All citations are embedded in the text.

Reviewed by Ida Weldon, Adjunct Professor, Bunker Hill Community College on 6/30/20

The overall comprehensiveness was strong. However, I do think some sections should have been discussed with more depth read more

The overall comprehensiveness was strong. However, I do think some sections should have been discussed with more depth

Most of the information was accurate. However, I think more references should have been provided to support some claims made in the text.

The material appeared to be relevant. However, it did not provide guidance for teachers in addressing topics of social justice, equality that most children will ask as they try to make sense of their environment.

The information was presented (use of language) that added to its understand-ability. However, I think more discussions and examples would be helpful.

The text appeared to be consistent. The purpose and intent of the text was understandable throughout.

The text can easily be divided into smaller reading sections or restructured to meet the needs of the professor.

The organization of the text adds to its consistency. However, some sections can be included in others decreasing the length of the text.

Interface issues were not visible.

The text appears to be free of grammatical errors.

While cultural differences are mentioned, more time can be given to helping teachers understand and create a culturally and ethnically focused curriculum.

The textbook provides a comprehensive summary of curriculum planing for preschool age children. However, very few chapters address infant/toddlers.

Reviewed by Veronica Harris, Adjunct Faculty, Northern Essex Community College on 6/28/20

This text explores child development from genetics, prenatal development and birth through adolescence. The text does not contain a glossary. However, the Index is clear. The topics are sequential. The text addresses the domains of physical,... read more

This text explores child development from genetics, prenatal development and birth through adolescence. The text does not contain a glossary. However, the Index is clear. The topics are sequential. The text addresses the domains of physical, cognitive and social emotional development. It is thorough and easy to read. The theories of development are inclusive to give the reader a broader understanding on how the domains of development are intertwined. The content is comprehensive, well - researched and sequential. Each chapter begins with the learning outcomes for the upcoming material and closes with an outline of the topics covered. Furthermore, a look into the next chapter is discussed.

The content is accurate, well - researched and unbiased. An historical context is provided putting content into perspective for the student. It appears to be unbiased.

Updated and accurate research is evidenced in the text. The text is written and organized in such a way that updates can be easily implemented. The author provides theoretical approaches in the psychological domains with examples along with real - life scenarios providing meaningful references invoking understanding by the student.

The text is written with clarity and is easily understood. The topics are sequential, comprehensive and and inclusive to all students. This content is presented in a cohesive, engaging, scholarly manner. The terminology used is appropriate to students studying Developmental Psychology spanning from birth through adolescents.

The book's approach to the content is consistent and well organized. . Theoretical contexts are presented throughout the text.

The text contains subheadings chunking the reading sections which can be assigned at various points throughout the course. The content flows seamlessly from one idea to the next. Written chronologically and subdividing each age span into the domains of psychology provides clarity without overwhelming the reader.

The book begins with an overview of child development. Next, the text is divided logically into chapters which focus on each developmental age span. The domains of each age span are addressed separately in subsequent chapters. Each chapter outlines the chapter objectives and ends with an outline of the topics covered and share an idea of what is to follow.

Pages load clearly and consistently without distortion of text, charts and tables. Navigating through the pages is met with ease.

The text is written with no grammatical or spelling errors.

The text did not present with biases or insensitivity to cultural differences. Photos are inclusive of various cultures.

The thoroughness, clarity and comprehensiveness promote an approach to Developmental Psychology that stands alongside the best of texts in this area. I am confident that this text encompasses all the required elements in this area.

Reviewed by Kathryn Frazier, Assistant Professor, Worcester State University on 6/23/20

This is a highly comprehensive, chronological text that covers genetics and conception through adolescence. All major topics and developmental milestones in each age range are given adequate space and consideration. The authors take care to... read more

This is a highly comprehensive, chronological text that covers genetics and conception through adolescence. All major topics and developmental milestones in each age range are given adequate space and consideration. The authors take care to summarize debates and controversies, when relevant and include a large amount of applied / practical material. For example, beyond infant growth patterns and motor milestone, the infancy/toddler chapters spend several pages on the mechanics of car seat safety, best practices for introducing solid foods (and the rationale), and common concerns like diaper rash. In addition to being generally useful information for students who are parents, or who may go on to be parents, this text takes care to contextualize the psychological research in the lived experiences of children and their parents. This is an approach that I find highly valuable. While the text does not contain an index, the search & find capacity of OER to make an index a deal-breaker for me.

The text includes accurate information that is well-sourced. Relevant debates, controversies and historical context is also provided throughout which results in a rich, balanced text.

This text provides an excellent summary of classic and updated developmental work. While the majority of the text is skewed toward dated, classic work, some updated research is included. Instructors may wish to supplement this text with more recent work, particularly that which includes diverse samples and specifically addresses topics of class, race, gender and sexual orientation (see comment below regarding cultural aspects).

The text is written in highly accessible language, free of jargon. Of particular value are the many author-generated tables which clearly organize and display critical information. The authors have also included many excellent figures, which reinforce and visually organize the information presented.

This text is consistent in its use of terminology. Balanced discussion of multiple theoretical frameworks are included throughout, with adequate space provided to address controversies and debates.

The text is clearly organized and structured. Each chapter is self-contained. In places where the authors do refer to prior or future chapters (something that I find helps students contextualize their reading), a complete discussion of the topic is included. While this may result in repetition for students reading the text from cover to cover, the repetition of some content is not so egregious that it outweighs the benefit of a flexible, modular textbook.

Excellent, clear organization. This text closely follows the organization of published textbooks that I have used in the past for both lifespan and child development. As this text follows a chronological format, a discussion of theory and methods, and genetics and prenatal growth is followed by sections devoted to a specific age range: infancy and toddlerhood, early childhood (preschool), middle childhood and adolescence. Each age range is further split into three chapters that address each developmental domain: physical, cognitive and social emotional development.

All text appears clearly and all images, tables and figures are positioned correctly and free of distortion.

The text contains no spelling or grammatical errors.

While this text provides adequate discussion of gender and cross-cultural influences on development, it is not sufficient. This is not a problem unique to this text, and is indeed a critique I have of all developmental textbooks. In particular, in my view this text does not adequately address the role of race, class or sexual orientation on development.

All in all, this is a comprehensive and well-written textbook that very closely follows the format of standard chronologically-organized child development textbooks. This is a fantastic alternative for those standard texts, with the added benefit of language that is more accessible, and content that is skewed toward practical applications.

Reviewed by Tony Philcox, Professor, Valencia College on 6/4/20

The subject of this book is Child Growth and Development and as such covers all areas and ideas appropriate for this subject. This book has an appropriate index. The author starts out with a comprehensive overview of Child Development in the... read more

The subject of this book is Child Growth and Development and as such covers all areas and ideas appropriate for this subject. This book has an appropriate index. The author starts out with a comprehensive overview of Child Development in the Introduction. The principles of development were delineated and were thoroughly presented in a very understandable way. Nine theories were presented which gave the reader an understanding of the many authors who have contributed to Child Development. A good backdrop to start a conversation. This book discusses the early beginnings starting with Conception, Hereditary and Prenatal stages which provides a foundation for the future developmental stages such as infancy, toddler, early childhood, middle childhood and adolescence. The three domains of developmental psychology – physical, cognitive and social emotional are entertained with each stage of development. This book is thoroughly researched and is written in a way to not overwhelm. Language is concise and easily understood.

This book is a very comprehensive and detailed account of Child Growth and Development. The author leaves no stone unturned. It has the essential elements addressed in each of the developmental stages. Thoroughly researched and well thought out. The content covered was accurate, error-free and unbiased.

The content is very relevant to the subject of Child Growth and Development. It is comprehensive and thoroughly researched. The author has included a number of relevant subjects that highlight the three domains of developmental psychology, physical, cognitive and social emotional. Topics are included that help the student see the relevancy of the theories being discussed. Any necessary updates along the way will be very easy and straightforward to insert.

The text is easily understood. From the very beginning of this book, the author has given the reader a very clear message that does not overwhelm but pulls the reader in for more information. The very first chapter sets a tone for what is to come and entices the reader to learn more. Well organized and jargon appropriate for students in a Developmental Psychology class.

This book has all the ingredients necessary to address Child Growth and Development. Even at the very beginning of the book the backdrop is set for future discussions on the stages of development. Theorists are mentioned and embellished throughout the book. A very consistent and organized approach.

This book has all the features you would want. There are textbooks that try to cover too much in one chapter. In this book the sections are clearly identified and divided into smaller and digestible parts so the reader can easily comprehend the topic under discussion. This book easily flows from one subject to the next. Blocks of information are being built, one brick on top of another as you move through the domains of development and the stages of development.

This book starts out with a comprehensive overview in the introduction to child development. From that point forward it is organized into the various stages of development and flows well. As mentioned previously the information is organized into building blocks as you move from one stage to the next.

The text does not contain any significant interface issued. There are no navigation problems. There is nothing that was detected that would distract or confuse the reader.

There are no grammatical errors that were identified.

This book was not culturally insensitive or offensive in any way.

This book is clearly a very comprehensive approach to Child Growth and Development. It contains all the essential ingredients that you would expect in a discussion on this subject. At the very outset this book went into detail on the principles of development and included all relevant theories. I was never left with wondering why certain topics were left out. This is undoubtedly a well written, organized and systematic approach to the subject.

Reviewed by Eleni Makris, Associate Professor, Northeastern Illinois University on 5/6/20

This book is organized by developmental stages (infancy, toddler, early childhood, middle childhood and adolescence). The book begins with an overview of conception and prenatal human development. An entire chapter is devoted to birth and... read more

This book is organized by developmental stages (infancy, toddler, early childhood, middle childhood and adolescence). The book begins with an overview of conception and prenatal human development. An entire chapter is devoted to birth and expectations of newborns. In addition, there is a consistency to each developmental stage. For infancy, early childhood, middle childhood, and adolescence, the textbook covers physical development, cognitive development, and social emotional development for each stage. While some textbooks devote entire chapters to themes such as physical development, cognitive development, and social emotional development and write about how children change developmentally in each stage this book focuses on human stages of development. The book is written in clear language and is easy to understand.

There is so much information in this book that it is a very good overview of child development. The content is error-free and unbiased. In some spots it briefly introduces multicultural traditions, beliefs, and attitudes. It is accurate for the citations that have been provided. However, it could benefit from updating to research that has been done recently. I believe that if the instructor supplements this text with current peer-reviewed research and organizations that are implementing what the book explains, this book will serve as a strong source of information.

While the book covers a very broad range of topics, many times the citations have not been updated and are often times dated. The content and information that is provided is correct and accurate, but this text can certainly benefit from having the latest research added. It does, however, include a great many topics that serve to inform students well.

The text is very easy to understand. It is written in a way that first and second year college students will find easy to understand. It also introduces students to current child and adolescent behavior that is important to be understood on an academic level. It does this in a comprehensive and clear manner.

This book is very consistent. The chapters are arranged by developmental stage. Even within each chapter there is a consistency of theorists. For example, each chapter begins with Piaget, then moves to Vygotsky, etc. This allows for great consistency among chapters. If I as the instructor decide to have students write about Piaget and his development theories throughout the life span, students will easily know that they can find this information in the first few pages of each chapter.

Certainly instructors will find the modularity of this book easy. Within each chapter the topics are self-contained and extensive. As I read the textbook, I envisioned myself perhaps not assigning entire chapters but assigning specific topics/modules and pages that students can read. I believe the modules can be used as a strong foundational reading to introduce students to concepts and then have students read supplemental information from primary sources or journals to reinforce what they have read in the chapter.

The organization of the book is clear and flows nicely. From the table of context students understand how the book is organized. The textbook would be even stronger if there was a more detailed table of context which highlights what topics are covered within each of the chapter. There is so much information contained within each chapter that it would be very beneficial to both students and instructor to quickly see what content and topics are covered in each chapter.

The interface is fine and works well.

The text is free from grammatical errors.

While the textbook does introduce some multicultural differences and similarities, it does not delve deeply into multiracial and multiethnic issues within America. It also offers very little comment on differences that occur among urban, rural, and suburban experiences. In addition, while it does talk about maturation and sexuality, LGBTQ issues could be more prominent.

Overall I enjoyed this text and will strongly consider using it in my course. The focus is clearly on human development and has very little emphasis on education. However, I intend to supplement this text with additional readings and videos that will show concrete examples of the concepts which are introduced in the text. It is a strong and worthy alternative to high-priced textbooks.

Reviewed by Mohsin Ahmed Shaikh, Assistant Professor, Bloomsburg University of Pennsylvania on 9/5/19

The content extensively discusses various aspects of emotional, cognitive, physical and social development. Examples and case studies are really informative. Some of the areas that can be elaborated more are speech-language and hearing... read more

The content extensively discusses various aspects of emotional, cognitive, physical and social development. Examples and case studies are really informative. Some of the areas that can be elaborated more are speech-language and hearing development. Because these components contribute significantly in development of communication abilities and self-image.

Content covered is pretty accurate. I think the details impressive.

The content is relevant and is based on the established knowledge of the field.

Easy to read and follow.

The terminology used is consistent and appropriate.

I think of using various sections of this book in some of undergraduate and graduate classes.

The flow of the book is logical and easy to follow.

There are no interface issues. Images, charts and diagram are clear and easy to understand.

Well written

The text appropriate and do not use any culturally insensitive language.

I really like that this is a book with really good information which is available in open text book library.

Table of Contents

• Chapter 1: Introduction to Child Development
• Chapter 2: Conception, Heredity, & Prenatal Development
• Chapter 3: Birth and the Newborn
• Chapter 4: Physical Development in Infancy & Toddlerhood
• Chapter 5: Cognitive Development in Infancy and Toddlerhood
• Chapter 6: Social and Emotional Development in Infancy and Toddlerhood
• Chapter 7: Physical Development in Early Childhood
• Chapter 8: Cognitive Development in Early Childhood
• Chapter 9: Social Emotional Development in Early Childhood
• Chapter 10: Middle Childhood - Physical Development
• Chapter 11: Middle Childhood – Cognitive Development
• Chapter 12: Middle Childhood - Social Emotional Development
• Chapter 13: Adolescence – Physical Development
• Chapter 14: Adolescence – Cognitive Development
• Chapter 15: Adolescence – Social Emotional Development

Ancillary Material

About the book.

Welcome to Child Growth and Development. This text is a presentation of how and why children grow, develop, and learn. We will look at how we change physically over time from conception through adolescence. We examine cognitive change, or how our ability to think and remember changes over the first 20 years or so of life. And we will look at how our emotions, psychological state, and social relationships change throughout childhood and adolescence.

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• Volume 30 , pages 640–669, ( 2022 )

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• Nuno Archer de Carvalho   ORCID: orcid.org/0000-0001-6620-0804 1 , 2 &
• Feliciano Henriques Veiga   ORCID: orcid.org/0000-0002-2977-6238 1 , 2  

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Erikson’s psychosocial development is a well-known and sound framework for adolescent development. However, despite its importance in scientific literature, the scarcity of literature reviews on Erikson’s theory on adolescence calls for an up-to-date systematization. Therefore, this study’s objectives are to understand the extent and nature of published research on Erikson’s psychosocial development in adolescence (10–19 years) in the last decade (2011–2020) and identify directions for meaningful research and intervention. A scoping review was conducted following Arksey and O’Malley’s framework, PRISMA-ScR guidelines, and a previous protocol, including a comprehensive search in eight databases. From 932 initial studies, 58 studies were selected. These studies highlighted the burgeoning research on Erikson’s approach, with a more significant representation of North American and European studies. The focus of most studies was on identity formation, presenting cross-cultural evidence of its importance in psychosocial development. Most of the studies used quantitative designs presenting a high number of different measures. Regarding topics and variables, studies emphasized the critical role of identity in adolescents’ development and well-being and the relevance of supporting settings in psychosocial development. However, shortcomings were found regarding the study of online and school as privileged developmental settings for adolescents. Suggestions included the need to consider the process of identity formation in the context of lifespan development and invest in supporting adolescents’ identity formation. Overall, conclusions point out Erikson’s relevance in understanding adolescents’ current challenges while offering valuable research and intervention directions to enhance adolescent growth potential.

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Introduction

Adolescence, the second decade of life, is also the second window of opportunity to influence developmental trajectories, promoting health, well-being, full potential development, and positive contribution to society (UNICEF, 2018 ). For this reason, adolescence is a pivotal phase of the life course that requires not only the basic conditions to survive but the best opportunities to thrive (e.g., Alfvén et al., 2019 ; Patton et al., 2016 ; UNICEF, 2018 ; WHO, 2019 ). These opportunities are intrinsically connected to education as a human right, which encompasses the mission of each person’s personality and full potential development (United Nations, 1989 , Art. 29), with particular attention to school as a privileged developmental setting (United Nations, 2001 ).

To better understand that mission, Erikson’s psychosocial development approach was convened as a key theory of human development that still challenges researchers, practitioners, and educators. Firstly, its understanding of development as a lifelong continuum of opportunities for growth, reconstruction, and positive change (Newman & Newman, 2015 ; Sprinthall & Collins, 2011 ) challenges research to go beyond sickness and to strive for a new and dynamic meaning for being alive and vital personality (Erikson, 1968/ 1994b , p. 91). This suggestion seems to anticipate positive psychology’s focus on the qualities, strengths, and virtues that enhance thriving (Newman & Newman, 2015 ; Seligman & Csikszentmihalyi, 2000 ). Secondly, psychosocial development has its cornerstone on the dynamic and complementary interplay between biological, psychological, and social dimensions (Erikson, 1968/ 1994b ; Erikson & Erikson, 1998 ). Therefore, its study implies overcoming disciplinary reifying restrictions or isolated dimensions (Newman & Newman, 2015 ). Thirdly, the theory presents a roadmap for development, with eight stages built around main developmental tasks and challenges from birth to old age. More than a rigid timetable as some authors present it (e.g., Lerner, 2002 ), Erikson’s framework should be read from a non-deterministic and interactionist perspective (Caldeira & Veiga, 2013 ; Sprinthall & Collins, 2011 ). This perspective assumes that the emphasis of psychosocial development’s stages should be set on the relation between the person and the social world, which accounts for development and the differences between persons and cultures (Koepke & Denissen, 2012 ; Newman & Newman, 2015 ). Similar attention toward bidirectional relation person context, and resulting developmental plasticity, is suggested in positive youth development approaches (Burkhard et al., 2020 ; Lerner et al., 2005 ; Silbereisen & Lerner, 2007 ).

For the above reasons, the psychosocial approach, grounded on Erikson’s care for human growth and fulfillment (Erikson, 1968/ 1994b ), is an influential, enduring, positive, and comprehensive framework, which continues to inspire abundant research and intervention (Dunkel & Harbke, 2017 ; Marcia, 2015 ; Zhang, 2015 ). Nevertheless, 70 years have passed since the publication of Childhood and Society (Erikson, 1950/ 1993 ), and children and adolescents’ process of growing has been undergoing fast-paced change (Dahl et al., 2018 ; Patton et al., 2016 ). This reality calls for a better understanding of how research on Erikson’s psychosocial development currently addresses these changes and their effects on adolescent development, thus contributing to enhance their optimum development and thriving. This call for understanding led the authors to conduct a prior and exploratory search of existing literature reviews published in the last decade, focusing on adolescents’ broad psychosocial development, using Google, Scopus, and Web of Science (Dec. 2020). The search rendered 362 literature reviews after removing duplicates. Four critical ideas of this exploratory search not only justified the need for a new and more comprehensive study, but also guided its options and design.

The first idea was the small number of psychosocial development reviews grounded on Erikson’s theory, focusing on adolescence and school setting, peer-reviewed, and published in the last decade. Only eight literature reviews fulfilled all the selection criteria (Chávez, 2016 ; Dunkel & Harbke, 2017 ; Knight et al., 2014 ; Koepke & Denissen, 2012 ; Meeus, 2011 , 2016 ; Ragelienė, 2016 ; Tsang et al., 2012 ). The most recent of these eight literature reviews was from 2017, and six were from Europe or North America. These findings heightened the question regarding the presence of Erikson’s theory in recent research on adolescent development. They also raised the question regarding research’s social and cultural comprehensiveness (Chávez, 2016 ), especially in a time of increased connection beyond geographical borders (Dunkel & Harbke, 2017 ).

The second idea of the exploratory search was the focus on identity, which was the main subject of five of the eight reviews. This emphasis on identity is not surprising. Erikson defended that personal identity, the “style of one’s individuality” (Erikson, 1968/ 1994b , p. 50), was the core striving of adolescent development (Rosenthal et al., 1981 ; Zacarés & Iborra, 2015 ). However, in the small set of five literature reviews on personal identity, different theoretical and empirical approaches were found, highlighting three main approaches. The first is identity resolution, centered on Erikson’s crisis between identity synthesis and identity confusion (Claes et al., 2014 ; Hatano et al., 2018 ). The second is identity exploration and commitment (Waterman, 2015 ), based on James Marcia’s identity status paradigm and complemented, in the last decades, with newer models aiming to deepen the processes and domains of identity development (Hatano et al., 2018 ; Waterman, 2015 ). Looking at these new and extended models, Waterman ( 2015 ) highlights two: the five dimension models of identity formation, including exploration in breadth, in-depth exploration, ruminative exploration, commitment making, and identification with commitment (Bogaerts et al., 2019 ), and the three dimension models of identity formation, including commitment, in-depth exploration, and reconsideration of commitment (Crocetti et al., 2011 ; Meeus, 2011 ). An appealing feature of this last model, also known as Meeus-Crocetti model, is the study of identity development across different identity domains (Crocetti, 2017 ; Crocetti et al., 2011 ), including the educational and interpersonal domains, particularly important in adolescence (Hatano et al., 2020 ). Finally, the third approach is known as identity styles, and it is anchored on Berzonsky’s identification of adolescents’ social-cognitive strategies to manage self-relevant information (Crocetti et al., 2014 ). Finally, in what concerns other identity types, one literature review calls attention to the growth of studies focusing on ethnic identity and its association with academic achievement (Meeus, 2011 ).

The third idea was the wide range of different methodological approaches (Erikson, 1968/ 1994b ; Ragelienė, 2016 ). Erikson’s research, mostly grounded on his clinical experience and logic, soon demanded empirical validation (Rosenthal et al., 1981 ; Santrock, 2011 ), which engaged many researchers using qualitative and quantitative approaches (Newman & Newman, 2015 ). Regarding quantitative studies, one review pointed to the need for more longitudinal approaches on psychosocial development (Chávez, 2016 ), while one meta-analysis showed that longitudinal studies have increased in the first decade of the twenty first century (Meeus, 2011 ). On the subject of measures of psychosocial development, studies conveyed evidence of researchers’ efforts to assess identity (Meeus, 2011 , 2016 ) and include different psychosocial stages (Dunkel & Harbke, 2017 ). Other authors reinforce the significance of this strive for instruments with good psychometric properties for adolescent samples that aim to assess psychosocial development and not only its isolated stages (Markstrom et al., 1997 ; Newman & Newman, 2015 ; Rosenthal et al., 1981 ).

The fourth idea was the broad and scattered set of topics and variables. Reviews encompass evidence of psychosocial development and identity’s critical role in adolescent’s health and well-being (Meeus, 2011 , 2016 ; Tsang et al., 2012 ); the relationship with personality features and psychological strengths (Chávez, 2016 ; Ragelienė, 2016 ; Tsang et al., 2012 ); and the role of parents (Chávez, 2016 ; Koepke & Denissen, 2012 ; Meeus, 2016 ; Tsang et al., 2012 ), peers (Meeus, 2016 ; Ragelienė, 2016 ), intergenerational voluntary interaction (Knight et al., 2014 ), and school safety (Tsang et al., 2012 ). One meta-analysis presented evidence to defend a general factor of psychosocial development (Dunkel & Harbke, 2017 ), and different suggestions were found regarding identity understanding and promotion (Tsang et al., 2012 ). Finally, some authors defended that the importance of Erikson’s theory for adolescents’ development is related to present-day challenges, namely, technological advances and Internet possibilities (Dunkel & Harbke, 2017 ; Tsang et al., 2012 ).

Current Study

The exploratory analysis of existing literature reviews on Erikson’s theory has confirmed a systematization shortcoming. It also confirmed the need for a present-day understanding of the extent and nature of the research on Erikson’s psychosocial development in adolescence. Aiming to fill in the gap, a rigorous and comprehensive scoping review was conducted. The scoping review is a recent methodology for literature review with an increasing presence in health and education research (O’Flaherty & Phillips, 2015 ; Pham et al., 2014 ). Oriented by a research problem, the scoping review thoroughly searches, selects, and synthesizes knowledge with the purpose of mapping “key concepts, types of evidence, and gaps in research related to a defined area or field” (Colquhoun et al., 2014 , pp. 1292–1294). It differs from a systematic review by presenting a research problem that aims for a wider breadth of coverage, but not for exhaustiveness, nor the quality assessment of the studies (Arksey & O’Malley, 2005 ; Levac et al., 2010 ; Tricco et al., 2018 ).

The present study aims to review and summarize the piecemeal research on Erikson’s psychosocial development, with the following research problem: what are the main features of the research on Erikson’s psychosocial development in adolescence produced over the last decade (2011–2020)? Five overarching study questions were derived from the research problem: (Q1) What is the extent of the research? (Q2) What conceptual definitions are used? (Q3) What designs and measures are used? (Q4) What are the main topics and variables studied? (Q5) What implications for research and intervention can be suggested?

This scoping review was conducted following Arksey and O’Malley’s ( 2005 ; Levac et al., 2010 ) five-stage framework and PRISMA-ScR standards checklist (Tricco et al., 2018 ). In addition, a scoping review protocol was developed and is available as supplementary material (Appendix 1 ) in the online version of the article. Other relevant references in the structuring of this review were a study about the use of scoping review methodology in research (Pham et al., 2014 ) and a scoping review about educational strategies in higher education (O’Flaherty & Phillips, 2015 ).

Identifying Relevant Studies

The information sources for this review included eight bibliographic databases: (1) Academic Search Complete, (2) Education Source, (3) Eric—Educational Resources Information Center, (4) PsycARTICLES, (5) PsycINFO, (6) Scielo, (7) Scopus, and (8) Web of Science (WoS). The search started in January 2021, and the last search was done on the 22nd of February 2021. The search strategy was based on a previous and exploratory search of existing literature reviews (December) and the discussion between researchers (January). Aiming to answer to the research problem balancing comprehensiveness and feasibility (Levac et al., 2010 ), the search focus was on the term “Erikson” and not on “psychosocial development.” To assess the adequacy of the search strategy, we selected a small set of authors and articles considered unavoidable to identify amid the results. An example of the final search string is presented in Table 1 .

Study Selection

The selection was an iterative process (Arksey & O’Malley, 2005 ; Levac et al., 2010 ) that engaged researchers in a permanent discussion and decision-making. Table 2 presents the eligibility criteria. About adolescence definition, the study followed WHO and UNICEF’s recommendation to consider the life period between 10 and 19 years (e.g., Patton et al., 2016 ; Sawyer et al., 2018 ; UNICEF, 2018 ; WHO, 2019 ).

The sources of evidence were selected using Microsoft Office Excel in three phases: (i) organization - the records were imported to a table, organized by authors, and duplicates were removed; (ii) screening - the titles, keywords, and abstracts were analyzed, allowing the exclusion of the records not complying with the eligibility criteria; and (iii) eligibility - a deeper analysis of each study was conducted to decide on its selection according to the eligibility criteria.

Charting the Data

Like the eligibility process, data charting was an iterative process of understanding the categories that will define the information to be sought, extracted, and charted (Arksey & O’Malley, 2005 ; Levac et al., 2010 ). This process was done for each study question, implying the permanent engagement and discussion between researchers. For the first three study questions, researchers previously defined the categories and refined them along the review process. For the fourth and fifth study questions, researchers built the categories upon the information extracted from each study, aiming to identify a set of common clusters to organize and present the results meaningfully. More than full coverage of all the topics of the studies, this process aimed to underpin their main features for each study question. The categories were defined using concepts from APA thesaurus (APA, 2021 ) or APA dictionary (APA, 2020 ), thus allowing more meaningful conceptual clusters. Data extraction was done using a characterization tool, filled in excel. The tool is presented as supplementary material (Appendix 2 ) in the online version of the article.

Collating, Summarizing, and Reporting Results

This phase of the work is visible in the presentation of results and their discussion. The Results section begins with a clear indication of the studies/ sources of evidence selection process, using the flow diagram suggested by PRISMA (Tricco et al., 2018 ) and a brief list of each study included. Because of the large number of studies involved, two options were taken. The first was to use O’Flaherty and Phillips’s ( 2015 ) suggestion to number each study and to use this number to mention or quote the study in the text. The second option was to use Pham’s et al. (2014) suggestion of presenting more detailed information of each study as supplementary information (Appendix 3 ), available in the online version of the article.

The presentation of the results also includes a summary table with a synthesis of the main results for each study question, followed by a narrative synthesis using the same order (Levac et al., 2010 ). The Discussion section follows, using the study question order and ending with the study’s main implications and limitations. A final section of Conclusion is presented.

The initial search on the eight databases rendered 930 studies. After duplicates removal, screening, and eligibility assessment, 58 studies entered the final selection. This process is presented in Fig.  1 using the PRISMA flow diagram (Tricco et al., 2018 ). The studies included in the final selection are shown in Table 3 , organized by authors and with a numerical reference used throughout the text.

PRISMA flowchart of study selection process

Research Extent

Answering the first study question (Q1), the selection points to an increase in the number of studies from 2011–2015 (22 studies) to 2016–2020 (36 studies). Regarding the origin of the studies, 80% of the studies were from western provenance, with a slight difference between North America (25 studies) and Europe (21 studies). In the European studies, a substantive contribution of Belgium and Netherlands was found, related to research teams highly active in identity development study. The other regions account for a small percentage of the selection (3 or 4 studies). South America was represented with only one study from Brazil on the identity of adolescents living in institutional shelters (5). These results are visible in Table 4 , which summarizes the results for all the study questions.

Conceptual Approaches

The focus of 78% of the studies in this research was identity. Nevertheless, because identity summons different conceptual approaches, it is essential to understand which conceptual lenses were used. For this purpose, three main categories were suggested. The first category, named general identity issues , includes studies addressing more general questions regarding identity and accounts for 20% of the references. The second category, called identity formation , includes the studies addressing identity development throughout adolescence and accounts for 46% of the references. Finally, the third category is named specific identities and includes the studies focusing on specific elements valued in personal identity formation and accounts for 12% of the references. Table 5 presents the distribution of the studies in these three categories related to identity.

The general identity issues category includes important broad themes regarding identity. The first theme is identity’s central role in adolescent psychosocial development and well-being in western samples (e.g., 16, 29, 54, 55) and non-western samples, where interesting contextual specificities are presented (1, 13, 29, 36, 47). Another theme is the value of studying identity in the lifespan context, encompassing earlier stages of development, and considering identity development throughout life (9, 15). Other studies acknowledge the role of the context in adolescents’ development, including the relation with peers (39, 50), and the need to consider change and novelty, visible in the study of urban configurations like tagging cliques (7) or the study of online settings (30). Apart from this last reference, whose subject is drama education and the online environment, no other study was found that addressed online settings or social media. Still, in the context of this category, a single study was found focusing on Erikson’s moratoria (11).

In the category identity formation, three different conceptual approaches were found. The most represented approach was identity resolution (22 studies), which focuses on the tension between identity synthesis and identity confusion. Most of the studies in this approach point to the distinction between identity synthesis and identity confusion, whose differences are visible in adolescent development and well-being outcomes. Regarding other approaches, identity exploration and commitment is the primary approach of 12 studies, and identity styles appear in just one study (12). Finally, in the category addressing specific identities, ethnic identity is the guiding approach of seven studies from North America (8, 24, 25, 26, 44, 48, 54), while gender identity and occupational and vocational identity are approached in a single study each (52, 9).

Besides identity, there are four other categories of conceptual approaches. The first is psychosocial development (13% of the studies). In this category, five studies discussed the importance of understanding development as permanent growth. Some of them remind us of Erikson’s epigenetic continuum and the value of the association between stages and each stage-specific tasks and challenges across development (9, 15, 18, 37, 42). Despite this, only one literature review on occupational and vocational identity (9) approached adolescent’s identity integrating pre-adolescent stages. In the same category, another important conceptual focus was the biological dimension of development (33, 46, 53) and the social dimension, including family, school, and peers (14, 32). The last three categories of conceptual approaches included the study of other stages in adolescence, like intimacy or generativity (34, 35, 49, 58), the study of Erikson’s ego strengths (6, 24), and a single study focusing on the gifted students (51).

Designs and Measures

Erikson’s psychosocial development research presents a high number of studies with quantitative designs (72%), with a slight difference between longitudinal (40%) and cross-sectional studies (33%). Qualitative studies (10%) and literature reviews (10%) were also found in a smaller number, followed by studies using mixed methods (4%) and by two studies using quasi-experimental designs (4%).

Regarding measures, twenty different instruments were found. The Erikson Psychosocial Stage Inventory (EPSI) (Rosenthal et al., 1981 ) must be highlighted as the instrument used in more studies (43%). However, caution is required regarding this result because, with one exception (58), only the identity subscale of the instrument was used. A second important finding was the number of scales used exclusively in one study (28.57%). The measures used in two or more studies were different versions of the Utrecht-Management of Identity Commitments Scale (U-MICS) (2, 3, 29, 45); the Extended Objective Measure of Ego Identity Status (EOM-EIS) (5, 33, 36); the Identity Style Inventory (ISI) (12, 34); the Psychosocial Inventory of Ego Strengths (PIES) (24, 36); and the Loyola Generativity Scale (LGS) (34, 35, 49) present in three of the studies.

Main Topics and Variables

From the review of all the studies, a set of categories was created to present the main topics and variables. These topics were distributed in three complementary dimensions of psychosocial development: biological, psychological, and social (Erikson, 1968/ 1994b ; Erikson & Erikson, 1998 ). Table 6 presents the three dimensions, the main topics, the variables found, and the number of studies addressing them. Because the same study may examine more than one variable, some studies appear in the table more than once.

The biological dimension is the dimension with fewer studies. Nevertheless, these studies illustrate the importance of the physical component in identity development (33, 46, 53). The psychological dimension , which addresses the person’s mental functions, attributes, or states (APA, 2021 ), includes two topics. The first is adolescent characteristics , which groups the studies on adolescents’ features, traits, or qualities (APA, 2021 ). Besides attachment (35), results highlight the relation between identity and personality traits, including the “big five” (31), reactivity and regulation (21), sociotropy and autonomy (19), differentiation of self (50), and self-concept (55). Other results express the relations between identity and a set of psychological factors or strengths related to adolescents’ personality, health, or well-being (APA, 2020 ), such as fidelity (6), life goals (17), purpose in life (31), trust (20, 32), resilience and cognitive autonomy (36), optimism and self-esteem (44), and empathy (50). A single study was found focusing on the need to attend to the specific needs of gifted adolescent development (51).

The second topic in the psychological dimension was adolescent health , addressing the adolescent state of complete well-being (WHO, 1948 ) and all related behaviors, services, activities, and other factors that promote well-being (APA, 2021 ). This topic is undoubtedly the one that concentrates more studies, which speaks loudly of the importance of identity formation (identity synthesis, identity confusion, identity status, or identity maturity) as pivotal in adolescent health, development, and well-being. This topic includes a set of studies with the subject of well-being, including subjective well-being (29), psychological well-being (25), and the relation between identity resolution and identity exploration (4). It also includes a set of studies focused on risk factors that may affect identity formation, including the state of “lostness” (32), confusion (44), gender identity issues (52), or self-definition problems (55). Another set of studies brought forward identity as a protective factor regarding nonsuicidal self-injury (10, 19, 20, 21, 22, 23, 27, 38), substance use (26, 48), and eating disorders (56), and also, psychological and mental adjustment, namely, anxiety (2, 28) and depression symptoms (10, 28, 43). Another interesting result was the study of identity in the framework of positive youth development (PYD) (6, 16, 17).

Social dimension variables were organized according to different settings of the adolescent ecosystem, thus including community, family, peers, and school. In general, the set of studies in the social dimension draws attention to the importance of the context in adolescent development and how context-specific challenges, expectations, possibilities, and constraints may promote or hinder identity. Looking at the community topic, some studies tackle the question of cultural change, approaching issues affecting many immigrant adolescents or adolescents with immigrant families (24, 25, 26, 48), and adolescents in cultures whose values are in accelerated change (e.g., 1, 47). Still looking at the community topic, studies also point to specific opportunities like extracurricular activities (14) and support for occupational identity (9), or to their absence, of which a study (11) discussing how youth prospects may transform Erikson’s moratoria into a kind of waithood, is a good example. Other studies focus on the relation between development–identity and prosocial behavior, understood as contribution to the community (6, 49). Another study shows how religion is related to a more mature and adaptive identity style (12). Looking at the family topic, a first result is that almost all the studies focused on parents–adolescent relations, highlighting parenting practices (49) and the relation adolescent–mother (20, 23). Three studies focus on challenging family situations and their impact on adolescent development, like growing up in shelters (5), exposure to violence (40), and emotional abuse (27). Looking at peers topic, one study focuses on the relation between identity and group belonging (50), and several studies value the association between identity formation and positive relationships with peers (20, 23, 28, 34, 39, 50) including dating goals (58). Two studies focused on issues related to the formation of negative identities, including the urban cliques (7) and delinquency (45). One study brought up the romantic involvement subject and the impact of early romantic relationships on adolescents’ development (18). Looking at the school topic, the first finding is that none of the studies specifically addresses school. Some studies refer to the educational domain of identity development (2, 3, 29); others present results regarding the relation between development–identity and school adjustment (8, 9), including student connectedness (32), student engagement, and student achievement (54). Apart from one study analyzing immigrant adolescents’ lack of interest in social studies class (8), which included some concrete pedagogical features, and another study examining after-school activities (14), no other study specifically addresses school as a psychosocial developmental setting. In addition to this dim investment in studying the relationship between development and the school setting, there is a blatant absence in this selection of studies regarding technology, online settings, and social media in adolescence.

In the intervention topic , only four studies were found. One intervention focused on drama learning online (30). Another intervention, aiming to promote ethnic-racial identity, presented promising results regarding psychosocial functioning, including school adjustment (54). The most striking result on intervention oriented to enhance identity is the concept of cascade effects, that is, the evidence that the promotion of psychosocial resources like identity has positive effects in other personal and social adolescent resources, which affect others’ resources, and so on (16, 17, 54). In the methodology topic , our attention was drawn to the possibility and interest of combining identity statuses and identity narrative approaches in the study of identity (3, 42), as well as to the concern with identity measurement psychometry (13, 37, 57) and conceptual definition (41). Finally, in this topic, one literature review analyzed the data from Erikson’s psychosocial development measures, confirming not only the strong association between stages but a “general factor” of psychosocial development (15).

Research and Intervention Suggestions

About research , some common limitations were found regarding sample issues such as size or composition (19 studies), instruments or measures issues (10 studies), and the value of longitudinal research to study development (10 studies). Beyond these general limitations, Table 7 presents more specific suggestions regarding psychosocial development research. Some of these suggestions are more related to methodological issues, including the advantage of complementing self-report assessment with more objective information (4, 10, 20, 27, 38, 54, 56) or combining identity status with identity narrative (42). Other suggestions include the widening of the geographical and cultural scope of research (4, 56, 29) or the deepening of the relation between development and different developmental settings (2, 4), with particular regard to contexts marked by change, technology innovations, social media, and online communication (30). Finally, some suggestions valued the need for a more integrated understanding of identity in lifespan development, that is, considering identity along with other psychosocial stages of infancy and adult life (9, 34, 35, 49).

Because the subject of most of the studies was identity, the results regarding intervention also focus primarily on identity. Table 6 presents five different ideas conveyed by the different studies. The first idea highlights the importance of personal identity for adolescent development and well-being. In this sense, not only the role played by identity synthesis and confusion is amplified (e.g., 43), but also exploration processes (45) and different identity styles (12) are valued, with benefits for adolescents and also for society well-being (6, 46, 48). The second idea considers identity’s preventive power (10, 38, 20, 21, 22, 46, 56) and its value in promoting self-discovery and coping with contexts and life challenges (5, 17, 47). The third idea is the need for opportunities for active identity development through self-construction and self-discovery (43), including the importance of investing in contexts like school community (33), school and educators’ cultural responsiveness (8), extracurricular opportunities (14), and online contexts (30), among others. A fourth idea arises from studies with adolescents from minority groups that defend the importance of identifying with their own cultural or social group background (24, 25, 44, 54) and, concurrently, with the larger society (25). Finally, the fifth suggestion appears from the evidence that personal identity development fosters other personal and social resources in a cascade effect (16, 33, 34, 54).

Our research problem aimed to identify the main features of research on Erikson’s psychosocial development in adolescence over the last decade. This section discusses results for each study question (Q1 to Q5), ending with the main implications and limitations of the study.

Erikson’s Inspired Research Growth

Starting with the extent of the research (Q1), the studies show a growing trend throughout the decade. These results stress the actuality of Erikson’s way of looking at things (Erikson, 1950/ 1993 , p. 403), acknowledged in some studies included in the review (e.g., 31, 42, 6 15, 32) but also in the work of other authors (Marcia, 2015 ; Newman & Newman, 2015 ; Zhang, 2015 ). About the western affiliation of most of the studies, although in part due to the methodological search and selection options, it is consistent with the predominance of North America and Western Europe in psychological research (García-Martínez et al., 2012 ; O'Gorman et al., 2012 ) and in identity research (Schwartz et al., 2012 ). This reality is a challenge to give voice to researchers from other geographies, fostering a deeper understanding of human psychology (Arnett, 2008 ) and psychosocial development (Chávez, 2016 ; Hatano et al., 2020 ), moreover at the present time of heightened international contact (Dunkel & Harbke, 2017 ).

Identity in the Center of Research

About the conceptual approaches (Q2), most of the studies focused on identity. This finding is coherent with the centrality of identity in adolescent psychosocial development, not only the basis for feeling alive in the “social jungle of human existence” (Erikson, 1968/ 1994b , p. 130) but also the key to a healthy adult life (Kroger, 2018 ). Among different conceptual approaches, results highlighted three main approaches: identity resolution, identity exploration and commitment, and identity styles. Although studies focused differently on these three approaches, one study shows the relation between identity resolution and identity exploration and commitment (4). This study indicates that adolescents achieving a certain level of identity synthesis engage in more proactive identity exploration. Returning to different identity approaches; most of the studies opted for the identity resolution approach, the one closest to Erikson’s identity crisis definition, which includes identity synthesis (or coherence in some studies) and identity confusion. In this approach, many studies defend that identity synthesis and identity confusion are two distinct realities, with specific outcomes in adolescent development and well-being (e.g., 10, 32, 43, 44). These results align with Erikson’s claim that identity synthesis and identity confusion contribute differently to a personal sense of identity (Erikson, 1968/ 1994b ). Other authors explain this claim by showing that identity synthesis enhances adolescent positive and meaningful action, while in contrast, identity confusion enhances the perception of the inability to stick to one’s view of oneself, to integrate the different roles, or to make good decisions (Newman & Newman, 2015 ). The fewer number of studies using other identity approaches besides identity resolution deserves a note. This result may be explained by the search strategy option that used “Erikson” as the key search term, thus hindering the selection of studies where “Erikson” is referred to only in the main text body. Maybe, for this reason, our selection did not fully grasp the research vitality of approaches such as identity exploration and commitment (e.g., Meeus, 2011 ) or identity styles (e.g., Crocetti et al., 2014 ).

Two other findings considering conceptual approaches are noteworthy. The first raises the question of the criticism toward psychosocial theory because of its cultural limitations (Newman & Newman, 2015 ). In this review, non-western studies in South Africa (1), Brazil (5), Japan (29), Taiwan (36), and Nigeria (47) validate the cross-cultural importance of personal identity in psychosocial development, stressing contextual and cultural specificities. These results align with Schwartz et al. ( 2012 ) review of different studies that validate the cross-cultural importance of identity while suggesting differences between western and non-western countries. The second finding is about the specific identities that are integrated into personal identity. Among the selected studies, ethnic identity appears as an essential subject, calling attention to the role of ethnic heritage and cultural values in identity (Meeus, 2011 ; Newman & Newman, 2015 ; Rivas-Drake et al., 2014 ; Zacarés & Iborra, 2015 ) and the needs and challenges of adolescents from immigrants or minority groups concerning identity development (Rivas-Drake et al., 2014 ; Schwartz et al., 2012 ). In addition, ethnic identity, as sexual identity and occupational identity, is strongly present in Erikson’s identity theory (1968/ 1994b ). However, in this review, besides the ethnic identity expressivity, mainly in North American studies, only one study was found for gender identity (52) and another for occupational and vocational identity (9).

Another significant theme in the conceptual approach question is psychosocial development as a continuum throughout the lifespan, where the identity crisis should not be understood as an isolated stage (9, 15, 37, 46). For Erikson (1968/ 1994b ), the advantage of a human development theory is the possibility to understand and study the “wherefrom” and “whereto” of development as permanent growth (p. 24). The idea of identity formation as an isolated happening prompted Erikson’s impatience with “the faddish equation, (…) of the term identity with the question ‘Who am I?’” (1968/ 1994b , p. 314). We can find the expression of who one is, who one wishes to be, and what one wishes to do with life (Schwartz et al., 2012 ) in the concept of wholeness . For Erikson (1968/ 1994b ), wholeness expresses an inner sense of identity that entails and realigns (a) the former identifications of childhood with a new way of envisaging the future and (b) the perception of oneself with the perception of other’s assessments and expectations (pp. 86–87). This dynamic interplay between previous development and future envisagement and between oneself and significant others explains each person’s lifelong permanent revision and growth. It also explains why pre-adolescent stages matter for identity and why identity matters to all other stages, including adult life (Kroger, 2018 ).

The interconnection between stages is well explained in Erikson’s epigenetic principle (1950/ 1993 , 1968/ 1994b , 1959/ 1994a ), which assumes (a) all parts of the development should be considered in relation to all others and (b) all of them exist in some form before its decisive and critical time of ascendance. Illustrating the idea, several studies in the selection focused on intimacy (34, 58) and generativity (34, 35, 49) in adolescence). Another study from the sample (15), aiming to review Erikson’s psychosocial development assessment, analyzed 62 correlation matrices of 50 different samples. Evidence supported the strong association between stages, as well as the existence of a psychosocial development general factor, as if all stages were built on one another to form a “functional whole” (Dunkel & Harbke, 2017 , p. 59). What implications should these findings have for psychosocial development and identity research? Among the studies included in this research, although some studies raised the question (e.g., 42), only one literature review on occupational and vocational identity suggested an analysis of identity that included pre-adolescent stages (9).

Methodological Challenges

Results about the designs and measures of the studies in this selection (Q3) showed a predominance of quantitative studies divided between longitudinal and cross-sectional designs. The option for longitudinal studies is highly valued in the study of development (e.g., 4), allowing a deeper understanding of changes and how identity “emerge and become consolidated over time” (Newman & Newman, 2015 , 81). Regarding the measurement of Erikson’s psychosocial development, a high number of studies used the Erikson Psychosocial Stage Inventory (Rosenthal et al., 1981 ), an instrument built to assess the six first stages of psychosocial development from trust to intimacy. However, the studies only included the identity subscale, comprising six items that assess identity synthesis (positive items) and six items that assess identity confusion (negative items). Other scattered instruments were found, most of them used only in one or two studies. This reality may express some dispersion concerning methodological and assessment issues. Amid the results regarding methodological issues, three challenges seem to be noteworthy. The first appears as a plea for complementarity between quantitative and qualitative methods in psychosocial development and identity study, in which the narrative approach has a special place (Bazuin-Yoder, 2011 ; McLean & Pasupathi, 2012 ). The second is the challenge to overcome the fragilities of self-assessment questionnaires (Waterman, 2015 ) and the importance of measures oriented to integrate the different stages in lifespan development (Dunkel & Harbke, 2017 ; Rosenthal et al., 1981 ). The third challenge refers to the need for measures with good psychometric qualities (Newman & Newman, 2015 ).

Psychosocial Development and Supporting Settings

About topics and variables (Q4), the results present a diverse and rich set of subjects covering many aspects of psychosocial development. From the analysis of the results, we identified four main issues for the discussion: (i) prominence of identity in adolescent development and well-being; (ii) social environment opportunities and limitations; (iii) psychosocial developmental settings; and (iv) psychosocial development and positive youth development (PYD).

The prominence and strength of identity in adolescent development and well-being are the most meaningful result of this research when considering the number of studies. This finding is in line with Erikson’s (1968/ 1994b ) intuition of identity not as “high privilege” or “lofty ideals” but as a “psychological necessity” (p. 132). Other authors also underline the importance of identity for adolescent and future adult development and well-being (e.g., Kroger, 2018 ; Meeus, 2011 , 2016 ; Newman & Newman, 2015 ; Ragelienė, 2016 ; Tsang et al., 2012 ; Zacarés & Iborra, 2015 ). Results express eloquently the association between identity and subjective and psychological well-being, anxiety, depressive symptoms, delinquency, nonsuicidal self-injury, eating disorders, substance use, delinquency, and school adjustment. The importance of identity encompasses personal well-being, but because identity promotes adolescent prosocial behavior and contribution (6, 49), it also encompasses community and social well-being, which is consistent with other studies (e.g., Crocetti et al., 2014 ).

The second issue considers the social environment and its opportunities and limitations. Because development does not happen in a vacuum (2, 4), social environment or ethos (Erikson & Erikson, 1998 ), with its social, economic, and historical factors (Erikson, 1959/ 1994a ), is a keystone of psychosocial development that influence “pattern, pace, and direction” of development (Newman & Newman, 2015 , p. 8), which other authors support (e.g., Chávez, 2016 ; Koepke & Denissen, 2012 ; Zacarés & Iborra, 2015 ). Psychosocial development entails the encounter between adolescents’ “increasing capacities” and their culture’s “opportunities and limitations” (Erikson, 1968/ 1994b , p. 93). Several studies focused on social realities that hinder identity or promote identity confusion or negative identity. Besides contextual distress such as exposure to violence, emotional abuse, and institutional shelters, an expressive theme is the visibility of cultural change and its challenges, affecting many minority groups or immigrant adolescents and adolescents in cultures facing accelerated change. In this context, different studies highlight the role of ethnic identity. Along with the importance of occupational, sexual, and ideological dimensions of identity (Caldeira & Veiga, 2013 ), Erikson stressed the importance of ethnic identity (1959/ 1994a , 1968/ 1994b ). In the present research, results from the studies focusing on ethnic identity showed that identification with the ethnic culture of origin, over bicultural or fluid identifications, is positively related with identity development (1, 24, 25, 26, 47, 48) and negatively associated with a “state of lostness” (32). These results may be better explained by Erikson’s (1968/ 1994b ) understanding of identity as a pressing psychological need that cannot be accomplished by a weak or impoverished sense of being “not-quite-somebody” (p. 176). In the same direction, one of the studies analyzed one intervention to enhance adolescents’ ethnic-racial identity (54) and presented evidence that ethnic-racial identity is related to adolescents’ identity synthesis, higher self-esteem, lower depressive symptoms, and better grades. These results are consistent with other studies on immigrant identity formation that favor the integration of cultural heritage and mainstream culture versus assimilation, separation, or marginalization (Bazuin-Yoder, 2011 ). These results also complement the extant research by heightening the role of a positive and valued ethnic identity (e.g., Meeus, 2011 ; Rivas-Drake et al., 2014 ).

One common feature of the studies in our sample focusing on ethnic identity is their North American origin. Does it mean that ethnic identity lessons are exclusive for North American youth? The “intriguing picture” of ethnic differences on identity formation must convey differences between ethnic groups, identity domains, and countries (Crocetti et al., 2011 ). Nevertheless, lessons considering ethnic identity, especially the lesson of empowering adolescents to discover, connect and identify with their origin heritage and culture, versus tepid biculturalism or forced integration, may be progressively more meaningful in our increasingly diverse societies (Schwartz et al., 2012 ).

The third issue addresses psychosocial developmental settings. Erikson (1968/ 1994b ) points out the role of context in psychosocial development, which demands “concepts and studies to understand the mutual complementation of ego synthesis and social organization” (Erikson, 1968/ 1994b , p. 53). This need is more striking when settings, culture, and social relations face so many changes and even more pressing when we address online communication and social media with its promises and threats (Kay, 2018 ). However, only one study in this research selection addressed online environments (30). The absence of this subject, although unexpected considering prior literature (Dunkel & Harbke, 2017 ; Tsang et al., 2012 ) and the growing concern regarding the role of social media in adolescent well-being (Shankleman et al., 2021 ), is consistent with other reviews that call attention to the fragility of theoretical frameworks and the scarcity of studies about the relation between identity, social media, and online contexts (Valkenburg & Peter, 2011 ; Wängqvist & Frisén, 2016 ). In the balance between promising prospects of online settings for adolescent’s identity, relations, and development (Shapiro & Margolin, 2014 ; Wängqvist & Frisén, 2016 ), and specific challenges regarding the time spent, activity, and addiction (Keles et al., 2020 ; Shankleman et al., 2021 ), Erikson’s way of looking at things could propel innovative insights for research and intervention (Kay, 2018 ; Tsang et al., 2012 ).

Although covering research on Erikson’s psychosocial development on adolescence in the last decade, the selected studies narrowly account for the role of developmental relations or settings in adolescents’ development, including community, family, peers, or schools. The results express a clear need for research in all these types of relations or settings, a finding which is confirmed in other literature reviews (e.g., Koepke & Denissen, 2012 ; Ragelienė, 2016 ). The paramount importance of social environments in children and adolescents’ health and development (Koepke & Denissen, 2012 ), particularly in school settings, is well documented (McLaughlin & Clarke, 2010 ; Twum-Antwi et al., 2020 ). For this reason, the sparse presence of the school in the cluster of studies included in this research was unexpected. Educational issues are brought up in nine studies. Still, while most studies emphasized the positive association between development–identity and broad school adjustment outcomes, like achievement or connectedness, only one study focuses on the school setting and pedagogical features (8). The school’s potential to provide rich bases for a positive and firm sense of inner identity is suggested in some studies (e.g., 32) and in many literature reviews (Cross & Cross, 2017 ; McLaughlin & Clarke, 2010 ; Symonds & Galton, 2014 ; Twum-Antwi et al., 2020 ; Wang et al., 2020 ), both for the lasting benefits of academic learning and foundational social experiences, but also for the possibility of intentionally boosting school support, relations, experiences, and opportunities (McLaughlin & Clarke, 2010 ; Sprinthall & Collins, 2011 ; Carvalho, 2019 ). Moreover, the main goal of the right to education and, therefore, the school’s primary mission is students’ personality development (Dahl et al., 2018 ; Patton et al., 2016 ; UNESCO, 2019 ; UNICEF, 2018 ). This mission requires new concepts and approaches, especially today, when the student population is increasingly diverse regarding backgrounds, socioeconomic status, gender, ethnicity, and abilities, including gifted or high abilities adolescent students (Cross & Cross, 2017 ). Although Erikson’s framework is commonly suggested as a guide to support the psychosocial development of gifted adolescent students (Cross, 2001 ; Cross & Cross, 2017 ), only one article was found in this selection focusing on this subject (51). The article compared the positive identity of “intellectually gifted” and “sport talented” adolescents, with better results to the former.

The fourth and last issue focuses on the relation, featured in some studies, between Erikson’s psychosocial development and the framework of positive youth development or PYD. This relation is present in a study about the relation between Erikson’s concept of fidelity and adolescent contribution to the community (6). Another two studies highlight the association between PYD-based intervention and psychosocial development, including identity (16, 17). Consistent with results presented in other studies not included in the selection (e.g., Crocetti et al., 2014 ; Carvalho & Veiga, 2020 ), this association may offer promising avenues for research and intervention (Tsang et al., 2012 ).

Studying and Promoting Identity

Moving to the last study question (Q5), three challenges can be stressed regarding research . The first is to broaden the cultural scope beyond Europe and North America to understand better personal identity (Newman & Newman, 2015 ; Schwartz et al., 2012 ; Zacarés & Iborra, 2015 ). The second is a more significant investment in the study of privileged developmental settings, including online settings for their novelty (Shapiro & Margolin, 2014 ; Tsang et al., 2012 ; Valkenburg & Peter, 2011 ) and school settings for their importance (McLaughlin & Clarke, 2010 ; Symonds & Galton, 2014 ; Twum-Antwi et al., 2020 ; Wang et al., 2020 ). The third challenge is to integrate identity in psychosocial development across the lifespan (Chávez, 2016 ; Dunkel & Harbke, 2017 ).

Regarding intervention , identity formation is highlighted in adolescent development, health, and well-being, appearing as an essential and promising focus of intervention (e.g., 44), which is supported by other authors (Knight et al., 2014 ; Tsang et al., 2012 ). Some studies emphasize this idea through the concept of a cascade effect, supporting that the intervention to enhance psychosocial development (e.g., trust and identity) initiates a dynamic of personal and social resources enrichment (16, 32, 54). Selected studies reinforced this idea when presenting evidence of the relation between identity and psychological strengths such as fidelity, life goals, purpose in life, trust, resilience, cognitive autonomy, optimism, self-esteem, and empathy.

Implications and Limitations

The present research was based on a rigorously planned selection of studies that allowed a comprehensive overview of the existing research on Erikson’s psychosocial development in adolescence over the last decade. To our knowledge, this is the only updated and comprehensive mapping of published research explicitly on Erikson’s psychosocial development theory. For this reason, results allow the discussion about what exists, what is needed, what is challenging, and what is worthwhile regarding research and intervention.

Nevertheless, some limitations must be considered. The first is that a scoping review aims for coverage but not for exhaustiveness. Therefore, findings must be considered with caution. This limitation is visible in the range of the studies, excessively centered in western studies and publications. In future studies, increased attention should be given to different databases and journals to include a more diverse representation of studies, namely, from South America. One solution to tackle this limitation is to complement the option for published, peer-reviewed articles with other sources of information known as gray literature (O’Flaherty & Phillips, 2015 ). Another feature that narrowed the results was the focus on Erikson’s approach. Though it may stress the need for researchers to invest in a better presentation of their theoretical filiation, this option left out studies that, although inspired by Erikson’s theory, do not mention it in the title, abstract, or keywords, thus hampering their search in databases. Because Erikson’s inspired research was the focus of this study, other studies are needed to deepen and systematize the piecemeal scientific literature on specific psychosocial concepts like identity and its different approaches, including identity exploration and commitment, and identity styles. Another limitation, due to time and budget constraints, was the decision not to include research focused on young adult development and its challenges, which would promote a richer understanding of identity development in early and middle adolescence. A last general limitation, felt during the research process, was the need to include more researchers, which would have enriched the analysis and reduced the risk of biased options more effectively.

This research aimed to understand and systematize piecemeal research based on Erikson’s theory. When looking at the results, two conclusions appear. The first conclusion highlights that Erikson’s way of looking at things continues to inspire a dynamic and burgeoning research activity. Research shows that not only is Erikson “in fashion” (Zhang, 2015 ), but research on his theory is accelerating (Dunkel & Harbke, 2017 ), providing a rich and diverse set of studies covering many of Erikson’s psychosocial development issues. They also strengthen the importance of Erikson’s psychosocial concepts for adolescents’ present-day development, health, and well-being, emphasizing the pivotal role of adolescent identity formation, the central theme of most studies in this selection.

The second conclusion highlights the conviction that researchers, practitioners, and educators can enhance adolescents’ “high growth potential” (Erikson, 1968/ 1994b , p. 163). The studies in this selection reinforce this possibility, pointing to the importance of developmental settings like family, friends and peers, school, and community in adolescents’ psychosocial development. However, the dispersed and small number of studies addressing these settings facing accelerated change and new challenges exposes the need for more profound and systematic research. Besides this general stance, the dim presence of studies focusing on online and school settings appears as a current research and intervention challenge. A final emerging theme, present in the selected studies and related to enhance adolescents’ high growth potential, is the need to study identity in lifespan development, thus avoiding static notions and keeping (some) fidelity toward Erikson’s view of development as a permanent and dynamic process of human growth.

Materials Availability

All relevant data are included in this article or in its Supplementary Information.

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Acknowledgements

The authors thank Conceição Martins and Filomena Covas for their help in assessing methodological options and text revision and Rita Fonseca and Sandra Torres for their advice regarding English accuracy.

This work was supported by the FCT — Fundação para a Ciência e a Tecnologia, IP, within the scope of the UIDEF — Unidade de Investigação e Desenvolvimento em Educação e Formação, under the reference UID/CED/04107/2020.

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NC and FV worked on the protocol and methodological design of the review. NC carried out the research, analyzed the studies, and presented the initial text for the results and their discussion. FV oversaw the conceptualization, research, and analysis of the studies. Both authors read and approved the final manuscript.

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de Carvalho, N.A., Veiga, F.H. Psychosocial Development Research in Adolescence: a Scoping Review. Trends in Psychol. 30 , 640–669 (2022). https://doi.org/10.1007/s43076-022-00143-0

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This article is written with our Owen convictions as competitive students in the academic jamboree and due to the pro-active and unabated quantum of youngster’s physiological transition and contextual influences during adolescence development. This paper shows the environmental cues and detailed description of topics that have dominated recent research, including the meaning of adolescence, preadolescence, social, the mental and emotional development of the adolescent child, adolescent problem-solving behaviour (skills), parent-adolescent relations, puberty, the development of the self, and peer relations. We then identify and elaborate on what seem to us to be the most important new directions that have come to the fore in the last decade, including research on the strange and significant interests of adolescents (be it recreational, religious or influential interests), their developmental tasks and contextual influences on development, genetic behaviours that passed on through their family lineage, and some intellectual developments, they undergo (together with the time span at which this intelligence level (IQ) of every single adolescent can be developed). We go further to briefly explain the problems that result from some of the physical deviations that occur during the adolescence period (changes) and how we can help to make these deviations suit us or our children properly. We also expound on the need for adolescents to take up leadership positions or roles and the merits and demerits of associating with friends (and also the type of friends to keep). We draw the curtains down with a well knowledgeable summary that briefly outlines everything discussed in the chapters plus some solutions to help curb some of the problems adolescents are challenged with.

Dr Yashpal D Netragaonkar

The study broadly explores the thesis developed by Prof. T.S. Saraswathi that contests the conception of adolescents as a single universal cohort. This study was aimed at exploring adolescence at the micro level by interviewing participants in the age group of 13 to 20 year. The study attempts to understand individuals as situated in their contexts. We found that adolescence is experienced in some way or the other by people of all classes and gender. However, the manifestation and concerns of adolescence may vary.

Journal of Youth and Adolescence

Anne Petersen

Sharlene Swartz

Adolescent Psychology

Evans A G Y E M A N Gyasi

In times past, the main focus of the study of psychology has been seen to be on the unacceptable and negative behavioral characteristics of humans and for that matter, adolescents. However the increase in knowledge about psychological issues in young people and especially the quest to understand their behavior, cognition and learning abilities etc., have birthed an aspect of psychology called Adolescent psychology. This aspect of psychology is aimed at understanding teenagers, helping them to understand themselves and guiding them in their milestone transition from childhood to adulthood. Hence with the study of Adolescent psychology, adolescents can be understood better and helped to navigate through their new world of growth, development and learning.

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8 Research Methodology in Clinical Child and Adolescent Psychology

Jonathan S. Comer, Florida International University

Laura J. Bry Department of Psychology Florida International University Miami, FL, USA

• Published: 07 November 2018
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To continue to move the field of clinical child and adolescent psychology forward, researchers must systematically rely on research strategies that achieve favorable balances between scientific rigor and clinical relevance. This chapter presents an overview of modern methods and considerations that maximize both rigor and relevance in the evaluation of child and adolescent treatments. This research methodology chapter is organized around the four stages of a clinical trial: (a) planning a clinical trial; (b) conducting a clinical trial; (c) analyzing trial outcomes, and (d) reporting results. Sample selection, random assignment, control condition selection, treatment integrity, missing data, clinical significance, treatment mechanisms, and consolidated standards for communicating study findings to the scientific community are addressed. Collectively, the methods and design considerations detail modern research strategies for the continually evolving science of clinical child and adolescent psychology.

Children’s mental health problems impose a staggering public health burden. For example, roughly 40% of adolescents in the United States have reportedly suffered from a mental disorder in the past year (Kessler, Avenevoli, Costello, et al., 2012), and these disorders are associated with enormous individual, family, and societal costs. Youth mental disorders are associated with complex comorbid presentations (Kessler, Avenevoli, McLaughlin, et al., 2012); elevated substance use (Kendall & Kessler, 2002; Wu, Goodwin, Comer, Hoven, & Cohen, 2010 ); and medical comorbidities ( Merikangas et al., 2015 ). When left untreated, they persist into adulthood, during which time they are associated with family dysfunction; disability in major life roles ( Merikangas et al., 2007 ); poorer educational attainment ( Breslau, Lane, Sampson, & Kessler, 2008 ); criminality; suicide ( Nock & Kessler, 2006 ); and overall reduced health-related quality of life ( Comer et al., 2011 ).

Despite these daunting statistics, recent years have witnessed very promising advances in the development and evaluation of evidence-based interventions for the broad range of children’s mental health problems ( Kendall, 2012 ; Ollendick & King, 2004 ). Evaluations of therapeutic efficacy and effectiveness have evolved from a historical reliance on simply professional introspection and retrospective case histories to modern reliance on complex multimethod experimental investigations and well-controlled randomized trials across well-defined and increasingly generalizable samples.

However, much still remains to be learned about the treatment of child and adolescent mental health problems, and this should not be surprising. After all, whereas many sciences have been progressing for centuries (e.g., physics, chemistry, biology), it has been only relatively recently that empiricism and the scientific method have been applied systematically to clinical child and adolescent psychology ( Comer & Kendall, 2013b ). At this relatively early stage in the science of clinical child and adolescent psychology, most of the research is still ahead of us. As we face the challenge of optimally informing best practices in youth mental health care with data, the prepared investigator must be familiar with the portfolio of modern research strategies for conducting clinical evaluations of treatment methods—a set of “directions” so to speak for getting from “here” to “there” (see Comer & Kendall, 2013b ). Just as with any travel directions, where there may be many acceptable ways to get to the same destination (e.g., the scenic way, the quick way, the cheap way), for each testable question in clinical child and adolescent psychology, there are many methods that can be used to reveal meaningful information, each with limitations and strengths.

To continue to move the field of clinical child and adolescent psychology forward, investigators must systematically rely on research strategy “routes” that achieve favorable balances between scientific rigor and clinical relevance ( Comer & Kendall, 2013b ). This necessitates careful considerations regarding the trade-offs between internal validity (which is typically linked with rigor ) and external validity (which is typically linked with relevance ). Internal validity pertains to the extent to which the independent variable, rather than an extraneous influence, accounts for variance in the dependent variable. The more rigorous and tightly controlled a study design, the more persuasively the study is able to rule out the possibility that variables beyond the independent variable might be accounting for variance in the dependent variable. External validity, on the other hand, pertains to the extent to which study results generalize to people, settings, times, measures, and characteristics other than those included in a particular study. Accordingly, design decisions focusing on internal validity and aiming to improve interpretative conclusions typically have the consequence of reducing the external validity and generalizability of findings to broadly relevant settings and vice versa. With this in mind, we present an overview of modern methods and considerations that maximize both rigor and relevance in the evaluation of child and adolescent treatments.

Planning a Clinical Trial

When planning a clinical evaluation to examine the efficacy or effectiveness of treatment for child and adolescent mental health problems, six sets of considerations are essential: (a) design considerations; (b) control condition considerations; (c) independent variable considerations; (d) dependent variable considerations; (e) assessment point considerations; and (f) sample and setting considerations.

Design Considerations in Clinical Child and Adolescent Psychology

Broadly speaking, the development and evaluation of novel therapeutic interventions occur through a sequence of three progressive stages ( Rounsaville, Carroll, & Onken, 2001 ). Stage 1 encapsulates an iterative development process, combining previous research, clinical expertise, and consultation with experts. An experimental intervention is tested, preliminarily, on a small number of subjects of the population for which the treatment is intended. This idiographic approach provides initial evidence to show the relationship between treatment and symptoms on an individual basis. Stage 1 designs also address issues related to intervention feasibility and acceptability and provide opportunities for intervention refinement or tweaking before progressing to Stage 2, large-scale evaluation. In Stage 2, tightly controlled, systematic, and rigorous evaluations with high internal validity establish broad efficacy of the intervention by looking at nomothetic patterns. Stage 3 designs evaluate intervention effectiveness, prioritizing external validity, generalizability to a wider range of patients, and transportability across clinical settings and practitioners.

Depending on research goals and the stage of the intervention, a range of study designs is available to evaluate an experimental treatment. Selecting a study design involves finding a balance between one’s research question and goals and the limitations associated with each design option. We now turn our attention to leading design options available to investigators, including single-case and multiple-baseline experimental designs, the randomized controlled trial (RCT), and sequenced treatment designs.

Single-case and multiple-baseline designs.

Systematic research designs encompassing a single individual or a small sample of subjects are useful for informing our understanding of individual behavior change and revealing a signal of “how,” “why,” and “when” treatment-related changes may occur. This idiographic portrait of the relationship between an intervention and symptoms makes such designs particularly useful during Stages 1 and 3 of treatment evaluation ( Barlow & Nock, 2009 ). Indeed, these designs have played a prominent role in developing clinical guidelines and best practices, underscoring their importance in evidence-based practice ( American Psychological Association, 2002 ). Understanding treatment-related change at the individual level provides an opportunity for intervention refinement prior to initiating costly large-scale evaluations. After large-scale clinical evaluations have been conducted, single-case designs can again be useful to evaluate the intervention’s applicability to individuals in new settings or with different symptom profiles or when implemented by clinicians of different training backgrounds. Single-case and multiple-baseline trials are also relatively cost-efficient, making them valued designs in the context of limited funding.

Generally, single-case experimental designs employ a systematic, repeated-measures approach wherein data related to a specific dependent variable (i.e., clinical target) are collected across a baseline and treatment phase. Researchers must balance a data collection schedule that is frequent enough to provide clues about when treatment-related changes occur, while avoiding potential subject response fatigue ( Barlow, Nock, & Hersen, 2009 ; Gallo, Comer, & Barlow, 2013 ; Kazdin, 2001 ). Typically, the baseline phase is referred to as the “A” phase. Dependent variable data are collected across a baseline phase (rather than at a single time point) to document the stability of the target behavior as it occurs naturally. These data are then compared to observations collected during the treatment phase (or “B” phase) of the design. Capturing stability of the behavior during the baseline period is critical for attributing changes to the treatment, rather than attributing changes to a natural cycle of fluctuations of that behavior ( Gallo et al., 2013 ).

The most traditional representation of the single-case experimental design is the A–B design , in which a target behavior is measured repeatedly across both a baseline A phase and a treatment B phase. This design allows the researcher to capture data on a naturally occurring, preintervention behavior, which is then directly compared to observations of the behavior after the intervention has been introduced. A more rigorous permutation adds an additional A or baseline phase of data collection. In such an A–B–A design , the A and B phases are followed by an additional phase of data collection during which the intervention has been withdrawn (A). Such introduction and removal of treatment allow for stronger conclusions. Importantly, within clinical psychology, withdrawal designs are often hard to attain and perhaps even less desirable. For example, unlike psychopharmacology evaluations in which a patient can simply stop taking a medication, “unlearning” a specific coping skill or behavioral strategy can be difficult, if not impossible, and in some cases may even be unethical.

Some investigators will add a second B phase to an A–B–A design to address some of the shortcomings of the A–B–A design. Such an A–B–A–B design adds rigor by offering an inherent replication of findings and the ethical shortcomings of withdrawing an effective intervention. Another permutation, the B–A–B design allows the investigator to begin the evaluation with the intervention. This is useful when assessing a clinical behavior that requires immediate attention and for which waiting throughout a baseline period may be contraindicated (e.g., suicidal ideation, self-injury), but it does not provide observations of target behaviors as they occur naturally in the absence of intervention. Moreover, to control for possible placebo effects, the A–B–C–B design introduces a third “C” phase that corresponds to a placebo condition (e.g., education, support, and attention). Addition of a C phase allows investigators to more readily attribute improvements seen in the treatment B phase to the specific intervention, rather than broadly to any intervention that could have been applied.

For researchers evaluating psychosocial interventions that do not provide opportunity for withdrawal phases, a multiple-baseline design can serve as a valuable alternative. Multiple-baseline designs employ an A–B design that differentially extends the length of the baseline (A) phase across behaviors, subjects, or settings. To establish intervention efficacy, improvements in the target behavior must be seen only after the treatment phase (B) is initiated. The baseline phase length may be determined prior to beginning a study or a researcher may wait until the target behavior stabilizes in participants and then initiate treatment (B phase) only after stabilization is achieved.

Multiple-baseline designs may occur across behaviors , across subjects , and across settings . A multiple-baseline design across behaviors evaluates the effects of an intervention on different behaviors, but within the same individual. Improvements seen in the clinical targets are attributed to intervention only if they occur after initiation of the phase of the intervention in which they were specifically targeted. Multiple-baseline designs across subjects evaluate the effects of a single intervention on multiple individuals who share a similar clinical presentation (e.g., Comer et al., 2012 ; Jarrett & Ollendick, 2012 ; Ollendick, 1995 ; Suveg, Kendall, Comer, & Robin, 2006). Each subject is assigned to a baseline period of varying and randomly determined lengths, and efficacy is demonstrated when improvements in target behaviors occur after the treatment phase is initiated, regardless of the duration of the baseline period assigned. In multiple-baseline designs across settings, intervention is applied sequentially in different settings for the same individual (e.g., at home, at school). To demonstrate treatment efficacy, improvements in the target behavior should occur in a specific setting only after intervention has been implemented in that setting.

Strengths of the multiple-baseline design include its ability to circumvent challenges of withdrawal designs when applied to psychosocial interventions. Moreover, multiple-baseline designs allow researchers to examine an intervention across multiple behaviors, settings, or individuals, which yields more generalizable findings. Some have argued that the strength of the multiple-baseline design decreases when fewer than three or four behaviors, individuals, or settings are measured ( Barlow & Nock, 2009 ; Gallo et al., 2013 ), although there is some debate about this.

Randomized controlled trials.

Whereas single-case experimental designs offer idiographic data and inferences regarding treatment effects on individual children and adolescents, to examine causal impacts of therapeutic interventions in ways that can inform clinical and policy decision-making, a treatment must be tested with tightly controlled procedures derived from experimental science in a nomothetic manner. By maximizing internal validity and systematically manipulating the intervention as the independent variable in a randomized controlled trial, researchers can more confidently and robustly conclude whether observed changes in clinical targets resulted from the intervention itself or from other extraneous factors ( Kendall, Comer, & Chow, 2013 ).

The RCT can take the form of a small pilot RCT or a larger scale clinical trial. The small pilot RCT represents a randomized, controlled study design with a restricted sample size and is useful at the end of Stage 1 research following refinement of the intervention but before entering into a larger, more costly RCT (for an example, see Comer et al., 2017 ). Small pilot RCTs ensure the intervention is suitable for a randomized study design and identify issues related to feasibility to be addressed before reaching Stage 2 research. Large-scale RCTs represent Stage 2 evaluations of therapeutic intervention and use adequately powered sample sizes to examine nomothetic effects across groups of children and adolescents with similar clinical portraits.

Regardless of sample size, the defining characteristic of the RCT is random assignment between groups . Youth are randomly assigned to either an active treatment condition where the independent variable (e.g., a given therapeutic intervention) is applied or a control condition where the experimental intervention is absent. Assignment to treatment conditions must be determined randomly and independent of baseline symptom levels, family preferences, or therapist/investigator sense of which condition would be best for a given child. At trial outset, each child has an equal chance of being assigned to various conditions (although for variations, see Kendall et al., 2013 ). Including both a treatment and control condition allows researchers to directly compare observations of a target behavior across youth who have been similarly matched on key clinical characteristics. Because of the controlled study design, changes seen uniquely or more prominently in the treatment group can confidently be attributed to the therapeutic intervention.

Importantly, randomly assigning youth across treatment conditions does not guarantee ultimate comparability across conditions, although the likelihood of such is high. Simply due to chance, participants in one group may be older, more impaired, or different on any number of meaningful variables. After data collection is complete, researchers can evaluate the comparability of youth across groups, and if baseline group differences are found, such differences are attended to as covariates at the data analysis phase. Alternately, to ensure children and adolescents across groups are matched on key characteristics, researchers can use randomized block assignments . Participants are arranged into small, equal numbered subgroups based on comparability on key characteristics (e.g., subgroups of one boy and one girl to ensure gender comparability across groups). Randomization then occurs at the subgroup level, rather than at the individual child level, retaining the randomized element while also ensuring comparability across groups.

Sequenced treatment designs.

In clinical care settings, treatments result in a range of outcomes, including improvements on target symptoms (treatment response), worsening of target symptoms (deterioration), no change in target symptoms (nonresponse), or some, but not sufficient, improvement of target symptoms (partial response). Throughout the course of treatment, therapists make clinical decisions based on response to that point to determine what, if any, changes should be made to the child’s treatment plan (e.g., continuing with the treatment course vs. switching to another treatment). The rigor and structure of the traditional RCT does not allow for flexibility during treatment implementation and therefore cannot inform clinical decision-making in cases of nonresponse, partial response, or clinical deterioration during the course of treatment.

Sequenced treatment designs and adaptive treatment regimens retain randomization procedures while also systematically evaluating shifting treatment strategies across time for children and adolescents who are not sufficiently improving. The most common and increasingly popular adaptive treatment design is the sequential multiple-assignment randomized trial (i.e., the SMART design ) ( Dawson & Lavori, 2012 ; Murphy, 2005 ), which yields quality data with which to develop evidence-based adaptive treatment algorithms that differentially incorporate the benefits of intervention forms across critical points in treatment. A SMART includes multiple intervention stages, but as each child moves through intervention stages, randomization options at key decision points are determined by the child’s treatment response at that point (see Barlow & Comer, 2013 ). Indeed, the design of a SMART improves on traditional factorial RCT designs focused on broad main effects of treatment conditions across a single treatment phase and instead recognizes the true multiphase nature of the treatment process for the majority of children and adolescents in clinical practice. The sample SMART design illustrated in Figure 8.1 examines sequences of treatment in the context of behavioral parent training (BPT) and individual child therapy (ICT) and yields data to meaningfully inform eight distinct adaptive treatment regimens. This single design requires a very large sample size but can efficiently inform sequenced treatment decisions for children and adolescents showing a range of clinical responses to different forms of initial intervention. Despite the adaptive nature of children’s individual intervention courses, the randomization element of a SMART at critical decision points still affords causal conclusions ( Barlow & Comer, 2013 ; Lei, Nahum-Shani, Lynch, Oslin, & Murphy, 2012 ). Accordingly, the SMART offers a hybrid of the nomothetic groups-based (factorial) design strategy that typically informs policy decisions and the more idiographic single-case experimental designs that clarify individualized changes.

A sample sequential multiple-assignment randomized trial (SMART) design.

A recent SMART in clinical child and adolescent psychology ( Pelham et al., 2016 ), for example, found that central nervous system stimulant medication for attention deficit hyperactivity disorder (ADHD) is most effective when it is used as a supplemental second-line treatment following an adequate course of quality low-dose behavior therapy, rather than as a first-line treatment. Pelham and colleagues were also able to document that the behavioral-first treatment strategy was far less expensive for the healthcare system than starting treatment with medication. This SMART has the potential to meaningfully influence treatment sequencing for children with ADHD in primary care, where medication alone has traditionally been the most often used treatment, with poor long-term outcomes and high associated costs.

Control Condition Considerations in Clinical Child and Adolescent Psychology

Once the investigator has decided on an appropriate study design, the investigator must select an appropriate control condition. In a “controlled” evaluation, comparable children and adolescents are randomly assigned to either the treatment condition and receive the experimental intervention or a control condition and do not receive the intervention. By contrasting changes between youth across conditions, the efficacy of the intervention beyond outcomes produced by extraneous factors (e.g., passage of time, family expectations) can be assessed. Control conditions take many forms, each carrying a unique set of strengths and limitations that affect the inferences that can be made.

No-treatment control condition.

Youth assigned to groups in which they receive no treatment are considered to be in a no-treatment control condition . This straightforward design allows researchers to draw comparisons between treatment and no treatment and consider the effect of intervention above and beyond the passage of time. Comparing intervention outcomes to outcomes in a no-treatment control condition allows the investigator to rule out the possibility that intervention effects are simply due to the regression of extreme scores to the mean across the study time period. Importantly, however, a no-treatment control condition does not rule out other explanatory factors beyond the possibility that changes represent what might naturally unfold with the passage of time. Sometimes when participants simply know they are going to get treatment, it affects their expectancies, and they show symptom improvements. Accordingly, a no-treatment control condition cannot rule out the possibility that superior changes in the treatment condition are accounted for by differences in participant expectancies associated with being assigned to (any) treatment. Accordingly, no-treatment control conditions are best suited for early stages of treatment development and evaluation and are not appropriate to meaningfully address conceptual questions about treatment efficacy and active treatment components. That said, pragmatic considerations make no-treatment controlled designs hard to implement, given difficulties of recruiting and retaining participants in a no-treatment condition.

Wait-list control condition.

An improvement over the no-treatment control condition that accounts for patient expectancies is the wait-list control condition. In a wait-list controlled design, children are assigned to receive the treatment either immediately or after a predetermined waiting period. At outset, all participants know they will receive treatment at some point in the study and likely hold similar expectations that their symptoms will improve, regardless of condition. Target clinical behaviors are assessed at uniform intervals throughout both conditions. For example, if an experimental intervention is 12 weeks, then the wait-list interval would ideally be 12 weeks as well.

Although wait-list control conditions effectively account for the passage of time as well as patient expectancies of ultimate symptom improvement, wait-list control conditions do not account for inherent benefits associated with receiving care and attention from clinical staff that have nothing to do with the specific therapeutic components hypothesized to be responsible for treatment-related change. Further, participants in a wait-list control condition are prohibited from accessing other care services during the interim wait period. Accordingly, attrition from wait-list control conditions can be high. Moreover, it can be unethical to implement a wait-list control design when alternative treatments for the clinical target have been supported in previous work. In such cases, a multiple-treatment comparison design (discussed further in this chapter) is more appropriate.

With these limitations in mind, similar to the no-treatment control, wait-list control conditions are best suited for early stages of treatment development and evaluation. Importantly, wait-list and no-treatment control conditions can carry with them ethical dilemmas. Children and adolescents in these control conditions must be regularly monitored throughout study participation to ensure they do not show serious clinical deterioration that would suggest they should be withdrawn from their assigned condition. Indeed, these control condition designs are not suitable for clinical populations that cannot tolerate a wait-list or no-treatment phase (e.g., adolescents showing suicidal behaviors).

Attention-placebo control condition.

Attention-placebo control conditions are valuable for investigators looking to additionally rule out “common factors” associated with all therapeutic interventions (e.g., receiving care and attention from warm clinical staff, having an outlet through which problems can be discussed). These designs contrive a control condition that mimics elements of treatment by inviting participants to receive face-to-face interactions with attentive clinical staff. Importantly, the attention-placebo control condition is explicitly devoid of elements that are believed to be specifically effective in the experimental intervention. Attention-placebo control conditions typically consist of general psychoeducation, clinical monitoring, and broad patient support.

Despite the advantage that attention-placebo control conditions have for accounting for common, nonspecific therapeutic factors, it can be difficult to establish credibility (for patients and for therapists) when implementing these control conditions. It is useful for therapists to hold equally positive expectations of improvement for participants across conditions ( Kazdin, 2003 ), and establishing positive expectations for a condition oriented around nonspecific treatment factors can be difficult to achieve. Thus, researchers utilizing attention-placebo control conditions should measure participant expectations across conditions so that participant expectancy effects can be accounted for in analyses.

Standard-treatment comparison condition.

A standard-treatment comparison or treatment-as-usual control condition consists of an invention that is routinely given and allows the investigator to evaluate the incremental benefits of an experimental intervention over and above the existing standard of care. Ethical concerns that arise in no-treatment, wait-list, and attention-placebo conditions are minimized because children in this condition are receiving exactly what they would have received for their problems had the study never taken place. Moreover, attrition is minimized as all children receive active care, and patient and therapist expectations for change are likely to be more comparable. Despite these benefits, however, what exactly constitutes “treatment as usual” has been difficult to operationalize as it varies widely across settings, making it difficult to integrate findings across studies incorporating these control conditions. Further, differences between an experimental intervention and a treatment-as-usual condition might be attributed to differences in therapist quality, training, supervision, or organization, rather than to differences specific to the hypothesized active ingredients of the experimental intervention. Moreover, it can be difficult to match the intensity, dosing, or duration of treatments when comparing an experimental treatment condition to a treatment-as-usual condition. For example, suppose an experimental treatment protocol calls for weekly 60-minute sessions with a therapist for 12 weeks, whereas the standard care that is currently offered in a setting entails 20-minute sessions every other week for up to 8 weeks. If the investigator changes the treatment-as-usual condition to have control participants meet weekly and for longer periods of time with therapists, the control group is no longer a “standard care” condition; it is a new condition contrived by the investigator. Alternatively, if the investigator in this scenario compares the experimental condition to the true treatment as usual, it is possible that differences between the conditions could simply be due to differences in the frequency and intensity of care and not to the putative active ingredients of the experimental treatment.

Multiple-treatment comparisons.

Some more rigorous and revealing studies include multiple active treatment conditions and are thus able to address issues of relative or comparative efficacy. These studies offer direct comparisons of alternative active treatments. For multiple treatment comparisons, it is important that each treatment is comparable on a number of characteristics, including duration, session length, and frequency; setting; and level of credibility. For example, if children who received Treatment A were found to show superior outcomes to children in Treatment B, but Treatment A was 8 weeks and Treatment B was 4 weeks, the investigator would not be able to determine whether Treatment A had stronger effects than Treatment B or whether the study just found that 8 weeks of treatment was better than 4 weeks of treatment. Further, multiple-treatment comparison studies must ensure comparability of therapists across conditions. Therapists should be matched on their levels of training and experience, expertise in administration of study treatment protocols, and attitudes toward the treatments, including their allegiance to specific therapeutic approaches and their intervention expectancies. For example, it would be problematic if in a multiple-treatment comparison design a group of psychodynamic therapists conducted both a behavioral intervention (in which their expertise is low) and a psychodynamic therapy (in which their expertise is high). If outcomes differed across conditions, it would not be clear whether this was the result of true differences between behavioral and psychodynamic approaches or whether this was simply due to differences in therapist expectancies across the conditions.

Researchers using a multiple-treatment comparison design must also consider issues of sample size and outcome measurement. Whereas comparisons of active conditions against inactive control conditions typically yield large effect sizes, comparisons of multiple active conditions typically yield smaller effect sizes and accordingly require larger samples for adequate power. Moreover, to avoid potential biases, measures should cover a range of target clinical symptoms, and assessments should be equally sensitive to expected changes associated with each treatment type. For example, a measure that primarily evaluates children’s self-talk may be a well-suited measure for examining the impact of cognitive behavioral therapy but may not evaluate meaningful changes associated with antidepressant medication, for which the direct targeting of children’s self-talk is not a proposed mechanism of change ( Comer & Kendall, 2013a ).

Independent Variable Considerations in Clinical Child and Adolescent Psychology

In the context of a clinical trial, the independent variable that is manipulated is treatment assignment, that is, whether a child does or does not receive treatment or which treatment condition a child will receive. As in any experimental study, this independent variable must be carefully operationalized and implemented with integrity. Specifically, when evaluating an experimental intervention, the treatment must be adequately detailed and described in order to replicate the evaluation or to be able to communicate to others how to conduct the treatment ( Comer & Kendall, 2013a ). A treatment protocol that clearly defines the intervention and dictates how it is to be administered is critical for internal validity and ensuring the integrity of the independent variable. However, manualized intervention protocols can limit external validity, especially when attempting to generalize findings to settings and practitioners who do not typically use treatment manuals to guide their services. Some critics argue that manualized treatment protocols are overly rigid and do not afford clinicians needed flexibility to adapt to the complex and individualized patient needs encountered in routine practice settings ( Addis & Krasnow, 2000 ). Although most supported treatment manuals have always afforded a great deal of flexibility to individual patient needs, more modern treatment protocols are increasingly taking a modular approach, in which supported practices for specific identified problems are structured as free-standing modules, and decision flowcharts guide treatment component sequencing and module selection ( Chorpita, 2007 ; Comer, Elkins, Chan, & Jones, 2014 ). Modularized treatment protocols address complex comorbidities and shifting clinical needs by accommodating personalized tailoring of care for specific problems presenting in each child.

Dependent Variable Considerations in Clinical Child and Adolescent Psychology

The investigator must decide which dependent variables will be assessed and how they will be measured. Indeed, it is critical to measure outcomes using a variety of methods in order to minimize bias. Given research documenting poor cross-informant agreement in the assessment of child psychopathology (e.g., Comer & Kendall, 2004 ; De Los Reyes & Kazdin, 2005 ; Grills & Ollendick, 2003 ), investigators are wise to collect reports from multiple informants (e.g., parents, teachers, therapists, children). Such a multi-informant strategy allows researchers to evaluate symptoms that may differentially present across various contexts and life domains or that may be perceived differently across key people in children’s lives ( Silverman & Ollendick, 2005 ). Features of cognitive development can interfere with the accuracy of young children’s reports, and demand characteristics may cause children to offer what they believe to be desired responses. Accordingly, it is important to collect data simultaneously from important adults in children’s lives who observe their behavior across different settings. On the other hand, parents and teachers may not be privy to more internal and unobservable symptoms (e.g., anxiety).

Multimodal assessment strategies draw on multiple modes of assessment (e.g., observations, questionnaires) to evaluate the same dependent variable. For example, positive parenting practices might be measured via behavioral codings of structured parent–child interactions, as well as parent self-reports. For other dependent variables, objective records (e.g., medical or school records) might be collected. Data on peer relations might draw on sociometric data and peer nominations.

Finally, multiple targets should be assessed ( De Los Reyes & Kazdin, 2006 ). Improvement can take many forms, including decreased symptoms, loss of clinical diagnosis, improved quality of life, higher academic functioning, and improved interpersonal functioning. No single dependent variable independently and sufficiently captures treatment response. Inherent in a multiple-domain assessment strategy, however, is the fact that treatments rarely produce uniform effects across assessed domains. For example, one treatment might improve child anxiety but not peer relationships, whereas another treatment might improve children’s peer relationships but not anxiety. If a clinical trial were to compare these two treatments, it is not readily apparent which treatment should be deemed more efficacious ( Comer & Kendall, 2013a ). Typically, the investigator selects a primary outcome, as well as secondary and exploratory outcomes that provide more nuanced information about treatment responses. Importantly, selection of a primary outcome variable must occur prior to collection and review of the findings, so that decisions about which variables are most important are made a priori and are not biased by the significance of results. De Los Reyes and Kazdin (2006) have argued for a multidimensional conceptualization of intervention change, and similarly we caution consumers of the treatment literature against simplistic dichotomous appraisals of treatments as effective or not.

Assessment Point Considerations in Clinical Child and Adolescent Psychology

Evaluating a novel intervention through an experimental design requires a clinical researcher to take careful observations of the dependent variables across the duration of the study at key time points. Target clinical behaviors are selected for measurement and should be assessed at the outset of the study to provide baseline data . Baseline data serve as benchmarks against which subsequent observations of dependent variables are assessed. Post-treatment assessments are another critical time point for assessment, as those observations speak to acute treatment outcomes or the impact of an experimental intervention on clinical symptoms immediately after treatment is complete.

Although post-treatment data are critical, post-treatment data do not allow researchers to examine enduring treatment effects. To demonstrate lasting treatment gains or maintenance , researchers must also measure clinical outcomes at predetermined intervals after treatment has been completed (e.g., 3 months post-treatment, 6 months post-treatment). Such follow-up evaluations add methodological rigor to a study. For example, in a study comparing multiple active treatments, acute post-treatment outcomes may be comparable, but follow-up assessments may reveal that children in one experimental treatment condition showed higher maintenance of treatment gains with continued time. Importantly, for follow-up assessments to capture true lasting effects, participants should not have contact with other clinical services during the follow-up assessment period. Because follow-up intervals can be lengthy, it is not always feasible or ethical to prevent participants from receiving outside services during a follow-up interval. Many investigators, accordingly, include a naturalistic follow-up component that allows participants to seek outside services during the interval between post-treatment and follow-up evaluation. Additional service use after treatment completion may actually be a variable of interest, and when it is not, outside service use during the follow-up interval should be controlled for statistically.

Investigators are also increasingly incorporating assessments at different points during treatment, or midtreatment, to establish growth curves, consider the rate and shape of change during the treatment phase, and better understand potential mediators of treatment response. Midtreatment assessments provide revealing data on when symptom changes occur during treatment, at what pace, and how changes across different domains of response may unfold and interact with one another across time ( Chu, Skriner, & Zandberg, 2013 ; Gallo, Cooper-Vince, Hardway, Pincus, & Comer, 2014 ; Kendall et al., 2009 ; Marker, Comer, Abramova, & Kendall 2013 ).

Sample and Setting Considerations in Clinical Child and Adolescent Psychology

Careful consideration is needed when selecting a sample to best represent the clinical population of interest. Those youth chosen to participate in the trial will strongly influence the extent to which findings can be generalized to the larger population of youth who may benefit from the treatment. A genuine clinical sample made up of youth shown to have a disorder and who are seeking treatment will afford greatest external validity and generalizability. However, genuine clinical samples can be difficult for researchers to recruit into studies; moreover, they frequently carry more complex clinical portraits, which can threaten the internal validity of the study. Alternatively, analogue or selected samples can afford a higher degree of control and internal validity in study design, but youth in such samples are not necessarily comparable to the majority of patients typically seen in clinical practice.

Broadly speaking, it is important that the sample in a study evaluating an experimental intervention reflect the population for which that intervention is intended to ultimately benefit. Thus, in addition to considering a sample’s clinical characteristics, researchers in clinical child and adolescent psychology must consider sociodemographic diversity. Race, ethnicity, gender, socioeconomic status, education level, and other related demographic characteristics must all be considered when recruiting an appropriate study sample that can generalize to the general population.

The setting in which a study takes place will also have important implications for the generalizability of results. Early stage evaluations of therapeutic interventions are often conducted in clinical research laboratory settings and require investigators to recruit subjects to participate. Therapists in these trials are typically part of the investigator’s research team, and as such their outcomes may not generalize to the practices of front-line clinicians who differ from research staff clinicians with regard to experience, caseload size, supervision, and oversight. It is ultimately critical to demonstrate the transportability of an intervention to front-line service settings. Therefore, later stage evaluations of therapeutic interventions must evaluate outcomes beyond tightly controlled research settings.

Conducting a Clinical Trial

Once a clinical trial has been carefully designed, it does not simply run itself. The investigator must play a highly active role in organizing and implementing each aspect of the study in order to ensure a successful trial.

Training and organizing study staff merits special attention. Independent evaluators ( IEs ) refer to staff members who participate in assessment procedures and who are masked to each participant’s treatment assignment. IEs must be trained to a prespecified criterion (e.g., must match the diagnostic profile generated by the principal investigator on at least three consecutive diagnostic interviews) prior to their active participation on the trial, and throughout the course of the study periodic reliability checks are further necessary to ensure interrater reliability across study IEs. Systematic safeguards must be put in place to guarantee that IEs are kept unaware of each participant’s treatment assignment. IEs should try to avoid patient waiting rooms in which they might run into families assigned to treatment. IEs should not attend clinical supervision meetings that would reveal participant assignment information. For smaller teams in which the same staff members serve as both IEs and as therapists on different cases, multiple supervision teams are required, and staff members can only serve as IEs on cases carried on opposite supervision teams. Prior to post-treatment assessments, participating families should be reminded that their post-treatment assessor does not know which treatment they received (or even whether they received treatment if it is a wait-list controlled trial), and families should be cautioned against speaking about any treatment experiences during the interview.

Study therapists must be adequately trained. This typically involves initial didactic training on the study protocol and knowledge quizzes, followed by role plays. Ideally, there is opportunity for trainee therapists to shadow and then cotreat several cases using the study protocol prior to their active participation as a therapist on the study. Investigators should set a criterion that must be met by study therapists prior to their carrying study cases independently (e.g., complete didactic training, achieve a score of 80% or greater on a knowledge quiz, shadow one case, and cotreat one case). Regular supervision is critical to avoid therapist drift and to ensure treatment integrity.

Just because study therapists have been trained to criterion does not guarantee that they will deliver the independent variable (treatment) as intended. In the course of a study, the treatment that was assigned may not in fact be the treatment that is provided (see also Perepletchikova & Kazdin, 2005 ). To ensure that study treatments are implemented as intended, treatment integrity checks should be conducted. Therapy sessions should be regularly recorded such that independent raters can view them and provide quantifiable judgments on the implementation of key treatment components. McLeod, Islam, and Wheat (2013) provided more detailed descriptions of procedural issues in the conduct of quality assurance and treatment integrity checks.

Throughout the course of a clinical trial, someone must be responsible for monitoring the sample and the data and for ensuring that all data are collected as designed and intended. This person must be omniscient: The person must know the condition of every participant, must know who is assigned to which cases and who is responsible for collecting each piece of data, must know who can know about each participant’s condition, and must be aware of where each family is in the flow of study phases. Even with such a person dedicated to this role, data will inadvertently be missed, blinds will unintentionally be broken, and families will mistakenly not be contacted at their appropriate follow-up points. For a large clinical trial, this is a full-time job, but for smaller studies, a principal investigator can often perform in this role. Most important, the individual in charge of tracking cannot serve as an IE or as an IE supervisor because their role inherently unmasks them to all study-related information that could bias responses.

Throughout treatment, study staff must regularly monitor adverse events, and an individual or panel of individuals must be responsible for deciding whether a particular child suffering adverse events should be withdrawn from the study. This is particularly important when treatment conditions include medications that can introduce unfavorable side effects, but psychological treatments can also be stressful and associated with adverse events.

Retaining the sample throughout the study can be challenging. It is recommended that study staff phone, email, or text families weekly to “welcome” them to their next session or appointment. During the treatment phase, there is an attrition risk when study treatment cannot address complex and shifting patient needs that may present. For example, a family crisis, an emergent academic issue, or a serious peer conflict may present, and such unforeseen events may become a clinical priority for the family that is not explicitly addressed by the treatment protocol. Adjunctive services and attrition prevention ( ASAP ) procedures (e.g., Abikoff et al., 2002 ) are often implemented to maintain the sample, in which each case in a trial is allowed a prespecified number of additional sessions during the treatment phase to address exigencies or clinical crises that fall outside of the scope of the treatment protocol. Even children who do not complete treatment should be invited to participate in as many post-treatment and follow-up evaluations as possible. Monthly calls, birthday wishes, and holiday cards are recommended during follow-up intervals in order to maintain contact with families between the end of treatment and follow-up evaluation, thus maximizing sample participation at follow-up.

Analyzing Trial Outcomes

After conducting a clinical trial, the data analysis phase entails the active process through which the investigative team extracts relevant information from the collected data in ways that permit statistical inferences about the larger population of youth the sample was recruited to represent. A comprehensive outline of clinical trial data analysis is beyond the scope of the present chapter (the interested reader is referred to Jaccard & Guilamo-Ramos, 2002a , 2002b ; Read, Kendall, Carper, & Rausch, 2013 ); here, we briefly address (a) missing data and attrition; (b) evaluation of clinical significance; and (c) evaluation of change mechanisms.

Missing data and attrition.

Even in the most diligently organized and carefully implemented clinical trial, not every child randomized will actually complete participation. Mason (1999) estimated that on average roughly 20% of participants withdraw prematurely from their participation in a clinical trial. Attrition can be problematic for data analysis, particularly when large numbers of youth do not complete treatment or when rates of attrition vary across study conditions ( Leon et al., 2006 ).

When there is a meaningful discrepancy between the number of children randomized to the various treatment conditions and the number of children who completed their participation, the investigator can conduct and report two sets of data analyses: (a) treatment completer analyses that evaluate only those youth who completed the full course of their treatment and (b) intent-to-treat analyses that include all those initially randomized. Treatment completer analyses evaluate intervention effects when someone receives a full “dose” of treatment. Those who drop out of treatment, those who refuse treatment, and those who do not adhere to treatment are not included in such analyses ( Kendall et al., 2013 ). Treatment completer outcomes may be somewhat inflated because they only capture the results of children who fully adhered to and completed treatment. At the same time, treatment completer analyses directly examine outcomes associated with true exposure to the experimental manipulation and therefore provide very valuable information.

On the other hand, intent-to-treat analyses are more conservative and evaluate outcomes for all children involved at the point of randomization. Such analyses speak more directly to issues of generalizability of findings as they incorporate information about treatment tolerability. A simplistic method for handling missing data for intent-to-treat analyses is the last observation carried forward ( LOCF ) method, which assumes that the scores for children who withdraw from treatment remain constant from their last assessment point throughout the conclusion of the study. For example, if a family withdraws participation at Week 8, then the data values from that child’s Week 7 assessment (or most recently completed assessment) would be substituted for all subsequent assessment points. However, LOCF introduces systematic bias and fails to take into account the uncertainty of postdropout functioning ( Leon et al., 2006 ). Accordingly, LOCF methods have fallen out of fashion, in favor of (a) multiple imputation methods , which impute a range of values for missing data by incorporating the uncertainty of the true values of missing data ( Little & Rubin, 2002 ); and (b) mixed-effects modeling , which relies on regression modeling to address missing data in the context of random (e.g., child) and fixed (e.g., treatment condition, gender) effects. Mixed-effects modeling is a particularly strong approach to handling missing data when numerous assessments are collected across a treatment trial (e.g., weekly data are collected).

Evaluation of statistical and clinical significance.

Statistical significance is identified when the mean difference between treatment conditions is beyond that which could have resulted by chance alone (most commonly defined as p < .05). Tests of statistical significance are critical as they indicate how likely it is that observed differences between conditions were not due solely to chance. However, tests of statistical significance alone do not provide compelling information on the clinical significance of group differences. Relying solely on statistical significance can lead an investigator to interpret treatment gains as meaningful when in fact they may be clinically insignificant ( Kendall et al., 2013 ). For example, suppose that a treatment for disruptive behavior problems results in significantly lower scores on the Externalizing Scale of the Child Behavior Checklist (CBCL). An examination of CBCL means however reveals only a small but reliable shift from a mean of 81 to a mean of 78. With a large enough sample size, this change can achieve statistical significance at the conventional p < .05 level, but a 3-point change from 81 to 78 on the CBCL Externalizing Scale is of limited practical significance. At both baseline and still at post-treatment, the scores are within the clinically elevated range, and such a small magnitude of change may have little effect on a child’s functioning.

Clinical significance refers to the meaningfulness or persuasiveness of the magnitude of change ( Jacobson & Truax, 1991 ; Kendall, 1999 ). Whereas tests of statistical significance ask the question, “Were there intervention-related changes?” tests of clinical significance ask the question, “Were intervention-related changes convincing and meaningful?” Clinical significance can be evaluated by (a) considering the extent to which treated youth are returned within normal limits (i.e., they are indistinguishable from a normative sample of youth; Kendall, Marrs-Garcia, Nath, & Sheldrick, 1999 ); (b) evaluating the magnitude of effect sizes of change, regardless of statistical significance; or (c) computing the Reliable Change Index (RCI; Jacobson & Truax, 1991 ) across participants. To calculate the RCI, the investigator assesses the extent to which each individual participant’s change pre- to post-treatment was reliable, versus the possible result of simple measurement error. For each participant, the investigator calculates a difference score (e.g., post score minus baseline score) and compares it to the standard error of measurement (i.e., ±1.96 SE ). As such, the RCI is determined by two factors: (a) the magnitude of change and (b) the reliability of measurement. Each of these approaches to assessing clinical significance (e.g., normative comparisons, effect size interpretations, RCI) provides an important, but unique, perspective on the meaningfulness of treatment outcomes; thus, they are often used in conjunction with one another. For example, an investigator might use published norms of a measure to evaluate which participants crossed over from the clinical range to the nonclinical range and also calculate an RCI for each participant. The investigator can use these data to group participants into the following categories: recovered (i.e., passed both normative cutoff and RCI criteria), unchanged (i.e., passed neither criteria), improved (passed RCI but not normative cutoff criteria), or deteriorated (i.e., passed RCI criteria in the negative direction) ( Comer & Kendall, 2013a ; Jacobson & Truax, 1991 ; McGlinchey, Atkins, & Jacobson, 2002 ).

Evaluation of change mechanisms.

Researchers and funding agencies are increasingly interested in identifying the conditions that determine when an intervention is more or less potent (moderation) and the processes through which an intervention produces change (mediation). A moderator is a variable that delineates the conditions under which a given intervention is related to an outcome. Conceptually, moderators identify on whom and under which circumstances treatments have different effects, and they are usually measured prior to treatment ( Kendall et al., 2013 ; Kraemer, Wilson, Fairburn, & Agras, 2002 ). Functionally, a moderator is a variable that influences either the direction or magnitude of an association between the independent variable (treatment condition) and a dependent variable (outcome). Treatment moderators help identify which youth might be most responsive to which interventions and for which youth alternative interventions might be appropriate. Of note, when a variable broadly predicts treatment response across all treatment conditions in a clinical trial, conceptually that variable is simply a predictor , not a moderator (see Kraemer et al., 2002 ).

A mediator, on the other hand, is a variable that is measured during treatment and clarifies the process by which an intervention influences an outcome. Conceptually, mediators identify how and why treatments have the effect they do ( Kraemer et al., 2002 ). The mediator effect reveals the mechanism through which treatment is associated with outcomes. Significant meditation affords causal conclusions. If a supported treatment for child anxiety was found to influence negative self-talk, which in turn was found to have a significant influence on child anxiety and avoidance, then negative self-talk might be considered to mediate the treat-to-outcome association. Specific statistical methods used to evaluate the presence of treatment moderation and mediation can be found elsewhere ( MacKinnon, Lockhart, Baraldi, & Gelfand, 2013 ).

Funding agencies are increasingly prioritizing interventions research that explicitly examines mechanisms that can explain treatment effects. The experimental therapeutics paradigm has the researcher first hypothesize a “target” or mechanism of action. Rather than focusing on clinical effects and treatment response, the experimental therapeutics researcher studies an intervention first as a manipulation to verify whether the intervention has a predicted effect on the target mechanism (i.e., target engagement). Once target engagement has been documented, the experimental therapeutics researcher then examines whether clinical outcomes are indeed related to successful target engagement.

Reporting Results

Presenting the written study findings to the scientific community in a peer-reviewed outlet is the final step of a clinical trial. A well-constructed data report must present all relevant methodological and study-related information with enough context to afford meaningful interpretation of results and to allow for replication. Study aims and results must be placed in the context of related research to illustrate how the current findings compare to previous results, and the investigator must discuss how the results build on, support, or diverge from other findings in the field. A candid and nondefensive articulation of study limitations and shortcomings is also critical in order to direct future research.

To avoid potential bias in the reporting of clinical trial results, a multidisciplinary panel of experts established a checklist of guidelines for maximizing transparency in reporting (i.e., CONSORT guidelines; see Begg et al., 1996 ). CONSORT (i.e., Consolodated Standards of Reporting Trials) guidelines offer a minimum set of recommendations for preparing reports of clinical trial findings that ensure transparent, comprehensive reporting to facilitate critical evaluation and interpretation. Chief among the CONSORT items is inclusion of a graphical representation of the flow of study participation from baseline to study completion. Such a “CONSORT chart” provides important information on recruitment, randomization, retainment, and participant attrition across treatment conditions and assessment time points.

We remain at a relatively nascent stage in the science of clinical child and adolescent psychology, with the majority of work ahead of us. Having reviewed key considerations for planning, conducting, analyzing, and reporting clinical evaluations of child and adolescent treatments, it is clear that no individual investigation, even with optimal design and procedures, is able to adequately answer all relevant questions. Rather, a collection and series of investigations, drawing on a broad range of methodological strategies, is needed to progress our understanding of best practices for the widely diverse range of mental health problems that present in childhood and adolescence.

Those looking for the “correct” research methodology with which to address all questions in clinical child and adolescent psychology are misguided. Throughout this chapter, we have outlined how for each testable question there are many research strategies that can be used to reveal meaningful information, each with strengths and limitations. Collectively, the methods and design considerations outlined in this chapter detail a portfolio of modern research strategies for the continually evolving science of clinical child and adolescent psychology: a set of alternative and complementary “directions” so to speak for advancing our field from where we are now to where we need to be.

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