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Pediatricians provide care for children who live in a variety
of family situations. Children may live with two working parents,
unmarried parents, grandparents, or another nonparental caregiver,
or they may live in single-parent families where the mother may
be divorced or never married, or they may live with gay parents,
in foster homes, or in blended families. The traditional nuclear
family, consisting of a mother and a father who are married and
living with their biological children, is becoming rare; in fact,
only 25% of households fit this description.1 Although
it was the norm three decades ago, today only one half of American
households include a married couple, and only one half of those
have children.1 Only one third of preschoolers
are raised in a two-parent home with a working father and a mother
who stays home full-time.2 Given the diversity
of family forms, it is important to identify the ideas central to
the definition of family.
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The notion of family is universal in all cultures and societies,
but the definition is changing, confused, and often vague. At a
broad conceptual level, the family is a system of social relationships
that are shaped by expectations and values and that are based on distinctions
of age and sex. Each member occupies a particular position or status
that governs behavior toward other family members. On a more practical
level, the US Bureau of the Census defines a family as
two or more persons who live together and are related by blood,
marriage, or adoption.
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Given the difficulty in defining family, it
may be useful to conceptualize the characteristics and functions
of family units. First, many families share biology, including temperament, personality,
talent, and disease vulnerability. Second, families typically have
a power hierarchy that is determined in part by age, generation,
culture, personality characteristics, and gender. Third, families
tend to have their own “culture,” which includes
a family-specific set of values, goals, and expectations. Although they
are unique to each family, these “microcultures” reflect
the larger societal and ethnic cultures. Fourth, every family has
an “invisible boundary” that defines who is a
member and who is not.
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Another set of family characteristics are developmental and arise
from a family’s common history and future. Family history
may extend back for generations, and it usually reflects both ethnic
and religious beliefs and the dramatic life-altering events that
have affected the family. A family’s future course usually follows
a pattern of successive developmental phases that depend in part
on both biology and social norms. The phase of expansion includes the
initial parental union and continues until the youngest child becomes
an adult. This period spans fertility and the physical and emotional
maturation of children. The phase of dispersion occurs
when the first child achieves adulthood and leaves home. The phase
of independence begins when all the children have left
and the parents are alone. The phase of replacement covers
the ...