At the start of the twenty-first century, scores of applied developmental scientists are actively and productively pursuing hundreds of significant research questions with important implications and applications to the well-being of children, youth, and families. Table 2.1 lists many of these topics of
Sample Study or Review
Early child care & education Early childhood education Education reform & schooling Literacy
Parenting & parent education Poverty
Developmental assets Successful children & families Marital disruption & divorce Developmental psychopathology Depression
Domestic violence & maltreatment Adolescent pregnancy Aggression & violence Children's eyewitness reports Pediatric psychology Mass media, television, & computers Prevention science
Lamb (1998); Ramey & Ramey (1998); Scarr (1998); Zigler & Finn-Stevenson (1999). Elkind (2002).
Adelman & Taylor (2000); Fishman (1999); Renninger (1998); Strauss (1998). Adams, Trieman, & Pressley (1998); Lerner, Wolf, Schliemann, & Mistry (2001). Collins et al. (2000); Cowan et al. (1998). Black & Krishnakumar (1998); McLoyd (1998).
Benson (1997); Scales & Leffert (1999); Weissberg & Greenberg (1998). Masten & Coatsworth (1998); Wertlieb (2001). Hetherington, Bridges, & Insabella (1998); Wertlieb (1997).
Cicchetti & Sroufe (2000); Cicchetti & Toth (1998b); Richters (1997); Rutter & Sroufe (2000).
Cicchetti & Toth (1998a).
Emery & Laumann-Billings (1998).
Coley & Chase-Landsdale (1998).
Loeber & Stouthamer-Loeber (1998).
Huston & Wright (1998); Martland & Rothbaum (1999). Coie et al. (1993); Kaplan (2000).
inquiry and action to provide a sense of the broad scope of ADS. Recent textbooks (e.g., Fisher & Lerner, 1994), review chapters (e.g., Zigler & Finn-Stevenson, 1999), handbooks (e.g., Lerner, Jacobs & Wertlieb, 2002; Sigel & Renninger, 1998), special issues of journals (e.g., Hetherington, 1998), and regular sections of journals such as the "Applied Developmental Theory" section of Infants and Young Children provide ongoing articulation of ADS inquiry. Journals such as the Journal of Applied Developmental Psychology, Applied Developmental Science, and Children's Services: Social Policy, Research and Practice are among the central outlets for new work in ADS. Each of the chapters that follow in the present volume on developmental psychology reflects, to varying degrees, some influence of ADS in establishing the current state of knowledge, and the final section of this volume includes several chapters specifically focused on ADS-related scholarship across the life span. For the purposes of this chapter's overview of ADS, just two of the many areas of inquiry and action have been selected to illustrate some of the substantive concerns of ADS: (a) parenting and early child care and education, followed by (b) developmental psy-chopathology and developmental assets. As will be evident, each of these complex areas involves foci of theoretical and methodological concerns, and most link to several of the others listed in Table 2.1, consistent with the highly contextual and interdisciplinary orientation of ADS.
The state of ADS in parenting and early child care education is well summarized in several reviews (e.g., Bornstein, 1995; Collins, Maccoby, Steinberg, Hetherington, & Bornstein,
2000; Cowan, Powell, & Cowan, 1998; Harris, 1998, 2000; Scarr, 1998; Vandell, 2000; Zigler & Finn-Stevenson, 1999) and covers core questions such as
1. How do parenting behaviors influence a child's behavior and development?
2. How do children influence parenting behavior?
3. What are the influences of different forms of child care and early education on children's development?
4. How effective are different interventions for parent education and early education of young children?
5. How do social policies influence the qualities of interventions and programs for children and parents?
Political, philosophical, and scientific controversies permeate many discussions of parenting and early child care and education. In recent years, as challenges to what had become conventional wisdom about the salience of parents' attitudes, beliefs, and behaviors as shapers of their children's development (e.g., Harris, 1998) gained notoriety, applied developmental scientists have acknowledged the shortcomings of extant socialization research (see chapter by Kerr, Stattin, & Ferrer-Wreder in this volume). "Early researchers often overstated conclusions from correlational findings; relied excessively on singular, deterministic views of parental influence; and failed to attend to the potentially confounding effects of biological variation" (Collins et al., 2000, p. 218). Now, with augmented behavior-genetic designs, longitudinal analyses, animal comparative studies, more sophisticated data collection, and analyses and grounding in more comprehensive and contextual biopsychosocial ecological theories, researchers offer more valid and sophisticated accounts of the important influences of parenting on behavior. These accounts are highly nuanced with emphasis on interaction and moderator effects, reciprocal influences, nonfamilial influences, and attention to impacts of macrocontexts such as neighborhoods, policies, and cultures.
As an example, consider the studies of children's temperaments and parenting reviewed by Collins et al. (2000). Children can be characterized in terms of constitutionally based individual differences or styles of reacting to the environment and self-regulating. Developmental research had established modest statistical correlations between "difficult" temperamental profiles in young children and later behavior problems and disorders.
Bates, Pettit, and Dodge (1995), in a longitudinal study, found that infants' characteristics (e.g., hyperactivity, impulsivity, and difficult temperament) significantly predicted externalizing problems 10 years later. Although this finding at first seems to support the lasting effects of physiologically based characteristics, Bates et al. (1995) also showed that predictive power increased when they added information about parenting to the equation. Infants' early characteristics elicited harsh parenting at age 4, which in turn predicted externalizing problems when the children were young adolescents, over and above the prediction from infant temperament. Similarly, this and other findings imply that even though parenting behavior is influenced by child behavior, parents' actions contribute distinctively to the child's later behavior. (Collins et al., 2000, p. 222)
Coupled with the increasingly sophisticated literature on the development and effectiveness of intervention programs that help parents alter their parenting behavior with infants, young children, or adolescents (e.g., Cowan et al., 1998; Webster-Stratton, 1994), this area of scholarship is a prototypical domain of inquiry and action for ADS, and one that provides theoretical, methodological, and practical contributions.
When care by other than the child's parents is examined, similar advances are evident (Lamb, 1998, 2000; National Institute of Child Health and Human Development Early Child Care Research Network, 2000; Scarr, 1998; Zigler & Finn-Stevenson, 1999). Again, these advances are in the context of political, philosophical, and scientific controversies. The last quarter century has seen a shift away from research aimed at documenting how much damage is done to children who are left in daycare as their mothers enter the work force, to research discovering and describing varieties and qualities of day care and early education experiences for children, and more recently to sophisticated longitudinal studies comparing and contrasting varieties of maternal and nonmaternal care, including in-home, family-based, and center-based care. These latter studies increasingly include "not only proximal influences on the child but distal influences as well" (Scarr, 1998, p. 101) and adopt conceptual frameworks requiring attention to individual differences in children, in family processes, and contextual issues such as staff training and support, access to care, and related social policies. Attention to the special needs of at-risk populations such as children living in poverty or other disadvantaged conditions shows similarly increasing sophistication as ADS frameworks are employed (e.g., Ramey & Ramey, 1998).
Lamb's (1998) summary of the current state of knowledge on child care reflects the orientation of ADS:
In general, the quality of care received both at home and in alternative care facilities appears to be important, whereas the specific type of care (exclusive home care, family day care, center day care) appears to be much less significant than was once thought. Poor quality care may be experienced by many children . . . and poor quality care can have harmful effects on child development. Type of care may also have varying effects depending upon the ages at which children enter out-of-home care settings, with the planned curricula of day care centers becoming increasingly advantageous as children get older. Interactions between the type of care and the age of the child must obviously be considered, although claims about the formative importance of the amount of nonparental care and the age of onset have yet to be substantiated empirically. It also appears likely that different children will be affected differently by various day care experiences, although we remain ignorant about most of the factors that modulate these different effects. Child temperament, parental attitudes and values, preenrollment differences in sociability, curiosity and cognitive functioning, sex and birth order may all be influential, but reliable evidence is scanty. . . . We know that extended exposure to nonparental child care indeed has a variety of effects on children, but when asked about specific patterns of effects or even whether such care is good or bad for children we still have to say It depends. (pp. 116-117)
Such an analysis of the state of our science becomes a starting point for the ADS professional in pursuing the collaborations with researchers from allied disciplines and community partners to advance knowledge and build and evaluate programs.
Developmental Psychopathology and Developmental Assets
In fostering synergy among disciplines concerned with the understanding and well-being of children, ADS provides a forum for significant scientific cross-fertilization between two powerful new traditions of inquiry and action: developmental psychopathology and developmental assets. An early definition of the science of developmental psychopathology called it "the study of the origins and course of individual patterns of behavioral maladaptation, whatever the age of onset, whatever the causes, whatever the transformations in behavioral manifestation, and however complex the course of the developmental pattern may be" (Sroufe & Rutter, 1984, p. 18). Cicchetti and Toth (1998b) confirmed that developmental psychopathologists should investigate functioning through the assessment of ontogenetic, genetic, biochemical, biological, physiological, societal, cultural, environmental, family, cognitive, social-cognitive, linguistic, representational, and socioemotional influences on behavior. . . . The field of developmental psychopathology transcends traditional disciplinary boundaries. . . . Rather than competing with existing theories and facts, the developmental psychopathology perspective provides a broad integrative perspective within which the contributions of separate disciplines can be fully realized. . . . The developmental psychopathology framework may challenge assumptions about what constitutes health or pathology and may redefine the manner in which the mental health community operationalizes, assesses, classifies, communicates about, and treats the adjustment problems and functioning impairments of infants, children, adolescents, and adults. . . . Thus, its own potential contribution lies in the heuristic power it holds for translating facts into knowledge, understanding and practical application. (p. 482)
As society grasps the challenges and the costs of mental disorder and behavior dysfunction, only a multidisciplinary vision so broad and so bold, with attendant reliance on the newly grand theories noted earlier, especially developmental contextualism and bioecological theory, can suffice. And even with this breadth and boldness evident in developmental psychopathology, vulnerability to the critique of its being illness oriented or deficit oriented limits its scope. Richters's (1997) critique of developmental psychopathology identifies dilemmas and a "distorted lens" (p. 193) that hamper research advances. ADS provides a support for the bridges needed by developmental psychopathology by linking to the complementary concepts and methods of the developmental assets approach. When contemporary clinical psychologists or clinical-developmental psychologists (Noam, 1998), for instance, who are increasingly comfortable in claiming their role as developmental psychopathologists, can collaborate with community psychologists, for instance, who are increasingly comfortable in cultivating developmental assets, ADS approaches its promise as a framework for understanding and addressing the needs of children in our society.
The developmental assets framework (Benson, Leffert, Scales, & Blyth, 1998; Scales & Leffert, 1999) has some of its roots and branches in developmental psychopathology but contributes its own heuristic power to ADS, especially in grafting its roots and branches in community psychology and prevention science (e.g., Weissberg & Greenberg, 1998). Although developmental psychopathology may focus more often on outcomes reflecting health and behavior problems or mental disorders or illness, the developmental assets framework emphasizes outcomes (or even processes) such as competence or thriving, as captured in the "emerging line of inquiry and practice commonly called positive youth development" (Benson et al., 1998, p. 141; see also Pittman & Irby, 1996). ADS emphasizes the importance of simultaneous consideration of both orientations. In addition, whereas developmental psychopathology is explicitly life-span oriented as noted in the definitions stated earlier, the developmental assets framework, at least to date, is more focused (in derivation though not implication) on the processes boldest in the second decade of life. The empirical and theoretical foundations for the framework emphasize "three types of health outcomes: a) the prevention of high risk behaviors (e.g., substance use, violence, sexual intercourse, school dropout); b) the enhancement of thriving outcomes (e.g., school success, affirmation of diversity, the proactive approach to nutrition and exercise); and c) resiliency, or the capacity to rebound in the face of adversity" (p. 143).
Developmental assets theory generates research models that call upon a system or catalog of 40 developmental assets, half of them internal (e.g., commitment to learning, positive values, social competencies, and positive identity) and half of them external (e.g., support, empowerment, boundaries and expectations, and constructive use of time). Assessments of these characteristics and processes in individuals and in communities then provide for problem definition, intervention design, and program evaluation. While the developmental psychopathologist might focus on similar constructs and word them only in a negative or deficit manner (e.g., a positive identity is merely the opposite of poor self-esteem), simultaneous consideration of both the assets and psy-chopathology orientations reveals that beyond the overlapping or synonymous concept or measure are complementing and augmenting meanings with important implications for both research and practice.
Some features of the synergy obtained with the perspectives fostered by developmental psychopathology and developmental assets orientations are evident in theory and research conducted in frameworks termed the stress and coping paradigm (e.g., Wertlieb, Jacobson, & Hauser, 1990), or vulnerability/risk and resiliency/protective factors model (e.g., Ackerman, Schoff, Levinson, Youngstrom, & Izard, 1999; Hauser, Vieyra, Jacobson, & Wertlieb, 1985; Jes-sor, Turbin & Costa, 1998; Luthar, Cicchetti, & Becker, 2000; Luthar & Zigler, 1991; Masten & Coatsworth, 1998).
To illustrate some dimensions of this synergy that are basic to advancing ADS, we offer an overview of the stress and coping paradigm.
An important step toward the integration of emergent approaches to developmental psychopathology and extant stress theories salient to both health and mental health researchers was taken about 20 years ago at a gathering of scholars at the Center for Advanced Study in the Behavioral Sciences. Attendants generated what at the time was a comprehensive state-of-the-art review and compelling research agenda published as Stress, Coping, and Development in Children (Garmezy & Rutter, 1983). At a reunion a decade later, many of the same scientists and their younger colleagues now pursuing the agenda took stock of the research to produce Stress, Risk, and Resilience in Children and Adolescents (Haggerty, Sherrod, Garmezy, & Rutter, 1994). This latter volume was especially impressive in its articulation of important interventions and prevention applications, reflecting the historical trend noted earlier to be fueling ADS. A comparison of the two titles reveals that the coping construct disappeared—an unfortunate decision in light of present concerns with the promises of coping interventions and developmental assets as elements of overcoming stress, risk, and poor health outcomes. However, the second title did introduce core biomedical and epidemiological constructs of risk and resiliency, basic conceptual and methodological tools consistent with ADS as defined earlier. In any event, these volumes provide a comprehensive treatment of the stress and coping field as an ADS. Figure 2.1 is a simple schematic that illustrates some basic features.
The stress and coping paradigm depicted in Figure 2.1 juxtaposes four variable domains capturing the complex and dynamic stress process (Pearlin, 1989) as a slice in time and context. The dimensions of time, or developmental progression, and context are those noted earlier as the bioecological framework (Bronfenbrenner & Ceci, 1994) and life-course models (e.g., Clausen, 1995; Elder, 1995); they are the background and foreground absent from, but implicit in, the schematic in Figure 2.1. A common critique of stress research focuses on the circularity of some of its constructs and reasoning. For instance, consider a stressful life event such as the hospitalization of a child and the necessity to consider it both as a stressor in the life of the child and his family and as an outcome of a stress process. As ADS evolves with its more sophisticated longitudinal and nonlinear analytic methodologies, these critiques will be less compelling. For the moment and for the sake of this brief description of the paradigm, a circular form with multiple dual-direction arrows is adopted. The reciprocity of influences and the transactional qualities of relationships among and across domains are signaled by both the intersections of the quadrants and the dual-directed arrows around the circumference. Consideration of each quadrant should convey the substance and form of this developmental stress and coping paradigm and the way it calls upon key variables in developmental psychopathology and developmental assets orientations.
Beginning with the stress quadrant, reference is made to the types of stress that are familiar in the literature and have documented developmental and health consequences. For instance, each child encounters biological, psychological, and social milestones and transitions. Examples include the toddler's first steps, kindergartners entering school, teenagers entering puberty, and young people marrying. These are the developmental stressors, or transitional life events, of development.
Traditional psychosomatic medicine as well as contemporary health psychology and behavioral medicine have focused most heavily on health consequences of major life events. Among these are normative experiences such as entering high school or starting a new job, nonnormative events such as the death of a parent during childhood or getting arrested, and events that do not fit classification by normative life course transitions. Thus, being diagnosed with a serious chronic illness or undergoing a divorce are examples of nonnormative event changes. The horserace between major life events such as these and, in turn, what are termed hassles, or the microstressors of everyday life—efforts to quantify one type or the other as more strongly related to particular health outcomes—has been a feature of recent research in developmental psychopathology. This work teaches us the importance of avoiding overly simple variable-centered strategies and striving to capture the richness of conceptualizations that link, for instance, chronic role strain and acute life events, be they major or quotidian (Eckenrode & Gore, 1994; Pearlin, 1989). Notions of chronic stressors allow for consideration of a relatively vast child development literature on the adverse impacts of, for example, poverty (e.g., McLoyd, 1998). The distinction between chronic and acute stressors also serves applied developmental scientists when they can differentiate variables and processes in an acute experience. Thus, for instance, receiving a diagnosis of a chronic illness, such as diabetes, may be considered an acutely stressful event, whereas living with diabetes may be viewed as a chronic stressor (Wertlieb et al., 1990).
Health consequences associated with these stressors appear in the outcomes quadrant of Figure 2.1. Highlighted here are a commitment to multidimensional and multivariate assessments of health outcomes; an appreciation of both physical and mental health indexes, acknowledging both interdependence and unity; an emphasis on a balance among assets, health, and competence indexes; and a context of health as a part of a broader biopsychosocial adaptation. In traditional terms, ADS is concerned with the health and mental health of individuals. In contemporary terms, the health of developmental systems and communities must also be indexed.
For decades, it was these two domains—stressors and outcomes—that alone constituted the field of stress research. Consistent, reliable, and useful relationships were documented confirming the stress and illness correlation. Across scores of studies, statistically consistent relationships on the order of .30 were obtained and replicated. Thus, we could consistently account for close to 10% of the variance shared by stress and health—scientifically compelling, but hardly enough given the magnitude of the decisions that health care providers and policy makers must make. Using the ADS framework, stress and coping researchers pursue a quest for the other 90% of the variance. The expansions and differentiations of stressor types exemplified in the stress quadrant of Figure 2.1 contribute to the cause. In addition, it is the incorporation of the other two quadrants—coping processes and coping resources/moderators—that are the keys to achieving the goal. As these variables are incorporated into our models, explanatory and predictive power increases, and the quest for the other 90% advances.
The present model employs a specific conceptualization and assessment methodology for coping processes as advanced by Lazarus and Folkman (1984) and adapted for children by Wertlieb, Weigel, and Feldstein (1987). This model emphasizes three types or dimensions of coping behavior exhibited by children as well as adults. A focus on the appraisal process, the problem-solving process, or the emotionmanagement process can be distinguished and measured in the transactions between an individual and the environment as stress is encountered and as developmental or health consequences unfold. Other researchers have employed similar or competing coping theories, and many, perhaps most, are consistent with the broader stress and coping paradigm presented here (e.g., Aldwin, 1994; Basic Behavioral Science Task Force of the National Advisory Mental Health Council, 1996; Bonner & Finney, 1996; Compas, 1987; Fiese & Sameroff, 1989; Luthar & Zigler, 1991; Pellegrini, 1990; Sorensen, 1993; Stokols, 1992; Wallander & Varni, 1992; Wills & Filer, 1996).
Similarly, there is a wide range of coping resources/ moderators investigated in the literature, and Figure 2.1 selects a few examples to illustrate the range and demonstrate the relevance to the developmental psychopathology and developmental assets domains of ADS. Many of the
40 elements of the developmental assets framework reflect various dimensions of social support (e.g., family support, a caring school climate, a religious community, or school engagement). A large and complicated literature documents the manners in which social support in its diverse forms influences the relationships between health and illness. Key discriminations of pathways for such influences in terms of main effects, interactions, buffering effects, and mediation or moderation are elaborated in these studies (Cohen & Syme, 1985; Sarason, Sarason, & Pierce, 1990). Similarly complex, and even controversial, are formulations that call upon constructs and measures of intelligence or cognitive capacities or styles, as resources, moderators, or mediators of the stress-health relationship (Garmezy, 1994; Goleman, 1995). Diverse ranges of personality variables have also been employed in this work, including biologically oriented notions of temperament and psychological control orientations (Wertlieb, Weigel, & Feldstein, 1989).
Socioeconomic status (SES) is depicted in this resource quadrant, reminding us of the problem of redundancy and circularity. In the earlier description of types of stress I noted the manner in which poverty—a level or type of SES—could be modeled. Here, whether the SES is conceived as a factor that psychological researchers too often relegate to the status of background variable in a multivariate model or as a factor that sociologists might emphasize in a social structural analysis, its elements are crucial pieces of the contemporary context for the stress-health linkage. Again, the general stress and coping model in Figure 2.1 can accommodate considerable diversity in this coping resources/moderators domain; success in the quest will reflect the achievement of simplicity and parsimony.
A specific composite case example from our research program in pediatric psychology, or child health psychology, will serve to show the stress and coping paradigm in action. Again, the ADS framework orients us to significant demands for both knowledge generation and knowledge utilization in this example of a child's development, where understanding as well as application in terms of health care intervention and social policy are intertwined (Wertlieb, 1999). The example of Jason Royton involves each of the four domains shown in Figure 2.1.
Twelve-year-old Jason Royton was rushed to the pediatric hospital emergency room by his distraught father the morning after a vociferous battle in their home about whether Jason will get to see the R-rated movies that he contends all his friends are allowed to see. Within hours, the pediatrician emerges with the diagnosis: insulin-dependent diabetes mel-litus (IDDM). In this scenario, the applied developmental scientist can quickly document multiple interacting dimensions of stress that potentially impinge on the child: the acute trauma of the health emergency and diagnosis, the parallel stress of the separation and autonomy struggle in the Roytons' lives, the onset of a chronic stressor of living with a life-threatening illness, and the initiation of multiple series of hassles or quotidian stressors associated with the precise regimen of diet, insulin injection, exercise, and medical care. Also immediate are the coping processes and a mélange of challenges and responses—shock, grief, denial, anxiety, appraisal (sizing up the nature of the challenges), problem solving (assessing and marshaling resources to comprehend and meet these challenges)—and for each individual, as well as for the family system, managing the feelings, threats, and disequilibria now introduced into their lives.
Influences of coping resources/moderators can be recognized as well. Mobilization of social support is part of the problem-solving process as we see Jason's grandmother arriving on the scene once they return home. Caring for the other two Royton children will be only a minor worry for Mr. and Mrs. Royton as they get through these initial days of their new status as a family with IDDM. Less minor and more surprising is the extent to which some of the protection offered by their comfortable middle-class lifestyle does not turn out to be what they thought it was. Clarifying their benefits and expenses in their new managed health care plan confirms that health insurance is not what it once was. IDDM, too, is not what it once was. Several decades ago, prior to the 1922 introduction of insulin therapy, the diagnosis was a death sentence. Now, people living with IDDM are part of a large group enjoying productive lives and pioneering novel challenges. The hope for ever-greater advances in biomedical science and technology is part of that life; a cure for IDDM, or a prevention, is an active research area.
Jason, meanwhile, is having his various "intelligences" challenged as his health care team launches him on an education for life with IDDM. Processing complex biomedical and psychosocial information, shifting notions of future threats and complications in and out of awareness, and anticipating how to live with this difference, especially when being different, has little cachet in a young adolescent's social circles. These stressors are moderated and will unfold as elements of the multidimensional health outcomes profile that must be considered in assessing the current or future health of a youngster with IDDM. Most immediate health outcomes focus on maintaining healthy blood glucose levels and some optimal adherence with the medical regimen. Psychological dimensions of accommodation of psychosocial strivings for autonomy and consolidation of a positive sense of competence and self-worth are related developmental processes. Undoubtedly, this set of experiences for Jason and his family engages the applied developmental scientist in an array of conceptual and methodological endeavors guided by frameworks of developmental psychopathology and developmental assets. (A more detailed consideration of IDDM in a stress and coping paradigm can be found in Wertlieb et al., 1990; a comprehensive survey of pediatric psychology is offered by Bearison, 1998.)
In elaborating the stress and coping paradigm as an example of an ADS heuristic, a key point to be made is that although any science can be described by mapping its domains of inquiry, to describe ADS, one must map domains of inquiry and action. The synergy and cross-fertilization between inquiry and action are core processes in advancing the ADS field. For instance, in the stress and coping paradigm example, note that each quadrant includes variables that are amenable to some range of intervention, influence, or change. Families, health or social service professionals, communities, or public policies may be among the instigators or agents of such changes. Stressors of various types can be reduced, modified, or ameliorated by individual actions or shifts in public policies. Coping processes can be taught or modified. Resources and moderators can be introduced, altered, strengthened, or weakened. Outcomes can be changed. The design and evaluation of such change processes constitutes key elements of ADS. These foci involve a number of special methods as well as ethical imperatives.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...