Chapter 4: Middle Childhood

Module 4.1

Physical Development inMiddle Childhood

Physical Growth• Height

• While they are in elementary school, children in the United States grow, on average, 2 to 3 inches a year. By the age of 11, the average height for girls is 4 feet, 10 inches and the average height for boys is slightly shorter at 4 feet, 9 1/2 inches. This is the only time during the life span when girls are, on average, taller than boys. This height difference reflects the slightly more rapid physical development of girls, who start their adolescent growth spurt around the age of 10.

• Weight• Weight gain follows a similar pattern. During middle childhood, both boys and

girls gain around 5 to 7 pounds a year. Weight is also redistributed. As the rounded look of “baby fat” disappears, children’s bodies become more muscular and their strength increases.

These average height and weight increases disguise significant individual differences, as anyone who has seen a line of fourth-graders walking down a school corridor has doubtless noticed. It is not unusual to see children of the same age who are six or seven inches apart in height.

Benefits of Adequate Nutrition

• More peer involvement• More positive emotions• Less anxiety• More eagerness to explore new environments• More persistent in frustrating situations• Generally higher energy levels• Research:

– Test of the speed and accuracy of response on problem-solving tasks given to children who did or did not eat breakfast skipping breakfast had an adverse influence on their performance on the tests (Pollitt et al. 1991)

Obesity

• Most common causes:– Genetic factors– Lack of physical activity– Unhealthy eating patterns– Combination of these factors

• Only in rare cases is being overweight caused by a medical condition such as a hormonal problem

Costs of Childhood Obesity

Obese children• More likely to be

overweight as adults• Greater risk of heart

disease, diabetes, and other diseases

• Some scientists believe that an epidemic of obesity may be leading to a decline in life span in the U.S.

Obesity and Eating Disorders• In fact, concern about weight can border on an obsession,

particularly among girls. For instance, many 6-year-old girls worry about becoming “fat”

• Some 40 percent of 9- and 10-year-olds are trying to lose

weight. Why? Their concern is most often the result of the U.S. preoccupation with being slim, which permeates every sector of society

• Children become overweight for a variety of reasons: genetic and social

• In the United States over the past 20 years, obesity has increased by 54 percent in 6 to 11 year old children and by 39 percent among 12 to 17 year olds.

Obesity and Eating Disorders

• Even very young children are aware of society's fixation on thinness

• Lowered self-esteem has been associated with being overweight in girls as young as 5

• Attitude was closely correlated with parents' perceptions

Gross Motor Development

• Improved muscle coordination

Do boys and girls differ in motor skills?

• Gender differences in gross motor skills became increasingly pronounced during middle childhood, – Boys outperform girls– Little or no difference when equal participation in

exercise/activities – Influenced by societal expectations

• American Academy of Pediatrics suggests that boys and girls should engage in the same sports and games, and that they can do so together in mixed-gender groups. There is no reason to separate the sexes in physical exercise and sports until puberty, when the smaller size of females begins to make them more susceptible to injury in contact sports.

Fine Motor Development• Necessary for wide range of school-related tasks

• Influenced by increase in amount of myelin speeds up electrical impulses between neurons

• Six- and 7-year-olds are able to tie their shoes and fasten buttons; by age 8, they can use each hand independently; and by 11 and 12, they can manipulate objects with almost as much capability as they will show in adulthood.

Health • Middle childhood is period of robust health

• Routine immunizations have produced considerably lower incidence of life-threatening illnesses

• More than 90 percent of children in middle childhood have at least one serious medical condition but most are short term illnesses

Health Risks

• Accidents– Motor vehicles– Bikes– Fires and burns– Drowning– Gun-related deaths

• Reduced by use of seatbelts and helmets

Safety in Cyberspace • Newest threat to the safety of school-age children comes from

Internet and the World Wide Web• Parent and Caregiver Resources:

– The Serious Risks of Cyberspace - What are the dangers facing children on the Internet? This site will help answer that question. Created by Donna Rice Hughes, Internet safety expert and author of Kids Online: Protecting Your Children in Cyberspace

– Child Safety on the Information Highway Risks Online - This is a great place to learn about the basics of child safety on the Internet. It also talks about some guidelines that parents might consider. Created by the National Center for Missing and Exploited Children

– Safety Net for the Internet: A Parent's Guide - This is a quick, easy-to-read Internet safety guide for parents. Created by the New York Public Library

– Risks Online — Internet safety concerns are not always the same for a toddler as they are for an older child. This site will help you think about safety concerning different ages. Created by the Internet Education Foundation

Psychological Disorders

• Psychological disorders in children overlooked for years– Incidence

• One in five children and adolescents has psychological disorder that produces at least some impairment.

• About 5 percent of preteens suffer from childhood depression• Thirteen percent of children between 9 and 17 experience

anxiety disorder

– Symptoms inconsistent from those of adults

– Antidepressant drugs used for treatment have never been approved by governmental regulators for use with children

Drugs As TreatmentFOR• Depression and other

psychological disorders treated successfully using drug

• More traditional nondrug therapies that largely employ verbal methods simply are ineffective

AGAINST• Long-term effectiveness of

antidepressants with children not known

• Use of antidepressants on developing brains and long-term consequences more generally not known

• Correct dosages for children of given ages or sizes no known

• Some observers suggest that the use of special children’s versions of the drugs, in orange- or mint-flavored syrups, might lead to overdoses or perhaps eventually encourage the use of illegal drugs.

• Some evidence linking the use of antidepressant medication with an increased risk of suicide.

Children with Special Needs

• Visual impairments

• Auditory impairments

• Speech impairments

• Learning disabilities

Vision Impairments

– Blindness (20/200 after correction)

– Partial sightedness (20/70 after correction)

– Even if a person is not so impaired as to be legally blind, their visual problems may still seriously affect their schoolwork. For one thing, the legal criterion pertains solely to distance vision, while most educational tasks require close-up vision. In addition, the legal definition does not consider abilities in the perception of color, depth, and light—all of which might influence a student’s educational success. About one student in a thousand requires special education services relating to a visual impairment.

Hearing Impairment• Loss of hearing or some aspect of hearing

• Affects 2 percent of school-age children

• Varies across number of dimensions:– Hearing losses affect a significant number of people, and range from a

slight to a very severe loss. Very few people with hearing impairments are totally deaf; most have some degree of residual hearing.

– Some people with hearing impairments benefit from the use of amplification. However, in the majority of cases, even when a sound is amplified loud enough to be heard, the sound quality is affected; the sound may still be unintelligible.

– People with hearing impairments communicate in a variety of ways, depending on several factors: amount of residual hearing, type of hearing impairment, language skills, age when the impairment began, speech abilities, speech-reading skills, personality, intelligence, family environment, and educational background.

Speech-Language Impairment

• Children with speech-language impairment have an impairment of their speech and/or language structures and functions

• Parts of the body used in speaking and understanding - the brain, nerves, mouth and throat - may be damaged or not developing or working properly

• Level of speech-language impairment can range from mild to severe

• Impairment may be obvious before school or not show itself until the child has difficulty learning at school

Speech-Language Impairment• A severe speech-language impairment may

result in one or more of the following:

– The child not being able to speak

– Having speech that is very hard to understand

– The child having great difficulty making sense of speech sounds

– The child not always being able to understand others

– The child not being able to say what he or she wants.

Stuttering• Substantial disruption in rhythm and fluency

of speech

• Most common speech impairment; 20 percent of all children go through stage

• No clear-cut answers to the causes of stuttering– Genetics– Neurophysiology– Child development– Family dynamics

Learning Disabilities: Discrepancies Between Achievement

and Capacity to Learn

• Difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities– 2.8 million children in US– Dyslexia, dysgraphia, dyscalculia– ADHD

Developmental Reading Disability

• Dyslexia affects 2 to 8 percent of elementary school children

• Reading difficulties

• Inability to separate sounds in words

• Problems sounding out words

Developmental Writing Disabilities

• Writing involves several brain areas and functions (dysgraphia)

• Brain networks for vocabulary, grammar, hand movement, and memory must all be in good working order

• Developmental writing disorder may result from problems in any of these areas

Developmental Arithmetic Disability

• Arithmetic involves recognizing numbers and symbols, memorizing facts, aligning numbers, and understanding abstract concepts like place value and fractions

• Any of these may be difficult for children with developmental arithmetic disorders, also called dyscalculia

Attention Deficit Hyperactivity Disorder (ADHD)

Common Signs:• Persistent difficulty in finishing tasks, following

instructions, and organizing work• Inability to watch an entire television program• Frequent interruption of others or excessive

talking• Tendency to jump into a task before hearing all

the instructions. • Difficulty in waiting or remaining seated• Fidgeting, squirming

Diagnostic Criteria

Behaviors must: • Be excessive, long-term, and pervasive• Appear before age 7, and continue for at least 6

months• Create a real handicap in at least two areas of a

person's life, such as school, home, work, or social settings

• Different than "normal" distractibility or overstressed lifestyle prevalent in our society

Only a trained clinician can make an accurate diagnosis following an extensive evaluation of the child and interviews with parents and teachers

ADHD Treatment Controversy

• Ritalin or Dexadrine reduce activity levels in hyperactive children and are routinely prescribed– Effective in increasing attention span and

compliance BUT side effects considerable and long-term health consequences unclear

– Help scholastic performance in short run BUT long-term evidence for continuing improvement is mixed

Are there other treatments for ADHD?

• Behavioral therapy - With behavior therapy, parents and teachers are trained in techniques for improving behavior, primarily involving the use of rewards (such as verbal praise) for desired behavior. In addition, teachers can increase the structure of classroom activities and use other class management techniques to help children with ADHD, who have great difficulty with unstructured tasks.

• Diet - Because some research has shown links between ADHD and children’s diet, particularly in terms of fatty acids or food additives, dietary treatments have sometimes been prescribed. However, dietary treatments are usually insufficient by themselves.

Informed Consumer of Development

Keeping Children Fit• Make exercise fun. Gear activities to the child’s physical

level and motor skills. • Be an exercise role model.• Encourage the child to find a partner. Start slowly.• Urge participation in organized sports activities, but do

not push too hard. • Don’t make physical activity, such as jumping jacks or

push-ups, a punishment for unwanted behavior. • Provide a healthy diet.