Chapter 4: Middle Childhood Module 4.1 Physical Development in Middle Childhood

PHYSICAL DEVELOPMENT IN MIDDLE CHILDHOOD

See How We Grow! Slow but steady… Height changes Weight changes Only time in lifespan when on average girls taller than boys Variation in heights up to 6 inches not unusual 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. 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 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. 200

Cultural Patterns of Growth Sufficient or insufficient nutrition Disease Genetic inheritance Familial stress 200

Should hormones be used to make short children grow? Growth hormones given to abnormally short children; Idiopathic short stature (5th percentile for height) Ask: What do you think? What contributed to your answer? In all instances? Under what conditions? Whose decision is it? Ask: Is being short a social disadvantage?

Benefits of Adequate Nutrition Relationship to social and emotional functioning More peer involvement More positive emotions Less anxiety More eagerness to explore new environments More persistent in frustrating situations Generally higher energy levels 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) 201

What would Ugly Betty’s life be like in a real elementary school? Before beginning these questions, be especially sensitive to students in class who may be directly affected by this discussion. Be prepared to help students who may inadvertently disclose painful recollections of their early school years as obese children. Encourage students to answer the question. Ask: what do you think are the underlying causes of eating disorders in middle childhood? Define:

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 In fact, concern about weight can border on an obsession, particularly among girls. For instance, many 6-year-old girls worry about becoming “fat,” and 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. 202

Costs of Childhood Obesity Obese children More likely to be overweight as adults Greater risk of heart disease, diabetes, and other diseases In fact, some scientists believe that an epidemic of obesity may be leading to a decline in life span in the U.S. 202

The other side of “fat” 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 202

Review and Apply REVIEW In middle childhood, height and weight increase gradually. Differences in height and weight are influenced by both genetic and social factors. Adequate nutrition promotes physical, and cognitive development, while overnutrition and a sedentary lifestyle may lead to obesity. 203

Review and Apply APPLY What are some aspects of U.S. culture that may contribute to obesity among school-age children? 203

MOTOR DEVELOPMENT

Gross Motor Development Improved muscle coordination 204

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. 204

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. Myelin, which insulates nerve fibers, contains only 18% protein and 76% lipid. 205

Health and School-agers 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 For most children, this is a period of robust health, and most of the ailments they do contract tend to be mild and brief. Routine immunizations during childhood have produced a considerably lower incidence of the life-threatening illnesses that 50 years ago claimed the lives of a significant number of children. 205

Other Health Risks Accidents Reduced by use of seatbelts and helmets Motor vehicles Bikes Fires and burns Drowning Gun-related deaths Reduced by use of seatbelts and helmets Auto crashes annually kill 5 out of every 100,000 children between the ages 5 and 9. Fires and burns, drowning, and gun-related deaths follow in frequency. 205

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 Child Safety on the Information Highway Risks Online Safety Net for the Internet: A Parent's Guide 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 — 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 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 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 205

PSYCHOLOGICAL DISORDERS

Identifying the Problem Psychological disorders in children overlooked for years Incidence Symptoms inconsistent from those of adults Antidepressant drugs used for treatment have never been approved by governmental regulators for use with children 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 206

Drugs As Treatment FOR AGAINST 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. 206

Depression Key defining features of major depressive disorder in children and adolescents are same as they are for adults Way symptoms are expressed varies with developmental stage of child 206

Review and Apply REVIEW Gross motor skills continue to improve during the school years. Muscular coordination and manipulative skills advance to near-adult levels. Threats to safety include accidents, a result of increased independence and mobility, and unsupervised access to cyberspace. 207

Review and Apply APPLY How would you design an experiment to examine the roots of gender differences in gross motor skills? What impediments would you encounter in doing so? 207

Children with Special Needs Visual impairments Auditory impairments Speech impairments Learning disabilities The Law and Exceptional Students: Over twenty years ago, President Ford and Congress passed a law that made provisions for exceptional children and adults to be educated in public schools. The law covered ages three to twenty-one and required an extensive evaluation. Individuals with Disabilities Education Act: IDEA has been considered the "Bill of Rights for Handicapped Children". This Act expanded the age range of PL 94-142 to include infants and twenty-two year olds. This Act also emphasized family involvement. Understanding Inclusion: Inclusion states that there is a commitment to educate all children to the maximum extent possible for the institution and the educator. Inclusion states that disabled children benefit from being with non-disabled children, even if they are not on their academic level. Funding Special Education Programs: The Federal Government should pick up forty percent of the cost of special education programs, according to the 1975 special education law. In previous years, the Federal Government has paid for less than ten percent of the programs. Most of the cost of these programs are picked up by state and local governments through taxes. Parents of Special Children Working with the School: The parents of disabled children should play a vital role in their child's education. PL 101-476 is the law that guarantees parents' participation in the decision making process of their child's education. It is the parents' responsibility to make sure the child's rights are being protected. 207

Do you see what I see? Difficulties in seeing Blindness (20/200 after correction) Partial sightedness (20/70 after correction) Visual impairment happens when there is a problem with one or more parts of the eyes or the parts of the brain needed to process the images sent from the eyes. Although many people think blindness means a person can't see at all, this isn't always true. Some children who are considered blind can still see a little light or shadows, but they can't see things clearly. Diabetes Macular degeneration (scarring in middle area of retina) Glaucoma (Your eyes are filled with a thin fluid called aqueous humor. The fluid is made in the back of the eye, where it then passes through to the front and drains through tiny holes called outflow channels. When something stops the flow of this fluid, pressure builds up inside the eye, causing problems with vision) Cataracts are cloudy spots in the eye's lens that block light and change vision. Babies can be born with cataracts, but they usually affect older people and not kids. No one knows what causes them, although too much sunlight exposure over the years may cause cataracts to form at a younger age in adults. 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. The behaviors of children with CVI reflect their adaptive response to the characteristics of their condition Children with CVI may experience a "crowding phenomenon" when looking at a picture: difficulty differentiating between background and foreground visual information. Close viewing is common, to magnify the object or to reduce crowding. Rapid horizontal head shaking or eye pressing is not common among children with CVI. Overstimulation can result in fading behavior by the child, or in short visual attention span. The ability of children with CVI to navigate through cluttered environments without bumping into anything could be attributed to "blind sight", a brain stem visual system. Children are often able to see better when told what to look for ahead of time. Children with CVI may use their peripheral vision when presented with a visual stimulus, appearing as if they are looking away from the target. Some children look at an object momentarily and turn away as they reach for it. 208

Say what? 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. 208

Children who do not hear 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 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. 208

I am talking to YOU! Definition Impairment of speech articulation, voice, fluency, or the impairment or deviant development of language comprehension and/or expression Impairment of use of spoken or other symbol system that adversely affects educational performance The language impairment may be manifested by one or more of the following components of language: morphology, syntax, semantics, phonology, and pragmatics; Severe and early loss of hearing is also associated with difficulties in abstract thinking. Because hearing-impaired children may have limited exposure to language, they may have trouble mastering abstract concepts that can be understood fully only through the use of language than concrete concepts that can be illustrated visually. 208

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 No clear-cut answers to the causes of stuttering Genetics Neurophysiology Child development Family dynamics 208

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 ADD/ADHD LD is a disorder that affects people's ability to either interpret what they see and hear or to link information from different parts of the brain. These limitations can show up in many ways: as specific difficulties with spoken and written language, coordination, self control, or attention. Such difficulties extend to schoolwork and can impede learning to read, write, or do math. 209

The Basic Definition in Individuals with Disabilities Education Act (IDEA) “Learning disability” = umbrella term IN GENERAL: disorder is found in one or more of basic psychological processes involved in understanding or using language, spoken or written disorder may manifest itself in imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations DISORDERS INCLUDED- Such term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. DISORDERS NOT INCLUDED- Such term does not include a learning problem that is primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage. 209

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 When you think of what is involved in the "three R's" -reading, 'riting, and 'rithmetic- it's astounding that most of us do learn them. Consider that to read, you must simultaneously: Focus attention on the printed marks and control eye movements across the page Recognize the sounds associated with letters Understand words and grammar Build ideas and images Compare new ideas to what you already know Store ideas in memory 209

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 For example, a child with a writing disability, particularly an expressive language disorder, might be unable to compose complete, grammatical sentences 209

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 Problems with number or basic concepts are likely to show up early Disabilities that appear in the later grades are more often tied to problems in reasoning. 209

What are the most common signs of ADHD? 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 Because there is no simple test to identify whether a child has ADHD, it is hard to know for sure how many children have the disorder. Most estimates put the number between 3 to 7 percent of those under the age of 18. Only a trained clinician can make an accurate diagnosis following an extensive evaluation of the child and interviews with parents and teachers 209

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 209

ADHD Treatment Controversy Ritalin or Dexadrine reduce activity levels in hyperactive children and are routinely prescribe 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 210

Are there other treatments for ADD/ADHD? Behavioral therapy Diet 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. 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. 210

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. Make exercise fun. In order for children to build the habit of exercising, they need to find it enjoyable. Activities that keep children on the sidelines or that are overly competitive may give children with inferior skills a lifelong distaste for exercise. Be an exercise role model. Children who see that exercise is a regular part of the lives of their parents, teachers, or adult friends may come to think of fitness as a regular part of their lives, too. Gear activities to the child’s physical level and motor skills. For instance, use child-size equipment that can make participants feel successful. Encourage the child to find a partner. It could be a friend, a sibling, or a parent. Exercising can involve a variety of activities, such as roller skating or hiking, but almost all activities are carried out more readily if someone else is doing them too. Start slowly. Sedentary children—those who aren’t used to regular physical activity—should start off gradually. For instance, they could start with 5 minutes of exercise a day, 7 days a week. Over ten weeks, they could move toward a goal of 30 minutes of exercise 3 to 5 days a week. Urge participation in organized sports activities, but do not push too hard. Not every child is athletically inclined, and pushing too hard for involvement in organized sports may backfire. Make participation and enjoyment the goals of such activities, not winning. Don’t make physical activity, such as jumping jacks or push-ups, a punishment for unwanted behavior. Instead, schools and parents should encourage children to participate in organized programs that seek to involve children in ways that are enjoyable. Provide a healthy diet. Children who eat nutritiously are going to have more energy to engage in physical activity than those who have a diet heavy in soda and snack foods. 210

Review and Apply REVIEW Many school-age children have special needs, relating to vision, hearing, and speech that can impact their social relationships and school performance. Learning disabilities include difficulties in acquiring and using language, speaking, reading, writing, reasoning, or mathematical abilities. Attention-deficit hyperactivity disorder poses attention, organization, and activity problems for 3% to 5% of school-age children. 211

Review and Apply APPLY If hearing is associated with abstract thinking, how do people who were born deaf think? 211