1. Infants, Children, and Adolescents
Eighth Edition
Chapter 11
Physical Development in Middle Childhood

2. Learning Objectives (1 of 3)
11.1 Describe changes in body size, proportions, and skeletal maturity during middle childhood.
11.2 Describe brain development in middle childhood.
11.3 Describe the causes and consequences of serious nutritional problems in middle childhood, giving special attention to obesity.
11.4 What factors contribute to myopia, otitis media, nocturnal enuresis, and asthma, and how can these health problems be reduced?

3. Learning Objectives (2 of 3)
11.5 Describe changes in the occurrence of unintentional injuries during middle childhood, and cite effective interventions.
11.6 What can parents and teachers do to encourage good health practices in school-age children?
11.7 Cite major changes in gross- and fine-motor development during middle childhood.
11.8 Describe individual differences in motor performance during middle childhood.

4. Learning Objectives (3 of 3)
11.9 What qualities of children’s play are evident in middle childhood?
11.10 What steps can schools take to promote physical fitness in middle childhood?

5. Body Growth in Middle Childhood
Physical growth continues at a slow, regular pace.
Girls are slightly shorter and lighter than boys until about age 9, when this trend reverses.
Lower portion of body is growing fastest.
After age 8, girls accumulate fat at a faster rate.

6. Middle Childhood Growth Worldwide
Shortest children are found in South America, Asia, Pacific Islands, parts of Africa.
Tallest children are found in Australia, northern and central Europe, Canada, United States.
Factors accounting for physical size differences:
Heredity: Evolutionary adaptations to particular climates
Environment: Availability or scarcity of food; control of infectious diseases

7. Secular Trends in Physical Growth
In industrialized nations, a secular gain in height and weight
appears early in life.
increases over childhood and early adolescence.
declines as mature body size is reached.
Gain is largely due to improved health and nutrition.
Gains in height have stabilized, but weight gain continues.

8. Skeletal Growth in Middle Childhood
Bones lengthen and broaden.
Ligaments are not yet firmly attached to bones, resulting in unusual flexibility.
Nighttime “growing pains” are common.
By age 12, all primary teeth have been replaced by permanent teeth.
Malocclusion occurs in one-third of school-age children.

9. Brain Development in Middle Childhood
Weight of the brain increases by 10%:
White matter rises steadily, especially in prefrontal cortex, parietal lobes, and corpus callosum.
Gray matter peaks in middle childhood and then declines as as result of synaptic pruning.
Synaptic pruning and reorganization and selection of brain circuits lead to more effective information processing.
Neurotransmitters and hormones may affect brain development and functioning.

10. Common Health Problems in Middle Childhood
Nutrition
Overweight and obesity
Vision and hearing
Bedwetting
Illnesses
Unintentional injuries

11. Nutrition in Middle Childhood
Causes of poor nutrition:
More focus on new friends and activities, less on eating
Drop in percentage of children eating meals with family
Poor-quality diets high in soft drinks and fast foods
Malnutrition resulting from poverty
Children report feeling better and focusing better after eating healthy foods.
Prolonged malnutrition can result in permanent physical and mental impairments.

12. Overweight and Obesity
About 32% of U.S. children and adolescents are overweight, 17% obese, based on body mass index (BMI).
Dramatic rise in overweight and obesity has occurred in many Western nations.
Obesity rates have risen in developing countries as a result of urbanization and dietary shifts.
In China, 20% of children are overweight and 8% are obese—a fortyfold increase over the past 25 years.
Cultural beliefs may contribute (view of overweight as sign of prosperity).
Obese children are at risk for physical, emotional, and social problems.

13. Overweight Adults in 18 Industrialized Nations
Figure 11.2: Overweight adults in eighteen industrialized nations
Figure 11.2
(Based on World Health Organization, 2014c.)

14. Causes of Obesity in Middle Childhood
Heredity (overweight parents)
Socioeconomic status
Early growth pattern of rapid weight gain
Family eating habits: use of food as reward, overfeeding, parental control of children’s intake
Responsiveness to food cues vs. hunger
Lack of physical activity
Television viewing
Early malnutrition and growth stunting

15. Family Stressors and Childhood Obesity
Stressful daily life prompts overeating through various routes:
Elevated stress hormones signal brain to boost caloric intake.
Chronic stress triggers insulin resistance.
Effort required to manage persistent stress strains self-regulatory capacity, interfering with ability to limit excessive eating.

16. Consequences of Obesity
Social isolation leads to emotional, social, and school difficulties.
Unhappiness and overeating contribute to each other.
Overweight girls are likely to reach puberty early.
Life chances are reduced by psychological consequences combined with discrimination.

17. Treating Obesity Family-based interventions: School interventions:
Focus is on changing behaviors, both diet and exercise.
Rewards for giving up inactivity are helpful.
School interventions:
Schools can serve healthier lunches and ensure regular physical activity.
Other measures include weight-related school screenings and improved school nutrition standards.
National campaigns, such as Let’s Move

18. Vision and Hearing Myopia (nearsightedness):
Most common vision problem in middle childhood
Affected by heredity, early biological trauma, increased eye strain
Increases with SES
Otitis media (middle ear infection):
Common in early childhood
May cause hearing loss after repeated infections
Regular screenings: Early detection and correction of vision and hearing defects

19. Bedwetting Nocturnal enuresis (bedwetting during the night)
occurs in 1 in 10 children.
affects more boys than girls at all ages.
usually has biological roots.
can be treated with medication or, more effectively, by using a urine alarm.

20. Illnesses in Middle Childhood
Rates of illness rise during first two years of school because of
exposure to sick children.
an immune system that is still developing.
About 20–25% of U.S. children living at home have chronic diseases:
Asthma, the most common, has increased steadily over past several decades.
Severe illnesses (sickle cell anemia, cystic fibrosis, diabetes, arthritis, cancer, AIDS) affect about 2% of U.S. children.

21. Interventions for Families with Chronically Ill Children
Health education: Parents and children learn about illness and how to manage it.
Home visits: Health professionals offer counseling and social support to parents and children.
Schools can accommodate special health and education needs.
Disease-specific summer camps teach children self-help skills and give parents time off.
Parent and peer support groups can help families cope.

22. Unintentional Injuries in Middle Childhood
Most common types of injuries:
Motor vehicle accidents involving children as passengers or pedestrians
Bicycle accidents
Characteristics of effective injury-prevention programs:
Modeling and rehearsing safety practices
Targeting specific injury risks, such as traffic safety
Emphasizing helmet use while bicycling, in-line skating, skateboarding, or using scooters
Taking steps to alter high-risk factors in families of highly active, impulsive children

23. Health Education for School-Age Children
School-age period is especially important for fostering healthy lifestyles.
Gap remains between knowledge of health information and children’s behavior.
Adults should work to reduce environmental health risks.
Parents and teachers must model and reinforce good health practices.

24. Fostering Healthy Lifestyles in School-Age Children
Increase health-related knowledge, encourage healthy behaviors.
Involve parents in supporting health education.
Provide healthy environments in schools.
Provide voluntary screening for risk factors.
Promote pleasurable physical activity.
Teach children to be critical of media advertising.
Work for safer, healthier community environments.

25. Motor Development in Middle Childhood
Gains in basic gross-motor capacities:
Flexibility
Balance
Agility
Force
Advances in fine-motor skills:
Writing
Drawing

26. Changes in Gross-Motor Skills During Middle Childhood
Running: increased speed
Other gait variations: skipping, sideways stepping
Vertical jump and standing broad jump: performance improvements
Precision jumping and hopping
Throwing and catching: improved ability over greater distances
Kicking: improved speed and accuracy
Batting: more effective batting motions
Dribbling: improvements in style

27. Fine-Motor Development in Middle Childhood
Writing:
Mastery of uppercase letters, then lowercase
Increased legibility
Drawing:
Dramatic gains in organization, detail, representation of depth
Ability to copy two-dimensional shapes
Ability to relate objects to one another as part of an organized whole

28. Increase in Organization, Detail, and Depth Cues in School-Age Children’s Drawings
Figure 11.5: Increase in organization, detail, and depth cues in school-age children’s drawings
Figure 11.5
International Collection of Child Art, Milner Library, Illinois State University, Normal, IL

29. Individual Differences in Motor Skills
Differences reflect both heredity and environment.
Body build: Taller, more muscular children excel at many motor tasks.
Family income and parental encouragement affect access to lessons in athletics and other motor skills.
Sex differences extend and, in some instances, become more pronounced:
Girls have advantage in fine-motor skills as well as balance and agility.
Boys outperform girls on throwing, kicking, and other gross-motor skills.
Educating parents about minimal differences between boys’ and girls’ physical capacities can help increase girls’ self-confidence and participation.

30. Games with Rules
Gains in perspective taking permit transition to games with rules.
These experiences contribute to emotional and social development.
Informal play is declining in industrialized countries, as a result of
parental concern about neighborhood safety.
competition from TV, video games, Internet.
rise in adult-organized sports
Child-organized games express distinct cultural values.

31. Adult-Organized Youth Sports
About half of U.S. children aged 5 to 18 participate in organized sports outside of school.
Participation is generally associated with increased self-esteem and social skills.
Valid criticisms of organized sports include
overemphasis on competition and adult control.
potential for social ostracism of weaker performers, especially for boys.

32. Providing Developmentally Appropriate Organized Sports in Middle Childhood
Build on children’s interests.
Teach age-appropriate skills.
Emphasize enjoyment.
Limit frequency and length of practices.
Focus on personal and team improvement.
Discourage unhealthy competition.
Let children contribute to rules and strategies.

33. Rough-and-Tumble Play
Friendly chasing and play-fighting
Emerges in preschool years, peaks in middle childhood
Common in many mammals and across cultures
More common among boys
Helpful in establishing dominance hierarchy

34. School Recess In U.S. school districts,
80% no longer mandate recess for students.
fewer than half mandate at least 20 minutes of recess per day.
Recess periods boost classroom learning by
distributing cognitively demanding task over longer time.
enhancing attention and performance at all ages.
Children may be more active at recess than in gym class.
Recess fosters children’s health and physical, academic, and social competence.

35. Physical Education in Middle Childhood
Physical activity supports children’s
health.
sense of self-worth as physically active, capable beings.
cognitive and social skills necessary for getting along with others.
Among U.S. students,
nearly half have no physical education classes in a typical week.
fewer than one-third engage in moderate-intensity activity for 60 minutes per day.
Physical education should
emphasize enjoyable, informal games and individual exercise.
focus on each child’s personal progress and team contribution.

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