Physical and Cognitive Development in Middle Childhood

1. Physical and Cognitive Development in Middle Childhood

2. Body Growth girls are slightly shorter than boys from 6 to 8 then trend reverses • girls have slightly more body fat • lowest portion of body growing the fastest during this time frame • between 6 and 12 years, all 20 primary teeth are replaced with permanent teeth

3. Physical Development 9 – 10-year-olds: beginning of growth spurt for girls 11-year-olds: beginning of growth spurt for boys Growth is influenced by activity level, exercise, nutrition, gender, and genetic factors

4. Health Problems • common vision problem-myopia-nearsightedness nearly 25% children affected • Myopia is affected by heredity and experience • less ear infections-Eustachian tube becomes longer and narrower • malnutrition-prolonged affects can cause physical growth problems, low test scores, poor motor coordination, inattention and distractibility

5. Bedwetting • Nocturnal enuresis -bedwetting that occurs during the night • most cases cause is failure of muscular responses that inhibit urination or hormonal imbalance that permits too much urine to accumulate during the night • treatment-urine alarm; special pants (underwear)

6. Obesity Is defined as body weight that is more than 20% above the average for a person of a given height and weight. 15% of children are obese. 70% of children who are obese at ages 10 to 13 will continue to be seriously overweight as adults. Obesity can lead to high blood pressure, diabetes, and other medical problems

7. Causes of Obesity Genetic Factors: a child with one obese parent has a 40% chance of becoming obese, and the proportion leaps to 80% if both parents are obese.

8. Causes for Obesity Environmental Factors: The proportion of obesity has risen 54% since the 1960. Television viewing Lack of exercise Parental encouragement Low-cost, high fat foods, and family stress School food Food as a reward system

9. Obesity • children that are obese have lower self-esteem, report feeling more depressed and display more behavioral problems than their peers • There is an increase in type II diabetes in children in recent years • Treatment for obesity should be a family program and focus on changing behaviors

10. (Nutrition and physical development during middle childhood, continued) • Despite growing rates of obesity, American society places a strong emphasis on thinness. • Concern about weight increasingly borders on obsession in the United States (especially for girls) • Research indicates that a substantial number of 6 year old girls worry about becoming “fat” • 40+% of 9 & 10 year olds are trying to lose weight! • WHY? Mostly due to our society’s preoccupation with being slim

11. Life expectancy affected? • Obesity • Hypertension, heart disease, diabetes • Stress • Too much pressure on children-school, sports, activities? • Lack of sleep • Children should get about 10-13 hours of sleep per night

12. Illnesses • higher range of illnesses during the first 2 years of elementary school; exposure to more sick children and immune system is still developing • Asthma-most frequent cause of school absence • boys, African American children and children that were low birth weight, smoking parents, parents that have had asthma and children that live in poverty have the greatest risk

13. Injuries • Common in middle childhood • auto and bicycle accidents very common • school-based safety programs are a must at this age • be careful of toy related injuries – i.e., skateboards, bicycles

14. Health during middle childhood: Psychological Disorders ~ It is important that psychological disorders not be ignored in school age children (which often occurs because symptoms are different than those of adults) ~ Childhood depression is one psychological issue often overlooked by teachers and parents. ~ 2-5% of school age children suffer from depression ~ For 1 % depression is severe (express suicidal ideas)

15. Health during middle childhood: Psychological Disorders • All kids are sad sometimes. This is different than depression (depth of sadness, length distinguish) • Childhood depression is also characterized by the expression of exaggerated fears, clinginess, or avoidance of everyday activities. • In older children it may produce sulking, school problems, and acts of delinquency.

16. Children with Special Needs • Auditory impairments are sometimes accompanied by SPEECH IMPAIRMENTS,speech that is impaired when it deviates so much from the speech of others that it calls attention to itself, interferes with communication, or produces maladjustments in the speaker. • 3 to 5 %of school-age children have speech impairments. • STUTTERING, a substantial disruption in the rhythm and fluency of speech is the most common speech impairment.

17. (Children with Special Needs, continued) • Some 2.3 million school-age children in the U.S. are officially labeled as having LEARNING DISABILITIES,difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. • Some suffer from dyslexia, a reading disability that can result in the reversal of letters during reading and writing, confusion between left and right, and difficulties in spelling

18. Approaches to treating childhood depression… • Drugs • Controversial • About 200,000 Prozac prescriptions written in 1996 for kids aged 6-12 (a 300% increase over the previous year!) • Criticisms: not approved for use with children and teens; lack of long term effectiveness of the drug; consequences to developing brains; lead in for further drug use • SSRIs and suicide

19. ADHD • Diagnostic Criteria for inattentive type: • Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities. • Often has trouble keeping attention on tasks or play activities. • Often does not seem to listen when spoken to directly. • Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions). • Often has trouble organizing activities. • Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework). • Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools). • Is often easily distracted. • Is often forgetful in daily activities. • Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

20. ADHD • Diagnostic Criteria for Hyperactive type: • Hyperactivity • Often fidgets with hands or feet or squirms in seat. • Often gets up from seat when remaining in seat is expected. • Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless). • Often has trouble playing or enjoying leisure activities quietly. • Is often "on the go" or often acts as if "driven by a motor". • Often talks excessively.

21. Impulsivity • Often blurts out answers before questions have been finished. • Often has trouble waiting one's turn. • Often interrupts or intrudes on others (e.g., butts into conversations or games). • Some symptoms that cause impairment were present before age 7 years. • Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home). • There must be clear evidence of significant impairment in social, school, or work functioning. • The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

22. Treatments for ADHD • Drug therapy: • Ritalin, Adderall, Concerta, Strattera • About 1 out of every 8 children may take some form of stimulant • Behavior therapy: • Token economy • Self-reinforcement • Negative consequences

23. Overprescribing Ritalin? U.S. doctors prescribe Ritalin for ADHD more frequently. Some experts argue the drug is overprescribed.

24. Oppositional Defiant Disorder (ODD) • Diagnostic Criteria • A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present: • often loses temper • often argues with adults • often actively defies or refuses to comply with adults' requests or rules • often deliberately annoys people • often blames others for his or her mistakes or misbehavior • is often touchy or easily annoyed by others • is often angry and resentful • is often spiteful or vindictive

25. Treatments for ODD • Drug therapy: • Ritalin appears to work well with those who have also been diagnosed with ADHD • Strattera-non-stimulant ADHD med • Divalproex (mood stabilizer for those who are prone to violence) • Omega-3 and Vitamin E – combo – research is a bit iffy on this

26. Treatment for ODD • Behavior therapy: • Parent management • Give effective timeouts • Avoid power struggles • Remain calm and unemotional in the face of opposition • Recognize and praise your child's good behaviors and positive characteristics • Offer acceptable choices to your child, giving him or her a certain amount of control • Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both parents will do with the child • Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount of time

27. COGNITIVE DEVELOPMENT • Piaget’s Concrete Operational Stage • 7 to 11 years • thought process is more logical, flexible and organized that in early childhood • Able to see beyond here and now • Less egocentric • Can see cause and effect relationships

28. Conservation • children can conserve at this stage-one of the most important developments • clear evidence of operations-mental actions that obey logical rules • Decentration-focus on several aspects of problem at once and relate to them • Reversibility-the ability to mentally go through the series of steps in a problem and then reverse the direction returning to the starting point

30. Decentering & Reversibility

31. Child achieves conservation of: • Number – Age 6 to 7 • Mass – Age 7 to 8 • Length – Age 7 to 8 • Area – Age 8-9

32. At the beginning of the concrete operational stage, kids reason that the 2 cars on these routes are traveling the same speed even though they arrive at the same time. Later, they realize the correct relationship between speed & distance.

33. Hierarchical Classification • now can group objects into hierarchies of classes and subclasses • collections are common in middle childhood • Seriation-order items in length and weight and height • Transitive inference-ability to perform seriation mentally

34. Spatial Reasoning • 7 to 8 years-mental rotations-align self’s frame to match that of a person in a different orientation; identity left and right for positions that they do not occupy • 8 to 10 years-can give clear, well-organized directions for how to get from one place to another using “mental walk” strategies.

35. Limitations of Concrete Operational Thought • Children still need concrete information for the most part • abstract concepts are still difficult • Horizontal decalage-conservation problems in certain order;number first than length than mass than liquid

36. Information Processing in Middle Childhood • During middle childhood, short-term memory capacity improves significantly. • META-MEMORY, an understanding about the processes that underlie memory emerge and improve during middle childhood. • Children use control strategies, conscious, intentionally used tactics to improve cognitive functioning. • Children can be trained to use control strategies and improve memory.

37. Language Development During Middle Childhood • Vocabulary continues to increase during the school years. • School-age children's mastery of grammar improves. • Children's understanding of syntax, the rules that indicate how words and phrases can be combined to form sentences, grows during childhood. • Certain phonemes, units of sound, remain troublesome (j, v, h, zh). • One of the most significant improvements – metalinguistic awareness

38. Early on, children may be talking to each other, but not about the same subject • Later, they develop the ability to actually communicate with another child that has meaning

39. Reading • Stage: • 0 recognize letters/sounds • 1 sound out words • 2 reading becomes easier, but there is not as much understanding of the meaning • 3 reading becomes more meaningful • 4 can understand multiple points of view

40. When are kids ready for school? • Recent research suggests that age is not a critical indicator of when children should start school. • Some research suggests that delaying children’s entrance into school based on age may actually be harmful! ~Developmental readiness is a better measure (family support, etc.)