Chapter 11 - Physical Development in Middle Childhood

Question 1

Brain Development

Answer 1

By Age 6 the brain has reached 90% of its size
Brain weight increases by only 10% during middle childhood and adolescence
White matter increases (prefrontal cortex, parietal lobes, and corpus collosum) while gray matter (peaks then decreases)
Lateralization increases, specialization increases
Other brain changes may involve alterations in neurotransmitter activity (more selective activation leads to more efficient and flexible thinking.) and the increase in androgens experienced by children of both sexes at about age 7 or 8

Question 2

Body Growth

Answer 2

By age six- weigh 45 pounds and are 3 ½ feet tall
Lower half grows faster
Growth norms are different around the world and in countries with large immigration populations
Long lean – hot climate, food is plentiful, few diseases
Short stocky – cold climate, food is scarce,
Ligaments are not firmly attached to bone which causes flexibility

Question 3

malocclusion

Answer 3

A condition in which the upper and lower teeth do not meet properly

Question 4

Secular trends in physical growth

Answer 4

Changes from one generation to the next

In industrialized nations – taller and heavier during childhood then evens out by adulthood – most likely due to a faster rate of physical development.

Question 5

Common Health Problems

Answer 5

Children from economically advantaged homes are often at their healthiest in middle childhood
Good nutrition
Development of the immune system
Growth in lung size

For children of lower SES families, we’re more likely to see health issues

Question 6

Nutrition

Answer 6

Due to increasing focus on play, friendships and new activities children spend less time at the table
Children like foods they have eaten repeatedly in the past

Question 7

obesity

Answer 7

A greater than 20% increase over healthy body weight based on BMI
BMI over 85th percentile is overweight
95th percentile is obese
At risk for: high blood pressure, high cholesterol, respiratory abnormalities, and insulin resistance. Which can cause: heart disease, sleep and digestive disorders, cancer, diabetes, stroke, circulatory problems, and death.
Causes: heredity accounts for a tendency (overweight parents, twins), environment does the rest.
Parents who undermine children’s ability to regulate their own food intake.
Children form maladaptive eating habits: more responsive to external stimuli, and less to internal hunger cues, eat faster, chew less.
Insufficient sleep may increase chances of being overweight. (more time for eating, less energy to be active, disrupt regulation of hunger and metabolism.
Inactivity is both the consequence and cause of weight gain.
Combating it: family programs, rewarding children for giving up inactivity

Question 8

Myopia

Answer 8

Myopia - nearsightedness; inability to see distant objects clearly
Nearly 25% of children experience myopia by the end of school years
By early adulthood, 60%
Genetic component
Early biological trauma, such as low birth weight
Experiences such as reading in dim light or sitting too close to the television
Increases with SES
Large amounts of time spent reading even in good light, or spent at computers

Question 9

Changes that led to the obesity epidemic and ways to combat it

Answer 9

Changes that led to the obesity epidemic
Availability of cheap commercial fat (palm oil) and sugar (high-fructose corn syrup)
Portion supersizing
Increasingly busy lives
Declining rates of physical activity

ways to combat it
public education about healthy eating and physical activity
building parks and recreation centers
expanding affordable healthy foods in low income neighborhoods
mandatory posting of nutrition information
special taxes
incentives for schools and workplaces for promoting healthy life style
obesity-related medical coverage

Question 10

Hearing

Answer 10

In middle childhood, the eustachian tube becomes longer, narrower, and more slanted, preventing fluid and bacteria from travelling as easily from the mouth to the ear as it could in earlier years. Otitis media becomes less frequent than it was in infancy and early childhood.
About 3-4% of the school-age population develop some hearing loss from repeated infections, though
This rate raises to as many as 20% for low-SES children

Question 11

Malnutrition

Answer 11

Children in middle childhood often take little time to sit and eat at the table if their parents don’t make them
Children report feeling better and having better focus after eating healthy foods, and feeling more sluggish after unhealthy foods
Easy availability is a big factor with children of this age
It’s notable that even mild nutritional deficits can affect cognitive functioning
Among children from middle- to high-SES families, insufficient iron and folate predict slightly lower mental test performance
Poverty-stricken children are more likely to have diets more lacking, over a longer period of time

Question 12

Obesity

Answer 12

Obesity - a greater-than-20-percent increase over healthy body weight, based on body mass index, a ratio of weight to height associated with body fat
Note that the BMI is not particularly useful for people who have a larger- or smaller-than-average bone structure or who are particularly muscular

Even developing countries are experiencing increased obesity rates
Populations are becoming more urbanized, and we see more sedentary activities and diets higher in meats and refined foods
In China, obesity was nearly nonexistent just a generation ago

Rates of overweight and obesity tend to increase with age
Over 80% of overweight children become overweight adults

In many cases, overweight children have overweight parents
The parents often do not believe their children have a weight problem
Only about 20% of obese children get treatment, in part because of parental attitudes
In adolescence, these children often use crash diets to try to lose weight, making matters worse for them

When obese children do receive treatment, long-term changes in body weight often occur
It’s important for these treatments to be family-based and to focus on changing behaviours
Weight loss by parents in these programs is often correlated with weight loss by their children
Children maintain this weight loss better than do adults, highlighting the importance of learning good habits early in life
Schools can also contribute to reduction in obesity by providing healthier food choices and ensuring physical activity

Question 13

Risks of Obesity

Answer 13

Serious emotional and social difficulties in childhood
High blood pressure
High cholesterol
Respiratory abnormalities
Insulin resistance
Cancer
Type II diabetes, once seen almost exclusively in adults, in rising rapidly among overweight children

Question 14

Childhood obesity has multiple contributors

Answer 14

Genetic tendency to gain weight easily
Lack of knowledge about healthy diet
A tendency to buy high-fat, low-cost foods
Family stress, which can prompt overeating
Not getting enough sleep
Early undernourishment
Parental use of junk food as rewards
Parental control of diet

Question 15

So obese children tend to

Answer 15

Respond more to external stimuli, and less to internal hunger cues
Eat faster, and chew their food less thoroughly
Be less physically active (and have parents who are less physically active)
Watch more TV

Question 16

Consequences of obesity include

Answer 16

Being seen as lazy, sloppy, dirty, ugly, stupid, and deceitful
Being socially isolated
By middle childhood, more emotional, social, and school difficulties, and more behaviour problems
In adolescence, more defiance, aggression, and depression
Early puberty among girls, with increased risk for early sexual activity and other adjustment problems
In adulthood, less likelihood of being given financial aid for college, to be rented apartments, to find mates, and to be offered jobs

Question 17

Nocturnal enuresis

Answer 17

Nocturnal enuresis - repeated bedwetting during the night

This is usually a biological issue. Most often, there’s a failure of muscular responses that inhibit urination or there’s a hormonal imbalance that permits too much urine to accumulate during the night. Some children have trouble waking up to the sensation of a full bladder. Punishing a school-aged child for bedwetting doesn’t help, and often makes the problem worse.

Antidepressant drugs are often prescribed to treat enuresis. These drugs reduce the amount of urine produced. This is generally a temporary measure. Note there are side effects to these drugs, such as anxiety, loss of sleep, and personality changes.

The most effective treatment is an alarm that wakes a child at the first sign of dampness. Conditioning usually leads them to start waking up when they need to.

Less than 1/3 of school-age children with nocturnal enuresis see a health worker about it. Treatment in middle childhood usually has immediate positive psychological consequences. Parents start evaluating their child’s behaviour more positively. Children gain in self-esteem. Children do often grow out of enuresis on their own, but it can take years, and with treatment, it doesn’t have to.

Question 18

Illnesses

Answer 18

In the first 2 years of elementary school, we see a higher rate of illness than later. They’re being exposed to a lot of other children. Their immune systems are still developing

About 15-20% of North American children leaving at home have some sort of chronic disease or condition. The most common is asthma, accounting for about 1/3 of childhood chronic illness.

About 2% of North American children have more severe chronic illnesses. (Sickle-cell anemia, Cystic fibrosis, Diabetes, Arthritis, Cancer, AIDS)

Some of these involve painful treatments, physical discomfort, and changes in appearance. The child’s daily life is often disrupted. School concentration can suffer. The child may be separated from peers. If the illness worsens, family stress increases. So chronically ill children are at risk for academic, emotional, and social difficulties. In adolescence, they’re more likely to suffer from low self-esteem and depression.

Good family functioning can help, so there are interventions available that include
• Health education, in which parents and children learn about the illness and get training in how to manage it
• Home visits by health professionals, who offer counselling and social support to enhance parents’ and children’s strategies for handling the stress of chronic illness
• Schools that accommodate children’s special health and education needs
• Disease-specific summer camps, which teach children self-help skills and give parents time off from the demands of caring for an ill child
• Parent and peer support groups
• Individual and family therapy

Question 19

Asthma

Answer 19

Asthma - a chronic illness in which, in response to a variety of stimuli, highly sensitive bronchial tubes fill with mucus and contract, leading to episodes of coughing, wheezing, and serious breathing difficulties

Asthma rates have more than doubled in the past 30 years, with the rate of asthma-related deaths increasing as well

Heredity is partially responsible for asthma, and we do see some group differences. Boys are at greater risk than girls, African-Americans are at greater risk than Caucasians.

There are also important environmental factors
Being born underweight
Having parents who smoke
Living in poverty
Childhood obesity

Question 20

Unintentional Injuries

Answer 20

As older children spend more time outside the home, safety education becomes especially important, so school-based programs are crucial
The ones with lasting effects: use extensive modeling and rehearsal of safety practices, give children feedback about their performance and praise and rewards for acquiring safety skills, provide occasional booster sessions.

One safety measure that is often overlooked is ensuring that children wear proper protective gear for bicycling, in-line skating, skateboarding, or using scooters. Just wearing a helmet leads to an 85% reduction in risk of head injury

Highly active, impulsive children are particularly susceptible to injury in middle childhood. They have as much safety knowledge as their peers, but are less likely to act on it. Parents tend to be lax in intervening in the dangerous behaviours of these children.

Boys also judge risky play activities as less likely to result in injury, compared with girls, and they pay less attention to injury risk cues.
E.g., a peer who looks hesitant or afraid

Question 21

Health Education

Answer 21

Middle childhood may be an especially important time to foster healthy lifestyles. Growing in independence and cognitive capacities. Self-concept are developing rapidly. Capable of learning about the structure and functioning of their bodies, good nutrition, and the causes and consequences of physical injuries and diseases.

Yet most attempts at health education don’t have much impact on behaviour, because: health is seldom an important goal for children, who feel good most of the time, children do not yet have an adultlike time perspective that relates past, present, and future; much health information given to children is contradicted by other sources, such as television advertising the examples of adults and peers.

Health education during middle childhood is crucial. It should be supplemented by reduction in environmental hazards, modelling of good health behaviours, and provision of good health care.

Question 22

Gross Motor Development

Answer 22

During middle childhood, we see the refinement of diverse motor skills, which reflect 4 basic motor capacities
Flexibility
Balance
Agility
Force

Body growth isn’t the only contributor to skills here. More efficient information processing also plays a role. Younger children often have trouble with skills that require rapid responding. During middle childhood, we see improvements in reaction time, and in the ability to respond to relevant stimuli only.

Question 23

Fine Motor Development

Answer 23

By age 6, most children can print: The alphabet, Their names, and The numbers from 1 to 10.

Writing is large, because they use their entire arm to make strokes, rather than just wrist and fingers. They master uppercase first because horizontal and vertical motions are easier to control then small curves. Legibility and uniformity of height and spacing improves throughout middle childhood. By third grade, children are learning cursive

Drawings improve in terms of: Organization, Detail, Representation of depth

By the end of preschool, children can copy many two-dimensional shapes, which they integrate into their drawings.
They have difficulty copying 3-dimensional figures before about age 8
At 9 to 10, we see overlapping objects, diagonal placement, and converging lines indicating the third dimension

Question 24

Individual Differences in Motor Skills

Answer 24

Individual differences have several sources
Height, muscle mass
Degree to which parents encourage physical exercise
Access to various lessons, either through their parents’ income or through school or government programs
Gender—girls tend to outperform boys in fine motor skills and skills involving balance and agility; boys outperform girls in other tasks

The gender difference is not fully attributable to genetics
Parents hold higher expectations for boys’ athletic performance than girls
Beginning in first grade, girls are less positive about the value of sports and their own sports ability
By sixth grade, girls devote less time to athletics than do boys

Question 25

Child-Organized Games

Answer 25

Child-invented games usually rely on simple physical skills and luck
Rather than contests of individual ability, these games tend to allow children to try out different styles of
Cooperating
Competing
Winning
Losing

These games really show different aspects of development coming together
Gains in perspective-taking are necessary for children to be capable of playing games in which there are multiple roles
Children come to understand that rules are agreements, and can be changed by agreement
Cooperation and negotiation are necessary, and are practiced

Question 26

Adult-Organized Youth Sports

Answer 26

About 60% of boys and 40% of girls participate in organized sports outside of school hours at some point between ages 5 and 14
For most children, this is associated with increased self-esteem and social competence
Physical activity in adolescence also promotes physical activity in adulthood
BUT
When children are enrolled in activities that are beyond their capabilities, they soon lose interest
When coaches and parents criticize rather than encourage, some children experience intense anxiety

Parents have greater influence on their children’s athletic attitudes and abilities than do coaches
Parents who place high levels of pressure on their children may be setting them up for emotional difficulties and early athletic dropout
Intense practice can also be unhealthy, leading to overuse injuries
Parents and coaches should emphasize effort, improvement, participations, and teamwork. The kids will have a better time.

Question 27

Physical Education

Answer 27

There’s been a trend in Canada and the US toward: Cutting back recess, Cutting back on physical education

Physical inactivity is pervasive, with less than half of children as active as is necessary for good health

Current recommendations are that schools should have daily exercise, Children need at least 30 minutes of vigorous aerobic activity and 1 hour of walking per day.

A shift in focus is also recommended. Competition scares off kids who need exercise. Enjoyable, informal (non-competitive) games, and individual exercise may help!

Question 28

Rough and tumble play

Answer 28

Emerges in preschool and peaks in middle childhood.
Engage in it with peers they like well.
After they continue to interact, if it was aggressive and not play they would separate.
Girls – more chasing
Boys – more wrestling
In evolutionary past if may a have prepared for fighting and established a dominance hierarchy.

Question 29

recess

Answer 29

Boosts classroom learning
Cognitive breaks – enhance attention
Disruptive behavior declines
Child organized games: Social skills leadership, inhibition, aggression, cooperation,
Physical activity