Milestone Flashcards
Infants: Birth to 2 Years
Play Occupations
The play occupations of infants in the first 12 months are exploratory and social—that is, they are related to bonding with caregivers (Boxes 3-1 and 3-2). As in every stage, these occupations overlap (e.g., bonding occurs during exploratory play with the parent’s hair and face, and the parent’s holding supports the infant’s play with objects). Much of the infant’s awake and alert time is spent in exploratory play, often play that occurs in the caregiver’s arms or with the caregiver nearby.
Exploratory play is also called sensorimotor play. Rubin defined exploratory play as an activity performed simply for the enjoyment of the physical sensation it creates. It includes repetitive movements to create actions in toys for the sensory experiences of hearing, seeing, and feeling. The infant places toys in the mouth, waves them in the air, and explores their surfaces with the hands. These actions allow for intense perceptual learning and bring delight to the infant (without any more complex purpose).
In the second year of life, the infant engages in functional, or relational, play; that is, an object’s function is understood, and that function determines the action (Boxes 3-3 and 3-4). Initially, children use objects on themselves (e.g., pretending to drink from a cup or to comb the hair). These self-directed actions signal the beginning of pretend play.83 The child knows cause and effect and repeatedly makes the toy telephone ring or the battery-powered doll squeal to enjoy the effect of the initial action.
By the end of the second year, play has expanded in two important ways. First, the child begins to combine actions into play sequences (e.g., he or she relates objects to each other by stacking one on the other or by lining up toys beside each other). These combined actions show a play purpose that matches the function of the toy. Second, 2-year-old children now direct actions away from themselves. The objects used in play generally resemble real-life objects.67 The child places the doll in a toy bed and then covers it. The child pretends to feed a stuffed animal or drives toy cars through a toy garage. At 2 years of age, play remains a very central occupation of the child, who now has an increased attention span and the ability to combine multiple actions in play. The emergence of sym- bolic, or imaginary, play with toys and objects offers the first opportunities for the child to practice the skills of living.
The child also engages in gross motor play throughout the day. As he or she becomes mobile, exploration of space, sur- faces, and large action toys becomes a primary occupation. Movement is also enjoyed simply as movement; the child delights in swinging and running or attempting to run and moving in water or sand. Deep proprioceptive pressure and touch are craved and requested. As in exploratory play, the child’s exploration of space involves simple, repeated actions in which the goal appears to be sensation. Often, extremes in sensation seem to be enjoyed and are frequently requested. Repetition of these full-body kinesthetic, vestibular, and tactile experiences appears to be organizing to the CNS. In addition, this repetition is important to the child’s development of bal- ance, coordination, and motor planning. Hence, the occupa- tional goal of movement and exploration becomes the means for development of multiple performance areas.
In the first year, the goal of an infant’s social play is attach- ment, or bonding, to the parents). As described by Greenspan, this is a period in which the infant falls in love with the parents and learns to trust the environment because of the care and attention provided by the parents or caregivers.54 These occu- pations are critical foundations to later occupations that involve social relating and demonstration of emotions. At 1 year of age, infants play social games with parents and others to elicit responses. Although infants at this age engage readily with individuals other than family, they require their parents’ presence as an emotional base and return to them for occa- sional emotional refueling before returning to play.105
By the second year, children exhibit social play in which they imitate adults and peers. Imitation of others is a first way to interact and socially relate. Both immediate and deferred imitation of others are important to social play as chil- dren enter preschool environments and begin to relate to their peers.
Performance Skills
Performance Skills
Sensory and Motor Skills
The newborn can interpret body sensations and respond reflexively. He enjoys and needs a consistent caregiver’s physi- cal contact and tactile stimulation. The neonate turns his head when touched on the cheek, relaxes in his mother’s arms, and expresses discomfort from a wet diaper. Self-regulation of sleep-wake cycles, feeding, and display of emotions and arousal emerge in early infancy. The infant molds himself to the par- ents’s embrace, clinging to the parent’s arms and chest. The newborn’s vestibular system is also quite mature as he calms from rocking and enjoys the motion of a parent walking him
about the room. The neonate demonstrates orientation and attention to visual, auditory, and tactile stimuli. An important fact is that the newborn also exhibits habituation, or the ability to extinguish incoming sensory information (e.g., ability to sleep by blocking out sound in a noisy nursery).
Gross motor activity begins prenatally in response to vestib- ular and tactile input inside the womb. The first movements of newborns appear to be reflexive; however, on closer examina- tion, they reveal the ability to process and integrate sensory information. The neonate’s motor responses contribute to per- ceptual development and organization. In the first month of life, the infant moves the head side to side when in a prone position and rights the head when supported in sitting. By 4 months, the prone infant lifts the head to visualize activities in the room. This ability to lift and sustain an erect-head posi- tion appears to relate to the infant’s interest in watching the activities of others, as well as improved trunk strength and sta- bility. As the infant reaches 6 months, he or she demonstrates increased ability to lift the head and trunk when in a prone position to visualize the environment when prone. The infant can also move side to side on the forearms, then the hands, and can lift an arm to grasp a toy (Figure 3-4). When supine, the child actively kicks and brings the feet to the mouth. Over the next 6 months, this dynamic, postural stability prepares the infant to become mobile.
Rolling is normally the infant’s first method of becoming mobile and exploring the environment. Initially, rolling is an automatic reaction of body righting; usually the infant first rolls from the stomach to the side and then from the stomach to the back. By 6 months, the infant rolls sequentially to move across the room. Heavy or large babies may initiate rolling sev- eral months later, and infants with hypersensitivity of the ves- tibular system (i.e., overreactivity to rotary movement) may avoid rolling entirely.
Most infants enjoy supported sitting at a very early age. As their vision improves in the first 4 months, they become more eager to view their environment from a supported sitting position. The newborn sits with a rounded back; the head is erect only momentarily. Head control emerges quickly. By 4 months, the infant can hold the head upright with con- trol for long periods, moving it side to side with ease. Most 6-month-old infants sit alone by propping forward on the arms, using a wide base of support with the legs flexed. How- ever, this position is precarious, and the infant easily topples when tilted. Many 7-month-old infants sit independently. Often their hands are freed for play with toys, but they strug- gle to reach beyond arm’s length.
By 8 to 9 months, the infant sits erect and unsupported for several minutes. At that time, or within the next couple of months, the infant may rise from a prone posture by rotating (from a side-lying position) into a sitting position. This impor- tant skill gives the infant the ability to progress by creeping to a toy and then, after arriving at the toy, to sit and play. By 12 months, the infant can rise to sitting from a supine posi- tion, rotate and pivot when sitting, and easily move in between positions of sitting and creeping (Figure 3-5).
After experimenting with pivoting and backward crawling in a prone position, the 7-month-old infant crawls forward. He or she may first attempt belly crawling using both sides of the body together. However, reciprocal arm and leg movements quickly emerge as the most successful method of forward progression. Crawling in a hands-and-knees posture (sometimes called creeping) requires more strength and coordi- nation than belly crawling. The two sides of the body move reciprocally. In addition, shoulder and pelvic stability are needed for the infant to hold the body weight over the hands and knees. Mature, reciprocal hands-and-knees crawling also requires slight trunk rotation (Figure 3-6). Through the prac- tice of crawling in the second 6 months of life, the child devel- ops trunk flexibility and rotation. Most 10- to 12-month-old infants crawl rapidly across the room, over various surfaces, and even up and down inclines.
Infants at 5 and 6 months delight in standing, and they gleefully bounce up and down while supported by their par- ents’ arms. The strong vestibular input and practice of patterns of hip and knee flexion and extension are important to the development of full upright posture after 1 year. The young infant also prepares for a full upright posture by standing against furniture or the parent’s lap. A 10-month-old infant practices rising and lowering in upright postures while holding onto the furniture. By pulling up on furniture to standing, the infant can reach objects previously unavailable. This new level of exploration and increase in potential play objects motivates infants to practice standing and motivates parents to place breakable objects on higher shelves (Figure 3-7). At 12 months the infant learns to shift the body weight onto one leg and to step to the side with the other leg. The infant soon takes small steps forward while holding onto furniture or the parent’s finger.
The infant’s first efforts toward unsupported forward move- ment through walking are often seen in short, erratic steps, a wide-based gait, and arms held in high guard. All these postural and mobility skills contribute to the infant’s ability to explore
space and obtain desired play objects. By 18 months, the infant prefers walking to other forms of mobility, but balance remains immature, and the infant falls frequently. He or she continues to use a wide-based gait and has difficulty with stopping and turn- ing. Infants remain highly motivated to practice this new skill, however, because walking brings new avenues of exploration and a sense of autonomy, and the parent must now protect the infant from objects that previously could not be reached and from spaces that have not yet been explored.
The newborn moves the arms in wide ranges, mostly to the side of the body. In the first 3 months, the infant contacts objects with the eyes more than with the hands. By 3 months, he follows his mother’s face in a smooth arc, crossing midline. As early as 1 to 2 months, an infant learns to swipe at objects placed at his or her side. This first pattern of reaching is inac- curate, but by 5 months, the accuracy of reaching towards objects increases greatly.91 The infant struggles to combine grasp with reach and may make several efforts to grasp an object held at a distance. As postural stability increases, the infant also learns to control arm and hand movements as a means of exploring objects and materials in the environment. By the time an infant is 6 months old, direct unilateral and bilateral reaches are observed, and the infant smoothly and accurately extends the arm toward a desired object. Grasp changes dramatically in the first 6 months (Figure 3-8, A and B). Initially, grasping occurs automatically (when anything is placed in the hand) and involves mass flexion of the fingers as a unit. The object is held in the palm rather than distally in the fin- gers or fingertips. Three- to 4-month-old infants, therefore, squeeze objects within their hands, and the thumb does not appear to be involved in this grasp. At 4 to 5 months, the infant exhibits a palmar grasp in which flexed fingers and an adducted thumb press the object against the palm (Figure 3-8, C). At 6 months, the infant uses a radial palmar grasping pattern in which the first two fingers hold the object against the thumb. This grasp enables the infant to orient the object so that it can be easily seen or brought to the mouth (Figure 3-8, D). The infant secures small objects using a raking motion of the fingers, with the forearm stabilized on the surface.
Grasp continues to change rapidly between 7 and 12 months.14,27 A radial digital grasp emerges in which the thumb opposes the index and middle finger pads. At approxi- mately 9 months, wrist stability in extension increases, and the infant is better able to use the fingertips in grasping (e.g., the infant can use fingertips to grasp a small object, such as a cube or cracker). By holding objects distally in the fingers, the infant can move the object while it is in the hand; movement of objects within the hands allows the infant to explore them and use objects for functional purposes. A pincer grasp, with which the infant holds small objects between the thumb and finger pads, develops by 10 to 11 months. The 12-month- old infant uses a variety of grasping patterns, often holding an object in the radial fingers and thumb. The infant may also grasp a raisin or piece of cereal with a mature pincer grasp (i.e., one in which the thumb opposes the index finger).
In the second year of life, grasping patterns continue to be refined. The child holds objects distally in the fingers, where holding is more dynamic. By the end of the second year, a tri- pod grasp on utensils and other tools may be observed. Other grasping patterns may also be used, depending on the size, shape, and weight of the object held. For example, tools are held in the hand using first a palmar grasp and then a digital grasp. Blended grasping patterns develop toward the end of the second year, allowing the child to hold a tool securely in the ulnar digits while the radial digits guide its use.
Voluntary release of objects develops around 7 and 8 months. The first release is awkward and is characterized by full extension of all fingers. The infant becomes interested in dropping objects and practices release by flinging them from the high chair. By 10 months, objects are purposefully released into a container, one of the first ways the infant relates separate objects. As the infant combines objects in play, release becomes important for stacking and accurate placement. For example, the play of 1-year-old children includes placing objects in con- tainers, dumping them out, and then beginning the activity again.
Between 15 and 18 months, the infant demonstrates release of a raisin into a small bottle and the ability to stack two cubes. Stacking blocks is part of relational play, because the infant now has the needed control of the arm in space, precision grasp without support, controlled release, spatial relations, and depth perception. The infant can also place large, simple puzzle pieces and pegs in the proper areas. At the same time, the infant acquires the ability to discriminate simple forms and shapes. Therefore, the infant’s learning of perceptual skills is supported by improved manipulative abilities, and increased perceptual discrimination promotes the infant’s practice of manipulation.82 Perception of force increases, enabling the infant to hold an object with the just-right amount of pressure (e.g., so cookies are not crushed before eaten).
The complementary use of both hands to play with objects develops between 12 months and 2 years. During this time, one hand is used to hold the object while the other hand manipulates or moves the object. It is not until the third year that children consistently demonstrate use of two hands in
simultaneous, coordinated actions (e.g., using both hands to string beads or button a shirt).36
Cognitive Skills
and the sensory input these actions provide. The infant’s learning occurs through the primary senses: looking, tasting, touching, smelling, hearing, and moving. The infant enjoys repeating actions for their own sake, and play is focused on the action that can be performed with an object (e.g., mouthing, banging, shaking), rather than the object itself.67 By 8 to 9 months, the infant has an attention span of 2 to 3 minutes and combines objects when playing (e.g., placing favorite toy in a container). At this age, children begin to understand object permanence; that is, they know that an object continues to exist even though it is hidden and cannot be seen.23 They can also find a hidden sound and actively try to locate new sounds.
By 12 months, the infant’s understanding of the functional purpose of objects increases. Play behaviors are increasingly determined by the purpose of the toy, and toys are used according to their function. The infant also demonstrates more goal-directed behaviors, performing a particular action with the intent of obtaining a specific result or goal. Tools become important at this time, because the infant uses play tools (e.g., hammers, spoons, shovels) to gain further understanding of how objects work. At the same time, the infant begins to understand how objects work (e.g., how to activate a switch or open a door).
In the second year, the child can put together a sequence of several actions, such as placing small “people” in a toy bus and pushing it across the floor. The sequencing of actions indicates increasing memory and attention span. Some of the first sequen- tial behaviors illustrate the child’s imitation of parent or sibling actions; therefore, increased ability to imitate and increased play sequences appear to develop concurrently (Figure 3-9).
Social Skills
The infant’s emotional transition from the protective, warm womb to the moment of birth is a dramatic change. The primary purpose of the newborn’s system is to maintain body functions (i.e., the cardiovascular, respiratory, and gastroin- testinal systems). However, as the infant matures, the focus shifts to increasing competence in interaction with the envi- ronment. The sense of basic trust or mistrust becomes a main theme in the infant’s affective development and is highly dependent on the relationship with the primary caregivers. According to Erikson, the first demonstration of an infant’s social trust is observed in the ease with which he or she feeds and sleeps.35
The basic trust relationship has varying degrees of involvement. Parent-infant bonding is not endowed but is developed from experiences shared between parent and child over time. These feel- ings are seen in the progression of physical contact between parent and infant. The infant shows a differentiated response to the parent’s voice, usually quieting and calming. Although infants are capable of crying from birth, they begin to express other emotions by 2 months, such as smiling and laughing.
By 5 to 6 months, the infant becomes very interested in a mirror, indicating a beginning recognition of self. By 4 to 5 months, he or she vocalizes in tones that indicate pleasure and displeasure. In the second year of life, the parents (or care- givers) remain the most important people in the child’s life.
Contexts of Infancy
Cultural Contexts
The family’s cultural beliefs and values influence caregiving practices and determine many of the child’s earliest experi- ences. For example, feeding and co-sleeping practices both influence the infant’s development. Breast feeding and bottle feeding practices vary in different cultures and ethnic groups. Although practices vary in the United States, European American mothers tend to breast-feed for the first 6 months. Mothers often establish a feeding schedule, separating feedings by longer intervals as the infant matures. African American families expect the infant to make the transition to table food quickly, and infants generally eat only table food by 1 year.113 In contrast, Chinese and Filipino infants are often breast-fed on demand until 2 to 21⁄2 years of age.17,18 These parents are often very attentive, carrying and holding their infants throughout the day, even during naps. When the infants are not held, they are kept nearby and picked up immediately if they cry.18 In many countries, children are fed certain foods as medicine, that is, to improve health or prevent illness. For example, in the Middle East, infants are given tea and herbal mixtures to prevent or cure illness, and a dietary balance of hot and cold foods is believed to be essential to good health.95
Children around the world are encouraged to self-feed at different ages using different utensils and methods. In India, toddlers learn to use only the right hand to eat. The left hand is dirty and is used only to clean oneself after defecation. As children learn to self-feed, parents often restrain the left hand.88 As a result, the right hand develops early advanced skills to manipulate and prehend food without the assistance of the left. These self-feeding practices can contribute to chil- dren’s rapid maturation of right-hand dexterity. Studies of Japanese child have shown higher-level fine motor skills than those in American children. The greater fine motor skills of Chinese children have been attributed, in part, to their early use of chopsticks as feeding utensils.114
In most middle-class U.S. homes, children sleep separated from their parents. For the earliest ages, children are placed in a separate crib and generally a separate room. The parents believe that infants and toddlers need to learn to sleep inde- pendently and become independent in self-care skills as soon as possible. In most societies outside the United States, infants sleep with their mothers.88 Mayan infants and toddlers sleep in the same room with their parents, often in the mother’s bed.77 Asian and Middle Eastern parents tend to sleep with their infants, because they believe that these sleeping arrangements are important to nurturing and bonding. In some African American and Appalachian families, parents sleep with their infants. Close physical contact at night and then into the day
can foster interdependence within families, in contrast with the independence that most U.S. parents often foster in their children.
Physical Contexts
Although many infants have a supplemental play area in a child care center, the home provides the infant’s first play environ- ment. The crib is often a play environment, providing a place for comforting toys (e.g., music boxes, colorful mobiles). Other early play spaces include the playpen, infant seat, and swing. The infant also spends time playing on the floor’s car- peted surface or on a blanket. Because the infant is not yet mobile, safety is not as much of a concern as it will be in the next 2 years of life. Early play also occurs in the parent’s or caregiver’s arms. Exploratory play and attachment occupations are pursued on the parent’s lap, and the infant is fascinated by the parent’s face and clothing. At the same time, the infant feels safe and comforted by the parent’s presence.
In the second 6 months, the infant requires less support to play, and a major role of the parent becomes one of protector from harm. As the infant becomes more mobile, spaces are closed and objects now within reach are removed. Exploration of all accessible spaces becomes an infant’s primary goal.
In the second year of life, the child’s environment may expand to the yard, to neighbors’ homes and yards, and to pre- viously unexplored spaces in the home. Most children have opportunities for play in their home’s yard or in the fenced- in areas of their child care centers. Although the child’s increasing interest in visiting outdoor spaces provides impor- tant opportunities for sensory exploration, it also creates cer- tain safety concerns. Parents therefore invest in gates and other methods of restricting the child’s mobility to safe areas.
Early Childhood: Ages 2 to 5 Years
Play Occupations
The three types of play that predominate in early childhood are (1) pretend, or symbolic, play, (2) constructive play, and (3) rough-and-tumble, or physical, play (Boxes 3-5 and 3-6). Similar changes are observed in each type of play. First, the child’s play becomes more elaborate—that is, the child now combines multiple steps and multiple schema. Short play sequences become long scripts involving several characters or actors in a story.64,67 Second, play becomes more social. The preschool-age child orients play toward peers, involving one or two peers in the story and taking turns playing various roles. When preschool-age children play with peers, the interaction appears to be as important as the activity’s goal. As the child approaches 5 years of age, all play becomes increasingly social, generally involving a small group of peers.64,99
Beginning at 2 years of age and continuing through the early childhood years, the child’s play is symbolic and imagina- tive. The child pretends that dolls, figurines, and stuffed ani- mals are real. He or she may also imitate the actions of parents, teachers, and peers. At ages 3 and 4, pretend play becomes more abstract, and objects, such as a block, can be used to represent something else. Pretend play now involves many steps that relate to each other. Children develop scripts as a basis for their play (e.g., one child is the father and one is the mother). They base these scripts on real-life events and play their roles with enthusiasm and imagination, creating their own stories and enjoying the power of their imaginary roles. Their dramatic play is quite complex at this time. However, when they are in small groups, their interaction with their peers seems to be more important than the play goal, and they can easily turn to new activities suggested by one of the group.
By 5 years of age, this imaginary play is predominantly social, as small groups of two and three join in cooperative play. About one-third of the time, a 5-year-old child engages in pretend play.93 However, this pretend play is based on imitation of real life and dressing up to play certain roles (e.g., firefighter, police officer, ballerina). Although children of this age demonstrate some understanding of adult roles, they erroneously assume that roles are one-dimensional (e.g., a firefighter has one role, that of putting out fires). Through pretending, children develop creativity, problem solving, and an understanding of another person’s point of view (Boxes 3-7 and 3-8).96
Play that involves building and construction also teaches the child a variety of skills during early childhood. At first, these skills are demonstrated in the completion of puzzles and toys with fit- together pieces (Figure 3-10). However, with mastery of simple pegs and puzzles, the child becomes more creative in construc- tion. For example, the 4-year-old child can develop a plan to build a structure with blocks and then carry out the steps to com- plete the project. With instructions and a model, the 5-year-old child can make a simple art project or create a three-dimensional design. A 5-year-old child can also put together a 10-piece puz- zle. The final product has become more important, and the child is motivated to complete it and show others the final result. The planning and designing involved in building and construction play helps the child acquire an understanding of spatial
perception and object relationships. This activity also appears to be foundational to academic performance in school.
Children from 2 to 5 years of age are extremely active and almost always readily engage in rough-and-tumble play. They continue to delight in movement experiences that provide strong sensory input. Activities such as running, hopping, skip- ping, and tumbling are performed as play without any particu- lar goal. Although rough-and-tumble play generally involves other children, it is generally noncompetitive and rarely organized. Children enjoy this activity for the simple, simulta- neous pleasure of movement as they play together.15
In associative physical play, children are generally more interested in being with other children than in the goal of the activity. However, it is important to note that some chil- dren enjoy primarily social play, whereas others enjoy solitary play. These differences do not relate to ability as much as they relate to preferences and temperament.105
Performance Skills
Sensory and Motor Skills
Young children are amazingly competent individuals, and their repertoire of motor function leaps forward during the preschool years (see Performance Skills in Boxes 3-6, 3-7, and 3-8). By age 2 years, the child walks with an increased length of stride and an efficient, well-coordinated, and well-balanced gait. Although children begin to run by 2 years, they do not exhibit true running (characterized by trunk rotation and arm swing) until 3 to 4 years of age. The 4-year-old child demonstrates a walking pattern similar to that of an adult. By 5 to 6 years of
age, the mature running pattern has developed, and children test their speed by challenging each other to races.
As mobility develops, children gain access to spaces previ- ously unavailable to them. By 2 years of age, a child walks up stairs without holding onto a parent’s hand, and at 21⁄2 years the child can walk down stairs without support. The 31⁄2- year-old child walks up and down stairs by alternating the feet and without needing to hold onto a rail.
Running and stair climbing become possible, in part, because the child’s balance and strength increase. Emerging balance can be observed as the 2-year-old child briefly stands on one foot to kick a ball. By 5 years of age, the child can bal- ance on one foot for several seconds and walk on a curb without falling.40 Between 3 and 5 years, the child may suc- cessfully attempt to use skates or roller blades.
Jumping is first observed in the 2-year-old child. This skill requires strength, coordination, and balance. By 3 years of age the child can jump easily from a step. Hopping requires greater strength and balance than jumping and is first observed at 31⁄2 years. Skipping is the more difficult gross motor pattern, because it requires sequencing of a rhythmic pattern that includes a step and a hop. A coordinated skipping pattern is not observed until 5 years of age.63
Two-year-old children begin to pedal tricycles and move small riding toys. By 3 years of age they can pedal a tricycle but may run into objects. The 4-year-old child can steer and maneuver the tricycle around obstacles.
By 21⁄2 years, most children can catch a 10-inch ball. This pattern of maturity enables the 4-year-old child to catch a much smaller ball successfully, such as a tennis ball.40 The first pattern of throwing involves a pushing motion, with the elbow providing the force for the throw. The 4-year-old child demonstrates more forward weight shift with throwing, thereby increasing the force of the ball and the distance thrown. Kicking emerges in the 2- to 3-year-old child, with accurate kicking to a target exhibited by 6 years of age. Ball skills become increasingly important as the child begins partici- pating in organized sports during the primary grades.
Early childhood is a time of rapid improvement in fine motor and manipulation performance. By 4 years of age, chil- dren learn to move small objects efficiently within one hand (i.e., in-hand manipulation). The 4-year-old child can hold several small objects in the palm of the hand while moving individual pieces with the radial fingers.82 In-hand manipula- tion indicates that isolated finger movement is well contro- lled and that the thumb easily moves into opposition for pad-o-pad prehension. These skills also indicate that the child can modulate force and that he or she has an accurate percep- tion of the gentle force needed to handle small objects with the fingertips.82
With efficient in-hand manipulation, the preschool child also learns the functional use of drawing and cutting tools. Most 3-year-old children hold a pencil with a static tripod grasp (i.e., with the pencil resting between the thumb and first two fingers) and use forearm and wrist movement to draw; however, by 5 years, a child demonstrates a mature, dynamic tripod. In this grasp pattern, the pencil is held in the tips of the radial fingers and is moved using finger movement. By controlling the pencil using individual finger movements, the child can make letters and small forms.
Drawing skills progress from drawing circles to lines that intersect and cross in a diagonal (e.g., an X). The 5-year-old child can draw a person with multiple and recognizable parts. Drawing is often a strong interest at this age and therefore contributes to the child’s imaginative play. He or she can also draw detailed figures created in the imagination (i.e., mon- sters, fairies, and other fanciful creatures).
The development of scissors skills follows the development of controlled pencil use. The first cutting skill, observed at 3 years, is snipping with alternating full-finger extension and flexion. Between 4 and 6 years, bilateral hand coordination, dexterity, and eye-hand coordination improve, enabling the child to cut out simple shapes. Mature use of scissors is not achieved until 5 to 6 years, because it requires isolated finger movements, simultaneous hand control, and well-developed eye-hand coordination for cutting accuracy.40
Other fine motor skills acquired during the preschool years are important to the child’s constructive and dramatic play. Activities such as putting puzzles together, building towers, stringing small beads, using keys, and cutting out complex designs usually require dexterity, bilateral coordination, and motor planning.
Cognitive Skills
Preschool-age children create symbolic representations of real- life objects and events during play. In addition, they begin to plan pretend scenarios in advance, organizing who and what are needed to complete the activity. Play becomes an elaborate sequence of events that is remembered, acted out, and later described for others. For example, the child may act out the role of an adult, imitating action remembered from an earlier experience. This form of role play demonstrates the child’s understanding of how roles relate to actions and how actions relate to each other (e.g., the child may role play a grocery store clerk, displaying items for sale, taking money from the customer, and placing the money in a toy cash register).
Abstract thinking begins in the preschool years as the child pretends that an object is something else. For example, the child may pretend a block is a doll bed; later the same block may become a telephone receiver or a train car.
The motor skills noted in early childhood also reflect cogni- tive skills. To construct a three-dimensional building, the child must have the ability to discriminate size and shape. Building in three dimensions also requires spatial understanding and problem-solving skills. When building from a set of blocks, the child usually must first categorize and organize the blocks. Next, the child must solve the problem of how to fit them together to replicate a model or create the imagined structure.
In a similar way, the emergence of drawing skills reflects both cognitive abilities and fine motor skills. The 3-year-old child makes crude attempts to represent people and objects in drawings. By 4 years of age, a child can draw a recognizable person, demonstrating the ability to select salient features and represent them on a two-dimensional surface. The 4-year-old child not only identifies the parts of a person but also relates them correctly, although the size of the parts is rarely propor- tional to real life. At 5 years, the child’s drawing is more refined, more realistic, and better proportioned. By this age, pictures begin to tell stories and reflect the child’s emotions.67
Social Skills
In early childhood, interaction and play with peers take on increasing importance. Children become social beings and identify themselves as individuals (i.e., separate from parents). Autonomy dominates the psychosocial development from 2 to 4 years, as the toddler shows his independence by moving away from the parent. The child is adamant about making per- sonal decisions. The development of trust in the environment and improvements in language bring forth control over self, strengthening the child’s autonomous nature.
The discovery of the body and how to control it promotes independence in self-care. Success in acting independently instills a sense of confidence and self-control. The child also begins to perceive that now all of his independent actions meet the approval of adults.
Children need to achieve a balance between initiative to act independently and the responsibility they feel for their own actions. Children 4 to 5 years old explore beyond the environ- ment, discovering new activities. They seek new experiences for the pleasure of learning about the environment and for the opportunities they offer for exploration. If the child’s learning experiences are successful and effective and his or her actions meet parental approval, a sense of initiative is devel- oped. Through these activities, the child learns to question, reason, and find solutions to problems.
Adult-child relationships and early home experiences also influence later peer relations. According to research, children whose attachments to their mothers are rated as secure tend to be more responsive to other children in child care settings. They are also more curious and competent.62,115 Peer play becomes an important avenue for the child’s development of social and cognitive abilities. With their peers, they practice social roles, engage in dramatic play, and enjoy rough and tum- ble play.
The development of autonomy provides a foundation for the child’s imagination. Now the young child explores the world not only through the use of his or her senses but also by thinking and reasoning. Although play can be reality based, it usually includes fantasy, wishes, and role play. Words, rhymes, and songs also complement this type of play.
Contexts
Cultural and Social Contexts
The social roles of young children vary across cultures. The fol- lowing discussion of cultural differences highlights how culture contributes to a child’s development. In the United States, the importance of interaction with peers is stressed at young ages. Most American children begin to interact with their peers (same age group) at about 3 years of age. Same-age peers become increasingly important through elementary school and dominate the social life of a teenager. In the United States and much of the world, children are grouped exclusively by age. These age groupings may provide more opportunities for play, but they also diminish opportunities for older children to teach and nurture younger children. Younger children have fewer opportunities to imitate older children.
Children in other parts of the world play and socialize with people of different ages. For example, in Mayan communities, children spend almost all of their time with siblings and other young relatives of a wide range of ages.10 In Polynesia, chil- dren remain with family members, including extended family. They socially participate in mixed-age groups, playing “on the edge” and watching intently until they can join in the play. In Mexican families, toddlers play with children of various ages. Often they play with older siblings. This “enduring social network” remains in place over time to care for, teach, and dis- cipline children to adulthood.88
When children spend their days with a variety of ages, they have many opportunities to imitate and learn from older chil- dren and adults. Interaction with children of varying ages pro- vides older children the opportunity to practice teaching and nurturance with young children and provides young children with the opportunity to imitate older children.112
At very young ages, Mayan children play within their par- ents’ work activities.10 For example, children engage in play activities while helping their mothers wash clothes. The chil- dren’s play in the Mayan culture is tolerated during daily work activities but is not specifically encouraged.10 Bazyk and her colleagues10 found that children’s work was playful, blurring the European American distinction between work and play. When children play in work activities, they are learning skills that will serve them well in adulthood. In contrast, the age- based groupings used in U.S. child care centers and preschools provide children with opportunities to play with same-age peers but reduce their opportunities to play within adult work activities.
Families in the United States specifically design and encour- age their children’s play and at times become playmates with children. Although play is emphasized as the primary occupa- tion for young children, children demonstrate interest in help- ing parents accomplish their work. Parents may encourage young children (e.g., 5-6 years) to participate in household tasks, such as picking up their own toys. When children begin school, parents usually expect them to participate more in household tasks such as cleaning and meal preparation.65
Physical Contexts
By the age of 5, a child’s outdoor environment has expanded beyond the areas around the home and child care center. A variety of outdoor environments offer space for rough-and- tumble play, and expanded social and physical environ- ments give the child new opportunities for learning (and gen- eralizing) the skills he or she has achieved. Although adult supervision remains essential, the entire neighborhood may become the child’s playground.
The availability of new indoor environments is also to be expected. Preschool classrooms usually have centers for differ- ent types of activities (e.g., creating art, listening to stories, playing games). In addition, community groups often sponsor a variety of indoor activities (e.g., preschool gymnastics, organized play programs) in which the child can take part.
Expanded environments offer children the opportunity to adapt play skills learned at home to the constraints of new spaces. For example, the child who climbs and slides down the stairs at home learns to climb a 6-foot ladder and slide down the slide in the neighborhood park. Parks and playgrounds also provide the child with new surfaces that challenge balance and equipment that offers intense vestibular experiences.
Cultural and socioeconomic differences can influence a child’s physical environment. Inner city parents frequently confine their children to the immediate household and forbid them to go outside after school, particularly to play. These protective strategies limit children’s exposure to dangerous neighborhood influences, but they also severely restrict the physical context available for play.41
Most preschool-aged children also enjoy spending time in quiet spaces. Children, especially those who demonstrate over- reactivity to sensory input, may feel drawn to quiet, enclosed spaces (e.g., a space behind the couch, the safe haven of their bedrooms, a small tent in the corner of the playroom) (Figure 3-11). Quiet spaces can be organizing and calming after a day in a child care center. Other children who may have under-reacting sensory systems may seek stimulating environments that are full of activity, or they may create their own high activity in an otherwise quiet space.
When placed in new environments, children often respond by instinctively exploring the new spaces (e.g., hallways, cup- boards, corners, furniture). Exploring the features of an envi- ronment can help orient children to the spaces that surround them, promote perceptual learning, and provide an under- standing of the play possibilities in that environment.
Middle Childhood: Ages 6 to 10 Years
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Play Occupations
Although 6-year-old children continue to enjoy imaginative play, they begin increasingly to structure and organize their play. By the time a child is 7 or 8 years of age, structured games and organized play predominate (Box 3-9). Games with rules are the primary mode for physical and social play. Groups of children organize themselves, assign roles, and explain (or cre- ate) rules to guide the game they plan to play. The goal of the game now competes with the reward of interacting with peers, and children become fascinated with the rules that govern the games they play.
At 7 and 8 years of age, children do not understand that rules apply equally to everyone involved in the game, and they are often unable to place the rules of the game above the per- sonal need to win.39 However, breaking the rules may incur the criticism of peers, who also acknowledge the importance of rules at this time. By 9 and 10 years of age, children are more conscientious about obeying rules. They also learn to negotiate the rules of a game and construct their own rules.
By 8 and 9 years, children become interested in sports, and parents are generally supportive of sports activities. Although a form of play, organized sports can assume a serious nature (i.e., intrinsic motivation and the internal sense of control are over- ridden by the external demands of practice and serious compe- tition with peers). In addition to organized sports, physical play is a favorite interest, including climbing, rollerblading, skipping rope, and skateboarding (Figure 3-12).
Interest in creating craft and art projects continues into middle childhood. During this time, the child shows an increased ability to organize, solve problems, and create from abstract materials. However, the completion of craft and art projects continues to require the support of adults to organize materials and identify steps. The final product, which is rela- tively unimportant to younger children, is now valued.
In middle childhood, children play in cooperative groups and value interaction with their peers. When friends come together, almost all activity is play and fun. Simply talking and joking become playful and entertaining. Children spend more than 40% of their waking hours with peers.24 In these peer groups, children learn to cooperate but also to compete.39 They are now interested in achievement through play; they rec- ognize and accept an outside standard for success or failure and criteria for winning or losing. With competition in play comes risk taking and strategic thinking. Children who com- pete in sports and other activities exhibit courage to perform against an outside standard.
Performance Skills
Sensory and Motor Skills
During the elementary school years, motor development con- tinues to focus on the refining of previously acquired skills. With this refinement, hours of repetition of activities to attain mastery of common interests are observed. Children ride bicycles, scale fences, swim, skate, and jump rope (Figure 3-13). Although motor capabilities are highly varied for this age group, balance and coordination improve throughout the middle childhood years, providing children with the agility to dance and play sports with proficiency. Research indicates that children who struggle in physical skills have lower self-esteem and are very socially marginalized.69 Not only does self-esteem improve as children master physical skills, but peer acceptance improves as well.
Fine motor skills in middle childhood include efficient tool use (e.g., scissors, tweezers) and precise drawing skills. Chil- dren handle and manipulate materials (fold, sort, adhere, cut) with competency. The drawing skills of 8- and 9-year-old chil- dren demonstrate appropriate proportions and accuracy, and handwriting skills improve in speed and accuracy as children learn manuscript and then cursive writing. These improve- ments provide evidence of increased dexterity and coordina- tion. Construction skills, manipulation, and abilities to use tools continue to generalize across performance areas, with increases in speed, strength, and precision.
Cognitive Skills
In middle childhood, concepts and relationships in the physical world are understood and applied. The child relates past events to future plans and comprehends how situations change over time. Thinking has become more flexible and abstract. The child has become a reasoning individual who can solve pro- blems by understanding variables and weighing pertinent fac- tors before making decisions. They now have a clear understanding of the difference between fantasy and reality and they choose to move from one to the other.
At younger ages, children could apply only one solution, and they often were stuck when the solution of choice did not work. By 8 and 9 years of age, however, they recognize that different solutions can be tried, and they arrive at answers through abstract reasoning rather than through concrete trial and error. At this age, children can also pay attention to more than one physical characteristic at a time and can systematically put elements together.
In play, children order objects by size or shape, demonstrat- ing the ability to discriminate perceptual aspects of objects and to order them accurately. They also understand the relation- ship of the whole to the parts, and they imagine pieces as parts of a whole. With this understanding, they become more com- petent in organizing tasks and organizing time. Children 9 and 10 years of age can give instructions to others and tell stories in detail.
By middle childhood, children learn to combine tasks and routines into complex games and competitive sports. Because a number of rules are needed to play sports, such as baseball or hockey, the child understands the need to combine the rules into a complete game. To participate in the activity success- fully, he or she also understands when rules apply and when rules can be negotiated.
Social Skills
Children 6 to 10 years of age form close friendships and “belong” to one or more peer groups that greatly influence their decisions, how they spend their time, and what they value. Florey and Greene explain, “In the beginning of middle childhood, friendships are characterized by sharing of interests. Toward the end of this period, children tend to organize around common values, commitment, loyalty, and mutual sup- port” (p. 282).39
Children in middle childhood focus on meeting challenges in themselves as well as challenges presented by others. Chil- dren appreciate the recognition that comes with successful completion of assignments or projects. Comparison with peers is increasingly important during this time. If a child’s school- work is compared with the work of a more successful student, a negative evaluation can reduce his or her sense of mastery and may produce feelings of inferiority.
School-aged children seek independence of identity. They are not as egocentric as young children and demonstrate a more objective view of themselves. Children at this age have a defi- nite subculture, or clique, that includes only certain friends. At this age, children are quick to criticize those who do not con- form to the group esthetic. Therefore rejection by the child’s peers may result from a lack of conformity in dress or physical appearance. Children who have difficulty communicating or who do not know how to initiate relationships are less likely to have close friendships. Children who are socially able and positive are more accepted and have more close friendships.
Contexts
Cultural Contexts
Expectations for children to work appear to vary across cul- tures. These expectations determine the timing and type of occupations children develop and the balance between work and play. In countries other than the United States and those of Europe, the typical age for children to assume work respon- sibilities is 5 to 7 years. In a study of 50 communities, children at 5 to 7 years are given responsibility for caring for younger children, for tending animals, and for carrying out household chores.90 In the United States, chores are rarely given to chil- dren younger than 8 or 9 years of age. Many American families do not expect children to take responsibility for chores until the age of 10 or 11. In contrast, Polynesian children develop household skills by 3 or 4 years, at which time they gather wood, sweep, or run errands to the store. In West Africa, chil- dren have duties and run errands when they are 3 years old. In Kenya, 8-year-old girls perform most of the housework.88
Mayan children are continuously at their parents’ side during work days. At early ages, they participate in work tasks, such as running errands and helping with cleanup. Bazyk et al. found that although Mayan children began work activities at a very early age, they embedded play in these chores.10 Children in Central Africa acquire work experience from toddler age, and by age 12 they can trap animals, kill game, make medicines, and garden.88 Ogunnaike and Houser examined the effects of participation in work activities and errands on cognitive perfor- mance in young Yoruban children.80 In Yoruba, young children are taught to be helpful, responsible, and respectful. Before age 5, Yoruban girls are taught to perform household chores such as washing, sweeping, cooking, and caring for their younger sib- lings. By middle childhood, the girls take full responsibility for these work roles. The number of errands a child was required to run and cognitive performance were significantly related, indicating that having children participate in work tasks at an early age may enhance cognitive competence.80
In the United States, most children and youth have very few opportunities to work with adults. Goldscheider and Waite estimated that children contribute about 15% of all labor in households.51 Rogoff believes that American children are miss- ing valuable opportunities for learning and gaining self- satisfaction.88 In comparison with practices in societies outside the United States, the lack of work opportunities for American
children limits their practice of skills important to their future and may delay their entry into adult work roles. Through experiences in school and guided participation in household work, children may develop work skills and also learn social rules and cultural values.65
Physical Contexts
In middle childhood, the child’s play environment is now large and complex; more activities take place in the neighborhood and at school. The school’s playground supports both social and physical play of small groups (or pairs) of children. Play occurs on ball fields and in community centers, amusement parks, and sports arenas. Organized activities are often sponsored by churches or by groups such as the Young Men’s Christian Asso- ciation (YMCA). By middle childhood, children have the mobil- ity skills to maneuver through all environments (e.g., rough terrain, busy city streets). The society of school-aged children dominates neighborhood streets and backyards, with bicycle races and spontaneous street hockey games. These children explore the woods and go on adventures in nearby parks to find areas unexplored by others. Although supervision by adults is still needed at times, intermittent supervision usually suffices.
Children spend many of their waking hours in school. Schools offer complex environments (e.g., playgrounds, com- puter rooms, libraries, classrooms, lunchrooms) with many social and learning opportunities.
