Chapter 16: Physical Development in Middle Childhood

Chapter 16 Learning Objectives

  • Summarize the overall physical growth
  • Describe the changes in brain maturation
  • Describe the positive effects of sports
  • Describe reasons for a lack of participation in youth sports
  • Explain current trends regarding being overweight in childhood, the negative consequences of excess weight, the lack of recognition of being overweight, and interventions to normalize weight

Overall Physical Growth: Rates of growth generally slow during these years. Typically, a child will gain about 5-7 pounds a year and grow about 2-3 inches per year (CDC, 2000). They also tend to slim down and gain muscle strength and lung capacity making it possible to engage in strenuous physical activity for long periods of time. The beginning of the growth spurt, which occurs prior to puberty, begins two years earlier for females than males. The mean age for the beginning of the growth spurt for girls is nine, while for boys it is eleven. Children of this age tend to sharpen their abilities to perform both gross motor skills, such as riding a bike, and fine motor skills, such as cutting their fingernails. In gross motor skills (involving large muscles) boys typically outperform girls, while with fine motor skills (small muscles) girls outperform the boys. These improvements in motor skills are related to brain growth and experience during this developmental period.

Brain Growth: Two major brain growth spurts occur during middle/late childhood (Spreen, Riser, & Edgell, 1995). Between ages 6 and 8, significant improvements in fine motor skills and eye-hand coordination are noted. Then between 10 and 12 years of age, the frontal lobes become more developed and improvements in logic, planning, and memory are evident (van der Molen & Molenaar, 1994). Myelination is one factor responsible for these growths. From age 6 to 12, the nerve cells in the association areas of the brain, that is those areas where sensory, motor, and intellectual functioning connect, become almost completely myelinated (Johnson, 2005). This myelination contributes to increases in information processing speed and the child’s reaction time. The hippocampus, responsible for transferring information from the short-term to long- term memory, also show increases in myelination resulting in improvements in memory functioning (Rolls, 2000). Children in middle to late childhood are also better able to plan, coordinate activity using both left and right hemispheres of the brain, and to control emotional outbursts. Paying attention is also improved as the prefrontal cortex matures (Markant & Thomas, 2013). 

Sports

Middle childhood seems to be a great time to introduce children to organized sports, and in fact, many parents do. Nearly 3 million children play soccer in the United States (United States Youth Soccer, 2012). This activity promises to help children build social skills, improve athletically and learn a sense of competition. However, it has been suggested that the emphasis on competition and athletic skill can be counterproductive and lead children to grow tired of the game and want to quit. In many respects, it appears that children’s activities are no longer children’s activities once adults become involved and approach the games as adults rather than children. The U. S. Soccer Federation recently advised coaches to reduce the amount of drilling engaged in during practice and to allow children to play more freely and to choose their own positions. The hope is that this will build on their love of the game and foster their natural talents. 

Sports are important for children. Children’s participation in sports has been linked to:

  • Higher levels of satisfaction with family and overall quality of life in children
  • Improved physical and emotional development
  • Better academic performance

Yet, a study on children’s sports in the United States (Sabo & Veliz, 2008) has found that gender, poverty, location, ethnicity, and disability can limit opportunities to engage in sports. Girls were more likely to have never participated in any type of sport (see Figure 5.2). They also found that fathers may not be providing their daughters as much support as they do their sons.

While boys rated their fathers as their biggest mentor who taught them the most about sports, girls rated coaches and physical education teachers as their key mentors. Sabo and Veliz also found that children in suburban neighborhoods had a much higher participation of sports than boys and girls living in rural or urban centers. In addition, Caucasian girls and boys participated in organized sports at higher rates than minority children (see Figure 5.3).

Figure 5.2 

Figure 5.3 Percent of Students Participating in Organized Sports, by Gender, Race, and Ethnicity

Finally, Sabo and Veliz asked children who had dropped out of organized sports why they left. For both girls and boys, the number one answer was that it was no longer any fun (see Table 5.1). According to the Sport Policy and Research Collaborative (SPARC) (2013), almost 1 in 3 children drop out of organized sports, and while there are many factors involved in the decisions to drop out, one suggestion has been the lack of training that coaches of children’s sports receive may be contributing to this attrition (Barnett, Smoll & Smith, 1992). Several studies have found that when coaches receive proper training, the drop-out rate is about 5% instead of the usual 30% (Fraser-Thomas, Côté, & Deakin, 2005; SPARC, 2013).

Table 5.1 Top Reasons Dropped Out or Stopped Playing Organized/Team Sports

Welcome to the world of esports: According to Discover Esports (2017), esports is a form of competition with the medium being video games. Players use computers or specific video game consoles to play video games against each other. In addition to playing themselves, children my just watch others play the video games. The recent SPARC (2016) report on the “State of Play” in the United States highlights a disturbing trend. One in four children between the ages of 5 and 16 rate playing computer games with their friends as a form of exercise. Over half of males and about 20% of females, aged 12-19, say they are fans of esports.

Since 2008 there has also been a downward trend in the number of sports children are engaged in, despite a body of research evidence that suggests that specializing in only one activity can increase the chances of injury, while playing multiple sports is protective (SPARC, 2016). A University of Wisconsin study found that 49% of athletes who specialized in a sport experienced an injury compared with 23% of those who played multiple sports (McGuine, 2016).

Physical Education: For many children, physical education in school is a key component in introducing children to sports. After years of schools cutting back on physical education programs, there has been a turn around, prompted by concerns over childhood obesity and the related health issues. Despite these changes, currently only the state of Oregon and the District of Columbia meet PE guidelines of a minimum of 150 minutes per week of physical activity in elementary school and 225 minutes in middle school (SPARC, 2016).

Childhood Obesity

The decreased participation in school physical education and youth sports is just one of many factors that has led to an increase in children being overweight or obese. The current measurement for determining excess weight is the Body Mass Index (BMI) which expresses the relationship of height to weight. According to the Centers for Disease Control and Prevention (CDC), children’s whose BMI is at or above the 85th percentile for their age are considered overweight, while children who are at or above the 95th percentile are considered obese (Lu, 2016). In 2015-2016 approximately 13.9% of 2-5 year-olds and 18.4% of 6-11 year-olds were obese (Hales, Carroll, Fryar, & Ogden, 2017). Excess weight and obesity in children are associated with a variety of medical and cognitive conditions including high blood pressure, insulin resistance, inflammation, depression, and lower academic achievement (Lu, 2016).

Being overweight has also been linked to impaired brain functioning, which includes deficits in executive functioning, working memory, mental flexibility, and decision making (Liang, Matheson, Kaye, & Boutelle, 2014). Children who ate more saturated fats performed worse on relational memory tasks, while eating a diet high in omega-3 fatty acids promoted relational memory skills (Davidson, 2014). Using animal studies Davidson et al. (2013) found that large amounts of processed sugars and saturated fat weakened the blood-brain barrier, especially in the hippocampus. This can make the brain more vulnerable to harmful substances that can impair its functioning. Another important executive functioning skill is controlling impulses and delaying gratification. Children who are overweight show less inhibitory control than normal weight children, which may make it more difficult for them to avoid unhealthy foods (Lu, 2016). Overall, being overweight as a child increases the risk for cognitive decline as one ages. 

Figure 5.4 Being Overweight can be a Lifelong Struggle

A growing concern is the lack of recognition from parents that children are overweight or obese. Katz (2015) referred to this as oblivobesity. Black, Park and Gregson (2015) found that parents in the United Kingdom (UK) only recognized their children as obese when they were above the 99.7th percentile while the official cut-off for obesity is at the 85th percentile. Oude Luttikhuis, Stolk, and Sauer (2010) surveyed 439 parents and found that 75% of parents of overweight children said the child had a normal weight and 50% of parents of obese children said the child had a normal weight. For these parents, overweight was considered normal and obesity was considered normal or a little heavy. Doolen, Alpert, and Miller (2009) reported on several studies from the United Kingdom, Australia, Italy, and the United States, and in all locations, parents were more likely to misperceive their children’s weight. Black et al. (2015) concluded that as the average weight of children rises, what parents consider normal also rises. Needless to say, if parents cannot identify if their children are overweight they will not be able to intervene and assist their children with proper weight management.

An added concern is that the children themselves are not accurately identifying if they are overweight. In a United States sample of 8-15 year-olds, more than 80% of overweight boys and 70% of overweight girls misperceived their weight as normal (Sarafrazi, Hughes, & Borrud, 2014). Also noted was that as the socioeconomic status of the children rose, the frequency of these misconceptions decreased. It appeared that families with more resources were more conscious of what defines a healthy weight.

Children who are overweight tend to be rejected, ridiculed, teased and bullied by others (Stopbullying.gov, 2018). This can certainly be damaging to their self-image and popularity. In addition, obese children run the risk of suffering orthopedic problems such as knee injuries, and they have an increased risk of heart disease and stroke in adulthood (Lu, 2016). It is hard for a child who is obese to become a non-obese adult. In addition, the number of cases of pediatric diabetes has risen dramatically in recent years.

Behavioral interventions, including training children to overcome impulsive behavior, are being researched to help overweight children (Lu, 2016).

Practicing inhibition has been shown to strengthen the ability to resist unhealthy foods. Parents can help their overweight children the best when they are warm and supportive without using shame or guilt. Parents can also act like the child’s frontal lobe until it is developed by helping them make correct food choices and praising their efforts (Liang, et al., 2014). Research also shows that exercise, especially aerobic exercise, can help improve cognitive functioning in overweight children (Lu, 2016). Parents should take caution against emphasizing diet alone to avoid the development of any obsession about dieting that can lead to eating disorders. Instead, increasing a child’s activity level is most helpful. 

In 2018 the American Psychological Association (APA) developed a clinical practice guideline that recommends family-based, multicomponent behavioral interventions to treat obesity and overweight in children 2 to 18 (Weir, 2019). The guidelines recommend counseling on diet, physical activity and “teaching parents strategies for goal setting, problem-solving, monitoring children’s behaviors, and modeling positive parental behaviors,” (p. 32). Early research results have shown success using this model compared to controls. Because there is no quick fix for weight loss, the program recommends 26 contact hours with the family. Unfortunately, for many families cost, location, and time commitment make it difficult for them to receive the interventions. APA has recommended that behavioral treatment could be delivered in primary care offices to encourage greater particiapation. APA also recommend that schools and communities need to offer more nutritious meals to children and limit sodas and unhealthy foods.

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