Middle Childhood

Why learn about development during middle childhood?

Four girls shown from behind jumping and holding hands

When Raekwon first started school, he wasn’t sure that he would like it. The thought of going to one place for a long time every day seemed sort of boring. Raekwon found that school was actually really exciting, though. He made friends, he got to learn about new things, he got to play at recess, and the food was good! He found that the days actually went by quickly! Now in fourth grade, Raekwon cannot wait for summer to be over so that he can go to school and meet-up with his friends regularly again.

Middle childhood is the period of life that begins when children enter school and lasts until they reach adolescence. Think for a moment about children at this age that you may know. What are their lives like? What kinds of concerns do they express and with what kinds of activities are their days filled? If possible, would you want to return to this period of life? Why or why not?

Early childhood and adolescence seem to get much more attention than middle childhood. Perhaps this is because growth patterns slow at this time, the id becomes hidden during the latent stage, according to Freud, and children spend much more time in schools, with friends, and in structured activities. Parents may easily lose track of their children’s development unless they stay directly involved in these worlds. It is important to stop and give full attention to middle childhood to stay in touch with these children and to take notice of the varied influences on their lives in a larger world. After all, they are developing in many incredible ways.

What you’ll learn to do: describe physical development during middle childhood

Children enter middle childhood still looking very young, and end the stage on the cusp of adolescence. Most children have gone through a growth spurt that makes them look rather grown-up. The obvious physical changes are accompanied by changes in the brain. While we don’t see the actual brain changing, we can see the effects of the brain changes in the way that children in middle childhood play sports, write, and play games.

Learning Outcomes

  • Describe physical growth during middle childhood
  • Examine health risks in school-aged children

Growth Rates and Motor Skills

Rates of growth generally slow during middle childhood. Typically, a child will gain about 5-7 pounds a year and grow about 2 inches per year. Many girls and boys experience a prepubescent growth spurt, but it tends to happen earlier in girls (around age 9-10) than in boys (around age 11-12). Because of this, girls are often taller than boys at the end of middle childhood. Children in middle childhood 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 brain reaches its adult size at about age 7. That is not to say that the brain is fully developed by age 7. The brain continues to develop for many years after it has attained its adult size. The school-aged child is 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. As the myelin continues to develop throughout middle childhood, the child’s reaction time also improves.

During middle childhood, physical growth slows down. One result of the slower growth rate is an improvement in motor skills. Children of this age tend to sharpen their abilities to perform gross motor skills, such as riding a bike, and fine motor skills, such as cutting their fingernails.

Losing Primary Teeth

smiling boy on a swing with gap in teeth
Figure 1. A toothless smile is typical of middle childhood.

Deciduous teeth, commonly known as milk teeth, baby teeth, primary teeth, and temporary teeth, are the first set of teeth in the growth development of humans. The primary teeth are important for the development of the mouth, development of the child’s speech, for the child’s smile, and play a role in chewing of food. Most children lose their first tooth around age 6, then continue to lose teeth for the next 6 years. In general, children lose the teeth in the middle of the mouth first and then lose the teeth next to those in sequence over the 6-year span. By age 12, generally, all of the teeth are permanent teeth. However, it is not extremely rare for one or more primary teeth to be retained beyond this age, sometimes well into adulthood, often because the secondary tooth fails to develop.

Health Risks: Childhood Obesity

Nearly 20 percent of school-aged American children are obese. The percentage of obesity in school-aged children has increased substantially since the 1960s, and it continues to increase. This is true in part because of the introduction of a steady diet of television and other sedentary activities. In addition, we have come to emphasize high fat, fast foods as a culture. Pizza, hamburgers, chicken nuggets, and “Lunchables” with soda have replaced more nutritious foods as staples.

School Lunches

School lunches must meet the applicable recommendations of the Dietary Guidelines for Americans. These guidelines state that no more than 30 percent of an individual’s calories should come from fat and less than 10 percent from saturated fat. Regulations also state that school lunches must provide one-third of the recommended dietary allowances of protein, Vitamin A, Vitamin C, iron, calcium, and calories. School lunches must meet federal nutrition requirements over the course of one week’s worth of lunches. However, local school food authorities may make decisions about which specific foods to serve and how they are prepared.

Many children in the United States buy their lunches in the school cafeteria, so it might be worthwhile to look at the nutritional content of school lunches. You can obtain this information through your local school district’s website. An example of a school menu and nutritional analysis from a school district in north-central Texas is a meal consisting of pasta alfredo, breadstick, peach cup, tomato soup, and a brownie, and 2% milk. Students may also purchase chips, cookies, or ice cream along with their meals. Many school districts rely on the sale of dessert and other items in the lunchrooms to make additional revenues and many children purchase these additional items so our look at their nutritional intake should also take this into consideration.

Consider another menu from an elementary school in the state of Washington. This sample meal consists of a chicken burger, tater tots, fruit and veggies, and 1% or nonfat milk. This meal is also in compliance with Federal Nutrition Guidelines but has about 300 fewer calories. And, children are not allowed to purchase additional desserts such as cookies or ice cream.

Michelle Obama has been a recent advocate for nutritional school lunches. Since the Healthy, Hunger-Free Act of 2010, she has worked diligently to defend the importance of healthy school lunches but has largely not been successful in her efforts. Schools in the United States are having difficulty enforcing nutrition values for fear of being wasteful because some new standards, such as whole grains, more vegetables, and reduced sodium levels initially resulted in fewer children eating their lunches. Children eat 16% more vegetables and 23% more fruit during lunches, and over 90% of schools report meeting the new nutritional guidelines.

One consequence of childhood obesity is that children who are overweight tend to be ridiculed and teased by others. This can certainly be damaging to their self-image and popularity. In addition, obese children risk suffering orthopedic problems such as knee injuries, and an increased risk of heart disease and stroke in adulthood. It may be difficult 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.

Dieting is not the solution to childhood obesity. If you diet, your basal metabolic rate tends to decrease, making the body burn even fewer calories to maintain the weight. Increased activity is much more effective in lowering the weight and improving the child’s health and psychological well-being. Exercise reduces stress and being an overweight child, subjected to the ridicule of others can certainly be stressful. Parents should take caution against emphasizing diet alone to avoid the development of any obsession about dieting that can lead to eating disorders as teens. Again, increasing a child’s activity level is most helpful.

Organized Sports: Pros and Cons

Children playing soccer. A green team and a yellow team, both boys and girls, run towards the ball.
Figure 2. Organized sports like soccer are especially popular during middle childhood.

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. This activity promises to help children build social skills, improve athletically, and learn a sense of competition. It has been suggested, however, 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 during practice and allow children to play more freely and choose their own positions. The hope is that this will build on their love of the game and foster their natural talents.

What you’ll learn to do: explain changes and advances in cognitive development during middle childhood

A boy shown deep in thought

Children in middle childhood are beginning a new experience—that of formal education. In the United States, formal education begins at a time when children begin to think in new and more sophisticated ways. According to Piaget, the child is entering a new stage of cognitive development where they are improving their logical skills. During middle childhood, children also make improvements in short-term and long-term memory.

Learning Outcomes

  • Describe key characteristics of Piaget’s concrete operational intelligence
  • Explain the information processing theory of memory
  • Describe language development in middle childhood

Piaget’s Stages of Cognitive Development

Table 1. Piaget’s Stages of Cognitive Development
Age (years) Stage Description Developmental issues
0–2 Sensorimotor World experienced through senses and actions Object permanence
Stranger anxiety
2–7 Preoperational Use words and images to represent things but lack logical reasoning Pretend play
Language development
7–11 Concrete operational Understand concrete events and logical analogies; perform arithmetical operations Conservation
Mathematical transformations
11– Formal operational Utilize abstract reasoning and hypothetical thinking Abstract logic
Moral reasoning

Concrete Operational Thought

Iraqi girl in headscarf sits with a laptop.
Figure 1. This child is likely in the concrete operational stage of cognitive development.

According to Piaget, children in early childhood are in the preoperational stage of development in which they learn to think symbolically about the world. From ages 7 to 11, the school-aged child continues to develop in what Piaget referred to as the concrete operational stage of cognitive development. This involves mastering the use of logic in concrete ways. The child can use logic to solve problems tied to their own direct experience but has trouble solving hypothetical problems or considering more abstract problems. The child uses inductive reasoning, thinking that the world reflects one’s personal experience. For example, a child has one friend who is rude, another friend who is also rude, and the same is true for a third friend. Using inductive reasoning, the child may conclude that friends are rude. (We will see that this way of thinking tends to change during adolescence as children begin to use deductive reasoning effectively.)

The word concrete refers to that which is tangible; that which can be seen or touched or experienced directly. The concrete operational child is able to make use of logical principles in solving problems involving the physical world. For example, the child can understand the principles of cause and effect, size, and distance.

As children’s experiences and vocabularies grow, they build schema and are able to classify objects in many different ways. Classification can include new ways of arranging, categorizing, or creating classes of information. Many psychological theorists, including Piaget, believe that classification involves a hierarchical structure, such that information is organized from very broad categories to very specific items.

One feature of concrete operational thought is the understanding that objects have an identity or qualities that do not change even if the object is altered in some way. For instance, the mass of an object does not change by rearranging it. A piece of chalk is still chalk even when the piece is broken in two.

During middle childhood, children also understand the concept of reversibility, or that some things that have been changed can be returned to their original state. Water can be frozen and then thawed to become liquid again. But eggs cannot be unscrambled. Arithmetic operations are also reversible: 2 + 3 = 5 and 5 – 3 = 2. Many of these cognitive skills are incorporated into the school’s curriculum through mathematical problems and in worksheets about which situations are reversible or irreversible. (If you have access to children’s school papers, look for examples.)

Remember the example from the earlier module of children thinking that a tall beaker filled with 8 ounces of water was “more” than a short, wide bowl filled with 8 ounces of water? Concrete operational children can understand the concept of reciprocity which means that changing one quality (in this example, height or water level) can be compensated for by changes in another quality (width). So there is the same amount of water in each container, although one is taller and narrower and the other is shorter and wider.

These new cognitive skills increase the child’s understanding of the physical world. Operational or logical thought about the abstract world comes later.

Information Processing Theory

Information processing theory is a classic theory of memory that compares the way in which the mind works to computer storing, processing, and retrieving information. According to the theory, there are three levels of memory:

1) Sensory memory: Information first enters our sensory memory (sometimes called sensory register). Stop reading and look around the room very quickly. (Yes, really. Do it!) Okay. What do you remember? Chances are, not much, even though EVERYTHING you saw and heard entered into your sensory memory. And although you might have heard yourself sigh, caught a glimpse of your dog walking across the room, and smelled the soup on the stove, you may not have registered those sensations. Sensations are continuously coming into our brains, and yet most of these sensations are never really perceived or stored in our minds. They are lost after a few seconds because they were immediately filtered out as irrelevant. If the information is not perceived or stored, it is discarded quickly.

2) Working memory (short-term memory): If information is meaningful (either because it reminds us of something else or because we must remember it for something like a history test we will be taking in 5 minutes), it moves from sensory memory into our working memory. The process by which this happens is not entirely clear. Working memory consists of information that we are immediately and consciously aware of. All of the things on your mind at this moment are part of your working memory.

A limited amount of information can be kept in the working memory at any given time. For most people, this is somewhere around 7 + or – 2 pieces or chunks of information. If you are given too much information at a time, you may lose some of it. (Have you ever been writing down notes in a class and the instructor speaks too quickly for you to get it all in your notes? You are trying to get it down and out of your working memory to make room for new information and if you cannot “dump” that information onto your paper and out of your mind quickly enough, you lose what has been said.)

Rehearsal can help you maintain information in your working memory, but the process by which information moves from working memory into long term memory seems to rely on more than simple rehearsal. Information in our working memory must be stored in an effective way in order to be accessible to us for later use. It is stored in our long-term memory or knowledge base.

3) Long-term memory (knowledge base): This level of memory has an unlimited capacity and stores information for days, months, or years. It consists of things that we know of or can remember if asked. This is where you want the information to ultimately be stored. The important thing to remember about storage is that it must be done in a meaningful or effective way. In other words, if you simply try to repeat something several times in order to remember it, you may only be able to remember the sound of the word rather than the meaning of the concept. So if you are asked to explain the meaning of the word or to apply a concept in some way, you will be lost. Studying involves organizing information in a meaningful way for later retrieval. Passively reading a text is usually inadequate and should be thought of as the first step in learning material. Writing keywords, thinking of examples to illustrate their meaning, and considering ways that concepts are related are all techniques helpful for organizing information for effective storage and later retrieval.

During middle childhood, children are able to learn and remember due to an improvement in the ways they attend to and store information. As children enter school and learn more about the world, they develop more categories for concepts and learn more efficient strategies for storing and retrieving information. One significant reason is that they continue to have more experiences on which to tie new information. New experiences are similar to old ones or remind the child of something else about which they know. This helps them file away new experiences more easily.

Children in middle childhood also have a better understanding of how well they are performing on a task and the level of difficulty of a task. As they become more realistic about their abilities, they can adapt studying strategies to meet those needs. While preschoolers may spend as much time on an unimportant aspect of a problem as they do on the main point, school-aged children start to learn to prioritize and gauge what is significant and what is not. They develop metacognition or the ability to understand the best way to figure out a problem. They gain more tools and strategies (such as “i before e except after c” so they know that “receive” is correct but “recieve” is not.)

Language Development


One of the reasons that children can classify objects in so many ways is that they have acquired a vocabulary to do so. By 5th grade, a child’s vocabulary has grown to 40,000 words. It grows at the rate of 20 words per day, a rate that exceeds that of preschoolers. This language explosion, however, differs from that of preschoolers because it is facilitated by associating new words with those already known (fast-mapping) and because it is accompanied by a more sophisticated understanding of the meanings of a word.

A child in middle childhood can also think of objects in less literal ways. For example, if asked for the first word that comes to mind when one hears the word “pizza”, the preschooler is likely to say “eat” or some word that describes what is done with a pizza. However, the school-aged child is likelier to place pizza in the appropriate category and say “food” or “carbohydrate”.

This sophistication of vocabulary is also evidenced in the fact that school-aged children are able to tell jokes and delight in doing so. They may use jokes that involve plays on words such as “knock-knock” jokes or jokes with punch lines. Preschoolers do not understand plays on words and rely on telling “jokes” that are literal or slapstick such as “A man fell down in the mud! Isn’t that funny?”

Grammar and Flexibility

School-aged children can also learn new grammar rules with more flexibility. While preschoolers are likely to be reluctant to give up saying “I goed there”, school-aged children will learn this rather quickly along with other rules of grammar.

While the preschool years might be a good time to learn a second language (being able to understand and speak the language), the school years may be the best time to be taught a second language (the rules of grammar).

What you’ll learn to do: explain emotional, social, and moral development during middle childhood

A girl whispering into another girl's ear

Children in middle childhood are starting to make friends in more sophisticated ways. They choose friends for specific characteristics, including shared interests, a sense of humor, and being a good person. That is quite a departure from the earlier days of playing with the people in your group just because they are there. Children in middle childhood are starting to realize that friendships have benefits, and there are sometimes difficulties. In this section, we’ll examine some aspects of these relationships.

Learning outcomes

  • Examine Erikson’s stage of industry vs. inferiority as it relates to middle childhood
  • Describe the importance of peer relationships to middle childhood
  • Understand Kohlberg’s theory on preconventional, conventional, and postconventional moral development
  • Examine short term-and long term consequences of divorce on children
  • Describe issues regarding sexual abuse and children

Psychodynamic and Psychosocial Theories of Middle Childhood

Now let’s turn our attention to concerns related to social development, self-concept, the world of friendships, and family life. During middle childhood, children are likely to show more independence from their parents and family, think more about the future, understand more about their place in the world, pay more attention to friendships, and want to be accepted by their peers.

Freud’s Psychosexual Development: The Latency Stage

Freud’s Theory 

Table 1. Freud’s Stages of Psychosexual Development
Stage Age (years) Erogenous Zone Major Conflict Adult Fixation Example
Oral 0–1 Mouth Weaning off breast or bottle Smoking, overeating
Anal 1–3 Anus Toilet training Neatness, messiness
Phallic 3–6 Genitals Oedipus/Electra complex Vanity, overambition
Latency 6–12 None None None
Genital 12+ Genitals None None

Remember that Freud’s theory of psychosexual development suggests that children develop their personality through a series of psychosexual stages. In each stage, the erogenous zone is the source of the libidinal energy. So far we have seen the oral stage (ages birth – 18 months), the anal stage (ages 18 months – 3 years), and the phallic stage (ages 3 years – 6 years).

During middle childhood (6-11), the child enters the latency stage, focusing their attention outside the family and toward friendships. Freud’s fourth stage of psychosexual development is the latency stage. This stage begins around age 6 and lasts until puberty. The biological drives are temporarily quieted (latent) and the child can direct attention to a larger world of friends. If the child is able to make friends, they will gain a sense of confidence. If not, the child may continue to be a loner or shy away from others, even as an adult.

In the latency stage, children are actually doing very little psychosexual developing according to Freud. Where pleasure and development occurred through erogenous zones in the first 3 stages, in the latency stage all pleasure from erogenous zones is repressed. In other words, it is latent—hence the stage’s name. Freud believed that in the latency stage all development and stimulation come from secondary sources since the erogenous forces are repressed. These secondary sources can include education, forming various social relationships, and hobbies.

Erikson’s Psychosocial Development: Industry vs. Inferiority (Competence)

Erikson’s Psychosocial Stages of Development
Stage Age (years) Developmental Task Description
1 0–1 Trust vs. mistrust Trust (or mistrust) that basic needs, such as nourishment and affection, will be met
2 1–3 Autonomy vs. shame/doubt Develop a sense of independence in many tasks
3 3–6 Initiative vs. guilt Take initiative on some activities—may develop guilt when unsuccessful or boundaries overstepped
4 7–11 Industry vs. inferiority Develop self-confidence in abilities when competent or sense of inferiority when not
5 12–18 Identity vs. confusion Experiment with and develop identity and roles
6 19–29 Intimacy vs. isolation Establish intimacy and relationships with others
7 30–64 Generativity vs. stagnation Contribute to society and be part of a family
8 65– Integrity vs. despair Assess and make sense of life and meaning of contributions

As we have seen in previous modules, Erikson believes that children’s greatest source of personality development comes from their social relationships. So far, we have seen 3 psychosocial stages: trust versus mistrust (ages birth – 18 months), autonomy versus shame and doubt (ages 18 months – 3 years), and initiative versus guilt (ages 3 years – around 6 years).

During the elementary school stage (ages 7–12), children face the task of industry vs. inferiority. Children begin to compare themselves with their peers to see how they measure up. They either develop a sense of pride and accomplishment in their schoolwork, sports, social activities, and family life, or they feel inferior and inadequate because they feel that they don’t measure up. If children do not learn to get along with others or have negative experiences at home or with peers, an inferiority complex might develop into adolescence and adulthood.

According to Erikson, children in middle childhood are very busy or industrious. They are constantly doing, planning, playing, getting together with friends, and achieving. This is a very active time and a time when they are gaining a sense of how they measure up when compared with friends. Erikson believed that if these industrious children view themselves as successful in their endeavors, they will get a sense of competence for future challenges. If instead, a child feels that they are not measuring up to their peers, feelings of inferiority and self-doubt will develop. According to Erikson, these feelings of inferiority can lead to an inferiority complex that lasts into adulthood.

To help children have a successful resolution in this stage, they should be encouraged to explore their abilities. They should be given authentic feedback as well. Failure is not necessarily a horrible thing according to Erikson. Indeed, failure is a type of feedback that may help a child form a sense of modesty. A balance of competence and modesty is ideal for creating a sense of competence in the child.


Children in middle childhood have a more realistic sense of self than do those in early childhood. That exaggerated sense of self as “biggest” or “smartest” or “tallest” gives way to an understanding of one’s strengths and weaknesses. This can be attributed to greater experience in comparing one’s own performance with that of others and to greater cognitive flexibility. A child’s self-concept can be influenced by peers, family, teachers, and the messages they send about a child’s worth. Contemporary children also receive messages from the media about how they should look and act.  Movies, music videos, the internet, and advertisers can all create cultural images of what is desirable or undesirable and this too can influence a child’s self-concept.


The pre-adolescent, or tween, age range of roughly 9-12 is a major force in the marketing world. This group has a spending power of $200 billion, and are primarily targeted as consumers of media, clothing, and products that make them look “cool” and feel independent. This market came under heavy fire a few years ago for being overly sexualized, which led to the creation of a task force by the American Psychological Association to learn more—their findings and recommendations to reduce this problem can be accessed here.

The Society of Children

Friendships during middle childhood take on new importance as judges of one’s worth, competence, and attractiveness. Friendships provide the opportunity for learning social skills such as how to communicate with others and how to negotiate differences. Children get ideas from one another about how to perform certain tasks, how to gain popularity, what to wear, what to say, what to listen to, and how to act. This society of children marks a transition from a life focused on the family to a life concerned with peers.  In peer relationships, children learn how to initiate and maintain social interactions with other children. They learn skills for managing conflict, such as turn-taking, compromise, and bargaining. Play and communication also involve the mutual, sometimes complex, coordination of goals, actions, and understanding.

Social Comparison and Bullying

However, peer relationships can be challenging as well as supportive (Rubin, Coplan, Chen, Bowker, & McDonald, 2011). Being accepted by other children is an important source of affirmation and self-esteem, but peer rejection can foreshadow later behavior problems (especially when children are rejected due to aggressive behavior). With increasing age, children confront the challenges of bullying, peer victimization, and managing conformity pressures.

Social comparison with peers is an important means by which children evaluate their skills, knowledge, and personal qualities, but it may cause them to feel that they do not measure up well against others. For example, a boy who is not athletic may feel unworthy of his football-playing peers and revert to shy behavior, isolating himself, and avoiding conversation. Conversely, an athlete who doesn’t “get” Shakespeare may feel embarrassed and avoid reading altogether.

Most children want to be liked and accepted by their friends. Some popular children are nice and have good social skills. These popular-prosocial children tend to do well in school and are cooperative and friendly. Popular-antisocial children may gain popularity by acting tough or spreading rumors about others (Cillessen & Mayeux, 2004). Rejected children are sometimes excluded because they are shy and withdrawn. The withdrawn-rejected children are easy targets for bullies because they are unlikely to retaliate when belittled (Boulton, 1999). Other rejected children are ostracized because they are aggressive, loud, and confrontational. The aggressive-rejected children may be acting out of a feeling of insecurity. Unfortunately, their fear of rejection only leads to behavior that brings further rejection from other children. Children who are not accepted are more likely to experience conflict, lack confidence, and have trouble adjusting. Other categories in the most commonly used sociometric system, developed by Coie & Dodge, includes neglected children, who tend to go unnoticed but are not especially liked or disliked by their peers; average children, who receive an average number of positive and negative votes from their peers, or controversial children, who may be strongly liked and disliked by quite a few peers.

Also, with the approach of adolescence, peer relationships become focused on psychological intimacy, involving personal disclosure, vulnerability, and loyalty (or its betrayal)—which significantly affects a child’s outlook on the world. Each of these aspects of peer relationships requires developing very different social and emotional skills than those that emerge in parent-child relationships. They also illustrate the many ways that peer relationships influence the growth of personality and self-concept.

Moral Development

Lawrence Kohlberg (1963) built on the work of Piaget and was interested in finding out how our moral reasoning changes as we get older. He wanted to find out how people decide what is right and what is wrong. In order to explore this area, he read a story containing a moral dilemma to boys of different age groups (also known as the Heinz dilemma). In the story, a man is trying to obtain an expensive drug that his wife needs in order to treat her cancer. The man has no money and no one will loan him the money he requires. He begs the pharmacist to reduce the price, but the pharmacist refuses. So, the man decides to break into the pharmacy to steal the drug. Then Kohlberg asked the children to decide whether the man was right or wrong in his choice. Kohlberg was not interested in whether they said the man was right or wrong, he was interested in finding out how they arrived at such a decision. He wanted to know what they thought made something right or wrong.

Pre-conventional Moral Development

The youngest subjects seemed to answer based on what would happen to the man as a result of the act. For example, they might say the man should not break into the pharmacy because the pharmacist might find him and beat him, or they might say that the man should break in and steal the drug and his wife will give him a big kiss. Right or wrong, both decisions were based on what would physically happen to the man as a result of the act. This is a self-centered approach to moral decision-making. He called this most superficial understanding of right and wrong pre-conventional moral development.

Pre-conventional development covers stages one and two in Kohlberg’s theory. In stage one, the focus is on the direct consequences of their actions. Their main concern is avoiding punishment and being obedient. In stage two, the focus is more “what’s in it for me”? A stage two mentality is self-interest driven.

Conventional Moral Development

Middle childhood boys seemed to base their answers on what other people would think of the man as a result of his act. For instance, they might say he should break into the store, and then everyone would think he was a good husband. Or, he shouldn’t because it is against the law. In either case, right and wrong are determined by what other people think. Because what other people think is usually a function of socially accepted morality, this view is often thought of as applying society’s standards. A good decision is one that gains the approval of others or one that complies with the law. This is conventional moral development.

The conventional moral development covers stages three and four. In stage three, the focus is on what society deems okay or good in order to gain approval from others. In stage four, the focus is on maintaining social order. The person has an understanding that laws and social conventions are created to maintain a properly functioning society.

Post-conventional Moral Development

Older children were the only ones to appreciate the fact that the Heinz dilemma has different levels of right and wrong. Right and wrong are based on social contracts established for the good of everyone or on universal principles of right and wrong that transcend the self and social convention. For example, the man should break into the store because, even if it is against the law, the wife needs the drug and her life is more important than the consequences the man might face for breaking the law. Or, the man should not violate the principle of the right of property because this rule is essential for social order. In either case, the person’s judgment goes beyond what happens to the self. It is based on a concern for others, for society as a whole, or for an ethical standard rather than a legal standard. This level is called post-conventional moral development because it goes beyond convention or what other people think to a higher, universal ethical principle of conduct that may or may not be reflected in the law. Notice that such thinking (the kind supreme justices do all day in deliberating whether a law is moral or ethical, etc.) requires being able to think abstractly. Often this is not accomplished until a person reaches adolescence or adulthood.

Post-conventional moral development covers stages five and six. In stage five, the person realizes that not everything is black and white. The person realizes there are many different ways of thinking about what is good and right. Further, just because there is a law does not mean that the law is necessarily good for everyone. In stage five, the idea is to do the most good for the most people. Kohlberg’s sixth stage is interesting in that it does not seem that people make it to this stage and stay. Indeed, many researchers have failed to identify people who operate within a stage six mentality at all, while others have identified a very few people who operate within stage six on occasion. Why might this be the case? Stage six is a way of thinking about the question of morality in a way that is not personal. Instead, a person tries to empathize with others and see the world from the other person’s perspective before making a decision. While this sounds easy, very few people can do this well, and even fewer can do it consistently. Further, the idea of universal justice is involved in stage six. Indeed, a person in stage six is ready to disobey unjust laws. The focus is on doing the right thing, regardless of the personal consequences.

Watch It

The Heinz dilemma is a frequently used example used to help us understand Kohlberg’s stages of moral development. It is described in the following video:

From a theoretical point of view, it is not important what the participant thinks that Heinz should do. Kohlberg’s theory holds that the justification the participant offers is what is significant, the form of their response. Below are some of many examples of possible arguments that belong to the six stages:

Modern Views of Moral Development

Kohlberg continued to explore his theory after the initial theory was researched. He theorized that there could be other stages and that there could be transitions into each stage. One thing that Kohlberg never fully addressed was his use of nearly all-male samples. Men and women tend to have very different styles of moral decision making; men tend to be very justice-oriented while women tend to be more compassion oriented. In terms of Kohlberg’s stages, women tend to be in lower stages than men because of their compassion orientation.

Carol Gilligan was one of Kohlberg’s research assistants. She believed that Kohlberg’s theory was inherently biased against women. Gilligan suggests that the biggest reason that there is a gender bias in Kohlberg’s theory is because males tend to focus on logic and rules while women focus on caring for others and relationships. She suggests, then, that in order to truly measure women’s moral development, it was necessary to create a measure specifically for women. Gilligan was clear that she did not believe neither male nor female moral development was better, but rather that they were equally important.

Think It Over

Consider your own decision-making processes. What guides your decisions? Are you primarily concerned with your personal well-being? Do you make choices based on what other people will think about your decision? Or are you guided by other principles? To what extent is this approach guided by your culture?

Stressors in Middle Childhood

Family Life

Three smiling girls posing with peace signs for a picture.
Figure 1. Family relationships change as preteens want to spend more time with friends.

During middle childhood, children spend less time with parents and more time with their peers. Parents may have to modify their approach to parenting to accommodate the child’s growing independence. Authoritative parenting which uses reason and joint decision-making whenever possible may be the most effective approach (Berk, 2007). A more harsh form of parenting, authoritarian parenting, uses strict discipline, and focuses on obedience. Asian-American, African-American, and Mexican-American parents are more likely than European-Americans to use an authoritarian style of parenting. Children raised in authoritative households tend to be confident, successful, and happy (Chao, 2001; Stewart and Bond, 2002).

Family Tasks

One of the ways to assess the quality of family life is to consider the tasks of families.

Berger (2005) lists five family functions:

  1. Providing food, clothing, and shelter
  2. Encouraging Learning
  3. Developing self-esteem
  4. Nurturing friendships with peers
  5. Providing harmony and stability

Notice that in addition to providing food, shelter, and clothing, families are responsible for helping the child learn, relate to others, and have a confident sense of self. The family provides a harmonious and stable environment for living. A good home environment is one in which the child’s physical, cognitive, emotional, and social needs are adequately met. Sometimes families emphasize physical needs but ignore cognitive or emotional needs. Other times, families pay close attention to physical needs and academic requirements but may fail to nurture the child’s friendships with peers or guide the child toward developing healthy relationships. Parents might want to consider how it feels to live in the household. Is it stressful and conflict-ridden? Is it a place where family members enjoy being?

Family Change: Divorce

A lot of attention has been given to the impact of divorce on the life of children. The assumption has been that divorce has a strong, negative impact on the child and that single-parent families are deficient in some way. Research suggests 75-80 percent of children and adults who experience divorce suffer no long term effects (Hetherington & Kelly, 2002). Children of divorce and children who have not experienced divorce are more similar than different (Hetherington & Kelly, 2002).

Mintz (2004) suggests that the alarmist view of divorce was due in part to the newness of divorce when rates in the United States began to climb in the late 1970s. Adults reacting to the change grew up in the 1950s when rates were low. As divorce has become more common and there is less stigma associated with divorce, this view has changed somewhat. Social scientists have operated from the divorce as a deficit model emphasizing the problems of being from a “broken home” (Seccombe &Warner, 2004). More recently, a more objective view of divorce, re-partnering, and remarriage indicate that divorce, remarriage, and life in stepfamilies can have a variety of effects. The exaggeration of the negative consequences of divorce has left the majority of those who do well hidden and subjected them to unnecessary stigma and social disapproval (Hetherington & Kelly, 2002).

The tasks of families listed above are functions that can be fulfilled in a variety of family types-not just intact, two-parent households. Harmony and stability can be achieved in many family forms and when it is disrupted, either through a divorce, or efforts to blend families, or any other circumstances, the child suffers (Hetherington & Kelly, 2002).

Factors Affecting the Impact of Divorce

Keep these family functions in mind as well as the consequences (both pro and con) of divorce and remarriage on children. Some negative consequences result from financial hardship rather than divorce per se (Drexler, 2005). Some positive consequences reflect improvements in meeting these functions. For instance, we have learned that positive self-esteem comes partly from a belief in the self and one’s abilities rather than merely being complemented by others. In single-parent homes, children may be given more opportunity to discover their own abilities and gain the independence that fosters self-esteem. If divorce leads to fighting between the parents and the child is included in these arguments, the self-esteem may suffer.

The impact of divorce on children depends on a number of factors. The degree of conflict before the divorce plays a role. If the divorce reduces tensions, the child may feel relief. If the parents have kept their conflicts hidden, the announcement of a divorce can come as a shock and be met with enormous resentment. Another factor that has a great impact on the child concerns financial hardships they may suffer, especially if financial support is inadequate. Another difficult situation for children of divorce is the position they are put into if the parents continue to argue and fight-especially if they bring the children into those arguments.

Short-term consequences: In roughly the first year following divorce, children may exhibit some of these short-term effects:

  1. Grief over losses suffered. The child will grieve the loss of the parent they no longer see as frequently. The child may also grieve about other family members that are no longer available. Grief sometimes comes in the form of sadness, but it can also be experienced as anger or withdrawal. Preschool-aged boys may act out aggressively, while the same-aged girls may become quieter and withdrawn. Older children may feel depressed.
  2. Reduced Standard of Living. Divorce often means changing the amount of money coming into the household. Children experience new constraints on spending or entertainment. School-aged children, especially, may notice that they can no longer have toys, clothing, or other items to which they’ve grown accustomed. The custodial parent may experience stress at not being able to rely on child support payments or having the same income level as before. This can affect decisions regarding healthcare, vacations, rents, mortgages, and other expenditures. The stress can result in less happiness and relaxation in the home. The parent taking on more work may also be less available to the children.
  3. Adjusting to Transitions. Children may also have to adjust to other changes accompanying a divorce. The divorce might mean moving to a new home and changing schools or friends. It might mean leaving a neighborhood that has meant a lot to them as well.

Long-Term consequences: The following are some effects found after the first year of a divorce:

  1. Economic/Occupational Status. One of the most commonly cited long-term effects of divorce is that children of divorce may have lower levels of education or occupational status. This may be a consequence of lower-income and resources for funding education rather than to divorce per se. In those households where economic hardship does not occur, there may be no impact on education or occupational status (Drexler, 2005).
  2. Improved Relationships with the Custodial Parent (usually the mother): The majority of custodial parents are mothers (approximately 80.4 percent) and
    19.6 percent of custodial parents are fathers. Shared custody is on the rise, however, and shows promising social, academic, and psychological results for the children. Children from single-parent families talk to their mothers more often than children of two-parent families (McLanahan & Sandefur, 1994). Most children of divorce lead happy, well-adjusted lives and develop stronger, positive relationships with their custodial parent (Seccombe and Warner, 2004). In a study of college-age respondents, Arditti (1999) found that increasing closeness and a movement toward more democratic parenting styles was experienced. Others have also found that relationships between mothers and children become closer and stronger (Guttman, 1993) and suggest that greater equality and less rigid parenting is beneficial after divorce (Steward, Copeland, Chester, Malley, and Barenbaum, 1997).
  3. Greater emotional independence in sons. Drexler (2005) notes that sons who are raised by mothers only develop an emotional sensitivity to others that is beneficial in relationships.
  4. Feeling more anxious in their own love relationships. Children of divorce may feel more anxious about their own relationships as adults. This may reflect a fear of divorce if things go wrong, or it may be a result of setting higher expectations for their own relationships.
  5. Adjustment of the custodial parent. Furstenberg and Cherlin (1991) believe that the primary factor influencing how children adjust to divorce is how the custodial parent adjusts to the divorce. If that parent is adjusting well, the children will benefit. This may explain a good deal of the variation we find in children of divorce. Adults going through divorce should consider good self-care as beneficial to the children-not as self-indulgent.
  6. Mental health issues: Some studies suggest that anxiety and depression that are common in children and adults within the first year of divorce may actually not resolve. A 15-year study by Bohman, Låftman, Päären, Jonsson (2017) suggests that parental separation significantly increases the risk for depression 15 years later when depression rates were compared to matched controls. In fact, the risk of depression was related more strongly with parental conflict and parental separation than it was with parental depression!

Sexual Abuse in Middle Childhood

Researchers estimate that 1 out of 4 girls and 1 out of 10 boys have been sexually abused (Valente, 2005). The median age for sexual abuse is 8 or 9 years for both boys and girls (Finkelhor et. al. 1990). Most boys and girls are sexually abused by a male. Childhood sexual abuse is defined as any sexual contact between a child and an adult or a much older child. Incest refers to sexual contact between a child and family members. In each of these cases, the child is exploited by an older person without regard for the child’s developmental immaturity and inability to understand the sexual behavior (Steele, 1986).

Although rates of sexual abuse are higher for girls than for boys, boys may be less likely to report abuse because of the cultural expectation that boys should be able to take care of themselves and because of the stigma attached to homosexual encounters (Finkelhor et. al. 1990). Girls are more likely to be victims of incest and boys are more likely to be abused by someone outside the family. Sexual abuse can create feelings of self-blame, betrayal, and feelings of shame and guilt (Valente, 2005). Sexual abuse is particularly damaging when the perpetrator is someone the child trusts. Victims of sexual abuse may suffer from depression, anxiety, problems with intimacy, and suicide (Valente, 2005). Sexual abuse has additional impacts as well. Studies suggest that children who have been sexually abused have an increased risk of eating disorders and sleep disturbances Further, sexual abuse can lead to Post Traumatic Stress Disorder.

Being sexually abused as a child can have a powerful impact on self-concept. The concept of false self-training (Davis, 1999) refers to holding a child to adult standards while denying the child’s developmental needs. Sexual abuse is just one example of false self-training. Children are held to adult standards of desirableness and sexuality while their cognitive, psychological, and emotional immaturity level is ignored. Consider how confusing it might be for a 9-year-old girl who has physically matured early to be thought of as a potential sex partner. Her cognitive, psychological, and emotional state do not equip her to make decisions about sexuality or, perhaps, to know that she can say no to sexual advances. She may feel like a 9-year-old in all ways and be embarrassed and ashamed of her physical development. Girls who mature early have problems with low self-esteem because of the failure of others (family members, teachers, ministers, peers, advertisers, and others) to recognize and respect their developmental needs. Overall, youth are more likely to be victimized because they do not have control over their contact with offenders (parents, babysitters, etc.) and have no means of escape (Finkelhor and Dzuiba-Leatherman, in Davis, 1999).

What you’ll learn to do: examine common learning disabilities and other factors related to education during middle childhood

Two boys at a desk looking down at a book

Across the world, by the time a child is entering middle childhood, they are being educated in some form or fashion. In western society, most children are enrolled in a formal education program by the time they are in middle childhood. That said, what children learn within that formal education program varies greatly across cultures. Further, most programs are set-up for typically developing children, but they may not be set-up to handle children who are accelerated learners or children with learning disabilities. In this section, we’ll take a look at some of these educational differences and developments, as well as struggles and learning difficulties during middle childhood.

Learning outcomes

  • Evaluate the impact of labeling on children’s self-concept and social relationships
  • Describe autism spectrum disorders
  • Identify common learning disabilities such as dyslexia and attention deficit hyperactivity disorder
  • Compare Gardner’s theory of multiple intelligences and Sternberg’s triarchic theory of intelligence
  • Apply the ecological systems model to explore children’s experiences in schools

Developmental Disorders and Learning Disabilities

Girl screaming with anger and frustration as she works on some homework.
Figure 1. What are the pros and cons of labeling a child with a learning disability?

Children’s cognitive and social skills are evaluated as they enter and progress through school. Sometimes this evaluation indicates that a child needs special assistance with language or in learning how to interact with others. Evaluation and diagnosis of a child can be the first step in helping to provide that child with the type of instruction and resources needed. But diagnosis and labeling also have social implications. It is important to consider that children can be misdiagnosed and that once a child has received a diagnostic label, the child, teachers, and family members may tend to interpret the actions of the child through that label. The label can also influence the child’s self-concept. Consider, for example, a child who is misdiagnosed as learning disabled. That child may expect to have difficulties in school, lack confidence, and out of these expectations, have trouble indeed. This self-fulfilling prophecy, or tendency to act in such a way as to make what you predict will happen, comes true, calls our attention to the power that labels can have whether or not they are accurately applied.

It is also important to consider that children’s difficulties can change over time; a child who has problems in school may improve later or may live under circumstances as an adult where the problem (such as a delay in math skills or reading skills) is no longer relevant. That person, however, will still have a label as learning disabled. It should be recognized that the distinction between abnormal and normal behavior is not always clear; some abnormal behavior in children is fairly common. Misdiagnosis may be more of a concern when evaluating learning difficulties than in cases of autism spectrum disorder where unusual behaviors are clear and consistent.

Keeping these cautionary considerations in mind, let’s turn our attention to some developmental and learning difficulties.


Think It Over: Disability Inclusion

Some disabilities are very apparent and such as a person being in a wheelchair.  However, there are also many invisible disabilities that may not be apparent went first looking at a person. How would you react to seeing a person with a disability? How would you interact with them? It is important to remember that children will model the behavior that they see. We must actively teach children about disability inclusion and how to treat people with all abilities with respect.  Watch this video of a mom who has a daughter with special needs talk about her 5 Tips for disability inclusion.

Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behavior. The estimate published by the Center for Disease Control (2018)[ is that about 1 out of every 59 children in the United States has been diagnosed with Autism Spectrum Disorder (ASD), which covers a wide variety of ranges in ability, from those with milder forms (formerly known as Asperger’s Syndrome) to more severe deficits in communication.

Link to Learning

Learn more about Autism Spectrum Disorders at Autism Speaks, or the Autistic Self Advocacy Network.

A person with autism has difficulty with and a lack of interest in learning language. An autistic child may respond to a question by repeating the question or might rarely speak. Sometimes autistic children learn more difficult words before simple words or can complete complicated tasks before they can complete easier ones. The person often has difficulty reading social cues such as the meanings of non-verbal gestures such as a wave of the hand or the emotion associated with a frown. Intense sensitivity to touch or visual stimulation may also be experienced. Autistic children often have poor social skills and cannot communicate with or empathize with others emotionally. People with autism often view the world differently and learn differently than people who do not have autism. Autistic children tend to prefer routines and patterns and become upset when routines are altered. For example, moving the furniture or changing the daily schedule can be very upsetting.

Many children with ASD are not identified until they reach school age, although our ability to diagnose children earlier continues to improve. In the 2017-2018 school year, about 710,000 children on the spectrum received special education through the public schools. These disorders are found in all racial and ethnic groups and are more common in boys than in girls. All these disorders are marked by difficulty in social interactions, problems in various areas of communication, and difficulty altering patterns or daily routines. There is no single cause of ASD and the causes of these disorders are to a large extent, unknown. In cases involving identical twins, if one twin has autism, the other is also autistic about 75 percent of the time. Rubella, fragile X syndrome and PKU that have been untreated are some of the medical conditions associated with risks of autism.

Some individuals benefit from medications that alleviate some of the symptoms of ASD, but the most effective treatments involve behavioral intervention and teaching techniques used to promote the development of language and social skills. Children also excel when they are in structured learning environments that accommodate the needs of children on the spectrum.

Impaired Theory of Mind in Individuals with Autism

People with autism or an autism spectrum disorder (ASD) typically show an impaired ability to recognize other people’s minds. Under the DSM-5, autism is characterized by persistent deficits in social communication and interaction across multiple contexts and restricted, repetitive patterns of behavior, interests, or activities. These deficits are present in early childhood, typically before age three, and lead to clinically significant functional impairment. Symptoms may include lack of social or emotional reciprocity, stereotyped and repetitive use of language or idiosyncratic language, and persistent preoccupation with unusual objects.

About half of parents of children with ASD notice their child’s unusual behaviors by age 18 months, and about four-fifths notice by age 24 months, but often a diagnosis comes later, and individual cases vary significantly. Typical early signs of autism include:

  • No babbling by 12 months.
  • No gesturing (pointing, waving, etc.) by 12 months.
  • No single words by 16 months.
  • No two-word (spontaneous, not just echolalic) phrases by 24 months.
  • Loss of any language or social skills, at any age.

Children with ASD experience difficulties explaining and predicting other people’s behavior, leading to problems in social communication and interaction. Children who are diagnosed with an autistic spectrum disorder usually develop the theory of mind more slowly than other children and continue to have difficulties with it throughout their lives.

The Sally-Anne test is performed to test whether someone lacks the theory of mind. The child sees the following story: Sally and Anne are playing. Sally puts her ball into a basket and leaves the room. While Sally is gone, Anne moves the ball from the basket to the box. Now Sally returns. The question is: where will Sally look for her ball? The test is passed if the child correctly assumes that Sally will look in the basket. The test is failed if the child thinks that Sally will look in the box. Children younger than four and older children with autism will generally say that Sally will look in the box.

CONNECT THE CONCEPTS: Emotional Expression and Emotion Regulation

Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized by repetitive behaviors, communication, and social problems. Children who have autism spectrum disorders have difficulty recognizing the emotional states of others, and research has shown that this may stem from an inability to distinguish various nonverbal expressions of emotion (i.e., facial expressions) from one another (Hobson, 1986). In addition, there is evidence to suggest that autistic individuals also have difficulty expressing emotion through tone of voice and by producing facial expressions (Macdonald et al., 1989). Difficulties with emotional recognition and expression may contribute to the impaired social interaction and communication that characterize autism; therefore, various therapeutic approaches have been explored to address these difficulties. Various educational curricula, cognitive-behavioral and pharmacological therapies have shown some promise in helping autistic individuals process emotionally relevant information (Bauminger, 2002; Golan & Baron-Cohen, 2006; Guastella et al., 2010).

Emotion regulation describes how people respond to situations and experiences by modifying their emotional experiences and expressions. Covert emotion regulation strategies are those that occur within the individual, while overt strategies involve others or actions (such as seeking advice or consuming alcohol). Aldao and Dixon (2014) studied the relationship between overt emotional regulation strategies and psychopathology. They researched how 218 undergraduate students reported their use of covert and overt strategies and their reported symptoms associated with selected mental disorders and found that overt emotional regulation strategies were better predictors of psychopathology than covert strategies. Another study examined the relationship between pregaming (the act of drinking heavily before a social event) and two emotion regulation strategies to understand how these might contribute to alcohol-related problems; results suggested a relationship but a complicated one (Pederson, 2016). Further research is needed in these areas to better understand patterns of adaptive and maladaptive emotion regulation (Aldao & Dixon-Gordon, 2014).

Learning Disabilities

What is a learning disability? If a child is mentally disabled, that child is typically slow in all areas of learning. However, a child with a learning disability has problems in a specific area or with a specific task or type of activity related to education. A learning difficulty refers to a deficit in a child’s ability to perform an expected academic skill (Berger, 2005). These difficulties are identified in school because this is when children’s academic abilities are being tested, compared, and measured. Consequently, once academic testing is no longer essential in that person’s life (as when they are working rather than going to school) these disabilities may no longer be noticed or relevant, depending on the person’s job and the extent of the disability.

Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. Dyslexia is one of the most commonly diagnosed disabilities and involves having difficulty in the area of reading. This diagnosis is used for a number of reading difficulties. For example, the child may reverse letters, have difficulty reading from left to right, or have problems associating letters with sounds. Dyslexia appears to be rooted in some neurological problems involving the parts of the brain active in recognizing letters, verbally responding, or being able to manipulate sounds (National Institute of Neurological Disorders and Stroke, 2006). Treatment typically involves altering teaching methods to accommodate the person’s particular problematic area.

Attention Deficit Hyperactivity Disorder (ADHD) is considered a neurological and behavioral disorder in which a person has difficulty staying on task, screening out distractions, and inhibiting behavioral outbursts. The most commonly recommended treatment involves the use of medication, structuring the classroom environment to keep distractions at a minimum, tutoring, and teaching parents how to set limits and encourage age-appropriate behavior (NINDS, 2006). Some people say that the term Attention Deficit is a misnomer because people who suffer from ADHD actually have great difficulty tuning things out. They are bombarded with information… their brains are trying to pay attention to everything. They do not have a deficit of attention- they are trying to pay attention to too many things at once, so everything suffers.

Recent research suggests that several brain structures may be implicated in ADHD. These studies have mainly focused on the frontal lobe and prefrontal cortex. Some studies suggest that the frontal lobe is underdeveloped in children and adults with ADHD. The frontal lobe is involved in executive function, attention, planning, impulse control, motivation, and decision-making. In some cases the development is delayed, but catches up to expected standards by adulthood; in other cases, the frontal lobe never fully develops.

link to learning

How is ADHD diagnosed? The DSM-V lists the criteria that must be present in order for a diagnosis to be made and an official diagnosis must be made by a qualified mental health professional.  It is also important to note that the term ADD is an older term that has been phased out in the newer versions of the DSM. Review the criteria for ADHD. Do you think that making a diagnosis would be difficult?  Why or why not?

In general, ADHD is treated with stimulants. While this may seem counter-intuitive (why give a hyperactive child a stimulant?), it makes a lot of sense when you understand the neurological processes involved. There are two ways that stimulants may work to help people with ADHD focus. Some researchers have found that the stimulants activate the underdeveloped parts of the brain (prefrontal cortex and frontal lobe) thereby making these brain areas function more as they should. This allows the child or adult to focus properly. Other researchers suspect that the stimulants affect the way the neurotransmitters function in these brain areas, leading to better function in those areas.

There is still a lot of controversy about medicating children with ADHD. While there is clear evidence that medication works to control the negative effects of ADHD, there are also negative side effects that must be dealt with including problems sleeping, changes in appetite, headaches, and more. Further, the long term effects of medicating young children are not well understood. For these reasons, many parents prefer an intervention that does not involve medication. The most common non-pharmaceutical intervention for ADHD is Cognitive Behavioral Therapy (CBT). CBT works by helping children to become aware of their thought processes, and then to learn to change those thought processes to be more beneficial or positive. CBT can also help by educating parents about ways to help their children learn about self-control and discipline. There is good evidence that CBT is effective in treating ADHD. Indeed, in some studies, children treated with CBT have better long-term outcomes than children treated with medication. Some studies show that a combination of medication and CBT is most beneficial because the medication helps with behavior change more quickly, allowing for the child to learn through CBT more quickly. The CBT then helps with longer-term behavior change so that the child can stop taking medications and deal effectively with their ADHD symptoms based on what they have learned through CBT.

DIG DEEPER: Why Is the Prevalence Rate of ADHD Increasing?

Many people believe that the rates of ADHD have increased in recent years, and there is evidence to support this contention. In a recent study, investigators found that the parent-reported prevalence of ADHD among children (4–17 years old) in the United States increased by 22% during a 4-year period, from 7.8% in 2003 to 9.5% in 2007 (CDC, 2010). Over time this increase in parent-reported ADHD was observed in all sociodemographic groups and was reflected by substantial increases in 12 states (Indiana, North Carolina, and Colorado were the top three). The increases were greatest for older teens (ages 15–17), multiracial and Hispanic children, and children with a primary language other than English. Another investigation found that from 1998–2000 through 2007–2009 the parent-reported prevalence of ADHD increased among U.S. children between the ages of 5–17 years old, from 6.9% to 9.0% (Akinbami, Liu, Pastor, & Reuben, 2011).

A major weakness of both studies was that children were not formally diagnosed. Instead, parents were simply asked whether or not a doctor or other health-care provider had ever told them their child had ADHD; the reported prevalence rates thus may have been affected by the accuracy of parental memory. Nevertheless, the findings from these studies raise important questions concerning what appears to be a demonstrable rise in the prevalence of ADHD. Although the reasons underlying this apparent increase in the rates of ADHD over time are poorly understood and, at best, speculative, several explanations are viable:

  • ADHD may be over-diagnosed by doctors who are too quick to medicate children as a behavior treatment.
  • There is greater awareness of ADHD now than in the past. Nearly everyone has heard of ADHD, and most parents and teachers know its key symptoms. Thus, parents may be quick to take their children to a doctor if they believe their child possesses these symptoms, or teachers may be more likely now than in the past to notice the symptoms and refer the child for evaluation.
  • The use of computers, video games, iPhones, and other electronic devices has become pervasive among children in the early 21st century, and these devices could potentially shorten children’s attention spans. Thus, what might seem like inattention to some parents and teachers could simply reflect exposure to too much technology.
  • ADHD diagnostic criteria have changed over time.

Learning and Intelligence

Schools and Testing

When Should School Begin?

four elementary students sit in front of computers taking a standardized test.
Figure 2. An average elementary schooler will spend around 7 hours a day in school.

Children in the United States begin school around age 5 or 6. In fact, most Western countries follow this model. But WHY do we begin school at 5 or 6? For the most part, this age was chosen as a matter of convenience. In countries where the mother is expected to work, the age at which children begin school tends to be younger. That said, research does not support that children should begin formal education so early. Many research studies suggest age 7 is the most appropriate age to begin formalized school. Before age 7, children learn best through play. By age 7, most children can learn in a more formal academic-forward setting.

The Controversy Over Testing In Schools

Children’s academic performance is often measured with the use of standardized tests. Achievement tests are used to measure what a child has already learned. Achievement tests are often used as measures of teaching effectiveness within a school setting and as a method to make schools that receive tax dollars (such as public schools, charter schools, and private schools that receive vouchers) accountable to the government for their performance. In 2001, President George W. Bush signed into effect the No Child Left Behind Act mandating that schools administer achievement tests to students and publish those results so that parents have an idea of their children’s performance and the government has information on the gaps in educational achievement between children from various social class, racial, and ethnic groups. Schools that show significant gaps in these levels of performance are to work toward narrowing these gaps. Educators have criticized the policy for focusing too much on testing as the only indication of performance levels.

Aptitude tests are designed to measure a student’s ability to learn or to determine if a person has potential in a particular program. These are often used at the beginning of a course of study or as part of college entrance requirements. The Scholastic Aptitude Test (SAT) and Preliminary Scholastic Aptitude Test (PSAT) are perhaps the most familiar aptitude tests to students in grades 6 and above. Learning test-taking skills and preparing for SATs has become part of the training that some students in these grades receive as part of their pre-college preparation. Other aptitude tests include the MCAT (Medical College Admission Test), the LSAT (Law School Admission Test), and the GRE (Graduate Record Examination). Intelligence tests are also a form of aptitude tests that are designed to measure a person’s ability to learn.

The World of School

Remember Urie Bronfenbrenner’s ecological systems model we learned about when we first examined theories of development? This model helps us understand an individual by examining the contexts in which the person lives and the direct and indirect influences on that person’s life. School becomes a very important component of children’s lives during middle childhood and one way to understand children is to look at the world of school. We have discussed educational policies that impact the curriculum in schools above. Now let’s focus on the school experience from the standpoint of the student, the teacher and parent relationship, and the cultural messages or hidden curriculum taught in school in the United States.

Parents vary in their level of involvement with their children’s schools. Teachers often complain that they have difficulty getting parents to participate in their child’s education and devise a variety of techniques to keep parents in touch with daily and overall progress. For example, parents may be required to sign a behavior chart each evening to be returned to school or may be given information about the school’s events through websites and newsletters. There are other factors that need to be considered when looking at parental involvement. To explore these, first ask yourself if all parents who enter the school with concerns about their child are received in the same way? If not, what would make a teacher or principal more likely to consider the parent’s concerns? What would make this less likely?

Lareau and Horvat (2004) found that teachers seek a particular type of involvement from particular types of parents. While teachers thought they were open and neutral in their responses to parental involvement, in reality, teachers were most receptive to support, praise, and agreement coming from parents who were most similar in race and social class with the teachers. Parents who criticized the school or its policies were less likely to be given a voice. Parents who have higher levels of income, occupational status, and other qualities favored in society have family capital. This is a form of power that can be used to improve a child’s education. Parents who do not have these qualities may find it more difficult to be effectively involved.

Student Perspectives

Imagine being a 3rd-grader for one day in public school. What would the daily routine involve? To what extent would the institution dictate the day’s activities and how much of the day would you spend on those activities? Would you always be on task? What would you say if someone asked you how your day went? or “What happened in school today?” Chances are, you would be more inclined to talk about whom you sat at lunch with or who brought a puppy to class than to describe how fractions are added.

McLaren (1999) describes the student’s typical day as filled with a constrictive and unnecessary ritual that damages the desire to learn. Students move between various states as they negotiate the demands of the school system and their own personal interests. The majority of the day (298 minutes) takes place in the student state. In this state, the student focuses on a task or tries to stay focused on a task, is passive, compliant, and often frustrated. Long pauses before getting out the next book or finding materials sometimes indicate that frustration. The street corner state is one in which the child is playful, energetic, excited, and expresses personal opinions, feelings, and beliefs. About 66 minutes a day take place in this state. Children try to maximize this by going slowly to assemblies or when getting a hall pass-always eager to say ‘hello’ to a friend or to wave if one of their classmates is in another room. This is the state in which friends talk and play. In fact, teachers sometimes reward students with opportunities to move freely or to talk or to be themselves. But when students initiate the street corner state on their own, they risk losing recess time, getting extra homework, or being ridiculed in front of their peers. The home state occurs when parents or siblings visit the school. Children in this state may enjoy special privileges such as going home early or being exempt from certain school rules in the mother’s presence, or it can be difficult if the parent is there to discuss trouble at school with a staff member. The sanctity state is a time in which the child is contemplative, quiet, or prayerful. Typically the sanctity state is a very brief part of the day.

Cultural Influences

Another way to examine the world of school is to look at the cultural values, concepts, behaviors, and roles that are part of the school experience but are not part of the formal curriculum. These are part of the hidden curriculum but are nevertheless very powerful messages. The hidden curriculum includes ideas of patriotism, gender roles, the ranking of occupations and classes, competition, and other values. Teachers, counselors, and other students specify and make known what is considered appropriate for girls and boys. The gender curriculum continues into high school, college, and professional school. Students learn a ranking system of occupations and social classes as well. Students in gifted programs or those moving toward college preparation classes may be viewed as superior to those who are receiving tutoring.

Gracy (2004) suggests that cultural training occurs early. Kindergarten is an “academic boot camp” in which students are prepared for their future student role-that of complying with an adult imposed structure and routine designed to produce docile, obedient, children who do not question meaningless tasks that will become so much of their future lives as students. A typical day is filled with structure, ritual, and routine that allows for little creativity or direct, hands-on contact. “Kindergarten, therefore, can be seen as preparing children not only for participation in the bureaucratic organization of large modern school systems but also for the large-scale occupational bureaucracies of modern society.” (Gracy, 2004, p. 148)

Emphasizing math and reading in preschool and kindergarten classes is becoming more common in some school districts. It is not without controversy, however. Some suggest that emphasis is warranted in order to help students learn math and reading skills that will be needed throughout school and in the world of work. This will also help school districts improve their accountability through test performance. Others argue that learning is becoming too structured to be enjoyable or effective and that students are being taught only to focus on performance and test-taking. Students learn student incivility or lack of sincere concern for politeness and consideration of others is taught in kindergarten through 12th grades through the “what is on the test” mentality modeled by teachers. Students are taught to accept routinized, meaningless information in order to perform well on tests. And they are experiencing the stress felt by teachers and school districts focused on test scores and taught that their worth comes from their test scores. Genuine interest, an appreciation of the process of learning, and valuing others are important components of success in the workplace that are not part of the hidden curriculum in today’s schools.

Think It Over

  • Do an online search for “kindergarten schedule” and look for a typical daily schedule. Do you think it includes a healthy amount of learning and play? Why or why not?
  • To what extent do you think that students are being prepared for their future student role? What are the pros and cons of such preparation? Look at the curriculum for kindergarten and the first few grades in your own school district.

A group of scouts walking across a field in a single-file line

Until middle childhood, the development process isn’t usually as structured as it is during middle childhood when children enter the formal education setting. Children in school are taught new ways of thinking about things that they already know—they learn why they structure sentences the way they do, and they learn new words not through hearing them from others but from lists provided by teachers or determined by committees. They are even taught how to play sports in specific ways with explicit rules that they get tested on in written form. This is quite a departure from the organic learning of younger years.

Learning in this new way is difficult for some children who have never had to sit down for formal instruction. Structured learning can also shed light on learning difficulties and learning disabilities. Educators today are trained to recognize the signs of many learning disabilities so that children can get help early on in their academic careers.

Developing social relationships in the school environment and keeping up with the changing relationships at home can be difficult tasks for children during middle childhood. Children begin the period relatively dependent on their parents. By the end of the period, children should be able to act autonomously in terms of decision-making and caring for themselves. This change may feel quick to parents, and it can be difficult for them to let go of control and to allow the child to make more decisions. In order for the child to continue healthy development, though, that gradual letting go is necessary. Parents should pay close attention to their children to recognize signs that the child can take on new responsibilities. This will help the child continue developing their skills, sense of self, sense of place in the family, and sense of place in the greater community.

Additional Supplemental Resources


  • Autism Science Foundation (Links to an external site.)
    • An organization supporting autism research by providing funding and other assistance to scientists and organizations conducting, facilitating, publicizing, and disseminating autism research. The organization also provides information about autism to the general public and serves to increase awareness of autism spectrum disorders and the needs of individuals and families affected by autism.
  • Stop Bullying (Links to an external site.)
    • There are many types of bullying, including physical, verbal, social, and cyber. With bullying affecting so many people, it is important to understand what it is and how to respond to it and prevent it. This Web site provides a plethora of resources for a variety of audiences.


  • Crash Course Video #13 – How We Make Memories
    • This video on how we make memories includes information on topics such as stages of memory, mnemonics, and levels of processing. Closed captioning available.
  • Kohlberg’s Stages of Moral Development 
    • This video summarizes Kohlberg’s stages of moral development.  The stages themselves are structured in three levels: Pre-Conventional, Conventional, and Post-Conventional.
  • What is dyslexia? – Kelli Sandman-Hurley- TEDed 
    • Dyslexia affects up to 1 in 5 people, but the experience of dyslexia isn’t always the same. This difficulty in processing language exists along a spectrum — one that doesn’t necessarily fit with labels like “normal” and “defective.” Kelli Sandman-Hurley urges us to think again about dyslexic brain function and to celebrate the neurodiversity of the human brain.
  • Piaget – Stage 3 – Concrete – Reversibility 
    • Does this child understand the concept of reversibility?  Which stage would that put her in?
  • Egocentrism 
    • The Three Mountain Problem was devised by Piaget to test whether a child’s thinking was egocentric, which was also a helpful indicator of whether the child was in the preoperational stage or the concrete operational stage of cognitive development. Which stage are these children in?
  • ADHD at School 
    • ADHD stands for Attention Deficit Hyperactivity Disorder and is considered a mental disorder. Children with ADHD have trouble paying attention, are hyperactive, and have difficulty controlling their behavior. To understand how it affects children in school, let’s look at the story of Leo, a 12-year-old boy who is going to school with the best intentions, but is struggling hard to succeed.
  • The World Needs All Kinds of Minds- TED talk 
    • Temple Grandin, diagnosed with autism as a child, talks about how her mind works — sharing her ability to “think in pictures,” which helps her solve problems that neurotypical brains might miss. She makes the case that the world needs people on the autism spectrum: visual thinkers, pattern thinkers, verbal thinkers, and all kinds of smart geeky kids.


Icon for the Creative Commons Attribution 4.0 International License

Lifespan Development Copyright © 2020 by Julie Lazzara is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

Share This Book