Middle Childhood & Adolescence Development Review

Exam and Course Overview

Exam 1 Details

• Covers Content From: Weeks $1-6$

• Study Guide: Will be posted on Blueline

• Date: Monday, September $29^{th}$

Occupational Profile Resubmission Opportunity

• Details and announcement available at: https://blueline.instructure.com/courses/1206185/discussion_topics/3977525

OTD $435$ Course Map (Weeks $1-17$)

• Week $1$: Course Introduction & Pediatric Evaluation, Occupational Profile & PDMS-$ext{3 Introduction}$

• Week $2$: Prenatal and Infant Development, Neuromotor Assessment & PDMS-$ext{3 Administration}$

• Week $3$ (Labor Day): Assessment Checkout $1$ (PDMS-$ext{3})$

• Week $4$: Toddler & Preschool Development, BOT-$ext{3 Brief}$

• Week $5$: Gender Diverse Children and Youth, Play Assessments & BOT-$ext{3 Brief Administration}$

• Week $6$: Middle Childhood ($6-10$ years) & Adolescents ($11-24$ years), Assessment Checkout $2$ (BOT-$ext{3 Brief})$

• Week $7$: Exam $1$, Documenting Clinical Observations & Hands-On Experience with children

• Week $8$: Level IC FW (Fieldwork)

• Week $9$: Fall Break

• Week $10$: Interpreting Standardized Assessment Data, Beery – VMI Introduction

• Week $11$: Developing Clinical Impressions & Goal Writing, Documenting Clinical Impressions & Beery – VMI Review

• Week $12$: Theory and FOR Guiding Intervention Planning & Behavioral Strategies and Behavior Management, Assessment Checkout $3$ (Beery – VMI)

• Week $13$: Sensory Integration Theory, IPE Collaborate Assessment & Assessment of Sensory Modulation and Discrimination

• Week $14$: Frames of References based on Sensory Integration Theory, Assessment of Sensory Based Motor Skills

• Week $15$: Motor Skill Acquisition and $4$QM Frames of Reference (No Lab)

• Week $16$: Neurodevelopmental Treatment (NDT) Frame of Reference, Therapeutic Handling & Assessment of Cognition

• Week $17$: Finals Week, Exam $2$

Middle Childhood (Ages $6-10$ years)

Overview

• Ages: $6-10$ years

• Grades: $1^{st}-5^{th}$

• Often referred to as the "Golden Age of Childhood".

Learning Objectives for Middle Childhood & Adolescence

• Describe development in Physical/Movement, Cognitive, Communication, Social-Emotional, Adaptive/Self-Help/Occupation areas.

• Discuss contexts and environments (cultural, physical, personal, social) that influence development.

Physical/Motor Development

Body Structure & Function

• By age $6$, body build and height-to-weight relationship are predictive of adult proportions.

• Growth: Average of $2-3$ inches ($5-7.6$ cm) per year between ages $6-11$.

• Limbs experience the greatest growth.

• Center of gravity lowers, which helps maintain balance.

• Muscle Strength: Dramatic increase, allowing for precise calibration of movements to task demands.

• Children can move and complete tasks simultaneously (e.g., kicking a ball while moving and using hands).

• Grip Strength: Increases between $206$% and $393$% between ages $7$ and $17$.

• Physical differences between genders begin to become apparent during this period.

Refining Motor Skills

• Gross Motor Skills:

  • Necessary trunk control and balance mature, enabling complex occupations.

  • Bilateral coordination matures.

  • Balance expands, allowing for activities like running, bike riding, climbing fences, swimming, and jumping rope.

  • Development of specialized skills such as dance, gymnastics, skating, martial arts, and team sports.

• Fine Motor Skills:

  • Increased dexterity and in-hand manipulation skills (e.g., adjusting pencils, opening containers, learning musical instruments).

  • Improved bi-manual skills.

  • Proficient tool use, precise drawing, and manipulation skills.

Hand Dominance

• Usually consistent by $5$ years old.

• No observed preference by age $4$ is significantly correlated with poorer motor performance.

• Use of different hands for skilled tasks is more common than generally thought; consistency is the key factor.

• The dominant hand in bimanual patterns develops refined dexterity and specialization, crucial for tasks like writing, keyboarding, shoe tying, and other school-related demands.

Sensory Development

• Visual Perception:

  • Figure-ground: Ability to locate and focus on an object embedded in a distracting background matures by age $8$.

  • Movement perception/tracking: Ability to detect and track a moving object with the eyes matures by age $10$.

  • Size Consistency: Ability to recognize that objects maintain a constant size even if their distance from the observer varies matures by age $11$.

  • Depth perception: Ability to judge distances and recognize the $3$-dimensional nature of objects matures by age $12$.

• Spatial Awareness:

  • Body Schema is established by age $6$.

  • Understanding of both near and far space.

  • By age $10$, spatial awareness increases dynamically, involving the use of cognitive maps.

  • Improvements in planning and sequencing skills occur during elementary years.

• Temporal Awareness (Kinesthetic Awareness):

  • Improvements in reaction time.

  • Body awareness matures by age $10$.

Drawing Development (Viktor Lowenfeld's Stages)

• Scribbling Stage ($2$ years):

  • First disordered scribbles are records of enjoyable kinesthetic activity, not attempts to portray the visual world.

  • After six months of scribbling, a first conscious creation of form occurs.

• Preschematic Stage ($3-4$ years):

  • Provides a tangible record of the child's thinking process.

  • The first representational attempt is usually a person (circle head, two vertical lines for legs).

  • Later, other forms develop, becoming clearly recognizable and often complex.

  • Children continually search for new concepts, so symbols constantly change.

• Schematic Stage ($6$ years):

  • The child arrives at a "schema" – a definite way of portraying an object, which may be modified for important details.

  • The schema represents the child's active knowledge of the subject.

  • There is definite order in space relationships; everything typically sits on a base line.

• Gang Stage: The Dawning Realism ($8-12$ years):

  • The child finds that schematic generalization no longer suffices to express reality.

  • This dawning of how things truly look is expressed with more detail for individual parts, but is not yet naturalism.

  • Space is discovered and depicted with overlapping objects and a horizon line instead of a base line.

  • Children begin to compare their work and become more critical of it.

  • They become more independent of adults but more anxious to conform to peers.

Handwriting Development Progression

• Controlled scribble

• Vertical line

• Horizontal line

• Circle

• Cross

• Right Oblique ($/$)

• Square

• Left Oblique ($ext{ extbackslash}$)

• X

• Triangle

• Upper case letters

• Lowercase letters, numerals, words

• Consistency across teaching philosophies and strategies is a key factor.

Cognitive Development (Piaget: Concrete Operational Stage)

• Ages: $7-11$ years

• Characteristics:

  • Reversibility: The ability to mentally reverse actions.

  • Rules: Increased adherence to and understanding of rules.

  • Follows steps more logically in multi-step sequences.

  • Begins to develop increasingly flexible & abstract thought ($7-12$ years).

  • Increased attention span.

  • Improved cognitive monitoring.

• Cognitive development during this stage often manifests in how children engage in games that involve rules and sequences.

Social-Emotional Development (Erikson: Industry vs. Inferiority)

• Ages: $5-13$ years

• Psychosocial Crisis: Industry vs. Inferiority

• Children are seeking independence and developing a sense of identity.

• Greatly influenced by friends and peers.

• Friendships: Shift from just sharing interests to sharing values, loyalty, and commitment.

• Approximately $40$% of a child's waking hours are spent with peers.

Communication Development

• Vocabulary: Develops fourfold, eventually exceeding comprehension of $40,000$ words.

• Children learn about $20$ words per day, with a greater rate in early elementary grades.

• Reading contributes significantly to vocabulary growth.

• Word Descriptions: Progression from concrete descriptions (e.g., in kindergarten: describing a bicycle by function or appearance) to understanding synonyms and relationships (e.g., by end of elementary).

• Double Meanings: Understanding of double meanings, including subtle metaphors, riddles, and sarcasm, develops by ages $8-10$ years.

• Complex Constructions: Mastery of complex linguistic constructions, including the use of the passive voice.

Adaptive/Self-Help/Occupation

Primary Occupations

• Education

• Self-Cares/Self-Management

• Community Involvement/Activities

• Play/Leisure

• Chores

Educational Goals

• Master basic educational skills.

• Develop positive interactions with others.

• Achieve emotional regulation.

• Explore and pursue interests in arts and sciences.

• Develop organizational strategies.

• Internalize moral and civic values.

• Maintain physical fitness and health.

Additional Skills Learned

• Cognitive Monitoring: Evaluating and regulating one's own cognitions, crucial for persisting in tasks.

• Self-Management: Taking responsibility for oneself.

• These skills are fostered appropriately across development, leading to decreased impulsivity and increased personal error detection.

• School Function Assessment (SFA): An assessment tool used to evaluate a child's participation in school.

Self-Cares/Self-Management

• Increased independence in self-care routines.

• Eats all types and textures of food and uses utensils well.

• Independent with dressing, grooming, and personal hygiene.

• Improved ability to self-manage daily tasks.

Play/Leisure

• Types of Play: Fantasy, constructive, sports, exploration, unstructured.

• Rules become more important in play.

• Increased interest in achievement through play.

• Play predominantly occurs with peers (school, community, or team settings).

• Gender Differences in Play:

  • Boys often engage in more aggressive/rough-and-tumble play.

  • Girls tend to engage in smaller group conversations and less rule-driven play.

Takata's (1974) Taxonomy of Play (with adaptations by Bryze, 2008)

• Sensorimotor: Birth to $2$ years

• Symbolic and simple constructive: $2$ to $4$ years

• Dramatic, complex constructive, and pregame: $4$ to $7$ years

  • Emphasis: Cooperative play with purposeful use of materials for construction; dramatization of reality and building habits.

  • Materials: Raw materials for fine motor actions and role playing; large adventure toys for refining gross actions.

  • People: Peer group ($2-5$ children), imaginary friends, parents, immediate family, and other adults.

  • Setting: School, neighborhood, and extended surroundings.

• Games: $7$ to $12$ years

  • Emphasis: Enhancement of constructional and sports skills; rule-bound behaviors, competition, and cooperative play.

  • Materials: Games with rules (e.g., checkers), raw materials to make complex products, sports (e.g., basketball), books, and puzzles.

  • People: Peer group of the same sex; organized groups.

  • Setting: Neighborhood, playground, school, and home.

• Recreational: $12$ to $16$ years

Chores

• In the US, children are rarely given chores until ages $8-9$ years old, and chores constitute about $15$% of household labor.

• In other countries, children may be given responsibilities as young as $3-4$ years old, with an average age for responsibilities being $5-7$ years old.

• Common Chores: Caring for younger siblings, caring for animals, household chores.

• Chores provide learning opportunities and a sense of self-satisfaction.

Social Participation

• Domains: School, Home/Family, Peer-related interactions, Achievement, Social life, Relationships, Financial awareness.

• Activities: Work and pre-vocational experiences, interpersonal interactions and relationships, education and post-secondary training, recreation and leisure, community life, religion, and citizenship.

• Social participation helps children try new things, develop new skills, understand limitations, expand emotional skills, and foster a sense of belonging.

Adolescence (Ages $12-24$ years)

Overview

• Ages: $12-24$ years

• Educational Stages: Middle School, High School, & College

• Often characterized as a period of "Living in the Moment" with significant immaturity, juvenile behavior, and a developing sense of self.

What Defines Adolescence

• Periods of Self-Examination: Intense focus on self and emerging identity.

• Onset: Typically marked by puberty or formal cultural/religious rites of passage.

• End: Not well-defined; best described as a process considering multiple individual variables:

  • Financial independence

  • Work roles

  • Education completion

  • Relationship stability

Facts about American Teenagers

• There are approximately $64$ million adolescents in the USA.

• Adolescents between $10$ and $24$ years old are more racially and ethnically diverse than the general population.

• About $2/3$ of adolescents between $12$ and $17$ years old live with both parents.

• Approximately $94.6$% of $16-$ to $17$-year-olds are enrolled in school.

• $17$% of children younger than age $17$ live below the federal poverty line.

• More than $5$ million children between ages of $5$ and $20$ years have a disability.

• $15$% of children between $12-17$ years are bullied by peers (CDC $2018$).

• $8$% receive special education services (CDC, $2018$).

• Top three causes of death (ages $12-19$):

  1. Unintentional accidents (e.g., drug overdose & car accidents).

  2. Suicide.

  3. Homicide.

• $80$% of adolescents manage this life stage without serious problems.

Physical/Motor Development

Body Structure & Function

• Puberty: Significant increases in height and weight.

  • Girls: Onset typically between $8-13$ years, with peak growth around $11$ years (average).

  • Boys: Onset typically between $11-12$ years, with peak growth around $13$ years (average).

• Peak Motor Performance:

  • Males: $17-18$ years.

  • Females: $14$ years.

• Physical Appearance: Becomes increasingly important, leading to a strong desire to "fit in."

• Effects of Early Maturation: Can have differing impacts on individuals.

Motor Skills

• Ongoing Refinement: Continued improvement of motor skills.

• Routinely performing ADL (Activities of Daily Living) and IADL (Instrumental Activities of Daily Living) tasks with ease.

• Bilateral coordination skills are fully matured.

• Many motor tasks are performed automatically without conscious thought.

• Enhancement of performance skills is focused on specialized areas (e.g., sports, arts).

Maturation in Adolescence (Sensory/Perceptual)

• Visual Acuity: How clearly one can see.

• Accommodation: How well the eyes change to maintain focus (e.g., looking back and forth between a board and paper on a desk).

• Eye-Tracking: Ability to follow a moving object or words on a page.

• Visual Perception: Processing and making sense of what one sees.

• Binocular Vision: Both eyes working together to support good depth perception.

Cognitive Development (Piaget: Formal Operational Stage - Implicit)

• Develop Logical Thinking: Move beyond concrete thought.

• Symbolic Thought and Hypothetical-Deductive Reasoning: Ability to think about abstract concepts, possibilities, and test hypotheses.

• Future Orientation: Fosters an interest in the future and long-term planning.

• Independence: Enables adolescents to achieve independence in thought and action.

• Values: Allows them to understand and solidify their personal values.

Cognitive Development Continued

• Emerging Metacognition: A monitoring function that allows thinking before, during, and after a task or thought process.

• Increased Speed of Information Processing: Leads to continued improvements in process skills.

• Adaptation Skills: The ability to anticipate, correct for, and benefit from the consequences of errors that naturally arise during routine task performance.

Social-Emotional Development (Erikson: Identity vs. Role Confusion - Implicit)

Psychosocial Development

• Key Questions: "Who am I?" (individual perspective) and "Where and how do I fit in my world?" (contextual perspective).

• Development: Occurs through the recognition of one's abilities, interests, strengths, and weaknesses.

• Identity Components: Includes gender orientation, culture, ethnicity, and personality.

Stages of Adolescent Psychosocial Development

• Early Adolescence (Middle School Years):

  • Preoccupied with self.

  • Self-evaluative about their attractiveness; compare their own body and appearance with other teens.

  • Interest in as well as anxiety about their sexual development.

  • Challenging authority figures.

  • Ability to self-regulate emotionally and limit behaviors, but may struggle to think beyond immediate needs or wants.

• Middle Adolescence (High School Years):

  • Pubertal changes are largely achieved.

  • Developing acceptance of their bodies; shift interest to their appearance, grooming, and "trying to be attractive."

  • More apt to develop eating disorders and other body image-related disorders.

  • Moving toward independence from parents; peers replace parents as the most influential group.

  • Risk-taking behaviors are common, often fueled by a sense of "invincibility."

• Late Adolescence (College Years):

  • Strengthen relationships with parents.

  • Develop a stable value system.

  • Achieve a stable sense of self and self-ability.

  • Improved ability to regulate emotions and anticipate consequences.

  • Develop realistic and concrete thoughts about the future (e.g., careers, relationships).

Positive Self-Esteem Behavioral Indicators

• Expresses opinions freely.

• Mixes with other teens easily.

• Initiates friendly interactions.

• Makes eye contact and faces others when speaking.

• Keeps comfortable, socially determined space between self and others.

• Talks fluently in their first language.

• Participates in group activities.

• Works collaboratively with others.

• Gives directions or instructions to others.

• Volunteers for tasks and activities.

Negative Self-Esteem Behavioral Indicators

• Avoids eye contact.

• Appears overly confident (often as a facade).

• Expresses self-criticism, makes self-deprecating comments, makes fun of self.

• Speaks loudly or dogmatically to avoid others responding.

• Submissive and overly agreeable to others’ requests or demands.

• Gives opinions or views reluctantly.

• Monitors behaviors of others excessively.

• Makes excuses for performance; seldom evaluates personal performance as good or satisfactory.

• Engages in putting others down, name-calling, gossiping, and bullying.

• Reports a lack of emotional support from parents and friends.

Adolescence and Mental Health

• Adolescents are particularly vulnerable to mental health disorders.

• One in every $5$ adolescents experiences symptoms of emotional distress.

• One in every $10$ adolescents is emotionally impaired.

• Common Disorders: Depression, anxiety disorders, substance use/abuse, attention deficit disorders.

Communication Development

• Communication and interaction increase significantly and occur in multiple environments.

• Adolescents learn and understand effective gestures, including appropriate physical space.

• Communication skills are practiced and refined through a variety of relationships (e.g., with family, friends, educators, romantic partners).

Adaptive/Self-Help/Occupation

Self-Care/Self-Management Skills

• Independently managing self-care routines.

• Perfecting grooming skills.

• Sleep: Adolescents need $8-10$ hours of sleep per night.

IADLs (Instrumental Activities of Daily Living)

• Education management.

• Performing chores consistently.

• Shopping for personal and household needs.

• Money management (budgeting, saving, spending).

• Health management (nutrition, exercise, managing basic health issues).

• (Learning) Driving.

• (Part-time) Work and volunteering.

Work

• Paid employment.

• Volunteerism.

Play/Leisure

• Engagement in passive activities (e.g., media consumption).

• Participation in sports.

• Involvement in extra-curricular activities, which are often linked to higher academic performance.

Context and Environment Influencing Development

Key Contexts

• School/Education: Providing challenging material, social environment.

• Culture: Shapes values, beliefs, and behaviors.

• Child/Adolescent (Individual Factors): Personal traits, temperament.

• Peers: Comparison, social influence.

• Community: Resources, opportunities, safety.

• Family/Home: Family makeup, support, expectations.