chpt 7 MIDDLE CHILDHOOD Body and Mind

CHILDHOOD OBESITY

Childhood overweight is usually defined as a BMI above the 85th percentile, and childhood obesity is defined as a BMI above the 95th percentile for children of a particular age based on growth charts in 1980. In 2016, 18 percent of U.S. 6- to 11-year-olds were obese, a significant difference from 2- to 5-year-olds, whose obesity rate was 14 percent (Hales et al., 2017). childhood overweight In a child, having a BMI above the 85th percentile, according to the U.S. Centers for Disease Control's 1980 standards for children of a given age. childhood obesity In a child, having a BMI above the 95th percentile, according to the U.S. Centers for Disease Control's 1980 standards for children of a given age. Childhood obesity is increasing worldwide, having more than doubled since 1980 in all three nations of North America (Mexico, the United States, and Canada) (Ogden et al., 2011). It also continues to creep higher in the United States, except for some reductions among 2- to 5-year-olds. Recent increases are dramatic in developing nations as food becomes more plentiful and parents no longer need to worry that their children might starve. For instance, in China, in only two decades (from 1991 to 2011), overweight among 6- to 12-year-olds more than doubled (from 11 percent to 26 percent) (Jia et al., 2017) (see Visualizing Development, page 240). Many of the oldest generations remember when children died of malnutrition, but they do not know the dangers of obesity. This helps explain why, unlike for children whose families have lived in the United States for generations, children of recent immigrants are more likely to be overweight than their parents. A Canadian review of 49 studies on obesity among immigrants found that when they change their diet, from traditional to American, obesity increases (Sanou et al., 2014). Childhood overweight correlates with asthma, high blood pressure, and elevated cholesterol (especially LDL, the "lousy" cholesterol), all of which increase death rates in adulthood. But during childhood, obesity is less a medical problem than a social one. As weight builds, school achievement decreases, self-esteem falls, and loneliness rises (Harrist et al., 2012). Loneliness in middle childhood is especially painful, because friends become crucial. A vicious cycle may develop: Children with poor social skills and few friends are more likely to overeat and vice versa (Jackson & Cunningham, 2015; Vandewater et al., 2015). Although obesity is somewhat affected by genes, culture is more influential. Look at the figure on obesity among 2- to 19-year-olds in the United States (see Figure 7.2). Are the large ethnic gaps (such as only 11 percent of Asian Americans but 26 percent of Hispanic Americans) genetic? But why the gender differences? Boys and girls of the same ethnicity share 45 of their 46 chromosomes, yet African American girls are more often obese than boys, while Asian American and Hispanic American boys are more often obese than girls. Thus, the social context is crucial. What parenting practices affect children's weight? Obesity rates rise if newborns are born too early, if infants are not breast-fed and begin eating solid foods before 4 months, if young children have televisions in their bedrooms and drink large quantities of soda, if older children sleep too little but have several hours of screen time (TV and so on) each day, if people of any age rarely play outside (Hart et al., 2011; Taveras et al., 2013). During middle childhood, children themselves have pester power—the ability to get adults to do what they want (Powell et al., 2011). That often includes pestering their parents to buy calorie-dense snacks that are advertised on television or that other children eat. However, there is hope for both parents and pestering children. Rather than targeting parents or children, educating parents and their children together improves weight and health, not just during the intervention but also over the long term (Yackobovitch-Gavan et al., 2018). A dynamic-systems approach that considers individual differences, parenting practices, school lunches, fast-food restaurants, television ads, and community norms is needed. Prevention must be tailored to the particular child, family, and culture (Harrison et al., 2011; Baranowski & Taveras, 2018). That makes progress slow—many treatments in isolation seem to have little impact—but given the long-term effects of childhood obesity, those who care about children must encourage every step.

Gifted and Talented

Children who are unusually gifted are often thought to have special educational needs, although federal laws in the United States do not include them as a special category. Instead, each U.S. state selects and educates gifted and talented children in a particular way. Some children score very high on IQ tests, which qualifies them as gifted, and some are divergent thinkers, who find many solutions and even more questions for every problem. These two characteristics sometimes coincide in the same child, but not always. Instead, a high-IQ child might be a convergent thinker, quickly finding one, and only one, correct answer for every problem. That child might be impatient not only with children who think more slowly but also with quick-thinking children who are highly creative. Should children who are unusually intelligent, talented, or creative be home-schooled, skipped, segregated, or enriched? Each of these solutions has been tried and found lacking. Historically, parents recognized their gifted or talented child, and then they taught the child themselves or hired a special coach or tutor. For example, Mozart composed music at age 3 and Picasso created works of art at age 4. Both boys had fathers who recognized their talent. Mozart's father transcribed his earliest pieces and toured Europe with his gifted son; Picasso's father removed him from school in second grade so that he could create all day. Although intense early education nourished their talent, neither Mozart nor Picasso had a happy adult life. Mozart had a poor understanding of math and money. He had six children, only two of whom survived infancy. He died in debt at age 35. Picasso regretted never learning to read or write. He married at age 17 and had a total of four children by three women. When school attendance became universal about a century ago, gifted children were allowed to skip early grades and join other children of the same mental age, not their chronological age. Many accelerated children never learned how to get along with others. As one woman remembers: Nine-year-old little girls are so cruel to younger girls. I was much smaller than them, of course, and would have done anything to have a friend. Although I could cope with the academic work very easily, emotionally I wasn't up to it. Maybe it was my fault and I was asking to be picked on. I was a weed at the edge of the playground. [Rachel, quoted in Freeman, 2010, p. 27] Calling herself a weed suggests that she never overcame her conviction that she was less cherished than the other children. Her intellectual needs may have been met by skipping two grades, but her emotional and social needs were severely neglected. My own father skipped three grades, graduating from high school at age 14. Because he attended a one-room school, and because he was the middle child of five, his emotional and social needs were met until he began college, where he almost failed because of his immaturity. He recovered, but some other children do not. A chilling example comes from: Sufiah Yusof [who] started her maths degree at Oxford [the leading University in England] in 2000, at the age of 13. She too had been dominated and taught by her father. But she ran away the day after her final exam. She was found by police but refused to go home, demanding of her father in an email: "Has it ever crossed your mind that the reason I left home was because I've finally had enough of 15 years of physical and emotional abuse?" Her father claimed she'd been abducted and brainwashed. She refuses to communicate with him. She is now a very happy, high-class, high-earning prostitute. [Freeman, 2010, p. 286] The fate of creative children may be worse than that of intellectually gifted children. If not given an education that suits them, they joke in class, resist drudgery, ignore homework, and bedevil their teachers. They may become innovators, inventors, and creative forces in the future, but they also may become drug addicts or school dropouts. They may find it hard to earn a degree or get a steady job because they are eager to try new things and feel stifled by normal life. Among the well-known creative geniuses who were poor students were Albert Einstein, Sigmund Freud, Isaac Newton, Oliver Sachs, Steve Jobs, and hundreds of thousands of others, probably some of whom you know personally. One such person was Charles Darwin, whose "school reports complained unendingly that he wasn't interested in studying, only shooting, riding, and beetle-collecting" (Freeman, 2010, p. 283). At the behest of his physician father, Darwin entered college to study medicine, but he dropped out. Without a degree, he began his famous five-year trip around South America at age 22, collecting specimens and developing the theory of evolution—which disputed conventional religious dogma as only a highly creative person could do. Since both acceleration and intense home schooling have led to later social problems, a third education strategy has become popular, at least in the United States. Children who are bright, talented, and/or creative—all the same age but each with special abilities—are taught as a group in their own separate class. Ideally, such children are neither bored nor lonely; each is challenged and appreciated by classmates and teachers. Some research supports the strategy of special education for children with exceptional music, math, or athletic gifts. Their brain structures develop in ways to support their talents (Moreno et al., 2015). Since plasticity means that children learn whatever their context teaches, perhaps some children need gifted-and-talented classes. Such classes require unusual teachers—bright and creative, and able to individualize instruction. For example, a 7-year-old artist may need freedom, guidance, and inspiration for magnificent art but also need patient, step-by-step instruction in sounding out simple words. Similarly, a 7-year-old classmate who already reads at the twelfth-grade level might have immature social skills, so the teacher must find another child to befriend him or her and then must help both of them share, compromise, and take turns. The teacher must also engage the child who is advanced in reading in conversation about books that most children cannot read until college. The argument against gifted-and-talented classes is that every child needs such teachers, no matter what the child's abilities or disabilities. If each school district (and sometimes each school principal) hires and assigns teachers, as occurs in the United States, then the best teachers may have the most able students, and the school districts with the most money (the most expensive homes) have the highest paid teachers. Should it be the opposite? High-achieving students are especially likely to have great teachers if the hidden curriculum includes tracking, putting children with special needs together, sorting regular classes by past achievement of the students, and allowing private or charter schools to select only certain students and expel difficult ones. The problem is worse if the gifted students are in a separate class within the same school as the other students, or if two schools are in the same building, a regular school and a special school. Then all of the students suffer: Some feel inferior and others superior—with neither group motivated to try new challenges and no one learning how to work together (Herrmann et al., 2016; Van Houtte, 2016). Mainstreaming, IEPs, and so on were developed when parents and educators saw that segregation of children with special needs led to less learning and impaired adult lives. The same may happen if gifted and talented children are separated from the rest. Some nations (China, Finland, Scotland, and many others) educate all children together, assuming that all children could become high achievers if they put in the effort and are guided by effective teachers. Since every child is special, should every child have special education?

Information Processing

Contemporary educators and psychologists find both Piaget and Vygotsky insightful. International research confirms the merits of their theories (Griffin, 2011; Mercer & Howe, 2012). Piaget described universal changes; Vygotsky noted cultural impact. However, both grand theories of child cognition are limited, especially regarding school curriculum. Each domain of achievement may follow a particular path (Siegler, 2016). Developmentalists now recognize the need for a third approach to understanding cognition. That third approach is information-processing, which benefits from technology that allows much more detailed data and analysis than were possible for Piaget or Vygotsky. Like computers that process information, people accumulate large amounts of facts. They then (1) seek relevant facts (as a search engine does) for each cognitive task, (2) analyze (as software programs do), and (3) express conclusions (as a printout might). By tracing the paths and links of each of these functions, scientists better understand the learning process. The usefulness of the information-processing approach is evident in data on children's school achievement year by year and even month by month. Absences, vacations, new schools, and even new teachers may set back a child's learning because learning each day builds on the learning of the previous day. Brain connections and pathways are forged from repeated experiences, allowing advances in processing. Without careful building and repetition, fragile connections between neurons break. One of the leaders of the information-processing perspective is Robert Siegler, who has studied the day-by-day details of children's cognition in math (Siegler & Braithwaite, 2017). Siegler compared the acquisition of knowledge to waves on an ocean beach when the tide is rising. After ebb and flow, eventually a new level is reached. Similarly, math understanding accrues gradually, with new and better strategies for calculation tried, ignored, half-used, abandoned, and finally adopted (Siegler, 2016). The specifics are influenced by the culture, which may or may not emphasize math, and the teachers, who may or may not understand the need for patience as well as practice. Counting itself may be the product of culture: Some languages lack words for large numbers, fractions, and so on (Everett, 2017). Overall, information processing guides teachers who want to know exactly which concepts and skills are crucial foundations for mastery of reading, writing, science, math, and human relations. Theory of mind, for example, turns out to be pivotal for understanding the scientific process and for estimating where a number might fall on a line (such as where the number 53 would be placed on a line from 0 to 100). That skill predicts later math achievement (Piekny & Maehler, 2013; Peng et al., 2017; Libertus et al., 2013).

POVERTY AND LANGUAGE

Every study finds that SES affects cognitive development, with poor language mastery the prominent sign and perhaps the major cause. Children from low-SES families usually have smaller vocabularies than those from higher-SES families, and they also are impaired in grammar (fewer compound sentences, dependent clauses, and conditional verbs) (Hart & Risley, 1995; Hoff, 2013). That slows down school learning in every subject. Image Especially for Parents You've had an exhausting day but are setting out to buy groceries. Your 7-year-old son wants to go with you. Should you explain that you are so tired that you want to make a quick solo trip to the supermarket this time? (see response, page 272) Brain scans confirm that development of the hippocampus is particularly affected by SES, and that may be critical for language learning (Jednoróg et al., 2012). How does poverty affect the brain? Possibilities include inadequate prenatal care, no breakfast, lead in the bloodstream, crowded households, few books at home, teenage parents, authoritarian child rearing, inexperienced teachers, air pollution, neighborhood violence, lack of role models . . . the list could go on and on (Van Agt et al., 2015; Kolb & Gibb, 2015; Rowe et al., 2016). All of these conditions correlate with low SES, slower language development, and less learning. One factor seems to be a cause, not just a correlate: language heard early on. The mother's education is influential, especially if she continues her quest for learning by reading and asking questions. Children who grow up in homes with many books accumulate, on average, three more years of education than children who live in homes with no books (Evans et al., 2010). Remember the plasticity of the brain. In some families, neuronal connections are strengthened and dendrites grow to support language. Low income per se is not as influential as maternal talk and listening. Educated parents are more likely to take their children to museums, zoos, and libraries, and to engage children in conversation about the interesting sights around them. Many sing to their children, not just a few simple songs but dozens of songs with varied vocabulary. Children benefit from conversations with relatives, strangers, friends, and teachers. Some fortunate bilingual children speak one language at home and learn another language elsewhere, because they spend extensive time with speakers of that second language. It is amazing how much children can learn. One of my African students speaks five languages, all learned in childhood. His mother and his father each came from a different tribe, so he learned both local languages. He was schooled in Senegal (French-speaking) and Sierra Leone (English-speaking). Finally, he learned Arabic to study the Quran. Some immigrant children then have another advantage. They are motivated to validate their parents' decision to leave their native land (Ceballo et al., 2014; Fuller & García Coll, 2010). Their parents expect them to learn the school language and study hard. They do.

REACTION TIME

Physical play as well as maturation during middle childhood also improves reaction time, which is how long it takes to respond to a stimulus. Preschoolers are sometimes frustratingly slow in putting on their pants, eating their cereal, throwing a ball. Reaction time is reduced every year of childhood, thanks to increasing myelination. Skill at games is an obvious example, from scoring on a video game, to swinging at a pitch, to kicking a soccer ball toward a teammate—timing on all of these improve every year from age 6 to 11, depending partly on practice. reaction time The time it takes to respond to a stimulus, either physically (with a reflexive movement such as an eyeblink) or cognitively (with a thought).

Special Education

The overlap of the biosocial, cognitive, and psychosocial domains is evident to developmentalists, as is the need for parents, teachers, therapists, and researchers to work together to help each child. However, deciding whether a child should be educated differently than other children is not straightforward, nor is it closely related to individual needs. Parents, schools, and therapists often disagree. The distinction between typical and atypical is not clear-cut (the first principle of developmental psychopathology) (Clark et al., 2017). In the United States, that realization led to a series of reforms in the education of children with special needs. According to the 1975 Education of All Handicapped Children Act, all children can learn, and all must be educated in the least restrictive environment (LRE). least restrictive environment (LRE) A legal requirement that children with special needs be assigned to the most general educational context in which they can be expected to learn. This means that children with special needs are usually educated within a regular class (a practice once called mainstreaming) rather than restricted to a special class. Sometimes a class is an inclusion class, which means that children with special needs are "included" in the general classroom, with "appropriate aids and services" (ideally from a trained teacher who works with the regular teacher). A more recent strategy is called response to intervention (RTI) (Al Otaiba et al., 2015; Jimerson et al., 2016; Ikeda, 2012). First, all children are taught specific skills—for instance, learning the sounds that various letters make. Then the children are tested, and those who did not master the skill receive special "intervention"—practice and individualized teaching, within the regular class. response to intervention (RTI) An educational strategy intended to help children who demonstrate below-average achievement in early grades, using special intervention. Then they are tested again, and, if need be, intervention occurs again. If children do not respond adequately to repeated, focused intervention, they are referred for special education. At that point, the school proposes an individual education plan (IEP), ideally designed for the particular child. Unfortunately, educators do not always know effective strategies, partly because research on remediation focuses on the less common problems. For example, in the United States "research funding in 2008-2009 for autistic spectrum disorder was 31 times greater than for dyslexia and 540 times greater than for dyscalculia" (Butterworth & Kovas, 2013, p. 304). individual education plan (IEP) A document that specifies educational goals and plans for a child with special needs. As Figure 7.6 shows, the proportion of children designated with special needs in the United States rose from 10 percent in 1980 to 13 percent in 2012. The greatest rise was in children called "learning disabled" (National Center for Education Statistics, 2016). This increase could result from: more brain-damaging chemicals in the air, food, or water (as with the lead in Flint, Michigan). implicit prejudice, since a disproportional number of children in special education are from immigrant or African American families (Harry & Klingner, 2014). adults who are more likely to notice and test a child who isn't learning, and then quicker to decide that special education is the solution. The U.S. school system designates more children as having special needs than does any other nation: Whether this is a reason for national pride or shame depends on which of the above reasons seems more accurate. How many children really need special education? Some U.S. experts fear that neurodiversity, RTI, and inclusion may limit help for children with special needs. If everyone is special, will that prevent help for children who desperately need it (Kauffman et al., 2017)?

TEN QUESTIONS

1. Should public schools be well-supported by public funds, or should smaller class sizes, special curricula, and expensive facilities (e.g., a stage, a pool, a garden) be available only in private schools, paid via tuition from wealthy parents? All told, about 11 percent of students in the United States attend private schools (see Figure 7.4). Other nations have higher and lower rates. 2. Should parents be given vouchers to pay for some tuition at a private school? Each state regulates vouchers differently, but a detailed look at vouchers in Wisconsin found that most parents who used vouchers were inclined to send their children to nonpublic schools in any case, partly for religious and safety reasons (D. Fleming et al., 2015). Thus, vouchers subsidize schools that differ from public schools, which may allow parents to choose a school that does not follow public school policy or curriculum. 3.Should more charter schools open or close? Charters are funded and licensed by states or local districts. Thus, they are public schools but are exempt from some regulations, especially those negotiated by teacher unions (hours, class size, etc.). Most have some control over admissions and expulsions, which makes them more ethnically segregated, with fewer children with special needs (Stern et al., 2015). Quality varies. Overall, more children (especially African American boys) and teachers leave or are expelled from charter schools than from other public schools, a disturbing statistic. However, some charters report that children who stay learn more and are more likely to go to college than their peers in regular schools (Prothero, 2016). 4. In 35 of the 50 U.S. states, and in several other nations, parents can choose to home school their children, never sending them to school. In the United States, home-schooled children must learn certain subjects (reading, math, and so on), but each family decides schedules and discipline. About 2 percent of all U.S. children were home-schooled in 2003 and about 3 percent in 2007. Since then numbers have leveled off at between 3 and 4 percent (Snyder & Dillow, 2013; Ray, 2013; Redford et al., 2017). Home schooling requires intense family labor, typically provided by an educated, dedicated, patient mother in a two-parent family. The major problem with home schooling is not academic (some home-schooled children have high test scores) but social: no classmates. To compensate, many parents plan activities with other home-schooling families. 5.Should public education be free of religion to avoid bias toward one religion or another? In the United States, thousands of parochial schools were founded when Catholics perceived Protestant bias in public schools. In the past 20 years, many Catholic schools have closed, but schools teaching other religions—Judaism, Islam, conservative Christianity—have opened. 6.Should the arts be part of the curriculum? Music, drama, dance, and the visual arts are essential in some places, not in others. Half of all U.S. 18- to 24-year-olds say that they had no arts education in childhood, either in school or anywhere else (Rabkin & Hedberg, 2011). By contrast, schools in Finland consider arts education essential, with a positive impact on learning (Nevanen et al., 2014). 7.Should children learn a second language in primary school? In Canada and in most European nations, almost every child studies two languages by age 10. In the United States, less than 5 percent of children under age 11 study a language other than English in school (Robelen, 2011). 8.Can computers advance education? Some enthusiasts hope that connecting schools to the Internet or, even better, giving every child a laptop (as some schools do) will advance learning. The results are not dramatic, however. Sometimes computers improve achievement, but not always. Widespread, sustainable advances are elusive (Lim et al., 2013). Technology may be only a tool—a twenty-first-century equivalent of chalk—that depends on a creative, trained teacher to use well. 9.Are too many students in each class? Parents typically think that a smaller class size encourages more individualized education. That belief motivates many parents to choose private schools or home schooling. However, mixed evidence comes from nations where children score high on international tests. Sometimes they have large student-teacher ratios (Korea's average is 28-to-1) and sometimes small (Finland's is 14-to-1). 10.Should teachers nurture soft skills such as empathy, cooperation, and integrity as part of the school curriculum, even though these skills cannot be tested by multiple-choice questions? Many scholars argue that soft skills are crucial for academic success and later for employment (Reardon, 2013).

At the outset, four general principles should be emphasized.

Abnormality is normal, meaning that everyone has some aspects of behavior that are unusual. The opposite is also true: Everyone with a serious disorder is, in many respects, like everyone else. The cutoff between what is, and is not, a disorder is arbitrary (Clark et al., 2017). Disability changes year by year. Most disorders are comorbid, which means that more than one problem is evident in the same person (Clark et al., 2017). A severe disorder in childhood may become milder, but another problem may become disabling. Life may get better or worse. Prognosis is uncertain. Many children with severe disabilities (e.g., blindness) become productive adults. Conversely, some conditions (e.g., conduct disorder) become more disabling. Diagnosis, treatment, and prognosis reflect the social context. Each individual interacts with the surrounding setting—including family, school, community, and culture—to modify, worsen, or even create psychopathology (Clark et al., 2017). comorbid Refers to the presence of two or more unrelated disease conditions at the same time in the same person.

WHO DECIDES?

An underlying issue for almost any national or international school is the proper role of parents. In most nations, matters regarding public education—curriculum, funding, teacher training, and so on—are set by the central government. Almost all children attend the local school, whose resources and standards are similar to those of the other schools in that nation. The parents' job is to support the child's learning by checking homework and so on. In the United States, however, local districts provide most of the funds and guidelines, and parents, as voters and volunteers, are often active in their child's school. Although most U.S. parents send their children to the nearest public school, almost one-third send their children to private schools, charter schools, or magnet schools. Parental choices may vary for each child, depending on the child's characteristics, the parents' current economic status, and the political rhetoric at the time. Every option has strengths and weaknesses, both for the child and for society. It is difficult for parents to determine the best school for their child, partly because neither the test scores of students in any of these schools nor the moral values a particular school may espouse correlate with the cognitive skills that developmentalists seek to foster (Finn et al., 2014). Thus, parents may choose a school that advertises what the parents value, but the school may not actually be the best educational experience for their child. Statistical analysis raises questions about home schooling, vouchers, and charter schools (Lubienski et al., 2013; Finn et al., 2014), but empirical data allow many interpretations. As one review notes, "the modern day, parent-led home-based education movement . . . stirs up many a curious query, negative critique, and firm praise" (Ray, 2013, p. 261). Schoolchildren's ability to be logical and teachable, now that they are no longer preoperational and egocentric, makes this a good time to teach them—they will learn whatever adults deem important. Parents, politicians, and developmental experts all agree that school is vital for development, but disagreements about teachers and curriculum—hidden or overt—abound.

ADJUSTING LANGUAGE TO THE CONTEXT

Another aspect of language that advances markedly in middle childhood is pragmatics, defined in Chapter 5. This is evident when a child knows which words to use with teachers (never calling them a rotten egg) and informally with friends (who can be called rotten eggs or worse). As children master pragmatics, they become more adept at making friends. Shy 6-year-olds cope far better with the social pressures of school if they use pragmatics well (Coplan & Weeks, 2009). By contrast, children with autism spectrum disorder are usually very poor at this aspect of language (Klinger et al., 2014). Mastery of pragmatics allows children to change styles of speech, or linguistic codes, depending on their audience. Each code includes many aspects of language—not just vocabulary but also tone, pronunciation, grammar, sentence length, idioms, and gestures. Sometimes the switch is between formal code (used in academic contexts) and informal code (used with friends); sometimes it is between standard (or proper) speech and dialect or vernacular (used on the street). All children need instruction because the logic of grammar and spelling (whether who or whom is correct or how to spell you) is almost impossible to deduce. Yet everyone will be judged by their ability to speak and write the formal code, so children need to learn it.

TEACHER ETHNICITY

Another aspect of the hidden curriculum is who the teachers are. If their gender, ethnicity, or economic background is unlike their students, children may conclude that education is irrelevant for them. School organization is also significant. If the school has gifted classes, the non-gifted may conclude that they are not capable of learning. The United States is experiencing major demographic shifts. Since 2010, half of the babies born are from Hispanic, Black, Asian, or Native American families, whereas more than two-thirds of the adults are of European background. Given the past history of sexual and racial discrimination, many experienced teachers are older white women. Thus, most children never have an elementary school teacher who is a man of minority background. Of course, many older, European American women are excellent teachers, but schools also need more excellent male, minority teachers—not only for the minority boys. The hidden curriculum could teach that caring educators come in many colors. Does it?

ASTHMA

Another childhood condition that can affect learning is asthma, a chronic inflammatory disorder of the airways that makes breathing difficult. Sufferers have periodic attacks, sometimes requiring a rush to the hospital emergency room, a frightening experience for children who know that asthma might kill them (although it almost never does in childhood). asthma A chronic disease of the respiratory system in which inflammation narrows the airways from the nose and mouth to the lungs, causing difficulty in breathing. Signs and symptoms include wheezing, shortness of breath, chest tightness, and coughing. If asthma continues in adulthood, which it does about half the time, it can be fatal (Banks & Andrews, 2015). But children's most serious problem related to asthma is frequent absence from school. This impedes not only learning but also friendships, which thrive between children who see each other every day. In the United States, childhood asthma rates tripled from 1980 to 2000, increased more gradually from 2000 to 2010, and then decreased somewhat (probably because smog has become less prevalent as clean air regulations have taken effect) (Zahran et al., 2018). Currently, 1 in every 10 U.S. 5- to 11-year-olds has been diagnosed with asthma and still suffers from the condition. For more than half of them, asthma has meant missing school and having an attack in the past year. Rates somewhat higher for boys, African Americans, and children of Puerto Rican descent (Zahran et al., 2018). Rates increase as income falls. Researchers have found many causes. Some genetic alleles have been identified, as have many aspects of modern life—carpets, pollution, house pets, airtight windows, parental smoking, cockroaches, dust mites, less outdoor play. None acts in isolation. A combination of genetic sensitivity to allergies, early respiratory infections, and compromised lung functioning increases wheezing and shortness of breath (Mackenzie et al., 2014). Some experts suggest a hygiene hypothesis: that "the immune system needs to tangle with microbes when we are young" (Leslie, 2012, p. 1428). Children may be overprotected from viruses and bacteria, especially in modern nations. In their concern about hygiene, parents mistakenly prevent exposure to minor infections, diseases, and family pets. All these would strengthen their child's immunity. This hypothesis is supported by data showing that (1) first-born children develop asthma more often than later-born ones; (2) asthma and allergies are less common among farm-dwelling children; and (3) children born by cesarean delivery (very sterile) have a greater incidence of asthma. Overall, it may be "that despite what our mothers told us, cleanliness sometimes leads to sickness" (Leslie, 2012, p. 1428). Remember the microbiome—those many bacteria within our bodies. Some in the lungs affect asthma (Singanayagam et al., 2017). Accordingly, changing the microbiome—via diet, drugs, or exposure to animals—may treat asthma. However, asthma has multiple, varied causes and types; no single treatment will help everyone.

APPLICATION TO MATH

Another example of concrete logic is seriation, the knowledge that things can be arranged in a logical series. Seriation is crucial for using (not merely memorizing) the alphabet or the number sequence. By age 5, most children can count up to 100. But because they do not yet grasp seriation, they cannot correctly estimate where any particular two-digit number would be placed on a line that starts at 0 and ends at 100 (Meadows, 2006). seriation The concept that things can be arranged in a logical series, such as the number sequence or the alphabet. Indeed, every logical concept helps with math. Concrete operational thinkers begin to understand that 15 is always 15 (conservation); that numbers from 20 to 29 are all in the 20s (classification); that 134 is less than 143 (seriation); and that because 5 × 3 = 15, it follows that 15 ÷ 5 must equal 3 (reversibility). By age 11, children use mental categories and subcategories flexibly, inductively, and simultaneously, unlike at age 7.

SCANNING THE BRAIN

Another way to indicate aptitude is to measure the brain directly. In childhood, brain scans do not correlate with IQ scores (except for children with abnormally small brains), but they do later on (Brouwer et al., 2014). Brain scans can measure activity (reaction time, selective attention, emotional excitement) or the size of various brain areas, but they are not accurate in diagnosing cognitive disorders in childhood (Goddings & Giedd, 2014). Neuroscientists and psychologists agree, however, on four generalities: Brain development depends on experiences. Thus, a brain scan is accurate only at the moment, not for the future. Dendrites form and myelination changes throughout life. Middle childhood is crucial, but developments before and after these years are also significant. Children with disorders often have unusual brain patterns, and training may change those patterns. However, brain complexity and normal variation mean that diagnosis and remediation are far from perfect. Each brain functions in a particular way, a concept called neurodiversity. Diverse neurological patterns are not necessarily better or worse; they are simply different, an example of the difference is not deficit idea explained first in Chapter 1 (Kapp et al., 2013). neurodiversity The idea that each person has neurological strengths and weaknesses that should be appreciated, in much the same way diverse cultures and ethnicities are welcomed. Neurodiversity seems particularly relevant for children with disorders on the autism spectrum.

Teaching and Learning

As we have seen, middle childhood is a time of great learning. Children worldwide learn whatever adults in their culture teach, and their brains are ready. (See the accompanying At About This Time tables for some of the universally recognized sequences of learning reading and arithmetic.) Traditionally, they were educated at home, but now almost all of the world's 7-year-olds are in school.

Health Habits

Children can maintain good health if adults teach them how and if regular doctor and dentist visits are part of their lives. Every child needs good medical care; without it, adult health is affected. Adults who now have good care still suffer if their childhood circumstances were poor (McEwen & McEwen, 2017; Juster et al., 2016). Peers and parents make a difference. If children see that others routinely care for their own health, social learning pushes them to do the same. Camps for children with asthma, cancer, diabetes, sickle-cell anemia, and so on are beneficial because other children and knowledgeable adults teach self-care. Health habits should be established before teenage rebellion erupts, often causing resistance to diets, pills, warning signs, and doctors (Dean et al., 2010; Naughton et al., 2014). Ideally self-care is already routine; rebellion focuses on curfews or hairstyles, not health habits.

SPEAKING TWO LANGUAGES

Code changes are obvious when children speak one language at home and another at school. Every nation includes many such children; most of the world's 6,000 languages are not school languages. In the United States, about one school-age child in five speaks something other than English at home (see Figure 7.3). Many other U.S. children speak 1 of the 20 or so English dialects with regional or ethnic word use, pronunciation, and grammar. That creates a challenge for teachers, because code-switching correlates with school achievement yet pride in origins correlates with motivation (Terry et al., 2016). Fortunately, children can learn several codes—easily before age 5, with some help in middle childhood, and with effort after puberty—and they also need to be proud of their first language. Educators and political leaders in the United States argue about how to teach English to English Language Learners (ELLs), whose first language is not Standard English. One strategy is immersion, with instruction entirely in the new code. The opposite strategy is to teach children in their first language initially and then to add instruction of the second as a "foreign" tongue (a strategy that is rare in the United States but common elsewhere). English Language Learners (ELLs) Children in the United States whose proficiency in English is low—usually below a cutoff score on an oral or written test. Many children who speak a non-English language at home are also capable in English; they are not ELLs. immersion A strategy in which instruction in all school subjects occurs in the second (usually the majority) language that a child is learning. Between these extremes lies bilingual education, with instruction in two languages, and ESL (English as a Second Language), with all non-English speakers taught English in one multilingual group, preparing them to join English-only classes. bilingual education A strategy in which school subjects are taught in both the learner's original language and the second (majority) language. ESL (English as a Second Language) A U.S. approach to teaching English that gathers all of the non-English speakers together and provides intense instruction in English. Students' first languages are never used; the goal is to prepare them for regular classes in English. Every method for teaching a second language sometimes succeeds and sometimes fails. Language-learning abilities change with age: The youngest children learn a new language fastest. For cognitive advances during middle childhood, the information-processing perspective suggests that children should learn two languages. When bilingual individuals are asked to reason about something in their second language, they tend to be more rational and less emotional—which usually (but not always) leads to better thought (Costa et al., 2017). Fluently bilingual children must inhibit one language while using another. This is a benefit because it increases cognitive control, not only in language but also in other aspects of executive function (Bialystok, 2018). Cognitive advances depend on linguistic proficiency: Children who are not fluent in at least one language are also impaired in cognitive skills.

Children with Special Brains and Bodies

Developmental psychopathology links usual with unusual development, especially when the unusual results in special needs (Cicchetti, 2013b; Hayden & Mash, 2014). This topic is relevant lifelong because "[e]ach period of life, from the prenatal period through senescence, ushers in new biological and psychological challenges, strengths, and vulnerabilities" (Cicchetti, 2013b, p. 458). Turning points, opportunities, and past influences are always apparent. developmental psychopathology The field that uses insights into typical development to understand and remediate developmental disorders.

The Hidden Curriculum

Differences between nations and between schools in the United States are stark in the hidden curriculum—all of the implicit values and assumptions of schools. Schedules, tracking, teacher characteristics, discipline, teaching methods, sports competitions, student government, and extracurricular activities are all part of the hidden curriculum. That teaches children far more than the formal, published curriculum that lists what is taught in each grade. hidden curriculum The unofficial, unstated, or implicit patterns within a school that influence what children learn. For instance, teacher background, organization of the play space, and tracking are all part of the hidden curriculum—not formally prescribed, but instructive to the children. An obvious example is the physical surroundings. Some schools have spacious classrooms, wide hallways, and large, grassy playgrounds; others have cramped, poorly equipped classrooms and cement play yards. In some nations, school is held outdoors, with no chairs, desks, or books; classes are canceled when it rains. What does that tell the students?

PROBLEMS WITH INTERNATIONAL COMPARISONS

Elaborate and extensive measures are in place to make the PIRLS, TIMSS, and PISA valid. Test items are designed to be fair and culture-free, and participating children represent the diversity (economic, ethnic, etc.) of each nation's child population. Thousands of experts work to ensure validity and reliability. Consequently, most social scientists respect the data gathered from these tests. The tests are far from perfect, however. Creating questions that are equally fair for everyone is impossible. For example, in math, should fourth-graders be expected to understand fractions, graphs, decimals, and simple geometry? Nations introduce these concepts at different ages, and some schools stress math more than others: Should every fourth-grader be expected to divide fractions? After such general issues are decided, items are written. The following item tested math: Three thousand tickets for a basketball game are numbered 1 to 3,000. People with ticket numbers ending with 112 receive a prize. Write down all the prize-winning numbers. Only 26 percent of fourth-graders worldwide got this one right (112; 1,112; 2,112—with no additional numbers). About half of the children in East Asian nations and 36 percent of the U.S. children were correct. Those national scores are not surprising; children in Singapore, Japan, and China have been close to the top on every international test for 20 years, and the United States has been above average but not by much. Children from North Africa did especially poorly; only 2 percent of Moroccan fourth-graders were correct. Is basketball, or 3,000 tickets for one game, or random prizes as common in North Africa as in the United States? Another math item gives ingredients—4 eggs, 8 cups of flour, ½ cup of milk—and asks: The above ingredients are used to make a recipe for 6 people. Sam wants to make this recipe for only 3 people. Complete the table below to show what Sam needs to make the recipe for 3 people. The number of eggs he needs is shown.

INTERNATIONAL TESTING

Every nation now wants to improve education, because they believe that longitudinal data find that when achievement rises, the national economy advances (Hanushek & Woessmann, 2015). Better-educated children become more productive and healthier adults. That is one reason many developing nations are building more schools and colleges. Nations also want to make education more effective for all students. To measure that, almost 100 nations have participated in at least one massive international test of children's learning. Science and math achievement are tested in the Trends in Math and Science Study (TIMSS). The main test of reading is the Progress in International Reading Literacy Study (PIRLS). A third test is the Programme for International Student Assessment (PISA), which is designed to measure the ability to apply learning to everyday issues. East Asian nations always rank high, and scores of several nations (some in Europe, most in Asia) surpass the United States (see Tables 7.1 and 7.2). Trends in Math and Science Study (TIMSS) An international assessment of the math and science skills of fourth- and eighth-graders. Although the TIMSS is very useful, different countries' scores are not always comparable because sample selection, test administration, and content validity are hard to keep uniform. Progress in International Reading Literacy Study (PIRLS) Inaugurated in 2001, a planned five-year cycle of international trend studies in the reading ability of fourth-graders. Programme for International Student Assessment (PISA) An international test taken by 15-year-olds in 50 nations that is designed to measure problem solving and cognition in daily life. One surprising example is that Finland's scores increased dramatically, especially in the PIRLS and the PISA, after a wholesale reform of its public education system. Reforms occurred in several waves (Sahlberg 2011, 2015). In 1985 ability grouping was abolished, and in 1994 the curriculum began to encourage collaboration and active learning rather than competitive passive education. Currently, in Finland, all children learn together—no tracking—and teachers are mandated to help each child. If some children need special help to master the formal curriculum, teachers provide it within the regular class. Over the past two decades, strict requirements for becoming a teacher have been put in place in Finland. Only the top 3 percent of Finland's high school graduates are admitted to teachers' colleges. They study for five years at the university at no charge, earning a master's degree in the theory and practice of education.

NATIONAL STANDARDS

For decades, the U.S. government has sponsored the National Assessment of Educational Progress (NAEP), which is a group of tests designed to measure achievement in reading, mathematics, and other subjects. The NAEP finds fewer children proficient than do state tests. For example, New York's tests reported 62 percent proficient in math, but the NAEP found only 32 percent; 51 percent were proficient in reading on New York's state tests but only 35 percent according to NAEP (Martin, 2014). National Assessment of Educational Progress (NAEP) An ongoing and nationally representative measure of U.S. children's achievement in reading, mathematics, and other subjects over time; nicknamed "the Nation's Report Card." The NAEP also finds that Latino and African American fourth-graders are about 12 percent lower than their European American peers in reading and 9 percent lower in math (National Center for Health Statistics, 2016). Moreover, "Federal civil rights data show persistent and widespread disparities among disadvantaged students from prekindergarten to high school" with low-SES children, English Language Learners, and minority ethnic groups all suffering (McNeil & Blad, 2014, p. 8). For some statistics—high school graduation, for instance—Asian American children achieve at higher rates than European Americans. However, the "model minority" stereotype obscures disadvantages for many children of Asian heritage. Further, Asian children may suffer from parental pressure and peer jealousy (Cherng & Liu, 2017). The reason for disparities within the United States seems more economic than ethnic, because African Americans in some of the wealthier states (Massachusetts) score higher than European Americans in the poorer states (Mississippi). Many suggest that the disparity in local funding for schools is at the root of the problem: High-SES children of all groups attend well-funded schools. That raises the first of several issues within U.S. education, ten of which are mentioned now.

THE NEED FOR MOVEMENT

Given the importance of physical activity for health and learning, many developmentalists are troubled when indoor activities (homework, television) crowd out active play. Parents used to tell their children "go out and play"; now they say, "don't leave the house." Such free play has many benefits, as does programmed activity that gets children to move. Many parents now enroll their children in after-school sports that vary by culture—tennis, karate, cricket, yoga, rugby, baseball, or soccer (football). However, the children who most need to connect their bodies and their minds—those from low-SES families or who have physical disabilities—are least likely to join Little League and the like, even when enrollment is free. The reasons are many, the consequences sad (Dearing et al., 2009). Ideally, all children learn various skills as well as exercise their bodies in school. However, a study of all elementary schools in Illinois found that schools with the least time scheduled for physical activity tend to be those with the most low-SES children, as well as the lowest reading scores (Kern et al., 2018). In this example, understanding correlation provides a novel way to interpret the relationship between reading scores and recess. It is easy to assume that more reading instruction is needed in schools with low scores, so academic instruction crowds out time for physical education. But, the correlation might occur in the opposite direction: Less physical activity might cause less learning (Kern et al., 2018). Even when policies mandate in-school physical education and recess, requirements may be ignored. For instance, although Alabama requires at least 30 minutes daily of physical education in primary schools, the average in one poor district was only 22 minutes. No school in that district had recess or after-school sports (Robinson et al., 2014).

Brain Development

How could body movement improve intellectual functioning? A review of the research suggests several possible mechanisms, including direct benefits on cerebral blood flow and neurotransmitters as well as indirect results from better moods (Singh et al., 2012). Many studies have found that children's brains benefit from physical exercise (Voelcker-Rehage et al., 2018). While aerobic exercise directly affects brain structures, every movement can cause learning indirectly. Children learn by doing and then express what they know by moving, in embodied cognition, the idea that thinking is connected to body movement (Pexman, 2017). For example, the physical act of handwriting helps children learn to read (James, 2017).

PHYSICAL EXERCISE IN JAPAN

In Japan, children score high on international tests, and yet many schools have more than an hour of recess (in several segments) a day, in addition to gym classes. The Japanese believe that physical activity promotes learning and character development (Webster & Suzuki, 2014). Consequently, many Japanese public schools have swimming pools, indoor gyms, and outdoor yards with structures for climbing, swinging, and so on. The emphasis on exercise is lifelong; that is one explanation for the fact that the Japanese live longer, on average, than people in any other nation. Even in Japan, however, teachers are hesitant to teach physical education to students with disabilities (Hodge et al., 2013). From what we know about the brain and the body during middle childhood, all children—especially those who are not athletically gifted—need daily physical activity.

GENDER DIFFERENCES IN SCHOOL PERFORMANCE

In addition to marked national, ethnic, and economic differences, gender differences in achievement scores are reported. The PIRLS finds fourth-grade girls ahead of boys in reading in every nation, by an average of 19 points (Mullis et al., 2017). The 2016 female verbal advantage on the PIRLS in the United States is 8 points, which is a difference of less than 2 percent. Several other nations are close to the U.S. norms, including France, Spain, and Hong Kong. Does that mean that those nations are more gender-equitable than the nation with the widest gender gap—Saudi Arabia with a 65-point gap (464/399)? Maybe, maybe not. Historically, boys were ahead of girls in math and science. However, TIMSS reported that those gender differences among fourth-graders in math have narrowed, disappeared, or reversed. In many nations, boys are still slightly ahead, with the United States showing a male advantage (7 points—less than 2 percent). However, in other nations, girls are ahead, sometimes significantly, such as 10 points in Indonesia and 20 points in Jordan. Why? Is there an anti-male bias in their schools or culture? In middle childhood, girls in every nation have higher report card grades, including in math and science. Is that biological (girls are better able to sit still, to manipulate a pencil)? Or cultural (girls have been taught to do as they are told)? Or does the hidden curriculum favor girls (most of their elementary school teachers were women)? The popularity of various explanations has shifted. Analysts once attributed girls' higher grades in school to their faster physical maturation. Now explanations are more often sociocultural—that parents and teachers expect girls to be good students and that schools are organized to favor female strengths. The same switch in explanations, from biology to culture, appears for male advantages in science. Is that change itself cultural?

A Healthy Time

In marked contrast to infancy or adolescence, middle childhood is a time of slow and steady growth. Children gain about 2 inches and 5 pounds a year (more than 5 centimeters and 2 kilograms). Nature and nurture combine to make these the healthiest years of life. To be specific, the death rate for 5- to 9-year-olds is by far the lowest of any age group, with the rates for 11- to 14-year-olds the second lowest (Murphy et al., 2017) (see Figure 7.1). Genetic diseases are most threatening in early infancy or old age; infectious diseases are kept away via immunization; and fatal accidents—although the most common cause of death—are lower than at every other period. The naturally low death rate of children this age has continued to fall in recent years, thanks to better injury control and modern medicine. In the United States in 1950, the death rate per 100,000 5- to 14-year-olds was 60; in 2015, it was less than 13 (National Center for Health Statistics, 2017). Oral health has improved, with more brushing and fluoride. A survey found that 75 percent of U.S. children saw a dentist for preventive care in the past year, and for 70 percent of them, the condition of their teeth was very good (Iida & Rozier, 2013) No wonder the boys on page 232 look proud of their new front teeth.

Language

Language is crucial for cognition in middle childhood. It is the means by which children learn new concepts, and it also indicates how much children have learned. A school-age child who can explain ideas with complex sentences is a child who is thinking well. Every aspect of language—vocabulary, comprehension, communication skill, and code-switching—advances each year from age 6 to 11.

TEACHER EXPECTATIONS

Less visible but probably more influential is the hidden message that comes from teacher attitudes. If a teacher expects children to be disruptive, or unable to learn, children confirm those expectations. Fortunately, teacher expectations are malleable: Learning increases and absences decrease when teachers believe all of their students can learn and they teach accordingly, with encouragement (Sparks, 2016). One teacher expectation is that students talk, or do not talk, in class. In the United States, adults are expected to voice their opinions. Accordingly, many teachers welcome student questions, call on children who do not speak up, ask children to work in pairs so that each child talks, and grant points for participation. North American students learn to speak, even when they do not know the answers. Elsewhere, children are expected to be quiet. This aspect of the hidden curriculum affects learning. In one study, middle-class children asked questions and requested help from their teachers more often than lower-SES students did (Calarco, 2014). The researchers suggested that the low-SES students sought to avoid teacher attention, fearing it would lead to criticism. Might that have given teachers the impression that they were disinterested? Thus, the hidden curriculum might prevent students who most need encouragement from getting it.

Vygotsky and Culture

Like Piaget, Vygotsky felt that educators should consider children's thought processes, not just the products. He also believed that middle childhood was a time for much learning, with the specifics dependent on the family, school, and culture. Vygotsky appreciated children's curiosity and creativity. For that reason, he believed that an educational system based on rote memorization rendered the child "helpless in the face of any sensible attempt to apply any of this acquired knowledge" (Vygotsky, 1994a, pp. 356-357).

AUTISM SPECTRUM DISORDER

Of all the children with special needs, those with autism spectrum disorder (ASD) are especially puzzling. Causes and treatments are hotly disputed. autism spectrum disorder (ASD) A developmental disorder marked by difficulty with social communication and interaction—including difficulty seeing things from another person's point of view—and restricted, repetitive patterns of behavior, interests, or activities. A century ago, autism was a rare disorder affecting fewer than 1 in 1,000 children with "an extreme aloneness that, whenever possible, disregards, ignores, shuts out anything . . . from the outside" (Kanner, 1943). Children with autism were usually nonverbal and severely impaired. Now, in the United States, among 8-year-olds, 1 child in every 59 (1 boy in 38; 1 girl in 151) is said to have ASD (MMWR, April 27, 2018). That's more than four times as many boys as girls. The other disparity is ethnic: The rate is higher for European American than Hispanic, Asian, or African American children. The increase could be real: Perhaps it is caused by the environment—chemicals in the food, pollution in the air and water. Or it could be that professionals are now aware of ASD and, since education for children with this diagnosis is now publicly funded, parents are more willing to seek a diagnosis (Klinger et al., 2014). Or it could be an expanded definition: The DSM-5 expanded the term autism to autism spectrum disorder, which now includes mild, moderate, and severe categories. Children who once were diagnosed as having an intellectual disability or Asperger syndrome are now "on the spectrum." All children with ASD find it difficult to understand the emotions of others, which makes them feel alien, like "an anthropologist on Mars," as Temple Grandin, an educator and writer with ASD, expressed it (quoted in Sacks, 1995). Consequently, they are less likely to talk or play with other children, and they are delayed in developing theory of mind. Verbal and social skills are impaired, but some children with ASD have special talents, such as in art or math. Many are above average in IQ tests (MMWR, March 28, 2014). This wide range of abilities illustrates neurodiversity (Graf et al., 2017). Because of their diverse abilities, adults should neither be dazzled by children's talents nor despairing at their deficiencies. Many scientists are searching for biological ways to detect autism early in life, perhaps with blood tests or brain scans before age 1. At the moment, behavioral signs are the best we have. Most children with ASD show signs in early infancy (no social smile, for example, or less gazing at faces and eyes than most toddlers). Some improve by age 3; others deteriorate (Klinger et al., 2014). As more children are diagnosed, some people wonder whether ASD is a disorder needing a cure or whether, instead, our culture needs to adjust to a society in which not everyone is outgoing, flexible, and a fluent talker—the opposite of people with ASD. Instead of trying to make all children alike, we might welcome the neurological variation of human beings (Kapp et al., 2013; Silberman, 2015). The neurodiversity perspective leads to new criticisms of the many treatments for ASD. When a child is diagnosed with ASD, parental responses vary from irrational hope to deep despair, from blaming doctors and chemical additives to feeling guilty for their genes, for their behavior during pregnancy, or for the circumstances they allowed at their child's birth. A sympathetic observer describes one child who was medicated with Abilify, Topamax, Seroquel, Prozac, Ativan, Depakote, trazodone, Risperdal, Anafranil, Lamictal, Benadryl, melatonin, and the homeopathic remedy, Calms Forté. Every time I saw her, the meds were being adjusted again . . . [he also describes] physical interventions—putting children in hyperbaric oxygen chambers, putting them in tanks with dolphins, giving them blue-green algae, or megadosing them on vitamins . . . usually neither helpful nor harmful, though they can have dangers, are certainly disorienting, and cost a lot. Diagnosis and treatment are difficult; an intervention that seems to help one child proves worthless for another. It is known, however, that biology (genes, copy number abnormalities, birth complications, prenatal injury, perhaps chemicals during fetal or infant development) is crucial. Family nurture is not the cause.

Early Intervention

One conclusion from all of the research on special education is that diagnosis and intervention often occur too late, or not at all. The numbers of children in public schools who are designated as needing special education increase as children grow older, which is the opposite of what would occur if early intervention were successful. This is apparent in each of the disorders we have discussed. Sometimes the current approach is called "wait to fail," when ADHD and learning disorders are not diagnosed until a child has been struggling for years without help for sensory, familial, or cultural problems. As one expert says, "We need early identification, and . . . early intervention. If you wait until third grade, kids give up" (Shaywitz, cited in Stern, 2015, p. 1466). A similar problem occurs with autism spectrum disorder. You read that autism appears in infancy, but children are not usually diagnosed until age 4, on average (MMWR, March 28, 2014). This is long after many parents have noticed something amiss in their child, and years after the most effective intervention can begin. In fact, some children diagnosed with autism spectrum disorder before age 4 no longer have it later on—an outcome that seems to be related to intense social intervention in the early years (Kroncke et al., 2016). Even with early intervention, most children with ASD have deficits in adulthood, but the fact that some children overcome social and cognitive symptoms is another argument for early intervention. Plasticity of the brain and behavior is especially evident.

A HIERARCHY OF CATEGORIES

One logical operation is classification, the organization of things into groups (or categories or classes) according to some characteristic that they share. For example, family includes parents, siblings, and cousins. Other common classes are animals, toys, and food. Each class includes some elements and excludes others; each is part of a hierarchy. classification The logical principle that things can be organized into groups (or categories or classes) according to some characteristic that they have in common. Food, for instance, is an overarching category, with the next-lower level of the hierarchy being meat, grains, fruits, and so on. Most subclasses can be further divided: Meat includes poultry, beef, and pork, each of which can be divided again. Adults grasp that items at the bottom of a classification hierarchy belong to every higher level: Bacon is always pork, meat, and food. They also know that each higher category includes many lower ones but not vice versa (most food, meat, and pork are not bacon). This mental operation of moving up and down the hierarchy is beyond preoperational children. Piaget devised many classification experiments. In one, he showed a child a bunch of nine flowers—seven yellow daisies and two white roses. Then the child is asked, "Are there more daisies or more flowers?" Until about age 7, most children answer, "More daisies." The youngest children offer no reason, but some 6-year-olds explain that "there are more yellow ones than white ones" or "because daisies are daisies, they aren't flowers" (Piaget et al., 2001).

Piaget in Middle Childhood

Piaget called middle childhood the time for concrete operational thought, characterized by new logical abilities. Operational comes from the Latin verb operare, meaning "to work; to produce." By calling this period operational, Piaget emphasized productive thinking. Piaget's theory is a classic stage theory: Concrete operational thinking is the stage after preoperational thought and before formal operational cognition. concrete operational thought Piaget's term for the ability to reason logically about direct experiences and perceptions. In middle childhood, thinking is concrete operational, grounded in actual experience (like the solid concrete of a cement sidewalk). Concrete thinking arises from what is visible, tangible, and real, not abstract and theoretical (as at the next stage, formal operational thought). Children become more systematic, objective, scientific—and therefore educable.

Special Needs in Middle Childhood

Problems with testing are not the only reason diagnosis of psychopathology is complex (Hayden & Mash, 2014; Cicchetti, 2013b). One cause can have many (multiple) final manifestations, a phenomenon called multifinality (many final forms). The opposite is also apparent: Many causes can result in one symptom, a phenomenon called equifinality (equal in final form). Thus, a direct line from cause to consequence cannot be drawn with certainty. multifinality A basic principle of developmental psychopathology which holds that one cause can have many (multiple) final manifestations. equifinality A basic principle of developmental psychopathology which holds that one symptom can have many causes. For example, an infant who has been flooded with stress hormones may become hypervigilant or irrationally placid, may be easily angered or quick to cry, or may not be affected (multifinality). Or a nonverbal child may have autism or hearing impairment, be electively mute or pathologically shy (equifinality). To illustrate the many complexities, we discuss three disorders: attention-deficit/hyperactivity disorder (ADHD), specific learning disorder, and autism spectrum disorder (ASD). As a reference, we use DSM-5 (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association in 2013). The DSM-5 is only one set of criteria—the World Health Organization has another (ICD-11), some experts are using a third (RDoC) for research. Psychiatrists are already discussing DSM-6 (Clark et al., 2017). There are hundreds of disorders: Some are added, combined, or deleted with each new edition of DSM. The following is only a beginning.

PAYING ATTENTION

Remember executive control, which includes the ability to inhibit some impulses to focus on others. Neurological advances allow children to pay special heed to the most important elements of their environment. Selective attention, concentrating on some stimuli while ignoring others, improves markedly at about age 7. Selective attention is partly the result of maturation, but it is also greatly affected by experience, particularly social play. School-age children not only notice various stimuli (which is one form of attention) but also select appropriate responses when several possibilities conflict (Wendelken et al., 2011). In kickball, soccer, basketball, and baseball, it is crucial to attend to the ball, not to dozens of other stimuli. For example, in baseball, young batters learn to ignore the other team's attempts to distract them; fielders start moving into position as soon as the bat connects; and pitchers adjust to the height, handedness, and past performance of the person at bat. Another physical activity that seems to foster executive function is karate, which requires inhibition of some reactions in order to execute others (Alesi et al., 2014).

MANY INTELLIGENCES

Since scores change over time, IQ tests are much less definitive than they were once thought to be. Some scientists doubt whether any single test can measure the complexities of the human brain, especially if the test is designed to measure g, one general aptitude. People inherit and develop many abilities, some high and some low (e.g., Q. Zhu et al., 2010). Two leading developmentalists (Robert Sternberg and Howard Gardner) are among those who believe that humans have multiple intelligences, not just one. Sternberg originally described three kinds of intelligence: analytic, creative, and practical (Sternberg, 2008, 2011). Children who are unusually creative, or very practical, may not be the best students in school, but they may flourish as adults, as explained more in Chapter 12. multiple intelligences The idea that human intelligence is composed of a varied set of abilities rather than a single, all-encompassing one. Gardner originally described seven intelligences: linguistic, logical-mathematical, musical, spatial, bodily-kinesthetic (movement), interpersonal (social understanding), and intrapersonal (self-understanding), each associated with a particular brain region (Gardner, 1983). He subsequently added an eighth (naturalistic: understanding nature, as in biology, zoology, or farming) and a ninth (spiritual/existential: thinking about life and death) (Gardner, 1999, 2006; Gardner & Moran, 2006). Although everyone has some of all nine intelligences, Gardner believes each individual excels in particular ones. For example, someone might be gifted spatially but not linguistically (a visual artist who cannot describe her work) or might have interpersonal but not naturalistic intelligence (an astute clinical psychologist whose houseplants die). Schools, cultures, and families dampen or expand particular intelligences. If two children are born with creative, musical aptitude, the child whose parents are musicians is more likely to develop musical intelligence than the child whose parents are tone-deaf. Gardner (2011) believes that schools often are too narrow, teaching only some aspects of intelligence and thus stunting children's learning.

ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

Someone with attention-deficit/hyperactivity disorder (ADHD) is inattentive, active, and impulsive. DSM-5 says that symptoms must start before age 12 (in DSM-IV it was age 7) and must impact daily life. (DSM-IV said impair, DSM-III said impact.) attention-deficit/hyperactivity disorder (ADHD) A condition characterized by a persistent pattern of inattention and/or by hyperactive or impulsive behaviors; ADHD interferes with a person's functioning or development. Partly because the definition now includes ADHD that first appears at puberty, the number of children diagnosed with ADHD has increased worldwide (Polanczyk et al., 2014). In 1980, about 5 percent of all U.S. 4- to 17-year-olds were diagnosed with ADHD; more recent rates are 7 percent of 4- to 9-year-olds, 13 percent of 10- to 13-year-olds, and 15 percent of 14- to 17-year-olds (Schwarz & Cohen, 2013). Calculating IQ: Answers (from page 260) 1.75 (slow learner) 2.125 (superior) 3.150 (genius) All young children are sometimes inattentive, impulsive, and active, gradually settling down with maturation. However, those with ADHD "are so active and impulsive that they cannot sit still, are constantly fidgeting, talk when they should be listening, interrupt people all the time, can't stay on task, . . . accidentally injure themselves." All this makes them "difficult to parent or teach" (Nigg & Barkley, 2014, p. 75). Diagnosis can lead to helpful treatment, often involving medication. Because many adults are upset by children's moods and actions, and because any physician can write a prescription to quiet a child, thousands of U.S. children may be overmedicated. But, because many parents do not recognize that their child needs help, or they are suspicious of drugs and psychologists (Moldavsky & Sayal, 2013; Rose, 2008), thousands of children may suffer needlessly. This dilemma is explored in Opposing Perspectives, on page 263. In general, three problems are apparent. Misdiagnosis. If ADHD is diagnosed when another disorder is the problem, treatment might make the problem worse (Miklowitz & Cicchetti, 2010). Many psychoactive drugs alter moods, so a child with disruptive mood dysregulation disorder (formerly called childhood bipolar disorder) might be harmed by ADHD medication. Drug abuse. Although drugs sometimes are therapeutic for true ADHD cases, some older children want an ADHD diagnosis in order to obtain legal amphetamines (McCabe et al., 2014). In addition, parents or teachers may also overuse medication to quiet children. Typical behavior considered pathological. If a child's activity, impulsiveness, and curiosity are diagnosed as ADHD, exuberance and self-confidence may suffer. "Typical considered pathological" is one interpretation of data on 378,000 children in Taiwan, a Chinese nation whose rates of ADHD are increasing (M.-H. Chen et al., 2016). Boys who were born in August, and hence entered kindergarten when they had just turned 5, were diagnosed with ADHD at the rate of 4.5 percent, whereas boys born in September, starting kindergarten when they were almost 6, were diagnosed at the rate of 2.8 percent. Diagnosis typically occurred years after kindergarten, but August birthday boys were at risk throughout their school years. (See Figure 7.5.) The example in Taiwan highlights another concern. For ADHD diagnosis, "boys outnumber girls 3-to-1 in community samples and 9-to-1 in clinical samples" (Hasson & Fine, 2012, p. 190). Could typical male activity, troubling to mothers and female teachers, be the reason?

Specific Learning Disorders

The DSM-5 diagnosis of specific learning disorder now includes problems in both perception and information processing that cause low achievement in reading, math, or writing (including spelling) (Lewandowski & Lovett, 2014). Disabilities in these areas undercut academic achievement, destroy self-esteem, and qualify a child for special education (according to U.S. law) or formal diagnosis (according to DSM-5). specific learning disorder A marked deficit in a particular area of learning that is not caused by an apparent physical disability, by an intellectual disability, or by an unusually stressful home environment. The most commonly diagnosed learning disorder is dyslexia—unusual difficulty with reading. Historically, some children with dyslexia figured out themselves how to cope—as did Hans Christian Andersen and Winston Churchill. dyslexia Unusual difficulty with reading; thought to be the result of some neurological underdevelopment. Early theories hypothesized visual difficulties—for example, reversals of letters (reading god instead of dog) and mirror writing (b instead of d)—as causing dyslexia, but we now know that dyslexia more often originates with speech and hearing difficulties (Gabrieli, 2009; Swanson, 2013). Another common learning disorder is dyscalculia, unusual difficulty with math. For example, when asked to estimate the height of a normal room, second-graders with dyscalculia might answer "200 feet." When shown both the 5 and 8 of hearts from a deck of playing cards and asked which is higher, they might use their fingers to count the hearts on each card (Butterworth et al., 2011). dyscalculia Unusual difficulty with math, probably originating from a distinct part of the brain. Although learning disorders can appear in any skill, the DSM-5 recognizes only dyslexia, dyscalculia, and one more—dysgraphia, difficulty in writing. Few children write neatly at age 5, but practice allows most children to write easily and legibly by age 10. Some children have several learning disabilities; they may be diagnosed as intellectually disabled. For them, as with children with only one learning disability, targeted help from teachers and guidance for parents make life easier for the child and family and may remediate learning problems (Crnic et al., 2017). Remember plasticity: Skills improve with precise practice (not general practice, such as doing homework, but specific practice, such as sounding out letters).

KNOWLEDGE LEADS TO KNOWLEDGE

The more people already know, the better they can learn. Having an extensive knowledge base, or a broad body of knowledge in a particular subject, makes it easier to remember and understand related new information. As children gain knowledge during the school years, they become better able to judge (1) accuracy, (2) what is worth remembering, and (3) what is not important (Woolley & Ghossainy, 2013). knowledge base A body of knowledge in a particular area that makes it easier to master new information in that area. Past experience, current opportunity, and personal motivation all facilitate increases in the knowledge base. Motivation explains why a child's knowledge base may not be what parents or teachers prefer. Some schoolchildren memorize words and rhythms of hit songs, know plots and characters of television programs, or recite names and statistics of basketball (or soccer, baseball, or cricket) stars. Yet they do not know whether World War I was in the nineteenth or twentieth century or whether Pakistan is in Asia or Africa. Concepts are learned best when linked to personal and emotional experiences. For example, children from South Asia, or who have classmates from there, learn the boundaries of Pakistan when teachers appreciate and connect their students' heritage. On the other hand, children who are new to a nation, or even new to a particular school, may be confused by some kinds of learning that are easy for those who have always lived in that community.

Control Processes

The neurological mechanisms that put memory, processing speed, and the knowledge base together are control processes; they regulate the analysis and flow of information within the brain. Two terms are often used to refer to cognitive control—metacognition (sometimes called "thinking about thinking") and metamemory (knowing about memory). control processes Mechanisms (including selective attention, metacognition, and emotional regulation) that combine memory, processing speed, and knowledge to regulate the analysis and flow of information within the information-processing system. (Also called executive processes.) Control processes require the brain to organize, prioritize, and direct mental operations, much as the CEO (chief executive officer) of a business organizes, prioritizes, and directs business operations. For that reason, control processes are also called executive processes, and the ability to use them is called executive function (already mentioned in Chapter 5). Control processes allow a person to step back from the specifics to consider more general goals and cognitive strategies. Maturation and experience matter. For instance, in one study, children took a fill-in-the-blank test and indicated how confident they were about each answer. Young children do not do well: They may be quite sure of a wrong answer. Then these children were allowed to delete some questions, with the remaining ones counting more. By age 9, children could estimate correctness; by age 11, they knew what to delete (Roebers et al., 2009). Control processes develop spontaneously as the prefrontal cortex matures, but they can be taught. Examples include spelling rules ("i before e except after c") and ways to remember how to turn a lightbulb ("lefty-loosey, righty-tighty"). Preschoolers ignore such rules or use them only on command; 7-year-olds begin to use them; 9-year-olds can create and master more complicated rules. Efforts to teach executive control succeed if the particular neurological maturation of the child is taken into account, which is exactly what information-processing theorists would predict (Karbach & Unger, 2014).

APTITUDE, ACHIEVEMENT, AND IQ

The potential to master a specific skill or to learn a certain body of knowledge is called aptitude. A child might have the intellectual aptitude to be a proficient reader, for instance, even though that child has not learned to read or write. By middle childhood, most children have the aptitude to read and write; in adulthood, some people have the aptitude to be talented athletes, chefs, artists, or whatever. aptitude The potential to master a specific skill or to learn a certain body of knowledge. Aptitude is distinct from achievement, which is what is actually mastered. We all have aptitudes that we never achieved, either because we chose not to develop those abilities or because our social context discouraged us. For children, academic achievement is measured by comparing a child with norms for each grade. Thus, a child who is at a third-grade reading level might, in fact, be in another grade—second or fifth, for instance. But nonetheless, the child reads at a third-grade level. People assumed that, for intelligence, one general aptitude (often referred to as g, for general intelligence) could be assessed by answers to a series of questions (vocabulary, memory, and so on). The number of correct answers was compared to the average for children of a particular age to compute an IQ. Such scores correlated with school achievement, because a child with a certain intellectual potential is able to learn if given the proper instruction. IQ scores could also indicate whether a child would have difficulty learning in class. Originally, IQ tests produced a number that was literally a quotient: Mental age (the average chronological age of children who answer a certain number of questions correctly) was divided by the chronological age of a child taking the test. The answer from that division (the quotient) was multiplied by 100. An IQ of 100 was exactly average, because when mental age was the same as chronological age, the quotient was 1, and 1 × 100 = 100. It was once assumed that aptitude was a fixed characteristic, present at birth. Longitudinal data show otherwise. Young children with a low IQ can become above average or even gifted adults, like my nephew David (discussed in Chapter 1). Indeed, the average IQ scores of entire nations have risen substantially every decade for the past century—a phenomenon called the Flynn effect. This effect is more apparent for women than for men, and in southern Europe more than northern Europe, as educational opportunities for women and for southern Europeans improved in the twentieth century (D. Weber et al., 2017). Flynn effect The rise in average IQ scores that has occurred over the decades in many nations. Most psychologists now agree that the brain is like a muscle, affected by mental exercise—which often is encouraged or discouraged by the social setting. This is proven in language and music (brains literally grow with childhood music training) and is probably true in other domains (Moreno et al., 2015; Zatorre, 2013). Both speed and memory are crucial for g, and they are affected by experience, evident in the Flynn effect. Calculating IQ (answers on page 262) 1. Child is age 8. Mental age is 6. IQ is . 2.Child is age 8. Mental age is 10. IQ is . 3.Child is age 6. Mental age is 9. IQ is .

THE ROLE OF INSTRUCTION

Unlike Piaget, who thought children would discover most concepts themselves, Vygotsky stressed direct instruction from teachers and other mentors. They provide the scaffold between potential and knowledge by engaging each child in his or her zone of proximal development. Vygotsky would not be surprised at one finding of recent research: Internationally as well as nationally, children who begin school at age 4 or 5, not 6 or 7, tend to be ahead in academic achievement compared to those who enter later. The benefit of early schooling is still apparent at age 15, although not in every nation (Sprietsma, 2010). Vygotsky would explain the variation in impact by noting that in some nations early education is far more interactive, and hence better at guided participation, than in others. Play with peers, screen time, dinner with families, neighborhood play—every experience, from birth on, teaches a child, according to Vygotsky. On their own, children gradually become more logical, but Vygotsky thought mentoring was helpful. Thus, when children are taught, they can master logical arguments (even counterfactual ones) by age 11. For example, they know that if birds can fly, and if elephants are birds, then elephants can fly (Christoforides et al., 2016). Vygotsky emphasized that lessons vary by culture and school and are not simply the result of maturation. He recognized, however, that children are limited in grasping the philosophical issues of life and death. They tend to be quite matter-of-fact, absorbing whatever their parents and culture teach rather than seeking the deeper meaning—as was true for Philip in A Case to Study.

VOCABULARY

Vocabulary builds during middle childhood. Concrete operational children are logical; they can understand prefixes, suffixes, compound words, phrases, and metaphors, even if they have not heard them before. For example, 2-year-olds know egg, but 10-year-olds also know egg salad, egg-drop soup, egghead, a good egg, and "last one in is a rotten egg"—a metaphor from my childhood that a 2017 Google search found still relevant today. By age 10, a child who has never smelled a rotten egg, nor heard that phrase, can figure out the meaning. In middle childhood, some words become pivotal for understanding the curriculum, such as negotiate, evolve, allegation, deficit, molecules. Consequently, vocabulary is taught in every elementary school classroom.