child development case study of 5 year old

Early Childhood Education: How to do a Child Case Study-Best Practice

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Description of Assignment

During your time at Manor, you will need to conduct a child case study. To do well, you will need to plan ahead and keep a schedule for observing the child. A case study at Manor typically includes the following components: 

• Three observations of the child: one qualitative, one quantitative, and one of your choice. 
• Three artifact collections and review: one qualitative, one quantitative, and one of your choice. 
• A Narrative

Within this tab, we will discuss how to complete all portions of the case study.  A copy of the rubric for the assignment is attached. 

• Case Study Rubric (Online)
• Case Study Rubric (Hybrid/F2F)

Qualitative and Quantitative Observation Tips

Remember your observation notes should provide the following detailed information about the child:

• child’s age,
• physical appearance,
• the setting, and
• any other important background information.

You should observe the child a minimum of 5 hours. Make sure you DO NOT use the child's real name in your observations. Always use a pseudo name for course assignments. 

You will use your observations to help write your narrative. When submitting your observations for the course please make sure they are typed so that they are legible for your instructor. This will help them provide feedback to you. 

Qualitative Observations

A qualitative observation is one in which you simply write down what you see using the anecdotal note format listed below. 

Quantitative Observations

A quantitative observation is one in which you will use some type of checklist to assess a child's skills. This can be a checklist that you create and/or one that you find on the web. A great choice of a checklist would be an Ounce Assessment and/or work sampling assessment depending on the age of the child. Below you will find some resources on finding checklists for this portion of the case study. If you are interested in using Ounce or Work Sampling, please see your program director for a copy. 

Remaining Objective 

For both qualitative and quantitative observations, you will only write down what your see and hear. Do not interpret your observation notes. Remain objective versus being subjective.

An example of an objective statement would be the following: "Johnny stacked three blocks vertically on top of a classroom table." or "When prompted by his teacher Johnny wrote his name but omitted the two N's in his name." 

An example of a subjective statement would be the following: "Johnny is happy because he was able to play with the block." or "Johnny omitted the two N's in his name on purpose." 

• Anecdotal Notes Form Form to use to record your observations.
• Guidelines for Writing Your Observations
• Tips for Writing Objective Observations
• Objective vs. Subjective

Qualitative and Quantitative Artifact Collection and Review Tips

For this section, you will collect artifacts from and/or on the child during the time you observe the child. Here is a list of the different types of artifacts you might collect: 

Potential Qualitative Artifacts 

• Photos of a child completing a task, during free play, and/or outdoors. 
• Samples of Artwork 
• Samples of writing 
• Products of child-led activities 

Potential Quantitative Artifacts 

• Checklist 
• Rating Scales
• Product Teacher-led activities 

Examples of Components of the Case Study

Here you will find a number of examples of components of the Case Study. Please use them as a guide as best practice for completing your Case Study assignment. 

• Qualitatitive Example 1
• Qualitatitive Example 2
• Quantitative Photo 1
• Qualitatitive Photo 1
• Quantitative Observation Example 1
• Artifact Photo 1
• Artifact Photo 2
• Artifact Photo 3
• Artifact Photo 4
• Artifact Sample Write-Up
• Case Study Narrative Example Although we do not expect you to have this many pages for your case study, pay close attention to how this case study is organized and written. The is an example of best practice.

Narrative Tips

The Narrative portion of your case study assignment should be written in APA style, double-spaced, and follow the format below:

• Introduction : Background information about the child (if any is known), setting, age, physical appearance, and other relevant details. There should be an overall feel for what this child and his/her family is like. Remember that the child’s neighborhood, school, community, etc all play a role in development, so make sure you accurately and fully describe this setting! --- 1 page
• Observations of Development :   The main body of your observations coupled with course material supporting whether or not the observed behavior was typical of the child’s age or not. Report behaviors and statements from both the child observation and from the parent/guardian interview— 1.5  pages
• Comment on Development: This is the portion of the paper where your professional analysis of your observations are shared. Based on your evidence, what can you generally state regarding the cognitive, social and emotional, and physical development of this child? Include both information from your observations and from your interview— 1.5 pages
• Conclusion: What are the relative strengths and weaknesses of the family, the child? What could this child benefit from? Make any final remarks regarding the child’s overall development in this section.— 1page
• Your Case Study Narrative should be a minimum of 5 pages.

Make sure to NOT to use the child’s real name in the Narrative Report. You should make reference to course material, information from your textbook, and class supplemental materials throughout the paper . 

Same rules apply in terms of writing in objective language and only using subjective minimally. REMEMBER to CHECK your grammar, spelling, and APA formatting before submitting to your instructor. It is imperative that you review the rubric of this assignment as well before completing it. 

Biggest Mistakes Students Make on this Assignment

Here is a list of the biggest mistakes that students make on this assignment: 

• Failing to start early . The case study assignment is one that you will submit in parts throughout the semester. It is important that you begin your observations on the case study before the first assignment is due. Waiting to the last minute will lead to a poor grade on this assignment, which historically has been the case for students who have completed this assignment. 
• Failing to utilize the rubrics. The rubrics provide students with guidelines on what components are necessary for the assignment. Often students will lose points because they simply read the descriptions of the assignment but did not pay attention to rubric portions of the assignment. 
• Failing to use APA formatting and proper grammar and spelling. It is imperative that you use spell check and/or other grammar checking software to ensure that your narrative is written well. Remember it must be in APA formatting so make sure that you review the tutorials available for you on our Lib Guide that will assess you in this area. 
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5-Year-Old Child Development Milestones

Your child’s growth and development at age 5

• Language and Cognitive Milestones
• Movement Milestones
• Emotional and Social Milestones
• Other Milestones
• Help Your 5-Year-Old Learn and Grow
• Keep Your 5-Year-Old Safe
• When to Be Concerned

Five years old can be a really fun age! Your child loves to play and is extremely imaginative. They still feel little and adorable, but they are becoming quite the conversationalist, and their ability to pick up new information and ask thoughtful questions will seriously impress you.

This age isn’t without its ups and downs. Five-year-olds are still learning to regulate their emotions, so meltdowns happen from time to time. Still, your child is moving toward becoming more mature, and is able to do big kid things like going to school , and brushing their own teeth.

Let’s take a look at what to expect in terms of growth and development as you parent your 5-year-old, as well as some red flags that might warrant a call to your pediatrician.

5-Year-Old Language and Cognitive Milestones

Your child’s language skills are really exploding at this age. “Five-year-olds are fluent talkers,” says Molly O'Shea , MD, official pediatrician of  Goldfish Swim School . “They use pronouns correctly, recognize colors, and understand and use direction words like 'over,' 'under,' and 'next to.'”

Dr. O’Shea says that children this age love to recount the things that happened to them during the day, and can recall details from hours before. They are also able to carry out more detailed directions than they did before, a skill that will help prepare them for kindergarten.

“When following directions, five-year-olds can usually carry out a three-step sequence such as, ‘Get your shoes, put on your jacket, and pack your backpack,’ with few reminders,” Dr. O’Shea describes.

Cognitively, you will be wowed by how quickly your child is absorbing new information, says Tiffany Kimbrough, MD , associate professor and pediatrician at Children’s Hospital of Richmond at VCU. “Five-year-olds are like sponges and are constantly learning,” Dr. Kimbrough explains. “They can count ten or more items, can understand concepts like money, print letters and numbers, and copy shapes.”

Although your child still enjoys playing imaginatively, they are better able to distinguish between imaginative play and real life, says Dr. O'Shea. “Fantasy vs. reality are getting clearer, but kids still struggle to understand what can really happen and what can’t,” she notes.

Language and Cognitive Checklist

• Five-year-olds have a vocabulary of about 2000 words, and speak in sentences with at least five words.
• They can recount things like their phone number, and the first and last names of their parents.
• They still ask a lot of questions, but they can also answer simple questions.
• They can recognize rhymes, like "hop" and "stop."
• Their speech is more easily understood by others, and they are starting to use the future tense when speaking (“I will go to school tomorrow”).

5-Year-Old Movement, Hand, and Finger Milestones

As your child moves from preschool age to school-age, they are growing a bit more slowly, and their round cheeks and chunky thighs may start to lean out a bit. At this age, your child will gain about 4 or 5 pounds a year, and grow about 5 to 8 centimeters. On average, 5-year-olds weigh roughly 40 pounds and are about 40 inches in height.

Your child is no longer a teetering toddler or preschooler. Their movements are becoming more synchronized and their hand-eye coordination is getting more refined.

“Five-year-olds have gotten a lot more coordinated and are ready for action,” Dr. O’Shea says. “Gross motor skill development allows them to throw and catch smaller balls, run, jump and skip, and even do more complex movements like gymnastics and swimming real strokes.” They should also be able to hop on one foot.

As for fine motor skills, your child should be able to do things like feed themselves easily, and may even be able to use a child-safe knife to do things like spread butter on bread. Your child’s writing skills are also improving, which is readying them for exciting things like printing their own name. They also have some ability to dress themselves, such as by buttoning large buttons.

“They should have established hand dominance and be exhibiting a mature pencil grasp called a dynamic tripod (or quadrupod) grasp,” explains Caitlin Sanschagrin, an occupational therapist at Bright SpOT Pediatric Therapy . But all children are different, Sanschagrin says, and you shouldn’t expect your child to have a “textbook” pencil grasp at this age. 

Physical Milestones Checklist

• Your 5-year-old should be able to stand on one foot for about 10 seconds.
• They are mastering the art of climbing, swinging, and somersaulting.
• They should be able to use the potty on their own.
• They can hop, and may even be able to skip.

5-Year-Old Emotional and Social Milestones

One of the things you may notice at this age is just how much fun it is to chat with your 5-year-old. Yes, they still say the cutest things, but they also have a lot of interesting thoughts and opinions to share. “They are very capable of participating in conversations and may ask questions to gain information,” says Emily Rooker, a speech-language pathologist at Bright SpOT Pediatric Therapy.

Additionally, Rooker notes, your 5-year-old is growing and maturing when it comes to making friends and engaging with people outside their immediate family. At this age, children more consciously make and choose friends on their own, Rooker says.

They are also able to engage in play that involves directions, expectations, and cooperation, Rooker explains, which is another important prerequisite for the type of activities they will engage in once they begin elementary school. A 5-year-old can also do simple chores, such as putting their plate and cup in the sink after a meal.

But as much as your child is becoming more able to adhere to rules and become a team player, they are still very much capable of testing limits , especially with their parents. Regressing in behavior—and even having the occasional meltdown—is typical at this age, and it’s important to remember that you child is young and still learning.

“It can be frustrating for parents to see children behaving ‘like babies’ in their eyes, but by acknowledging the feelings and supporting the child, their emotional capabilities will grow and the child will have more ways of handling tough situations,” Dr. O’Shea advises.

Other Milestones for Your 5-Year-Old

Get your tooth fairy skills ready, because 5 years old is when most children start to lose their baby teeth. Starting at around age 5 or 6 is when your child’s mature sets of incisors (the middle bottom and middle top teeth) start to come in. The teeth will be wiggly for a few days or weeks before they fall out, and they often fall out while your child is eating. There may be a little blood, but the bleeding should be minimal.

At this age, your child should also be fully potty-trained, for both pee and poop. Most children this age can clean up after themselves in the bathroom as well. Don’t be surprised if your child still has accidents, though (that’s why their kindergarten teacher will have you send in an extra set of clothes). Kids this age still sometimes wet the bed.

How to Help Your 5-Year-Old Learn and Grow

As a parent, you may feel frustrated by the fact that your child still has occasional tantrums at 5 years old. This behavior is normal, says Dr. O’Shea, but there are some things you can do as a parent to help your child navigate these difficult feelings.

“Children will get upset,” she says. “When they do, parents can try hard to empathize rather than diminish their children’s feeling by saying things like ‘stop crying’ or ‘you’ll be fine.’” Even though your instinct as a parent may be to try to make the behavior stop immediately, allowing children a chance to share their emotions is important.

“By leaning into it with empathy, we give our children an opportunity to express their feelings and for us to help them come up with new ways to express themselves in the long run,” Dr. O’Shea offers.

How to Keep Your 5-Year-Old Safe

Your child will have a well checkup at the pediatrician's office soon after they turn 5. Their healthcare provider will make sure they are up to date with their immunizations , especially the ones required for school. Immunizations typically offered at this age include additional doses of the DTaP vaccine, the polio vaccine, the chickenpox vaccine, and the MMR vaccine. Your child’s provider will likely offer the flu shot as well.

Additionally, your child’s pediatrician will discuss the kinds of lifestyle choices that will keep your child healthy during this time. Five-year-olds need regular physical activity—at least one hour of movement a day. They need to get adequate sleep as well, and many kids this age need to sleep between 11 and 13 hours each night.

When to Be Concerned About Your 5-Year-Old

Every child is different when it comes to reaching milestones, and this is especially true at age 5. Some children are able to read a little at this age, while others are still learning their letters. Some children are little gymnasts while others are still mastering catching a ball . There is a wide range of normal, so don’t worry too much if your child has or hasn't mastered certain skills before others.

Still, there are some signs that your child may need a little extra help or an evaluation by a medical professional.

“If your child cannot say their first and last name, doesn't play with a variety of toys or play different games, doesn't respond to others, has extreme emotions (anxious, shy, or overly fearful), is unable to wash their own hands, cannot draw a picture, or if your child ever loses skills they once possessed, you should speak with your child's pediatrician or family practice doctor for more of an in-depth developmental assessment,” Dr. Kimbrough advises.

You can bring up your concerns with your pediatrician. If they agree that there may be an issue, they will be able to refer you to a specialist who can evaluate your child, and help them get the help they need.

A Word From Verywell

As you observe your 5-year-old and consider their growth and development, you probably have their entry into elementary school at the forefront of your mind. This is natural, because starting kindergarten is a major milestone for both you and your child.

Thankfully, although the adjustment to school can be bumpy, most children do fine in kindergarten—and yes, their parents learn to let go as well. But there are some children who struggle.

If you are concerned about your child’s ability to self-regulate their emotions, or if your child is showing lags in social skills or pre-reading and math skills, don’t hesitate to reach out to your pediatrician with your questions and concerns.

Centers for Disease Control and Prevention. Important milestones: Your child by five years .

Mott Children’s Hospital. Milestones for 5-year-olds .

U.S. National Library of Medicine. Developmental milestones record - 5 years .

Nemours KidsHealth. Growth and your 4- to 5-year-old .

Nemours KidsHealth. Your teeth .

Centers for Disease Control and Prevention. Vaccines at 4 to 6 years .

Nemours KidsHealth. Your child's checkup: 5 years .

By Wendy Wisner Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.

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Casebook: Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth Through Age 8

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About the book.

• Make connections to the fourth edition of Developmentally Appropriate Practice in Early Childhood Programs 
• Think critically about the influence of context on educator, child, and family actions 
• Discuss the effectiveness of the teaching practices and how they might be improved 
• Support your responses with evidence from the DAP position statement and book 
• Explore next steps beyond the case details 
• Apply the learning to your own situation 

Table of Contents

• Editors, Contributors, and Reviewers
• Introduction and Book Overview | Jennifer J. Chen and Dana Battaglia
• 1.1 Missed Opportunities: Relationship Building in Inclusive Classrooms | Julia Torquati
• 1.2 “My Name Is Not a Shame” | Kevin McGowan
• 1.3 Fostering Developmentally Appropriate Practice Through Virtual Family Connections | Lea Ann Christenson
• 1.4 Counting Collections in Community | Amy Schmidtke
• 1.5 The Joy Jar: Celebrating Kindness | Leah Schoenberg Muccio
• 1.6 Prioritizing Listening to and Learning from Families | Amy Schmidtke 
• 2.1 Julio’s Village: Early Childhood Education Supports for Teen Parents | Donna Kirkwood
• 2.2 Healthy Boundaries: Listening to Children and Learning from Families | Jovanna Archuleta
• 2.3 Roadmap of Family Engagement to Kindergarten: An Ecological Systems Approach | Marcela Andrés
• 2.4 Taking Trust for Granted? The Importance of Communication and Outreach in Family Partnerships | Suzanna Ewert
• 2.5 Book Reading: Learning About Migration and Our Family Stories | Sarah Rendón García 
• 3.1 Pairing Standardized Scale with Observation | Megan Schumaker-Murphy
• 3.2 The Power of Observing Jordan | Marsha Shigeyo Hawley and Barbara Abel
• 3.3 “But What Is My Child Learning?” | Janet Thompson and Jennifer Gonzalez
• 3.4 Drawing and Dialogue: Using Authentic Assessment to Understand Children’s Sense of Self and Observe Early Literacy Skills | Brandon L. Gilbert
• 3.5 The ABCs of Kindergarten Registration: Assessment, Background, and Collaboration Between Home and School | Bridget Amory
• 3.6 Creating Opportunities for Individualized Assessment Activities for Biliteracy Development | Esther Garza
• 3.7 Observing Second-Graders’ Vocabulary Development | Marie Ann Donovan
• 3.8 Writing Isn’t the Only Way! Multiple Means of Expressing Learning | Lee Ann Jungiv 
• 4.1 Engaging with Families to Individualize Teaching | Marie L. Masterson 
• 4.2 Tumbling Towers with Toddlers: Intention and Decision Making Over Blocks | Ron Grady  
• 4.3 What My Heart Holds: Exploring Identity with Preschool Learners | Cierra Kaler-Jones 
• 4.4 “I See a Really Big Gecko!” When Background Knowledge and Teaching Materials Don’t Match | Germaine Kaleilehua Tauati and Colleen E. Whittingham 
• 4.5 Using a Humanizing and Restorative Approach for Young Children to Develop Responsibility and Self-Regulation | Saili S. Kulkarni, Sunyoung Kim, and Nicola Holdman 
• 4.6 Joyful, Developmentally Appropriate Learning Environments for African American Youth | Lauren C. Mims, Addison Duane, LaKenya Johnson, and Erika Bocknek 
• 5.1 Using the Environment and Materials as Curriculum for Promoting Infants’ and Toddlers’ Exploration of Basic Cause-and-Effect Principles | Guadalupe Rivas 
• 5.2 Social Play Connections Among a Small Group of Preschoolers | Leah Catching 
• 5.3 Can Preschoolers Code? A Sneak Peek into a Developmentally Appropriate Coding Lesson | Olabisi Adesuyi-Fasuyi 
• 5.4 Everyday Gifts: Children Show Us the Path—We Observe and Scaffold | Martha Melgoza 
• 5.5 Learning to Conquer the Slide Through Persistence and Engaging in Social Interaction | Sueli Nunes 
• 5.6 “Sabes que todos los caracoles pueden tener bebés? Do You Know that All Snails Can Have Babies?” Supporting Children’s Emerging Interests in a Dual Language Preschool Classroom | Isauro M. Escamilla 
• 5.7 “Can We Read this One?” A Conversation About Book Selection in Kindergarten | Larissa Hsia-Wong  
• 6.1 Take a Chance on Coaching: It’s Worth It! | Lauren Bond 
• 6.2 It Started with a Friendship Parade | Angela Vargas 
• 6.3 The World Outside of the Classroom: Letting Your Voice Be Heard | Meghann Hickey 
• 7.1 Communication as a Two-Way Street? Creating Opportunities for Engagement During Meaningful Language Routines | Kameron C. Cardenv 
• 7.2 Eli Goes to Preschool: Inclusion for a Child with Autism Spectrum Disorder | Abby Hodges
• 7.3 Preschool Classroom Supports and Embedded Interventions with Coteaching | Racheal Kuperus and Desarae Orgo
• 7.4 Addressing Challenging Behavior Using the Pyramid Model | Ellie Bold
• 7.5 Dual Language or Disability? How Teachers Can Be the First to Help | Alyssa Brillante
• 7.6 Adapting and Modifying Instruction Using Reader’s Theater | Michelle Gonzalez
• 7.7 Supporting Children with Learning Disabilities in Mathematics: The Importance of Observation, Content Knowledge, and Context | Renee B. Whelan 
• 8.1 Facilitating a Child’s Transition from Home to Group Care Through the Use of Cultural Caring Routines | Josephine Ahmadein
• 8.2 Engaging Dual Language Learners in Conversation to Support Translanguaging During a Small Group Activity | Valeria Erdosi and Jennifer J. Chen
• 8.3 Incorporating Children’s Cultures and Languages in Learning Activities | Eleni Zgourou
• 8.4 Adapting Teaching Materials for Dual Language Learners to Reflect Their Home Languages and Cultures in a Math Lesson | Karen Nemeth
• 8.5 Studying Celestial Bodies: Science and Cultural Stories | Zeynep Isik-Ercan
• 8.6 Respecting Diverse Cultures and Languages by Sharing and Learning About Cultural Poems, Songs, and Stories From Others | Janis Strasser

Book Details

Faculty resources.

To access tips and resources for teaching the cases, please complete this brief form.  You’ll be able to download the items after you complete the form. 

Teacher Inquiry Group Resources

To access reflection questions to deepen your learning, please click here.

More DAP Resources

To read the position statement, access related resources, and stay up-to-the-minute on all things DAP, visit  NAEYC.org/resources/developmentally-appropriate-practice .

Pamela Brillante,  EdD, is professor in the Department of Special Education, Professional Counseling and Disability Studies, at William Paterson University. She has worked as an early childhood special educator, administrator, and New Jersey state specialist in early childhood special education. She is the author of the NAEYC book The Essentials: Supporting Young Children with Disabilities in the Classroom. Dr. Brillante continues to work with schools to develop high-quality inclusive early childhood programs. 

Jennifer J. Chen, EdD, is professor of early childhood and family studies at Kean University. She earned her doctorate from Harvard University. She has authored or coauthored more than 60 publications in early childhood education. Dr. Chen has received several awards, including the 2020 NAECTE Foundation Established Career Award for Research on ECTE, the 2021 Kean Presidential Excellence Award for Distinguished Scholarship, and the 2022 NJAECTE’s Distinguished Scholarship in ECTE/ECE Award. 

Stephany Cuevas, EdD, is assistant professor of education in the Attallah College of Educational Studies at Chapman University. Dr. Cuevas is an interdisciplinary education scholar whose research focuses on family engagement, Latinx families, and the postsecondary trajectories of first-generation students. She is the author of Apoyo Sacrifical, Sacrificial Support: How Undocumented Parents Get Their Children to College (Teachers College Press). 

Christyn Dundorf, PhD, has more than 30 years of experience in the early learning field as a teacher, administrator, and adult educator. She serves as codirector of Teaching Preschool Partners, a nonprofit organization working to grow playful learning and inquiry practices in school-based pre-K programs and infuse those practices up into the early grades.

Emily Brown Hoffman, PhD, is assistant professor in early childhood education at National Louis University in Chicago. She received her PhD from the University of Illinois at Chicago in Curriculum & Instruction, Literacy, Language, & Culture. Her focuses include emergent literacy, leadership, play and creativity, and school, family, and community partnerships. 

Daniel R. Meier, PhD, is professor of elementary education at San Francisco State University. His publications include Critical Issues in Infant-Toddler Language Development: Connecting Theory to Practice (editor), Supporting Literacies for Children of Color: A Strength-Based Approach to Preschool Literacy (author), and Learning Stories and Teacher Inquiry Groups: Reimagining Teaching and Assessment in Early Childhood Education (coauthor). 

Gayle Mindes, EdD, is professor emerita, DePaul University. She is the author of Assessing Young Children , fifth edition (with Lee Ann Jung), and Social Studies for Young Children: Preschool and Primary Curriculum Anchor, third edition (with Mark Newman). Dr. Mindes is also the editor of Teaching Young Children with Challenging Behaviors: Practical Strategies for Early Childhood Educators and Contemporary Challenges in Teaching Young Children: Meeting the Needs of All Students . 

Lisa R. Roy, EdD, is executive director for the Colorado Department of Early Childhood. Dr. Roy has supported families with young children for over 30 years, serving as the director of program development for the Buffett Early Childhood Institute, as the executive director of early childhood education for Denver Public Schools, and in various nonprofit and government roles.

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Raising a 5-Year-Old Child: Behavior, Milestones, and Development

Your little one is heading off to kindergarten this year—where did the time go? Here's what to expect when raising a 5-year-old.

The Year Ahead: Age 5

Exciting times are ahead as your little one officially begins their school life. Over the next year, your child will become more independent, conquer challenges, and cross developmental milestones. Here's what you can expect when raising a 5-year-old.

Physical Development

"Physical development consists of both gross motor and fine motor development ," says Cheryl Wu, M.D., of LaGuardia Place Pediatrics in New York City. "And while every child develops at their own pace, there are certain milestones I expect most of my patients (90 to 95%) to achieve by their fifth birthday."

By age 5, a child has largely developed gross motor skills; they can jump high, run, climb well, and start doing more advanced movements like ballet, gymnastics, or karate. A 5-year-old can draw a triangle and write their own name, and they usually have a preferred handedness by now. (Some children remain ambidextrous at this age.)

"Most teachers want kindergarteners to know how to hold a pencil correctly and to be able to use safety scissors, and those are tasks a parent can practice at home," says Brenda Rogers, M.D., a general pediatrician at Children's Mercy Hospitals and Clinics in Kansas City, MO. Even though children this age are developing better coordination, they still need oversight to avoid serious injuries.

• Kindergarten Curriculum: 5 Learning Milestones Your Child Will Reach

Your 5-year-old is becoming more independent , which means they enjoy being around other family members and friends more. They might test boundaries or ask to do things on their own. Some you should encourage (like making their own bed—don't worry if it's not perfect) and some you need to stand firm on (like bathing alone, which can be a safety issue).

With your child starting kindergarten, pay attention to their ability to follow directions and get along with others, says Carl Sheperis, Ph.D., the director of doctoral programs for Walden University's School of Counseling and Social Service. "If you see your child becoming more aggressive or oppositional once they start school, figure out the reasons behind the behavior now. It is much easier to address any behavioral issues now than it will be in the teen years."

It's important to reinforce good behavior through praise, and to set clear limits so that your child knows what to expect.

Kindergartners have usually mastered speech sounds, and people should understand what they are saying. "A 5-year-old will have a pretty vast vocabulary," says Lauren Krause, Chief of Speech-Language Pathology at La Rabida Children's Hospital in Chicago. "If you're still concerned and counting how many words they can say, then that is a clear sign of a delay ."

Five-year-olds can usually express themselves clearly, give explanations, retell stories, and put together sentences to make themselves understood. "Kindergartners are also starting the reading process, so it's important to continue to read to your child and work on their own reading capabilities," says Krause. A slight lisp at this age is normal, but if it persists beyond age 6, talk to your pediatrician about the possibility of speech therapy.

Your child is entering kindergarten, so it's important that they're up-to-date on all required immunizations . Every state has its own standards, but your child's pediatrician should guide you.

After the doctor checks if any vaccinations are needed, your child will be weighed and measured. A 5-year-old typically gains about 4 pounds and grows about 2 inches during the year. There will also be vision and hearing tests performed, as well as a tuberculosis test and a blood test for lead poisoning. Your doctor will ask your child some questions to see how their speech is progressing, check for any signs of a delay or impediment, and analyze how their gross and fine motor skills are developing.

Your little one might also be playing sports now, and there's a potential for dental injury. If your child's tooth is chipped, broken, or knocked out, contact your pediatric dentist immediately. This can save the tooth and prevent infection. If the tooth is knocked out, rinse it off with cool water and, if possible, replace it in the socket immediately (hold it there with clean gauze if necessary). If you can't put it back, place it in a container with cold milk, water, or saliva. Then head to the dentist. According to the American Academy of Pediatric Dentistry, baby teeth should not be replanted because of the potential for subsequent damage to the developing permanent tooth.

• A Guide to Predicting Height for Kids Aged 3 to 10

Five-year-olds can handle adult portions, but keep them manageable and minimize snacking. "Kids this age have a tendency to fill up on snacks, which interferes with mealtime," says Amy Marlow, a New York-based registered dietician and certified nutritionist serving as an advisor for Happy Family, the nation's leading premium organic baby and toddler food maker. "Kids should be eating three meals a day, along with two healthy snacks."

Expand your child's horizons when it comes to trying new foods . Limit items high in fat and sugar, and concentrate on serving fruits, vegetables, lean meats, and dairy products. "You want to choose different foods for them to try," says Marlow. "If they don't want to try it at first, don't give up. When they're hungry, they will eat what's in front of them—even the healthy stuff!" Establish a family mealtime so that your child considers eating well a fun activity.

Once your child turns 5, they'll be sleeping about 11 hours each night. Although they won't be napping anymore, quiet time in the late afternoon is still beneficial. Whether they sit with some books or lie down quietly, be sure they get some time to rest, says Kim West, LCSW-C, aka The Sleep Lady. "This will help avoid any meltdowns before dinner."

Wake your child somewhere between 6 a.m. and 7:30 a.m., depending on what time school starts. Many parents deal with kids who are waking up too early, a habit that West suggests nipping in the bud. "Lack of sleep affects their learning and memory abilities, so it's important that they get enough sleep ."

A common complaint from elementary school teachers is that students are too tired in class. "Adjust your child's exact bedtime and wake-up time to coincide with your family schedule and their school-start time," says West.

• Here's How Much Sleep Your Baby and Kids Should Be Getting

Social Development

By age 5, children are socially interactive and communicative. They can follow simple games with rules and begin to enjoy board games. The biggest milestone for this age is going to kindergarten . "This can be a huge adjustment socially and even the most gregarious child may feel shy and reticent," says Jessica Mercer Young, Ph.D., a research scientist at Education Development Center in Newton, MA. "Having your child spend time in the new classroom, meeting the teacher, talking about the transition, reading books about going to kindergarten , and setting up playdates or opportunities to meet other children before school starts are all very helpful."

Dr. Young suggests that once school starts, set up a playdate with someone that your child has expressed an interest in getting to know, and help foster the relationship. "Having one good friend in kindergarten can make the transition to school easier for all," she says.

The sky's the limit as to what your child will be learning. Many of the lessons (letters, numbers, colors) are subjects they might have already mastered in preschool. They'll start writing upper and lowercase letters and, eventually, words, their name, their address, and your phone number. Kindergartners learn how to match the sound to each letter; identify, draw, cut, and name shapes; classify and group objects according to characteristics; and use their five senses to identify items.

Your child will begin learning to read , which can be a daunting task for both parent and child. How can you help them? Increase their vocabulary, says Susan Cooper, M.Ed., early child development expert at Applied Scholastics . "This doesn't mean sitting with a dictionary and memorizing words. What it means is learning new words, using the new words, and seeing the new words. When parents go into a grocery store with their children, make it a learning experience by showing what unusual fruits and vegetables are there and using the new words in conversation. The new words will show up in some reading assignment and your child will know what the word means. The more words a child knows, the easier reading becomes."

• 6 Little Things You Can Do Every Day to Make Your Child More Independent

Lots of children this age haven't yet learned how to negotiate and get their point across, and they instead resort to whining . Although it can be annoying for parents, it's a normal developmental stage that Dr. Sheperis says is best to ignore.

A useful strategy is to get down to your child's level and explain that you simply cannot understand them when they whine. You'll be validating their feelings but at the same time letting them know that whiny behavior doesn't get them what they want.

Even though your child is in school now, you should still use playtime as learning time, says Dr. Rogers. You can do this by pointing out letters and numbers when you see a sign at the park or grocery store, making up stories or songs as you walk around your neighborhood and most importantly sharing a book together. "Read, read, read, and then read some more to your child. They love it, they learn from it, and you get to ask questions to stimulate their imaginations," says Dr. Rogers.

Related Articles

5-Year-Old With Asthma: Developmental Milestones & Care Case Study

G.J is an African American, a five-year-old boy who is brought up in a Christian setting home by his parents. The mother is aged 32 years, the father is 35 years and has a brother who is 4 years. The primary language that is used at their home is English. G.J was taken for medical evaluation and admitted diagnosis was asthma. His mother reported that the boy developed respiratory symptoms at two months of age but she thought that it was not that serious. G.J has been reported to have wheezes, coughs, and a running nose. The boy had sleepless nights due to the wheezes, coughs and vomiting.

G.J was allergic to dogs, seasonal allergies including mold allergies. The hallmark of his illness was that a cold would always trigger his asthma. G.J. would miss school because of asthma. He had never had any emergency room visits, and had never been hospitalized. His asthma symptoms would typically worsen with the weather changes in the spring and fall; the cold winter months were often particularly difficult. According to his mother, he also regularly grinds his teeth at night.

G.J. was delivered normally and the mother had no complications. He weighed 3.0 kilograms at birth. He currently weighs 19.8 kilograms which is fine for his age. He is 43 inches in height. As it was reported by his parent, G.J was a healthy boy who had no illness. He has never been involved in any accident and had not taken any operation. This was his major hospitalization. The father reported that his immunizations were updated.

Developmental milestones

Fine mortal level.

G. J’s developmental assessment revealed that his fine motor skills were fine because he could take small actions such as grasping objects between the thumb and fingers and could use his lips and tongue to taste objects (Hockenberry and Wilson, 2000, p. 468). He could also feed himself, play, write and draw some funny pictures and he could color them.

Gross motor development

GJ’s developmental assessment clearly indicates the normal fine level of development (Hockenberry and Wilson, 2000, p. 477). G.J was able to grasp objects, point at objects and people, lift and transfer objects from one place to another. He could also exchange items from one hand to the others. G.J could sit, crawl and at the age of 8 months he could stand and walk while holding unto furniture. He could also walk at 15 months and at 2 years he could kick a ball. Now he is five years and he can ride a bike without balancing problems.

Language development

According to his mother, G.J had Language delay a condition whereby he developed with the right sequence but at a slower age. This affected his social life because people could not understand his needs (Hockenberry and Wilson, 2000, p. 25). G.J took speech therapy when he was three years old.

Cognitive development

G.J was having no problems with cognitive development. He is able to understand what people said. He could listen to instructions and get whatever he is being asked by his mother. He also had reasoning and he could remember his things like toys at a tender age of 2 years. He could not confuse his toys with his brother’s toys. Now that he five years he does not have problems in learning, he remembers what they covered in class and can give the right description to pictures or drawings. This therefore indicated that he had a normal cognitive development (Hockenberry and Wilson, 2010, p. 556)

Social development

G. J’s social development had some problems at his early ages because he took long to pronounce sensible words. Sometimes he could just cry to be given something and this brought conflict with his brother. These problems also extended when he went to school, he could not freely socialize and form relationships with his classmates. He sometimes feared his teacher and he could not cooperate in games or molding. Mum and dad both shares responsibility. Child bonds very well with both parents G.J could bond very well with both parents

G.J developed some problems when he lost appetite. This has greatly affected his growth because his height is 43 inches and his weight has also been affected because right now he weighs 19.8 kilos G.J does not eat much and he mostly prefers to eat junk foods like cheese sticks. He only ate 10% of his food. This is not recommendable to a child of his age because they require a lot of energy for their development (Hockenberry and Wilson, 2000, p. 560).

G.J being diagnosed with asthma is on medication that is composed of Albuterol. It is used to prevent and treat wheezing, difficulty breathing and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease. Albuterol inhalation aerosol is also used to prevent breathing difficulties during exercise (Treece, 2010; Casale, 2010). It works by relaxing and opening air passages to the lungs to make breathing easier. Albuterol controls symptoms of asthma and other lung diseases but does not cure them and so they will help to open his airways (Castro-Rodriguez and Rodrigo, 2009).

G.J. was also given Ampicillin and sulbactam which are antibiotics in the penicillin group of drugs (National Asthma Education and Prevention Program, 2007). They fight bacteria in your body. Ampicillin and sulbactam are antibiotics in the penicillin group of drugs (Polit, 2008). These drugs fight bacteria and they will help to reduce the effects of the allergies that G.J. has developed.

According to Duvall’s developmental stages of the family, G.J. is in stage II: Families with pre-scholars being the first born in the family which upgrades from stage one (Hockenberry and Wilson, 2010). The parents live together and they share responsibilities in the family. They involve their children in the house chores. G.J. bonded well with his parents and they both take responsibility of G.J. hospital care. His family is extended because it has both parents and the two kids.

Planning and Implementation

Below are the two internet resources I believe to be helpful both G.J. and his family:

Internet Source I is sponsored by US National Library of Medicine, the largest library in the world that explains all about asthma. It is the encyclopedia of all diseases, their causes incidence, and risk factors, symptoms, signs and tests, treatment, home care, prognosis, complications and prevention. This site will be helpful for both parents and caregivers of children suffering from asthma. It will help the caregivers and parents to know the home based care for such children. It will also help the affected people to know about allergies so that they can avoid whatever they are allergic to.

Internet Source II gives information about asthma medicine and asthma help. It has tabs where you can get information about the cause of asthma, what triggers asthma, diagnosis, symptoms, treatment, medical help and how to deal with children with asthma.

Short-term goal: Through each assessment, G.J will:

• Achieve social skills and language development will be efficient for his age within the scope of his present abilities during the hospitalization and speech therapy.
• While in hospital G.J. will gain good nutrition for his age without problems in vomiting. For this goal, I observed G.J.’s eating habits keenly and had no signs of vomiting. His eating habits changed from taking 10% of his food to 50%. This was a good sign that he was progressing well.
• During hospitalization all the parents were involved in the medical care of their son. They could ask questions and were free to give G.J.’s past history.
• Within each assessment and hospital stay, G.J. will show some signs of improvement like decrease in coughs and the wheezes will reduce. For this goal, continuous breathing assessment will be taken and the parents will be advised to keep him warm and away from the things that he is allergic to like pets and moulds.

Long-term goal: Through each assessment, GJ will:

G.J. will attain steady gain in weight pattern and progress towards age-appropriate size upon discharge and at home. For this goal, daily weight during hospitalization will be maintained to evaluate the amount of weight G.J. gain in the hospital. Teachings on correct feeding techniques will be given to parents and caregiver, and return demonstration will be required for proficiency. Also restriction on unhealthy diets as well as education on healthy nutrition will be given to family in an understandable language to rid any discrepancies in G.J.’s dietary intakes.

• By discharge and at home, G.J. will maintain weight gain toward goal with normalization of laboratory values and be free of signs of malnutrition. For this goal, G.J.’s laboratory test should be done again in the hospital to evaluate improvement in results. Family must be thought by medical team on signs and symptoms of malnutrition, and infection, and when to seek doctor’s advice.
• G.J will not experience any incidences of wheezing, coughs, vomiting or any other sign for asthma. For this goal, progressive assessment will be carried out as well as proper dressing and preventions of allergic conditions. The parents will be required to report to the staff about any signs and symptoms of asthma.
• G.J. will have no breathing problems. For this goal, medication should according to doctor’s prescriptions. The family members should continually inspect G.J.’s condition. The parents would also be encouraged to visit the websites that were provided for any information regarding to asthma conditions.

Brozek J.L., Bousquet, J., Baena-Cagnani, C.E., Bonini, S., Canonica, G.W. and Casale, T.B. (2010). Pediatric Airway Management and Respiratory Distress Self-Study Module. Allergy Clin Immunol , 126 (3), 466-76.

Bush, A. and Saglani, S. (2010). Respiratory System. Lancet, 376 (9743), 348-61.

Castro-Rodriguez J.A. and Rodrigo, G.J. (2009). Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Ediatrics , 123 (3), 519-25.

Hockenberry, M.J., & Wilson, D. (2010). Wong’s nursing care of infants and children. St. Louis, MO: Mosby Elsevier.

Monte, C. (2000). Malnutrition: A Secular Challenge to Child Nutrition. Jornal de Pediatria, 3 (1), 285-297.

National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma . Rockville: NIH publications.

Polit, D.F. (2008). Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company.

Rogers, C.A., Burge, H.A. and Spengler, J.D. (2011). British Management guideline on the Management of Asthma. Journal of Urban Health ; 84 (2), 185–208.

Rutishauser, C., Sawyer, S and Bowes, G. (1998). Quality-of-life Assessment in Children and Adolescents with Asthma. European Respiratory Journal, 5 (1), 486-494.

Treece, J.W. (2010). Elements of Research in Nursing . St. Louis: Mosby.

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Bibliography

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• 3- to 5-Year-Old Development and Learning
• Observation of a 5-Year-Old Child in the Active Environment
• Child Medical Examination Record
• Probate and Administrative Processes in Three States
• Case Study on Hypersensitivity Reaction
• Substance-Related and Addictive Disorders
• Patient With Pneumonia: Health Assessment
• Turkish Airline's 5-Year Global Growth Plan
• Family Health Assessment: Child Poverty, Toxic Stress
• Atrial Fibrillation Management in an Elderly Man
• Asthma Respiratory Disorder Treatment
• Analysis and Application of Clinical Practice Guidelines
• Pulmonology Nursing Care Plan for Coughing Patient
• Acute Bronchitis and Pneumonia: How to Differentiate?
• Pulmonary Emphysema: 60-Year-Old Male Patient

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Case Studies and Scenarios

Case studies.

Each case study describes the real experience of a Registered Early Childhood Educator. Each one profiles a professional dilemma, incorporates participants with multiple perspectives and explores ethical complexities. Case studies may be used as a source for reflection and dialogue about RECE practice within the framework of the Code of Ethics and Standards of Practice​.

Scenarios are snapshots of experiences in the professional practice of a Registered Early Childhood Educator. Each scenario includes a series of questions meant to help RECEs reflect on the situation.

Case Study 1: Sara’s Confusing Behaviour

Case study 2: getting bumps and taking lumps, case study 3: no qualified staff, case study 4: denton’s birthday cupcakes, case study 5: new kid on the block, case study 6: new responsibilities and challenges, case study 7: valuing inclusivity and privacy, case study 8: balancing supervisory responsibilities, case study 9: once we were friends, ​​​​scenarios​​, communication and collaboration.

Barbara, an RECE, is working as a supply staff at various centres across the city. During her week at a centre where she helps out in two different rooms each day, she finds that her experience in the school-age program isn’t as straightforward as when she was in the toddler room. Barbara feels completely lost in this program.

Do You Really Know Who Your Friends Are?

Joe is an RECE at an elementary school and works with children between the ages of nine and 12 years old. One afternoon, he finds a group of children huddled around the computer giggling and whispering. Joe quickly discovers they’re going through his party photos on Facebook as one of the children’s parents recently added him as a friend.

Conflicting Approaches

Amina, an experienced RECE, has recently started a new position with a child care centre. She’s assigned to work in the infant room with two colleagues who have worked in the room together for ten years. As Amina settles into her new role, she is taken aback by some of the child care approaches taken by her colleagues.

What to do about Lisa?

Shane, an experienced supervisor at a child care centre, receives a complaint about an RECE who had roughly handled a child earlier that day. The interaction had been witnessed by a parent who confronted the RECE. After some words were exchanged, the RECE left in tears.

Duty to Report

Zoë works as an RECE in a drop-in program at a family support centre. She has a great rapport for a family over a 10-month period and beings to notice a change in the mom and child. One day, as the child is getting dressed to go home for the day, she notices something alarming and brings it to the attention of her supervisor.

Posting on Social Media

Allie, an RECE who has worked at the same child care centre for the last three years, recently started a private social media group to collaborate and discuss programming ideas. As the group takes a negative turn with rude and offensive comments, it’s brought to her supervisor’s attention.

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1 Chapter 1: Introduction to Child Development

Chapter objectives.

After this chapter, you should be able to:

• Describe the principles that underlie development.
• Differentiate periods of human development.
• Evaluate issues in development.
• Distinguish the different methods of research.
• Explain what a theory is.
• Compare and contrast different theories of child development.

Introduction

Welcome to Child Growth and Development. This text is a presentation of how and why children grow, develop, and learn.

We will look at how we change physically over time from conception through adolescence. We examine cognitive change, or how our ability to think and remember changes over the first 20 years or so of life. And we will look at how our emotions, psychological state, and social relationships change throughout childhood and adolescence. 1

Principles of Development

There are several underlying principles of development to keep in mind:

• Development is lifelong and change is apparent across the lifespan (although this text ends with adolescence). And early experiences affect later development.
• Development is multidirectional. We show gains in some areas of development, while showing loss in other areas.
• Development is multidimensional. We change across three general domains/dimensions; physical, cognitive, and social and emotional.
• The physical domain includes changes in height and weight, changes in gross and fine motor skills, sensory capabilities, the nervous system, as well as the propensity for disease and illness.
• The cognitive domain encompasses the changes in intelligence, wisdom, perception, problem-solving, memory, and language.
• The social and emotional domain (also referred to as psychosocial) focuses on changes in emotion, self-perception, and interpersonal relationships with families, peers, and friends.

All three domains influence each other. It is also important to note that a change in one domain may cascade and prompt changes in the other domains.

• Development is characterized by plasticity, which is our ability to change and that many of our characteristics are malleable. Early experiences are important, but children are remarkably resilient (able to overcome adversity).
• Development is multicontextual. 2 We are influenced by both nature (genetics) and nurture (the environment) – when and where we live and our actions, beliefs, and values are a response to circumstances surrounding us.  The key here is to understand that behaviors, motivations, emotions, and choices are all part of a bigger picture. 3

Now let’s look at a framework for examining development.

Periods of Development

Think about what periods of development that you think a course on Child Development would address. How many stages are on your list? Perhaps you have three: infancy, childhood, and teenagers. Developmentalists (those that study development) break this part of the life span into these five stages as follows:

• Prenatal Development (conception through birth)
• Infancy and Toddlerhood (birth through two years)
• Early Childhood (3 to 5 years)
• Middle Childhood (6 to 11 years)
• Adolescence (12 years to adulthood)

This list reflects unique aspects of the various stages of childhood and adolescence that will be explored in this book. So while both an 8 month old and an 8 year old are considered children, they have very different motor abilities, social relationships, and cognitive skills. Their nutritional needs are different and their primary psychological concerns are also distinctive.

Prenatal Development

Conception occurs and development begins. All of the major structures of the body are forming and the health of the mother is of primary concern. Understanding nutrition, teratogens (or environmental factors that can lead to birth defects), and labor and delivery are primary concerns.

Figure 1.1 – A tiny embryo depicting some development of arms and legs, as well as facial features that are starting to show. 4

Infancy and Toddlerhood

The two years of life are ones of dramatic growth and change. A newborn, with a keen sense of hearing but very poor vision is transformed into a walking, talking toddler within a relatively short period of time. Caregivers are also transformed from someone who manages feeding and sleep schedules to a constantly moving guide and safety inspector for a mobile, energetic child.

Figure 1.2 – A swaddled newborn. 5

Early Childhood

Early childhood is also referred to as the preschool years and consists of the years which follow toddlerhood and precede formal schooling. As a three to five-year-old, the child is busy learning language, is gaining a sense of self and greater independence, and is beginning to learn the workings of the physical world. This knowledge does not come quickly, however, and preschoolers may initially have interesting conceptions of size, time, space and distance such as fearing that they may go down the drain if they sit at the front of the bathtub or by demonstrating how long something will take by holding out their two index fingers several inches apart. A toddler’s fierce determination to do something may give way to a four-year-old’s sense of guilt for action that brings the disapproval of others.

Figure 1.3 – Two young children playing in the Singapore Botanic Gardens 6

Middle Childhood

The ages of six through eleven comprise middle childhood and much of what children experience at this age is connected to their involvement in the early grades of school. Now the world becomes one of learning and testing new academic skills and by assessing one’s abilities and accomplishments by making comparisons between self and others. Schools compare students and make these comparisons public through team sports, test scores, and other forms of recognition. Growth rates slow down and children are able to refine their motor skills at this point in life. And children begin to learn about social relationships beyond the family through interaction with friends and fellow students.

Figure 1.4 – Two children running down the street in Carenage, Trinidad and Tobago 7

Adolescence

Adolescence is a period of dramatic physical change marked by an overall physical growth spurt and sexual maturation, known as puberty. It is also a time of cognitive change as the adolescent begins to think of new possibilities and to consider abstract concepts such as love, fear, and freedom. Ironically, adolescents have a sense of invincibility that puts them at greater risk of dying from accidents or contracting sexually transmitted infections that can have lifelong consequences. 8

Figure 1.5 – Two smiling teenage women. 9

There are some aspects of development that have been hotly debated. Let’s explore these.

Issues in Development

Nature and nurture.

Why are people the way they are? Are features such as height, weight, personality, being diabetic, etc. the result of heredity or environmental factors-or both? For decades, scholars have carried on the “nature/nurture” debate. For any particular feature, those on the side of Nature would argue that heredity plays the most important role in bringing about that feature. Those on the side of Nurture would argue that one’s environment is most significant in shaping the way we are. This debate continues in all aspects of human development, and most scholars agree that there is a constant interplay between the two forces. It is difficult to isolate the root of any single behavior as a result solely of nature or nurture.

Continuity versus Discontinuity

Is human development best characterized as a slow, gradual process, or is it best viewed as one of more abrupt change? The answer to that question often depends on which developmental theorist you ask and what topic is being studied. The theories of Freud, Erikson, Piaget, and Kohlberg are called stage theories. Stage theories or discontinuous development assume that developmental change often occurs in distinct stages that are qualitatively different from each other, and in a set, universal sequence. At each stage of development, children and adults have different qualities and characteristics. Thus, stage theorists assume development is more discontinuous. Others, such as the behaviorists, Vygotsky, and information processing theorists, assume development is a more slow and gradual process known as continuous development. For instance, they would see the adult as not possessing new skills, but more advanced skills that were already present in some form in the child. Brain development and environmental experiences contribute to the acquisition of more developed skills.

Figure 1.6 – The graph to the left shows three stages in the continuous growth of a tree. The graph to the right shows four distinct stages of development in the life cycle of a ladybug. 10

Active versus Passive

How much do you play a role in your own developmental path? Are you at the whim of your genetic inheritance or the environment that surrounds you? Some theorists see humans as playing a much more active role in their own development. Piaget, for instance believed that children actively explore their world and construct new ways of thinking to explain the things they experience. In contrast, many behaviorists view humans as being more passive in the developmental process. 11

How do we know so much about how we grow, develop, and learn? Let’s look at how that data is gathered through research

Research Methods

An important part of learning any science is having a basic knowledge of the techniques used in gathering information. The hallmark of scientific investigation is that of following a set of procedures designed to keep questioning or skepticism alive while describing, explaining, or testing any phenomenon. Some people are hesitant to trust academicians or researchers because they always seem to change their story. That, however, is exactly what science is all about; it involves continuously renewing our understanding of the subjects in question and an ongoing investigation of how and why events occur. Science is a vehicle for going on a never-ending journey. In the area of development, we have seen changes in recommendations for nutrition, in explanations of psychological states as people age, and in parenting advice. So think of learning about human development as a lifelong endeavor.

Take a moment to write down two things that you know about childhood. Now, how do you know? Chances are you know these things based on your own history (experiential reality) or based on what others have told you or cultural ideas (agreement reality) (Seccombe and Warner, 2004). There are several problems with personal inquiry. Read the following sentence aloud:

Paris in the

Are you sure that is what it said? Read it again:

If you read it differently the second time (adding the second “the”) you just experienced one of the problems with personal inquiry; that is, the tendency to see what we believe. Our assumptions very often guide our perceptions, consequently, when we believe something, we tend to see it even if it is not there. This problem may just be a result of cognitive ‘blinders’ or it may be part of a more conscious attempt to support our own views. Confirmation bias is the tendency to look for evidence that we are right and in so doing, we ignore contradictory evidence. Popper suggests that the distinction between that which is scientific and that which is unscientific is that science is falsifiable; scientific inquiry involves attempts to reject or refute a theory or set of assumptions (Thornton, 2005). Theory that cannot be falsified is not scientific. And much of what we do in personal inquiry involves drawing conclusions based on what we have personally experienced or validating our own experience by discussing what we think is true with others who share the same views.

Science offers a more systematic way to make comparisons guard against bias.

Scientific Methods

One method of scientific investigation involves the following steps:

• Determining a research question
• Reviewing previous studies addressing the topic in question (known as a literature review)
• Determining a method of gathering information
• Conducting the study
• Interpreting results
• Drawing conclusions; stating limitations of the study and suggestions for future research
• Making your findings available to others (both to share information and to have your work scrutinized by others)

Your findings can then be used by others as they explore the area of interest and through this process a literature or knowledge base is established. This model of scientific investigation presents research as a linear process guided by a specific research question. And it typically involves quantifying or using statistics to understand and report what has been studied. Many academic journals publish reports on studies conducted in this manner.

Another model of research referred to as qualitative research may involve steps such as these:

• Begin with a broad area of interest
• Gain entrance into a group to be researched
• Gather field notes about the setting, the people, the structure, the activities or other areas of interest
• Ask open ended, broad “grand tour” types of questions when interviewing subjects
• Modify research questions as study continues
• Note patterns or consistencies
• Explore new areas deemed important by the people being observed
• Report findings

In this type of research, theoretical ideas are “grounded” in the experiences of the participants. The researcher is the student and the people in the setting are the teachers as they inform the researcher of their world (Glazer & Strauss, 1967). Researchers are to be aware of their own biases and assumptions, acknowledge them and bracket them in efforts to keep them from limiting accuracy in reporting. Sometimes qualitative studies are used initially to explore a topic and more quantitative studies are used to test or explain what was first described.

Let’s look more closely at some techniques, or research methods, used to describe, explain, or evaluate. Each of these designs has strengths and weaknesses and is sometimes used in combination with other designs within a single study.

Observational Studies

Observational studies involve watching and recording the actions of participants. This may take place in the natural setting, such as observing children at play at a park, or behind a one-way glass while children are at play in a laboratory playroom. The researcher may follow a checklist and record the frequency and duration of events (perhaps how many conflicts occur among 2-year-olds) or may observe and record as much as possible about an event (such as observing children in a classroom and capturing the details about the room design and what the children and teachers are doing and saying). In general, observational studies have the strength of allowing the researcher to see how people behave rather than relying on self-report. What people do and what they say they do are often very different. A major weakness of observational studies is that they do not allow the researcher to explain causal relationships. Yet, observational studies are useful and widely used when studying children. Children tend to change their behavior when they know they are being watched (known as the Hawthorne effect) and may not survey well.

Experiments

Experiments are designed to test hypotheses (or specific statements about the relationship between variables) in a controlled setting in efforts to explain how certain factors or events produce outcomes. A variable is anything that changes in value. Concepts are operationalized or transformed into variables in research, which means that the researcher must specify exactly what is going to be measured in the study.

Three conditions must be met in order to establish cause and effect. Experimental designs are useful in meeting these conditions.

The independent and dependent variables must be related. In other words, when one is altered, the other changes in response. (The independent variable is something altered or introduced by the researcher. The dependent variable is the outcome or the factor affected by the introduction of the independent variable. For example, if we are looking at the impact of exercise on stress levels, the independent variable would be exercise; the dependent variable would be stress.)

The cause must come before the effect. Experiments involve measuring subjects on the dependent variable before exposing them to the independent variable (establishing a baseline). So we would measure the subjects’ level of stress before introducing exercise and then again after the exercise to see if there has been a change in stress levels. (Observational and survey research does not always allow us to look at the timing of these events, which makes understanding causality problematic with these designs.)

The cause must be isolated. The researcher must ensure that no outside, perhaps unknown variables are actually causing the effect we see. The experimental design helps make this possible. In an experiment, we would make sure that our subjects’ diets were held constant throughout the exercise program. Otherwise, diet might really be creating the change in stress level rather than exercise.

A basic experimental design involves beginning with a sample (or subset of a population) and randomly assigning subjects to one of two groups: the experimental group or the control group. The experimental group is the group that is going to be exposed to an independent variable or condition the researcher is introducing as a potential cause of an event. The control group is going to be used for comparison and is going to have the same experience as the experimental group but will not be exposed to the independent variable. After exposing the experimental group to the independent variable, the two groups are measured again to see if a change has occurred. If so, we are in a better position to suggest that the independent variable caused the change in the dependent variable.

The major advantage of the experimental design is that of helping to establish cause and effect relationships. A disadvantage of this design is the difficulty of translating much of what happens in a laboratory setting into real life.

Case Studies

Case studies involve exploring a single case or situation in great detail. Information may be gathered with the use of observation, interviews, testing, or other methods to uncover as much as possible about a person or situation. Case studies are helpful when investigating unusual situations such as brain trauma or children reared in isolation. And they are often used by clinicians who conduct case studies as part of their normal practice when gathering information about a client or patient coming in for treatment. Case studies can be used to explore areas about which little is known and can provide rich detail about situations or conditions. However, the findings from case studies cannot be generalized or applied to larger populations; this is because cases are not randomly selected and no control group is used for comparison.

Figure 1.7 – Illustrated poster from a classroom describing a case study. 12

Surveys are familiar to most people because they are so widely used. Surveys enhance accessibility to subjects because they can be conducted in person, over the phone, through the mail, or online. A survey involves asking a standard set of questions to a group of subjects. In a highly structured survey, subjects are forced to choose from a response set such as “strongly disagree, disagree, undecided, agree, strongly agree”; or “0, 1-5, 6-10, etc.” This is known as Likert Scale . Surveys are commonly used by sociologists, marketing researchers, political scientists, therapists, and others to gather information on many independent and dependent variables in a relatively short period of time. Surveys typically yield surface information on a wide variety of factors, but may not allow for in-depth understanding of human behavior.

Of course, surveys can be designed in a number of ways. They may include forced choice questions and semi-structured questions in which the researcher allows the respondent to describe or give details about certain events. One of the most difficult aspects of designing a good survey is wording questions in an unbiased way and asking the right questions so that respondents can give a clear response rather than choosing “undecided” each time. Knowing that 30% of respondents are undecided is of little use! So a lot of time and effort should be placed on the construction of survey items. One of the benefits of having forced choice items is that each response is coded so that the results can be quickly entered and analyzed using statistical software. Analysis takes much longer when respondents give lengthy responses that must be analyzed in a different way. Surveys are useful in examining stated values, attitudes, opinions, and reporting on practices. However, they are based on self-report or what people say they do rather than on observation and this can limit accuracy.

Developmental Designs

Developmental designs are techniques used in developmental research (and other areas as well). These techniques try to examine how age, cohort, gender, and social class impact development.

Longitudinal Research

Longitudinal research involves beginning with a group of people who may be of the same age and background, and measuring them repeatedly over a long period of time. One of the benefits of this type of research is that people can be followed through time and be compared with them when they were younger.

Figure 1.8 – A longitudinal research design. 13

A problem with this type of research is that it is very expensive and subjects may drop out over time. The Perry Preschool Project which began in 1962 is an example of a longitudinal study that continues to provide data on children’s development.

Cross-sectional Research

Cross-sectional research involves beginning with a sample that represents a cross-section of the population. Respondents who vary in age, gender, ethnicity, and social class might be asked to complete a survey about television program preferences or attitudes toward the use of the Internet. The attitudes of males and females could then be compared, as could attitudes based on age. In cross-sectional research, respondents are measured only once.

Figure 1.9 – A cross-sectional research design. 14

This method is much less expensive than longitudinal research but does not allow the researcher to distinguish between the impact of age and the cohort effect. Different attitudes about the use of technology, for example, might not be altered by a person’s biological age as much as their life experiences as members of a cohort.

Sequential Research

Sequential research involves combining aspects of the previous two techniques; beginning with a cross-sectional sample and measuring them through time.

Figure 1.10 – A sequential research design. 15

This is the perfect model for looking at age, gender, social class, and ethnicity. But the drawbacks of high costs and attrition are here as well. 16

Table 1 .1 – Advantages and Disadvantages of Different Research Designs 17

Consent and Ethics in Research

Research should, as much as possible, be based on participants’ freely volunteered informed consent. For minors, this also requires consent from their legal guardians. This implies a responsibility to explain fully and meaningfully to both the child and their guardians what the research is about and how it will be disseminated. Participants and their legal guardians should be aware of the research purpose and procedures, their right to refuse to participate; the extent to which confidentiality will be maintained; the potential uses to which the data might be put; the foreseeable risks and expected benefits; and that participants have the right to discontinue at any time.

But consent alone does not absolve the responsibility of researchers to anticipate and guard against potential harmful consequences for participants. 18 It is critical that researchers protect all rights of the participants including confidentiality.

Child development is a fascinating field of study – but care must be taken to ensure that researchers use appropriate methods to examine infant and child behavior, use the correct experimental design to answer their questions, and be aware of the special challenges that are part-and-parcel of developmental research. Hopefully, this information helped you develop an understanding of these various issues and to be ready to think more critically about research questions that interest you. There are so many interesting questions that remain to be examined by future generations of developmental scientists – maybe you will make one of the next big discoveries! 19

Another really important framework to use when trying to understand children’s development are theories of development. Let’s explore what theories are and introduce you to some major theories in child development.

Developmental Theories

What is a theory.

Students sometimes feel intimidated by theory; even the phrase, “Now we are going to look at some theories…” is met with blank stares and other indications that the audience is now lost. But theories are valuable tools for understanding human behavior; in fact they are proposed explanations for the “how” and “whys” of development. Have you ever wondered, “Why is my 3 year old so inquisitive?” or “Why are some fifth graders rejected by their classmates?” Theories can help explain these and other occurrences. Developmental theories offer explanations about how we develop, why we change over time and the kinds of influences that impact development.

A theory guides and helps us interpret research findings as well. It provides the researcher with a blueprint or model to be used to help piece together various studies. Think of theories as guidelines much like directions that come with an appliance or other object that requires assembly. The instructions can help one piece together smaller parts more easily than if trial and error are used.

Theories can be developed using induction in which a number of single cases are observed and after patterns or similarities are noted, the theorist develops ideas based on these examples. Established theories are then tested through research; however, not all theories are equally suited to scientific investigation.  Some theories are difficult to test but are still useful in stimulating debate or providing concepts that have practical application. Keep in mind that theories are not facts; they are guidelines for investigation and practice, and they gain credibility through research that fails to disprove them. 20

Let’s take a look at some key theories in Child Development.

Sigmund Freud’s Psychosexual Theory

We begin with the often controversial figure, Sigmund Freud (1856-1939). Freud has been a very influential figure in the area of development; his view of development and psychopathology dominated the field of psychiatry until the growth of behaviorism in the 1950s. His assumptions that personality forms during the first few years of life and that the ways in which parents or other caregivers interact with children have a long-lasting impact on children’s emotional states have guided parents, educators, clinicians, and policy-makers for many years. We have only recently begun to recognize that early childhood experiences do not always result in certain personality traits or emotional states. There is a growing body of literature addressing resilience in children who come from harsh backgrounds and yet develop without damaging emotional scars (O’Grady and Metz, 1987). Freud has stimulated an enormous amount of research and generated many ideas. Agreeing with Freud’s theory in its entirety is hardly necessary for appreciating the contribution he has made to the field of development.

Figure 1.11 – Sigmund Freud. 21

Freud’s theory of self suggests that there are three parts of the self.

The id is the part of the self that is inborn. It responds to biological urges without pause and is guided by the principle of pleasure: if it feels good, it is the thing to do. A newborn is all id. The newborn cries when hungry, defecates when the urge strikes.

The ego develops through interaction with others and is guided by logic or the reality principle. It has the ability to delay gratification. It knows that urges have to be managed. It mediates between the id and superego using logic and reality to calm the other parts of the self.

The superego represents society’s demands for its members. It is guided by a sense of guilt. Values, morals, and the conscience are all part of the superego.

The personality is thought to develop in response to the child’s ability to learn to manage biological urges. Parenting is important here. If the parent is either overly punitive or lax, the child may not progress to the next stage. Here is a brief introduction to Freud’s stages.

Table 1. 2 – Sigmund Freud’s Psychosexual Theory

Strengths and Weaknesses of Freud’s Theory

Freud’s theory has been heavily criticized for several reasons. One is that it is very difficult to test scientifically. How can parenting in infancy be traced to personality in adulthood? Are there other variables that might better explain development? The theory is also considered to be sexist in suggesting that women who do not accept an inferior position in society are somehow psychologically flawed. Freud focuses on the darker side of human nature and suggests that much of what determines our actions is unknown to us. So why do we study Freud? As mentioned above, despite the criticisms, Freud’s assumptions about the importance of early childhood experiences in shaping our psychological selves have found their way into child development, education, and parenting practices. Freud’s theory has heuristic value in providing a framework from which to elaborate and modify subsequent theories of development. Many later theories, particularly behaviorism and humanism, were challenges to Freud’s views. 22

Erik Erikson’s Psychosocial Theory

Now, let’s turn to a less controversial theorist, Erik Erikson. Erikson (1902-1994) suggested that our relationships and society’s expectations motivate much of our behavior in his theory of psychosocial development. Erikson was a student of Freud’s but emphasized the importance of the ego, or conscious thought, in determining our actions. In other words, he believed that we are not driven by unconscious urges. We know what motivates us and we consciously think about how to achieve our goals. He is considered the father of developmental psychology because his model gives us a guideline for the entire life span and suggests certain primary psychological and social concerns throughout life.

Figure 1.12 – Erik Erikson. 23

Erikson expanded on his Freud’s by emphasizing the importance of culture in parenting practices and motivations and adding three stages of adult development (Erikson, 1950; 1968). He believed that we are aware of what motivates us throughout life and the ego has greater importance in guiding our actions than does the id. We make conscious choices in life and these choices focus on meeting certain social and cultural needs rather than purely biological ones. Humans are motivated, for instance, by the need to feel that the world is a trustworthy place, that we are capable individuals, that we can make a contribution to society, and that we have lived a meaningful life. These are all psychosocial problems.

Erikson divided the lifespan into eight stages. In each stage, we have a major psychosocial task to accomplish or crisis to overcome.  Erikson believed that our personality continues to take shape throughout our lifespan as we face these challenges in living. Here is a brief overview of the eight stages:

Table 1. 3 – Erik Erikson’s Psychosocial Theory

These eight stages form a foundation for discussions on emotional and social development during the life span. Keep in mind, however, that these stages or crises can occur more than once. For instance, a person may struggle with a lack of trust beyond infancy under certain circumstances. Erikson’s theory has been criticized for focusing so heavily on stages and assuming that the completion of one stage is prerequisite for the next crisis of development. His theory also focuses on the social expectations that are found in certain cultures, but not in all. For instance, the idea that adolescence is a time of searching for identity might translate well in the middle-class culture of the United States, but not as well in cultures where the transition into adulthood coincides with puberty through rites of passage and where adult roles offer fewer choices. 24

Behaviorism

While Freud and Erikson looked at what was going on in the mind, behaviorism rejected any reference to mind and viewed overt and observable behavior as the proper subject matter of psychology. Through the scientific study of behavior, it was hoped that laws of learning could be derived that would promote the prediction and control of behavior. 25

Ivan Pavlov

Ivan Pavlov (1880-1937) was a Russian physiologist interested in studying digestion. As he recorded the amount of salivation his laboratory dogs produced as they ate, he noticed that they actually began to salivate before the food arrived as the researcher walked down the hall and toward the cage. “This,” he thought, “is not natural!” One would expect a dog to automatically salivate when food hit their palate, but BEFORE the food comes? Of course, what had happened was . . . you tell me. That’s right! The dogs knew that the food was coming because they had learned to associate the footsteps with the food. The key word here is “learned”. A learned response is called a “conditioned” response.

Figure 1.13 – Ivan Pavlov. 26

Pavlov began to experiment with this concept of classical conditioning . He began to ring a bell, for instance, prior to introducing the food. Sure enough, after making this connection several times, the dogs could be made to salivate to the sound of a bell. Once the bell had become an event to which the dogs had learned to salivate, it was called a conditioned stimulus . The act of salivating to a bell was a response that had also been learned, now termed in Pavlov’s jargon, a conditioned response. Notice that the response, salivation, is the same whether it is conditioned or unconditioned (unlearned or natural). What changed is the stimulus to which the dog salivates. One is natural (unconditioned) and one is learned (conditioned).

Let’s think about how classical conditioning is used on us. One of the most widespread applications of classical conditioning principles was brought to us by the psychologist, John B. Watson.

John B. Watson

John B. Watson (1878-1958) believed that most of our fears and other emotional responses are classically conditioned. He had gained a good deal of popularity in the 1920s with his expert advice on parenting offered to the public.

Figure 1.14 – John B. Watson. 27

He tried to demonstrate the power of classical conditioning with his famous experiment with an 18 month old boy named “Little Albert”. Watson sat Albert down and introduced a variety of seemingly scary objects to him: a burning piece of newspaper, a white rat, etc. But Albert remained curious and reached for all of these things. Watson knew that one of our only inborn fears is the fear of loud noises so he proceeded to make a loud noise each time he introduced one of Albert’s favorites, a white rat. After hearing the loud noise several times paired with the rat, Albert soon came to fear the rat and began to cry when it was introduced. Watson filmed this experiment for posterity and used it to demonstrate that he could help parents achieve any outcomes they desired, if they would only follow his advice. Watson wrote columns in newspapers and in magazines and gained a lot of popularity among parents eager to apply science to household order.

Operant conditioning, on the other hand, looks at the way the consequences of a behavior increase or decrease the likelihood of a behavior occurring again. So let’s look at this a bit more.

B.F. Skinner and Operant Conditioning

B. F. Skinner (1904-1990), who brought us the principles of operant conditioning, suggested that reinforcement is a more effective means of encouraging a behavior than is criticism or punishment. By focusing on strengthening desirable behavior, we have a greater impact than if we emphasize what is undesirable. Reinforcement is anything that an organism desires and is motivated to obtain.

Figure 1.15 – B. F. Skinner. 28

A reinforcer is something that encourages or promotes a behavior. Some things are natural rewards. They are considered intrinsic or primary because their value is easily understood. Think of what kinds of things babies or animals such as puppies find rewarding.

Extrinsic or secondary reinforcers are things that have a value not immediately understood. Their value is indirect. They can be traded in for what is ultimately desired.

The use of positive reinforcement involves adding something to a situation in order to encourage a behavior. For example, if I give a child a cookie for cleaning a room, the addition of the cookie makes cleaning more likely in the future. Think of ways in which you positively reinforce others.

Negative reinforcement occurs when taking something unpleasant away from a situation encourages behavior. For example, I have an alarm clock that makes a very unpleasant, loud sound when it goes off in the morning. As a result, I get up and turn it off. By removing the noise, I am reinforced for getting up. How do you negatively reinforce others?

Punishment is an effort to stop a behavior. It means to follow an action with something unpleasant or painful. Punishment is often less effective than reinforcement for several reasons. It doesn’t indicate the desired behavior, it may result in suppressing rather than stopping a behavior, (in other words, the person may not do what is being punished when you’re around, but may do it often when you leave), and a focus on punishment can result in not noticing when the person does well.

Not all behaviors are learned through association or reinforcement. Many of the things we do are learned by watching others. This is addressed in social learning theory.

Social Learning Theory

Albert Bandura (1925-) is a leading contributor to social learning theory. He calls our attention to the ways in which many of our actions are not learned through conditioning; rather, they are learned by watching others (1977). Young children frequently learn behaviors through imitation

Figure 1.16 – Albert Bandura. 29

Sometimes, particularly when we do not know what else to do, we learn by modeling or copying the behavior of others. A kindergartner on his or her first day of school might eagerly look at how others are acting and try to act the same way to fit in more quickly. Adolescents struggling with their identity rely heavily on their peers to act as role-models. Sometimes we do things because we’ve seen it pay off for someone else. They were operantly conditioned, but we engage in the behavior because we hope it will pay off for us as well. This is referred to as vicarious reinforcement (Bandura, Ross and Ross, 1963).

Bandura (1986) suggests that there is interplay between the environment and the individual. We are not just the product of our surroundings, rather we influence our surroundings. Parents not only influence their child’s environment, perhaps intentionally through the use of reinforcement, etc., but children influence parents as well. Parents may respond differently with their first child than with their fourth. Perhaps they try to be the perfect parents with their firstborn, but by the time their last child comes along they have very different expectations both of themselves and their child. Our environment creates us and we create our environment. 30

Theories also explore cognitive development and how mental processes change over time.

Jean Piaget’s Theory of Cognitive Development

Jean Piaget (1896-1980) is one of the most influential cognitive theorists. Piaget was inspired to explore children’s ability to think and reason by watching his own children’s development. He was one of the first to recognize and map out the ways in which children’s thought differs from that of adults. His interest in this area began when he was asked to test the IQ of children and began to notice that there was a pattern in their wrong answers. He believed that children’s intellectual skills change over time through maturation. Children of differing ages interpret the world differently.

Figure 1.17 – Jean Piaget. 32

Piaget believed our desire to understand the world comes from a need for cognitive equilibrium . This is an agreement or balance between what we sense in the outside world and what we know in our minds. If we experience something that we cannot understand, we try to restore the balance by either changing our thoughts or by altering the experience to fit into what we do understand. Perhaps you meet someone who is very different from anyone you know. How do you make sense of this person? You might use them to establish a new category of people in your mind or you might think about how they are similar to someone else.

A schema or schemes are categories of knowledge. They are like mental boxes of concepts. A child has to learn many concepts. They may have a scheme for “under” and “soft” or “running” and “sour”. All of these are schema. Our efforts to understand the world around us lead us to develop new schema and to modify old ones.

One way to make sense of new experiences is to focus on how they are similar to what we already know. This is assimilation . So the person we meet who is very different may be understood as being “sort of like my brother” or “his voice sounds a lot like yours.” Or a new food may be assimilated when we determine that it tastes like chicken!

Another way to make sense of the world is to change our mind. We can make a cognitive accommodation to this new experience by adding new schema. This food is unlike anything I’ve tasted before. I now have a new category of foods that are bitter-sweet in flavor, for instance. This is  accommodation . Do you accommodate or assimilate more frequently? Children accommodate more frequently as they build new schema. Adults tend to look for similarity in their experience and assimilate. They may be less inclined to think “outside the box.”

Piaget suggested different ways of understanding that are associated with maturation. He divided this into four stages:

Table 1.4 – Jean Piaget’s Theory of Cognitive Development

Criticisms of Piaget’s Theory

Piaget has been criticized for overemphasizing the role that physical maturation plays in cognitive development and in underestimating the role that culture and interaction (or experience) plays in cognitive development. Looking across cultures reveals considerable variation in what children are able to do at various ages. Piaget may have underestimated what children are capable of given the right circumstances. 33

Lev Vygotsky’s Sociocultural Theory

Lev Vygotsky (1896-1934) was a Russian psychologist who wrote in the early 1900s but whose work was discovered in the United States in the 1960s but became more widely known in the 1980s. Vygotsky differed with Piaget in that he believed that a person not only has a set of abilities, but also a set of potential abilities that can be realized if given the proper guidance from others. His sociocultural theory emphasizes the importance of culture and interaction in the development of cognitive abilities. He believed that through guided participation known as scaffolding, with a teacher or capable peer, a child can learn cognitive skills within a certain range known as the zone of proximal development . 34 His belief was that development occurred first through children’s immediate social interactions, and then moved to the individual level as they began to internalize their learning. 35

Figure 1.18- Lev Vygotsky. 36

Have you ever taught a child to perform a task? Maybe it was brushing their teeth or preparing food. Chances are you spoke to them and described what you were doing while you demonstrated the skill and let them work along with you all through the process. You gave them assistance when they seemed to need it, but once they knew what to do-you stood back and let them go. This is scaffolding and can be seen demonstrated throughout the world. This approach to teaching has also been adopted by educators. Rather than assessing students on what they are doing, they should be understood in terms of what they are capable of doing with the proper guidance. You can see how Vygotsky would be very popular with modern day educators. 37

Comparing Piaget and Vygotsky

Vygotsky concentrated more on the child’s immediate social and cultural environment and his or her interactions with adults and peers. While Piaget saw the child as actively discovering the world through individual interactions with it, Vygotsky saw the child as more of an apprentice, learning through a social environment of others who had more experience and were sensitive to the child’s needs and abilities. 38

Like Vygotsky’s, Bronfenbrenner looked at the social influences on learning and development.

Urie Bronfenbrenner’s Ecological Systems Model

Urie Bronfenbrenner (1917-2005) offers us one of the most comprehensive theories of human development. Bronfenbrenner studied Freud, Erikson, Piaget, and learning theorists and believed that all of those theories could be enhanced by adding the dimension of context. What is being taught and how society interprets situations depends on who is involved in the life of a child and on when and where a child lives.

Figure 1.19 – Urie Bronfenbrenner. 39

Bronfenbrenner’s ecological systems model explains the direct and indirect influences on an individual’s development.

Table 1.5 – Urie Bronfenbrenner’s Ecological Systems Model

For example, in order to understand a student in math, we can’t simply look at that individual and what challenges they face directly with the subject. We have to look at the interactions that occur between teacher and child. Perhaps the teacher needs to make modifications as well. The teacher may be responding to regulations made by the school, such as new expectations for students in math or constraints on time that interfere with the teacher’s ability to instruct. These new demands may be a response to national efforts to promote math and science deemed important by political leaders in response to relations with other countries at a particular time in history.

Figure 1.20 – Bronfenbrenner’s ecological systems theory. 40

Bronfenbrenner’s ecological systems model challenges us to go beyond the individual if we want to understand human development and promote improvements. 41

In this chapter we looked at:

underlying principles of development

the five periods of development

three issues in development

Various methods of research

important theories that help us understand development

Next, we are going to be examining where we all started with conception, heredity, and prenatal development.

Child Growth and Development Copyright © by Jean Zaar is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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5 year old Child case study

Case B is a five-year-old child who is in Reception class and has been attending Hague primary school since Nursery. And has a free school meal He was born in England his parents are separated and visits dad on weekends he has a varied home life goes out and about and obviously talks to his mother about what he has seen and done.

Using a language development chart case B is age appropriate he is able to do many of the things expected of a 66 months (5yearold) such as he is able to count to ten and will know tomorrow, today, yesterday, also be able describe common objects in terms of use (hat shoe chair) and know his name. Using Piaget s stages of cognitive development case B is at the intuitive phase. Expected of a child between 4 and 7years He plays with another child, he remembers names of people .He can follow the rules of a game. Case B is working within the foundation stage stepping stones levels with some areas of his development already reaching early learning goals.

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He has good listening skills and is confident when speaking to small and large groups of children he participates well in discussions in class he has learnt his letter sounds and is using this knowledge to read and write simple words. Case B has good early number skills he recognise numbers up to 20 and is starting to order these numbers correctly he can find one more or less than a number and is beginning to use the vocabulary involved in adding and subtracting.

With his personal social and emotional development case B becomes very involved in activities persists on at an activity of his choosing and takes appropriate risks also interested and excited to learn is confident to try new activities, initiate ideas and speak in a familiar group during our class topic of Judaism he showed interest and desire in cultural and religious differences he also forms good relationships with adults and peers works as part of a group or class taking turns and sharing fairly he is able to express needs and feelings in an appropriate way e.g. will say if he or someone else is hurt. Understands what is right and wrong i.e. aware of reception class rules.

Having observed him during PE and outside learning he is able to move freely with enjoyment and confidence in a variety of ways he is able to adjust speed or direction to avoid obstacles is able control large and small scale movements case B can use a range of small and large equipment e.g. small world play (little sea creatures) large construction (building blocks) case B learns through talk and connecting ideas explaining what is happening never afraid to ask questions. Is developing pencil control but will benefit from lots of practice in writing and drawing.

Behaviour Strategies

Of course we have to remind him about what you have to do when the teacher is talking i.e. are you sitting up straight have you switched your eyes and ears on. Also we do a lot of proximity praising e.g. where we praise the child sitting next to him so he notices and copies the other child who is focusing on the teacher also being his carpet partner e.g. positioning myself next to him.

For good behaviour we have stickers case B can receive a sticker for completing his homework and working hard in class we also have star of the week if case B has been working extra hard all week teacher or teaching assistant can choose him as star of the .week his photograph goes up on the wall. He will also receive a sticker in good behaviour assembly.

For unacceptable behaviour we have the three steps 1st step remind him of our class rules 2nd step we talk to him 3rd step sits at table by him self away from the rest of the class. He can join the rest of the class when he is ready to be sensible.

Self Esteem

Self esteem isn’t quite the same thing as confidence what is it? The word esteem comes from a Latin word which means ‘to estimate’ so self esteem is how you estimate yourself.

When introducing new things to Case B, we need to show him how to do an activity once and leave him to it. He will then come back to us and say ‘look I’ve done it’. We will then say well done. When he is handing out fruits during break time’, he will help the other children to peel their fruits. I.e. Satsuma’s and bananas we give him a. sticker for his sticker chart! For handling out the fruit so nicely and helping the other children, you can see the effect of praises, by the smile on his face. If he has done a good piece of work a postcard will be sent home, to the parent/carer. Before this, we explain to him why the postcard is being sent home. .

How We Record Progress

We use progress books which are records that go home to parents to see before their child’s report day. Also foundation stage stepping stones levels these are both formal. We record progress in formally using feed back sheets also verbal feed back to class teacher.

Confidentiality

Parent/cares can ask to see any thing written about their child .we should remember to keep all information written or verbal about a child or a family that is passed between staff and those adults who are directly involved in a situation is confidential. Finally, he likes to take part in plays and acting them out in assembly he is rarely absent from school infact he has only been absent six days since starting in September 2005. He is a confident member of reception class and pleasure to work with.

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Impact of Home Parenting Environment on Cognitive and Psychomotor Development in Children Under 5 Years Old: A Meta-Analysis

1 Department of Pediatrics, The First Affiliated Hospital of Hunan University of Medicine, Huaihua, China

2 Nursing College, Hunan University of Medicine, Huaihua, China

Jinlian Yang

3 Department of Child Health Care, Huaihua Maternal and Child Health Hospital, Huaihua, China

Liming Zheng

Associated data.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

This study aims to evaluate the relationship between home parenting environment and the cognitive and psychomotor development in children under 5 years old by using meta-analysis. A systematic search of the Chinese and English databases including Pubmed, Embase, the Cochrane Library, CNKI, Weipu, Wanfang, and CBMdisc databases from January 1, 1990, to July 31, 2021, was performed. Articles concerning the relationship between home parenting environment and the cognitive and psychomotor development in children under 5 years old were included. Review Manager 5.4 was used for meta-analysis. Subgroup analysis in terms of age and region were performed. A total of 12 articles were included, including 11 in English and 1 in Chinese. Meta-analysis showed that there was significant relationship between home parenting environment and the cognitive and psychomotor development of children ( r = 0.31; r = 0.21). Subgroup analysis showed that correlation between home parenting environment and the cognitive and psychomotor development of children was stronger in children over 18 months compared to those under 17 months [( r = 0.33, r = 0.21) vs. ( r = 0.28, r = 0.17)]. The converted summary r value between home parenting environment and cognitive development in developing and developed countries was both 0.32. Conclusively, there is a positive correlation between the home parenting environment and the cognitive and psychomotor development of children under 5 years old. Improving the home parenting environment of children is beneficial to promote their early development.

Introduction

Studies ( 1 , 2 ) have shown that the number of children under 5 years of age who have development deficiency due to poverty, disease, neglect of care and other reasons in developing countries worldwide has increased from 200 million to 250 million from 2007 to 2017, which includes 17.1 million in China. According to the 2020 Global Nutrition Report on malnutrition, nearly one in every four children under 5 years old (149 million) is stunted ( 3 ). In 2021, the prevalence rates of stunting in children under 5 years old in Ecuador, Nigeria, and Ethiopia were, respectively, 23.2, 36.2, and 39% ( 4 – 6 ). In China, 17.07% of children of 3–5 years old had a high risk of early development deficiency in 2021 ( 7 ). Early childhood is a critical period of life development, which has a crucial impact on the development and function of the brain ( 8 ); plays an important role in the formation of human intelligence, behavior, and social adaptability ( 9 ); and even affects adulthood achievement. A study in the field of economics has shown ( 10 ) that the average income in adulthood will drop by 26% in a setting of neglect of the key period of child development. Therefore, improving early childhood development is vital to promoting future social development.

Human development is the product of the interaction between certain congenital conditions and acquired developmental environment ( 11 ). During the rapid growth in early childhood, the brain particularly is vulnerable to external factors such as nutritional status, socioeconomic factors, and parent–child relationships ( 1 , 12 ). Such stimuli directly or indirectly have a positive or negative impact on children ( 13 ). In developing countries, due to long-term living in poverty, many children experience chronic diseases such as malnutrition and infection in their infancy and toddlerhood. Even if they survive, they easily suffer from neurodevelopmental defects ( 14 ). It has been confirmed that in low-income and middle-income environments, high-quality diets in childhood are positively correlated with the cognitive development scores of 24-month-old children, and chronic diseases are negatively correlated with cognitive development ( 15 ). Meanwhile, malnutrition affects gastrointestinal function. In a resource-poor environment, many children suffer from impaired intestinal function and environmental enteric dysfunction ( 16 ). This has been confirmed as an important cause of developmental delay in children ( 17 ). It is worth noting that due to economic development and urbanization transformation, many developing countries are experiencing the double burden of malnutrition and nutrition transition. The increase rate of overweight and obesity is much greater than the decrease rate of malnutrition ( 18 ), which will bring new challenges to national policy makers and health professionals. Finally, early education is an important factor in early childhood development ( 1 ). In economically developed countries and regions, early childhood education resources are abundant, and more families send their children to professional institutions as early as possible to receive early education and develop their potential ( 19 ). On the contrary, 25% of children under the age of 5 years old in developing countries live in extreme poverty ( 1 ). Poverty and other factors make early childhood education opportunities in professional institutions very limited. All these have increased the risk of early developmental delay in children in developing countries to a certain extent.

Parenting mainly refers to the care provided by the family for children's health promotion, nutritional needs, response, emotional support, developmental stimulation, etc. ( 1 ). Based on the Ecological Systems Theory ( 20 ), the parenting environment is the main influencing factor of children's development, which is a nested ecosystem with a core of children. The inner micro-system, i.e., home, has the most direct and significant impact on children development. The home parenting environment includes parental quality, family structure, parent-child response, family resource availability, learning conditions, etc. ( 1 , 21 ). Family structure, parenting styles, and family relationships are closely related to child development ( 21 ). Supporting parents and other child caregivers and improving parenting quality at the family level can promote child developmental potential ( 22 ). A multi-arm, cluster-randomized community effectiveness trial in rural western Kenya also reported that parental intervention could effectively promote the early development of children aged 6–24 months ( 23 ).

Cognitive and psychomotor development are important indicators of early childhood development ( 1 ), including thinking ability, attention, problem solving ability, memory, fine motor, gross motor, and other abilities that help children understand the world ( 24 ). In recent decades, the number of studies concerning family environment and child development, especially cognitive development, have gradually increased, but most of them ( 25 , 26 ) have focused on the impact of general factors such as family economic status, parent's educational level, and parenting methods on child development. Moreover, some studies, which evaluate home environment as a complete system and focus on child development, have small sample sizes; are of single-center design; and do not involve cultural background, socioeconomic differences, and other issues, finally leading to controversial results. For example, Ribe et al. ( 27 ) showed that there was no statistically significant relationship between family parenting and the early development of the children of 15 months old. However, Mccormick et al. ( 28 ) showed that there was a positive correlation between family parenting and the early childhood development.

Herein, we conducted a meta-analysis to evaluate the overall effect size of the relationship between family parenting environment and early cognition and psychomotor development in children under 5 years old. The observational studies published in Chinese and English from the 1990 s focusing on relationship between the family parenting environment and the cognitive and psychomotor development of children under 5 years of age were included in this meta-analysis. Our findings may provide a basis for promoting early childhood development and potential development.

Materials and Methods

Literature research.

The databases of Pubmed, Embase, The Cochrane Library, CNKI, Weipu, Wanfang databases, and CBMdisc databases were searched from January 1, 1990, to July 31, 2021. Each database was searched by using the following key terms: (cognitive development OR psychomotor development OR neuropsychological development) AND (home environment OR development environment) AND (child OR children OR infant OR infants), limited to English or Chinese language.

Inclusion and Exclusion Criteria

The inclusion criteria were as follows: (1) Observational study. (2) The study population consisted exclusively of children under 5-years-old. (3) Pearson correlation or Spearman correlation was used to investigate the relationship between home parenting environment and children's cognitive development or psychomotor development, and, the correlation coefficient [Pearson correlation coefficient (r) or Spearman correlation coefficient (rs)] was reported. (4) Home parenting environment and children's cognitive and psychomotor development were assessed by validated and reliable scales.

The exclusion criteria were as follows: (1) Non-observational study. (2) Study population was children over 6 years old. (3) Study population involved children with disorders affecting cognitive and psychomotor development. (4) The correlation coefficients between home parenting environment and children's cognitive development or psychomotor development was not reported; (5) The data were incomplete or the effect size cannot be extracted.

Data Extraction

Two researchers (Yang Q and Yang JL) conducted independent literature search and data extraction according to the search strategy and inclusion and exclusion criteria. The extracted data included the first author, publication year, research location, sample size, sex ratio, measurement tools, age of children at the time of evaluation, and correlation coefficient (r or rs) between home parenting environment and child development. Finally, the two researchers cross-checked the extracted data.

Outcome Variables

The outcome variables were defined as relationship between home parenting environment and children's cognitive development or psychomotor development, which was represented by correlation coefficient (r or rs).

Quality Evaluation

The study quality was evaluated according to the STROBE statement ( 29 ). A total of 22 items including six aspects of title, abstract, introduction, methods, results, and discussion were assessed. One item was scored 1 point and there were 22 points in total.

Statistical Analysis

Review Manager 5.4 was used for meta-analysis. Before merging the effect size, Fisher's Z values and SE values were converted according to the formula. The summary Fisher's Z was obtained based on Fisher's Z values and SE values. Cochran Q -test and I 2 test were used for heterogeneity test. If p > 0.10 and I 2 <50%, there was no statistical heterogeneity between the studies, and the fixed effects model was used. p < 0.10 or I 2 > 50% indicates that there is heterogeneity between the studies, and the random effects model was used. The subgroup analysis was performed according to the age of children and the research area. The funnel plot was used to analyze publication bias, and each included study was eliminated one by one to assess sensitivity. Finally, summary r was calculated according to summary Fisher's Z to determine the correlation of home parenting environment and child development. The value range of r ≥ 0.4 was defined as strong correlation; 0.1 < r < 0.4 as medium correlation; and r ≤ 0.1 as weak correlation ( 30 ). The formula was as follows ( 31 ):

Note: r , Pearson correlation coefficient; rs, Spearman correlation coefficient; SE, standard error; Z, summary Fisher's Z.

Literature Research Results

The study flowchart is shown in Figure 1 . A total of 983 articles were obtained after initial screening, including 336 in English and 647 in Chinese. After excluding duplicate articles, studies of obviously irrelevant topics, studies of inconsistent outcome indicators, or studies without extractable effect size, 12 articles ( 19 , 32 – 42 ) were finally included in the meta-analysis. Among them, there were 11 articles in English ( 19 , 32 – 38 , 40 – 42 ) and one article in Chinese ( 39 ). One article ( 32 ) divided the subjects into the 0–17-month-old group and the 18–30 month old group, and investigated the relationship between the early development of children and home parenting environment. Thus, the two groups of data were extracted independently. The study subjects came from eight countries including China, South Africa, the United States, Brazil, Spain, Norway, India, and Bangladesh. One group of the study subjects was Mexican-American ( 36 ). The basic characteristics and literature quality of all studies are shown in Table 1 . The quality score of the included studies ranged from 10 to 19 points, and the quality scores of three studies were less than half of the total score (≤11 points), which were rated as low quality in this study ( 32 , 33 , 39 ).

Flow chart of study selection.

Basic characteristics and quality evaluation of the included studies.

Early Development of Children Under 5 Years of Age Is Moderately Correlated With Home Parenting Environment

A total of 12 independent samples in 11 studies ( 19 , 32 – 38 , 40 – 42 ) reported the correlation coefficients between home parenting environment and cognitive development in children. The results of meta-analysis under random-effects model ( p = 0.08, I 2 = 40%) showed that the summary Fisher's Z value was 0.32 (95% CI: 0.27–0.37) ( p < 0.001). The converted summary r value was 0.31. This indicates that cognitive development of children under 5 years old is moderately correlated with the home parenting environment.

A total of eight independent samples in seven studies ( 19 , 32 , 35 – 37 , 39 , 42 ) reported the correlation coefficients between home parenting environment and psychomotor development in children. The results of meta-analysis under fixed-effects model ( p = 0.46, I 2 = 0%) showed that the summary Fisher's Z value was 0.21 (95% CI: 0.17–0.24) ( p < 0.001) and that the summary r value was 0.21. This indicates that psychomotor development of children under 5 years old is moderately correlated with the home parenting environment.

Subgroup Analysis

The age of children under development assessment and the national economic level may have a certain impact on the relationship between the home parenting environment and child development. Thus, the included studies were divided into groups of 0–17 months and over 18 months according to the age of children under development assessment. According to economic level, the included studies were divided into a group of developed countries and that of developing countries.

The results of the meta-analysis grouped by age of children under development assessment showed that the correlation coefficients combined with the summary Fisher's Z value between home parenting environment and cognitive and psychomotor development in the 0–17 months group were [0.29 (95% CI: 0.15–0.42)] and [0.17 (95% CI: 0.07–0.26), p < 0.001] ( Figures 2 , ​ ,3), 3 ), respectively. The correlation coefficients combined with summary Fisher's Z values of home parenting environment and cognitive development and psychomotor development in over 18 months group were [0.34 (95% CI: 0.30–0.38), p < 0.001] and [0.21 (95% CI: 0.18–0.25), p < 0.001] ( Figures 2 , ​ ,3), 3 ), respectively. The converted summary r values were 0.28, 0.17, 0.33, and 0.21, respectively. From the value of the summary correlation coefficient, the correlation between early childhood development and home parenting environment after 18 months may be stronger than before 17 months.

Forest map of the relationship between home parenting environment and cognitive development in children of different age groups.

Forest map of the relationship between home parenting environment and psychomotor development in children of different age groups.

Since there were only two developing countries that evaluated the relationship between home parenting environment and psychomotor development, subgroup analysis was not performed on psychomotor development. However, the studies evaluating the relationship between home parenting environment and cognitive development were subjected to subgroup analysis. The results showed that the correlation coefficients combined with summary Fisher's Z values of home parenting environment and cognitive development in developing and developed countries were [0.33 (95% CI: 0.29–0.38), p < 0.001], and [0.33 (95% CI: 0.22–0.43), p < 0.001] ( Figure 4 ). The converted summary r value between home parenting environment and cognitive development was both 0.32 in developing and developed countries, suggesting that the correlation between home parenting environment and cognitive development is the same between countries with different economic levels.

Forest map of the relationship between home parenting environment and cognitive development in developing and developed countries.

Publication Bias

Funnel plot was used to analyze the bias of 11 enrolled studies reporting the relationship between home parenting environment and cognitive development. The results were slightly asymmetrical, and there may be a certain degree of publication bias ( Figure 5 ).

Funnel diagram of relationship between home parenting environment and cognitive development.

Sensitivity Analysis

The method of eliminating each study one by one was used to observe the influence of a single study on the total combined effect size, and the results were not significantly different from the total combined effect size, suggesting that the study was stable. The results are shown in Table 2 .

Sensitivity analysis of relationship between home parenting environment and children's cognitive development (excluding individual studies one by one).

The development of cognition and movement in infants and young children is very rapid and has strong plasticity, which is known as “golden moment” of neuropsychological development. Among the three major living environments of children (natural environment, social environment, and family environment), the home parenting environment is the most exposed one in early childhood surroundings. This meta-analysis showed that the home parenting environment was moderately positively correlated with the cognitive development of children under 5 years old ( r = 0.31). Previous studies have also shown that a high-quality home parenting environment has a continuous positive effect on the cognitive development of children under 5 years old ( 28 ), which may be because the high-quality home parenting environment can provide children with safe environment, learning support, emotional and verbal responsivity ( 15 ), and sufficient stimulation ( 43 ) that are conducive to children's cognitive development. Meanwhile, the reasoning ability and depressive symptoms of the mothers, as relevant factors of home parenting environment, also may have an impact on children's early development; however, the negative roles of illness, infection, and poor infant feeding practices will increase the risk of constrained cognitive development in settings with less promotion of development ( 15 ). We also found that the home parenting environment was moderately positively correlated with the psychomotor development of children under 5 years old ( r = 0.21), which is consistent with the results by White-Traut et al. ( 44 ). Therefore, improving the home parenting environment in early childhood and providing positive stimulation is conducive to early childhood cognitive and psychomotor development ( 45 , 46 ).

In order to further explore the factors affecting the relationship between home parenting environment and child development, subgroup analysis was performed in terms of the age of child development assessment and the survey area. Subgroup analysis showed that the home parenting environment was positively correlated with the cognitive development and psychomotor development of children under 17 months and over 18 months. From the perspective of the correlation coefficient, the relationship between the home parenting environment and the development of children over 18 months was stronger than that of children under 17 months [( r = 0.33, r = 0.21) vs. ( r = 0.28, r = 0.17)]. Miquelote et al. ( 19 ) found that the correlation between home parenting environment and child development was stronger at 15 months of age than at 9 months of age. McCormick et al. ( 15 ) reported that the home parenting environment at 24 months and 60 months of age could better distinguish the cognitive development trajectory than that at 6 months of age. The results of this meta-analysis are consistent with their results, suggesting that the positive impact of home parenting environment on child development gradually increases with age and that the home parenting environment has continuous effect on the development of children ( 44 ). The subgroup analysis also showed that the combined correlation coefficient between home parenting environment and cognitive development was both 0.32 in developing and developed countries, indicating that this correlation of home parenting environment and cognitive development is the same in countries with different economic levels.

There were some limitations in this study. First, papers in languages other than Chinese and English and those using regression analysis to investigate the correlation between home parenting environment and child development were excluded. Second, the funnel plot showed that there may be a certain publication bias, which may have a certain impact on the final effect. Third, this study did not include children over 5 years old and could not provide evidence for the long-term effects of the home parenting environment on children's cognitive and psychomotor development. Finally, the quality of the included papers was mostly between 10 and 19 points, of which the quality scores of three studies were less than half of the total score. Almost all the studies lacked a reasonable description of the research samples, which may affect the scientificity of conclusions. Future studies with more high-quality articles are warranted to investigate the long-term impact of the home parenting environment on the development of children.

In conclusion, the home parenting environment was positively correlated with the cognitive and psychomotor development of children under 5 years old. The older the age, the stronger the correlation, indicating that the home parenting environment may have a continuous positive impact on the development of children. The early development potential of children in the family environment of high quality is relatively better. These results indicate that the main caregivers of children should not only provide children with reasonable dietary nutrition and economic security, but also enhance parent-child interactions, provide appropriate support and stimulation, and create a family environment conducive to the development of children.

Data Availability Statement

Author contributions.

LY and QY designed the study. QY and JY collected the data and searched the literatures. QY and LZ analyzed and interpreted the data. LZ and WS prepared the study. QY collected the funds and wrote the paper. LY revised the paper. All authors contributed to the article and approved the submitted version.

This study was funded by Scientific Research Project of Hunan Provincial Health Commission, China (No. 20200214).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Case Study of a 5-Year-Old Boy with Unilateral Hearing Loss

Jan 15, 2015 | Pediatric Care | 0 |

Case Study | Pediatrics | January 2015  Hearing Review 

A reminder of what our tests really say about the auditory system..

By Michael Zagarella, AuD

How many times have I heard— and said myself—that the OAE is not a hearing test? How many times have I thought to myself that, just because a child passes their newborn hearing screening test, it does not mean they have normal hearing? This case brought those two statements front and center.

A 5-year-old boy was referred to me for a hearing test because he did not pass a kindergarten screening test in his right ear. His parents reported that he said “Huh?” frequently, and more recently they noticed him turning his head when spoken to. He had passed his newborn hearing screening, and he had experienced a few ear infections that responded well to antibiotics. The parents mentioned a maternal aunt who is “nearly totally deaf” and wears binaural hearing aids.

Initial Test Results

Otoscopic examination showed a clear ear canal and a normal-appearing tympanic membrane on the right side. The left ear canal contained non-occluding wax.

Tympanograms were within normal limits bilaterally. Unfortunately, otoacoustic emissions (OAE) testing could not be completed because of an equipment malfunction.

Behavioral testing with SRTs was taken, and I typically start with the right ear. The child seemed bright and cooperative enough for routine testing. I obtained no response until 80 dB.

I switched to the left ear and he responded appropriately. This prompted me to walk into the test booth and check the equipment and wires; everything was plugged in and looked normal. I tried SRTs again with the same results, even reversing the earphones. Same results. When the behavioral tests were completed, the results indicated normal hearing in his left ear and a profound hearing loss in his right ear.

The child’s parents were informed of these results, and we scheduled him to return for a retest in order to confirm these findings.

Follow-up Test

One week later, the boy returned for a follow-up test. The otoscopic exam was the same: RE = normal; LE = non-occluding wax.

Tympanograms were within normal limits. I added acoustic reflexes, which were normal in his left ear (80-90 dB), and questionable in his right ear (105-115 dB).

DPOAEs were present in both ears. The right ear was reduced in amplitude compared with the left, but not what I would expect to see with a profound hearing loss (Figure 1).

I repeated the behavioral tests with the same results that I obtained the first time (Figure 2). Bone conduction scores were not obtained at this time because I felt I was reaching the limits of a 5-year-old, and the tympanograms were normal on two occasions.

Recommendation to Parents

After completing the tests, I explained auditory dyssynchrony to the parents, and told them that this is what their son appeared to have. Since they were people with resources, I advised them to make an appointment at Johns Hopkins to have this diagnosis confirmed by ABR.

Johns Hopkins Results

The initial appointment at Johns Hopkins was at the ENT clinic. According to the report from the parents, the physician reviewed my test results and said it was unlikely that they were valid. She suggested they repeat the entire test battery before proceeding with an ABR. All peripheral tests were repeated with exactly the same results that I had obtained. The ABR was scheduled and performed, yielding:

“Findings are consistent with normal hearing sensitivity in the left ear and a neural hearing loss in the right ear consistent with auditory dyssynchrony (auditory neuropathy). The normal hearing in the left ear is adequate for speech and language development at this time.”

Additional Follow-up

The boy’s mother was not completely satisfied with the diagnosis or explanation. After she arrived home and mulled things over, she called Johns Hopkins and asked if they could do an MRI. The ENT assured her that it probably would not show anything, but if it would allay her concerns (and since they had good insurance coverage), they would schedule the MRI.

Further reading: Vestibular Assessment in Infant Cochlear Implant Candidates

Figure 1. DPOAEs of 5-year-old boy.

Findings of MRI. Evaluation of the right inner ear structures demonstrated absence of the right cochlear nerve. The vestibular nerve is present but is small in caliber. The internal auditory canal is somewhat small in diameter. There is atresia versus severe stenosis of the cochlear nerve canal. The right modiolus is thickened. The cochlea has the normal amount of turns, and the vestibule semicircular canals appear normal.

The left inner ear structures, cranial nerves VII and VIII complex, and internal auditory canal are normal. Additional normal findings were also presented regarding sinuses, etc.

Key finding: The results were consistent with atresia versus severe stenosis of the right cochlear nerve canal and cochlear nerve and deficiency described above.

The Value of Relearning in Everyday Clinical Practice

Figure 2. Follow-up behavioral test of 5-year-old boy.

According to the MRI, the cochlea on the right side is normal—which would explain the present DPOAE results. The cochlear branch of the VIIIth Cranial Nerve is completely absent, which would explain the absent ABR result and the profound hearing loss by behavioral testing.

This case has certainly caused me to re-evaluate what I think and say about my test findings. How many times have I heard—and said myself!—that the OAE is not a hearing test? How many times have I thought to myself that, just because a child passes their newborn hear- ing screening test, it does not mean that they have normal hearing?

This case has surely brought those two statements front and center. In addition, what about auditory neuropathy? In about 40 years of testing, I had never seen a case that I was convinced was AN. Naturally, I was somewhat skeptical about this disorder: Is it real, or does it reside in the realm of the Yeti. (Personal note to Dr Chuck Berlin: I truly don’t doubt you, but I do like to see things for myself!)

Finally, this case only reinforces my trust in “mother’s intuition” and the value of deferring to the sensible requests of parents. If she had not felt uneasy about what she had been told at one of the most prestigious clinics in the country, the actual source of this problem would not have been discovered.

So what? Does any of this really make a difference? The bottom line is we have a 5-year-old boy with a unilateral profound hearing loss. How important is it that we know why he has that loss? From a purely clinical standpoint, I think that it is poignant because it brings home the importance of understanding what our tests really say about the hearing mechanism and auditory system (ie, is working or not working?).

And although it may not make a large difference in the boy’s current treatment plan, I do know that the boy’s mother is grateful for understanding the reason for her son’s hearing loss and that it’s at least possible the boy may benefit from this knowledge in the future.

Michael Zagarella, AuD, is an audiologist at RESA 8 Audiology Clinic in Martinsburg, WVa.

Correspondence can be addressed to HR or or Dr Zagarella at:  [email protected]

Citation for this article: Zagarella M. Case study of a 5-year-old boy with unilateral hearing loss. Hearing Review . 2015;22(1):30-33.

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The cognitive and socio-emotional development of 5-year-old children born after PGD

Affiliations.

• 1 Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.
• 2 School for Oncology and Developmental Biology, GROW, Maastricht University, Maastricht, The Netherlands.
• 3 Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
• 4 Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
• 5 Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
• 6 Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands.
• PMID: 30265304
• DOI: 10.1093/humrep/dey302

Study question: Does PGD increase the risk on adverse cognitive and socio-emotional development?

Summary answer: The cognitive and socio-emotional development in children born after PGD seems to be normal when compared to control groups.

What is known already: A limited number of studies with small sample sizes indicate that the cognitive and socio-emotional development of (pre)school-aged children born after either PGD or PGS seem to be comparable to those of children born after IVF/ICSI and to naturally conceived (NC) children from the general population.

Study design, size, duration: For this study we invited 72 5-year-old PGD children, 128 5-year-old IVF/ICSI children and 108 5-year-old NC children from families with a genetic disorder. All children were invited between January 2014 and July 2016.

Participants/materials, setting, methods: In total, 51 PGD children, 52 IVF/ICSI children and 35 NC children underwent neuropsychological testing (WPPSI-III-NL and AWMA). The children's parent(s) and teachers filled in questionnaires evaluating children's executive functioning (Behaviour Rating Inventory of Executive Functions; BRIEF) and socio-emotional development (Child Behaviour Checklist; CBCL and Caregiver-Teacher Report Form; C-TRF).

Main results and the role of chance: The mean full-scale intelligence quotient scores (P = 0.426) and performance on the AWMA Listening Span task (P = 0.873) and Spatial Span task (P = 0.458) were comparable between the three groups. Regarding socio-emotional development, the teachers' scores revealed more externalizing (P = 0.011) and total problem (P = 0.019) behaviour in PGD children than for IVF/ICSI children; both groups did not differ significantly from the NC children (P = 0.11). More children (13%) with an affected first-degree family member (mostly parent) were included in the PGD group than in the NC group. Scores in all groups fell within the normal population range and should be considered normal.

Limitations, reasons for caution: The number of NC children from families with a genetic disorder was relatively small. Furthermore, the fathers' CBCL results were based on small samples.

Wider implications of the findings: PGD children show levels of cognitive and socio-emotional development at 5 years that are within the normal range, despite the biopsy involved in PGD and the potential extra psychological burden associated with the presence of a genetic disorder in the family.

Study funding/competing interest(s): This study was funded by ZonMw (70-71300-98-106). None of the authors have any competing interests to declare.

Trial registration number: NCT02149485 .

Publication types

• Multicenter Study
• Research Support, Non-U.S. Gov't
• Analysis of Variance
• Case-Control Studies
• Child Development / physiology*
• Child, Preschool
• Cognition / physiology*
• Executive Function / physiology*
• Fertilization in Vitro / statistics & numerical data
• Intelligence Tests
• Memory and Learning Tests
• Memory, Short-Term / physiology*
• Preimplantation Diagnosis*
• Surveys and Questionnaires

Associated data

• ClinicalTrials.gov/NCT02149485

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5 year old Child case study.

Child Case Study B

Case B is a five-year-old child who is in Reception class and has been attending Hague primary school since Nursery. And has a free school meal He was born in England his parents are separated and visits dad on weekends he has a varied home life goes out and about and obviously talks to his mother about what he has seen and done.

Using a language development chart case B is age appropriate he is able to do many of the things expected of a 66 months (5yearold) such as he is able to count to ten and will know tomorrow, today, yesterday, also be able describe common objects in terms of use (hat shoe chair) and know his name. Using Piaget s stages of cognitive development case B is at the intuitive phase. Expected of a child between 4 and 7years He plays with    another child, he remembers names of people .He can follow the rules of a game. Case B is working within the foundation stage stepping stones levels with some areas of his development already reaching early learning goals.

He has good listening skills and is confident when speaking to small and large groups of children he participates well in discussions in class he has learnt his letter sounds and is using this knowledge to read and write simple words. Case B has good early number skills he recognise numbers up to 20 and is starting to order these numbers correctly he can find one more or less than a number and is beginning to use the vocabulary involved in adding and subtracting.

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With his personal social and emotional development case B becomes very involved in activities persists on at an activity of his choosing and takes appropriate risks also interested and excited to learn is confident to try new activities, initiate ideas and speak in a familiar group during our class topic of Judaism he showed interest and desire in cultural and religious differences he also forms good relationships with adults and peers works as part of a group or class taking turns and sharing fairly he is able  to express needs and feelings in an appropriate way e.g. will say if he or someone else is hurt. Understands what is right and wrong i.e. aware of reception class rules.

Having observed him during PE and outside learning he is able to move freely with enjoyment and confidence in a variety of ways he is able to adjust speed or direction to avoid obstacles is able control large and small scale movements case B can use a range of small and large equipment e.g. small world play (little sea creatures) large construction (building blocks) case B learns through talk and connecting ideas explaining what is happening never afraid to ask questions.  Is developing pencil control but will benefit from lots of practice in writing and drawing.

Behaviour Strategies

Of course we have to remind him about what you have to do when the teacher is talking i.e. are you sitting up straight have you switched your eyes and ears on. Also we do a lot of proximity praising e.g. where we praise the child sitting next to him so he notices and copies the other child who is focusing on the teacher also being his carpet partner e.g. positioning myself next to him.

For good behaviour we have stickers case B can receive a sticker for completing his homework and working hard in class we also have star of the week if case B has been working extra hard all week teacher or teaching assistant can choose him as star of the .week  his photograph goes up on the wall. He will also receive a sticker in good behaviour assembly.

For unacceptable behaviour we have the three steps 1 st  step remind him of our class rules 2 nd  step we talk to him 3rd step   sits at table by him self away from the rest of the class. He can join the rest of the class when he is ready to be sensible.

Self Esteem

 Self esteem isn’t quite the same thing as confidence what is it?  The word esteem comes from a Latin word which means ‘to estimate’ so self esteem is how you estimate yourself.

 When introducing new things to Case B, we need to show him how to do an activity once and leave him to it. He will then come back to us and say ‘look I’ve done it’. We will then say well done. When he is handing out fruits during break time’, he will help the other children to peel their fruits. I.e. Satsuma’s and bananas we give him a. sticker for his sticker chart! For handling out the fruit so nicely and helping the other children, you can see the effect of praises, by the smile on his face. If he has done a good piece of work a postcard will be sent home, to the parent/carer. Before this, we explain to him why the postcard is being sent home. .

How we record progress

 We use progress books which are records that go home to parents to see before their child’s report day. Also foundation stage stepping stones levels these are both formal. We record progress in formally using feed back sheets also verbal feed back to class teacher.

Confidentiality

  Parent/cares can ask to see any thing written about their child .we should remember to keep  all information written or verbal about a child or a family that is passed between staff and those adults who are directly involved in a situation is confidential. Finally, he likes to take part in plays and acting them out in assembly he is rarely absent from school infact he has only been absent six days since starting in September 2005. He is a confident member of reception class and pleasure to work with.

Document Details

• Word Count 997
• Page Count 2
• Level University Degree
• Subject Social studies

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Study reveals most crucial years for child development

A new study has found parents are deeply concerned about their child’s academic and character development before they turn 5 years old.

The poll of 2,000 parents of children ages five and younger found 59% are concerned about their children’s academic and character development, citing concerns about whether their children will learn to play fairly and cooperate with others (50%), communicate well with others (49%) and be able to appropriately express themselves (47%). 

Parents listed several challenges they face to support their children’s development, including creating a routine (38%), teaching positive behaviors (30%), planning activities (25%), providing a consistent environment (23%) and building early literacy and math skills (23%). 

Commissioned by Primrose Schools and conducted by OnePoll, the study revealed a large majority (98%) of parents understand the importance the first five years of life play in a child’s development and future successes.

According to results, parents shared the earliest ages they believed their children could learn important skills and concepts.

For example, some parents believe their children should be able to interact with peers, learn language skills and learn social skills by age two.

By age three, parents believe their children should be able to start benefitting from formal learning activities and grasp academic concepts. Over half of parents surveyed (55%) said their concerns about their children’s development are worrisome enough to keep them up at night. 

“In the first five years of a child’s life, parents have an opportunity to maximize the power and potential of this critical time,” said Dr. Amy Jackson, chief early learning strategy officer at Primrose Schools. “It’s clear that parents want their children to learn these important academic and character development skills while their brains are most receptive to learning, but we know many worry about finding the right approach.”

When it comes to support systems for parents, 82% of parents consider preschools to be a part of their support systems — alongside immediate family (88%), extended family (37%) and friends (33%). 

When looking at preschools, parents said they look for a place that offers a safe place where their child can feel like they belong (28%), qualified teachers invested in their child’s development (24%) and kindergarten readiness (15%).

When parents are not consulting their support system, 73% will at least occasionally consult the internet for parenting advice, instead. However, 43% said they feel “overwhelmed” by what they find online.

“Support systems are important for new parents, especially during their child’s first five years of life,” continued Dr. Jackson. “The experiences and connections children have in these early years will shape their academic, physical and social-emotional development — ultimately forming their foundation for learning and who they become.” 

TOP 10 SKILLS PARENTS WANT THEIR CHILDREN TO LEARN BEFORE KINDERGARTEN

• Naming colors - 76%
• Sharing - 72%
• Verbal skills - 72%
• Numbers and shapes - 72%
• The alphabet - 67%
• Creativity - 60%
• Self-control and cooperation - 54%
• Appropriate self-expression - 54%
• Self-confidence - 54% Compassion - 51%

Survey methodology:

This random double-opt-in survey of 2,000 American parents of children aged 0 to 5 was commissioned by Primrose Schools between Feb 22 and Feb 26, 2024. It was conducted by market research company OnePoll , whose team members are members of the Market Research Society and have corporate membership to the American Association for Public Opinion Research ( AAPOR ) and the European Society for Opinion and Marketing Research ( ESOMAR ).

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