Development During Middle Childhood The Years From Six to Twelve (1984) / Chapter Skim
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2 The Biological Substrate and Physical Health in Middle Childhood
2 The Biological Substrate and Physical Health in Middle Childhood
Pages 24-69
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From page 24... ...
Accidents accounted for half the deaths of children ages 5-14 in the United States in 1978, and more than 50 percent of them were related to motor vehicles (Bureau of the Census, 1982~. Multiple risk factors for the most common adult diseases have been shown to include a number of behaviors whose antecedents are germinated, if not sprouted, during middle childhood.
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From page 25... ...
THE BIOLOGICAL SUBSTRATE Physical Maturation Despite significant individual differences, the rate of increase in stature during middle childhood is generally similar and regular until the onset of puberty. Skeletal maturity, as measured by bone age, is the most useful biological indicator of overall physiologic maturation.
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From page 26... ...
The reasons for this secular trend are not well understood. The reduction of such growth-retarding factors as poor nutrition and chronic illness has been cited most often, and recently documented trends toward a later age of menarche in Bangladesh appear to support this hypothesis (Chow~hury et al., 1978~.
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From page 27... ...
The bulk of our knowledge regarding the process of neuromaturation comes from gross and microscopic anatomical studies that have demonstrated the highly regulated progression of cell proliferation, migration, and differentiation that characterizes the early development of the central nervous system in a wide variety of animal species. The relatively invariant timing of this process and the intricate coordination of its multiple interacting cellular systems strongly supports the assumption that early neuromaturation is largely controlled by a genetically determined regulatory system.
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From page 28... ...
Hormonal influences provide a classic example of this latter activity. Hormonal Influences Hormonal influences on the central nervous system have been studied in a wide variety of animal species.
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From page 29... ...
Despite the limitations of available data, a substantial body of evidence suggests that gonadal hormones, gonadotropins, and adrenal hormones influence and are affected by social interactions among groups of experimental animals and may play an important role in the regulation of human social behavior (Lloyd, 1975; Rose et al., 1971~. Future research in this area will demand sophisticated multidisciplinary collaboration in order to adequately investigate levels of interaction between neurohormonal regulation and the social-emotional milieu.
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From page 30... ...
The contribution of these hormones to specific patterns of reaction and adaptation to social pressures and stress, however, remains to be elucidated and may ultimately provide critical insight into individual differences in resilience displayed by school-age children. Possible implications of these findings for health in middle childhood are discussed later in this chapter.
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From page 31... ...
has renewed interest in the role of serotonin in the development of the central nervous system without clarifying the pathophysiology of autistic behavior. The continuing search for the neurochemical bases of attention'6eficit disorders is particularly illustrative of the frustrations that have plagued investigators in this area.
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From page 32... ...
Although all learning is essentially mediated through brain function, the relevance of most available neuroscientific data for the practical management of school dysfunction is currently unclear. Repeated attempts to reliably link atypical electroencephalographic patterns and clinical signs of neuromaturational delay (so-called soft signs)
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From page 33... ...
It is also clearly reflected in the ancient Chinese concepts of yin and yang (WalInofer and Von Rottauscher, 1972) and in the traditional health beliefs of many native American groups who believe that physical and mental health are a reflection of one's harmony with the earth (Primeaux, 1977~.
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From page 34... ...
Cultural Influences Physical illness implies a state of being that is undesirable, uncomfortable, or damaging in relation to the values and usual life situations characteristic of a given ecocultural niche. Thus, individual differences in perceptions, experiences, and coping patterns are significantly modified by systematic variations in the systems of meaning used to explain the phenomenon of sickness (Fabrega, 1972; Kleinman et al., 1978; Spector, 1979~.
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From page 35... ...
Its boundaries, however, have become increasingly apparent, especially with regard to the salient health issues of middle childhood. A critical examination of the biomedical model, in contrast to the proposed enhancements of a biopsychosocial orientation, provides a method for taking a broad look at the physical health needs of school-age children.
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From page 36... ...
The Biopsychosocial Orientation The biopsychosocial approach provides a "framework within which can be conceptualized and related, as natural systems, all the levels of organization pertinent to health and disease from subatomic particles through molecules, cells, tissues, organs, organ systems, the person, the family, the community, the culture, and ultimately the biosphere" (Engel, 1979:266~. In the tradition of viewing health as a state of relative balance and harmony, it provides a vehicle for analyzing the integrity of each component level as well as their reciprocal interactions within a dynamic hierarchical system that extends from molecule to culture.
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From page 37... ...
The potential richness of a biopsychosocial orientation is most compelling. Although the availability of sophisticated analytic techniques for the entire hierarchy as well as for each of its component levels is highly variable, the mode!
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From page 38... ...
. Generally speaking, these studies demonstrate that kindergarten children display magical thinking, that fourthgrade children believe that illness is caused by germs without any insight into the issue of host susceptibility, and that eighth-grade children understand the concept of multiple interacting mechanisms for etiology and treatment.
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From page 39... ...
Although available data regarding health (as opposed to illness) concepts are limited and largely descriptive and further study in this area is clearly needed it would appear reasonable to hypothesize that children's ideas about health are influenced in large part by their level of cognitive development.
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(1980) studied the health beliefs of 249 children ages 6-17 and found health issues to be a meaningful concern for the majority, regardless of age, sex, or participation in risk-taking behaviors.
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Greater understanding of the developmental unfolding of these issues will be particularly important in communicating more appropriately with school-age children, thereby enhancing our ability to meet the challenges of health promotion, education, and management of chronic illnesses and disabling conditions during this dynamic period of expanding self-understanding and self-regulation. PHYSICAL HEALTH AND THE EMERGING SENSE OF SELF The school-age years mark an important period of growing awareness of oneself.
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From page 42... ...
Whether inactivity is an independent risk factor or whether it has multiple effects through interactions with other variables remains to be determined. Studies of serum lipid profiles in adults, for example, have demonstrated greater risk for coronary artery disease when low-density lipoproteins (LDL-cholesterol)
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From page 43... ...
In addition, although the process of atherosclerosis begins in early childhood and continues throughout the life cycle, it is not at all clear whether physical fitness during childhood has any effect on the rate of decline of cardiovascular function or the risk of coronary artery disease in later life. That physical activity during the adult years does appear to be important for cardiovascular health, however, highlights the importance of reinforcing it in the emerging life-style of the schoolmate child.
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From page 44... ...
specifically examined the issue of sex differences and subsequently endorsed coeducational sports programs in the prepubescent years, noting that young girls can effectively compete against boys in any sport when matched for weight, skills, size, and physical maturation. Current knowledge regarding physical activity in childhood is limited.
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From page 45... ...
Ten percent of the advertisements were for quick meals and eating places, and sugar cereals outnumbered unsugared cereals by a ratio of 3 to ~ (Barcus, 1975; National Science Foundation, 19771. Children ages 5-10 have been noted to attend more closely to commercials than those ages 11-12 (Ward et al., 1972)
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From page 46... ...
Although definitions of obesity vary, a weight that is 20 percent or more above average for a given age, height, and gender is a commonly accepted standard (Van Itallie, 19791. Despite the failure to elucidate the role of obesity as an independent risk factor for cardiovascular disease in adult life, obesity is closely associated with a number of well-documented vuInerabilities, including hypertension, hypercholesterolemia, and diabetes mellitus (Hamburg et al., 1982~.
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From page 47... ...
The central importance of two major lifestyle issues in its pathogenesis, eating patterns and activity level, suggests that successful intervention in the school' age years will contribute to improved health in adult life. The validity of this hypothesis, however, remains to be documented.
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From page 48... ...
Suggestions that immediate and short-term risks be emphasized have not consistently led to a more effective impact on smoking by children (Bland et al., 1975; Bynner, 1970~. The relevance of these findings for the design and implementation of health education programs for preadolescents is clear.
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From page 49... ...
observed that "about one child in 10 will experience one or more chronic illnesses by the age of 15 and up to 30 percent of these children may be expected to be handicapped by secondary social and psychological maladjustments" (p.
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From page 50... ...
Questions regarding the impact of childhood chronic illness on healthy siblings have received increased attention in recent years. Although some studies have reported positive effects, such as increased understanding of problems and favorable responses to increased responsibilities (Caldwell and Guze, 1960; Hunt, 1973)
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From page 51... ...
These social and biological differences raise a fundamental theoretical question for the field of child development: do some handicapped children develop according to a healthy logic of their own? By ignoring this question developmentalists more than imperil the value of their research; they run the risk of sometimes perpetuating the traditional deviance analysis of disability in a more subtle and more socially acceptable form.
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From page 52... ...
Moreover, for children with chronic impairments, the impact of diminished physical health may exert a pervasive influence on the developmental process. This chapter has provided an overview of current knowledge regarding a selection of physical health issues for school-age children.
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From page 53... ...
While some investigators have suggested that basic values and perceptions regarding health and illness are fairly uniform among Westem cultures, others have highlighted the importance of subgroup differences related to a number of demographic variables (Gochman and Sheiham, 1978; Wright, 1982~. Several observers have characterized health beliefs as highly resistant to modification; others have examined the potent influences of such agents of change as parents and television.
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From page 54... ...
Practically speaking, we can neither raise health-promoting consciousness nor comprehensively manage persistent illnesses in school-age children until we can leam to speak and understand their language. The Enigma of Resilience and Vulnerability Individual differences in susceptibility to physical as well as psychiatric disease have been acknowledged clinically for a long time, and attempts to elucidate the mechanisms for these differences have been undertaken by both biomedical and social scientists.
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From page 55... ...
Many biological risk factors for mild mental retardation, such as malnutrition and increased body lead burden, are more prevalent in lower socioeconomic classes (Shonkoff, 1982~. For those interested in the nature-nurture dynamics of resilience and vulnerability regarding illness or disability in school-age children, efforts might be directed toward the elucidation of psychosocial protective factors
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From page 56... ...
Studies of their impact on the physical health of school-age children will considerably expand our knowledge of human adaptation. Whither Health Education, The need for effective health education for school-age children is universally accepted.
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From page 57... ...
SUMMARY Physical health in middle childhood is intimately related to interactions among a child's biological function, socioeconomic environment, and the evolution of his or her personal lifestyle. As such, it is determined by physiological mechanisms as well as the imperatives of the ecocultural niche.
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From page 58... ...
1981 The contribution of school health education to community health promotion: What can we reasonably expect? American Journal of Public Health 71:1384-1391.
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Health Education Monographs 4:377-398. Berenson, G., Frank, G., Hunter, S., Srinivasan, S., Voors, A., and Webber, L
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From page 60... ...
1978 The child in the sick role: Contributions of age, sex, parental status, and parental values. Journal of Health and Social Behavior 19:35-51.
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1971 Some correlates of children's health beliefs and potential health behavior. Journal of Health and Social Behavior 12: 148-154.
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1980 The state of school heart health education: A review of the literature. Health Education Quarterly 7:298-320.
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Proceedings of the Royal Society of Experimental Biology and Medicine 137:19. 1975 Social behavior and hormones.
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From page 64... ...
American Journal of Orthopsychiatry 47:388-395. Mattson, A
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From page 65... ...
1978 Children's ideas on the origin of illness. Health Education Journal 9:6.
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From page 66... ...
1980 Health beliefs of the school-aged child and their relationship to risk taking behaviors. luternational Journal of Health Education 23(4)
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From page 67... ...
1 978 Introduction to risk factors in coronary artery disease.
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From page 68... ...
1980 Children's health beliefs and acceptance of a dental preventive activity. Journal of Health and Social Behavior 21:59-74.
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From page 69... ...
BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH Zborowski, M 1952 Cultural components in responses to pain.
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