chapter 8 the health and individual human development … · the health and individual human...

The health and individual human development of Australia’s children

CHAPTEr 8

WHY IS THIS IMPOrTANT?Development that occurs during the infancy and childhood stages builds on the foundations laid down in the prenatal stage and plays a significant role in the development that will occur across the rest of the lifespan. Maintaining adequate health is a key factor in achieving optimal development and vice versa. Having an understanding of the health and development that occurs during these stages of the lifespan allows informed decisions to be made for the promotion of optimal wellbeing among children.

KEY KNOWLEDGE

2.1 physical, social, emotional and intellectual development from birth to late childhood (pages 235–43)

2.2 the principles of individual human development (pages 232–4)

2.3 the health status of Australia’s children (pages 244–51).

KEY SKILLS

• describe the characteristics of individual human development from birth to late childhood

• interpret data on the health status of Australia’s children.

FIgUrE 8.1 Childhood is a time of signifi cant individual human development, infl uenced by a range of factors.

264 UNIT 2 • Individual human development and health issues

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KEY TERM DEFINITIONSattention deficit hyperactivity disorder (ADHD) a condition characterised by a pattern of impulsiveness, inattention and overactivityautoimmune disease a disease characterised by the immune system attacking and destroying healthy body cellscephalocaudal development development that occurs from the head downwardschild mortality deaths that occur between the first birthday and 14 years of agecolostrum a concentrated form of breastmilk that is also rich in antibodies. Colostrum is produced for the first few days after birth.empathy the ability to see events from another person’s point of view and to understand the emotions of othersinfant mortality deaths that occur between birth and the first birthdaymeconium a dark, sticky, tar-like substance that is excreted through the bowels shortly after birth. It includes things ingested while in the uterus, such as mucous, bile and water.neonate describes an infant in the first 28 days after birthobject permanence an awareness that objects continue to exist even when they are out of sightperinatal conditions conditions causing death in the first 28 days of life (e.g. due to complications of the placenta or umbilical cord, infections, birth injury, asphyxia and problems relating to premature births)proximodistal development development that occurs from the core or centre of the body outwards (towards the extremities)


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8.1 Principles of individual human development

KEY CONCEPT Understanding the principles of individual human development

Development during the prenatal, infancy and childhood stages of the lifespan establishes a base that will be built upon during youth and adulthood. As explored in chapter 6, the prenatal stage is the fastest period of growth of all lifespan stages and is characterised by the development of body systems that will allow the foetus to survive outside its mother’s uterus after birth. Infancy and childhood are marked by significant developmental milestones such as learning to walk, talk, read, write and interact with others. Understanding the development that occurs during these lifespan stages facilitates analysis of the effects that such development has on the individual, both now and in the future.

Development in humans, although occurring at different times and at different rates, has some similarities for all people. A number of principles govern the development that humans experience and many of these are particularly evident in the infancy and childhood stages. Any example of development may display a number of the five principles discussed in the following sections.

1. Development occurs in a predictable and orderly way

Many aspects of development occur in predictable, orderly patterns. From observing many individuals over long periods of time, experts can roughly predict when certain milestones should occur. For example, most infants learn to walk at 9 to 15 months.

Many aspects of human development require other skills in order to occur. For example, if a child is to put a sentence together, they need to be able to manipulate their vocal chords, know the meanings of words and articulate the sentence so it makes sense. If any of these prior skills are not present, then the child will not be able to make a sentence that makes sense.

2. Development is continualDevelopment starts with conception and ends with death. All skills learnt and milestones achieved between these two events form part of development. The foundations laid in one stage (e.g. learning to write in early childhood) will be built upon in the next (figure 8.2). The decline in body systems and memory over time are also a part of this principle, indicating that humans never stop developing.

3. There are individual variations in the rate and timing of development

Many factors influence development such as hormones, genetics, family interaction, nutrition, physical activity levels and state of health. As a result, there will be variations in when milestones are reached and how developed one person is compared to another person of the same age. These factors also influence how quickly it takes a person to move through a developmental stage (figure 8.3).

FIgUrE 8.2 Writing is an example of a skill that, although achieved in the young years, will be refined over time as the individual builds on those initial skills.

FIgUrE 8.3 The rate and timing of development are different for all people.

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The health and individual human development of Australia’s children • CHAPTEr 8 267


4. Development follows predictable patterns

Growth and motor skill development follow patterns that are observable in all people. The cephalocaudal and proximodistal patterns of development are particularly evident during the prenatal, infant and childhood stages of the lifespan.

Cephalocaudal developmentCephalocaudal development refers to growth and development that occurs from the head down. An infant will gain control over their neck muscles first, which allows them to hold their head steady. Control over their shoulder muscles usually follows, which allows them to roll over. Finally, control over the muscles in their torso allows them to sit. The size of the head of an infant in relation to the rest of the body also illustrates this pattern of development (figure 8.4).

FIgUrE 8.4 The cephalocaudal pattern of development is shown in the changing proportions of the human body over time.

Proximodistal developmentProximodistal development occurs from the centre or core of the body in an outward direction. An example is the way that the spine develops first in the uterus, followed by the extremities and finally the fingers and toes (figure 8.5). In motor development, an infant reaches for a toy by using shoulder and torso rotation in order to move the hand closer to the object. In childhood, the elbow and wrist are responsible for the main movements.

Upper limb

Heart prominent

Developing head

Tail

Lower limb

Upper limbNoseEye

Umbilical cord

Lower limb

Ear

FIgUrE 8.5 The proximodistal pattern of development is evident in these 32- and 52-day-old embryos. The spine is prominent but the buds that will become the arms and legs are still underdeveloped.

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8.1 Principles of individual human development

5. Development proceeds from the simple to the complex

Thought processes and motor skill development go from simple to complex. Once the simple aspects have been attained, they can be built upon to make the skills more complex. For example, infants think in a concrete way but, as they move through the childhood and youth stages, abstract thought develops. A child usually learns to crawl before walking and ultimately running.

Case study

Spare the comparisonsComparing your kids with other children is a recipe for disaster. By Michael Grose.

Do you ever compare your child’s behaviour or progress with other children of the same age? If so, you are causing stress for yourself and your child. Comparing your child with others is an ultimately useless activity.

But it’s hard to resist, as we tend to assess our progress in any area of life by checking out how we compare with our peers.

When you were a child in school you probably compared yourself to your schoolmates. Your teachers may not have graded you, but you knew who the smart kids were and where you ranked in the pecking order.

Now that you have kids of your own, do you still keep an eye on your peers? Do you use the progress and behaviour of their kids as benchmarks to help you assess your own performance as well as your child’s progress? This is okay, as long as we don’t lose sight of three important aspects.

1. Kids develop at different rates. There are early developers, slow bloomers and steady-as-you-go kids in every group, so comparing your child’s results or performance can be completely unrealistic.

What this means for you: focus on your child’s improvement and effort and use your child’s results as the benchmark for his or her progress and development. ‘Your spelling is better today than it was a few days, weeks or months ago.’

2. Kids have different talents, interests and strengths. Okay, your eight-year-old may not be able to hit a tennis ball with Rafael Nadal, even though

your neighbour’s child can. Avoid comparing the two as your child may not care about tennis anyway.

What this means for you: help your child identify his or her own talents and interests. Recognise that his or her strengths and interests may be completely different to those of his or her peers and siblings.

3. Parents can have unrealistic expectations for their kids. We all have hopes and dreams for our kids, but they may not be in line with their interests and talents.

What this means for you: keep your expectations for success in line with their abilities and interests. If expectations are too high, kids will give up. If they are too low, they will usually meet them!

Parents should take pride in their children’s performance at school, sport or leisure activities. You should also celebrate their achievements and milestones, such as taking their first steps, scoring their first goal in a game or getting great marks at school.

However, you shouldn’t have too much personal stake in your children’s success or in their milestones, as this close association makes it hard to separate yourself from your kids. It also causes you to play the ‘compare and compete game’. By comparing kids you can put pressure on yourself and them to perform for the wrong reasons.

And certainly, your self-esteem as a parent should not be explicitly linked to your children’s behaviour or developmental levels.

‘You are not your child’ is a challenging but essential parental concept to live by. Doing so takes real maturity and altruism, but it is the absolute foundation of that powerful thing known as unconditional love.

Source: Sunday Herald Sun, 26 April 2009.

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Case study review1 Why is it not useful for parents to compare their children to other children?2 How could a child’s interests influence how fast they develop?3 How could performing ‘for the wrong reasons’ influence future development?

TEST your knowledge 1 Explain what each of the following principles refers

to and provide examples for each:(a) predictable and orderly development(b) continual development(c) variations in the rate and timing of development(d) the cephalocaudal and proximodistal patterns of

development(e) simple to complex development.

APPLY your knowledge 2 Consider the following developmental milestones

and explain how three principles of development are evident in each one:(a) learning to write(b) learning to throw a ball(c) a baby learning to sit up.

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8.2 Development during infancy

KEY CONCEPT Understanding physical, social, emotional and intellectual development during infancy

Infancy is the first stage of the lifespan after birth and lasts until the second birthday. Newborns are relatively helpless (figure 8.6). They cannot feed, maintain body warmth, or stay clean or hydrated without the assistance of others. With interaction and adequate care, the infant will begin to show significant gains in all areas of development. For the first 28 days after birth, the infant is referred to as a neonate and undergoes significant changes or adaptations that help it to survive outside the uterus.

Adaptations of the neonateIn the uterus, the foetus relies on its mother for the provision of oxygen, nutrients and warmth and for the excretion of wastes. After birth, the infant must adapt to the outside environment and carry out many of these bodily functions itself, although it is still heavily reliant on help from parents or other caregivers.

In the uterus, the lungs of the foetus are filled with fluid and play no part in circulation. Instead of travelling to the lungs, the blood must travel to the placenta to become oxygenated. The foetal heart has two shunts, called the foramen ovale, that are like valves that allow blood to travel between the chambers of the heart and cause the blood to be redirected from the lungs to the placenta. After birth, the foramen ovale close over and allow the blood to travel to the lungs to become oxygenated. Although the foetus may display a breathing-like motion in the uterus, there is only amniotic fluid in its immediate environment. As a result, its lungs are filled with fluid. Once outside the uterus, the infant will take its first breath, usually within 10 seconds after birth. This prompts the bloodstream to absorb the fluid from the lungs, so the lungs will fill with air for the first time. A special substance (called pulmonary surfactant) allows the lungs to expand when inhaling and prevents them from collapsing when exhaling. Breathing may be shallow and irregular for minutes or hours before it becomes more rhythmic.

During prenatal development, the foetus receives its nutrients from the mother. After birth, the infant has some nutrients stored but relies on regular feeding in order to grow and develop properly. The mother’s breast tissue produces a substance called colostrum for the first few days after birth and then regular breastmilk after that.

Colostrum is a concentrated form of breastmilk that is also rich in antibodies, which boosts the infant’s immune function.

At birth, the excretory organs — which include the kidneys, liver and bowel — become functional and capable of eliminating waste products. For the first few days after birth, meconium is passed through the bowels rather than normal faeces. Meconium is a dark, sticky, tar-like substance that includes things ingested whilst in the uterus such as mucous, bile and water. Unlike later faeces, meconium is a thick liquid that does not have an odour.

The mother’s body temperature maintains the temperature of the foetus. After birth, temperature must be regulated in some other manner. Although they have fat stores that assist with temperature regulation, newborn infants are not capable of regulating their body temperature and rely on blankets, clothing, environmental heat and body heat from others in order to survive.

FIgUrE 8.6 The newborn is relatively helpless and relies on parents/caregivers for almost everything.

FIgUrE 8.7 The foetus relies on its mother for the provision of oxygen, nutrients and warmth while in the uterus.

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The APGAR testAPGAR is an acronym for Activity, Pulse, Grimace, Appearance and Respiration. Generally the first test given to newborns, the APGAR test is used to assess the infant’s adaptation to life outside the uterus. The test is usually administered twice, at one minute and at five minutes after birth. Judgements are made on the five aspects of the test and scores given accordingly (table 8.1).

An infant receiving a score of 7 or over one minute after birth is generally considered to have adapted successfully to life outside the uterus. If the score is below 7 or after five minutes has not reached 7 (or if there are other concerns), medical attention may be required.

TAbLE 8.1 The APGAR test is administered to newborns to assess their overall physical condition.

Score

APGAR sign 2 1 0

Activity (muscle tone) Active, spontaneous movement Arms and legs flexed with little movement

No movement, ‘floppy’ tone

Pulse (heart rate) Normal (above 100 beats per minute)

Below 100 beats per minute Absent (no pulse)

Grimace (responsiveness or ‘reflex irritability’)

Pulls away, sneezes or coughs with stimulation

Facial movement only (grimace) with stimulation

Absent (no response to stimulation)

Appearance (skin coloration) Normal colour all over (hands and feet are pink)

Normal colour (but hands and feet are bluish)

Bluish-grey or pale all over

Respiration (rate and effort of breathing)

Normal rate and effort, good cry Slow or irregular breathing, weak cry

Absent (no breathing)

Physical developmentPhysically, the infancy stage is the second fastest period of physical development in the lifespan, second only to the prenatal stage. Birth weight doubles by six months and triples by 12 months. Body proportions also start to change, reflecting the cephalocaudal pattern of development.

The senses continue to develop and, although vision is still largely blurry, the infant will soon begin to recognise familiar faces and sounds. Bones continue to ossify during infancy. By the first year, the infant can support its own weight.

Reflexes that are present at birth (e.g. the grasping reflex) are gradually replaced by controlled movements as motor skills develop. A newborn infant does not have much control over its body but will soon learn to lift its head and roll over. At around six months, infants start crawling. By the age of one, many infants can stand and walk. By age two, they can usually throw and kick a large ball.

Social developmentThe family is the most significant influence on social development at this stage of the lifespan. The infant is totally dependent on its parents or other caregivers, and will learn certain social skills by observing these people.

The infant begins to smile at around six weeks, and after around six months the infant will begin to recognise facial expressions of others, such as a smile or a frown.

FIgUrE 8.8 By their first year, many infants can support their own weight.

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8.2 Development during infancy

At around six months of age, the infant can enjoy basic games such as peekaboo. As infants develop, play forms an important part of social develop ment. They enjoy games and become increasingly responsive to them. Many social skills are learnt about sharing and taking turns through play. This may occur with siblings and parents at home, and also with other children at child-care or playgroups. Through experiences such as these, the infant also begins to learn culturally acceptable behaviours such as listening to parents and not hitting others. Social roles are also imitated such as pushing a pram with a doll in it (figure 8.9).

FIgUrE 8.9 Social roles are often learned by imitating others.

As language develops (intellectual develop ment), infants can interact better with those around them. They can generally speak a few words at around one year of age, and understand many more. This allows parents to more easily guide the social development of their infant.

Emotional developmentEmotional development also revolves around the family at this stage of the lifespan. One of the first signs of emotional development is when the hurt or distressed infant can be comforted by its caregivers.

Emotional attachment is formed with the caregivers within months and this helps the infant to feel secure, safe and loved. It also helps to build trust. The emotional bond between caregivers and the infant may be so strong that the infant may become distressed when held by a stranger or when a caregiver leaves the room. Fear may be shown when confronted by unfamiliar things such as a clown or a dog.

By eight months, the infant can express anger and happiness, and may become frustrated if interrupted in their activities (e.g. when playing games). This expression of frustration may result in tantrum-throwing in later months.

By 12 months, the infant becomes sensitive to approval from parents. It may become upset or distressed if approval is not gained.

Intellectual developmentFrom the time of birth, all senses are working (although they become more acute over time) and the baby is capable of learning. The senses are the means

FIgUrE 8.10 The level of intellectual development experienced during infancy contributes to the joy many infants get out of playing peekaboo.

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At around six months of age, the infant can enjoy basic games such as peekaboo. As infants develop, play forms an important part of social develop ment. They enjoy games and become increasingly responsive to them. Many social skills are learnt about sharing and taking turns through play. This may occur with siblings and parents at home, and also with other children at child-care or playgroups. Through experiences such as these, the infant also begins to learn culturally acceptable behaviours such as listening to parents and not hitting others. Social roles are also imitated such as pushing a pram with a doll in it (figure 8.9).

FIgUrE 8.9 Social roles are often learned by imitating others.

As language develops (intellectual develop ment), infants can interact better with those around them. They can generally speak a few words at around one year of age, and understand many more. This allows parents to more easily guide the social development of their infant.

Emotional developmentEmotional development also revolves around the family at this stage of the lifespan. One of the first signs of emotional development is when the hurt or distressed infant can be comforted by its caregivers.

Emotional attachment is formed with the caregivers within months and this helps the infant to feel secure, safe and loved. It also helps to build trust. The emotional bond between caregivers and the infant may be so strong that the infant may become distressed when held by a stranger or when a caregiver leaves the room. Fear may be shown when confronted by unfamiliar things such as a clown or a dog.

By eight months, the infant can express anger and happiness, and may become frustrated if interrupted in their activities (e.g. when playing games). This expression of frustration may result in tantrum-throwing in later months.

By 12 months, the infant becomes sensitive to approval from parents. It may become upset or distressed if approval is not gained.

Intellectual developmentFrom the time of birth, all senses are working (although they become more acute over time) and the baby is capable of learning. The senses are the means

FIgUrE 8.10 The level of intellectual development experienced during infancy contributes to the joy many infants get out of playing peekaboo.

by which the baby makes sense of the world around it. Many infants collect information around them by putting objects into their mouth. This behaviour will often change as the infant develops and starts to use its other senses.

Within months, the infant will recognise its name and will respond when called. Over time, this word–object association progresses and the infant will begin to recognise the names of favourite people, toys, other objects and basic colours.

Early infancy also signifies an emerging understanding of cause and effect. Infants will begin to associate certain actions with particular outcomes. For example, if they cry, they get attention. If they reach for someone, that person may pick them up. If they kick their legs around, their caregivers might play with them.

The attention span of an infant is short and may last only a matter of seconds. The infant may give extra attention to games and objects that it finds interesting, but only for very short periods of time.

In early infancy, an object that is out of sight no longer exists in the mind of the infant. So a toy that is placed in a cupboard no longer exists. As the infant develops intellectually, it begins to understand that, although an object cannot be seen, it still exists. This concept is known as object permanence.

By 18 months, the infant can imitate and pretend in play activities. By observing others, the infant learns a lot about the world around it. Infants may imitate talking on a phone or having a dinner party.

Language development is rapid during infancy. A three-month-old will make speech-like sounds (‘goo’ and ‘gaa’), and will be able to say a couple of basic words by the first birthday (‘dada’ or ‘mumma’). The development of language occurs very quickly after this point. By the end of infancy the individual can say around 150–300 words, although there is still confusion in context and pronunciation.

TEST your knowledge 1 When does the infancy stage of the lifespan begin

and end? 2 (a) Briefly describe the APGAR test.

(b) Explain why the test would be administered twice after birth.

3 (a) Describe the adaptations an infant must make after birth.

(b) Which adaptations is the neonate particularly dependent on others for?

4 Describe the pattern of growth during infancy. 5 List three characteristics for each type of

development during the infancy stage.

APPLY your knowledge 6 Using the concept of object permanence as the

basis of your answer, discuss why infants may particularly enjoy a game of peekaboo.

7 An infant scores 4 on the APGAR test one minute after birth and then scores 8 five minutes after birth. Discuss two adaptations of the neonate that may have contributed to this increase in APGAR score.

8 (a) Brainstorm a list of factors that might affect the development of an infant.

(b) For each factor, identify the area of human development concerned and the way it could impact on an infant’s growth.

9 Explain why the role of parents is particularly influential during infancy.

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8.3 Development during early childhood

KEY CONCEPT Understanding physical, social, emotional and intellectual development during early childhood

Early childhood lasts from the second birthday until six years of age, typically the preschool years. Although not long in years, significant development occurs during early childhood.

Physical developmentEarly childhood is characterised by slow and steady growth. Although the rate of growth is variable, height increases by around 6 centimetres per year and weight by around 2.5 kilograms per year. Bones continue to lengthen and ossify during early childhood, resulting in the increases in height experienced. Body proportions change during early childhood, and the limbs and torso become more proportionate to the head. Body-fat levels also decrease, giving the child a leaner body type. Children may begin to lose baby teeth as the permanent teeth begin to develop.

While muscle development slows during early childhood, motor skill development continues at a rapid rate. Gross motor skills increase and the walking style becomes more fluid and refined. The child can climb stairs but will still need to place both feet on each step until towards the end of early childhood. Kicking, catching and throwing skills also develop, and the child might learn how to skip. Coordination improves, allowing the child to pedal and steer a tricycle (figure 8.11). Fine motor skills progress, and the child can learn to manipulate zippers on clothing, hold crayons, use scissors and even tie shoelaces. As a result of these activities, left- or right-handedness starts to appear in certain activities.

Social developmentThe family remains the primary social contact during childhood and is responsible for many achievements in social development made by the child. The child will begin participating in a wider range of family routines such as attending social functions, eating at the table and helping with the shopping. Communication skills and acceptable social behaviours increase as a result of these experiences.

The child may attend a playgroup, kindergarten or a child-care centre, and this provides many opportunities to further develop social skills such as sharing and taking turns. As the child becomes accustomed to spending short periods of time away from the family, independence starts to develop. The child may start wanting to do things for themselves such as dressing or washing, although they may not be completely successful.

Behaviours such as eating with a knife and fork are established during early childhood but they will be refined over time. Children at this age like to be accepted by others and may behave in a way that brings attention to them. This can include showing off or performing for family and friends.

Play is still an important aspect of social development, although it is more advanced than in infancy (figure 8.12). Children may have a friend to play with and some will create an imaginary friend. Make-believe play might also be a part of the child’s playing patterns.

Emotional developmentEmotional development continues to occur at a rather fast pace during early childhood. The emotional development of a two-year-old is quite different from that of a six-year-old. A child will begin to develop a sense of empathy and may

FIgUrE 8.11 As children gain greater control over their body, more complex activities such as riding a tricycle become possible.

FIgUrE 8.12 Play takes many forms, and is a great way of increasing social development.

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care for people who are crying or upset. Yet their way of dealing with emotions is still in its early stages, and children may use physical violence to express their frustration. This is particularly common with other children or siblings. Play often gives children a way of expressing their feelings.

FIgUrE 8.13 Children often show pride in their achievements.

Children take pride in their achievements and may want to show them off to everyone. As a result of enjoying positive feedback from others, they may become jealous when another child receives attention.

Children begin to develop an identity that will continue to form for years to come. They learn to see themselves as being separate from others, and begin to associate certain things with themselves such as ownership of a toy.

Mood can change quickly during this stage as children often do not have the skills required to control their feelings. As a result, they can switch from being happy to being upset and then happy again in a very short period.

Intellectual developmentLearning new words and how to use language occurs fairly rapidly during this stage and is a key part of the child’s intellectual development. By the age of five, a child knows approximately 1500–2500 words.

As interest in the world around them increases, children begin to question many aspects of their environment. They ask parents or caregivers ‘why?’ and like to share their knowledge with others about colours, objects and animals.

As their attention span lengthens and knowledge of language increases, children can remember and follow basic instructions such as getting a toy from the bedroom, bringing it back to the lounge room and sitting in a designated place with it.

In the first years of early childhood, the child can classify objects based on one aspect such as colour. For example, they can separate orange blocks from green blocks, but find it more difficult to classify items according to multiple aspects such as colour and size. These more complex skills develop over time.

Children in this lifespan stage may learn to write basic letters and read basic books. They can also learn to count to 10 or 20, although this is often memorised

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8.3 Development during early childhood

without really understanding the formation of numbers. Abstract thought and prediction of the outcome of events is still difficult, and children are more comfortable thinking about objects they have already encountered.

TEST your knowledge 1 When does the early childhood stage of the lifespan

begin and end? 2 Describe the pattern of growth during the early

childhood stage. 3 List three characteristics for each of the following

types of development during the early childhood stage:(a) physical(b) social(c) emotional(d) intellectual.

APPLY your knowledge 4 Carolyn is four years old and lives in rural Victoria

with her mother, father and three older brothers. Her father runs their farm and her mother is a stay-at-home mother. Her brothers all go to school so, for most of the day, it is just Carolyn and her mother at home. Carolyn’s physical development has been very slow and her mother is worried because Carolyn is significantly smaller than other children her age. In order to assist with her social development, Carolyn’s mother takes her to a local playgroup once a week.(a) Describe the physical development Carolyn

would be experiencing at this stage of her life.(b) i. What is the average growth during this stage

of the lifespan? ii. Explain why it is important to use these

figures as averages only.(c) Identify the factors that may affect Carolyn’s

social development.(d) Explain ways that Carolyn’s slow physical

development might affect other areas of her development both in the short and long term.

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8.4 Development during late childhood

KEY CONCEPT Understanding physical, social, emotional and intellectual development during late childhood

Late childhood starts at the sixth birthday and continues until 12 years of age. During this time, the child will begin formal schooling while continuing to grow in a similar fashion to that experienced in early childhood.

Physical developmentPhysical development in late childhood is slow and steady, as it was in early childhood. Bones and muscles continue to grow in length and width. Height continues to increase by 5 to 6 centimetres per year, and weight increases by around 3 kilograms per year. Both sexes have similar body shapes until the onset of puberty, although males may be slightly larger. Body proportions continue to change as the head grows more slowly in comparison to the torso, arms and legs. A child in the late childhood stage has similar body proportions to an adult. Permanent teeth continue to develop and, by the end of late childhood, most permanent teeth will be present (figure 8.14).

The child gains greater control over their body, and motor skills develop as a result. As size and strength increase, children can perform more complex physical tasks such as playing basketball or participating in gymnastics. They have also had years to develop speed, agility and balance, and these skills are used in many physical activities such as games and sport. More complex gross motor skills such as skipping are also refined during this time. Fine motor skills are developed, and a child at the beginning of late childhood can write basic sentences. Writing might still be illegible at times. By the end of late childhood, writing becomes more legible and the writing style may also be more established.

Social developmentWith the commencement of formal schooling, most children experience a wide range of social situations during late childhood (figure 8.15). As a result, relationships with others change and the child will generally have numerous social contacts outside the family. Social skills such as sharing, communication and conflict resolution are further developed by this increase in social interaction.

Relationships at school are formed but are generally limited to members of the same sex. Skills such as cooperation and sharing are further developed as a result.

The child may still ‘show off’ in front of friends and family in order to gain attention. Children in this lifespan stage place increasing importance on being accepted by others (e.g. parents, teachers and peers) and may modify their behaviour in order to achieve approval.

Morals further develop during this time, and children acquire a greater sense of right and wrong as well as a better understanding of what is acceptable behaviour in their society. As a result, children can generally make an informed decision about right and wrong even in new situations. In contrast, knowledge of right and wrong in early childhood is largely limited to the instances of right and wrong that have been taught by parents or caregivers.

FIgUrE 8.14 Losing teeth is a normal part of childhood development.

FIgUrE 8.15 School provides many opportunities for social development.

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8.4 Development during late childhood

Emotional developmentEmotional development continues during late childhood, allowing children to control and recognise their emotions much better than they could in early childhood. As children develop empathy, they begin to be able to identify emotions in others.

Having better control of their emotions allows children to better function in a range of settings including school and at friends’ houses. Tantrums are generally not a common occurrence in this lifespan stage. Children also become more skilled at conveying emotions in words, and this may further increase control of their emotions.

Self-concept is largely established during this time although it will continue to be modified throughout life. Children will have formed ideas about what they are and are not good at (e.g. ‘I am a fast runner’ or ‘I am good at school’). As a result of these feelings, a child may become self-conscious in situations where they feel inadequate. This might occur around certain people, or in certain activities (e.g. playing soccer) if they feel they are not good at them.

Intellectual developmentMuch of a child’s intellectual development takes place at school. The brain continues to develop during late childhood and intellectual skills develop considerably. At the beginning of this stage, children can generally follow basic instructions and place objects in a logical order (e.g. from big to small) or arrange them according to numerical value. As they develop intellectually, the child can follow instructions with multiple steps and classify items based on multiple criteria. Problem-solving skills develop and the child begins to be able to focus on ideas rather than objects.

Knowledge of language increases, allowing the child to complete tasks such as pluralising words most of the time. By the age of six, children know 2000–3000 words. By the end of late childhood, they might know over 10 000 words. Reading skills also develop during this stage and, by the age of 12, the individual can read and make sense of age-appropriate books.

FIgUrE 8.16 A lot of intellectual development occurs through formal education.

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Children in late childhood generally have an increased interest in numbers and can perform basic mathematical problems. They can also apply logic to equations and understand that 3 × 6 will produce the same answer as 6 × 3.

Attention span increases and the child can sit quietly in class for longer periods of time, but concentration will still lapse after a matter of minutes. Long-term memory develops and the child can more accurately recall stories of things that happened in the past.

TEST your knowledge 1 When does the late childhood stage of the lifespan

begin and end? 2 Describe the pattern of growth during the late

childhood stage. 3 List three characteristics for each of the following

types of development during the late childhood stage:(a) physical(b) social(c) emotional(d) intellectual.

APPLY your knowledge 4 With a partner, brainstorm how inadequate

development in the prenatal, infant and early and late childhood stages of the lifespan could affect future development.

5 Discuss how emotional development is different between those in early and late childhood.

6 Explain how intellectual development could affect social development during late childhood.

7 Choose a game or toy commonly enjoyed by children and discuss how it might promote each type of development.

8 Create a game that may assist in the social development of children in the late childhood stage of the lifespan.

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8.5 The health status of Australia’s children: mortality

KEY CONCEPT Understanding the health status of Australia’s children — mortality

Australia’s children have the best health status in the country, and key health indicators place their health among the best in the world. Improvements are continually being made with regards to many health indicators and, as a result, most Australian children in today’s society can expect to live in good health. Unfortunately, there are some exceptions, particularly among indigenous Australians, those living in remote areas and those of low socioeconomic backgrounds. Infants and children in these groups experience higher mortality rates and greater risk of disease and injury. Many statistics present average fi gures for all Australian children and, as a result, may mask the challenges facing some groups within the country. When examining statistics, it is important to remember that not everyone enjoys the good health experienced by the majority.

Because many sources of health data group infants and children in their statistics, infant and child health will generally be considered together.

Infant mortality rates in Australia have fallen considerably over the past two decades (fi gure 8.18), but still account for half of all deaths in those aged under 20. Although the rate for all Australians is relatively low by international standards, the fi gures mask higher infant mortality rates for Indigenous Australians. In fact, for the last ten years, the infant mortality rate for Indigenous Australians has been around three times higher than the rest of the population. As infants get closer to their fi rst birthday, the risk of death decreases. Particular causes of death in the fi rst year of life are outlined in fi gure 8.17.

All other causes

Other signs, symptomsand abnormal findings

Sudden infantdeath syndrome (SIDS)

Congenital malformationsof the circulatory system

Foetus and newborn affected bymaternal complications ofpregnancy

Foetus and newborn affected bycomplications of placenta, cordand membranes

Disorders of short gestationand low birthweight

Other perinatalconditions

Other congenital anomalies

All other causes

Other signs, symptomsand abnormal findings

Congenital malformationsof the circulatory system

Other perinatalconditions

Other congenital anomalies

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Perinatal conditions (46%)

Congenital anomalies (26%)

Signs, symptoms and abnormalfindings (10%)

Other causes (18%)

FIgUrE 8.17 Leading causes of infant mortality, 2008–2010Source: AIHW, Making progress: the health, development and wellbeing of Australia’s children and young people, 2008.

MortalityMost cases of infant mortality arise from problems associated with the birth or pregnancy itself. As a result of this, a majority of infant deaths occur in the period directly prior to or after birth. As shown in fi gure 8.17, perinatal conditions and congenital abnormalities account for around 75 per cent of all infant deaths.

Much of the decrease in infant mortality has been due to reductions in deaths from sudden infant death syndrome (SIDS). SIDS is the unexplained death of an apparently healthy infant. It is only diagnosed when other causes are ruled out. Although the exact causes of SIDS are unknown, there are a number of determinants that increase the risk of SIDS for an infant. These include being male (70 per cent of SIDS deaths are usually males) or sleeping on the stomach. Figure 8.19 outlines the decline in deaths attributable to SIDS over time.

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Child mortality rates refer to deaths occurring in children between the ages of 1 and 14. Child mortality rates have also decreased in recent decades. Awareness of illness and advances in medicine and technology have been largely responsible for these decreases. Mortality rates decrease as children get older, as shown in table 8.2. Although overall rates have decreased, child mortality rates for Indigenous, rural and remote, and low socioeconomic backgrounds remain higher than the rest of the population.

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FIgUrE 8.19 Infant deaths from SIDS, 1986–2010.Source: Adapted from ABS data and AIHW 2012, A picture of Australia’s children 2012, cat. no. PHE 112, Canberra, p. 14.

The majority of causes of mortality for children are termed ‘injuries’ (which includes poisoning), and are accidental in nature (figure 8.20). Injuries account for more deaths in childhood than any other cause. Injuries include falls, drowning, suffocation, poisoning, transport accidents and burns. According to the Australian Institute of Health and Welfare in 2008–10, males were 60 per cent more likely than females to be hospitalised for injuries and Indigenous children were 50 per cent more likely to be hospitalised than other children.

Inadequate supervision can increase the risk of injury among children, but they are also more likely to sustain injuries than older people due to their level of development.

Because children are not as developed intellectually, they may lack knowledge of how to avoid injuries. Burns, drowning, bike accidents and falls may all occur at higher rates in children due to lower levels of intellectual development.

FIgUrE 8.18 Infant mortality rates for boys and girls over timeSource: Adapted from ABS data and AIHW 2012, A picture of Australia’s children 2012, cat. no. PHE 112, Canberra, pp. 13, 140.

TAbLE 8.2 Mortality rates of those aged 1–12 years

AgeDeath rate

(per 100 000 population)

1–4 years 19

5–12 years 10

Source: Based on data from AIHW 2012, A picture of Australia’s children 2012, cat. no. PHE 112, Canberra, p. 14.

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8.5 The health status of Australia’s children: mortality

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FIgUrE 8.20 Leading causes of mortality among children aged 1–14 years, 2008–2010 (per 100 000 population)Source: AIHW 2012, A picture of Australia’s children 2012, cat. no. PHE 112, Canberra, p. 15.

A child’s physical development can also increase their risk of certain injuries:• The size of an infant’s head in relation to their body makes it difficult for them

to support the weight of their head. This can prevent them from lifting their head out of water and increase the risk of drowning.

• Underdeveloped motor skills can also contribute to injuries such as bike accidents and falls, as children may be more likely to trip over when running.

• Bones in children are not completely developed and may therefore fracture more easily than the bones of an adult.The risk of most cancers increases with age, but cancer remains a leading

cause of death for children. Cancer is characterised by an uncontrolled growth of abnormal cells that, over time, can prevent normal body cells from carrying out their functions. Cancers found in children are often different in type and their response to treatment compared to cancers found in adults. Leukaemia and brain cancers are the most common cancers in children. Although incidence rates have remained constant, mortality rates due to cancer have decreased in children as a result of advancements in medical technology and treatment options. Table 8.3 outlines the changes in cancer deaths and mortality rates in children.

TAbLE 8.3 Cancer deaths among children aged 0–14 years, 1997–2010

Year 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Number 140 154 122 106 118 124 102 114 96 90 90 84 74 116

Deaths per 100 000 children

3.6 3.9 3.1 2.7 3.0 3.1 2.5 2.8 2.4 2.2 2.2 2.0 1.8 2.7

Source: AIHW 2012, A picture of Australia’s children 2012, cat. no. PHE 112, Canberra, p. 22.

Diseases of the nervous system are the third leading cause of childhood mortality. These conditions include a range of diseases that affect the brain, spinal cord and nerves. Examples include meningitis; cerebral palsy; swelling of the brain; and malformed brain, skull and spinal cord.

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TEST your knowledge 1 (a) Using figure 8.18, identify two trends in infant

mortality over time.(b) What reasons can you think of that would

account for these trends (give specific examples)?

2 (a) What is the leading category for cause of death in infants according to figure 8.17?

(b) What causes of death are included in this category?

3 (a) Describe how the mortality rates for children have changed over time.

(b) What factors could explain this trend? 4 (a) Using table 8.2, compare the mortality rates for

1–4 year olds and 5–12 year olds.(b) Suggest reasons for this difference.

5 According to figure 8.20, what are the leading causes of death for:(a) i. 1–4 year olds? ii. 5–9 year olds?(b) What factors could account for differences

between age groups?

6 Outline two causes that contribute to the relatively high rates of injury deaths among children.

7 (a) Graph the cancer mortality rates among children from 1997 to 2010.

(b) Explain the changes in cancer mortality rates over time and suggest possible reasons for this change.

APPLY your knowledge 8 Write a press release describing the health of

Australia’s children. In your article, include:(a) the overall level of health of children(b) mortality rates(c) leading causes of death.

9 Use the SIDS and Kids links in the Resources section of your eBookPLUS to find the weblink and questions for this activity.

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8.6 The health status of Australia’s children: morbidity

KEY CONCEPT Understanding the health status of Australia’s children — morbidity

MorbidityAlthough child mortality rates have decreased over time, there are many chronic conditions that impact on the health and human development of children. In the following section, various causes of both infant and child morbidity are examined.

Birth weight is a good indicator of the health of newborns. Those born with a low birth weight are more likely to experience ill-health and even premature death. This is largely due to the underdevelopment of organs and the immune system, making infants with a low birth weight more susceptible to infections, other diseases and organ malfunction.

A number of factors contribute to low birth weight, including exposure to teratogens, the mother’s age (being under 20 or over 40 increases the chances of low birth weight) and access to antenatal care. Although overall rates of low birth weight are relatively low in Australia, Indigenous mothers are about twice as likely to give birth to a low birth-weight baby compared with non-Indigenous mothers, as shown in table 8.4.

Many chronic conditions have become more common in childhood over recent decades. According to the AIHW in 2012, 37 per cent of those aged 1–14 had a long term or chronic condition. The most frequently reported chronic conditions among children are shown in figure 8.21.

Asthma

Hayfever and allergic rhinitis

Allergy (undefined)

Short sighted/myopia

Long sighted/hyperopia

Chronic sinusitis

Dermatitis and eczema

Behavioural and emotional problems

Anxiety-related problems

Problems of psychological development

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Note: Long-term condition is defined here as a condition that has lasted, or is expected to last, 6 months or more.

FIgUrE 8.21 Most frequently reported chronic conditions, 2012Source: AIHW, A picture of Australia’s children 2012, cat. no. PHE 167, Canberra, p. 17.

As children get older, they are more able to communicate their problems. Thus a child might have suffered from poor eyesight for years but would not have been able to tell anyone until they learnt to speak. This contributes to the increase in chronic conditions as children get older.

Asthma, obesity, diabetes and mental health problems all contribute considerably to the burden of disease among children.

TAbLE 8.4 Percentage of low birth weight babies by Indigenous status, 2012.

Low birth weight

Indigenous (%) 11.8

Non-Indigenous (%) 6.0

Rate ratio 1.9

Source: AIHW, Australia’s mothers and babies 2012, cat. no. PER 69, p. 78.

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AsthmaAustralia has one of the highest asthma rates in the world (figure 8.22). While the exact causes are not known, a number of factors contribute to its onset. These include:• maternal smoking• exposure to tobacco smoke• air pollution and exposure to other pollutants.

Asthma is characterised by a narrowing of the airways that results in wheezing, coughing and difficulty breathing. Although asthma does not cause many deaths in children, it is the most commonly reported chronic condition and one of the major reasons for hospitalisation among children.

ObesityRates of overweight and obesity among Australian children have doubled in recent years. Around one-quarter of all Australian children are now overweight or obese (ABS, 2014). This increase contributes to the development of other chronic conditions in children such as asthma and type 2 diabetes. Children who are overweight or obese are also more likely to be overweight or obese in adulthood, which puts them at further risk of health complications.

DiabetesThe rates of both type 1 and type 2 diabetes have increased in children over time, although type 1 cases still account for around 90 per cent of total diabetes cases among children. Both type 1 and type 2 diabetes are characterised by an inability of the body to effectively transport glucose into the cells to be used for energy. As a result, glucose stays in the bloodstream, which can lead to serious health problems such as kidney damage, heart disease, poor circulation and premature death.

Type 1 diabetes is generally diagnosed by the age of 15 and is a significant contributor to burden of disease among children. Type 1 diabetes is an autoimmune disease characterised by the destruction of the cells in the pancreas that produce insulin. Insulin is the hormone responsible for transporting glucose into cells, so a lack of insulin results in high blood-glucose levels. As those with type 1 diabetes do not produce insulin, it must be administered by injections or an insulin pump. Insulin is given when blood-glucose levels rise in order to allow glucose to be used by the cells.

The incidence of type 1 diabetes in children increased from 19 to 24 new cases per 100 000 population between 2000 and 2004. The incidence rate has been fairly stable since 2004 (figure 8.23).

While previously considered an older person’s disease, type 2 diabetes is becoming more common among Australian children, mostly as a result of increasing rates of obesity. Indigenous and Pacific Islander children, those who live in rural and remote areas, and those who live in socioeconomic disadvantage, are most likely to develop the condition. While the effect of type 2 diabetes is similar to

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FIgUrE 8.22 Parent-reported asthma rates in children aged 0–14 yearsSource: AIHW, A picture of Australia’s children 2012, cat. no. PHE 167, Canberra, p. 18.

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FIgUrE 8.23 The incidence of type 1 diabetes (0–14 year olds) per 100 000 populationSource: Adapted from ABS data and AIHW, A picture of Australia’s children 2012, cat. no. PHE 167, Canberra, p. 19.UNCORRECTED P

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that of type 1 diabetes, the causes are quite different. Those with type 2 diabetes experience insulin resistance. Insulin resistance is characterised by an inability of the body to use the insulin that is produced. Lifestyle changes to dietary and exercise patterns can often reduce the effects of diabetes. For others, medication and/or insulin may be required.

Mental health problemsMental health problems (sometimes referred to as psychological, emotional and behavioural disorders) are also a large contributor to the burden of disease in childhood, and the rates increase as children get older. Indigenous children, those in rural and remote areas, and those from low socioeconomic backgrounds experience higher rates of mental health problems than the rest of the population. According to the National Aboriginal and Torres Strait Islander Health Survey (ABS, 2006), around 13 per cent of Indigenous children experienced a mental or behavioural disorder compared to 8 per cent of the rest of the population. Access to health care is essential for the prevention, diagnosis and treatment of mental health problems, and these population groups generally have lower levels of access to affordable, appropriate care. This contributes to the higher rates of mental health problems experienced.

The impact of mental health problems will often depend on the type of condition experienced. Three common mental health issues among children include conduct problems, emotional symptoms and hyperactivity. The proportion of Victorian children at high or moderate risk of these issues in 2012 is shown in figure 8.24.

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FIgUrE 8.24 Percentage of Victorian children at high or moderate risk of selected mental health issues, 2012

Source: Adapted from Victorian Department of Education, School Entrant Health Questionnaire (SEHQ), www.education.vic.gov.au.

Conduct problems can be characterised by aggression, defiance, destruction of property and deceitfulness. Oppositional defiant disorder (ODD) is a childhood conduct problem characterised by constant disobedience and hostility. Around one in 10 children under the age of 12 years are thought to have ODD, with boys outnumbering girls by two to one. Conduct problems can impact on all areas of health and development. The child may not experience success at school, which can lead to feelings of low self-esteem. Or other children may not want to interact with the child, leading to poor social health and development.

Emotional symptoms refer to a range of negative emotions, such as sadness, fear and worries. Emotional symptoms can indicate an increased risk of conditions

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such as depression and anxiety. Emotional symptoms can contribute to low self-esteem and a lack of interest in normally enjoyable activities. Sleeping and eating patterns may be disrupted, which can contribute to low energy levels and thereby impact on all areas of health and development.

Hyperactivity relates to a range of behaviours, including restlessness, impulsiveness and lack of concentration. An example of a common hyperactivity disorder in Australia is attention deficit hyperactivity disorder (ADHD). ADHD is characterised by hyperactivity and an inability to maintain attention on a task. Some children with ADHD will display only a few signs and may not experience the same burden that other children with the condition face. Intellectual development may be affected if the child cannot concentrate on key concepts at school.

Dental healthDespite steady improvement from the 1970s onwards, dental health has been declining in children since the mid-1990s (figure 8.25).

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Poor dental health has a number of implications for health and development. Bacteria can travel from the mouth to the lungs and contribute to lung infections and other respiratory problems. Bacteria found in plaque may also increase the risk of heart disease and stroke, although this research is still continuing. Children with poor dental health may experience decreased self esteem, especially if their appearance is affected. School absences are common, as treatment is administered or infections take hold. This can impact on social health and intellectual development in particular. Physical development can be further hindered if the bones that support teeth are also affected.

HospitalisationsHospitalisation among children can have a range of impacts on the health and development, especially if hospital stays are long.

Rates of hospitalisation due to asthma are higher in childhood than other lifespan stages, although rates have decreased over time (figure 8.26). The average stay in hospital as a result of asthma is 2.6 days for children.

FIgUrE 8.25 Trends in decayed, missing or filled teeth in children, 1990–2010

Source: AIHW 2014, Oral health and dental care in Australia: key facts and figures trends 2014, cat. no. DEN 228, Canberra, p. 2.

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Injuries are another significant cause of hospitalisation for children. Among the different types of injuries, falls contributed the most to the hospitalisation of children (table 8.5). The amount of time spent in hospital as a result of injuries depends on the severity of the injury sustained, and can vary from hours to months.

TAbLE 8.5 Hospitalisations among children aged 1–14 years from selected injuries, 2011–12

Age group

1–4 5–9 10–14

Transport 67.2 133.1 237.2

Drowning and submersion 13.0 2.0 2.0

Accidental poisoning 112.6 11.9 10.7

Falls 678.2 700.5 626.4

Source: Pointer S 2014, Hospitalised injury in children and young people 2011–12, Injury research and statistics series no. 91, cat. no. INJCAT 167, Canberra: AIHW, p. 84.

Chronic conditions can impact on all areas of health and development. The child may miss out on experiences due to extended periods away from school and, as a result, may not develop as they otherwise would have. They may develop low self-esteem and be marginalised by their peers.

The impact on the sufferer will largely depend on the severity of the condition. Some conditions, such as mild asthma, may be easily managed and not interfere too much with normal functioning. However, a serious injury may result in extended periods of hospitalisation and significant rehabilitation after being discharged from hospital, affecting many aspects of life. Reducing the rate of these conditions is important to limit the negative impacts on the health and individual human development of children.

TEST your knowledge 1 (a) Briefly explain why low birth weight babies are

more likely to experience ill-health than those of normal body weight.

(b) List three factors that increase the chance of having a low birth weight baby.

2 (a) Identify the most frequently reported chronic condition according to figure 8.21.

(b) Approximately what percentage of children suffer from this condition?

FIgUrE 8.26 Hospitalisations among children aged 0–14 years from asthma

Source: AIHW 2013, Asthma hospitalisations in Australia 2010–11, cat. no. ACM 27, Canberra, p. 11.


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3 (a) Briefly describe the changes in the incidence of type 1 diabetes over time according to figure 8.23.

(b) Suggest reasons for this change. 4 Explain the term ‘insulin resistance’. 5 (a) Explain the difference between conduct

problems, emotional symptoms and hyperactivity.

(b) Explain how each issue identified in part (a) could impact on health or individual human development.

6 (a) What factors could lead to poor dental health?(b) Outline three possible impacts of poor dental

health in children.

APPLY your knowledge 7 Using figure 8.22, identify one difference in the

rates of asthma experienced by males and females. 8 Brainstorm reasons why birth weight would be a

good indicator of a newborn baby’s health.

9 Suggest reasons that may account for Indigenous women having higher rates of low birth weight babies.

10 Why do you think Australia has a high asthma rate compared to other countries?

11 Explain how asthma could affect physical, social and mental health of children.

12 Explain how asthma hospitalisation rates have changed over time according to figure 8.26.

13 (a) Discuss the differences in hospitalisation rates for those aged 0–4 compared to those aged 10–14 as a result of: i. transport ii. drowning and submersion iii. accidental poisoning.

(b) Using table 8.5, discuss how changes in individual human development may contribute to the differences discussed in part (a).

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KEY SKILLS The health and individual human development of Australia’s children

KEY SKILL Describe the characteristics of development from birth to late childhoodThe key requirement for this key skill is to be able to describe the development that occurs from birth until the 12th birthday. An understanding of the four types of development (physical, social, emotional and intellectual) and the changes that occur during the stages of infancy and early and late childhood is essential.

Consider the following example, which is a discussion of the development that would be taking place for Juni, a six-year-old who is attending primary school.Physical development:❶

At Juni’s stage of the lifespan, growth would be slow and steady. Fine and gross motor skills would continue to develop.❷

Her running style would become more fluid and she may now be able to skip. Juni may be able to write a legible sentence by this stage.❸

Social development:As she is attending school, Juni would associate with more people outside the home and would refine social skills such as communication and cooperation. She may show off in front of friends and family to gain attention.❹

Emotional development:Juni may be able to identify basic emotions in others and has greater control over her own emotions, and tantrums are less common.❺

Intellectual development:Juni will be able to follow basic instructions and may be able to order objects from big to small.❻

PrACTISE the key skills1 Milan is two years old and an only child. He has just started attending child-care

twice a week.(a) Identify three physical changes that Milan will experience in the next five years.(b) Explain how attending child-care may affect Milan’s social development.

KEY SKILL Interpret data on the health status of Australia’s childrenThis key skill requires the analysis of data related to the health of children. Data can be presented in a number of ways. To revisit this skill, refer to the key skills section of chapter 2 (pages 66–7) and follow the steps outlined there. A knowledge of the basic issues concerning the health status of children will be beneficial in applying this key skill.

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❶ The type of development is identified and all four areas are covered.

❷ Juni’s lifespan stage is childhood. However, as a particular age is specified, discussion focuses on children around this age (within one or two years). Reference to the milestones for an 11-year-old would not be relevant, even though an 11-year-old would be placed within the same lifespan stage.

❸ Examples of physical development

❹ Examples of social development

❺ Examples of emotional development

❻ Examples of intellectual development

FIgUrE 8.27 Diabetes hospital separations for children aged 0–14 years, 2000–01 to 2010–11Source: AIHW, A picture of Australia’s children 2012, cat. no. PHE 167, Canberra, p. 20.

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Analyse the data in figure 8.27 and use it to draw conclusions about the health status of Australia’s children. In describing the trends evident in this graph, the following three statements can be made. However, there are important considerations to be taken into account.• Girls generally❼ have higher rates of hospitalisations due to diabetes❽ than boys.• Rates for hospitalisations have increased from around 58 per 100 000 female

children in 2000–01 to around 75 per 100 000❾ female children in 2010–11.• The rates of hospitalisations due to diabetes have increased for both males and

females between 2000–01 and 2010–11.❿

Key skills exam practice 2 Study figure 8.28 and answer the questions that follow.

(a) Identify two trends in the mortality rates as shown in figure 8.28.

2 marks(b) Use your knowledge of children’s health status to list three causes of death that are

common in the 0–4 age group.

3 marks(c) Discuss how causes of mortality change between infancy and childhood.

4 marks

FIgUrE 8.28 Mortality rates over time, per 100 000 for selected age groupsSource: Adapted from AIHW, National mortality database.

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❼ In 2003–04, the rates were very similar. Including the qualifier ‘generally’ takes this factor into account.

❽ It is important to clearly state the trend that is being identified.

❾ This information might also be presented in a different way. For example: ‘Female hospitalisations due to diabetes have increased by around 17 per 100 000 children.’ A similar trend focusing on ‘males’ or ‘all children’ could also be used.

❿ Reference is made to the span of years over which the trend occurred. Try to avoid making statements like ‘hospitalisations are increasing’ as this indicates that the trend is currently occurring when the data do not support this.

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CHAPTER 8 review

Chapter summary• Development occurs according to a number of principles: it is predictable and

orderly, it is continual, there is individual variation in its rate and timing, it follows the cephalocaudal and proximodistal laws, and it moves from simple to complex. Many achievements in development will display more than one of these principles.

• A neonate is the name given to a newborn from birth to 28 days.

• There are several adaptations that must occur for the neonate to survive outside the uterus. These include changes to respiration, circulation, nutrition, excretion and control of body temperature.

• The APGAR test is used to assess how well a newborn has adjusted to life outside the uterus

• Infancy is a rapid period of growth. Major milestones such as crawling and walking occur during this stage.

• The family is the most significant influence on social development during infancy.

• Emotional attachment to a significant caregiver occurs during infancy.

• Infants use their senses to learn. By the end of infancy, most infants can associate names with people and objects. Language development is rapid during infancy.

• Physical development during early and late childhood is described as being slow and steady.

• Gradual increases in height and weight are accompanied by increases in bone strength.

• As the child grows and gains strength, their motor development progresses and the child becomes capable of more complex motor skills.

• Social development is facilitated by play and interaction with family members. Children often imitate the actions of older people as a way of learning social skills and roles.

• By the end of early childhood, the child is usually toilet-trained and can use a knife and fork.

• The child gains an increasing sense of self during the childhood years and may become self-conscious in certain circumstances.

• Intellectual development continues to progress and, as the child ages, language skills become increasingly complex.

• By the end of childhood, the child can read, write and complete basic mathematical problems.

• Thought patterns begin to change and, by the end of late childhood, the child starts to think in an abstract way.

• Overall, Australian children experience excellent health but some groups, especially Indigenous, those in rural and remote areas, and those from low socioeconomic backgrounds, fare far worse than the majority of the population.

• Death rates and life expectancy are continually improving for Australian children.

• The main causes of death in this age group are perinatal conditions for infants and injuries for children.

• Asthma is the most commonly reported condition for children.

• Hospitalisation rates for asthma and injuries are relatively high for children.

TEST your knowledge 1 Brainstorm a list of factors that have contributed

to lower death rates and higher life expectancy throughout all the stages of childhood.

APPLY your knowledge 2 How can the family positively or negatively affect

the development of a child?

3 List three milestones of development that require prior skills in order to be achieved (list the prior skills as well).

4 Use the Development timeline links in the Resources section of your eBookPLUS to find the weblink and questions for this activity.

Interactivities:Chapter 8 crossword

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Chapter 8 definitionsSearchlight ID: int-2904

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